3. Question No.3—HealthDr SHANE RETI (Deputy Leader—National) to the Minister of HealthQuestion No.3—Health3. Dr SHANE RETI (Deputy Leader—National) to the Minister of Health: How many people per day have had a planned inpatient procedure delayed during the current lockdown if any and how many of these were for cancer surgery?Hon ANDREW LITTLE (Minister of Health): At this time the priority of the Government and the Ministry of Health as kaitiaki of the health and disability system is to support the district health boards in responding to COVID-19. As we've seen globally the Delta variant of COVID-19 creates an acute threat to individuals' health and as well to health systems. Reporting on delays caused by the current lockdown is not possible because DHBs have not yet reported data to the Ministry of Health. This data is not available on a real-time basis and is reported in arrears. We will have a clearer picture of what has been done and what has not been done in August once the data is coded in October. However the Ministry of Health is working closely with DHBs to support their response to the August 2021 outbreak and is monitoring the impact that alert level 4 lockdown is having on service delivery. At this stage I can report to the House that district health boards have estimated that there were approximately 1300 planned care cancellations in the first week of alert level 4 the majority of which are in the northern region. However all DHBs have reported disruption to their services. Regarding the proportion of these cancellations that are related to cancer services the Ministry of Health does not have real-time information on this either. However I am advised that clinicians are generally reporting there is strong focus on ensuring that cancer patients continue to receive the care they need and that while some treatments may have been rescheduled the vast majority of essential cancer treatments such as specialist appointments radiotherapy chemotherapy and surgeries have been continuing as expected. Cancellations of services when they happen are aligned with guidance from the Ministry of Health and consider urgency and clinical risk of patients. Members of this House should be aware that urgent and non-deferrable care is carried out under all alert levels.Dr Shane Reti: How long will it take to clear the backlog of in-patient procedures that have been delayed by the current outbreak and what actions has he taken to speed this up?Hon ANDREW LITTLE: I refer the member to the answer to the primary question where I said that the data on delays to planned care in this particular lockdown—the August 2021 lockdown—has not been evaluated or calculated yet and we won't until reliable data is available in October. But we have dealt with the consequence of lockdowns on planned care in our hospital system and that is why last year as a result of the lockdown in March and April last year as well as subsequent lockdowns in Auckland this Government appropriated $282.5 million over three years to assist DHBs to clear those backlogs.Dr Shane Reti: What actions has the Government taken in the last six months if any to minimise disruption to in-patient procedures in the event of a COVID outbreak like we currently have?Hon ANDREW LITTLE: Part of the $282.5 million appropriation last year as well as a $90 million appropriation this year and a further $50 million for additional facilities—that is to say infrastructure for DHBs—was precisely so that DHBs have the means and capability and capacity to clear surgical backlogs.Dr Shane Reti: Can he give examples of what criteria are used to determine what planned surgery will proceed during the current lockdown and what will not proceed?Hon ANDREW LITTLE: I think I made it clear in the answer to the primary question that urgent care will continue regardless of alert level. When it comes to cancer surgeries and cancer treatment then clinicians will make the judgment understand that there is a level of urgency and will be guided by the advice of all of that team making up a person's medical support for the particular condition that they've got. But those are clinical judgments that are made all the time and are being made across our health system right now even under alert level 4.Dr Shane Reti: How is the criterion to delay surgery different under the current coronavirus outbreak compared to previous coronavirus outbreaks if at all?Hon ANDREW LITTLE: I'm not aware that the criteria such as they are that relate to deferring planned care under alert level lockdown scenarios is any different now than it was before. These are in the end clinical judgments that are made by the health professionals attending to people who need that help. There are some people who inconvenient as it might be will experience some disruption and delay. There are others for whom there should not be and there will not be deferral or delay because their condition warrants treatment and attention straight away.Dr Shane Reti: Has he requested any additional funding to help bring hospital wait-lists back to levels prior to the current outbreak and if so how much?Hon ANDREW LITTLE: As a consequence of the $282.5 million investment that this Government made last year as well as the $90 million appropriated this year as well as the $50 million given to enhance infrastructure and facilities for our DHBs the backlog caused by previous lockdowns across our health system have been clearing at a pretty good pace. Until we know the data arising out of this particular lockdown which won't be available until October we won't know what the additional backlog is but there is the means and support there to continue the exercise of clearing hospital backlogs.