Ratings point to DHBs' deficiencies

Hospital emergency departments in much of Auckland are performing below par on newly issued national rankings of district health boards.

All seven district health boards from Taupo north scored well on access to cancer radiation therapy, but not on how long patients stay in emergency departments - a reflection of whole hospitals being overcrowded.

The 21 DHBs' ratings on the Government's six health targets are being published nationally for the first time today in a bid to force them to improve.

At the Auckland DHB's emergency departments, 70 per cent of patients were admitted to a ward, discharged or transferred within six hours. The target is 95 per cent.

Auckland, which in September broke its record for adult emergency attendances, expects to take up to two years to reach the target. Its biggest difficulty is finding space on wards to send patients to. Board chiefs want to add 300 beds.

Waitemata was worst nationally on 61 per cent. It is rebuilding North Shore Hospital's emergency department.

Counties Manukau achieved six hours for 89 per cent of patients in this first round of reporting, from July 1 to September 30. It has subsequently met the 95 per cent target, but this will not show up until the second quarter's results are published.

The six targets were introduced by Health Minister Tony Ryall in May as a slimmed-down version of the previous Labour-led Government's system, with the addition of a new target, regarding emergency departments.

The upper North Island shared first place with all but three DHBs on the target for progressively cutting waiting times for cancer radiation therapy.

Auckland took top place for increasing the number of patients receiving elective surgery, but came 18th for shorter emergency department stays, and for better diabetes services and cardiovascular screening. It came 14th for increasing the rate of child immunisation, and providing better help for hospitalised smokers to quit.

Counties Manukau's scores were: first equal, ninth (ED), 13th, 15th, 17th and 20th. Waitemata: first equal, last (ED), fourth, 12th, 20th and sixth.

Mr Ryall said: "I think there are areas of good improvement, but there are other areas where we still need improvement. I don't think anyone is happy with the long waits some people face in emergency departments. That's why a huge effort is needed nationally on this target."

Nor was anyone happy, he said, with the low ratings on the target to provide quit-smoking help to 80 per cent of hospitalised smokers - achieved only by Wairarapa - although this reflected that it was new.

Ministry of Health documents obtained under the Official Information Act show that the intention of publishing the results is to encourage staff at the 21 DHBs to improve their placings in the quarterly results.

"There is international evidence that public reporting changes provider performance, since it not only raises public understanding but also directly affects provider behaviour," one said.

"Staff working in health services care about providing high-quality care for their patients, and about the reputation of their organisation."

Mr Ryall said last night: "It's not about naming and shaming. The public want accountability from DHBs and people are entitled to know how well their health services are delivering.

"Public scrutiny helps improve performance and accountability."

The ministry papers indicate concerns over the risk the targets may lead to the false impression of a health system with a "narrow bias".

Mr Ryall said DHB performance in areas not covered in the six targets was reported separately to the ministry.