7. Question No. 7—HealthDr SHANE RETI (National) (remote) to the Minister of HealthQuestion No. 7—Health7. Dr SHANE RETI (National) (remote) to the Minister of Health: How many inpatient events have been cancelled in total since the Delta strain lockdown on 17 August 2021 and how many people are currently waiting more than four months for a first specialist assessment?Hon ANDREW LITTLE (Minister of Health): The Ministry of Health's latest reporting for the week ending 20 February 2022 estimates that approximately 7219 in-patient 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. Results for December 2021 show that there are 32896 patients waiting longer than four months for a first specialist appointment. This compares to 19765 in September 2021. As I have said in this 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 on 21 September 2021 many of the DHBs have reduced waiting times in their planned care schedule. DHBs have put a number of measures in place to maintain delivery. This includes prioritising urgent and non-deferrable cases outsourcing where possible running additional surgical lists and extending the use of providers that can deliver minor procedures in a day-case environment. We know that the Auckland based DHBs—Auckland Counties Manukau and Waitematā—have continued to be at the centre of the response to the latest outbreak and continue to see disruption to their schedules but even these DHBs have worked immensely hard to keep delivering services and have lifted their delivery.Dr Shane Reti: When he said recently that the management of the health system had been somewhat of a leader in terms of minimising harm" how does he explain his answer to written questions last week that a woman in Taranaki has now been waiting 789 days for a first specialist assessment?Hon ANDREW LITTLE: What that member fails to mention is of course that for some of those outlier and exceptional cases there are a number of factors that sit behind the delay of their first specialist appointment often including the patient's own request for a delay. I think what's important—as the member will know as a health specialist and health researcher—is that you know we tend to look at mediums and means as indicative of the performance of the system. In any event what we can say is that although the system in the early stage of the August outbreak cancelled and deferred procedures since then many of those procedures have managed to catch up and in fact in December what we saw across the public health system as a whole—85 percent achievement of planned care procedures against that plan which was a significant improvement in previous months given the disruption caused by the pandemic.Dr Shane Reti: Does he believe he has minimised harm to the woman at North Shore Hospital who has been on the priority 1 waiting list since July with specialist concerns that she may have thyroid cancer who has now been told this type of elective surgery has been cancelled?Hon ANDREW LITTLE: I'm not familiar with that individual case and even if I were I wouldn't be disclosing patient details in a public forum such as this. What I can say is that I am satisfied with the response of our DHBs including Waitematā and all those Auckland DHBs who have been under immense pressure responding to the Delta outbreak since August and now the Omicron outbreak now seeing over 300 patients admitted just in the last few weeks alone for treatment having to again defer procedures. They are doing what they need to do what they can do safely and properly to keep patients well and staff safe and they are doing what clinicians do in these circumstances: appropriately prioritising and triaging and keeping as many people as safe as possible.Dr Shane Reti: How has his leadership minimised harm to people with lung cancer who the cancer agency state have had a 30 percent fall in bronchoscopies?Hon ANDREW LITTLE: One thing this Government has done is increase funding to Pharmac by 25 percent because it was virtually static under the previous Government and we have significantly added a number of cancer treatments funded by Pharmac too. In fact we added outside the Budget cycle another $60 million to enable Pharmac to fund additional cancer treatments. We have continued the roll-out of the bowel screening programme because that was underfunded by the previous Government when it started. We've all but completed the roll-out of that programme. This is a Government through those measures and the establishment of the Cancer Control Agency that takes cancer seriously in a way that never has been before.Dr Shane Reti: How has his leadership minimised harm from the report of 147 surgeries that were cancelled at Counties Manukau in the past two weeks?Hon ANDREW LITTLE: I don't know whether the member has noticed but we're not only two years into a pandemic but we are sort of about three weeks into one of the most significant outbreaks of the total COVID pandemic that we have ever seen. So we're now up to roughly 100000 active cases in our communities right across New Zealand. We have over 300 people in hospital in Auckland alone as a consequence of the pandemic. The DHBs have been planning for this but part of their planning is to make sure they have room in hospital for the people with the very serious respiratory conditions they've got as a consequence of COVID and that has meant deferring planned care. That is what they are doing. It is a perfectly orthodox normal response to a pandemic that our DHBs are responding to appropriately.Dr Shane Reti: When the director-general said today that the staffing of hospital beds is an issue that will have an impact on in-patient procedures how many staffed hospital beds are currently available across New Zealand?Hon ANDREW LITTLE: I'm not quite sure what the member is referring to by staffed hospital beds but I do point out to the member one of the other consequences of the outbreak is that when staff are household contacts and are required under current protocols to isolate that does have an impact on the staffing of hospitals and that is happening now too. So part of the planning of the DHBs is not only planning for a significant increase in the number of patients with COVID who need treatment—particularly for those difficult respiratory conditions—but also planning for a reduction in staff because they have to respond to their exposure or risk of infection particularly when they are a household contact. That has all been planned for that is being played out at the moment and staff and patients are being kept safe as a result."