Speech at announcement of nationwide plan to tackle hospital waiting lists, Auckland, 4 May 2022
Today I am setting out our plan to deal with growing hospital waiting lists.
COVID-19 has been hugely disruptive to hospital systems all over the world.
In England, for example, there was a 200-fold increase in the number of people waiting more than a year for planned care, from just over 1600 in February 2020 to more than 300,000 in November 2021.
New Zealand has done better than most countries. Our elimination strategy not only prevented tens of thousands of deaths, it also protected our health system from being over-run, as we saw happen in countries like Italy and the United States.
In fact, for most of the past two years, our hospitals have been free of COVID.
We used that time to prepare the health system, to buy the new COVID-19 medicines as soon as they became available, and to get almost the entire population vaccinated.
We were also able to keep our hospitals functioning relatively normally for long periods of time.
Despite this excellent work, our health system has, nevertheless, been affected.
The Delta variant that arrived in August, and this year’s Omicron wave, have put our hospitals under pressure.
They have coped, and I want to, again, thank everyone who has played a part in that.
Critical services like cancer treatment and emergency departments have been maintained, but as a precaution, we did slow down the amount of planned care – appointments and procedures that are not urgent and that can, therefore, be scheduled or planned.
Hospitals also had to cope with the effects of staff being off work, because they were either sick themselves or looking after their sick families.
Hospitals have also had to deal with the shear cumbersomeness of COVID-protection measures, like wearing protective gear.
District health boards have kept working hard to see people as quickly as they can, but the latest figures show that in March, nearly 36,000 (35,942) people had been waiting longer than four months to have their first appointment with a hospital specialist.
That’s more than twice as many people as before the COVID pandemic hit (14,787 in February 2020).
The number of people waiting longer than four months for treatment has more than trebled, from just over 8000 (8153) in February 2020 to nearly 27,000 (26,764) in March this year.
Clearly, for people who need these procedures and appointments, having to wait is distressing.
Now, with the benefit of having one of the most highly vaccinated populations in the world, and with a suite of new medicines available to treat COVID patients and keep many of them out of hospital, we can start to manage on more of a business-as-usual basis.
It’s time, therefore, to deal the planned-care backlog.
Because of the upcoming changes to the health system and because it will be their problem eventually, I am putting Health New Zealand and the Maori Health Authority in charge of the process.
We have an opportunity right up front to harness one of the principal benefits of the Government’s health reforms – a truly nationwide approach to health problems that affect us all.
Today I am announcing a high-powered taskforce to work-up the national plan for planned-care.
The taskforce will be led by Andrew Connolly. Andrew is a colorectal surgeon, chief medical officer of Counties Manukau District Health Board and was recently chief medical officer for the Ministry of Health.
In addition to being a fine surgeon and health leader, he has also developed a strong track-record as a health service fix-it man.
Mr Connolly will be joined by:
- Professor Diana Sarfati, the chief executive of Te Aho o te Kahu, the Cancer Control Agency.
- Wellington GP Dr Jeff Lowe, who chairs General Practice New Zealand.
- Auckland District Health Board funding and development manager Jo Brown.
- Canterbury District Health Board chief operating officer for networks, Dan Coward.
- Canterbury District Health Board director of nursing Brenda Close.
- Bay of Plenty DHB clinical director Linda Chalmers.
- Northland DHB general and oncoplastic breast Surgeon Maxine Ronald.
- Dr Kiki Maoate, a paediatric surgeon at Canterbury DHB.
- And Dr Rawiri Jansen, the clinical director of the National Hauora Coalition. Dr Jansen has been appointed to the taskforce by the Interim Māori Health Authority.
The taskforce will support district health boards to take whatever short-term measures they can to reduce waiting times.
It will also be responsible for developing a national plan for planned care, which I expect to receive by September.
Central to it will be a new, national approach to specialist appointments and planned-care operations, getting rid of the postcode lottery that has seen people treated differently in different parts of the country once and for all.
We have one public health system, and I expect it to work together to make sure people get the treatment they need, no matter which part of the country they live in.
I expect a national review of all waiting lists and a reassessment of the situation of everyone on it. For some people, that might mean they move up the list or get their treatment in a place a little further from home than they expected.
For others, it might mean they are offered another form of treatment which is less invasive than surgery and can happen more quickly.
In Canterbury, for example, offering physiotherapy to women suffering from urinary incontinence secondary to pelvic floor dysfunction has meant 30 per cent no longer need surgery.
I also expect the taskforce to make full use of all health resources, including those in the private sector.
Some of this work is already under way in various parts of the country, and Andrew Connelly will talk more about that.
What is critical now, however, is that it happens right across the health system.
I have been told that if we approach this problem in the same way we have always we have always used, it could take between three to five years to clear the planned-care backlog.
That is not in anyone’s best interest.
It is my expectation that we can clear the backlog in considerably less time than that.
This approach reflects another important characteristic of this Government it comes to health, and that it is that serious problems need to be addressed and to be dealt with systematically.
We have a new opportunity to address those problems, harnessing all parts of the public health system.
That gives us a better chance of getting people who have been waiting a long time their treatment sooner, and dealing with all patients more equitably.