Annual Review Debate — Health Sector

I am absolutely delighted to take this call. The Heath Committee has been working incredibly hard this year, including work on the annual reviews. Can I start by thanking all the members on that committee, right across the various political hue and spectrum—it is a huge array of work.

It is really in that spirit of thanks, though, that I want to focus a bit of my initial time in these 5 minutes. It is on those who are actually working hard within the health sector. Through the annual reviews, we have heard primarily from the district health boards—a representative number of them—we cannot see all of them, for obvious reasons. In meeting with the various district health boards, those from the Health Research Council and other agencies, you realise and continue to appreciate the great work that they do. So I want to take this opportunity, rather than highlighting the particulars of their activities, just to say thank you to each and every person who works in the health area. I was going to fall into the trap of talking about doctors, nurses, and hospitals—but as everyone in this House will appreciate, it is much, much wider than that. That came through in the select committee process as the various board chairs, chief executives, and others were talking to us and sharing what they do. In a sense, on the record, I want to say thank you to them and to all those working in the sector.

We heard a number of positive elements coming through at the select committees and through the annual reviews. I am going to leave much of that to other speakers, both from the Opposition and the Government to share. It is oft-repeated—and I am all for good news stories, but I am not going to use my time there, bar one example—and that is what is coming out of the Health Research Council. It got a new chair recently, Dr Lester Levy, the new chief executive in Professor Kathryn McPherson—both of them doing a tremendous job. One of the reasons I want to highlight what they do is that the work of the Health Research Council is often not well known. Often it is the researchers themselves, or other bodies, that get the thanks. But, actually, the moneys through the Crown, and invested via the Health Research Council, bring about amazing results.

We heard about one example at the select committee; in fact, those of us who were at the Royal Society last night heard about this as well. We heard about some of the research that is being done and led by the likes of the Deputy Chair of the Heath Research Council, Professor Richard Beasley. Basically, it is looking at the efficacy of saline—in other words, water and salt—with other physiological products. In other words, can you make a product with all the other compounds and elements into, well, a drip that may be more effective?

💬 Grant Robertson: I would not use that word.

Well, we could not use it if we do not want to offend the Opposition. But the long and the short of it is that the Health Research Council found that there is no greater efficacy—or benefit, if you will—of using these new, amazing products that may replicate human blood plasmas and so forth. It found, actually, that saline in and of itself is just as effective. And saline costs, effectively, a couple of dollars, whereas these other physiological products cost hundreds of dollars. Here was a great example of the Health Research Council funding some research that is saving not only New Zealand taxpayers but also people across the world hundreds of thousands—if not millions—of dollars, because, ultimately, we do not need to invest in these more expensive products because they are not bringing out the same set of results. So I thought it was just one small example, but a relatively positive example, of what is happening in the health space.

We have heard from a number of other groups before the Health Committee that were highlighting, in small ways, the activities that are going on. One of the themes, actually, that was coming out—and I am sure my colleague from New Zealand First Barbara Stewart acknowledges it—was the importance of oral health. It was something that is always coming before us. I think it is one of the really strong announcements in recent days, by Minister Coleman in particular and, obviously, Minister Dunne, that is actually looking to change where the decisions around the fluoridation of water occur: moving it out of local government and into district health boards, which makes absolute sense, because, actually, this is a health issue. I think it is a really good example of how voices in the community are heard through the annual review process and can begin to make a change. I think it is just absolutely fantastic, and I want to thank the Minister in the chair, Jonathan Coleman, for his leadership in this role.

I am so glad that Minister Jonathan Coleman has joined us for this debate, because one of his colleagues, Minister Woodhouse, was in the chair a moment ago and he talked about how proud he was of this Government’s record in health—

💬 Chris Hipkins: Positively puffed up.

Positively puffed up—the Hyacinth Bucket of the Parliament. I have to say that I listened to some of the things that he said, and I was questioning them—I have to say, Minister—because he said there are 50,000 more operations that have been done under this Government. I know for a fact, Minister, that you are counting 12,000 of Labour’s operations done under the 2008-09 Budget—counting it dishonestly as operations done by the National—

💬 Hon Simon Bridges: No.

Oh yes, they are—12,000 of them.

The CHAIRPERSON (Hon Trevor Mallard): I will just freeze that. I will just warn the member that accusing a Minister of being dishonest—

I did not say that he was dishonest, Mr Chairman; I was very careful.

The CHAIRPERSON (Hon Trevor Mallard): I think the member will now sit down. I will say that it has been ruled many times that accusing a Government or a ministry of doing something is the same as accusing an individual member of it, especially the member in charge of it. So I am just asking you to take more care.

Let me just rephrase: it is a very misleading claim by this Government that it has done 50,000 more operations—counting 12,000 done under the 2008-09 Budget. Will the Minister deny that? I will table it and show that is correct. I find that very misleading.

He then went on to say that we are sending no patients to Australia for cancer treatment. Well, I am glad we are not, because I had to in 2000 and 2001. Does anyone know why I had to? It was because they received a report from the National Government in 1998 and 1999 that said our cancer services were in dire straits: we did not have enough linear accelerators, we did not have enough staff, and we could not provide this service. Do you know it took me months to get that report out of that Minister? I asked for it; they did not have it. They had never heard of it and denied it. I knew it existed because I did have a copy. I was testing the Minister and his ministry about being honest about cancer treatment.

What I think is happening in this health sector is that there is $1.7 billion missing in the health budget. If you look at the budget and you look at the track that it has been on, $1.7 billion is missing because the Government has not covered costs and it has not covered all of the demographic growth. That is not coming from Labour; that was independent work done by Infometrics. The Government has denied, denied, denied, but we are now starting to see the impact of those missing dollars, and we are seeing it in research that has been provided over the last few weeks. The Minister of Health may want to deny this research, but it has been done by the University of Otago Faculty of Medicine. It is proper research, printed in the Medical Journal, and it has said something I think is very significant. I do not think the Minister has read it. It says “Patients undergoing primary elective total hip and knee replacement in Otago in 2014 are more severely disabled than between 2006-2010. Patients currently being returned to GP would have qualified for publicly-funded surgery during that period.” This paper confirms that the increasing demand is not matched by the increase in supply. “The problems we describe are likely to becoming increasingly widespread across New Zealand.”—that is proper research given to the Government, which was denied by the Associate Minister of Health last week and continues to be denied by the Minister himself.

We also now know, because of data received from the Ministry of Health, that we have eight district health boards that have been unable to provide the number of elective surgeries that they were expected to provide, going right back to 2011. Two thousand one hundred and eighty one hip and knee procedures were supposed to be provided and were not provided during that period. I have to say to the Minister, why were they not provided? Of course, we know what he thinks. He said patients only think they need surgery; they do not actually need surgery—it is all in their minds. I challenge him to go and tell Grey Power that when they are asked whether they believe they need surgery because they are in pain and they cannot walk and they cannot go out and they are now housebound, or whether it is all in their mind. Have a listen to what they may say.

Well, there is so much to correct in that speech that I do not think we have got enough time to do it, quite frankly. There was so much fiction there. I mean, for starters, an extra 50,000 operations were provided under this Government. In Labour’s last year in Government it did 118,000 operations; we did 168,000 last year. That is a fact. But I will tell you what—you know, Mrs King talked a lot about the Southern District Health Board, and, actually, we could do better on hips and knees there. We raised the rate by 10 percent over our time there, but we have got to keep on doing more, and that is the answer to unmet need. But the really embarrassing thing for Mrs King, and the reason, actually, she asked questions about food rather than operations during question time, is that while she was Minister of Health she delivered 420 fewer operations in the Southern District Health Board. It was absolutely shameful.

💬 Hon Simon Bridges: Oh, here was me thinking it was just because she was hungry.

Yes. So when you get to a situation when question No. 1 in question time is about the Southern District Health Board’s food, in reality I think that means we are covering off the big issues pretty well. But I will tell you what: there has been a signal achievement this week announced by this Government, and that is moving the decision rights on the fluoridation—

💬 Hon Annette King: Yeah, and that was pretty gutless.

—of water from local government through to district health boards. Mrs King says that is “gutless”. Well, I will tell you what. She had—and this was a dental nurse—

The CHAIRPERSON (Hon Trevor Mallard): OK, the member will resume his seat. I was going to let it pass, but, again, there is a long history of calling members “gutless” and that being ruled out. The member will desist from saying that word, and the Minister will not respond to it.

Sure, sure. I think, actually, this great achievement of announcing the movement of decision rights to the district health boards is something the whole Parliament could join together to celebrate. I would love to see Labour—especially with the Opposition spokesperson being a former dental nurse who actually had 9 years to do this herself—issuing a supportive press release saying: “Let’s put aside the petty bickering over, you know, the minor bits and pieces. Let’s actually celebrate what is a major achievement.” When you look at fluoridation of water, that is one of the 10 greatest public health achievements of the 20th century. When you look at 35,000 children having a tooth extracted last year, that makes the point that this is a really important public health move. So if you look at 40 percent of our kids having a tooth go rotten before the age of 5—up to 60 percent in our young Māori kids under the age of 5—we had to do something about that, and that was a very important move.

Another great public health achievement under this Government has been the extension of free general practice visits to children under the age of 13. Much to Mrs King’s disappointment, that was taken up by 99 percent of practices—99 percent of practices. That is going to be a huge contributor to ensuring the good health of a whole cohort of children—free general practice visits now for 750,000 New Zealand children.

Progress reported.

Report adopted.

The House adjourned at 5.55 p.m.