Hutchison Paul: Questions for Oral Answer — Questions to Ministers 
Hutchison Paul: Questions for Oral Answer — Questions to Ministers 
[Volume:624;Page:19705] 
10.  
Dr PAUL HUTCHISON (National—Port Waikato) 
 to the  
Minister of Health 
: Can she confirm that the 2003  
Health and Independence Report 
 shows that in 1999-2000 there were 160574 publicly funded surgical inpatient discharges (acute and elective) and in 2002-03 this number had fallen to 157754; if not why not? 
Hon ANNETTE KING (Minister of Health) 
: 
 Yes and I can confirm that the Ministry of Health advised me in October 2003—and I made that information public—that the surgical inpatient discharges reported in 2002-03 are incomplete and fail to include all surgical procedures carried out in the mobile-surgery bus and all publicly funded operations undertaken in private hospitals. As well the ministry advised me that recent process and technological developments mean that some procedures that used to be carried out in public hospital inpatient or day-patient settings are now being delivered in outpatient or clinic settings. As people receiving outpatient procedures are not formally admitted to hospital they are now no longer counted as discharges in the national system. This shift amounts to thousands of procedures rather than hundreds. 
Dr Paul Hutchison 
: How can she explain to the 2000 people at present being cut from the Counties-Manukau waiting list—some who are going blind some in constant pain—that her Government is funding sex-change operations at $30000 each and is that not exactly what John Tamihere says this PC Labour Government is doing—betraying mainstream New Zealanders? 
Hon ANNETTE KING 
: If it is PC to fund a limited number of sex-change operations today it must have been PC to have done it in the 1990s—and it was done. 
Darren Hughes 
: Can she give examples to the House of procedures that were counted as inpatient surgical procedures and are now done as outpatient procedures? 
Hon ANNETTE KING 
: Yes I can. Cataract surgery for example is now commonly done as an outpatient procedure and no one would claim that a patient has not had an operation. Other examples include orthopaedic procedures such as carpel tunnel release and release of tennis elbow; gynaecological procedures such as D and C; and gastroenterology procedures including endoscopy and colonoscopy. 
Barbara Stewart 
: Is she aware of the reported comments today by a senior orthopaedic surgeon at Wellington Hospital that he has operated on only about half the patients he would have expected to treat in the first 3 months of the year because the number of orthopaedic beds at Wellington Hospital has been reduced from 28 to 18; and does she as the Minister of Health acknowledge any responsibility to ensure that hospital productivity actually increases in proportion to taxpayer dollars invested? 
Hon ANNETTE KING 
: In respect of the last part of the question no not always. In respect of the first part of the question I am advised by district health boards that they expect to provide all their contracted volumes in orthopaedic surgery by the end of the financial year and I have no indication they will not achieve that. 
Heather Roy 
: In light of her answers what explanation can she give for the fact that the number of patients waiting for a first specialist assessment increased by 5102 in the 3 months from September to December 2004 and we now have 118553 New Zealanders waiting to see a specialist for the first time? 
Hon ANNETTE KING 
: I can tell the people of New Zealand that of those 118000 people 93000 have been waiting fewer than 6 months so they are inside the Government’s expectation; and 25000 have been waiting longer than 6 months which is around 21 percent and that I will tell New Zealanders is a huge improvement over 1999 when 34 percent of people waited longer than 6 months. 
Dr Paul Hutchison 
: Does she disagree with Grey Power president Graham Stairmand who said: “A sex-change operation at about $30000 will buy 10 cataract operations.” and that: “We would consider that doing the 10 cataracts would be money better spent.” and does this not back up exactly what John Tamihere has said about the Labour Government that it has lost touch with ordinary New Zealanders? 
Hon ANNETTE KING 
: We do thousands of cataract operations a year and we will soon be announcing a whole lot more. We intend to double the number of knee and hip replacements that older people get and we are well on the way. However allowance has been made for up to four operations for people who require gender realignment. That member did not speak out against it in the 1990s. He has suddenly found a reason to. He would know if he is really a doctor that people who have to have this operation must undergo the most rigorous clinical assessment. I can only assume that he is telling the endocrinologists of New Zealand that they do not know what they are talking about. 
Georgina Beyer 
: Has the Minister heard any reports or received any reports on some of the reasons why sexual reassignment surgery may be considered under the public system particularly pertaining to suicide? 
Hon ANNETTE KING 
: Yes in fact for a person to receive such an operation—and funding has been put aside from the high-needs pool for up to four operations a year—the person must undergo a psychiatric assessment psychological counselling and a specialist’s appointment with an endocrinologist to meet the very high classification required to receive the surgery. [ 
Interruption 
] One of the problems that has been identified is suicide. I take that issue seriously. Nick Smith does not but I do. Any young person who is in a state of mind where he or she wishes to commit suicide because of his her gender identity deserves the same support as any other New Zealander in the health system. 
Dr Paul Hutchison 
: I seek leave to table four documents. The first is from the  
Eastern Courier 
 dated 1 April 2005 which states that 2000 will be removed from the waiting list at Counties-Manukau District Health Board. 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? There is. 
Dr Paul Hutchison 
: The second is from the Christchurch  
Press 
 dated 19 May 2003 stating that a total of nearly 25000 New Zealanders have been dumped from hospital waiting lists. 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? There is objection. 
Dr Paul Hutchison 
: The third document is from the Christchurch  
Press 
 dated 2 April 2005 where Grey Power president Graham Stairmand says that they would consider doing the 10 cataract operations would be money better spent. 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? There is objection. 
Dr Paul Hutchison 
: The fourth document is from the  
Health and Independence Report 
 dated 2003 that shows the number of operations from 1999 to 2003 have gone down by 3000 cases. 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? There is. The document will not be tabled. 
Judith Collins 
: I raise a point of order Madam Speaker. This is a point of clarification. During my colleague Dr Paul Hutchison’s seeking of leave to table documents members of the Labour Cabinet including Mr Swain commented all the way through calling out “Yeeaas” in that sort of tone before he had finished asking for leave to table. I am wondering whether that is going to be the standard from now on. 
Madam SPEAKER 
: There was a lot of noise during the seeking of leave to table those four documents from both sides of the House. I would ask members in the future particularly the chatterers in the back row to please keep the noise down. 
Hon ANNETTE KING 
: I seek leave to table a document that shows that gender reassignment surgery was carried out in the 1990s under a National Government. 
Document not tabled.