Part 2: Reasons for introducing a strategy for delivering scheduled services

2.1
In this Part, we discuss the introduction of the Strategy and its principles and main objectives.

Introducing the Strategy in 2000

2.2
Booking systems were introduced in 1996 to replace waiting lists, and all public hospitals were to have a booking system in place from 1 July 1998. In 2000, the then Government's response to problems that arose with the booking systems was to release the Strategy, which changed the booking systems and introduced other measures.

2.3
The Strategy states that the quantity of scheduled services that taxpayer funding can support is limited. Under the Strategy, public hospitals are expected to tell patients if they are unlikely to receive, or will not receive, publicly funded scheduled services. Patients who are not offered scheduled services can have their condition managed in some other way, such as by their GP or in the private sector. Otherwise, they wait until their condition worsens enough to qualify for publicly funded treatment.

2.4
By implication, the Strategy acknowledges that scheduled services will be delivered jointly by the public and private health systems. Many factors determine the specific contribution of the private health system, such as whether the public health system offers the service and whether services offered are enough to meet the health need. Whether patients get scheduled services in the private sector is also affected by:

• their willingness to accept the rules used to decide their access to scheduled services in the public system;
• how long they may wait for scheduled services at a public hospital; and
• whether it is feasible for them to opt out of the public system.

The Strategy's principles and objectives

2.5
Three principles – clarity, fairness, and timeliness – underpin the Strategy's four main objectives, which are to ensure:

• that patients wait no more than six months for their first assessment with a specialist (first specialist assessment, or FSA);
• that all patients with a level of need that can be met within the resources (funding) available are provided with surgery within six months of assessment;
• a level of publicly funded service that ensures access to scheduled services before patients reach a state of unreasonable distress, ill health, and/or incapacity; and
• national equity of access to scheduled services, which means that patients with a similar level of health need and ability to benefit from treatment have similar access to scheduled services, regardless of where they live.

2.6
The Strategy identified seven sub-strategies to achieve these objectives. We have focused on the first three of these, and the actions to implement them, because they are the most important to patients. They are:

• give patients certainty;
• achieve nationally consistent clinical assessment; and
• increase the supply of scheduled hospital services.