ISSUE #3: Health

KPI: Child Immunisation Rates

AKA: healthcare, hospitals

Key notes

Health KPIs are in a really poor state. There’s no way to sugarcoat it. The only data series we can find over many years and successive goernments are child immunisations.
The y (vertical) axis starts at 70% and not 0%. This is a common representation of the data, and that used by the New Zealand Medical Journal, since 1% shifts in vaccination rates have a significant impact on health outcomes. A scale from 0-100% hides these insights.
The prioritisation of, and method of the roll-out, of the Covid-19 mRNA vaccinations and vaccine mandates appears to have had an impact on more traditional childhood vaccination rates. Context and judgments like this are subjective, so they are impossible to show in a graph. It is up to each reader to evaluate the proportion of responsibility they place on each government over the timeframe shown, versus factors outside of their control.
Remember that each Labour-led or National-led government has had coalition partners that share the successes, and the failures, with them. A full list of governments for this time range is at the bottom of this page.

Data sources

Data shown:

% of children immunised by milestone age.
2009 Q2 onwards which is when the childhood immunisation data series began.

2009 Q3 data is missing. We have asked for this several times but have not received it, so have taken the average of the Q2 and Q4 numbers on either side for now.
2023 Q2 data has only just been released as we go live, but we will get that into the graph as soon as we can. It shows a slight increase from 76.3% to 76.8%.

Full data:

https://www.tewhatuora.govt.nz/for-the-health-sector/vaccine-information/immunisation-coverage/ [Scroll down to ‘Immunisation coverage data – three-month reporting period’]
Te Whatu Ora/Health NZ does not provide an aggregated data file over all time periods, so please contact us if you would like our aggregated data workings.

Frequency:

Quarterly

Updated:

Was 11 days after Q1, but the Q2 data took over 3 months, and Q3 has also taken more than 3 months.

Last update:

2023 Q4 = early March (they don't say)

Next update:

2024 Q1 = Unsure given the variable 2-3 month delays and no release schedule

Why this KPI?

Health has easily been the hardest area to obtain KPIs. Many health targets/goals under previous governments were discarded, and have not been sufficiently replaced. So, please bear with us as we try to explain the complexities and vagaries. Let’s start with the more commonly referenced KPIs and what we do have.

Childhood immunisation

This is the only health KPI with published data over many years, including 2023, that we could find. That is why it’s the only choice for the Health KPI at this stage.
This time series started in 2009 Q2, and 2023 Q2 has now been released.
Sometimes, governments report on only the 24-month immunisation rate. We have reported an aggregate across all 7 milestone ages: 6 months, 8 months, 12 months, 18 months, 24 months, 54 months (4.5 years), 5 years.

ED wait times

AKA ‘12 - Shorter Stays in Emergency Departments’
We can only find published data for:
- 2019/20 Q4 to 2020/21 Q4
- 2022
We asked Te Whatu Ora/Health NZ for all available ED wait time data for all periods via an OIA (Official Information Act) request but they refused saying “We are refusing this part of your request due to substantial collation under s18(f) because collating information with requested breakdown would take Te Whatu Ora employees away from their other core duties and would take significant number of days to extract from source data.”
You can see a visual representation and analysis of the most recent 2022 data at https://www.thefacts.nz/equality/ed-wait-times-2022/.

Faster Cancer Treatment

AKA ‘6 - Faster Cancer Treatment’
‘The 31-day faster cancer treatment measure is calculated as the proportion of eligible cancer patients who receive their first treatment within 31 days of a decision to treat by a health professional.’ It was 62 days under National.
We can only find published data for:
- The final 6 months of 2022.
Te Whatu Ora/Health NZ also refused to provide more data with the same OIA reply as above.

Elective surgery wait times

AKA ‘Access to planned care’ and ‘9 - Long Wait times (>12Months) for Surgery and FSA’
We can only find published data for:
- 2019 Q3 - 2022 Q2
- 2022.
Te Whatu Ora/Health NZ also refused to provide more data with the same OIA reply as above.

Other health metrics:

From Te Whatu Ora/Health NZ Health System Indicators
- General references and notes:
  - Health System Indicators framework - draft (there are no timeframes/dates on this page, but click on ‘Download data (.csv) for various 2018-2022 data ranges)
  - National Performance Reporting Metrics for January - December 2022 (we can not find reporting for 2023)
  - Under these Health System Indicators, all ethnicities have been consolidated down into just 3 ethnic groups:
    - Māori
    - Pacific peoples
    - Non-Māori non-Pacific
- Ambulatory Sensitive Hospitalisations (ASH)
  - 2 - ASH 0-4 (children 0-4 years).
    - We can only find published data for:
      - 12 months to Mar 2018 - Sep 2022
      - 2022.
      - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
    - We are not sure why this metric is only for 0-4-year-olds and not other children.
  - 4 - ASH 45-64 (adults 45-64 years).
    - We can only find published data for:
      - 12 months to Mar 2018 - Sep 2022
      - 2022.
      - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
    - We are not sure why this metric is only for 45-64 year-olds.
- Mental health
  - 3 - Mental health wait times (<25s only).
    - AKA ‘Under-25s able to access specialist mental health services within three weeks of referral’
    - We can only find published data for:
      - 12 months to Mar 2018 - Sep 2022
      - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
    - There is only a 12-month figure published for December 2021 to November 2022. We are not sure why this metric is only for < 25-year-olds.
  - Access to primary mental health and addiction services.
    - In development.
- 5 - Acute bed days.
  - AKA ‘Acute hospital bed day rate’
  - We can only find published data for:
    - 12 months to Mar 2018 - Sep 2022
    - 2022.
    - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
- First specialist assessment
  - AKA ‘7 - ESPI 2 (Elective Services Patient Flow Indicators) - Patients waiting longer than 4 months for their first specialist assessment’
  - We can only find published data for:
    - 2022.
- 8 - ESPI 5 - Patients given a commitment to treatment but not treated within 4 months.
  - We can only find published data for:
    - 2022.
- 10 - Emergency Department Presentations.
  - We can only find published data for:
    - 2022.
- 11 - Emergency Department Admissions.
  - We can only find published data for:
    - 2022.
    - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
- Participation in the bowel screening programme.
  - In development.
- People report they can get primary care when they need it
  - We can only find published data for:
    - 2020 Q3 - 2022 Q4
    - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
- People report being involved in the decisions about their care and treatment
  - We can only find published data for:
    - 2020 Q3 - 2022 Q4
    - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
- Financial performance:
  - Annual surplus/deficit at financial year-end
    - Blank answer given here
    - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
  - Variance between planned budget and year end actuals.
    - A blank figure showing for Jan-Mar 2019.
    - Plus some information on https://hqschqi.shinyapps.io/HSIapp/_w_cae171c0/#!/summary with no dates/timeframes cited.
National Health Targets created by the National Party that weren’t continued under Labour:
- Better help for smokers to quit.
  The target is 90 percent of PHO enrolled patients who smoke have been offered help to quit smoking by a health care practitioner in the last 15 months and 90 percent of pregnant women who identify as smokers upon registration with a DHB-employed midwife or Lead Maternity Carer are offered brief advice and support to quit smoking.
- Raising healthy kids
  The target is 95 percent of obese children identified in the Before School Check (B4SC) programme will be offered a referral to a health professional for clinical assessment and family based nutrition, activity and lifestyle interventions.
- Heart and diabetes checks
Targets proposed by the Labour-led Government in 2007 that were not implemented under the National-led Government in 2008 (although they did add ED wait times):
- Mental health
- Oral health
- Nutrition
- Physical exercise

We will continue to update this health section as we make progress in this difficult area. Given the complexities and confusion across all of these web pages and files, we have no doubt made a mistake somewhere above. If you spot an error, please let us know via the comments below!

Discarded

Health workforce.

This is an input, not an output measure. More spending and staff are useful measures but don’t necessarily lead to better outcomes. Outcome-focused KPIs are best.

Related facts

MMR vaccines expired and destroyed
Deaths per day and by cause
Adult obesity (2020/21 data which was the last time this was measured)
ED wait times 2022
Water supply compliance
Drugs in wastewater testing
Vaping ban poll
Sick leave allowance
Road deaths over time
Road deaths by gender
Suicides by gender (2021 data)
Covid

Wishlist

With support, we’ll be able to add multiple KPIs for each issue:

Updates on many of KPIs listed above.
Elective surgery volume
Alcohol abuse
Smoking/vaping
Mental health
- Overall wellness measure
- Hours worked
- Anxiety
- Stress
- Depression
- Loneliness
- Suicide per capita (a highly contested figure by those helping in this space)
ICU beds (this is reflected in the ED, elective surgery, and cancer wait times)
Aged care and hospice beds
Life expectancy

Governments over the timeframe shown

2008 = National + ACT, United, Māori
2011 = National + ACT, United, Māori
2014 = National + ACT, United, Māori
2017 = Labour/NZ First+Green
2020 = Labour+Green

Data published by Te Whatu Ora/Health New Zealand
© Crown Copyright
Licensed for use under the creative commons attribution licence (BY) 4.0

If you spot a typo, mistake, or improvement opportunity for this page, please let us know via the comments below or contact us!