This government has set much store in reintroducing targets to ensure the system improves and that improvement can be tracked.
As we have previously pointed out, while targets can be valuable in keeping the pressure on for improvement in certain areas, there is always a risk that pressure can result in gaming the system so it looks as if targets are being met.
This is a waste of money and energy which could be better spent elsewhere.
Also, the narrowness of the five targets mean there is much about the system they do not measure.
For instance, one of the targets is for shorter waits for a first specialist appointment, but what it does not show is how many referrals were declined.
Our recent reporting from figures gained through the Official Information Act show in the Southern district alone, there were more than 19,000 declined referrals a year from 2023 to 2025.
The most commonly declined referrals for treatment were for paediatric medicine, with gastroenterology not far behind.
The declined referrals figures also do not capture those patients general practitioners might have wanted to refer but did not because they considered it futile or because the patient’s situation fell slightly outside of referral criteria.
Nobody would doubt plenty of effort is going into achieving the targets, and that progress has been made, but it is not even across districts.
In the most recent results, for the quarter to December last year, only the target for faster cancer treatment was at the annual milestone level
nationally.
In Southern, we did not reach it, one of seven districts in that situation.
Targets’ importance was promoted by Prof Lester Levy. Remember him? He was elevated to the position of health commissioner from Health New Zealand chairman in mid-2024 for a year, amid much fanfare.
If we had believed the hype, he was singlehandedly going to sort out the finances of the public health system, deal with what he called the bloated bureaucracy, reduce waiting times, and boost productivity and compassion.
Not everyone is convinced that has been the case.
Prof Levy left his role as board chairman last month, but we had heard little from him for well over a year.
Whether this was because he had fallen out of favour with his political masters, or whether he had nothing worth shouting from the rooftops, is hard to say.
Wrestling information out of HNZ is not for the faint-hearted.
Many issues are still hanging around without resolution, including the settling of some of the collective agreements for health workers, among them most nurses and the senior doctors. That might be saving the government money in the short term, but at what cost long term?
The post code lottery is far from over, something the health target results show all too clearly.
Adequate staffing remains a problem in many areas.
This was starkly illustrated in our recent report of some North Island rural hospitals offering locum doctors $375 an hour, well above the nationally recognised rate of $260, making it hard for South Island rural hospitals to get specialist cover.
Splashing the cash on health may not be an option in this year’s Budget, coming as it will in the midst of ongoing uncertainty about the impact of the fuel crisis. (One effect is likely to be increased hospital building costs.)
In this climate, it is hard to tell how open the government might be to funding the range of preventive measures sought by the Cancer Society in its "election manifesto".
These include fully funding cervical screening, reducing the bowel screening age, introducing a lung screening programme and a national skin cancer prevention and early detection programme, reducing nicotine in tobacco, restricting unhealthy food and drink marketing to children, and eliminating alcohol marketing.
Whatever health promises political parties make, they need to ensure they are genuine and achievable.
All parties should have learned from National’s broken promises about the Dunedin hospital rebuild and lowering the bowel screening age.
