By: Lucy Bennett

The health targets dropped by the Government because they were creating “perverse outcomes” for patients were introduced by the Labour-led government in 2007.

Health Minister David Clark has confirmed that the coalition Government has dropped the National Health Targets in which data was collected and published on the performance of DHBs in areas such as emergency department waiting times, elective surgery, cancer treatment and child immunisation.

Asked in Parliament today by National’s health spokesman Michael Woodhouse what benefits dropping the targets would have for New Zealanders, Clark said: “That set of targets was driving a set of behaviours which may have led to the health dollar being more poorly spent with health consequences for New Zealanders.

“By defending a set of targets with perverse outcomes in it, the actual fact is that that member and his former government may well have been driving poorer health outcomes for New Zealanders.”

In August 2007, then-health minister Pete Hodgson said the 10 targets he introduced were aimed at “achieving the best possible health outcomes for all New Zealanders”.

In an update in October 2008 David Cunliffe, who was the health minister by then, said: “Although there is always room for further gains, the results released today show a continued overall improvement in health outcomes for New Zealanders”.

When National entered government in 2008, it cut the targets from 10 to six – dropping goals for mental health, oral health and nutrition and physical exercise.

It kept five of Labour’s targets – elective surgery, cancer treatment, immunisation, smoking, and heart and diabetes checks. It also added a new target of cutting emergency department waiting times.

Speaking to reporters earlier today, Clark said some of the targets had had little effect and were “derided” by many clinicians.

“We want to have a more transparent system that ensures that the incentives are lined up for every tax dollar that’s spent in the health system to be spent effectively.”

National leader Simon Bridges warned that more preventable deaths would result from dropping the targets.

“Over time dropping the targets, losing the accountability, will mean more illnesses and more fatalities in our health system that could have been avoided,” he told reporters.

Ian Powell, executive director of the Association of Salaried Medical Specialists, said that was not true.

“That’s crap. The obsessional nature of certain targets has contributed to some patients going blind,” he said.

Powell said the targets had not worked.

“They have led to superficial assessments of how the system has performed, they grossly mislead the public and they have had, especially in the context of underfunding, very perverse outcomes.

“The [Health] Minister, and we would agree with him, is looking more towards things that focus more on improved health outcomes,” he said.

Acting Prime Minister Winston Peters said National Health Targets had been a “miserable failure”.

“It’s not correct to say we’ve dropped health targets. I just think those health targets were such a miserable failure that we have to find something that works and that’s better,” Peters told reporters this morning.

National claimed the Government had also stopped reporting on the National Patient Flow project which had been underway since July 2014 and aimed to improve DHBs’ referral systems, administration processes and communications with patients to better understand patient outcomes and unmet need.

Ministry of Health spokeswoman Jessica Smaling said the most recent publication on May 14 2018 was for referrals received between October 2016 and September 2017.

“”The next release is planned for August 2018 with data covering the period of 1 January 2017 to 31 December 2017,” she said.

Source: NZ Herald

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  1. I agree with David Clark’s clear-sighted opinion : Having defined targets must create a perverse outcome. Our news media is now screaming out that the cancelling of targets will remove DHBs accountability – because somehow it is imagined that they must be held accountable if targets are missed. That is absurd, of course. DHBs can only be held accountable for their actions – never for missing a target, arbitrarily imposed on them by a third party. Ideally DHBs will set their own internal targets – and I am sure this happens from time to time. But when Government dictates targets on all 20 DHBs (thus also initiating an unavoidable, destructive competition), they create a burdensome need for a lot of time-consuming paperwork which will benefit nobody.
    Doctors and DHB’s can be held accountable only for working to the best of their abilities – and only criminal neglect and willful mistreatment can be grounds for censure.


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