Chadwick Steve: Estimates Debate —  
Chadwick Steve: Estimates Debate —  
[Volume:610;Page:7191] 
STEVE CHADWICK (Chairperson of the Health Committee) 
: 
 I am very proud to be speaking tonight on Vote Health especially with our Minister of Health sitting in the chair. This is the first time in New Zealand for many years that we have had a Minister leading Vote Health into a second term of Government. She is showing the sector and the communities of New Zealand that she is a Minister who is prepared to ride the hard knocks in health—and hard knocks are certainly what they are. The challenging health sector needed leadership in the second term of this long-term Government to show that we have stability and are prepared to continue to work through the challenges. Health is not just about money alone. 
I want to point out some of the very positive aspects of that vote in this estimates debate. With funding of $9.6 billion the health sector goes into a very well-financed period in this financial year. That funding is up virtually $1 billion since the previous year and is an 11 percent increase over that year. That is not well understood around the country but it is a very substantial chunk of all new spending in the overall Budget this year. In fact we have 31 percent of it with $443 million in new spending. One of the complex issues of this vote is that this is a 3-year funding package and we are in the second year of that package. That is what has given the health sector such certainty—it knows where it is going. It has a longer-term strategic view than it has ever had before in order to start planning and this is a forward-thinking debate. 
One of the things I want to talk about is the rhetoric we keep seeing in publications like  
GP New Zealand 
 that bureaucracy is killing the health system. That is rubbish. When Labour took over health the Ministry of Health had been run down while privatisation was occurring. We are now building up a vibrant public sector and we are also supporting the Minister in her role. 
We also hear about district health board deficits and I want to talk about that. Newspaper articles all around the country from Dr Scott and others in Opposition claim that they handed over a health sector in the black. I remind that member that in 1998 the Minister of Health did a deficit switch. The Crown health enterprise sector had a burgeoning deficit and was driven to brutal bottom-line management. National did a very natty little deficit switch that gave us all a clean slate which was a very artful thing to do. We inherited a run-down sector with hardly any capital spending going on at all. This year alone we have put $656 million into capital spending. That is hardly one of the things we want to trumpet because most of our emphasis in health in this term is moving that emphasis into the primary health sector. 
I personally know that the Minister opened the Nelson-Marlborough Hospital—$4.7 million worth—on Saturday. I know from many people who work in that hospital how thrilled they were that clinicians were involved in the planning of that hospital. The clinical director who planned the hospital happened to be my brother-in-law and those people are delighted with the end result. In fact it is one of the better hospitals. Things are much better planned when clinicians are involved. Another thing we heard in the estimates of capital spending is that the Auckland Hospital building programme is on time and to budget. To be able to deliver that is a massive undertaking and an absolute tribute to that hospital. 
We are moving the emphasis of our funding much more into the primary sector which is something that the Opposition cannot bear. I seem to be dancing along behind every general practitioner meeting in the country at which Dr Scott is saying that bureaucracy is killing the health system and primary health organisations are not targeting those in need. I go out there and get a totally different story. In fact the back of this magazine states: “Rotorua smells sweet.” Now here is a primary health organisation covering our entire community doing exceptionally well and actually realising that it is not an independent practice association in drag. It is a primary health organisation that is getting practice nurses physiotherapists child health workers community and women’s health workers all addressing the health needs of their community. It is a model primary health organisation and around the country 46 others are covering 1.7 million New Zealanders with primary health access. 
Extra funding is going in that area. It has jumped up from $115 million to $165 million and that is an incredibly exciting move. It is going into keeping people well and that is the secret whereas the Opposition still carps on about waiting lists which are the only things it likes to measure. Even though it claims that bureaucracy has run amok it likes information on waiting lists and hands out some very interesting facts about them. It tells us that we have culled 25000 people from waiting lists. I remind the Opposition that before we got into Government the Health Funding Authority culled 28000 people from waiting lists. Mrs Shipley did that but the Opposition has forgotten about it. 
The Opposition also talks about that magical 35-point threshold for cardiac surgery. No one ever achieved 35 points. General practitioners I used to visit had manuals about how to use the booking system and they had not even taken them out of the plastic. They did not even know how to use them. We now have people in liaison roles helping general practitioners to use the booking system manuals helping them integrate with hospital outpatient clinics and helping them with specialist assessments. Yes we have waiting lists and we will always have waiting lists. It is never going to be easy to get rid of them but we are much more concerned about waiting times in surgery. For the first time we have people who know that they will get their surgery within 6 months. 
I want to quote what Judith Collins from the Opposition who has just walked in said to physiotherapy students. It was a very good speech. She said: “No matter which political parties are the Government there will never be sufficient money to meet all people’s health needs. The best that any Government can do is create and foster a vibrant growing economy creating an environment where primary health care is everyone’s personal and family responsibility and that of the community; creating a health system where wastage is not accepted where the best use is made of taxpayers’ funds and where those in need get the help they need as quickly as possible.” That was a fantastic speech and she is absolutely right. That is what this Government is all about. We are focusing on primary health-care. We are giving certainty about waiting times for surgery. We are managing surgery honestly and openly with the community and taking the hard knocks. 
But there are also some very exciting things going on. Our community and every community in New Zealand that I go around understands that it is getting cheaper access to primary health-care so that people can see their general practitioner or practice nurse. They might not need to see their general practitioner and they are starting to cotton on to that too. Funding this year is going into decreasing general practitioner charges for 6 to 17-year-olds and that is vital. We had it for the under-sixes and now we are making it easier for 6 to 17-year-olds to have lower general practitioner charges. That will cost this Government $8.6 million but we do not mind that because we think it is money well spent. We are also lowering prescription charges for children and that is very valuable for those who are enrolled in primary health organisations. 
Another very interesting initiative is being developed called care-plus which focuses on “disease state” management. That will cost us $11.2 million and it will make a difference.