Roy Heather: Questions for Oral Answer — Questions to Ministers 
Roy Heather: Questions for Oral Answer — Questions to Ministers 
[Volume:615;Page:11293] 
6.  
HEATHER ROY (ACT) 
 to the  
Minister of Health 
: What methodology was followed to produce 20 percent extra primary health organisation funding for each enrolled Maori for all deprivation and age levels and what specific needs does this extra 20 percent funding address? 
Mr SPEAKER 
: Before I ask the Minister to answer the question I inform members that she did contact me earlier and advise that the specific answer to the question was seven pages in length. Of course she cannot give all that out in the answer that she is giving now but I have told her that she can have a little longer time than usual. At the end of the question she will seek leave to table the full answer. 
Hon ANNETTE KING (Minister of Health) 
: 
 The methodology has been on the Ministry of Health’s website since 2002 and what follows is an indication of the methodology used. Step 1: (a) assemble historical utilisation rates by age and gender; (b) multiply (a) by $35 per consultation for under-sixes and by $25 per consultation for all others; (c) weight the product of (a) x (b) by anticipated increased demand and additional needs—children only; (d) add the historical practice nurse subsidy; and (e) add $1.78 per person for health promotion. Step 2: using the above rates apply weightings for ethnicity and deprivation of 20 percent. Step 3: add high users and so on. The 20 percent weightings for ethnicity and deprivation are applied to the primary health organisation to provide services to improve access for the most needy. 
Gerry Brownlee 
: How long does this go on for? 
Hon ANNETTE KING 
: Mr Speaker you gave me permission to make my answer a little longer than usual; I do not think Mr Brownlee heard you say that. 
Mr SPEAKER 
: I thought that the Minister stuck within the ruling that I made. 
Heather Roy 
: Was the Ministry of Health’s head of clinical services Colin Feek correct about the 20 percent ethnic weighting for primary health organisations when he stated: “I’ll be quite honest—that’s a slightly arbitrary figure” and that: “We just felt that 20 percent weighting was enough to shift the balance. We don’t have any science behind it.”? 
Hon ANNETTE KING 
: Dr Feek was correct in that the weighting applies not just to ethnicity. The Ministry of Health decided on a 20 percent weighting by looking at previous services that had worked and used that figure as a weighting in the formula. There is no exact science behind it—it is very difficult to get exact science. It is important to know that the weighting is not just for ethnicity which is the only thing ACT concentrates on. There are also weightings for age gender and deprivation. 
Dianne Yates 
: Of the factors that attract funding for any public health organisation which category attracts the highest level of funding? 
Hon ANNETTE KING 
: The highest level is derived from having a high use health card—for people with the highest need. If people have a high use health card regardless of whether they are black white brindle rich poor young or old they attract the highest amount of funding. It is obviously a needs-based policy. 
Dr Lynda Scott 
: Is the way that Dr Colin Feek has described the ethnicity weighting the usual way to determine how to spend a huge amount of taxpayer money—that is there was no science behind it; it was just plucked out of the air as an arbitrary figure—and when will the Minister admit that the implementation of primary health organisations has been a disaster for patients who have high health needs but are denied cheaper health-care because they are not of the right race or do not live in the right location? 
Hon ANNETTE KING 
: No I do not agree because people with the highest health needs as I have just outlined are those who have a high use health card. They attract the highest level of funding regardless of whether they are rich or poor no matter what colour they are and regardless of whether they live in Kaitaia or Invercargill. 
Sue Kedgley 
: Has the Minister seen the  
Decades of Disparity: Ethnic mortality trends in New Zealand 1980-1999 
 report which provides compelling evidence that one reason that Maori health is poorer and is in need of targeted assistance is the new-right reforms of the 1980s and 1990s; and given that evidence what does she think would be the likely impact of another term of a new-right Government on Maori health? 
Mr SPEAKER 
: The member may comment on the first part of the question. 
Hon ANNETTE KING 
: I think any move to new-right politics would be disastrous on the health of the poor the needy and those who are relying on a Government like this to ensure they get better health-care. 
Dr Muriel Newman 
: In light of the Minister’s claim in question time last week that in addition to the 20 percent Maori funding allowance primary health organisations also get “20 percent more if they have a majority of people who are elderly or young” will she table the formula that shows that 20 percent allowance for age and if she cannot will she admit she was wrong and apologise for misleading the House? 
Hon ANNETTE KING 
: The formula is available to the member. I think she needs to listen to what I said. The funding is built on a basic formula and then has add-ons to it. I am happy to give it to the member if she has not been able to get it off the Ministry of Health’s website. 
Dr Lynda Scott 
: When will she admit that the implementation of primary health organisations has been a disaster for patients who are denied cheaper health-care because they are not of the right race or do not live in the right location for doctors only 9 percent of whom think primary health organisations will improve patient care and for district health boards which are picking up the pieces—for example by Middlemore Hospital in relation to the primary health organisation that has gone into liquidation—and stop this experiment that is doing irreparable harm to primary care in this country? 
Hon ANNETTE KING 
: More has been done for primary health-care in terms of the investment of money and concentrating on the needs of New Zealanders under this Government than we have seen in many decades. I take heart from my meeting this week with the Independent Practitioners Association Council the organisation that represents the doctors who are in the primary health organisations which came to me and said those doctors believe the primary health organisations are the way of the future and they want to work constructively with us. 
Deborah Coddington 
: If the primary health organisation funding was really needs-based instead of race-based would the formula not have true causative factors like obesity and smoking alongside age and gender as measures of health needs instead of race; is she not just guilty of stereotyping? 
Hon ANNETTE KING 
: If the member wants to put in obesity and other issues like that I would say she would be guilty of stereotyping. What we have in any formula are some key components. Some of the key components that are recognised not just in the health funding formula but in the formula that was devised for decile funding in schools by I think Dr Lockwood Smith include such things as ethnicity lower socio-economic status and so on. That has been accepted in New Zealand for many years. 
Stephen Franks 
: If the Minister considers that it is not race stereotyping to have a race loading because she hides it amongst four or five other factors what is it that generates the race loading? 
Hon ANNETTE KING 
: I find it remarkable that that member does not know that the health status of Maori and Pacific people in New Zealand particularly is worse than that of other New Zealanders. That is not stereotyping; it is a fact. They die 9 years earlier than other New Zealanders they have more cancers in every category except skin cancer and in almost every health statistic that is available Maori Pacific and low-income New Zealanders are worse off than other New Zealanders. Do we not want to address those issues? Yes we do. 
Dr Muriel Newman 
: I seek leave to table the funding formula which shows the 20 percent funding allowance is based on race not age. 
Document by leave laid on the Table of the House. 
Mr SPEAKER 
: Does the Minister want to table her answer? 
Hon ANNETTE KING 
: It is on the website. 
Peter Brown 
: Will the Minister advise the House whether Maori get their fair share of superannuation and whether they get their fair share of rest home entitlements? 
Hon ANNETTE KING 
: That is a very good question because in terms of paying taxes Maori pay taxes too—but 0.57 percent of Maori are alive after the age of 65 years in comparison with around 14 percent of the population that is over the age of 65. 
Stephen Franks 
: I raise a point of order Mr Speaker. I believe that the Minister should be given an opportunity to avoid misleading the House. She appears to be saying that a stereotype is not a stereotype when it is statistically true. 
Mr SPEAKER 
: No. That is a debating point.