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• ‘We’ve made it clear we need additional funding’ – health officials on targets
• Inability to fill vacancies is a “capacity constraint”
• Greens say warnings come true as health workers overworked and under-resourced
• Health Minister Shane Reti says reporting targets publicly will help identify problem areas and necessary action
• Te Whatu Ora says it has a plan to achieve its targets by 2030

Officials warned the health minister that it would be difficult to meet the government’s targets for emergency room wait times and elective surgeries without more money.

Documents obtained by the Green Party under the Official Information Act refer to “capacity constraints”, including the inability to fill vacancies.

Emails exchanged between senior Department of Health officials in February, ahead of the budget, set out their blunt assessment of what would be needed to meet the proposed “planned care” target of having 95% of people wait less four months for elective treatment.

“The cost of delivery will probably be the main topic of discussion with the minister,” wrote one.

“I think for this meeting it would be useful to clarify what element of the growth of planned care activities above existing production can be achieved within the 24/25 core funding…the implications of additional financing needs for the 2024 budget.”

His colleague responds: “we have made it clear that we need additional funds.”

According to a July 5 post-budget briefing to Health Minister Shane Reti on erectile dysfunction and planned care targets, he said that “due to the nature of Health NZ’s current financial situation, “Detailed plans for implementing the targets are still being developed as work continues to align budgets.” with the recovery plan.

The attached report said achieving these targets was “less likely” if the system did not address “capacity constraints,” including the inability to fill vacant positions.

This analysis was supported by other documents relating to Health New Zealand’s financial situation, released by Treasury a month earlier.

“If current trends and trajectory were to continue unabated, Health NZ says it will need to use up all, or almost all, of the increased cost pressure it received in Budget 2024 (which was intended to pay for inflation costs and prices and volumes). increases throughout the year) to meet the costs of existing staff.

Unless it “significantly restructures its cost base”, Health New Zealand would only be able to meet cost increases (including primary care contracts and salary increases) by running operating deficits or by receiving additional funding from the central government, Treasury officials concluded.

Despite this, Reti told cabinet that new health commissioner Lester Levy was committed to working to achieve the five health targets agreed by cabinet in March “within available funds”.

The health system is “underfunded, understaffed and under-resourced”

Green Party health spokesperson Hūhana Lyndon, whose office obtained the documents, said the minister had been clearly informed that the health system would “struggle” to meet targets without more money and more staff.

“These warnings are now coming to fruition as we have a broken health system with hiring freezes, staff overwhelmed by their workload and because of this underfunding, lack of staff and resources in the “As a whole health system, these goals are really under threat.”

The government must stop treating health as “a cost-cutting business” and start recognizing it as “a public good,” Lyndon said.

“Just because you want it… doesn’t mean it will.”

Association of Salaried Medical Specialists executive director Sarah Dalton, who represents senior hospital doctors and dentists, said the targets would be impossible to achieve without major investment in hospital staff and infrastructure.

“What the minister said is like saying ‘I have this big firework and I’m going to point it at the moon and it will get there’.” Just because you want it doesn’t mean that. That means it’s going to be.”

“There is ample evidence that if your hospital is filled with medical patients, you cannot safely admit patients requiring surgery if there are no beds to accommodate them.”

Increased waiting times for non-urgent procedures added to the pressure on the GPs caring for these patients, and patients who could not get an appointment with a GP ended up in emergency rooms, she declared.

The College of GPs said funding them to commission scans and tests for patients in the community would be the quickest and most effective way to achieve these lofty waiting time targets.

Its chair, Wellington GP Samantha Murton, said emergency departments saw a million patients a year, compared to 23 million patients seen by GPs.

“If we did one less day (per month), that would double their monthly work. If we changed what we could do in the community by six percent, we could cut what they do in half.”

Minister admits targets are “difficult”, but achievable

In a written response to RNZ, Health Minister Shane Reti said he had confidence in Health NZ as it worked to meet the targets.

“I have been very transparent about the challenges the health system continues to face and, as I said in March, when identifying these goals,” he said.

“It is important that we are ambitious in trying to achieve better health outcomes for New Zealanders. The health system regressed under the previous government and its failure to meet its targets.

“Having effective goals and reporting on them publicly helps identify where the problems are and how we can take steps to improve them.”

Health received $1.4 billion a year in new money to address cost pressures in the 2024 budget, he noted.

From next month, Health NZ will publish health target results each quarter.

Its director of health targets, Duncan Bliss, said Health NZ had received “more government funding than ever before”.

In September, the agency released implementation plans for how it would meet health goals for faster cancer treatment, improved vaccination rates, shorter emergency room stays, lower wait times shorter for initial specialist assessments (FSA) and shorter wait times for elective treatments by 2030.

“We know the goals are ambitious and it will take time to achieve them,” Bliss said.

“That’s why our plans include activities and milestones to help improve performance to provide timely access to quality healthcare for all New Zealanders.”

The Ministry of Health, which is tasked with “monitoring” Health New Zealand’s performance, said the agency continued to make “good progress” against first-year milestones.

Deputy director general for regulation and oversight Simon Medcalf said the department recognized the challenges of cost pressures, workforce shortages and resource constraints.

“The ministry is monitoring risks to targets so that appropriate action can be taken.

“The next reporting cycle on these two targets, by June 2024, is expected in the near future, which will show that progress is being made in both areas.”

Last month, Health New Zealand released 450 pages of financial documents which showed much of the overspending was linked to increased staffing, some one-off costs such as increased liability under the Holidays Act and the write-off of Covid stocks, and to ongoing costs like the nurses’ surplus. time.

Health New Zealand refused RNZ’s earlier OIA request regarding communications between the Commissioner, the Chief Executive, the Health NZ management team and the Minister’s office regarding HNZ’s financial position and how it is moved from a projected surplus to a deficit.

It says computer searches of emails have generated more than 4,000,000 results.

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