The government's new health system will abolish national health targets tied to funding and replace them with 12 measures of performance, Health Minister Andrew Little says.
Health Minister Andrew Little. Photo: RNZ / Dom Thomas
Little revealed the Health System Indicators framework to the College of GPs conference at TSB Arena in Wellington this morning in an update on the health reforms which would see New Zealand's 20 District Health Boards replaced with a single health authority alongside a Māori health authority.
He said the current National Health Targets regime introduced by the National government in 2007 was outdated and ineffective.
"The targets have been in place since 2007 and there's plenty of evidence - from New Zealand and other countries - that they don't work," Little said.
"They are arbitrary and don't reflect the real priorities of the health system."
"Even worse, they led to what can only be described as perverse outcomes ... such as doing lots of small procedures instead fewer major ones so they could claim more people were being treated."
The new system will include 12 measures - two for each of six government priorities - that will be publicly reported on every three months, he said.
Each measure would by 1 July 2022 also include a breakdown by ethnicity, on a national and location-specific level, Little said.
Work would be done in 2021/22 to finalise the two remaining measurements, and further measures may also be introduced including in relation to mental health, youth and infant health and access to health services.
The indicators were "a new way of thinking", Little said.
"They are not about incentivising with funding or pointing the finger if targets are not met - they are neither a carrot nor a stick.
"They are a measure of how well our health system is functioning across the country, and an opportunity to then create local solutions to address local health needs."
When the indicators showed there was a problem, health services would work with communities to find effective ways to fix it, he said.
National warns indicators will not be effective
In a statement, National's health spokesperson Dr Shane Reti said the indicators would do little to improve health outcomes.
"It's taken four years for Health Minister Andrew Little to recognise there needs to be some measuring and reporting on the performance of the health system, but indicators aren't targets," he said.
"One of Labour's first moves after taking office was to cancel these National Health Targets, claiming that reporting on performance and accountability was somehow unfair ... unsurprisingly, four years later every single one of these critical public health measures has gotten worse."
National's health spokesperson Dr Shane Reti Photo: RNZ / Samuel Rillstone
He said the announcement came less than 24 hours after Little was forced to admit the number of patients waiting longer than the four-month maximum for treatment in hospitals had ballooned from about 2000 in 2017 to nearly 30,000.
"Andrew Little tried to blame this on Covid-19 but figures released to National show the wait list had already blown out in 2019, well before the pandemic hit," he said.
"Targets are there to be met and they help improve health outcomes for Kiwis. Indicators don't force our DHBs to do better for New Zealanders.
"Wait list blow outs and delays in accessing health are a direct result of this Government's failure to do its job and hold DHBs accountable for their performance."
He said sticking with the approach National had pioneered would have meant a better health system and better outcomes.
GPs welcome shift away from hospital focus
Family doctors welcomed the new measures, saying they would look beyond hospitals. Royal New Zealand College of GPs president Dr Samantha Murton applauded the focus on primary health.
"It's good to have indicators that will make the health sector look outside the hospital walls to see what changes can be made in the community that will make a true difference to New Zealand's health outcomes."
Little told the audience of 700 GPs that primary health was "essential" to the success of the government overhaul of the health system, which was announced in April.
"The Labour Party is the party of public health, and 20 cents in every dollar currently goes into health ... it is time to shift the balance," he said.
The indicators, which are expected to come into force by July next year, are designed to complement the government's wider reform of the health sector which aims to cut down on bureaucracy and end "the postcode lottery system of health services".
Little said while the old National Health Targets would no longer be published as a set of metrics, DHBs would continue to report quarterly to the ministry on their performance for the targets.