Question: What short/long term policies should we utilise to clear New Zealand’s healthcare service backlog?

Written by Dr. Tom Varghese

The demand for hospital treatment outpaced hospital capacity well before COVID-19. It is therefore no surprise that the demands of delivering care during the pandemic have led to significant backlogs and longer waits for patients.

As COVID-19 cases started to rise in early 2020 and hospitalisation rates increased, health systems began to postpone non-emergency procedures to keep capacity available for COVID-19 patients, and to avoid elective patients being infected. This has subsequently led to longer waiting lists and waiting times in virtually all countries.

Issues around staff recruitment and retention, which have been exacerbated by the pandemic further aggravated the problem. For patients with common elective surgeries, such as hip and knee replacements, the backlog for care means that improvements in health and quality of life are postponed. For urgent care, such as missed chemotherapy sessions for cancer care, the delays can have more severe consequences.

In some countries, care activity has been restored to pre-pandemic levels. For example, in the Netherlands, the number of hospital surgeries was restored to pre-pandemic levels by July 2021 and increased further throughout the summer period.

 Waiting lists and waiting times are a dynamic phenomenon. Several factors relate to supply constraints: we were already struggling with proportionally low numbers per population of doctors, nurses, hospital staff, available hospital beds or low productivity before the pandemic started. COVID-19 exposed these gaps and may have worsened some through staff exhaustion and burnout. Other factors affect the backlog on the demand side. Relative to pre-COVID times, fewer patients may have been seeking health care due to fear of infection.

 In May, the Health Minister announced a special task force to tackle delays in hospital waiting lists caused by the Covid-19 pandemic. It will be responsible for delivering a national plan by September.

 In NZ, the number of people waiting longer than four months for their first appointments with hospital specialists has doubled because of the pandemic, and the number of people waiting longer than four months for treatment has more than trebled. Between May 2021-22, those promised treatment who had not received it within the four-month target grew from 23% to 41%.

 The omicron outbreak has caused delays in treating patients across the country, with health workers off sick or isolating, and DHBs cancelling thousands of planned operations and appointments.

 The solution, much like the problem isn’t a simple one. The workforce needs bolstering and we need to make judicious use of the infrastructure we have. These steps coupled with financial resourcing and capacity building are perhaps the building blocks we need, on the road to recovery.

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