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Government expands cataract surgery eligibility, targets waitlists
More people will become eligible for cataract surgeries under the first move to standardise access across the former DHB regions, the government says.
While the move would mean more people joining waitlists, the government is also promising to take steps to complete another 3500 surgeries over the next 18 months, to bring those waitlists down.
Health Minister Ayesha Verrall announced the plan on Monday, saying the former DHBs had used a point system which led to wildly different access to cataract surgery based on where people lived – known colloquially as “post code” health.
“In Auckland and Waitematā for example you become eligible for a cataract operation with a score of 46, but in Canterbury and Southern you need a score of 61.”
She said a score of 46 meant “mildly reduced vision”, compared to a score of 61, “poor vision” – bad enough the person could no longer legally drive.
Verrall said 46 would become the score for eligibility to surgery across New Zealand, and this would be rolled out in phases – with some areas taking up to 18 months to start on the new system.
She said Te Whatu Ora/Health NZ would work to outsource surgeries to other providers and ophthalmologists, and improve productivity “through innovative models of care and improving theatre efficiency”, to work through the waitlists.
The health minister made the announcement during Monday’s post-Cabinet press conference. Photo: RNZ / Angus Dreaver
“The main thing we will do is prioritise additional funding to those areas where that catchup is required.
“That can be used for one of two things: firstly outsourcing to the private sector where there’s capacity there, and secondly an approach called in-sourcing which is where we might pay our public staff to do extra operating lists, if they’re willing, on a Saturday to get through that hump of work that we have to do at the very beginning when the threshold criteria changes.”
Other changes could include things like patients getting surgery for both eyes at the same time if they had very dense cataracts, or were expecting to get surgical treatment for glaucoma or diabetes.
The government estimated the changes would mean completing a further 3500 surgeries from the waitlists over 18 months from 1 July 2023.
Verrall said there were more than 7800 people on the waitlists, with two thirds waiting less than four months.
“The work to get the long tail of people on the waitlist treated is well under way: 4052 of them in the northern region, 1278 in Te Manawa Taki (Bay of Plenty, Hauora Tairāwhiti, Lakes, Taranaki and Waikato), 1317 in Central, and 1237 in Te Waipounamu.”
The move was funded as part of the $118 million Budget allocation to reduce wait lists and standardise healthcare access, and was the first of several such changes.
“The government is committed to eliminating the inconsistency patients experience when they need surgical treatment across New Zealand because of the postcode lottery for care,” Verrall said.
“Today’s announcement is a first in what we can expect to see across elective surgeries from now on: a joined-up health system working towards timely consistent access to healthcare regardless of where you live.
“We will now be able to use and build on this revised cataract surgery threshold as a model to improve other waitlists into the future.”
She said further details on addressing other waitlists would be provided soon.
“I know that the ophthalmologists have been pointing out that this is such a visible and important area to act on first and they were ready to do that. We actually have a number of other engagements with other clinical groups to see if we can make similar changes in other areas, but it’s a matter of making sure we can get all of the logistics right.”
She did not immediately have details of overall surgical waitlists but said Te Whatu Ora would soon be publishing that data regularly.
“We are making progress, particularly where this has been the focus for a long time. In the Northern region we’re seeing them really get down to reduce those number of people waiting more than 12 months, substantially.
“There is a lot we can do to use our systems more efficiently, there’s a lot of work underway to make sure our theatre efficiency is improved for instance … to get maximum value out of our facilities.”
She also highlighted her announcement the previous day of another 830 placements for nursing students as another example where the reforms were making a difference.
“It’s early days and we know there is more to do but there’s already signs the reforms are making a difference, making care more accessible. Under the old system we would not have been able to add those 830 clinical places for nurses, or standardised access to cataract surgery.”
VIA RNZ
The chief executive of the Parliamentary Service is confident there will be enough room to accommodate the increased number of MPs and their staff coming into Parliament.
On current numbers, up to 131 MPs could be sitting in the Chamber following the election, brought on by a record overhang result.
Clerk of the House of Representatives Dr David Wilson told the Spinoff that currently the debating chamber had enough chairs to seat 124 MPs – including the Speaker of the House – and work was being done to accommodate more by altering the seating arrangement.
In a statement, Parliamentary Service chief executive Rafael Gonzalez-Montero said planning for a larger Parliament had been going for “some time”.
“Now that the election results have confirmed an increase to the number of members we are looking at several options.
“We are confident we will be able to accommodate all members within the Chamber.”
VNP / Phil Smith
Gonzalez-Montero said office accommodation for members and their staff would be “stretched” for a short time, but the new Members’ Building was only a few months away from “practical completion”.
That building – located behind Parliament – was due to be ready to occupy in April next year and had capacity to accommodate around 30 backbench MPs.
“All members should be in fit-for-purpose accommodation from that point,” Gonzalez-Montero said.
Following the 2023 election, 123 MPs sat in the Chamber – a record number at the time. That decreased to 122 following the resignation of National MP Judith Collins.
Collins held the seat of Papakura and stepped down in May and Parliament voted against holding a by-election because it was too close to the election.
The election result also meant high-ranking National Party MPs like Chris Bishop, Paul Goldsmith, Nicola Willis and Gerry Brownlee – Speaker of the House and an MP for 30 years – would likely not make it back into Parliament.
Only resigning or retiring MPs were permitted to give a valedictory speech meaning none of them would get the chance to give a valedictory statement.
Asked if their would be special allowances for valedictories, Wilson said in a statement that normally only MPs were allowed to speak in the House but the House could suspend its own rules or temporarily alter them.
“It could do so to allow former members to address the House.”
Wilson said no such arrangements could be made until the next Parliament opened and members sworn in.
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