National wants health performance targets back as new data shows one in four people waiting over six hours to be seen in emergency departments.

Health Minister Andrew Little has hit back, saying targets lead to "gaming" of the system with true results hidden, while a health researcher says they can be effective as long as the system as a whole is properly resourced.

Across the June quarter in MidCentral DHB just 54.8 per cent of patients were seen within six hours, and Capital and Coast 56.2 per cent.

Nationwide the figure sat at just over 76 per cent - down from just over 90 per cent in June 2020 as the Covid-19 response ramped up.

In 2009, the then-National government implemented a Shorter Stays in Emergency Department target of 95 per cent of patients being admitted, discharged or transferred within six hours.

While Labour officially dropped this target, it has kept track of the measurement.

Pressure meanwhile is being applied across the entire health system, with tens of thousands of people waiting for planned - or non-urgent - surgery, with wait times worsening due to the Covid-19 pandemic.

In June, there were over 35,000 people who had been waiting longer than four months for surgery, nearly triple the number there was in December 2019, just before the pandemic.

The number of people waiting longer than 12 months for a first specialist appointment – after being referred by their GP – has increased over the course of the pandemic by 17-fold, from 253 to 4255 patients.

The Planned Care Taskforce, set up in May to address these pandemic-related backlogs, on Tuesday delivered 101 recommendations to Te Whatu Ora/Health New Zealand to cut surgical wait times - but no targets for when they would be achieved.

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The figures and announcement come as pressure mounts over the death of a 4-year-old boy in a Wellington hospital last month.

Neil Sebastian "Sebby" Chua died on September 26 at Wellington Regional Hospital five days after he began complaining of a sore neck.

Parents Neil Arvin Chua and Abegail Chua have now lodged a complaint with the Health and Disability Commissioner concerning what they considered to be poor care for their son.

National's health spokesman Dr Shane Reti said using performance target measures would save lives.

Reti pointed to 2017 research published in the New Zealand Medical Journal that found thousands of lives had been saved through the six-hour wait time target for hospital emergency departments, which researchers said had helped halve the number of ED patient deaths.

The researchers also found EDs are running more efficiently than before the Government introduced the target in 2009, with patients waiting around three hours less to be admitted to a ward.

Reti said that currently there were people stuck on waiting lists who were becoming sicker and even dying before they could get surgery.

"They were well when the surgeon put them on the waitlist, but 12 months later, they're now so ill, they're being exited from the waitlist.

"They've waited that long. That's not fair."

Health Minister Andrew Little hit back, saying hospitals were managing their planned care waiting lists as best as possible.

The plan released on Tuesday would address both short and long-term issues, he said.

On ED wait times, Little said people there were still in the right place to get care.

"Pretty much all those people, they are not waiting with nothing happening.

"They have been assessed, triaged, the condition known and it is the right place for them to be to be waiting because if they do deteriorate, that is the best place to get care."

Little said while they kept track of wait times as a measurement, having targets and requirements could lead to "deception".

He referenced a 2020 research paper that found some examples of "gaming".

"The research found [targets] led to manipulation, and frankly deception, about the quality of management of patients.

"I don't want to repeat that.

"It is important that we have that short-stay emergency department measure and when it's low, that's a reason for management to intervene, not for clinicians to sort of manipulate things so that the figures look better the next time."

University of Auckland's Dr Peter Jones was involved in both studies referenced by the politicians.

"It just shows how you can make the data say what you want it to say," he told the Herald.

Jones said targets themselves were not the issue, and in most cases were effective, but rather how they were implemented.

Jones worked in the United Kingdom when performance measures were introduced and he saw firsthand instances of "gaming", including "clock-stopping" and moving patients to other units to avoid target breaches.

While their research had found some instances of gaming in New Zealand it was not to the same extent as in the UK, where there were financial incentives, he said.

Jones said issues occurred mostly where there was poor monitoring and motivation to "game", which could be addressed.

There also needed to be appropriate resourcing and a holistic view of the health system, so areas without targets were not neglected.

Jones said the stories coming out of emergency departments currently were like "déjà vu " looking back to the years before health performance targets were first introduced in 2009.

Since 2015 pressure around the targets had eased, and so issues had started to ramp up again, Jones said.

"It's not really the target. It's how you implement it.

"So if you're honest, and truthful, to the intent behind the targets, which will improve health systems so that they work more efficiently and people get better quality of care, then that's great.

"But if you're just trying to meet a number, then you're missing the whole point."

Jones said one of the biggest issues in the health sector was staffing and resources.

"There's nothing wrong with the measures. We just need to actually make them count, and we need to resource the system so that the measures will be met."