Health Productivity

Rodney Parsons made this Official Information request to The Treasury

Response to this request is delayed. By law, The Treasury should normally have responded promptly and by (details and exceptions)

From: Rodney Parsons

Dear The Treasury,

Treasury is quoted as suspecting a decline in productivity as measured by a decline in "case weights per FTE" (https://www.nzherald.co.nz/nz/politics/d...).

Presumably treasury is referring to the WIES measure? Can treasury confirm this.

Can treasury also confirm that it has received advice from Ministry of Health and Te Whatu Ora of the following:
- NZ's use of Victoria' WIES measure has morphed well beyond the intended use, with the core structure being broken by the separate creation of the neonatal weighting, meaning that there ceased to be a single national weighting some years ago.
- Rather than head warnings from Australia about this weighting, NZ decided to take a short term adjustment with multi-billion dollar consequences which have also driven health decisions for a number of years.
- The WIES implementation effectively "broke" in mid-2022, meaning that the current implementation is no longer valid.
- MoH has been aware of this for several years and pre-reform had a team exploring a transition to the Australian Independent Health and Aged Care Pricing Authority (IHACPA) National Weighted Activity Unit (NWAU), however the plan was deprecated during the reform and doesn't appear to have been adopted.
- Due to the failed national data integration, the activity weightings have not been reliable since 2021-22, and a simple explanation for some of the activity reductions is loss of the data, rather than a real under-activity position.
- Along with the publicly acknowledged difficulty in tracking FTE, this means that treasury's productivity measure is very unreliable - can treasury outline its uncertainty calculations on that figure.

In all, can treasury confirm that it's measure of outputs (WIES) is broken, and combined with the uncertainty around inputs (FTE), that treasury cannot be certain what productivity levels for health actually are. Given information uncertainty is common, can treasury disclose any Value of Information measurements it has undertaken, and any steps taken with MoH and HNZ to rectify the health costing/weighting system.

Yours faithfully,

Rodney Parsons

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From: Ministerial Services Inbox [TSY]
The Treasury

Good afternoon

Thank you for your request under the Official Information Act 1982, which was received on 2 November 2024. A response will be provided in accordance with the Act.

The Treasury may publish the response to your Official Information Act (OIA) request. When you are provided with a response to this request, you will be informed about whether the response to your OIA request will be published. If the Treasury does publish the response to your OIA request, personal information, including your name and contact details, will be removed. This publication process does not apply to extension letters or transfers.

Ngâ mihi

Bradley Martin| Senior Ministerial Advisor | Te Tai Ôhanga – The Treasury
Visit us online at https://treasury.govt.nz/ and follow us on Twitter, LinkedIn and Instagram
[IN-CONFIDENCE]

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From: Ministerial Services Inbox [TSY]
The Treasury


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Good afternoon

 

Please find attached the response to your request for information.

 

Ngâ mihi

 

Bradley Martin| Senior Ministerial Advisor | Te Tai Ôhanga – The Treasury

Visit us online at [1]https://treasury.govt.nz/ and follow us on
[2]Twitter, [3]LinkedIn and [4]Instagram

[IN-CONFIDENCE]

 

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From: Rodney Parsons

Dear Ministerial Services Inbox [TSY],

We provided information as part of the request to help you focus on the information requested. Unfortunately that appears to have been used to decline the request, and so the OIA dance begins.

To clarify the request, Treasury has made a statement about productivity in Health NZ. Please provide the basis for how that assessment was made, which is official information and not contained on the website. We note that when opinion is provided by policy advisors in the form of advice, this becomes official information. We're happy that you interpret that pragmatically, aware that you hold it (following discussions with HNZ and Treasury personnel), so welcome this progressing positively rather than becoming a game of interpreting the request in way that allows you to draw out providing the information that you hold on this, as that will result in appropriate action.

Yours sincerely,

Rodney Parsons

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From: Ministerial Services Inbox [TSY]
The Treasury

Dear Rodney

Thank you for your further reply.

The relevant Treasury team has clarified that the comment quoted by the NZ Herald was based on an analytical report the Treasury received from Health NZ (about productivity in the Hospital and Specialist part of the health system), rather than analysis undertaken separately by the Treasury.

The Treasury does not hold official information (including in any of its advice to Ministers which as you say is included in the definition) that would relate specifically to the questions in your original email. As your request asks for confirmation of Treasury’s views about the WIES measure, we also couldn’t transfer your request to Health NZ, as they would not hold that information either.

You are welcome to request, either from the Treasury or from HNZ, the analytical report HNZ provided to Treasury on Hospital & Specialist System productivity. That report has information more about the measures it presents, though it does not contain any Treasury opinion on those measures. It may be most efficient for you to request that report directly from HNZ if you want it, as we would have to consult with them on any redactions, but you are also welcome to request the document from us if you prefer.

I hope this information is helpful.

Ngā mihi

Bradley Martin| Senior Ministerial Advisor | Te Tai Ōhanga – The Treasury
Visit us online at https://treasury.govt.nz/ and follow us on Twitter, LinkedIn and Instagram
[IN-CONFIDENCE]

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From: Rodney Parsons

Dear Ministerial Services Inbox [TSY],

There does seem to be a continued misunderstanding of what my question is, which should be fairly straightforward to answer given the magnitude of the assertion attributed to treasury.

If you could please provide a copy of that report, and I'll revert with further clarification once it's been reviewed.

Yours sincerely,

Rodney Parsons

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From: Ministerial Services Inbox [TSY]
The Treasury

Dear Rodney

Thank you for your request under the Official Information Act 1982, which was received on 26 November 2024. A response will be provided in accordance with the Act.

The Treasury may publish the response to your Official Information Act (OIA) request. When you are provided with a response to this request, you will be informed about whether the response to your OIA request will be published. If the Treasury does publish the response to your OIA request, personal information, including your name and contact details, will be removed. This publication process does not apply to extension letters or transfers.

Ngā mihi

Bradley Martin| Senior Ministerial Advisor | Te Tai Ōhanga – The Treasury
Visit us online at https://treasury.govt.nz/ and follow us on Twitter, LinkedIn and Instagram
[IN-CONFIDENCE]

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