Surgery waitlists getting worse

Thousands more patients are waiting longer for surgery and appointments than they were 18 months ago, with one union leader saying they point to “system failure”.

A new report from the Ministry of Health delves into progress on the health reforms, which saw the seismic transformation from district health boards to the national system, Health New Zealand – Te Whatu Ora.

While plans for data and infrastructure had progressed, more patients were languishing on wait lists amid what it called “significant concern around system management risk capability”.

The number of people waiting longer than four months for a first specialist appointment almost doubled between September 2022 and December 2023, to 68,179.

Those waiting more than four months for a procedure had also risen over three quarters to 30,757 by December 2023.

This indicated “much work remains to turn this around, and to manage potential increasing clinical risk to those waiting to be seen,” the report said.

The Government wants 95% of patients waiting less than four months for both elective surgeries and first specialist assessments, with monitoring from July 1.

But the head of the Association for Salaried Medical Specialists, Sarah Dalton, described these as delusional without workforce measures.

“It’s not okay to just ignore that and wring our hands and say gosh, there are shortages everywhere. By the way, here are your health targets.”

There were 1700 senior medical officers missing from the workforce, Dalton said.

Health Minister Dr Shane Reti declined to comment for this story, with his office saying it would leave the response to the Health Ministry.

National secretary for the NZ Resident Doctors’ Association, Dr Deborah Powell, described a concertina effect as patients “continue to wait in pain, worried”.

“There’s a point at which workers can increase their efficiency and keep up but it only goes so far. And at that tipping point, you become more inefficient. We are at that point. “We have to say it, loud and bold. We are now getting more inefficient because of the system failures.”

Nationwide there were 500 vacancies for resident doctors, also known as RMOs, Powell said.

Powell said system failure could look like: “people dying on waiting lists, people becoming inoperable because they’ve waited too long ... inability to do MRI because we don’t have enough [technicians] to run the machines, the list goes on”.

Asked whether workforce shortages were behind the long wait times, Director-General of Health Dr Diana Sarfati said the health system had more doctors and nurses than ever before. The number of full-time nurses had risen by 900 since the third quarter of 2023 and almost 2000 compared with this time last year, she said. “The medical workforce is also growing, now totalling 9959 FTEs [full-time equivalents].”

A total of 1950 internationally qualified nurses had gone through a competency programme and some would be working in hospitals and others in the community, she said.

Sarfati pointed to the Health Workforce Plan, launched last winter, as a way of relieving the current pressures and meeting the challenges of the future. The plan revealed the system was short 8000 nurses, doctors and other health workers.

Eleven of the 81 (14%) initiatives had been achieved so far, with the rest due for completion before July, Sarfati said.

Labour’s health spokesperson Dr Ayesha Verrall said the plan alone was not enough. “They won’t be able to deliver on the number of operations we need unless there’s better staffing”.

The report stated clinical governance, which Powell labelled “the core part of our business” was significantly behind schedule, with permanent staff not expected to be in place until at least July.

“Why was clinical governance left till last? It should have been first. Front and centre.”

Regional health plans, which are meant to tailor care to suit local areas, were also delayed by a year. Sarfati said these regional plans “need to connect and flow” with two other plans which were due to come into effect from July 1.

“Why was clinical governance left till last? It should have been first. Front and centre.”

Dr Deborah Powell, pictured right

New Zealand Resident Doctors’ Association