Health target must be prevention

BY IAIN LEES-GALLOWAY
Last updated 14:08 20/05/2009

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In 2007, then Minister of Health Pete Hodgson introduced 10 targets linked to the Labour-led Government's health priorities.

The targets were introduced to stretch and challenge the health sector to produce measurable gains through steady and repeated improvements across several areas.

They ranged from lowering waiting times for cancer treatment to reducing preventable hospitalisations to improving both the number and quality of completed elective surgeries.

There was a genuine focus on both treatment and prevention of disease and injury.

Current Health Minister Tony Ryall recently announced the National-led Government's new health targets. The number has been cut from 10 to six. That in itself is no great concern.

The number of targets a Government sets gives no real indication of its commitment to improving the public health system. What is alarming, however, is which sectors of the health system no longer have a target pertaining to the work they do.

The target for Mental Health was to have at least 90 per cent of long-term clients with up-to-date relapse prevention plans.

An incredibly wide range of people access mental health services in New Zealand, including people seeking assistance with long-term addiction issues.

In the year when both Government and opposition parties have expressed a desire to reign in the damaging effects of alcohol and when a report has been published that estimates the economic costs of harmful alcohol abuse at over $5 billion each year, it is absolutely ludicrous to de-prioritise the very sector of our health system that can support the hard work being done to bring greater control to the sale and supply of alcohol.

Progress towards 85 per cent adolescent oral health use is another target that has been scrapped by Mr Ryall. Statistics from 2007/08 show only 58 per cent of young teens are regularly visiting the dentist.

Worryingly this figure is a result of a marked increase since the target was introduced so even to reach that insufficient level required the Government to be clear about oral health being a priority.

The chance of reaching 85 per cent without that prioritisation seems impossible with so many competing demands.

Improving nutrition, increasing physical activity and reducing obesity were objectives designed to help reduce the incidence of injury and disease.

Achieving these targets would not only mean we would be fitter, healthier and more active as a nation, they would also reduce strain on our health system and allow resources to be used to deliver the increase in elective surgeries and reduce waiting times we expect our hospitals to deliver.

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Taken individually the cuts to health priorities are enough of a concern. But it is what they have in common as a group that should be setting off alarm bells.

The targets the minister has chosen to remove are all related to a long-term approach to preventative healthcare. The real results will not be seen for some years but have the potential to create a step change in the effectiveness of our health system.

What's better, to see a larger number of people being able to access dialysis treatment or to see the number of people needing dialysis plummet because we have reduced the number of people suffering from diabetes?

The targets that have remained, important as they are, are focussed on getting more people through hospital. It is a focus on treatment at the expense of prevention, on outputs over outcomes.

It seems the Government, far from having an eye on what our health will be like in 20 years, has both eyes on producing statistics that will make it look good come the next election in 2011.

Such a short-term focus can only be detrimental to our health system.

We must have high expectations from our whole health system, and we must be able to measure improvement. But if we don't create the environment that supports long-term structural change rather than short-term feel-good statistics we will never get the health system we need.

- © Fairfax NZ News

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