The Health Quality & Safety Commission (the Commission) has today released part 2 of its investigation into the effects of the COVID-19 pandemic on health care services in Aotearoa New Zealand.
A window on quality 2022: COVID-19 and impacts on our broader health system (Part 2) | He tirohanga kounga 2022: Me ngā pānga ki te pūnaha hauora whānui (Wāhanga 2) (Window 2) follows a previous report (Window 1) published in December 2021 and was researched and produced by the Commission in partnership with clinical and academic experts and agencies, health care workers, community workers and consumers.
Dr Janice Wilson, Commission Chief executive, says the pandemic’s effects on Aotearoa New Zealand’s health system, our population’s mental health, health care workforce and experience of care for disabled people are examined in the report.
While a partial and curated view of the impact on the health system, the report identifies both positive findings and challenges.
‘Despite the lockdowns to fight the Delta wave, our levels of freedoms over the pandemic have remained higher than nearly all countries and are comparable with Scandinavian countries,’ Dr Wilson says.
‘While there has been an increase in mortality since the spread of the Omicron variant in the community, due to the lives saved during the initial phase of the pandemic in 2020 Aotearoa New Zealand is almost unique in having no excess mortality over the last three years.’
Dr Wilson says the pandemic affected rates of immunisation of babies, particularly Māori and Pacific infants, and babies in families living in poverty. Cancer screening coverage has been affected, emergency departments are experiencing greater pressure, and access to and numbers of planned care procedures are down. However, the report singles out cancer care as having been less disrupted than in many comparable countries.
The report also examines the effects of the pandemic on people’s mental health along the life course, and effects on our health care workforce. A dedicated chapter examines the experience of primary care for disabled people, and changes in the number and type of complaints to the Health and Disability Commissioner.
Our experience of and response to the pandemic was different and more successful than most other countries.
‘We were able to keep COVID-19 out of the country long enough to vaccinate strongly and save many lives,’ says Dr Wilson.
‘However, the arrival of the Omicron variant exposed long-standing, fundamental weaknesses in our health system, the first being the long-standing mismatch between the demand for health services and the ability to meet that demand.
‘The second weakness exposed was the entrenched inequities in health status, health care quality and outcome experienced by Māori, Pacific and disabled peoples.’
Dr Wilson says the mismatch between demand and supply led to a focus on finding different ways to do more for less, which meant our system had less in-built resilience and capacity to adapt to crisis.
‘In a nutshell, there was little slack in the system to cope with external shocks.’
Looking ahead, appropriate funding of health services must be balanced with a focus on efficiency and equity.
‘Insufficient resources in one part of the system can create waste in others, as patient flow through the system breaks down. A wider system view is needed to avoid this.’
Dr Wilson says the power of local communities, which worked so successfully in Pacific and Māori responses to lockdowns, vaccination and wider need in the community highlighted a unique opportunity for this country.
‘Opportunities exist in system-wide quality improvement approaches that combine established methodologies of collaboration and measurement for improvement with the strengths of consumers and local communities,’ she says.
Childhood immunisation, acute care and planned care have been powerfully affected by the pandemic and could benefit from an approach which includes collaborative expertise, local freedom and strong, innovative measurement, Dr Wilson says.