Stewart Barbara: Debate on Crown Entities Public Organisations  and State Enterprises — In Committee 
Stewart Barbara: Debate on Crown Entities Public Organisations  and State Enterprises — In Committee 
[Volume:626;Page:21305] 
BARBARA STEWART (NZ First) 
: 
 New Zealand First members are very pleased to have seen increased funding for health Crown entities over the last 2 years. We want to see health funding reach levels that are comparable with other European nations such as France which spends around 10 percent of its GDP on health. Dealing with the health sector is tough. It is at the coalface of society’s ills and it must deal not only with the physical but also with the emotional brunt of healing. 
One of the most disturbing studies over the past year has been a Treasury report showing that despite increased spending on health the sector has falling productivity—that is fewer operations from more money. This report highlights the obsession within district health boards to balance the books no matter what even if this does mean cutting some of the services. A clear example of this was the Nelson Marlborough District Health Board which reduced the number of operations it was performing by 12 a week last October when it was discovered that surgeons were performing more operations than were funded to be provided. So meeting the obligations of the balance sheets has come to mean vacancies and cutting staff even in essential services. This is not the way to provide the First World health services that New Zealanders deserve. 
We must question many of the monitoring regimes which are expensive and seem to be yielding few results that are in place across the district health boards. Do not get me wrong; adherence to procedures and protocols is really important but when it becomes an end in itself rather than a means to an end we begin to lose sight of why they are there in the first place. When we choose to keep increasing the number of accountants and auditors at our district health boards rather than the number of doctors and nurses we have a real problem. Given the advances of modern technology both in medicine and in information technology the health sector ought to be booming. Instead it is barely managing a fizzle in some areas. 
A second issue of major concern in the health sector is the training and retention of health practitioners across the whole range of professions. Hospitals are crying out for qualified doctors surgeons and other specialists. We know we have shortages of dental therapists rural general practitioners radiographers and other technicians and the list goes on. 
Jill Pettis 
: We need more immigrants. 
BARBARA STEWART 
: The member on the other side of the Chamber calls out for more immigrants. We actually want qualified immigrants—people who can add to our economy. 
We have to face up to two simple facts in this area. The first is that we are in a global marketplace for these skills and we are competing with Australia the UK and Canada. If we wish to maintain a First World health system people who have those skills are absolutely essential otherwise we are consigned to sending more and more of our patients on to waiting lists or offshore for treatment and that is something that we definitely do not want to do. We need to develop some strategies to ensure that we have sufficient graduates in the areas of need. [ 
Interruption 
] The Minister is acknowledging that we will do that. Secondly we also have to face up to the reality that we have to pay First World wages if we are to have a First World health system. This could include options such as bonding graduates for a number of years in return for writing off their student loans. It could also include targeting increased funding in health spending specifically for pay rises for those parts of the sector that need them to retain staff. 
One of the areas where we particularly want to see some action is that of adolescent oral health. Many teenagers cannot access dentists because the subsidy paid to dentists is insufficient. Parents often come to me and say that they cannot even get their child on to the dentist’s waiting list because the books are closed. The dentist has enough teenagers on his or her books and cannot provide extra cheap services to any more. Another area we need to be more honest about confronting is the state of our mental health services. Dealing with those who have mental health difficulties is one of the most taxing areas covered in our health system yet this is one aspect of health care that often has its budget cut and its staff numbers reduced and its staff have substandard wages.