Scott Lynda: Debate on Crown Entities Public Organisations and State Enterprises 
Text is incorporated into the Bound Volume 
Scott Lynda: Debate on Crown Entities Public Organisations and State Enterprises 
[Sitting date: 10 June 2003. Volume:609;Page:6100. Text is incorporated into the Bound Volume.] 
Dr LYNDA SCOTT (NZ National—Kaikoura) 
: 
 I hope that members on the other side of the House might just be able to hold their tongues long enough to let me get started. Tonight I will talk about the performance of the district health boards. This Government has had 4 years in which to deliver on its promises and for New Zealand to see how the district health boards are going to shape up. We went into the last election saying that a lot of people out there were at the point of saying— 
Mark Peck 
: What happened at the last election? 
Dr LYNDA SCOTT 
: I know that those members on the other side of the House cannot help but be rude. They just do not know how to sit there and keep quiet and listen. I will tell the House a story about the person I have just spoken to on the telephone. 
If those members want to talk about how well the district health boards are shaping up I will tell them. There is $9.6 billion going into 21 district health boards that are absolutely failing. This is a story about a 42-year-old man who had a heart attack. Did he get his angioplasty then? No. He was put on the waiting list but he did not have high enough points. So what happened? He had another heart attack in December last year. [ 
Interruption 
] 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: I remind members sitting to my right of Speaker’s ruling 51/5(3). 
Dr LYNDA SCOTT 
: The gentleman had another heart attack in December. What happened then? Did he get his surgery? No. His surgery was booked for May of this year. What happened then? He went to Capital and Coast Health but Capital and Coast Health has set up a system whereby it books its intensive care units fully with electives—and acutes are always going to bump electives. What happened? An acute came in and that man’s surgery was cancelled. OK—he got booked again. He came into hospital and the patient in the next bed had to tell him that his surgery was cancelled. Did members know that? No doctor no nurse—no one—could be found. When his fiancée came to pick him up he was told that that was common policy—that that was what was going to happen. He did not get put back on his warfarin. That man went home and died. 
The reason I bring up that case is that it shows a total systems failure. If a hospital books out its intensive care beds with electives it knows that patients will get their surgery cancelled. That district health board should have been using a private contract for the times when those patients have their surgery cancelled because in private hospitals no acute case bumps electives. Electives can be completed on time. Wakefield Hospital used to have a contract but that ideologically driven district health board and the chairman of that board cancelled that contract. And the number of points needed has gone up. I have the Clinical Priority Assessment Criteria here. The number of points required has gone up from 35 to 50 and that means that more patients will die. That is what district health boards are delivering despite the fact that $9.6 billion is being poured in. We have 21 district health boards. We are the size of Melbourne—we have 4 million people—and we have 21 boards with increased bureaucracy. 
The Health Funding Authority was doing a very very good job on contracting and it had reduced the inefficiencies in the system. Untargeted funding is now being poured into primary health organisations. On Friday I was up in Auckland and I went down to Drury Surgery. Drury Surgery happens to be 2 kilometres over the border for an access formula primary health organisation. This is how ridiculous it is: if those doctors move their surgery 2 kilometres down the road they will get the access formula and cheaper care for their patients. But if they stay where they are in the practice they have built up for 18 years they will have their practice totally destroyed by this Government’s philosophy and its funding formula. Even though—[ 
Interruption 
] Mr Assistant Speaker I cannot even hear myself. 
Lindsay Tisch 
: I raise a point of order Mr Speaker. I bring your attention to Speaker’s ruling 51/3(3). When a member has been asked to be quiet and disorderly conduct continues you need to rule. I ask you to implement that ruling. 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: I thank the honourable member. I know exactly what the member is saying about disorderly behaviour and Speaker’s ruling 52/3(3). I did not actually warn anyone in particular but I am going to now. The member has her first yellow card and I refer the member to Standing Order 85(1). Would the member now continue and I suggest members look at Standing Order 85(1). 
Dr LYNDA SCOTT 
: Thank you Mr Assistant Speaker. The reason that I am really concerned about primary health organisations is that the pouring of untargeted funding into primary health organisations at the same time that elective services are being severely curtailed and rationed—rationed all over this country—just does not make sense. Dr Shand and Christine Williams at Drury Surgery want the Minister of Health to come on down there and talk to them about the system that has been set up and is destroying their practice. The system is not based on the patient need; it is based on an ideology a philosophy meaning that patients with the same amount of need and the same income are treated differently in different parts of New Zealand. That system is destroying their practice their business that they spent years building up. 
The 21 district health boards had one ability and that was to go across primary and secondary care. If they had been able to do that they may have been able to get some advantage but that is not happening. We have 21 district health boards primary health organisations and all those structures are not working. This Government decided it was going to have elected boards so that the people of the community could speak out. Those board members are gagged and they are resigning. They are resigning because this Government makes futile promises. One of the Government’s other promises was about the waiting list. It said it would reduce the waiting list. One would think that with $9.6 billion worth of funding more people would be getting surgery but the 10500 patients in Canterbury who got dumped from the list 2 weeks ago— 
Brian Connell 
: How many? 
Dr LYNDA SCOTT 
: In just one day 10500 people got a letter saying: “You’re off the list. The public health system of New Zealand is not going to treat you.” We do not treat hernias and haemorrhoids and lump and bumps any more but no one had a discussion about that. Those patients should at some time get their surgery. If they are booked and they get bumped from surgery because of acutes they should be able to get their surgery in private hospitals. There should be a set list and times that should be able to be delivered upon. 
I want to tell members another story. It is about aged care. Ruth Dyson has said time and time again that people should stay in the community; that she believes in people being in the community for as long as possible. Well that is fine as long as people are safe. I will tell the story of an elderly gentleman in Waitemata who ended up with both legs amputated. This man was in severe pain and he was sent home to a disabled family who tried to care for him. He should never ever have been sent home but that is what happened because aged care is under stress. This Government is keeping $150 million for asset testing and at the same time it is absolutely screwing down aged-care services. 
Home care rest homes and assessment treatment and rehabilitation services are all under pressure. In my home town of Blenheim one cannot get an aged-care bed. One cannot get a hospital bed. Patients are banking up in the hospital. Because of the inefficiency of the system that this Government has created elderly people are ending up being banked up in hospital beds. They are banked up in hospital and they are banked up in the community with the whole degradation of that system which was working so well. Those are the facts and I have written to the Minister of Health about that. District health boards are bureaucratic. They are 21 times bureaucratic. They are expensive—they are $237 million in deficit—and they are making poor decisions. They are too closely wedded to their provider arm. They are not delivering better care; they are failing.