Hospital waiting lists will be managed nationally to tackle severe delays patients throughout New Zealand are experiencing to get specialist appointments and surgeries due to the impact of Covid-19.
Health Minister Andrew Little announced the Government's plan this morning, saying the number of people waiting longer than four months for hospital treatment had more than doubled from about 15,000 in February 2020 to nearly 36,000 now.
He expected it would take "considerably less time" to clear the backlog by taking a national approach rather than leaving it up to 20 DHBs, where it was estimated to take three to five years.
More patients will be diverted to other regions if there were no capacity at their own hospital. Public hospitals would also be offloading some patients to private care where possible, Little said.
It's understood if a patient does need to fly to another region for care, their transport costs would be publicly funded. It was not clear if that would include a support person.
The response will be led by the interim Health New Zealand and the interim Māori Health Authority - both of which will become permanent entities when the Government health reforms come into effect on July 1.
"I expect a national review of all waiting lists and a reassessment of the situation of everyone on it," Little said.
"With one public health system, we have the opportunity to work together to make sure people get the treatment they need, no matter which part of the country they live in."
When asked by the Herald if the minister was aware some DHBs were still taking only life-threatening referrals from GPs, Little said he wasn't familiar with that but it was that sort of stuff they wanted to get on top of.
"That illustrates the problem that if you're a GP with a patient and the only place you can refer someone to is your local DHB, when there might be more space in a different hospital ... we want to make sure people can get care even if it isn't at their local hospital."
The minister said there was money that had been allocated a couple of years ago, $280 million, to help clear the backlog.
"Some of that had been used but not all, so there is funding there available to help us work our way through this particular backlog. The taskforce and Health NZ and the Maori Health Authority will work through what the financial needs are."
Association of Salaried Medical Specialists (ASMS) executive director Sarah Dalton said a focused and co-ordinated approach was welcome, but the elephant in the room was the ability of an under-resourced and depleted workforce to do the work.
"We just don't have enough people across every workforce group and there are large numbers of vacancies in almost every specialty service across the country. One of our members recently said he couldn't remember the last time his team had done a planned joint replacement surgery due to entrenched staffing gaps," the doctors union leader said.
Little said Covid-19 had been hugely disruptive to hospital systems all over the world, but New Zealand was doing better than most countries.
"Our elimination strategy not only prevented tens of thousands of deaths, it also protected our health system from being overrun, as we saw happen in countries like Italy and the United States.
"In fact, for most of the past two years, our hospitals have been free of Covid-19 and were able to keep functioning normally for long periods of time.
"Now, with the benefit of having one of the most highly vaccinated populations in the world, and with a suite of new medicines available to treat Covid-19 patients and keep many of them out of hospital, we can start managing on a more business-as-usual basis."
A Herald review of recovery plans filed by all 20 DHBs identified dozens of services that were already under severe stress before the pandemic struck.
According to those documents, clinicians feared those needing treatment could suffer serious consequences. One major DHB warned that delays in its ophthalmology service could result in people going blind.
The recovery plans were sent to the Ministry of Health during the 2020-21 summer and estimated how quickly delays for planned care, including elective procedures, could be reduced.
Patients whose treatment was delayed during the first phase of the pandemic have since been treated, the ministry said in August. However, the system is so strained that new backlogs have since built up.
According to the ministry's figures, as of August, more than 15,700 people were waiting longer than four months - the maximum time someone should wait under official guidelines - for a first appointment with a specialist. Another 13,500 had been accepted for treatment, but were waiting longer than the four-month target.
On Sunday, the Herald reported nearly 50,000 women were overdue for their mammograms because breast screening couldn't happen during Covid-19 lockdowns.
New Zealand's Breast Cancer Foundation warned this meant more than 300 could have the disease without knowing.
Back in January, Auckland DHB reported it had 175 patients on wait lists for cardiothoracic surgeries.
A father who had two heart attacks and was told by a doctor there was a real risk he could drop dead at any moment, was being tormented after waiting months for surgery.
At the time, Auckland District Health Board's interim director for cardiovascular services, Joanne Bos, said there had been a significant increase of heart surgery referrals since October, as well as more-than-usual emergency cases, which were affecting wait times for planned surgeries.
A South Auckland teacher who suffered two heart attacks then waited months for surgery says today's announcement was "long overdue".
Clive Caine, 70, had two heart attacks in August, both while mowing the lawns. He said doctors at Middlemore Hospital told him he needed a triple bypass surgery to restore blood flow to his heart as there was a very real chance he could drop dead at any moment.
A letter dated October 20 from Auckland DHB and viewed by the Herald confirmed Caine needed surgery and they expected it to be performed in the "near future".
In January, Auckland DHB's interim director for cardiovascular services Joanne Bos said there had been a significant increase of heart surgery referrals since October, as well as more than usual emergency cases, which was affecting wait times for some planned surgery.
The DHB was doing everything they could to work through their wait list and reduce wait times, Bos said.
After more than four months of waiting, Caine's surgery was transferred to a private hospital and completed in early March.
"I'm very happy that they're doing something but I just feel it's a bit too late," Caine said of today's announcement.
"It's too late for some people who've already died in meantime."
He believed Government action to clear patient backlogs should have been taken months ago.
"They could've thought 'hospitals are busy with Covid so let's try and do something with some extra funding somewhere'. They could've done it and saved a few lives."
Waiting months for surgery was psychologically stressful and frustrating, he said.
"You woke up every morning and think 'gosh, I'm alive today and how long can this go on for?'"
Caine retired from teaching a few years ago after 50 years in the profession. However, he feels like he's never left the classroom as he regularly gets called to fill in.
Sitting at home, unable to teach for months, was difficult, he said. He's recently started driving again and resumed teaching this week for the first time since the heart attacks, but is fearful of catching Covid in his condition.
"I've done three days now and I'm OK. Luckily, I don't have to lift or pull things. I was lucky like that. It's just a matter of wearing my mask every time and trying to stay away from Covid."
They allege the Crown ignored Treaty obligations by not engaging with them.