4. Question No. 4—HealthDr SHANE RETI (Deputy Leader—National) to the Minister of HealthQuestion No. 4—Health4. Dr SHANE RETI (Deputy Leader—National) to the Minister of Health: Which of the new health indicators he announced last week directly measures waiting times for cancer management if any and how many people with a primary diagnosis of cancer have currently been waiting more than four months for management?Hon ANDREW LITTLE (Minister of Health): To the first part of the question the purpose of the health system indicators is to measure how the health system is operating as a whole. Every indicator relates to system-wide decision-making except for the one relating to mental health treatment for young people because there is a particular critical need in this area right now. The member's question doesn't distinguish between targets which encourage perverse outcomes that serve the needs of health providers rather than patients or the population they are part of and the health indicators framework which deals with the system-wide performance. Just to explain that: we all want fewer Kiwi kids being admitted to hospital for conditions which are preventable or that we manage through primary community care. The complexity is the significant variation in the practice leading to hospitalisation. So for example respiratory problems may be more prevalent in regions where it is colder or where there are higher rates of deprivation. The interventions by the health system in colder or more deprive d areas should be different to areas where other conditions are more prevalent. That is what the indicators will show. It's how we will end the postcode lottery and it's why we have the childhood ambulatory sensitive hospitalisations indicator. To the second part of the question maintaining waiting lists for cancer management is the responsibility of district health boards. All DHBs collect this information in a different way. This means that an accurate national view is not possible at this time. This inconsistency is why we have established Te Aho o Te Kahu the Cancer Control Agency and it is why we are reforming the hospital system across the board. However what I can report is that the Minister of Health's faster cancer treatment initiative aims to have 90 percent of patients receive their first cancer treatment or rather management within 62 days of being referred and for the 2020-21 financial year quarter three—that is to say the quarter ending 30 April this year—the national result is 85 percent.Dr Shane Reti: Is the faster cancer initiative he has just described one of his health indicators?Hon ANDREW LITTLE: Well if the member's first question is to be taken at face value demonstrably he knows that it is not. The health indicators are about making sure the system as a whole runs to serve the needs of local populations and the national population as a whole.Dr Shane Reti: Can he explain why last week's health data revealed 30000 people were waiting longer than the four months for hospital management but his new indicator claims 3 percent more than planned?Hon ANDREW LITTLE: The data that was released last week showed that there are waiting times for first specialist appointments bearing in mind that some who have their first specialist appointment don't go on to receive treatment and there are further waiting times or a waiting list for those waiting for treatment following their first specialist appointment. That has been part of the system for some time. The reality is following the disruption caused by the COVID-19 pandemic the waiting time for those awaiting their treatment following their first specialist appointment is going down.Dr Shane Reti: Why is he blaming the significant increase in patients waiting longer than four months for treatment on coronavirus when the wait list under Labour blew out from 2000 people to 18000 before the pandemic had even started?Hon ANDREW LITTLE: Well what I can point to is the disruption caused by COVID-19. In addition to that what I can point to is the additional $282.5 million that this Government put into the hospital system to address those waiting lists over a period of three years and those waiting times are coming down.Dr Shane Reti: Can he name any one of his new health indicators that will improve in the first 12 months of his half-billion-dollar health system restructure?Hon ANDREW LITTLE: The health system indicators will take effect from next year and they are about pointing out where the system is not meeting the population's expectations. We know that for example in that ambulatory sensitive hospitalisation measure the reasons why there are presentations to hospital for conditions that were for example the primary care system part of the health system working effectively—those people would not be presenting to hospital. So it is about having indicators that tell us where the system is in trouble so that we know where to go to fix the problem.