7. Question No. 7—HealthHon MICHAEL WOODHOUSE (National) to the Minister of HealthQuestion No. 7—Health7. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: Is he satisfied with district health boards' progress in achieving published performance measures for quarter 1 of the 2019/20 year?Hon Dr DAVID CLARK (Minister of Health): I am satisfied that the doctors nurses and allied health workers at our public hospitals are working hard to deliver the quality care that the people of New Zealand expect and deserve. I'm satisfied that our public health service does an incredible job responding to emergency situations. In terms of the narrow data set that the member asks about which does not represent the breadth of care provided by DHBs I'm satisfied that clinicians are working hard to make progress and deliver to their patients.Hon Michael Woodhouse: Is he concerned that the Smokefree 2025 target will not be achieved when 18 of the 20 DHBs' performance on better health for smokers have gone backwards since he became Minister?Hon Dr DAVID CLARK: I have often said that I have concern about the narrow set of political targets put in place by the previous Government. The particular quit smoking target the member refers to is based upon referrals. So if the member were to refer a person to me as a clinician and I were to refer them back to him as a fellow clinician that would count as two for that set of targets. I don't think that's a particularly useful measure. I think there are broader measures of our health system's success that show the work of the DHBs and their contribution to the health of New Zealanders. Hon Michael Woodhouse: Why then if as he says they are such an inappropriate proxy for the health of the health system has he not after two years done anything about it? Hon Dr DAVID CLARK: I reject the member's assertion.Hon Michael Woodhouse: Why have all 20 DHBs' performance under the Shorter Stays in Emergency Departments performance all dropped since he became Minister?Hon Dr DAVID CLARK: The member will know from my previous answers that I want to see meaningful and transparent measures of progress in health. Unfortunately we know that data for the emergency department target was falsified and gamed under management pressure on the previous Government's watch. As one DHB staffer reportedly told Auckland University associate professor Dr Tim Tenbensel The patient will be scanned out of the [emergency] department before they reach the six-hour mark even if they haven't actually physically left the department which I actually find quite unsafe and I don't like that practice."Hon Michael Woodhouse: Is the Minister aware that despite those anecdotes Waikato University research showed that 700 lives a year were being saved by that target? That's many thousands under the term of the previous Government. Hon Dr DAVID CLARK: I am very aware that there's lots of research which shows that those targets were being gamed. I'm also aware that the New Zealand Doctor recently reported that at one hospital a new chief executive exerted considerable direct pressure on emergency department (ED) medical and nursing staff and "Interviewees at this site described a range of gaming behaviours. One staff member described 'clock-stopping' behaviour … falsifying the record of time of departure from ED." The previous Government's targets were a failure—they failed to achieve what they wanted to achieve with them other than for political ends. I'm interested in a health service that builds and meets the needs of New Zealanders for the care that they would expect and deserve. We've inherited a health system that's been run down after nine long years of neglect and political focus and we want to see a health system that actually serves the needs of New Zealanders. Hon Michael Woodhouse: Does he believe that there is a link between the fact that 19 of 20 DHBs have lower immunisation rates since he became Minister and the recent measles outbreak?Hon Dr DAVID CLARK: What I will say about the immunisation target the previous Government never achieved is that it was dropping over the longer term and that that has actually turned around under this Government's watch. So I thank the member for his question.Hon Michael Woodhouse: In this year of delivery doesn't this show that he has delivered poorer health outcomes for New Zealanders?Hon Dr DAVID CLARK: I think what it shows is that we still have work to do to improve the health system after nine long years of neglect under the previous Government's watch."