6. Question No. 6—HealthDr SHANE RETI (Deputy Leader—National) to the Minister of HealthQuestion No. 6—Health6. Dr SHANE RETI (Deputy Leader—National) to the Minister of Health: How many inpatient procedures as they are described in answer to written question No. 51279 have been deferred since the start of the current Delta outbreak and how many people if any are now waiting more than four months for a specialist appointment? Hon ANDREW LITTLE (Minister of Health): The Ministry of Health's latest reporting for the week ending 14 November estimates that approximately 7070 inpatient elective procedures were deferred nationally due to COVID-19 since August 2021. As the member will be aware from my answer to his written question these are estimates subject to revision by DHBs. In response to the second part of the question the Ministry of Health reports on a metric for first follow-up specialist appointments within four months of referral. Results for September 2021 show that there are 27433 patients waiting longer than four months for a first specialist appointment; this compares to 19182 in July 2021. As I've said in the House previously the reality is that pandemics disrupt health systems; all services reduce procedures in order to keep patients and health workers safe. Every effort is being made to reduce the disruption of planned care. Since the alert level 4 was lifted many of the DHBs outside of Auckland have reduced waiting times in their planned care schedule; however DHBs like Auckland and Counties Manukau have been at the centre of the response to the latest outbreak and continue to see disruption to their schedules. The Ministry of Health is also working with DHBs as we move into the COVID protection framework to enable the delivery of more planned care and to further reduce backlogs.Dr Shane Reti: Point of order. Mr Speaker in the primary question I specifically asked for inpatient procedures as they're described in answer to a written question. That includes not just the procedures that the Minister has just talked about but also radiology first specialist assessments. I specifically asked in that format consistent with that question. They haven't been addressed.SPEAKER: Does the Minister have those figures?Hon ANDREW LITTLE: Well talking to the point of order the answer to the written question that was lodged provided the very answer I've just given. It answered the question that the member has just asked orally: 7070 as he described them inpatient procedures have been deferred in the period that he describes.Dr Shane Reti: Did officials provide him with any options to manage coronavirus that would have resulted in fewer cancelled procedures than he has just prescribed? And if so what were those options?Hon ANDREW LITTLE: The nature of the pandemic and particularly the outbreak that warranted the country being put into level 4 is that health services are disrupted and hospitals in particular because they are exposed to a particular vulnerability—that is to say unwell people turning up to get healthcare—amend their procedures to keep both those people safe the patients turning up as well as healthcare workers. And so it does cause disruption. Once the level 4 was lifted then many DHBs were able to get back to as close as possible life as normal restore their planned care schedule but hospitals in Auckland were not because hospitals like Counties Manukau and Auckland who have been carrying the heaviest patient workload—at least for those afflicted with COVID19—have had to slow down their planned care in order to keep again COVID19 patients and other patients and healthcare workers safe.Dr Shane Reti: At any time over the past 20 months did he ask officials to estimate how much it would cost to reduce the number of cancelled procedures; and if so what were the costs?Hon ANDREW LITTLE: Well two points on that: the member refers to cancelled procedures and that is the way they're categorised but actually most of them are postponed. So for many of those procedures that have been postponed many have actually been picked up since. But we saw from the experience last year and the disruption that an outbreak causes that DHBs are capable of catching up. That is why the Government provided them with an additional $282.5 million over three years to help them to manage their catch-up programme for planned care. Additional funding has been provided this year as well and I'm confident that DHBs particularly those outside of Auckland are working very hard to clear the backlog and those DHBs who are in Auckland and can refer patients to other DHBs are doing so. And every effort is being made to make sure that those backlogs are being reduced.Dr Shane Reti: Were all of the deferred procedures from last year's outbreak caught up prior to this current outbreak starting; and if so why were there 30000 still waiting for a first specialist assessment?Hon ANDREW LITTLE: As I recall from the reports I received certainly in the month or two just prior to the latest lockdown and outbreak actually a large percentage—the majority—of procedures that had been postponed last year had been caught up with. There were still some outstanding; in some cases it was because other circumstances had arisen for some patients. That meant that it was not propitious to carry out the planned care for that particular patient but they are still on a waiting list. And I imagine the same will happen as a result of the most recent outbreak.Dr Shane Reti: Why are GPs in Christchurch a city with barely any COVID cases already being told by Christchurch Hospital general surgery that as they have no chance of seeing new patients they will be declining most referrals; and when will he finally admit that this is because he failed to prepare the health system for coronavirus?Hon ANDREW LITTLE: The health system has been responding to and adapting to the coronavirus for some considerable time but I think that member will know and his colleagues on that side of the House will know that from the time they were in Government the health system had been underfunded for a considerable period of time. Buildings had not been invested in space had not been expanded staff had not had pay rises that kept pace with the cost of inflation and this is a Government in the last four years that has had to play major catch-up to make sure that we have a health system that is capable of responding effectively.