Herald backs health targets

The NZ Herald editorial favours the new health targets:

Targets can be the bane of any organisation. Unless they are well defined and readily measurable they are worse than useless, create more work than necessary and waste time and money that could be used for something more useful. The Minister of Health, Tony Ryall, has found some classics among the previous Government’s targets for district health boards (DHBs), which he has culled from 10 to six.

Worse than that:

As he put it, “We have inherited a system overburdened with 13 health priorities; 61 objectives, with an additional subset of 13 health objectives; a set of 10 health targets measured through 18 indicators; 25 other indicators of DHB performance; not to mention four hospital benchmark indicators assessed through 15 measures; and an outcomes framework with nine outcomes measured against 39 headline indicators”.

And think of all the administrators needed both at DHB level, but also at the MOH to measure and report on all these.

When Labour scrapped the previous National Government’s business model for hospitals and related services, replacing Crown health enterprises with district health boards, it made much of the democratic element of elected boards. But in fact the boards were set up as branch offices of the Health Ministry, which decided most of what they would do.

Having elected members on DHBs, actually dilutes accountability as it allows the Minister to blame the local DHB and vice-versa.

This Government is content to keep Labour’s administrative structure and the best it can do is try to simplify its procedures. Impractical, largely symbolic declarations on nutrition, obesity and physical activity have gone. As Mr Ryall said, how could a district health board be held responsible for increasing the number of people who ate the recommended daily portions of fruit and vegetables?

The six goals he has set look sharper: shorter stays in emergency departments (95 per cent of patients to be admitted, discharged or transferred within six hours), faster elective surgery (an increase of 4000 a year), shorter waits for cancer treatment (radiation within six weeks by August next year, and four weeks by December).

Those three are treatment targets, the rest are preventive: immunisation for 85 per cent of 2-year-olds by July next year, rising to 95 per cent two years later; help for hospitalised smokers to stop; more people to be assessed for risk of heart disease and more free checks for people with diabetes.

Inevitably, there will be complaints that worthy causes have been ignored. Already the Obesity Action Coalition asks where responsibility for nutrition, physical activity and obesity lies if not with health boards. Well, many could answer that one. It lies with the individual.

You can’t trust individuals – once you start doing that, society will crumble.