Growing Support For Booking System
HealthHealth Minister Bill English said today a survey of clinical leaders' views on the elective surgery booking system showed growing support in the public health service for changes in how it handles elective surgery.
"The survey amongst members of the Clinical Leaders' Association of New Zealand shows support for the general thrust of the booking system for elective surgery. In particular, there is support for making the elective surgery system fairer by ensuring those with the greatest need for surgery get it first and making the criteria for surgery transparent and consistent across the country.
"This support from clinical leaders is vital to achieving a better deal for people on waiting lists," said Mr English.
Findings from the survey include:
- 89% agree that it is desirable to use nationally consistent criteria to assess patients 90% think ability to benefit from treatment should be a major determinant of priority
- 88% disagree that it is ethical to 'fiddle' the system to get a higher priority for their own patients
- 93% agree that, despite some flaws, the booking system is a step in the right direction
- only 21% believe that the current system of waiting lists and individual clinical judgement works well
- 75% disagree that the length of the waiting list is a good indicator of the success of the public health service.
For further information contact:
Liz Rowe, Press Secretary, 04-471 9154 (wk) or 04-383 5491 (hm)
CLANZ Survey 2 report National Waiting time Project and Booking System Issues
As of November 24, 1998
Analysing 72 responses Question 1
Demand will always exceed the resources available for public healthcare:
Count Percent
Strongly Agree 39 54.2%
Agree 26 36.1%
Disagree 3 4.2%
Not Answered 4 5.6%
72 100.0%
Question 2
Some form of rationing is required in the public health service:
Count Percent
Strongly Agree 35 48.6%
Agree 29 40.3%
Disagree 4 5.6%
Not Answered 4 5.6%
72 100.0%
Question 3
Waiting lists are a form of rationing for elective services:
Count Percent
Strongly Agree 28 38.9%
Agree 31 43.1%
Disagree 8 11.1%
No Opinion 2 2.8%
Not Answered 3 4.2%
72 100.0%
Question 4
The system of waiting lists and individual clinical judgement of priority works well:
Count Percent
Strongly Agree 1 1.4%
Agree 14 19.4%
No Opinion 13 18.1%
Disagree 29 40.3%
Strongly Disagree 11 15.3%
Not Answered 4 5.6%
72 100.0%
Question 5
The length of the waiting list is a good indicator of the success of the public health system:
Count Percent
Strongly Agree 5 6.9%
Agree 7 9.7%
No Opinion 2 2.8%
Disagree 35 48.6%
Strongly Disagree 19 26.4%
Not Answered 4 5.6%
72 100.0%
Question 6
We have good data on which to judge the utility or potential risks of the waiting list system as a system of rationing:
Count Percent
Strongly Agree 1 1.4%
Agree 3 4.2%
No Opinion 13 18.1%
Disagree 34 47.2%
Strongly Disagree 17 23.6%
Not Answered 4 5.6%
72 100.0%
Question 7
Increasing government expenditure on health to 7% of GDP would largely solve the problem of long waiting lists:
Count Percent
Strongly Agree 1 1.4%
Agree 9 12.5%
No Opinion 13 18.1%
Disagree 33 45.8%
Strongly Disagree 11 15.3%
Not Answered 5 6.9%
72 100.0%
Question 8
It is desirable to achieve equity of access to elective health services across the country (using nationally-consistent priority access criteria):
Count Percent
Strongly Agree 37 1.4%
Agree 27 12.5%
Disagree 3 45.8%
Strongly Disagree 2 15.3%
72 100.0%
Question 9
Introduction of the Booking System and clinical priority access criteria has started to give us better data about the absolute and relative needs for elective healthcare in the NZ population:
Count Percent
Strongly Agree 10 13.9%
Agree 35 48.6%
No Opinion 14 19.4%
Disagree 9 12.5%
Strongly Disagree 1 1.4%
Not Answered 3 4.2%
72 100.0%
Question 10
There has been adequate consultation with clinicians about clinical priority access criteria:
Count Percent
Agree 9 12.5%
No Opinion 27 37.5%
Disagree 29 40.3%
Strongly Disagree 5 6.9%
Not Answered 2 2.8%
72 100.0%
Question 11
The concern of clinicians about the limitations of clinical priority access criteria have been largely ignored:
Count Percent
Agree 6 8.3%
No Opinion 22 30.6%
Disagree 30 41.7%
Strongly Disagree 11 15.3%
Not Answered 3 4.2%
72 100.0%
Question 12
Ability to benefit from treatment should be a major determinant of priority:
Count Percent
Strongly Agree 17 23.6%
Agree 48 66.7%
Not Answered 4 5.6%
Disagree 2 2.8%
Strongly Disagree 1 1.4%
72 100.0%
Question 13
It is ethical to 'fiddle' the points system to get a higher priority for your own patients, regardless of the consequences for other patients:
Count Percent
Agree 1 1.4%
No Opinion 6 8.3%
Disagree 20 27.8%
Strongly Disagree 43 59.7%
Not Answered 2 2.8%
72 100.0%
Question 14
The timetable of implementation of the Booking System is realistic:
Count Percent
Agree 8 11.1%
No Opinion 27 37.5%
Disagree 25 34.7%
Strongly Disagree 9 12.5%
Not Answered 3 4.2%
72 100.0%
Question 15
Given that the same information processing needs are required by every hospital using clinical priority access criteria and a Booking System, a coordinated approach to information system development would have been preferable:
Count Percent
Strongly Agree 28 38.9%
Agree 29 40.3%
No Opinion 7 9.7%
Disagree 3 4.2%
Strongly Disagree 2 2.8%
Not Answered 3 4.2%
72 100.0%
Question 16
'Waving the shroud' and highlighting individual cases of patient suffering is an effective tactic to persuade government to spend more on health:
Count Percent
Strongly Agree 2 2.8%
Agree 13 18.1%
No Opinion 6 8.3%
Disagree 35 48.6%
Strongly Disagree 11 15.3%
Not Answered 5 6.9%
72 100.0%
Question 17
Using clinical priority access criteria to document the national burden of risk and suffering for a given condition (such as coronary artery disease) gives clinicians a powerful political weapon in arguing for more funding:
Count Percent
Strongly Agree 21 29.2%
Agree 41 56.9%
No Opinion 1 1.4%
Disagree 5 6.9%
Strongly Disagree 1 1.4%
Not Answered 3 4.2%
72 100.0%
Question 18
The Booking System is doomed to failure because of inadequate funding and lack of commitment by clinicians therefore it should be scrapped completely:
Count Percent
Strongly Agree 2 2.8%
Agree 2 2.8%
No Opinion 23 31.9%
Disagree 28 38.9%
Strongly Disagree 14 19.4%
Not Answered 3 4.2%
72 100.0%
Question 19
For all its flaws, the Booking System is a step in the right direction. Clinicians should work in collaboration with the government to develop the system and find solutions to the many problems:
Count Percent
Strongly Agree 25 34.7%
Agree 42 58.3%
No Opinion 1 1.4%
Strongly Disagree 1 1.4%
Not Answered 3 4.2%
72 100.0%