Shane Reti Photo: RNZ / Samuel Rillstone
Health Minister Shane Reti has unveiled his prescription for achieving the government's five major health targets within the existing budget - but some experts remain sceptical that it can be done.
The five targets are faster cancer treatment, improved immunisation coverage, shorter stays in emergency departments, and shorter waits for specialist appointments and elective treatment.
Reti, who first announced the targets six months ago, said the baseline was 1 July and Health New Zealand / Te Whatu Ora now had concrete plans in place for driving and monitoring the targets.
He said that would prevent so-called "gaming" by hospitals to make their data look better than it actually was, and insisted focusing on five targets would not mean the rest of the health system was ignored.
"We don't want to just say the only things we're going to focus on are these five [areas]. For instance, maternity isn't in the targets. But what it does do, is drag the whole system along."
Reti said he had been assured by Health NZ commissioner Lester Levy the targets could be met within existing baseline funding.
"There was a cost pressure uplift, there was new money in the last Budget. And we will reprioritise away from areas that do not directly advance our targets or improve patient care as much as what we want to be doing through targets."
However, the Association of Salaried Medical Specialists - which represents senior doctors - said the health system would struggle to meet the targets without more staff, which would cost more money.
Director of policy and research Virginia Mills said the targets were largely "aspirational" and it was difficult to see how they could be achieved with an already stretched workforce.
For instance, the 2023 Budget included $110m to clear elective surgery backlogs.
"But this year, there was nothing. Staffing is absolutely critical for being able to deliver on these targets.
"We need more doctors, we need more nurses. We estimate that we've got about a 22 percent shortfall in senior doctors across the country. That presents a huge challenge to achieving these targets."
Primary care was not specifically included in any of the targets, however Reti conceded it was "the cornerstone" of the whole system.
General Practice NZ chair Bryan Betty said primary care was under pressure from workforce shortages, funding shortfalls, sicker patients and bounce-back from overwhelmed hospitals.
Bryan Betty. Photo: Chris McKeen / Stuff
"We know that if there is not enough capacity in the community, [emergency departments] get flooded, hospitals fill up. So primary care is critical to achieving these targets."
GPs had heard the minister acknowledge the problems in primary care several times and were waiting to see what the government's response would be, Betty said.
Health systems expert Professor Robin Gauld from the University of Otago said targets could be useful - but they had to be carefully chosen so as not to create "perverse incentives" seen previously, like putting emergency department patients in corridors.
"The sort of political football playing around the targets, with one government introducing them, another one dropping them and then being reintroduced again is actually pretty unhelpful.
"What we need is consistent approaches that give the public information but also help our health service to focus on the areas that really matter."
Health New Zealand will be publishing results against targets each quarter, with the first results reported in December for the July-September period.
