{"id":7713737,"date":"2025-08-11T03:44:31","date_gmt":"2025-08-11T03:44:31","guid":{"rendered":"https:\/\/orionhealth.com\/?p=7713737"},"modified":"2025-09-15T23:35:53","modified_gmt":"2025-09-15T23:35:53","slug":"rethinking-planned-care-for-equity-and-sustainability","status":"publish","type":"post","link":"https:\/\/orionhealth.com\/global\/blog\/rethinking-planned-care-for-equity-and-sustainability\/","title":{"rendered":"Rethinking Planned Care: Designing equitable, sustainable surgical systems"},"content":{"rendered":"\n

Planned care, covering a wide range of scheduled medical and surgical treatments, is under immense pressure globally. Commonly referred to as elective care<\/em>, this term has unfortunately contributed to a damaging misconception: that such procedures are optional.<\/p>\n\n\n\n

In truth, delayed access to joint replacements, hernia repairs, and cataract surgeries causes prolonged suffering, loss of independence, and worsened disability. The current model is failing many and failing them unequally.<\/p>\n\n\n\n

Why Planned care must be prioritised, not optional<\/h2>\n\n\n\n

In Aotearoa, New Zealand, people living in rural areas, experiencing socioeconomic deprivation, or identifying as M\u0101ori, Pacific, or disabled, wait longer and face systemic barriers to access. The Office of the Auditor-General has highlighted these inequities, showing that regional inconsistency, poor visibility of unmet need, and incomplete data on disabled patients all contribute to a fragmented system.<\/p>\n\n\n\n

Under the Pae Ora (Healthy Futures) Act 2022<\/em>, Health New Zealand is mandated to deliver equitable services. Yet, access remains deeply uneven. Planned care must be reframed as a core component of health equity, not a nice-to-have.<\/p>\n\n\n\n

Short-term fixes are exacerbating long-term inequities.<\/h2>\n\n\n\n

The government has turned to private sector outsourcing and surgical hubs to address long wait times. While these strategies can improve throughput for low-complexity cases, they risk entrenching inequity.<\/p>\n\n\n\n

Patients with comorbidities or frailty, who are often the most in need, are frequently excluded, not due to clinical need, but because they don’t “fit” into simplified private sector models. This creates a de facto tiered system: the healthy and insured at the front of the queue, while the public sector manages complex cases with increasingly strained resources.<\/p>\n\n\n\n

\"Graph
Counts of publicly funded hospital discharges, by private or public hospital type over time in New Zealand<\/strong>
Source: Te Whatu Ora<\/a><\/figcaption><\/figure>\n\n\n\n

What International Health Systems are doing differently<\/h2>\n\n\n\n

Globally, many countries have adopted multi-pronged approaches to reduce waiting times effectively. A comprehensive systematic review has identified seven high-impact strategies, including:<\/p>\n\n\n\n