Latest news with #electivesurgery
RNZ News
26-06-2025
- Health
- RNZ News
'Postcode healthcare' persists - new report by government watchdog
The report said access to treatment was to a significant extent, determined by where a person lived. (File photo) Photo: UnSplash/ Marcelo Leal Where you live (rather than how sick you are) is still a major factor in how quickly you get elective surgery - or whether you get it at all, according to a new report by the government watchdog. The report, Providing equitable access to planned care, which has just been tabled in Parliament by the Auditor-General John Ryan, showed elective services in the public system were often "not equitable or timely", with people with the same level of clinical need qualifying for treatment in some districts, but not others. "As a result, a person's ability to access treatment is, to a significant extent, determined by where they live," the report noted. "Some clinical staff we spoke with were of the view that a lack of capacity to provide treatment had led to some thresholds that no longer reflect clinical need." The Pae Ora (Healthy Futures) Act 2022 required Health New Zealand to ensure access to treatment (such as operations to remove cataracts or tonsils, joint replacements and hernia repairs) was based on people's clinical need - not their background, circumstances, or where they live. However, the audit found Māori, Pacific peoples, people with disabilities, those living in rural areas or in poverty had worse access to planned care. Health NZ was gradually introducing nationally consistent thresholds for ranking access to planned care. "It has introduced a national threshold for cataract treatment. Work is under way to align other thresholds for orthopaedics, otorhinolaryngology (ear, nose, and throat conditions), and cardiology." RNZ reported on Thursday, the long wait times for ear, nose and throat services in Tairāwhiti, which had less than a quarter of the specialist capacity needed. Introducing a national threshold for cataract treatment had led to about 1800 people added to the waiting list in the Southern District and about 900 more people put on the waiting list in Counties Manukau, the new report found. In orthopaedics, threshold "scores" for orthopaedic treatment range from 50 in Auckland and Canterbury to 80 in Wairarapa. "This means that a person's condition needs to be significantly worse in Wairarapa than Canterbury or Auckland to qualify for treatment." District-specific thresholds still in place were also "obscuring the extent of unmet need for treatment in some districts". "Significant work will be required to deal with the changes in demand that will result from the introduction of nationally consistent thresholds across all specialities." The true level of unmet need was unknown, the report continued. "One possible measure of unmet need is the number of people who are assessed by a specialist but do not meet the threshold for treatment. "However, we also heard some clinicians will not refer a person for specialist assessment if they are considered unlikely to meet the treatment threshold. "Media reports during our audit suggested that specialities in some districts were not accepting referrals because they did not have the resources and would be unable to meet target time frames for assessing or treating people." Meeting the government's target for 95 percent of people receiving planned care treatment within four months by 2030 was going to require "significant improvement". "During our audit, the latest available reporting (for October to December 2024) showed that about 59 percent of planned care patients received treatment within four months of being placed on a waiting list. "The proportion of people receiving planned care treatment within four months has been in decline since 2017." However, the focus on improving wait times should go hand-in-hand with a focus on equitable access, the report writers urged. "Equity also needs to be a central consideration in Health NZ's work to improve timely provision of treatment. If this does not happen, there is a risk that strategies to improve timeliness could cause further inequities." Health was so interconnected, that too much focus in one area inevitably put pressure on the system elsewhere. For instance, the number of patients waiting longer than one year for treatment was cut from more than 4000 in October 2023, to 1916 by July 2024, although it rose again to 2630 by December 2024. However, in the same period, the waiting list for first specialist assessments nearly doubled, from 5000 to 9936, the auditors found. Health Minister Simeon Brown's push for more outsourcing to private providers needed to be carefully managed so it did not lead to greater inequities, the Auditor-General said. "Access to the private hospitals that provide outsourced treatment is not equally distributed across the country. This means that some districts can outsource patients more easily and at shorter notice than others. "In addition, not all patients can be outsourced for treatment. The people selected for outsourcing to private facilities are generally determined to be non-complex patients." Māori and Pacific peoples and people living in socially deprived areas were also more likely to have complications, which would bar them from treatment in a private hospital. "Health NZ needs to manage and monitor the outsourcing of treatment so that it does not compromise its focus on the treatment of patients in priority order or otherwise increase inequity in planned care." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
RNZ News
04-06-2025
- Health
- RNZ News
The Health Minister Simeon Brown on his plans
Photo: RNZ / REECE BAKER The state of the health service has been a constant concern for New Zealanders in recent polling in the face of continuous media reports over staff shortages, lengthy waiting times in emergency departments and an inability to get in to see a GP. The Health Minister, Simeon Brown, took over the portfolio at the start of the year and has already focused heavily on primary health with a planned 24/7 digital health service, so- called performance based funding over and above the annual capitation. He has also targeted elective surgery waiting lists by outsourcing thousands of apparently straightforward operations to private hospitals. But both moves have sparked worries about the implications from health professionals at both the primary and hospital level. Simeon Brown joins Kathryn in the studio to discuss his plans for the health system.
ABC News
28-05-2025
- Business
- ABC News
Tasmania's healthcare is 'costing a lot of lives' says independent health analyst Martyn Goddard
Martyn Goddard It's too small, it hasn't had the economy of scale, none of the several operators over those years has been able to make a go of it, including Healthscope. Why should we think that that is suddenly going to be saleable? It's not. Kylie Baxter Do we need government intervention if the Hobart Private cannot be sold? Martyn Goddard If the Hobart Private cannot be sold, and I suspect strongly that that will be the case, then there is going to be no alternative but for the state government to step in and take it over. We cannot afford to lose 146 beds. Kylie Baxter What would it mean for health? Martyn Goddard Well, you know the problems we've got at the moment around the Royal Hobart Hospital, those would be magnified because the people who are in Hobart Private overwhelmingly are there people with elective surgery. And in this state and in this country, the private hospitals are doing a hell of a lot more elective surgery than the public hospitals. If you want elective surgery in this country, you've got to pay for it basically. You take that facility out and where are you? You're in a lot of trouble. And so are the people who rely on them, the patients who rely on them, and so of course are the staff. Kylie Baxter What do you actually think health care will look like in Tasmania in the next 12 months or even inside the next 12 months? Martyn Goddard I think it's likely that the Hobart Private Hospital will be reintegrated into the Royal Hobart Hospital. Overall, it's going to make relatively little difference to capacity because capacity in all of them is basically full. Kylie Baxter So you think there'll be no buyer and there'll have to be a bailout? Martyn Goddard I don't think we should bailout Brookfield, the private equity people. I mean, I think the smart thing would be actually to wait until it falls over and then just step in and take the lease back. The government still owns the property. It's just leased. So if they give up the lease, then back in the government's ownership. Kylie Baxter Anything else you wanted to add before we wind up? Martyn Goddard Just that I really wish our governments would wake up to the fact, genuinely wake up to the fact, that our health system is in deep, deep trouble. Really deep trouble. It's costing a lot of lives. It's costing a great deal of suffering. They could do something about it. They've chosen until now and ongoing to do nothing about it, to pretend it's not happening, to pretend everything's okay. It's not okay.
