Cunliffe David: Estimates Debate — In Committee 
Cunliffe David: Estimates Debate — In Committee 
[Volume:648;Page:17645] 
Hon DAVID CUNLIFFE (Minister of Health) 
: 
 It would be very interesting if the National Party had a constructive contribution to make in this debate. That party has no health policy unless of course one refers to the supposed phone book - sized book of policy that the party’s geniuses have been dreaming up in the background but have not deigned to put into the public domain. I wonder—and I ask Opposition members to confirm—when National will give that phone book to the public. When will it trust the public with its 10 million good ideas for solving all the problems of the health system? 
I was at the general practitioners’ conference in Queenstown 2 weekends ago. When Jo Goodhew was answering questions from the general practitioners she gave the same answer to all four questions. I will tell members what she said: “Why don’t you GPs tell us what you would do? We’re looking for your ideas.” The first time it sounded humble the second time it sounded vacuous the third time it sounded desperate and the fourth time it sounded tactical. 
It is the same with accident compensation. The only reason the public knows National’s accident compensation policy is that one of John Key’s former workmates at Merrill Lynch—[ 
Interruption 
] I raise a point of order Madam Chairperson. There is a constant barrage of drivel coming from the other side and the public does not need to hear that. [ 
Interruption 
] 
The CHAIRPERSON (Hon Marian Hobbs) 
: Sit down please; I think I can deal with this myself thank you very much. There has been a barrage from both sides actually. Members are meant to make pithy points not repetitive ones but it is not helpful to make a judgment about the interjections. Thank you. 
Lindsay Tisch 
: I raise a point of order Madam Chairperson. My colleague Jo Goodhew spoke on a matter of health; the Minister has deviated from health to talk about accident compensation. The debate is on the appropriation regarding Vote Health. It has nothing to do with accident compensation. The Minister should confine his comments to health and not talk about other subjects. 
The CHAIRPERSON (Hon Marian Hobbs) 
: I think the reference to accident compensation was a passing reference. The debate has been on health. We will continue. 
Hon DAVID CUNLIFFE 
: Accident compensation and health are of course intertwined because people require both. The point I am making is that the only reason the public has any knowledge about one National policy is that it was leaked by a company that helped to write it. That stands in contradiction with the situation regarding its health policy because either National does not have one or it does have one but is not telling ordinary New Zealanders about it. I do not know which is worse. Personally I think it is worse to have one and not be frank with the democratic process because whether one votes for Labour votes for National or votes for anybody else what is important is that one makes an educated decision. The public deserves to know whether National has ideas. How about it telling the public during the estimates debate which is forward looking and is occurring just months from the election what its policy is? Would not that be a good idea? But no National members will not do that. 
The reason they will not tell us their policy is that the last time they were in Government their experiment in market health services was a dismal failure. Why cannot health services work as a competitive private market? Well firstly because profit is not a good motive for health care and secondly because patients depend upon health professionals for their services. So there is an information problem that one cannot overcome with a market price. 
Our vision is for a health system that is collaborative that is patient centred and that is geared up through investment in each of capital development workforce development and service development and that is exactly what we have done in the last 8 years. The public know that they can trust Labour with health care—they always have been able to and they always will be able to—because our record is very different from National’s record. Our record is one of consistent investment and consistent improvement. 
Sixty percent of health costs are workforce costs. We have invested very strongly in the health workforce. Nurses doctors care workers radiologists Public Service Association workers—all the way through the sector—almost every workforce claim is now settled. Only one is outstanding and that is the junior doctors’ claim. We know what that is about and it is not about the money. 
Ladies and gentlemen the issue for the health service is where we go to from here. The public of New Zealand do not want to know just what we have done; they want to know where we are going. I will not pretend that there are no issues to be confronted but I will say that Labour has an active and consistent plan for getting there. On the workforce front we will build a nationwide demand-supply forecasting engine within the Ministry of Health that ensures we can predict well in advance where shortages will come. We will be working with each of the health workforce groups to ensure that we have a combination of short-term medium-term and long-term measures— 
Jo Goodhew 
: But you’ve had 9 years. 
Hon DAVID CUNLIFFE 
: —actions not reports—that will solve not only the workforce problems of today but also those of tomorrow. 
A health system also runs on money. There are no two ways about it. One can have all the fine theories one likes but if one is not funding the system properly one cannot do anything. Eighty percent of the health budget—and $2 billion of the $3 billion extra that we announced this year—goes into the district health board system to build health services that we can trust. I tell New Zealanders to line up the National Party members look them in the eye and ask whether they will keep increasing the health budget as quickly as Labour has increased it. What answer would they get? “I do not know; John Key has not told us yet.” Where is the phone book - sized book of policy and what does it say? I ask what those members’ policy is and whether they have a bright idea to save themselves. I do not think so; if they did why would they not tell it to us? 
To run a health system we need a workforce and we need money. What is the other thing we need? We need health information. We need information to be able to follow the patient through the system. Labour is investing in information systems in the health-care sector so that we can do things smarter. We have an ageing population. We have to look forward to the future. How do we balance rising public expectations an ageing population and limited growth potential in the health budget? We do it by working better by working smarter by cutting out waste and by having clinicians spend more of their time in front of patients and we enable that by assisting them with good business planning and good information that follows the patients through the system. Those are some of the strategic enablers that we are working on. 
Of course there is work to be done in mental health care but let us ask who has helped out there. The Government has been investing to fund the mental health blueprint over the last 8 years. It has been consistently funding— 
Sue Bradford 
: Well why don’t you make sure the money is spent properly? 
Hon DAVID CUNLIFFE 
: My colleague asks whether it is all done yet. No it is not. But when I walk around places like Waitakere Hospital and I see its brand new mental health ward I know that consistent investment is being made year on year. Ms Bradford asked a question about the Capital and Coast District Health Board. I look forward to the day which I hope is not very far away when ward 27 will be rebuilt. I know the Buckle family I know about that tragedy and I want to see that ward rebuilt. But I respect the governance decision of the district health board which has to balance that demand against the cardiac waiting list against obstetrics and gynaecology services against maternity services and against getting the new regional hospital up and running. Given the situation that the district health board has found itself in I think it is building a responsible forward plan and I know that it wants mental health services to be part of that plan too. That is very important. 
In respect of primary health care someone said to me that National was copying all of Labour’s policies. What is the difference? The difference is whether one wants Labour or “Labour-lite”. National for the first time that I can remember has actually put the words “primary” and “health care” into the same sentence. But all that those members could come up with was so-called integrated health centres—giving the problem to the general practitioners and letting them solve it. National members would not know a strategy if they tripped over one. Although the general practitioner clinics are—[ 
Interruption 
] If Jo Goodhew had had a good idea it would have been a good thing to tell it to the general practitioners’ conference instead of asking them to come up with the solutions. General practitioners are essential but they are not the only answer; the answer is to ensure that there are good linkages between primary health care delivery with low-cost access and population and public health policies that are working. That is why we are investing in Healthy Eating - Healthy Action. That is why we have been reducing the incidence of smoking. That is why we have campaigns against youth alcohol abuse. We are taking down the drivers of ill health in order to keep people well. 
How many New Zealanders now find that cost is a barrier to their accessing health services? According to the latest New Zealand Health Survey which was released just a few weeks ago the answer is 1.7 percent. Under that lot opposite with their market health-care system it would have been about—goodness me—50 percent 30 percent or something like that. The working-class which National has finally discovered suffered for a decade under that lot. They suffered in employment they suffered in welfare they suffered in health and they suffered in education. That is why the people of New Zealand sent us into Government and whatever they decide at the election we know that we have been good to our word and good to our programme. We are honestly putting our programme before them with plenty of detail and then it is up to them to choose. That is how democracy works. They get to choose and we respect their decision. But we can contrast that I say to the ladies and gentlemen who are listening with the position of the National Party. Either its members have no policy which is frightening or they have a phone book - sized book of policy that they are not telling people about.