Estimates Debate — Health Sector

Members, we now come to the vote in the health sector—volume B.5, volume 6. The question is that Vote Health stand part of the schedules. The chairman of the Health Committee speaks first. I call Simon O’Connor. Mr O’Connor, your task is to set out the major findings of your committee in relation to the estimates.

You can rest assured, Mr Chair, that we will happily be speaking to the main findings of the estimates for Vote Health from the Health Committee. I always say it when I stand up, but it is an excellent, cooperative committee. It is one of those committees where generally we are in agreement with what we have to do for the betterment of the country. By and large, and I see my colleague Barbara Stewart nodding, we get that right. Obviously, there are a few tensions. You can indicate and see those in the report.

As context for what came through the estimates report, we are in a fine space for health. We know that the under-13-year-olds are now getting free GP visits and prescriptions—a really positive step there. One thing that I thought was really neat, which I had not been aware of until I was reminded, was that 94 percent of those under 8 months of age are now fully immunised. It is a huge step forward. If I may make a plug—

💬 Chris Bishop: How much?

94 percent. May I make a plug to those people out there to please vaccinate. It does not matter if it is your children, your teenagers, or older. It is very positive—there have been 44,000 more elective surgeries compared with 2007-08. So this is the context in which the estimates began and were heard. There is a 62-day target for patients to get their first cancer treatment. I will not go into the context of the past, but that is an incredibly good period of time, and something that I think the select committee—

💬 Brett Hudson: We’re up against the world.

I think it is world-leading, actually, Mr Hudson. But this is the context in which the committee began its discussions. We are putting in, it was acknowledged, further funding to allow 4,000 more elective surgeries a year. So, again, bear in mind that we have increased by about 44,000 surgeries a year, and we intend to push that higher towards 48,000—I would hope eventually 50,000. Hopefully, none of us will have to avail ourselves of this particular target, but 95 percent of those going into the emergency department are seen within 6 hours.

Vote Health is the second-largest vote in Budget 2015. It accounts for about 17.8 percent of the total appropriation, so be in no doubt—as this Committee will know—that health is a serious issue. We noted in our report that the vote increased by approximately 4.9 percent, so we are now spending about $15.868 billion—in fact, that is not approximate as that is what we are spending; let us be precise about that.

In fact, one of the things that we noted in our report is that $55 million of non-departmental capital has been moved and provided to help district health boards around deficit support. I mention that because I do not think we are under any illusion as a select committee, and, hopefully, as a House, that it can be tight for some district health boards. That was acknowledged also in the estimates with the Minister of Health. It goes without saying that the Minister is the Hon Dr Jonathan Coleman, and when I was reading out those positive lines at the start, I think it is incredibly important to note to the Committee that they are not purely the musings, thoughts, insights, or feedback of the chair of the committee; that was, in fact, the feedback of the select committee itself to the Minister.

I quote: “We congratulated Dr Coleman on his appointment last year as Minister of Health and expressed our satisfaction with the working relationship he has established with us.” Those were the words put forward at the questioning but also written up in the report, and I would like to thank all the members who contributed to that and the continuing positive relationship we have with the Minister of Health.

We noted that there has been a change in sector leadership. Those who follow the health sector will be aware that we have had an acting director-general for a while, Mr Chai Chuah. Very shortly before we moved into this estimates hearing he was made the director-general. We were curious about how that was beginning, and amongst other things we noted that surveys done recently have shown improving staff engagement, and we are looking forward to seeing more of that as it goes along.

Other areas we looked at were the demographics, particularly around chronic disease. It is something that crops up in our informal conversations from time to time, and it certainly has been in front of the Health Committee. When we are talking about chronic disease we are talking about things like “COPD”—that is an acronym for chronic obstructive pulmonary disease—and we also have got the likes of diabetes. Diabetes is very much at front and centre of debates at the moment, and, in fact, over the weekend we had quite a constructive conversation in that space about how we engage with diabetes, particularly around healthy decisions around food and sport.

When we are looking at these chronic diseases, the Minister noted—quite rightly, I thought, and I hope I am not stealing his thoughts for later on—that new models of care are needed. Although we have always been around “sooner, faster, more convenient”, we, I think, as a Government, understand the need for people to be able to obtain their health needs closer to home from, particularly, GPs, medical practitioners they trust—sorry, health practitioners; I should be clear on that, particularly as we have a new bill before the House—and how we might work with them.

I have spoken to the House before about how we better work the scope of practices. I use again the examples of nurses doing endoscopy, GPs doing skin work, and so forth. This is part of how we can better engage and we can do it in these chronic areas. One thing that has been announced—and we touch on it later in our report—is around the development of pain teams. Strictly speaking, orthopaedic issues are not chronic—I do not think they are; I will have to take some medical advice on that. But the pain teams are pulling together—

💬 Hon Annette King: They can be chronically awful.

The honourable member notes they are very painful, and what we are trying to do is to have a lead provider in the community to help drive the care. So, again, you might have a GP, a specialist, a nurse, or an occupational therapist who is going to take the lead in that support.

I thought that the other thing that was really useful that came out was the whole notion of promoting healthy lifestyles. In fact, if I recall the session correctly, I asked the Minister of Health—who is not only the Minister of Health but also the Minister for Sport and Recreation—whether that was a coincidence of those two portfolios coming together, which of course it was not. It was a good insight of the Prime Minister to see how that was going to work together.

The Minister noted, of course, the Healthy Families New Zealand pilot, which has been launched and, I think, well lauded in the health community. There is also work that has been undertaken to see how we might get that crossover, particularly for our young people in schools, around sport and healthy eating—two things I am quite passionate about when I visit my primary schools. Some will be in the most, effectively, wealthy suburbs in the country, and then I go to other areas that are amongst the poorest, if not the poorest. You look at the lunches and the choices that are being made there—I think we can make improvements not only through working with the principals but, obviously, through working with the families.

The other aspect is activity. In fact, I think it was on Prime news tonight, or TV3, about how much time is spent in front of digital devices, and so forth—so how do we get our young people active? The other thing I would note, and we noted in the report from the Minister, is encouraging activity. There is the notion of cycleways—I just have to put in a plug for that. The Government put out some money recently, and the good people of Tāmaki are most pleased to have got the biggest chunk of that as we put in a cycleway from Glen Innes through to Tāmaki Drive. I am very much looking forward to stopping my running one weekend and actually jumping on a bike.

Smoke-free targets—there is some really good work going on there. Speaking personally—and it is noted in the report—I think many of us still have concerns, particularly with young Māori women, who have an almost 50 percent smoking rate. I think there is stuff that we need to do and must do there. I think that is an important signal to the community as well.

We have indicated that about another $12.4 million has been allocated to extend the bowel screening programme, which is being done in the Waitematā, so that has been extended again. A little bit like prostate work as well—you do this as a pilot, you see what is possible, and you take those learnings and then see whether it is feasible to roll it out across the country.

I am conscious that we are probably coming close to time and I have got quite a number of pages to go. The one I did want to finish, if I can, is around the flu vaccine. It is coming out of time now, but the committee was interested as to why there was an apparent delay. The long and the short of it was that as the flu vaccine was coming into the country, the officials were made aware that some strains could be introduced to the vaccine. In other words, there were new strains of flu out there and it seemed from the reports that we heard that it was actually better to get the new vaccines in so that those New Zealanders choosing the latter vaccinations could be fully protected from those new strains. There was a small blip at the start, but I think we have got every confidence that that will continue and work well next year. I just wanted to mention that. I do not think we want any impression, certainly from the Health Committee, that somehow there was bad planning or a lack of vaccines available. It was a prudent health choice to look at the best medical and scientific information out there and to say: “Hey, new strains.”—I am sorry, but I cannot quote what they are—“Let’s get them into the vaccine and make sure New Zealanders are good to go.”

An area I am always keen on is palliative care—$76 million - plus has been invested in that. That is going to work in a number of areas. It plays back into that original discussion I was having about “sooner, faster, more convenient”. A lot of it is for hospice care, which, importantly, is done from home.

I am going to pick up on the bits that the chair of the Health Committee, Simon O’Connor, left out of our report. I have to say, however, in starting my contribution, that we have a very fair chair of the Health Committee, and it is a committee that I very much enjoy working with. And to show what generous people we are, the Minister of Health will know that we congratulated him on becoming the Minister and on the constructive way he had worked with the select committee. I know, of course, that he would rather be the Minister of Foreign Affairs, but that is another matter.

I did raise with him at the very beginning of my contribution my disappointment in the slowness of responding to Official Information Act requests and answering written questions, and I said that the Tony Ryall school of thought had continued under the new Minister. I was very disappointed, because I was expecting much more. The Minister said he wanted the best possible result, but I have to tell you, Minister, it is slower than it was when you were before the select committee. So can I ask you to go back and speak to Mr Hundleby and others who hold up these Official Information Act requests and say “Pull finger.”, because we deserve to have the information that we ask for.

We then raised with the Minister the reports that I had had, and an anonymous letter that I had received about bullying in the health sector. I have to say that since that issue was raised, and it was raised in the media and picked up by many in the media, I have been inundated with letters and comments about bullying in the health sector, and it has come right from the top. I am not blaming this Minister, because he is quite new, but he does follow on from a former Minister who was very controlling indeed, who put his fingers into every part of the health system and used threats and phone calls on a regular basis. The Minister of Health said he too would be very worried about bullying in the health sector, but, unfortunately, he went away and absolutely nothing happened. That is why we continue to get reports about bullying, particularly in the Ministry of Health, in the very highest echelons, up with the director-general and his office.

We then raised the issue of cost pressures in the district health boards. We are constantly told by the Government that there is more money in health than there has ever been before. Well, Minister, if you put one dollar more in than you did last year, there would be more money than there had ever been in health before. The question is: is there sufficient money going into health? Of course, we have never been able to get this answer; we are just told how lucky we are to have the amount of money that we do.

We had some work done on this by Infometrics. It is independent. These are not our figures—Infometrics did the work. It looked at these six Budgets that the National Government had provided in health. Four of those six Budgets, including this one, have, effectively, cut the health funding. We have an accumulative shortfall of $1.7 billion from 2010 to 2015-16. They are not my figures. They are not Labour’s figures. They are Infometrics’ figures. Using the Treasury figures, it looked at how the change in core Crown health expenditure aligns with the growth in inflation and demographic characteristics. We now know that there is a shortfall. If the Minister wants to dispute the figures that Infometrics has provided, he should put on the table—using the same data that Treasury uses—what the real figures are, if the Minister does not agree. I suspect he will not, because it is a terrible embarrassment—$1.7 billion has been removed from the health budget over the last 6 years. We now know that 11 of our 20 district health boards are showing a deficit.

I then questioned the Ministry of Health on the cuts to its budget. It got $74 million, not $79 million as it actually says in our report from the select committee. From Official Information Act requests and papers released by Treasury, we know that the ministry asked for $170 million in early funding signalled in November last year. It wanted that to deal with the pressures of Vote Health. It then revised that down to $150 million, according to the figures that we received. The Minister received advice in February that $74.9 million was necessary to maintain core services in the Ministry of Health.

I want to quote what the Ministry of Health said to the Minister in February with regard to the provision of national services by the ministry. He probably went in to argue for more for the ministry, but he was a loser in this respect, because this is what the ministry said: “Easy wins had been exhausted and major service cuts and reconfiguration will be necessary to achieve further major savings.”

So, in fact, the Ministry of Health had been asked to reprioritise $32.1 million in savings. It told the select committee the reason that it could now live on $74 million—not the $170 million it started with, or the $150 million it then asked for and ended up with $74 million—was that it had revised its figures because Treasury’s inflation forecast was lower than what it had predicted. So what did it do? It adjusted the budget down by 50 percent. Did you know that inflation was running at 50 percent? Because that is the cut that came in the Ministry of Health’s budget. Based on wanting $150 million and getting close to $75 million because of the adjustment in inflation, which was lower than it expected—we were expected to believe that claptrap; it is just a nonsense.

The Minister, if he was fronting up to this issue, would say that his ministry is under huge pressure to be able to provide the core services that it has to provide, let alone the manifesto commitments that have been made to that ministry. Of course, what we got was flannel from his officials as they tried to make sure they looked all right in front of the Minister. We did not get the ungarnished truth about what is happening within the Ministry of Health.

We then asked about pharmaceuticals and the money that goes into the Pharmac budget. We are told that Pharmac has got $800 million out of the $15.6 billion budget. It has virtually not moved in 4 years. The same amount of funding has been going into Pharmac, and it is expected each year to make the savings for the Government. In fact, the Government now relies on Pharmac to help it to pay for the health budget. At the select committee we raised how long that could go on. How long can we expect Pharmac to take the load for the cuts in the health budget? It deserves a reasonable amount of money to provide pharmaceuticals to New Zealanders in a timely and appropriate way, in a First World way. We now know there are many drugs in this country that Pharmac cannot and will not provide because it cannot afford it. Minister, we have real concerns that you are not in fact providing sufficient money in the Pharmac budget. It cannot be a cash cow for this Government continuously, as it has been.

There were a number of other issues raised in our examination of these estimates. For example, we also raised the issue of social bonds. The Minister has been questioned on social bonds on a number of occasions. He has been unable to tell this House in question time whether the $28.8 million that has been allocated to social bonds will be paid on results, as he said at the beginning, or whether it will be payment along the way to the banks that are doing the funding. We have not had that answer from the Minister. Perhaps he would like to take the opportunity in this debate to tell the House whether the $28.8 million of funding will be paid once those social bond projects give the results back to the Government, or are they going to have sweeteners along the way out of the $28 million to make them look better, or even to say that they have worked? Was the Minister telling it straight when he said it is paid out on results—on outcomes? Well, you cannot be paying out on outcomes after a few days or a few weeks if you are going to really measure whether mental health patients got a real job and stayed in that job.

There are many things in the select committee that we raised. I am glad that the chair was able to be very positive about everything.

Look, it is great to take a call in this estimates debate as the Minister of Health. This has been a great Budget for health in New Zealand. There is $400 million of new money out of a total allocation across the Government of a billion dollars. I mean, that is a record result of $15.9 billion in the vote and $1.7 billion across the next 4 years. But, of course, it is not, as Labour would have it, just all about the money. You would have noticed in Mrs King’s speech there that her main theme was that there will never be enough money. Well, I can tell you that in health it never feels as if there is enough, but the fact is that we are a Government that has focused on results in health. That is the key thing, and if you look at the results, you just cannot dispute them.

We have been very targeted on the areas that we think make a real difference for New Zealanders. So there is an extra 50,000 first specialist assessments per year, an extra 45,000 elective operations each year, and an extra 5,000 doctors and nurses in the system. You know, these are real results. And if you look at the health target levels in terms of emergency departments, people are getting in and out of our emergency departments within 6 hours. That is 95 percent of people. We are immunising—nearly 94 percent of children are fully immunised at 8 months. Just a couple of years ago that figure was 70-odd percent. We are doing very well on the advice for stopping smoking, on heart and diabetes checks.

And cancer—that has been a major success. So when Labour was in power, 760 people a year went to Australia for cancer treatment.

💬 Hon Member: How many?

It was 760. Under us, no one now goes to Australia. We have set very tight targets around that and we are delivering in terms of cancer treatment for New Zealanders. We achieved our first target, which was around people being able to get their treatment started within 4 weeks of having all their lab tests and being ready. We achieved that. We are now aiming for the gold standard target of 62 days across the whole cancer pathway.

So Annette King will tell you about some report that the Labour Party has had commissioned. She talks about cuts in health. That is completely untrue. There is more money than ever; there is more money going in each year. What we have done, which Labour did not do, is actually look at where the money needs to be spent. So we have new models of care. We need people being treated in primary care, with an emphasis on prevention and early intervention. So that is where the money has to go. What happened when Labour was in power? It doubled the health budget, but 2,000 fewer people each year got an operation. It had those people going to Australia for cancer care. During Annette King’s time it actually delivered fewer first specialist assessments than ever.

I do need to also take issue with some of the points that she made there. She was talking about responses to Official Information Act requests. Well, actually, the more people that Labour has working on those, the more it generates, and the more it sends to district health boards, the more people we are having to employ to answer the requests and the longer they are going to take. But the real point is that it does make Mrs King sound a bit of a hypocrite, because if you look back to 2007—

The CHAIRPERSON (Lindsay Tisch): Order!

—or it could make her sound a little bit like one.

The CHAIRPERSON (Lindsay Tisch): No.

In 2007 it took her, when she was replying to an Official Information Act request on the Electoral Finance Act, 18 months to reply.

💬 Hon Member: What?

18 months. I mean, that is not just unethical and it is not just not playing by the rules; it must be illegal. So for Annette King to come here and argue that sort of thing just does not stack up. So there is a range of things she raised there. She was talking about bullying in the health sector and all these letters she claims she gets. Well, what she should be worried about is bullying in the Labour Party, because we know plenty of that is going on. Mr Chai Chuah is a very fine Director-General of Health. One thing I can tell you is that he may be many things, but he is not a bully. He is doing a very good job of getting the health system into shape.

You hear these outrageous claims from Mrs King on the radio each morning. I must say, she is a popular figure around the Parliament, but when you hear her on the radio—you know, yesterday morning she was saying that I must be making stuff up—and you contrast that with this lovely woman here, it is a bit like seeing your favourite aunt in court on burglary charges. It is hard to believe that someone like this has something like that in her. It is really quite outrageous. But today, tabling that Infometrics—well, she did not table the Infometrics—

💬 Hon Annette King: You’re telling porkies.

Mrs King talks about porkies. What I can tell you is she spends half her time trying to corrupt her officials and the other half making statistics up. There you have it.

I am very pleased to take a call in the estimates debate. We continue to be astonished in New Zealand First at the lack of preventative programmes rolling out across the country. The Government does not appear to have a plan for serving the needs of the current population, let alone future generations, and it is a worry. This is an issue that is seriously affecting the health of New Zealanders. Non-communicable diseases are on the increase, and we need a fence at the top of the cliff rather an ambulance at the bottom. We know that that ambulance at the bottom is slowly breaking down. We want the Government to be forward-looking, and it was quite interesting when we met the Minister of Health to catch up with the lack of programmes that have a preventative focus. We know that the need for health care is going to increase dramatically over the next few years, so we need that preventative focus—absolutely essential. Our nation’s health is at critically poor levels, with ever-increasing numbers of people suffering chronic illnesses and non-communicable diseases, and that is a shame.

There is an urgent need for more research into cancer prevention and treatment. We are falling drastically behind Australia in our treatment of cancer. For all cancers, New Zealanders’ survival rate at 5 years after diagnosis is 4 percent lower than that of Australia. The Government states that reducing the burden of cancer is one of its top priority areas, yet this is an area that remains drastically underfunded. We were very pleased to hear the Minister say that there was going to be a new roll-out of a cancer strategy. We would like to see the bowel cancer strategy increasing, and the roll-out of the screening programmes increasing. We cannot afford to wait until 2017, when the Waitematā trial finishes, when we have 1,200 Kiwis dying every year from bowel cancer. Of course, that has a drastic effect on families and the hospital system. Skin cancer—we have the highest death rate of skin cancer in the world, and this does need to be urgently addressed.

Obesity—our obesity rate is continuing. We are now third in the world, rapidly closing in on Mexico and the USA. We are an outdoors country. It is really shameful for us to have this rate of obesity. Critical health services—the ambulance service needs to have more funding. We know for a fact that people are complaining about the length of time they are having to wait for ambulances. The ambulances provide a very critical role, and we need them there when we need them most. We expect them to come. So extra funding is actually required in this area.

When we look at elective surgery, the need for elective surgery is increasing. We get more and more people coming to our door saying that they are on the waiting list. They are waiting and they are waiting, and they do not want to wait any longer. It is a shame. We know that despite the increase of $98 million for elective surgeries, that is not going to cope with even the current needs. There are far too many people who go to the hospital, wait to have an appointment, and then are told to go home. They are even called in for scans, do not get those scans, go home, and have to come back the next day or the next week when they can get an appointment.

We all know that we have got an ageing population, and, of course, this is going to mean a really sharp increase in all the diseases associated with ageing: Alzheimer’s, osteoporosis, macular degeneration, and type 2 diabetes. We know that the population is set to double. Why are we not doing something about the planning and investment in this area to try to meet the needs that we know are actually coming?

Today I had a visitor who is very interested in rural health. Rural health is an area that has been sadly underfunded by the Government. The Healthy Bastards group came to see me. They focus on men’s health. They cannot even get an appointment with the Minister to discuss the work they are doing.

I would like to focus tonight on one small aspect of the health estimates, rather than do the large overview. I would like this Committee to consider—what if there was a way of providing an essential medical service that was safer, more accessible, cheaper, and less traumatic for patients and that also saved millions of precious health budget dollars? Well, there is, but we need to change our abortion laws to make it possible.

Our abortion law in New Zealand was introduced in 1977, without even one woman’s vote in support of it. It maintains abortion is a crime, unless two certifying consultants sign off that a pregnant person meets the legal criteria for an abortion—that is, that there is a serious danger to the life or physical and mental—

The CHAIRPERSON (Lindsay Tisch): Order! We are debating on the appropriations estimates. The member must come back to what has been reported back. That is what this debate is about. It is not a general debate on health matters. So the member should concentrate on what is actually in the Estimates.

Point of clarification—I am just trying to understand this process. The Budget, where there are budget lines around sexual and reproductive health within the Budget—that is not enough—

The CHAIRPERSON (Lindsay Tisch): I do not have a copy in front of me. [Interruption] There is a copy here—

So it is the Budget, not the committee report?

The CHAIRPERSON (Lindsay Tisch): So this is the Estimates. I would just ask the member—what you are saying, if you could tie it back to what is actually in the Estimates. That is what it is about.

So it can be broader than the select committee discussion, which does introduce sexual and reproductive health?

The CHAIRPERSON (Lindsay Tisch): You just carry on, but I want you to tie it back into the appropriations.

Sure, and the budget that is in the estimates around funding for sexual and reproductive health does relate to the service and the fact that every year $3.5 million is spent on consulting physicians, which is required by our very outdated law. The law requires that a child would be severely handicapped physically or mentally, that pregnancy is a result of either incest or unlawful sex with their guardian, or severe mental subnormality of the mother. Clearly, this law entrenches deeply discriminatory beliefs that harm people with disabilities, and also represents a profound mistrust of women. You will note that in that list rape is not grounds for abortion in this country, because when it was debated by the men in this House at that time, they said that if it were, then all women would just say they had been raped to get an abortion. Women were not, and it seems they are still not, able to be trusted in our laws.

This system costs $3.5 million a year—

💬 Simon O’Connor: I raise a point of order, Mr Chairperson. Although I appreciate that the member is raising what is an important issue to her, this really has nothing to do with the estimates or what the committee discussed in any way, shape, or form.

💬 Metiria Turei: Point of order.

The CHAIRPERSON (Lindsay Tisch): No, I am going to deal with the point of order. The member is talking about the law, and how the law—that is what I am taking out of what you are saying, whereas this debate is about the appropriations rather than the law in general and those points of interest to you. So let us try again.

That was the framing for it, Mr Chair. Thank you very much.

This entire system costs far more than the $3.5 million that is required, as a result of our laws, for the consulting physicians because, in this country, in the way it is happening at the moment and is organised, pregnant people will be required to see up to five doctors just to be allowed an abortion. The doctors may be in different places, requiring separate appointments and trips. The West Coast and Whanganui still do not offer abortion services, which requires more money and more time to be found for travel—all paid for through our health budget. Plus, all but two district health boards that offer abortion services require mandatory ultrasounds, and in several districts you have to go to another service to get this ultrasound. This is all an unnecessary expense and stress, and is against the World Health Organization guidelines.

Critically, too, each of these steps delays access to abortion. Prior to 9 weeks, early medical abortion is carried out, which is more like a natural miscarriage. After 9 weeks it is a later medical abortion, which is more like inducing labour. The Abortion Supervisory Committee advises that it is best practice to carry out abortions before 9 weeks, but, sadly, because of our system, women are required to jump through so many hoops that most abortions happen in later term. Only a third of abortions were carried out in this country before 9 weeks, because the women were required to jump through so many unnecessary and medically unjustifiable hoops.

We have a law and a system in place that is expensive and prevents best medical practice. These processes, required or enabled by this system that shows up in our Budget, are also a breach of the Code of Health and Disability Consumers’ Rights, which guarantees every consumer the right to be provided with services that take into account the needs, values, and beliefs of different cultural, religious, social, and ethnic groups and guarantees that every consumer be presumed competent to make an informed choice and give informed consent, unless there are reasonable grounds for believing they are not competent. Our current law and Budget remove women’s competency.

Abortion is a health service. I get that some people are morally opposed to it; that is OK. If you do not want one, do not have one. But we recognised that abortion was a health service back in the 1970s. We need to ensure that our current health system is based on best practice and the needs of patients, rather than on the morals of a minority. Our wider health budget could do with the resources.

Progress reported.

Report adopted.

The House adjourned at 9.56 p.m.