Ryall Tony: Questions for Oral Answer — Questions to Ministers 
Ryall Tony: Questions for Oral Answer — Questions to Ministers 
[Volume:637;Page:7469] 
6.  
Hon TONY RYALL (National—Bay of Plenty) 
 to the  
Minister of Health 
: Is he satisfied with the level of hospital productivity and why? 
Hon PETE HODGSON (Minister of Health) 
: 
 I regret I cannot answer the member’s question because we cannot yet reliably measure productivity. However we are making good progress in developing a variety of productivity indicators for the future. 
Hon Tony Ryall 
: What is wrong with the health system when official Treasury reports calling for value for money in the health sector show that hospital performance has plummeted during Labour’s term in office with the reports suggesting that almost $3 of extra spending is now needed to get $1 of extra benefit for Kiwi patients? 
Hon PETE HODGSON 
: The member as usual selectively quotes. What the Treasury report found was not that productivity has gone down up or sideways but that productivity is difficult to measure. Let me just quote back to the member the substantive finding from the paper in question. Treasury states: “This research is useful as a case study that underlines how little is known about public sector activity.” 
Sue Moroney 
: Does he think that productivity means having fewer staff working harder for longer or does the Government take a more enlightened approach? 
Hon PETE HODGSON 
: The latter I can assure the member. During the 1990s the National Government’s view was that productivity was about putting a competitive market model at the core of the health system shifting costs on to individuals through part-charging and deflating salaries. National’s aim was to have doctors and nurses running ever faster down corridors. The Labour-led Government however knows that achieving higher productivity involves better training better facilities and better technology. We are delivering just that. 
Hon Tony Ryall 
: Has the Minister read the Treasury report that states quite distinctly that hospital efficiency has fallen by 8 percent in a 3-year period and further has he seen the Treasury report that states: “Although there has been an increase in staff numbers hospital outputs have not increased commensurately.” and “Output per full-time doctor and nurse has reduced.”; and could he explain to the House how come we have more doctors and nurses but less treatment? 
Hon PETE HODGSON 
: Again the member quotes selectively. He has not read out to the House the blizzard of caveats around the finding that the data may be wrong that the quality may have improved etc. In other words for example Treasury measured how many people were discharged from hospital but did not measure how many of them went on to live. Some of the things about productivity need to be examined a little more carefully than the member would have us believe. 
Hon Tony Ryall 
: How is it that Labour can put $4 billion extra into the health system and deliver fewer elective operations fewer specialist appointments and fewer day-stay operations and call that a success? 
Hon PETE HODGSON 
: The member straightforwardly makes it up as he goes along. I can say to the member for example in the totality of medical discharges that it has increased by a third or more since the change of Government—and that is the bulk of the work that goes on in our hospitals. The member makes assertions repeatedly in the belief that someone will believe him; I do not. 
Hon Tony Ryall 
: Does he think that New Zealanders can be confident that the substantial additional resources that have gone into the health system have produced the best results for citizens? 
Hon PETE HODGSON 
: I think the member now makes a good point which is that if we cannot measure productivity in our health system—or indeed elsewhere in our public sector—then we should attempt harder to do so. This Government does not lack initiative in this regard. We are keen to measure productivity. We want to know that the taxpayer’s dollar is spent in the best way and in the case of the health system I will repeat to the member that we are making good progress. 
Hon Tony Ryall 
: Does he stand by his statement: “One of my priorities for the health sector is achieving value for money …” and can he explain how employing 2000 extra hospital managers and administrators in the last 6 years is giving New Zealanders value for money for that extra $4 billion? 
Hon PETE HODGSON 
: Again the member quotes selectively. He says that we have this number of managers and administrators but forgets to tell the House that on top of that we have 5000 more doctors and nurses. I wonder which of those administrators the member would not employ. Would the member not employ the administrator who pays the staff? Would the member not employ the administrator who rings people to come in for the out-patient clinic? Would the member not employ the administrator who records the work done so that we can measure productivity? Which of those administrators would the member not employ and would he like to tell the House whether the health system would be better off for that? The long and short of it is that this health system is bigger and better than it was when he was in Cabinet. 
Hon Tony Ryall 
: In light of the fact that the Government says that there is no problem I seek leave to table nine detailed reports from Treasury showing that there is less being produced with more under the Hodgson health system. 
Madam SPEAKER 
: Leave is sought to table those documents. Is there any objection? There is objection.