It has incessantly talked up the importance of its reintroduction of health targets, the inference being the Labour-led government’s abandoning them was responsible for almost any negative health issue you care to name.
Never mind the targets’ narrow focus does not capture much of what is and is not happening in health services.
With targets there is always the risk the pressure to achieve them encourages gaming, particularly with regard to emergency department waiting times and anything involving waiting lists.
Without adequate staffing, the effect of targets can be to just stretch inadequate resources further and cause issues elsewhere in the system.
As the Association of Salaried Medical Specialists (ASMS) has pointed out, the government’s target for first specialist assessments within four months of referral puts pressure on services to do more such appointments, which could be at the cost of follow-up appointments or care of patients who require ongoing medical care without surgery.
Delays in access to specialist assessments can also mean our stretched general practices have to continue to provide care for people they have already identified as needing services beyond their expertise.
When we look at the national picture, there has been some improvement in the target statistics in the last year, but it will be a long time before we can retire that cliché about the post-code lottery in health.
Southern patients or would-be patients are not faring well, according to the latest set of target results for the July to September quarter.
The only one of the five target milestones reached was for 87% of children having their scheduled vaccinations by the time they are 2 years old.
Southern scored poorly for quick access to first specialist appointments and was second to bottom out of the country’s 20 districts for faster access to cancer treatment.
Its worst performance was for access to elective treatment. Just over half, 54%, of patients met the target for waiting less than four months for elective treatments, the poorest result in the country.
The situation may be worse than that because we hear reports of people not being put on waiting lists because the lists are too long.
With only nine districts at or above the milestone of 70% compliance with the target for this financial year, it is difficult to see how the 2030 target of 95% of people needing elective treatments can be achieved.
The government has employed more doctors and nurses, but the catch-up is insufficient to correct short staffing not adequately addressed by successive governments. Covid-19 has merely exacerbated the situation.
As we have pointed out before, the emphasis on outsourcing elective procedures to the private sector will not help those areas with little private coverage, risks making the most complex patients wait longer, and does nothing to help staff shortages in the public setting.
Health workers’ industrial action is one of the reasons the government gives for not meeting the elective treatment targets in the September quarter.
It will be pleased the Public Service Association is recommending 16,000 of its members, including mental health and public health nurses, physiotherapist, social workers and anaesthetic technicians accept their latest collective agreement offers in a vote next year.
We are not hearing yet of similar progress with the New Zealand Nurses Union or ASMS, which covers senior doctors and dentists.
If the government continues to play hard ball with these unions it seems a risky election year ploy, particularly when even the narrow focus of the health targets highlights the disparity in access to care across the country.
Also, it is not hard for voters to find examples of big spending from the government which they think could and should have been directed to making it more attractive for health workers to stay or come here.
Whether Labour will be able to offer more effective medicine for health’s ongoing headaches remains to be seen.
