National and a nursing union boss are questioning the accuracy of official health figures about emergency department (ED) wait times, saying they cannot be real - and could lead to vital funding being misdirected.
A regional breakdown of monthly ED wait times shows many areas last year lagged well behind the historic target of 95 per cent of people being seen within six hours.
This was consistent throughout 2022, before Northland, Southern and Taranaki EDs reported near-perfect figures in November and December.
National’s health spokesman Dr Shane Reti says he has never seen a figure like Northland’s - 99.7 per cent - and believed it was a mistake.
“They just can’t be correct,” he told RNZ’s Morning Report on Thursday. “I mean, I live in Northland - I would love Northland ED to be at 99.7 per cent. But the reality is I don’t think any ED ever has been, and unfortunately Northland won’t because at the same time those are reported as 99.7 per cent, Northland ED was urgently calling out for the Army to staff their ED, so they’re just not credible.”
According to the data, the West Coast normally has between 680 and 1000 people attend an ED each month - except for May, when only 92 supposedly showed up, ballooning to more than 8000 in both November and December.
In Northland, between January and October, EDs saw between 4500 and 5000 patients - then in November and December, that apparently dropped to 361 and 318 respectively.
Counties Manukau, Southern and Waitemata also saw enormous drops in recorded attendance in the last two months of 2022, while Wairarapa’s figures increased nearly 10-fold.
Reti also pointed out data for the Waikato region was missing from another document that measures the total number of ED presentations.
“How can that be [representative] data when one of the biggest centres, one of those most at risk and troubled, hasn’t even contributed their data?”
‘Issues in ED are everywhere’
Health Minister Ayesha Verrall’s office used the Northland figures earlier this week to suggest there had been a large improvement in the region’s ED response times.
Nurses Organisation president Anne Daniels said it was “very sad that she has been misinformed”.
“Just like anybody, she expects those who are employed to do the job, to do the job,” she told Morning Report.
“At the end of the day, funding is there to actually help us do our jobs - save lives, help people to get over their health issues - and it’s not been reflective of what’s happening on the ground…
“Those who are in power and need to make decisions are not actually having the data to enable them to do that correctly. And I know for a fact that just the issues in ED are everywhere and I would be very, very surprised if any ED throughout New Zealand was actually having a good run of it, because that’s not my experience or my understanding.”
She agreed with Reti that the numbers for November and December simply could not be true.
“I know for a fact that one of the regions was experiencing extremely high numbers to the point where their whole hospital was bed-blocked for days, yet the figures actually suggested that only 50 per cent of the presentations occurred and the wait time well and truly met the target - and the reality on the ground is just not showing that.”
Reti said the data was a mistake that could be put down to incompetence, and should be urgently corrected.
“I had them last week and when I looked at them, I had our analyst have a second look because I couldn’t make any sense of them, and he consumed a whole morning and still couldn’t. So then I asked an ED specialist and he said no, those numbers are fudged.
“So you know, [Te Whatu Ora will] have to explain why they put up on and in the public domain, numbers that just do not make sense and do not advance the cause of EDs that are really struggling at the moment ....They’ve put them out, they haven’t quality assured them, and ... they’re just gobbledygook.”
Without accurate figures, he said officials would not know where resources were most needed.
“If you really believe that Northland ED is 99.7 per cent to target, then you will turn your attention elsewhere. How can that be when they called out desperately for the Army to help them?”
Te Whatu Ora responds
Te Whatu Ora national medical director Pete Watson said the figures were “as accurate as we’ve got them at the moment”, but “clearly [are] not accurate”.
“This has been a merger of 20 different districts who collected data in different ways on different systems, so it is taking some time. But look, we’re confident of the data that we’ve got up there on our website currently, it will improve over time.”
Rather than improving, as Verrall’s office suggested was happening in Northland, Watson said nationwide, the situation was deteriorating.
“We’re not improving, so the system is under real pressure and we know that and that’s across the system, and we’re focusing on what we can do to address that.”
The nationwide figure showed a six-hour response performance trending downwards over the course of 2022, from 78.8 per cent in January to between 71 and 72 per cent from August onwards.
“Look, I think when you roll it all together, it gives a really good indication of where we’re at, which is that we are not improving. So, I think that we can be confident that things are not at a point we need them to be and we need to focus really closely on what we can do to get us through the winter and these acute periods.”
He said the data would be updated as more accurate figures came to hand, but was not sure if the current incorrect data would be taken offline.
Daniels wanted the data gone before it gets misused again.
“Whoever does use them is not going to be informed that they’re inaccurate. There’s nothing on the website to say so.
“And it’s very sad, because it’s suggesting that the nurse and doctor shortages that we’re experiencing are not there or they’re invisible, or we’re doing suddenly an incredible job with the same lack of resource that we’ve had for some time.”
Reti said he has submitted some questions to the minister, asking for a “please explain”.
This afternoon Te Whatu Ora - Health New Zealand chief executive Margie Apa issued an apology for the incorrect data.
“We want to assure the public the underlying data collection, collation and assessment was and remains robust; the error we made related to the publication process.
“We have identified what went wrong in our pre-publication assurance process, and have implemented a change. This is important to maintain public confidence in our health system.”
Apa said the incorrect data was taken down from the website this morning.
“The data will be updated tomorrow once we have completed the required data extract and validation process.
“We sincerely regret this error, and fully recognise how critical integrity is for our published data.”
Note, the ten local areas were Northland, South Canterbury, Southern, Tairawhiti, Taranaki, Waikato, Wairarapa, Waitemata, West Coast and Whanganui.