Health targets come down – and so the critics fix their sights on David Clark

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.

One thought on “Health targets come down – and so the critics fix their sights on David Clark

  1. Bad governance on several counts: not part of either coalition partners’ election policy platform the standards were quietly dropped last year (without being taken to Cabinet) and have only just come to light in the absence of quarterly figures being produced, and they have been cancelled before an alternative system has been put in place. The adjectives arrogant and inept keep surfacing.


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