About elective services

What has been happening with elective services

In New Zealand and many other countries with publicly funded healthcare systems, there has always been a limit to the amount of elective treatment that taxpayer funding can support. In addition, technological advancements in medicine and longer life expectancies have ensured that demand for elective services continues to grow.

By June 1996, 89,000 New Zealanders had been placed on waiting lists with no certainty of when they would receive treatment. Waiting lists did not always operate fairly, with many patients treated in order of their length of wait instead of their level of need compared with other patients. Waiting times for treatment also differed considerably around the country.

Over a period of years this situation has changed to one where:

• there is acknowledgement that resources are insufficient to meet all needs;
• all patients have the right to know whether or not they are likely to receive treatment; and
• all patients assessed by hospital specialists are now prioritised and then given a status that reflects both the capacity of a DHB service to treat patients and that patient’s priority relative to others who are assessed.

The principles of the system

The key principles underlying the new system are clarity, timeliness and fairness: clarity, where patients know whether or not they will receive publicly funded services; timeliness, where services can be delivered within the available capacity, patients receive them in a timely manner; and fairness, ensuring that the resources available are directed to those most in need.

A number of performance indicators have been established to measure clarity and timeliness. These assess how well a hospital manages the patient flow through the system, including whether:

• all patients referred to hospital by their GP who can be seen within the available resources, are seen for a first specialist assessment within six months
   
• all patients assigned a priority by a specialist are managed in accordance with that priority (relative to the priorities assigned to other patients managed by that service)
   
• all patients given a commitment to getting treatment receive that treatment within six months
   
• all patients have a plan of care.

You can use this site to see how well the system is performing against these principles, and to view the guidelines used in prioritising patients.