Estimates Debate — Vote Health

It is an absolute pleasure to speak on the estimates of Vote Health, because the National Government has been growing and protecting our public health service during very tough times. In fact, these latest estimates are a benchmark in showing that we are investing $14.1 billion in health. This is $2 billion more than was invested back in 2008, and we are making every endeavour to ensure that every health dollar is well spent, with better services and less bureaucracy.

Undoubtedly, it is quite extraordinary that this Government has been prepared to continue, during these tough times, to invest in this very vital area of health, in education, and, of course, in science and innovation—all areas where the increased investment has occurred. I think it was particularly significant a few weeks ago when under the excellent leadership of the Hon Tony Ryall it was pointed out that New Zealand had the third-highest growth in health spending of 28 OECD nations for 2009-10. This is quite remarkable, as the average growth of health investment by OECD nations was zero. During these tough times, there have been quite a few countries that have actually reduced spending, such as Denmark, Norway, and the UK, where there have been considerable funding cuts. We have seen New Zealand continue to invest in health, with spending increasing by 3.4 percent per year in real terms, which is a very remarkable record. We now have the fifth-highest level of public health spending as a percentage of GDP in the OECD. This may or may not be a great thing, but I believe that in New Zealand’s case, where we are concentrating on increasing productivity and increasing front-line services, we are, indeed, making great headway.

I think we have seen across the spectrum in the world—for example, countries like Singapore, which has a remarkable spend on health totalling about 4 percent of GDP, compared with Australia, which is a bit above us. I think for public and private we are at about 10 percent; public is probably at about 8 percent. Australia is a wee bit above that, and the UK a bit under.

💬 Hon Tony Ryall: A much younger population.

It has a much younger population, as you say. But the United States is at about 18 percent of GDP. In Singapore, Singaporeans live longer, and infant mortality is less than half of ours. So what we have got to do is exactly what the Government has been doing: increasing focus on diminishing bureaucracy, bringing in the front-line services, and ensuring that productivity is increased. This is in stark contrast with what happened with the previous Labour Government, which doubled the health budget, yet, in real terms, fewer people got operations—an awful indictment on those last years.

It is very, very encouraging when we look at what has happened to the health workforce over the last 4 years. Only today I got the updated numbers, and I understand we have delivered over 1,000 extra doctors in the last 4 years and 2,400 extra nurses in public hospitals. That is a pretty good record, because all we heard from the previous Labour Government was Annette King strutting around, talking about her workforce reports. She had 42 of them—42 of them in 9 years—with very little increase in the workforce during that time. It was a huge amount of talk.

It is very exciting, again, that this National-led Government has brought in a programme to combat rheumatic fever, a Third World disease, which, indeed, was identified by the previous Labour Government. It talked and talked but it did nothing. In these estimates there is an increase of $12 million, which adds to the previous $12 million, and already those children in various parts of New Zealand are being swabbed and treated as appropriate.

Of course, not only has the National Government done that but also it has insulated in the order of 140,000 homes—more than that, Tony Ryall says; it is more than that. One hundred and sixty thousand? It is something like that. Whatever it is, it is a significant amount, and a significant amount more than the previous Labour Government ever did.

Then we go on to elective surgery. Once again, the record of this National Government is extraordinary. Twenty-seven thousand extra patients a year are now getting elective surgery. Indeed, we have decided that there is going to be a new target. We are lifting our game by ensuring that all patients booked for elective surgery receive it within no more than 4 months by the end of 2014. That was something the Labour Government could never have dreamed of. What did it do? What was the term? “Cull”. It used to cull patients in their thousands—not just in their thousands but in their tens of thousands. Thirty thousand at a time were culled by the previous Labour Government from waiting lists.

I must say that I am very, very excited by the National Government’s record in immunisation, because it is spectacular. It is absolutely spectacular that only 4 years ago, for the average 2-year-old, the immunisation rate was 73 percent, and it has now boosted to 92 percent. In 4 years’ time it has gone from 73 percent to 92 percent. This is one of the most effective methods of preventive health that we know of, and, under National, it has been delivered. We have set a new and ambitious target for this as well: to have 95 percent of 8-month-old children fully immunised by the end of 2014.

I think it is worthwhile at this point acknowledging all those wonderful health professionals who are out there making this happen up and down the length and breadth of New Zealand. They have been absolutely wonderful, with the passion they have for their patients. I must say, I happened to be in Middlemore Hospital the other day with a relative who was having a baby, and the service she had was superb. Ten years ago there might have been six or seven shifts during a 24-hour labour, but while I was there one midwife came on for 12 hours during the day, and during the night there was another midwife for 12 hours. It was very, very impressive. Then my relative went off to a little country hospital in Pukekohe, where they looked after her just superbly. There was no rushing home; she was allowed to go home when she wanted to, when she was ready to go home, and when the breast milk was in. It was all being done under a new philosophy and a new efficiency where front-line services are being focused on by an excellent National Government.

I want to say that the zero fees for doctors’ visits for under-sixes scheme is also going extremely well under this Government. National has boosted the proportion of children under 6 receiving free doctors’ visits during the daytime to 93 percent. That has got to be pretty good. This is a massive improvement since 2008, when it was 70 percent—70 percent at the end of Labour’s tenure.

Ni hao. I also would like to speak about National’s commitment to growing and protecting our public health system. The honourable member Paul Hutchison has done an excellent job of elaborating some of those achievements. We are committed to delivering a strong, reliable public health system for all New Zealanders. This commitment is illustrated by our investment of $14.1 billion in health—the most ever—in Budget 2012. This investment is a clear signal that our National Government is delivering on our priority of providing better, sooner health care services for all New Zealanders.

As the honourable member Paul Hutchison just said, I am very proud of the National Government’s track record on delivering our health services. A recent OECD report said that out of 28 OECD countries, we had the third-highest growth in health spending for 2009-10—an increase of 3.1 percent in real terms, compared with the OECD average growth rate of zero. This investment in health has led to better services and less bureaucracy. Also there are a record number of patients now getting elective surgery, as the honourable member Paul Hutchison has just said. There are 27,000 patients a year who are getting operations such as hip and knee replacements. These people, who would otherwise be living their lives in discomfort, are now looking forward to a brighter future thanks to National.

We are offering better care for cancer patients. They have access to faster treatment, with radiation starting within 4 weeks for those who need it. National has expanded this target to include chemotherapy. Since National came to power in 2008 no patient has had to travel to Australia for radiation treatment. Under Labour some patients either had a 15-week wait for radiation treatment or had to be shipped to Australia because the health service was failing under Labour. Under the leadership of National, New Zealanders can be assured that they will be getting the best medical assistance, should they need the services of the public health system.

Other significant improvements under National have seen record successes of emergency departments treating patients faster. Ninety-two percent of emergency department patients are admitted, discharged, or transferred within 6 hours. Record numbers of children are being immunised—92 percent of 2-year-olds, compared with 73 percent under Labour—and record numbers of smokers are quitting. And we are not stopping there. We want to see more improvements so that New Zealanders have access to better, sooner health care. That is why 93 percent of under-sixes can now see their general practitioner for free during the day, compared with 70 percent in 2008. This year National has extended this to include free after-hours doctors’ visits, and 90 percent of children under 6 benefit from this. This has been possible because National has invested $65 million in the zero fees scheme over the past 3 years.

We are committed to eradicating rheumatic fever, with a doubling of our spending to $24 million in this year’s Budget to fight the disease over 5 years. This includes school-based sore throat swabbing services, involving 100 schools and 35,000 children, to help with the early detection of throat infections, which could lead to disease. Just the other week our Minister of Health announced that Auckland District Health Board will receive an extra $2.5 million over the next 3 years to improve productivity and provide more care for patients. That is good news.

The National-led Government is committed to building a brighter future for New Zealand. We are on track to achieve this. Thank you.

Nothing is more important to New Zealanders than their health. That is why this Government works every day with a huge number of very smart people in the New Zealand public health service to deliver better services for New Zealanders in these resource-constrained times. All around the world, health services are retrenching. They are cutting the services they offer their people, they are cutting the numbers of staff, and they are cutting the offering they have to the public. But here in New Zealand, under the leadership of both a Prime Minister and a finance Minister strongly committed to the New Zealand public health service, we continue to invest strongly. We continue to invest in priority interventions that will not only improve the health of individuals but also move to improve the health of the population within a framework of a need to get greater value.

I want to thank particularly the chairman of the Health Committee, Dr Paul Hutchison, who before he came to Parliament was one of New Zealand’s leading obstetricians and gynaecologists, for the work he does as chairman of the Health Committee. I thank him for the very strong interest he has, particularly in maternity and child health policy here in New Zealand. I think Dr Hutchison’s very strong focus on the importance of immunisation has to be recognised, but also I thank him for the very strong advice he has given to Parliament over a number of years about the need to invest in maternal and newborn health. I thank him for working with the Government on the significant announcements that will be made in the next few months about another very significant investment coming in the area of maternal and newborn health, and I thank him for the contribution he makes there.

The Government is very focused on improving child health in New Zealand. We worked hard to lift the immunisation rate, which has gone from 70 percent when we started to 93 percent today. In fact, the richest families and the poorest families have the best immunisation rates of 94 percent of their 2-year-olds at the moment. We have also invested very heavily in rheumatic fever. As Dr Hutchison said, it is a Third World disease that has an incredible impact on Māori and Pacific families in particular. It has actually been a national health strategy since 2001, when Annette King announced that it would be one of the Government’s health strategies. Basically, that Government did nothing, so we put in $12 million last year and another $12 million this year—huge. Tens of thousands of kids will be regularly throat-swabbed in order to try to really stamp out this rheumatic fever over a period of time.

This Government has also created a turning point in the fight against tobacco. We have created a turning point in the fight against tobacco. Information in the next couple of months, when it is released, will show that this Government, in a 4-year period, has delivered the most sustained reduction in smoking rates of any country in such a period. That information will indicate what happens when you have a focus on not only these sorts of punitive measures, which we might have seen elsewhere, but also the need to encourage people to change their lifestyle and their addiction to tobacco. That is the huge effort the Government has made to roll out brief intervention conversations between smokers and health professionals, not only in our hospitals but also in general practice. One of the most effective interventions to reduce smoking is to have those sorts of conversations, but, of course, the most effective, as Professor Blakely from the University of Otago said in the room opposite last night, is increasing tobacco excise tax.

The CHAIRPERSON (H V Ross Robertson): I am sorry to interrupt the honourable Minister, but the time, honourable members, has come for me to report progress.

Progress reported.

Report adopted.

The House adjourned at 9.56 p.m.