This is what happens when you abandon health targets

Stuff reports:

the reluctance or refusal to vaccinate despite the availability of vaccines – is now considered one of the top ten threats to global health.
This doesn’t just mean active anti-vaxxers. It means parents who aren’t sure. It means those who delay vaccination, because it seems like the easier decision.

This is timely with the growing number of measles cases in NZ. And let’s look at the change in vaccination rates in the last ten years.

So from the year ending 30 June 2009 to year ending 30 June 2017 the 24 month vaccination rates increased from 80% to 93% for all children and from 73% to 93% for Maori children.

This didn’t happen by accident. The last National Government made lifting vaccination rates both a national health target but also one of the 10 all of Government Better Public Services targets.

Committing yourself in public to an actual measurable outcome (not just spend more money and hope) is risky. It is a public failure if you don’t get an improvement. But they worked for almost all targets. With leadership from the Government, the public health staff responded to the target and got a huge improvement. In fact in 2017 the Maori vaccination rate (historically low) was slightly higher than the overall rate.

But what happened when the Government changed. The Government first scrapped all the Better Public Services targets. They didn’t want to commit to anything measurable. But even worse they also scrapped all the health targets. They promised that they’d come up with some new targets, but two years later they haven’t.

And what has happened to vaccination rates in the two years since Labour scrapped the targets? The overall rate has dropped 2.4% and the Maori vaccination rate has dropped 7.1%.

It is easy to blame anti-vaxxers and the like. And we should blame them. But we should also blame the Government for abolishing the health targets around vaccinations and the BPS target. These were tools with a proven record of success and they dumped them because they didn’t want the accountability.

UPDATE: A few people on Twitter are claiming that Labour didn’t abolish the immunisation health target as there is still an MOH page collating data for it.

The reality is that Labour did announce they were dropping the health targets when they became Government. Then facing an outcry, they said they’ll come up with some new and better health targets. Two years later they have been unable to come up with a single one.

In the interim yes the MOH still collates data on the old health targets but that is all they do. They are not published in newspapers as they used to be. The Minister doesn’t follow up with DHBs that are under performing. They are no longer the first item on every DHB’s agenda. The DHBs know that there is no longer a political price to pay for not meeting the targets.

Some have also claimed that there have been measles outbreaks around the world, so it is not just a NZ problem. Well firstly I never mentioned measles in my post. I’m talking all immunisations. And we had a clear trend where the rate increased and it is now decreasing.

The fact NZ managed such a huge increase in the vaccination rate shows that leadership can make a difference. It can’t get you to 100% as there is always a hard core you can’t reach, but DHBs do respond to incentives and the Government setting a small number of clear targets does work – or at least it used to.

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