Faster healthcare not the same as 'equitable care' - Auditor-General's report
Photo:
123rf
Health NZ needs to explain how the sickest patients will not be left behind in the push to outsource more surgeries to private hospitals, says the government watchdog.
At Parliament's health select committee today, the Auditor-General's office tabled
its report
on equitable access to planned care.
Principal auditor Richard Towers told MPs the problem was that not everyone could be outsourced to private facilities - some patients had too many other health problems or "co-morbidities", which meant they were stuck waiting in the public system.
"It's not spread evenly across the population.
"So Māori and Pacific people in particular, they are they known to have more co-morbidities, which is a risk because if it's not managed and monitored, then you have a population which is disproportionately waiting for care in the public system."
National MP Sam Uffindell, who chairs the committee, questioned why that would lead to greater inequity.
"Is that taking more pressure off the public system? Why isn't everyone sitting in those waiting lists for shorter periods of time because you've taken people off the list?"
Towers said while taking some people off the list could potentially bring down wait times for everyone eventually, some straight-forward patients could leapfrog over others who had waited longer.
Furthermore, the ongoing pressure from urgent cases would continue to squeeze those complex patients down the priority list.
"There's a risk that they continue to sit on those wait lists because there's no additional capacity in the public system. So there need to be plans around that - what do you do for those people? It's not whether you outsource or not."
Assistant Auditor-General Leeanne McAviney said faster care was not the same as "equitable care".
"You can end up with a situation where there can be improvements to speed but also exacerbate inequities. All we're saying is there is a risk of that.
"Given that Health NZ has obligations under the Act, it needs to monitor speed so it doesn't exacerbate inequities.
"Timeliness is a good thing - but need to think about those things [equity] together."
It was for Health NZ to explain what it was doing to respond to the Auditor-General's recommendations, she said.
Labour MP Ingrid Leary said it was worrying that Health NZ did not have a clear plan to mitigate the risk, nor was it possible to say how big the risk actually was.
"If we can't even see what the level of risk is that suggests to me that it's not being taken seriously."
Auditor-General's recommendations for Health NZ
Sign up for Ngā Pitopito Kōrero
,
a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
RNZ News
4 hours ago
- RNZ News
School calendar set to change in Samoa as schools closed for another week
Photo: 123RF Samoa's Ministry of Education and Culture chief executive A'eau Christopher Hazelman says the school term calendar is set to change due to prolonged dengue-related closures. Primary school students in Samoa will have a fourth week of school closure next week, while years 8 to 12 are going into a third week. A'eau said the week of 11 August would have been week three of term three. "Beginning from our ECE (early childhood education) centres through the years one to year seven, they have not had any classes over the last three weeks," he said. "On the first week of term three we had the years eight right up to year 12. "I want to make sure that people understand that the moment cabinet activated the NEOC - the National Emergency Operations Committee - this is when we now follow the law, the actual Act and the frameworks of NEOC within government - hence the ministry will not make a decision by itself." A'eau said T-Vet providers and those in universities have also been affected. He also thanked school teachers and principals for making classes available online, but said they need to look at changes. Further adding to the time, the government has announced public holiday on 28 and 29 August for the general election . "We now have to look at making amendments and changes to our school calendar," A'eau said. "I want to make this very clear to all schools and to all parents - we are going to change the school calendar, even to the point that there may be no school holidays between term three and term four to make up the time." A'eau said they will also look at changing the dates of the national assessments. There have been six dengue-related deaths and nearly 8000 clinically-diagnosed cases recorded in Samoa since January.
NZ Herald
7 hours ago
- NZ Herald
Hawke's Bay Regional Prison set to get air conditioning before Hawke's Bay Hospital
The tender for the project describes it as the Hawke's Bay Regional Prison High Security Units Cooling Project. Corrections said the project was to meet its obligations to ensure the health and safety of staff and prisoners at Hawke's Bay Regional Prison. Taradale resident Bridie Braham, who has started an online campaign to install air conditioning at the hospital before the prison, called the situation 'a cruel irony'. She said convicted criminals would soon enjoy the luxury of air-conditioning, while patients and staff at the hospital are left to 'swelter through pain, exhaustion, and illness'. 'The injustice is glaring: justice is being kept cooler than compassion, and the people who save lives are being treated with less dignity than those who took them apart.' Department of Corrections commissioner of custodial services Leigh Marsh said frontline Corrections employees worked 'tirelessly' in the summer months to manage prisoners in hot and confined spaces and conditions, sometimes while wearing heavy equipment like stab-resistant body armour. 'Prisons can be extremely volatile environments and heat can significantly increase prisoner tension and aggression, creating a real risk that a staff member or prisoner could be seriously hurt,' he said. 'Some units at Hawke's Bay Regional Prison currently have no air-conditioning, which poses significant health and safety risks to our frontline staff and people we manage.' The installation of the air-conditioning units starts this month and is expected to be completed by early 2026. Hawke's Bay Hospital. Photo / Paul Taylor Regional head of infrastructure central at Health New Zealand, Steve Crombie, said air-conditioning was available through some areas of Hawke's Bay Hospital and the areas without it 'are being considered as part of the planning and prioritisation process for future capital expenditure'. A Health NZ spokesperson said patient safety was the organisation's highest priority and they had effective measures in place at the hospital to ensure patient safety is maintained. The spokesperson said Corrections and Health NZ did not co-ordinate asset planning and replacement. Labour's corrections spokeswoman Dr Tracey McLellan said her party was not opposed to improving conditions at the prison, but felt the Government had its priorities wrong. Corrections is currently looking into a possible expansion of Hawke's Bay Regional Prison, which Labour has also hit out at in recent weeks. 'Christopher Luxon can find millions for air-conditioning in prisons and billions for mega-prisons, but if local hospitals don't even have AC for patients and frontline staff, he's got his priorities wrong and is making things worse,' McLellan said. Hawke's Bay Regional Prison and Hawke's Bay Hospital sit in the Tukituki electorate. Tukituki National MP Catherine Wedd said she had been a 'relentless advocate for better healthcare in Hawke's Bay and ensuring we have safe communities'. 'Our Government is strongly focused on providing better healthcare in Hawke's Bay and also keeping our Hawke's Bay community safe by restoring law and order,' she said. Wedd said the Government had already invested $100 million in Hawke's Bay Hospital for a new 28-bed inpatient unit, upgraded radiology department, new Linac Cancer Treatment Machine, and modernised heart failure treatment. Jack Riddell is a multimedia journalist with Hawke's Bay Today and has worked in radio and media in Auckland, London, Berlin, and Napier.
NZ Herald
8 hours ago
- NZ Herald
Christchurch Hospital's specialist trauma service made no difference in first year
'The Christchurch TAS was launched without adequate funding, resulting in significant staffing shortfalls, including limited trauma surgeon involvement (fewer than four hours per week), no dedicated house officer and restricted operational hours (Monday to Friday only),' it said. 'As a result, trauma patients admitted over the weekend were initially managed by the on-call surgical teams before being handed over to the TAS on Monday, potentially leading to delays or inconsistencies in tertiary survey completion. 'This has meant that patients admitted over weekends are initially managed by on-call teams before being transferred to the TAS, introducing delays and potential inconsistencies in care.' Because of staffing shortages, there were periods when the service was not functioning at all, which probably diluted its impact, the report noted. 'An example of this is when there was a lack of registrar cover, and so the entire service was closed over the Christmas and New Year period in 2023/2024.' Another limitation was 'inconsistent or missing data', which may have affected the accuracy of outcome measures and 'masked potential areas of improvement', researchers said. Injury is the leading cause of death in New Zealand for those under the age of 35, and the second most common reason for hospitalisation. Although most New Zealand hospitals have dedicated trauma assessment teams (including staff from emergency medicine, general surgery, anaesthetics and nursing), only two of the country's seven tertiary hospitals provide ongoing inpatient trauma-specific care through dedicated trauma admission teams. Health NZ has been approached for comment. - RNZ
