Lying on Wait
Tony Ryall revealed today that the waiting list statistics have been “manipulated” to make them look better than they really are. Nobody who has anything to do with the waiting lists – patients, doctors, admin staff – will be surprised by this. It has been obvious for years that the waiting times are getting worse, not better. Part of the reason Labour became known as “Liarbour” in the right wing blogosphere was their propensity to happily quote “feel-good” statistics which were contrary to everyday experience. You could then rely on the guys at the Standard to talk knowingly about “memes” and use the self-same statistics to counteract the objections raised by anecdotal experience.
The waiting lists were manipulated quite easily, firstly by removing thousands from the lists inappropriately. This was done by setting up criteria according to “what we can afford” rather than “what people need”. Points systems were set so high that many people, who truly needed the surgery, were sent back to their GP’s to manage while they deteriorated to the point where they could go onto the list.
Secondly, as Ryall points out, many DHBs maintained lists on their patient management systems and did not notify the National waiting lists program. This is a common practice when DHBs are not meeting their waiting list targets, otherwise they may be penalised.
The third way the waiting list is manipulated is by channeling the more urgent patients through the emergency system. Many hernia, gall bladder and hip operations are done this way. Wait for the condition to suddenly deteriorate and then operate. This is an artifact from setting the points threshold too high and letting the waiting lists become too long. It has the consequence of increased disease burden and extending the wait of the urgent patients who do not get sick.
The first two artificially decrease the number of people on the waiting list. The third artificially inflates the throughput of “elective” surgery. These very acute cases should not be counted alongside the elective slots as they extend the wait of less urgent cases, leading to ever-increasing thresholds and hiding of long waiting lists. Elective and emergency surgery should be funded separately.
Waiting lists should be as transparent as possible so that the problem can be seen clearly. Only then can a constructive plan be made to tackle this problem.
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Feb 19 09 11:30 pm
Would we even be able to handle the truth about the health care system? What would happen if the government told us the truth, and it sounded something like this: Sorry, there’s only so much money and so many surgeons and many nurses and so many beads so some of you we will just have to die.
I think a lot of people suspect this is the truth, but having it confirmed would be an entirely different matter altogether.
While this is true in an absolute sense, the full truth is that a great deal of money is spent in very non-essential ways. About $3 billion is being spent on subsidies that aren’t needed, poorly targeted community and preventative health initiatives and dumb bureaucracy.
Feb 20 09 8:12 am
While this is true in an absolute sense
what you mean is – it’s true. beginning and end. Surely you can see that this systemic to the whole idea of a state-controlled socialist/communist healthcare system?
All the health system does is turn people into bludgers. Most Kiwis have health insurance – so all this does is take taxes from people who bother to work and care for their families and use it to prop up bludgers, criminals, and people who basically don’t care about themselves and their kids.
Let’s get rid of the myth that NZ possibly can pay for healthcare for “everyone”
Let’s get socialism out of NZ’s hospitals and GP surgeries.
Problem solved.
Feb 20 09 9:07 am
Sinner:
Resource constraint is not solely a problem with socialised medicine. Privatised systems have similar constraints, they are just spelt out in the fine print of your health insurance policy.
Of course, the very wealthy can access whatever health care they like, with no constraints, but that is true in all countries, regardless of the state of that country’s healthcare system.