Estimates Debate — Vote Health

On behalf of New Zealand First, I rise to speak in the estimates debate. It was pleasing to see there is an increase in the health budget of 3.5 percent. The increase can be considered to be an attempt to regain our First World health system. The Minister of Health, in her Budget debate speech, stated that our rate of intervention lagged well behind that of the international average of countries like Australia, Canada, and Britain that we often compare ourselves with, and we hope that this Budget increase will make a difference to those statistics. On a positive note we are pleased, too, that the Government is taking some constructive steps in addressing meningococcal disease. While that is a little late in coming, we support its efforts on that front. They are definitely needed. Many parents, particularly in south Auckland, have welcomed the initiative, and we know that there are many other parents right throughout New Zealand who are anxiously waiting for the treatment regime to come to their area.

Although the Government has made some improvements with the cancer control strategy, we in New Zealand First still find it very disturbing that we require our cancer patients to travel to Australia for treatment. If we want to have a First World health service, we need to be able to treat those patients at home. It was very disturbing to read the article titled “The big C” in this week’s edition of the Listener, which stated: “When it comes to surviving cancer, you’re better off living in Australia, or just about any developed country, than here.”

That is quite disturbing. The article lists many shortcomings that we are all aware of: issues like waiting times for radiotherapy and surgery, workforce shortages, flagging research, and lack of funding for drugs that are available in Australia. We all know that delays in treatment here cost lives. We need really good coordinated care, allowing patients to be investigated and diagnosed quickly, and to have the proper access to treatment right here in New Zealand. We presently have piecemeal services and fragmented information about those patients. It is to be hoped that the implementation plan for the New Zealand cancer control strategy will be completed on time, at the end of July, and that the strategy and the increase in the health budget may, hopefully, address many of the shortages that were listed in the article.

One of the areas, too, that is of prime concern to New Zealand First is that of dental care for adolescents. We know that area is in a state of crisis, with very few dentists offering a free service for high school children because it is not worth their while to provide it. We believe that urgent action is required, because lack of oral health-care results in other problems that are far more expensive to treat. It is rapidly getting to a situation in which free dental care for adolescents is difficult to access, which is leading to a situation in which those who can afford to pay for the dental service do so and those who cannot pay go without. So it is really time for the Minister to become proactive in that area. I know she has said she has some good ideas that she will work through, so that adolescents receive dental care in a timely manner.

Free health-care for under-6s must really mean free health-care, not health care with additional fees. We are now reaping the results of several years of successive Governments not providing a subsidy to doctors that is adequate to ensure that all under-6s get free doctors’ visits. We are seeing rampant glue ear and asthma rates in low socio-economic areas, and that is all preventable with the right care. We hope that some of the additional money put aside in the Budget will actually be used for that purpose.

One other area of concern for New Zealand First is the need for nurses to be paid adequately, in order to ensure that we stem the flow of qualified nurses and doctors to Australia and elsewhere. We know that nurses are the basis of our health-care system, and they are now leaving New Zealand in greater numbers than ever before.

I would like to focus initially on one particular aspect of the health budget, which is the implementation of the Government’s recently released Healthy Eating - Healthy Action plan to reduce obesity in New Zealand. The Ministry of Health recently put out a report that acknowledged 8,000 to 9,000 New Zealanders die from what it called dietary-related risk factors a year. That is so astonishing that it is almost hard to believe, but it is true, and it therefore suggests that much of our focus in health should be on improving the diet of New Zealanders. Twice as many people are estimated to die from dietary-related factors than from smoking, but whereas the Government has put a tremendous across-the-board effort and resources into a major effort to reduce the health risks of smoking, when it comes to the healthy eating plan and the tackling of obesity, it has, unfortunately—and to our great astonishment— provided no new resources. We looked in vain through the Estimates for such resources. Essentially, the Government is full of wonderful recommendations and good ideas, but there are no resources and no national leadership, and there is a laissez-faire approach that basically relies on voluntary action by the food industry. It treats the whole issue of obesity as if it could be solved by personal responsibility. Unfortunately, that wonderful plan with all its wonderful ideas has about as much chance, in my view, of curbing obesity in New Zealand as I have of flying to the moon.

What is needed, if we are to turn around and improve the diet of New Zealanders and, in particular, our children, is leadership, resources, and for the Government to be prepared to tackle the hard issues. There is nothing here in the Estimates calling for any restrictions on the advertising of energy-dense, low-nutrient foods for children, which the World Health Organization states is one of the major underlying issues that contribute to obesity, and nothing about removing the selling of high-sugar soft drinks from schools and hospitals, or even a requirement for comprehensive nutrition education in all schools and preschools—or, indeed, for the teaching of cooking skills in our schools.

When the Minister came before the select committee she said the Government was not going to take a bossy nanny State approach, and the food industry had shown great willingness to work on this issue.

We are delighted if the food industry is prepared to collaborate with the Government, but we ask whether the food industry’s collaboration is part of a public relations initiative to try to stave off the necessity for regulation. I suspect it is the latter, and, frankly, it is naive to expect the industry to curb its highly profitable promotion of fatty, sugary foods to children. We have had the experience of the marketing undertaken by the tobacco and the baby milk industries, which has shown that voluntary approaches are ineffective. They are great for public relations, but they do not actually bring about the changes that are needed if we are to seriously reduce the number of New Zealanders who die of dietary-related factors from the present level of 8,000 to 9,000 a year. The World Health Organization points out that for every dollar that it spends on trying to improve the nutrition of the world’s population, $5 is spent by the food industry on promoting unhealthy processed food.

The truth is there is so much pressure on children to eat unhealthy food that it is becoming more and more difficult for parents to get children to eat ordinary nutritional food—to eat a healthy balanced diet. We have children who are becoming addicted to bad eating habits and to unhealthy food at a very young age, and that can, of course, condemn them literally to a lifetime of ill health. So there is little point in fiddling around the edges and trying to say all sorts of wonderful platitudes about our concern about obesity in New Zealand, if we are going to allow the children of our nation to be bombarded with unhealthy food.

I rise on behalf of ACT New Zealand to speak to the 2004-05 Vote Health estimates. I recently asked a question of the Minister of Health about the funding for Plunket Line for the forthcoming year 2004-05, and the Minister was not able to answer my question. She was not able to tell me, at the time anyway, that the Plunket Line funding was actually going to be very dependent on the funding for Healthline, because Plunket Line was about to be incorporated into the American-based system of Healthline. In fact, it has been contracted to an Australian branch of the 16th biggest company in America. So Plunket Line, which like Plunket itself has become a New Zealand icon since its inception in 1994, is really now on its last legs.

Plunket Line has helped hundreds of thousands of New Zealand families over the last 10 years. At the same time that Plunket services have been progressively withdrawn and made less available to New Zealand families, Plunket Line has taken up the slack and has been available in a very timely fashion to young parents and caregivers who are experiencing difficulties with their young families and young children. It was with great sadness yesterday—for the ACT party and for those of us on this side of the House—that we saw a 4-page press release from the Minister of Health telling us of Plunket Line’s demise and trying to put in very positive terms the fact that Healthline would be taking it over.

We should look back to the 1999 election. Just before the general election, the then Leader of the Opposition, Helen Clark, and the health spokesperson for the Opposition, Annette King, both lent their support to Plunket Line. Not only did they lend their support to it, they backed it to the hilt. They launched a petition, gathering 60,000 signatures, and promised—and many New Zealanders remember this—that under a Labour Government Plunket Line would not close due to a lack of funding. It was one of the credit card pledges—squashed on to that tiny little credit card—and was one of the most important planks for the Labour Government. What do we see today? Five years later, we are seeing the demise of Plunket Line and it being absorbed into Healthline.

My parliamentary questions have shown that the 0800 number for Plunket Line—the thing that has helped Plunket Line retain its unique identity—is also to go. Members should not listen to the talk about the 0800 number being retained, because I have a reply to a parliamentary question that states that as Healthline is rolled out, the 0800 number will remain until it is replaced by a single number, where callers can choose to receive well-child and parenting advice.

When people ring Plunket Line they have already chosen whom they want to speak to. They do not want to speak to somebody reading off a computer screen; they want to speak to a Plunket nurse.

💬 Jill Pettis: I managed to bring up my son without ringing anybody except my mother.

Perhaps the member would like to take a call.

An announcement was made yesterday, but it would appear that things are not as rosy as the Minister of Health, Annette King, tried to make out in her 4-page press release. We know that this would have been a big news item last night had not the Minister of Health refused to speak to Television New Zealand. The reason she refused to be interviewed by Television New Zealand is that the Prime Minister was caught off guard. When she was asked about Plunket Line she did not know what was happening, despite the fact that she had made such a song and dance in 1999. The item that was screened about 2 weeks ago is now the subject of an ongoing complaint. So the Minister of Health will not speak to Television New Zealand about Plunket Line, because she is very unhappy with the decision to roll it into Healthline.

Sir Truby King, who was responsible almost 100 years ago for the establishment of Plunket to help families, would turn in his grave if he knew what had happened—under a Labour Government—to the state of Plunket in this country, and now to Plunket Line. Plunket Line is about to be disestablished.

It is very frustrating to sit here and listen to the garbage coming from the ACT member, who is intent on unnecessarily stirring up and putting fear into the minds of parents up and down this country.

💬 Hon Bill English: Plunket Line is gone.

Plunket Line has not gone. Under the tenure of the Hon Bill English, Plunket almost went down the drain. We stepped in and secured its future. All one has to do is ask the chief executive of Plunket himself, Mr Paul Baigent, who says that the move is an exciting one for Plunket Line, because it secures its future. It will provide a 24-hour, nationwide service. The problem with the Opposition speakers in the debate, and with Mr English as well, is that they will not listen and they do not want to hear the truth.

The fact is that Healthline has been piloted in my region, along with the regions of Northland, the East Coast, Gisborne, and Canterbury, very, very successfully, providing a service for people who have neither the transport nor the ability to get directly to a general practitioner, a nurse, or an emergency department, and the assessment of Healthline has been very, very positive. In fact, 97 percent of people calling had a higher satisfaction rate than was expected, and 85 percent of calls were answered within 20 seconds. I doubt whether there is another health service in the world that could match that sort of service delivery.

The fact is that Plunket Line, which was an invaluable service for parents up and down this country, has been under constant threat. Plunket admitted that it has struggled to get funding for that ongoing service. The Government has secured Plunket Line along with Healthline, and committed to roll out that service to the entire country. We ran the four pilots on Healthline, proved its success, and then moved to secure Plunket Line services for parents throughout this country. That is a good-news story. No matter what Heather Roy does to try to twist that around, that is one of the success stories of this Government, along with the billions of dollars of funding.

💬 Hon Bill English: Why didn’t the Minister go on television?

I cannot speak for the Minister. I am not concerned, and I am not sure whether the Minister is concerned, about going on television. Mr Bill English is suffering from withdrawal symptoms. He finds it hard to get on television now. The Minister does not have to go on television to roll out what is one of the most crucial, vital, and appreciated services in this country in order to secure its future.

The Plunket Line is being wrapped in with the Healthline, and it will now be extended across the whole country. This is another of the remarkable success stories that we have rolled out across this country under a Labour-led Government in the area of health care.