Health Minister David Clark this week dropped the nation’s health targets.
The targets (which a previous Labour government had started) had been re-focussed by the National government in 2009 on six areas: increased immunisation, faster cancer treatment, shorter stays in emergency departments, improved access to elective surgery, helping smokers to quit and raising healthy kids.
Clark says they have not been measuring outcomes — instead, they are measuring activity.
His move to dump them – which apparently did not go to Cabinet – was attacked by the Opposition, which said dropping the targets meant there was less accountability and this would lead to more illnesses and deaths.
Health targets set priorities in a sector which receives the biggest share of the country’s budget. They present both a national and regional perspective. As one commentator pointed out, they give a good indication of whether patients in provincial district health boards (DHBs) are getting similar treatment as patients in Auckland, in specific categories.
Clark says he doesn’t think anybody would be surprised that the incoming government had different objectives to those of National …
“We’ve been very critical of the targets in opposition. We believe they’re actually leading to worse health outcomes overall for New Zealanders”.
His distaste for these particular targets contrasts with the enthusiasm of the Prime Minister Jacinda Ardern to set a target for the reduction of child poverty.
The minister is promising “a broader suite of measures” currently being worked on with clinicians. They will be announced later this year.
No-one is suggesting Clark is dropping the targets because he thinks a Labour-led coalition cannot match the performance of the previous government.
Nevertheless it may be a challenge to meet more comprehensive targets, even though Labour boasts it is increasing spending on health (some may quibble it is not increasing as a percentage of GDP).
But the government may have to allocate much more than it expected to salaries, if the nurses’ strike has to be settled at a greater cost than the DHBs had prepared for. Almost certainly other occupations within the health service will demand nothing less in terms of percentage increases than the nurses.
There are other problems within the health budget that may surprise a novitiate minister. The first is that medical technology costs are rising almost exponentially. A second is the speed at which the population is ageing, which is adding to the pressures within the health service. And a third is the shortage of skilled staff, not just nurses, to deliver the services to reach “more comprehensive” targets.
In the light of the difficulties exposed in the minister’s dealings with the Counties-Manukau DHB, it is not surprising his move on national health targets has added to the impression he is floundering in the health portfolio.