National calls for bringing back health targets to fix 'jellyfish' health system

National MP Simon Bridges says the Labour Government has turned the country's health system into a "jellyfish" by getting rid of performance targets.

But Labour's David Parker says the Government is doing what it can in the face of growing demand, particularly for mental health services. 

Set up in 2007 by Labour's then-Health Minister Pete Hodgson, the targets initially measured a wide range of areas - immunisation, oral health, elective services, cancer waiting times, avoidable admissions, diabetes, mental health, healthier lifestyles, smoking and efficiency. 

In 2008 his successor David Cunliffe said the targets showed "a continued overall improvement in health outcomes for New Zealanders". But after National took over later that year the number of targets were cut, new Health Minister Tony Ryall saying there were "far too many indicators and committees and targets".

After Labour regained power in 2017, David Clark dumped most of them altogether, saying they were creating "perverse incentives". Bridges wants them brought back.

"We have a health system proper - not just in mental health - that is under severe distress at the moment," he told The AM Show on Friday.

"I know there's about seven DHBs that are well over 100 percent capacity at the moment. They have acute staffing problems, staff not turning up… being overworked, not being able to get people in and so on. 

"It's a system overall that Dr [Ashley] Bloomfield [Director-General of Health], and ultimately [Health Minister] Andrew Little and Jacinda Ardern lead that's in real stress at the moment."

Appearing with Bridges on The AM Show, Parker asked what National would do differently - suggesting they'd just cut taxes.

"Rubbish," replied Bridges. "I'll tell you exactly what we'd do - we'd do what Tony Ryall did. We would have measures and targets and we'd drive some accountability. You got rid of all of that and the health system at the moment is a jellyfish." 

Mental health targets were among those dropped by Ryall in 2009. 

Bridges and Parker.
Bridges and Parker. Photo credit: The AM Show

In 2019, the Labour-led Government allocated $1.9 billion in mental health spending over five years, but there has been criticism since the funding has been too slow to be spent and not keeping up with demand. 

"It does take time to build up the workforce," Dr Bloomfield told The AM Show, appearing before Parker and Bridges. "I can say that that is happening, and it is happening with as much pace as possible." 

Dr Bloomfield said 11,000 people were now accessing services that didn't exist before - help for people suffering mild-to-moderate mental health issues, before they become acute cases. 

"Acute services are a challenge in themselves, but the big gap in New Zealand services has been primary healthcare," said Parker. "As [Dr Bloomfield] said there's 500 people more employed giving those services every week in New Zealand than there was a couple of years ago… it's not correct to say nothing is happening." 

Part of the constraint is getting the workforce. Dr Bloomfield acknowledged it's been made more difficult by the border restrictions thanks to COVID-19, but said it would have been a challenge even in normal times. 

"The increase we're seeing in mental health issues here in New Zealand, particularly amongst adolescents, is mirrored globally. It is not a New Zealand-specific issue. So there is a high demand for these staff."

"You can't just magic up a workforce," added Parker. "No single Government is the cause of the underlying rise in mental health issues. We all want to do better. Previously those services haven't been funded - now they are being funded. The services that are being funded are being ramped up as the workforce can be developed. To be frank, that's all you can do." 

In June Newshub revealed just five new spaces for acute mental health patients had been created since the 2019 announcement. Dr Bloomfield said it took time to plan and build new facilities, and much of the investment has gone on replacing old facilities no longer fit for purpose.