Stewart Barbara: Questions for Oral Answer — Questions to Ministers 
Stewart Barbara: Questions for Oral Answer — Questions to Ministers 
[Volume:642;Page:11992] 
4.  
PITA PARAONE (NZ First) 
 on behalf of  
BARBARA STEWART (NZ First) 
to the  
Minister of Health 
: Has he received any reports regarding the costs to the health system resulting from those who fail to turn up to medical appointments? 
Hon PETE HODGSON (Minister of Health) 
: 
 Yes I have. I have received many reports. The DNA or “did not attend” rate is an ongoing issue in New Zealand hospitals as it is elsewhere in the world. Good progress has been made in many areas particularly in Northland where the “did not attend” rate has reduced from 22 percent to 6 percent over recent years but there is still room for further improvement. 
Pita Paraone 
: Is the Minister aware that a recent study of the number of patients who did not attend medical appointments across all 21 district health boards found that the book cost of that non-attendance was $57 million last year alone and that nearly one in 10 people did not attend their pre-set appointments? 
Hon PETE HODGSON 
: Yes I am aware of the study that the member refers to and indeed the estimated cost which is as I am sure the member will agree more of an opportunity cost than a real cost both for the patient who did not turn up and for the patient who might have taken that person’s place. 
Pita Paraone 
: Is the Minister aware that the same study found that nearly two-thirds of those not attending were senior citizens with Maori Pacific Islanders and other ethnic minorities making up the majority of the remaining third and that almost without exception the reason for their non-attendance was a lack of transport? 
Hon PETE HODGSON 
: It may be useful if I refer the member to a different study a thoroughgoing study done recently by the MidCentral District Health Board which tends to confirm the member’s point of view that a lot of senior citizens Maori and Pacific Islanders are amongst those who did not attend appointments at that particular hospital but points out that we cannot really say that the major problem is a lack of transport. In fact the MidCentral District Health Board study gives 27 reasons and although transport is the most important of them it accounts for only 13 or 14 percent of the “did not attends”. 
Pita Paraone 
: Is the Minister aware that the National Travel Assistance Policy has been patchy at best in meeting the transport needs of seniors and others and that those district health boards—such as Taranaki—that have the lowest rates of non-attendance also have their own fleet of transport vehicles specifically to address this matter? 
Hon PETE HODGSON 
: Yes I am aware of a bus that runs twice daily from New Plymouth to Hawera and back and indeed another one that whips round the mountain. The Taranaki District Health Board does have a good “did not attend” rate but if one looks at the whole country one finds that there are very low “did not attend” rates in areas where there is poor public transport—Northland being an example and South Canterbury another—whereas in some other parts of the country where there is very good public transport such as Auckland the “did not attend” rate is actually high. 
Pita Paraone 
: Does the Minister believe that rather than the health system incurring a cost of $57 million a year a small investment by the district health boards nationwide in transport services would greatly reduce the number of those not attending appointments and result in not only a significant financial saving but better health outcomes for those affected; and is he prepared to direct district health boards to take this simple step? 
Hon PETE HODGSON 
: The district health boards are certainly free to take this step and I thank the member for his interest in this issue; it is an important one. I do however disagree with the member in his assertion that “did not attends” and transport issues are inextricably linked. They are not. The “did not attend” rates in Auckland where the transport system is very good are much higher—in fact twice as high—than they are in South Canterbury where the public transport system is nowhere near as good. So it is not at all clear that transport and non-attendance are as closely linked as that. The reasons for not attending are very complex; there are very many of them. If the member wants a copy of the research from the MidCentral District Health Board he can have it for the asking. 
Pita Paraone 
: I seek leave to table a copy of the report on “did not attend” numbers percentages and costings per district health board. 
Document by leave laid on the Table of the House.