The issue is that not everyone could be outsourced to private facilities, says the Auditor-General's report. File photo. Photo: 123rf
Health NZ needs to explain how the sickest patients will not be left behind in the push to outsource more surgeries to private hospitals, says the government watchdog.
At Parliament's health select committee today, the Auditor-General's office tabled its report on equitable access to planned care.
Principal auditor Richard Towers told MPs the problem was that not everyone could be outsourced to private facilities - some patients had too many other health problems or "co-morbidities", which meant they were stuck waiting in the public system.
"It's not spread evenly across the population.
"So Māori and Pacific people in particular, they are they known to have more co-morbidities, which is a risk because if it's not managed and monitored, then you have a population which is disproportionately waiting for care in the public system."
National MP Sam Uffindell, who chairs the committee, questioned why that would lead to greater inequity.
"Is that taking more pressure off the public system? Why isn't everyone sitting in those waiting lists for shorter periods of time because you've taken people off the list?"
Towers said while taking some people off the list could potentially bring down wait times for everyone eventually, some straight-forward patients could leapfrog over others who had waited longer.
Furthermore, the ongoing pressure from urgent cases would continue to squeeze those complex patients down the priority list.
"There's a risk that they continue to sit on those wait lists because there's no additional capacity in the public system. So there need to be plans around that - what do you do for those people? It's not whether you outsource or not."
Warning that faster care could worsen inequities
Assistant Auditor-General Leeanne McAviney said faster care was not the same as "equitable care".
"You can end up with a situation where there can be improvements to speed but also exacerbate inequities. All we're saying is there is a risk of that.
"Given that Health NZ has obligations under the Act, it needs to monitor speed so it doesn't exacerbate inequities.
"Timeliness is a good thing - but need to think about those things [equity] together."
It was for Health NZ to explain what it was doing to respond to the Auditor-General's recommendations, she said.
Labour MP Ingrid Leary said it was worrying that Health NZ did not have a clear plan to mitigate the risk, nor was it possible to say how big the risk actually was.
"If we can't even see what the level of risk is that suggests to me that it's not being taken seriously."
Auditor-General's recommendations for Health NZ
- 1. Prepare a plan with a clear timeline for introducing nationally consistent thresholds for planned care treatment
- 2. Put in place actions to improve equity of access to treatment and that efforts to improve timeliness do not increase inequities
- 3. Strengthen its knowledge of equitable access to treatment by looking at unmet need and other information gaps
- 4. Enable clear public reporting of how long people waiting for treatment, variations in access and how HNZ will improve equity of access.
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