Annual Review Debate — Health Sector (continued)

It is a pleasure to take a call in this Appropriation (2015/16 Confirmation and Validation) Bill debate on the health sector.

Since this Government came into office, health spending is up $4.3 billion, which is 6.2 percent of the economy. The New Zealand Health Strategy lays out the future direction of health, and it is a health system with a focus on prevention. It has really been good to see, over the last little while, the work that is going on between health, between education, and between all of the other departments having a look at putting the children first and doing the cross-agency work around social investment—and that process is starting.

Starting from the bottom, there is a whole lot of stuff going on for children. For a start, the free doctors visits for under-13s—that has increased almost 14 percent between July and December 2016, compared with the same period in 2014. That is a real credit, knowing that our children are able to get out and attend the doctor without parents having to find that extra financial burden of having to pay. It is also constructive to know that 99 percent of New Zealand’s GP practices have received funding to make the zero fees possible for children under 13. There are lots of doctors’ practices that are partaking in this great move.

I would also like to note that immunisation coverage for 18-month-olds is now at 95 percent. That compares with just 67 percent of 18-month-olds in 2007. That is a huge jump. That is a whole lot of children who are protected now who never were 10 years ago, and the spread and risk of some of those diseases that we do not want to see in our families are being prevented.

Moving on to the school front, we have 219 new decile 1 to 4 schools signed up for the Health Promoting Schools programme. That is 46 percent above target. That is really creditable. To think—when we look at the prevention approach, this is where the whole school community works together to address the health and well-being of students, of staff, and of the community, so everybody is on board. It takes a whole community to raise a child. Whether we are talking about education or health, everybody needs to be on board in this process, and it is really good that the schools are actually starting to get really engaged in it.

The Government is also currently in the process of co-designing a nationwide transformation of the disability support system. I would just like to put a call out to a couple of organisations in my electorate, EnrichPlus and ConneXu. They are actually working with people—helping them to live better lives—who are starting to find their own way in the world. That is one of the processes, and the other one is helping those people to integrate into the community, to get jobs. We have got a lot of employers who are quite prepared to employ people with disabilities. Having a disability does not mean that you are not able to work; it just means that sometimes some special things need to take place in the workplace to allow you to be there. I think it is fantastic, because those people want to live a really good life, like anybody else. I think it is commendable that this is going on.

I also would like to note the access to Pharmac’s medicines. There is a record $850 million—Budget 2016 invested an extra $124 million. As a result, Pharmac has widened access to HPV and varicella vaccinations. It has funded two new hepatitis medicines—

The CHAIRPERSON (Hon Trevor Mallard): Order! I am just going to warn the member that we are having a slight problem with the clock. She does have only 30 seconds left.

Oh, that is cool. I was wondering about that, thank you. Pharmac has increased the funding for two new hepatitis C medicines, a treatment for advanced melanoma, and patches for menopausal women. Those increases in Pharmac funding have actually given a lot of people opportunities, particularly around melanoma—to take a drug that is very effective in treating melanoma these days. So it is a pleasure to take a call on this. We can see some good things happening in health.

I want to begin by acknowledging the people who presented a petition to Parliament today on a topic that was covered frequently in the annual reviews, and that is the ActionStation petition on mental health, which was led by Kyle MacDonald and Mike King. That was presented to Parliament today, along with thousands of signatures from New Zealanders, calling on the Government to act in the area of mental health. I guess we saw today what was typified across the annual reviews—a kind of arrogance that says: “We do not need to fund this. There is no problem. There is nothing to see here.” That was the response that we got across the annual reviews when we looked at mental health, which we did across all of the district health boards (DHBs) in New Zealand. That was personified today in the health Minister’s dismissal of the 500 New Zealanders who had shared their personal stories of their experiences with the mental health system. In one fell swoop, the Minister trod on those people, calling them a bunch of left-wingers and anti-Government activists.

That has typified what we have seen through this annual review process from this Government. It has dismissed at every turn the need for funding mental health services adequately. That is the kind of arrogance and the out-of-touch nature of this Government, and it is personified in that Minister who sits in the chair over there, Mr Jonathan Coleman. We see him doing that time and time again. And Bill English, of course, will not stand on him, because Bill English fears his influence in the caucus. Yes, Jonathan Coleman has ambitions for that leadership. He is waiting for Bill English to get out of the way, and Bill English is happy to let him hang out to dry with a trickle of funding and a worsening crisis in the health sector. That is why Bill English will not discipline him. That is why Bill English’s failure of leadership is being shown over and over again. [Interruption] I come back to the matter that we saw directly in the annual reviews—

💬 Hon Dr Jonathan Coleman: I raise a point of order, Mr Chairperson. I believe this is a review of the 2015-16 year.

The CHAIRPERSON (Hon Trevor Mallard): Order! I think both members will sit down. Now you can stand up, Dr Clark. The member Dr Coleman is absolutely aware that I have just called the member Dr Clark back to the—

💬 Hon Dr Jonathan Coleman: You haven’t said anything.

The CHAIRPERSON (Hon Trevor Mallard): I think the member saw me indicate to the member, and the member did—

💬 Hon Dr Jonathan Coleman: I’ve seen nothing, I’m sorry.

The CHAIRPERSON (Hon Trevor Mallard): Well, I am sorry the member was not focusing.

Thank you, Mr Chair. I want to focus specifically on a couple of examples in the annual review that illustrate this point, because there has been a 60 percent increase in the demand over the last decade for mental health services in New Zealand. That is the increase in the number of users across New Zealand of mental health services. A recent example is the Kaikōura earthquake. We examined that in the review of the Canterbury District Health Board, which was presented in March, and we learnt at that stage that the chief executive of the Canterbury District Health Board had already spent $2 million of the $840,000 the Government had allocated for the year.

In March he had already spent twice as much as the Government had allocated to that particular earthquake in Kaikōura and the effects on mental health. The Government has put a little bit more money towards it since, but already the expenditure is running ahead of that. The Minister has failed to acknowledge the need that is present, particularly in Canterbury. I mean, the unbelievable thing is that the Canterbury District Health Board is funded below the national average for mental health and addiction services—below the national average. It spends, as a requirement of the Government, to a certain level above which it is funded, and then beyond that it spends more because the need is so great. Yet this Minister has the arrogance—the arrogance—to stand up and dismiss the experience of those people, and I bet plenty of those who submitted to that report were from the Canterbury DHB; the arrogance and the out-of-touch nature to just dismiss those 500 people and their experience of the mental health system in one fell swoop.

We are seeing it across all the DHBs, though. The $1.7 billion that this Government has stripped out of the health sector over the last 6 years is also apparent in my own DHB down in the south, the Southern District Health Board. It has—and we covered this as well—issued a 5 percent funding cut across all NGO providers. It has said that regardless of performance, regardless of how the NGOs are performing, over the course of the year as contracts are renewed they will all be cut by 5 percent. That is not even a failure to fund at the same level, that is not even a failure to fund wage increases; that is a cut—a cut. Services are being cut, and all of those NGOs are feeling the pinch.

The Minister knows it, but he thinks he is above it all. He thinks he is above it all. He thinks it has nothing to do with him. He can cut services in the health sector, because he does not care about them. That is what it looks like to ordinary middle New Zealand. Middle New Zealand, though, is crying out for a properly funded health service. New Zealanders demand, rightly so—and the Labour Party will support them in this—affordable access to quality health services.

Well, I mean, all we really got out of that speech was just one long, unrelenting personal attack, but I do have to take issue with Mr Clark there and what he is saying there about $1.7 billion being removed from the health system. That is just factually incorrect. Basically, health funding has gone up from about $12 billion to about $16 billion per year. That is a fact, and Mr Clark knows it. So the funding has gone up. Mr Clark needs to have a greater argument in the healthcare space than just more money.

Yes, the money has gone up, but it is actually about providing more services, and there is no question that under this Government, access to services has gone up right across the board. Only today we announced that there are 6,900 more doctors and nurses in the system than there were 8 years ago—6,900. That is a huge increase. There has been a 45 percent increase in the number of senior doctors working in the New Zealand health system compared with 8 years ago. So that clearly is more resources and more services being delivered across the board.

If you talk about funding, the member talked there about his own district health board (DHB), the Southern District Health Board, and said that funding had been cut. Well, actually, last year funding went up by $32 million. It has gone up in the Southern DHB by $194 million over the last 8 years. But what is really interesting, if you look at funding per head of population—so every New Zealander is having 21 percent more spent on them, per head of population, than 8 years ago. Inflation cumulatively over that period would be about 15 percent. So in actual fact, in real terms, health funding has gone up.

Mr Clark talked a little bit about mental health there, and, you know, what we have acknowledged quite clearly is that 96,000 people were seeking access to specialist services 8 years ago; this last year it was 168,000. So that is an extra 72,000 more per year. That is a lot of people. Funding has gone up in mental health. It has gone up by $300 million per year, from $1.1 billion to $1.4 billion. This is the interesting point, actually—there are more mental health nurses working in the system than ever before. If you look at where nursing graduates are going, more of them are going into mental health than anything else. So Mr Clark can launch personal attacks—

💬 Dr David Clark: I raise a point of order, Mr Chairperson. The Minister insists on using my false title, and I might like to refer to him as His Royal Highness, but I resist.

The CHAIRPERSON (Hon Trevor Mallard): I am prepared to rule on it now. The member did himself make that error once. The Minister in the chair has now made the error seven times. I am asking both of you to learn.

Well, I think the basic point is well made—that this man has no background in healthcare and does not know what he is talking about. The one bit of advice I would give Mr Clark is to go and spend some time with Mrs King. She was an excellent health spokesperson. We had a very good rapport. Question time was entertaining. She actually had health at the top of the question list every day. You always knew—Tuesday, Wednesday, Thursday, you would come down and health would be question 1 or 2. Where is it now? It is question 12 on a Thursday and I think that really shows, actually, what Mr Little thinks of “Dr” Clark.

Anyway, when we look at other areas—so look, it is quite clear that the levels of appointments have gone up across the board, quite massively, from about 400,000 specialist appointments per year to 550,000. The numbers of elective surgeries have gone up per year from 120,000 to 180,000, and I think Labour should very careful when it bases its argument just around funding, because last time it was in Government it increased the funding quite dramatically but managed to deliver fewer operations each year. So it doubled the funding, and 2,000 fewer operations were being performed per year. My colleague Barbara Kuriger, the excellent member for Taranaki—King Country, was talking about free GP visits. That has been a major achievement under this Government. So free under-13s—99 percent of practices across the country are offering free under-13 visits.

Of course, what really irritates the Labour Party is that it is a National Government that has delivered the $2 billion pay equity settlement to the hardest-working, lowest-paid people in New Zealand, the New Zealand care and support workers. I can tell you, I was in a rest home in my local electorate, Anne Maree Court, the other day. You know what? Those workers on the minimum wage—20,000 of whom are going to receive a pay rise between 21 and 49 percent—were singing and dancing. I can tell you what, if Labour wants to get in the game on health, it had better come up with some policy pretty soon, because we have got a great record there of increasing services, of extra delivery, of an extra $4 billion per year.

💬 Carmel Sepuloni: No one believes that, Minister.

💬 Dr David Clark: No one believes you.

I do not care if Labour members do not believe me, because the public of New Zealand do, and that is who really counts.

I am a fairly new member of the Health Committee, and it is a real pleasure to rise to participate in debate on the Appropriation (2015/16 Confirmation and Validation) Bill in the Committee of the whole House. I just want to congratulate the Minister of Health sitting there. In terms of the Budgets, health Ministers always want more money to do more, and there is always more to do, and I just want to congratulate the Hon Dr Jonathan Coleman, because he has managed to do more—make the money stretch a heck of a lot, as well. As the Minister actually said, we now have more than 4,600 more nurses compared with 2008. That is about, you know, nearly 23,000 nurses, and we have about 8,000 more doctors who are actually full-time equivalent. That is a heck of a lot more than we used to have back in 2008. I think that putting the budget where it is actually required, on the front line of service, is actually something that this Minister has managed to do, and I congratulate him.

One of the things that I am really fascinated with is the results that we achieve in health. Recently I was talking to a friend of mine—he is actually a volunteer for me, and 3 years ago, when he was volunteering for me in the last election, he had major issues walking with me, doorknocking. He needed a hip replacement, and, you know, now he is walking much better. He is running, almost. He is so healthy. His business is actually back on track. He is earning a heck of a lot of money, because he is actually a builder. He is so very happy. He has got two brand new hips. These elective surgeries that we have managed to provide for New Zealanders is something that we should actually congratulate.

There is more access to specialists. That is actually a priority for this Government, the first specialist assessments that people are getting. There were 552,423 patients who received a first specialist assessment in 2016, a rise of almost 10,000 on the previous year. That is actually a huge increase—148,000 patients since 2008. That is a 37 percent increase, I believe. I am trying to look at the numbers here, and, you know, I am obviously not having a very successful reading ability in terms of reading numbers here. I should actually do better in numbers because I am oriental. Unfortunately, the members opposite could not even pronounce the Chinese name that they were asking a question about, anyway.

The CHAIRPERSON (Hon Trevor Mallard): Order! [Interruption] Order! The member will resume her seat. She will come back to the debate that is current, and she will not make comments that, if made by any other member, would result in a severe telling-off.

I am a big supporter of the bowel screening that this Government has put in place. Budget 2016 invested $39.3 million for the start of the roll-out of the National Bowel Cancer Screening Programme, and I think it is really, really wonderful. You know, there are people who get diagnosed with cancer, and it is “the big C” that people actually worry about, and they are scared of it. The fact that we have actually introduced a screening programme—early detection means that they can actually deal to it. We have run successful programmes for early detection in terms of cervical cancer. We have also done it with breast cancer, and now is the chance for bowel cancer screening. Southern and Counties Manukau are the next district health boards (DHB) to in fact roll out the screening programme in 2017 and 2018, and the Hutt Valley and Wairarapa DHBs will receive it this July. I think it is actually wonderful that this early screening roll-out has been put in place, and that is expected to help about 500 to 700 people detect cancer so they can actually deal to it.

There have been other things that other members have mentioned. The “healthy kids” target—free for under-13s—is something that all parents up and down the country will be celebrating, because when you have a sick child it is in fact the parents who actually worry. I am very glad that the immunisation numbers are up, as well.

Reports noted.

Justice Sector