Ryall Tony: Questions for Oral Answer — Questions to Ministers 
Ryall Tony: Questions for Oral Answer — Questions to Ministers 
[Volume:631;Page:2819] 
4.  
Hon TONY RYALL (National—Bay of Plenty) 
 to the  
Minister of Health 
: Is he concerned about the Government’s ability to meet New Zealanders’ need for elective surgery; if not why not? 
Hon PETE HODGSON (Minister of Health) 
: 
 Yes. Despite a 24 percent increase in hip replacements a 52 percent increase in knee replacements and a 75 percent increase in angioplasties since the change of Government there are always improvements to make and this Government will pursue those improvements with vigour. 
Hon Tony Ryall 
: When the Hawke’s Bay District Health Board decided to cull 1800 of its patients why did he describe its doctors as “unethical”? 
Hon PETE HODGSON 
: The issue of ethics is addressed not by me but by the Medical Council of New Zealand and the Health and Disability Commissioner. Given that the member has raised the issue of Hawke’s Bay he might be pleased to learn that now that the process of prioritising patients has been concluded fewer than half of the 1800 patients will be returned to their general practitioner. 
Sue Moroney 
: What progress has been made in ensuring timely access to first specialist assessments for elective surgery? 
Hon PETE HODGSON 
: The number of people waiting for a first specialist assessment for more than 6 months has fallen by 42 percent under this Government. Around half of the people in need of specialist assessment have a wait time of less than 2 months. The percentage of people with a wait time of less than 6 months has increased by nearly 10 percent since 2000. We now need to make sure that prioritisation is working in all of our district health boards so that we can do even better. We are not there yet. 
Hon Tony Ryall 
: Who put the patients on the waiting lists in Hawke’s Bay and why are these people unethical? 
Hon PETE HODGSON 
: People are entered into the booking system by referral to the general practitioner and acceptance by the district health board. The district health board has an obligation to ensure that it accepts as many people as it can manage and it gives them certainty that they will have their first specialist assessment wherever possible within 6 months. 
Hon Tony Ryall 
: What did they do that was unethical? 
Hon PETE HODGSON 
: I refer the member to the Medical Council of New Zealand’s view on ethics under resource constraints—and we do have one it is called a health budget—in which the council requires or indeed states of its members that they must prioritise according to need under those circumstances. 
Hon Tony Ryall 
: How is it unethical for the Canterbury District Health Board to dump another 2000 patients including some top priority patients rated category A by the hospital’s own specialists? 
Hon PETE HODGSON 
: The issue of category A patients to which the member refers is a very difficult one and is related to the rheumatology and immunology clinic within the Canterbury District Health Board—which was indeed understaffed partially through one of the consultants being away on sabbatical—to which an extra rheumatologist has just been added. As to the Canterbury District Health Board as a whole I refer the member to a recent press statement by the chief executive in which he states that no one will be returned to their general practitioner until appropriate criteria are developed and approved by the board’s clinical advisory committee. 
Dr Jonathan Coleman 
: How ethical is it for the Minister to pretend there is no crisis in elective surgery when across the three Auckland district health boards there has been over the past 5 years a 23 percent decline in the number of elective hernia operations a 24 percent decline in the number of elective tonsillectomies and a 45 percent decline in the number of elective varicose vein operations performed—or are these conditions that he believes just get better if nothing is done? 
Hon PETE HODGSON 
: Unlike the member I am not myself a clinician but I am advised by clinicians that tonsillectomies are less inclined to be carried out these days than they used to be; the use of antibiotics is apparently an increasing method of managing that particular condition. As far as varicose veins are concerned I am advised—again by clinicians—that compression treatment is now more widely used than it used to be.