Dyson Ruth: Questions for Oral Answer — Questions to Ministers 
Dyson Ruth: Questions for Oral Answer — Questions to Ministers 
[Volume:665;Page:12833] 
6. 
Hon RUTH DYSON (Labour—Port Hills) 
 to the  
Minister of Health 
: Is he comfortable with the numerous announcements of health cuts in the last 20 months? 
Hon TONY RYALL (Minister of Health) 
:  
Contrary to the member’s assertion the health budget in the last 20 months has increased by over $1.3 billion. There always have been and always will be changes to services reflecting changing needs but this Government is moving resources from the back office to improve front-line services and engaging doctors and nurses in that leadership. 
Hon Ruth Dyson 
: Can he confirm the reported comments of Lindsay Smith clinical business manager at Dunedin’s Ashburn Clinic that the clinic will drop 9.7 full-time equivalent staff due to a shortfall in funding; if so is this work currently being done by those staff back room or front line? 
Hon TONY RYALL 
: No I am not able to confirm that quote. 
Hon Ruth Dyson 
: Can he confirm the reported comments of resident doctor Julia Taylor who says that weekend and night shifts at Christchurch Hospital are often understaffed that it is stressful and unsafe for both doctors and patients and that it is only a matter of time before a major incident occurs; if so what if anything will he do about it? 
Hon TONY RYALL 
: I have spoken to Alister James chairman of the Canterbury District Health Board as a result of these claims. Mr James assures me that no patient was at any risk of any harm as a result of staffing arrangements last week. Mr Alister James who is known to the member opposite advises me the Canterbury District Health Board is well staffed with senior doctors for the first time in quite some time and that they are playing an active role in helping to manage staffing issues. 
Dr Jackie Blue 
: Tena koe e te Mana Whakawa te Minita o Health. What reports has he received recently on improved front-line services? 
Hon TONY RYALL 
: I have seen numerous reports of improved front-line services from around the nation. There is a record rise of nearly 13000 extra patients receiving elective surgery in the 2009 year much shorter waiting times for cancer treatment and for the first time in many years we are closing the gap for 2-year-old immunisations. 
Hon Clayton Cosgrove 
: Does he acknowledge that the cuts in after-hours general practitioner services in Rangiora affecting 22000 people were done without consultation with the community? 
Hon TONY RYALL 
: The changes to the after-hours services in Rangiora have been made by the general practitioners in Rangiora. Following representations from the Hon Kate Wilkinson I am advised that discussions are under way between Pegasus Health St John and the acute demand programme about improving services in that area and that we hope there will be some announcements following that shortly. 
Hon Clayton Cosgrove 
: Why have his cuts forced the Canterbury District Health Board to do more with fewer resources which has resulted in the removal of services from 1 July of after-hours general practitioner care for the people of Rangiora a service they have enjoyed for 22 years? 
Hon TONY RYALL 
: I can advise the member that the decision in respect of after-hours services in Rangiora was a decision of the local general practitioners. The scaling back of after-hours services started quite some time ago. But I can tell that member that this year the Canterbury District Health Board received a massive funding boost of $50 million which is a 4.2 percent funding increase. This has allowed it to provide more cancer radiation treatments more elective surgeries and an improved emergency department. 
Mr SPEAKER 
: I am not sure what was in the water at lunchtime today but I do not think that members need to carry on with that shouting in unison. It is not very becoming in the House. 
Hon Clayton Cosgrove 
: Given that answer does he agree with his colleague Kate Wilkinson who said on Canterbury Television on 9 July 2010: “The service is definitely diminishing.”; and “The DHB is being forced to do more with less.”? 
Hon TONY RYALL 
: I tell that member that Kate Wilkinson is absolutely right when she says that the district health board in Canterbury has an extra $50 million and that as a result the latest data shows that we have had improvement in the number of nursing fulltime-equivalent staff by 170 extra and that the number of medical fulltime-equivalent staff has increased by 30 during that time. That is good news for the people of Canterbury. 
Hon Clayton Cosgrove 
: I raise a point of order Mr Speaker. I asked a very specific question as to whether the Minister agreed with the statements from his colleague that the service is diminishing and the district health board is being asked to do more with less in respect of resources. I gave the date; it was a singular question. He failed to go anywhere near that. 
Mr SPEAKER 
: When members ask Ministers whether they agree with a particular statement that someone has made—if I remember rightly the Minister answered that he did agree with a further statement attributed to Kate Wilkinson—it is very difficult to be pedantic about exactly how Ministers answer such a question. I am not going to put the heat on Ministers to really give a particular answer to that kind of question. 
Hon Clayton Cosgrove 
: I raise a point of order Mr Speaker. In your summary you said that the Minister said that he agreed with another statement from Kate Wilkinson and you were prepared to accept that. All I am asking is whether he is prepared to say he agrees with another statement from his colleague; I am simply asking him whether he is prepared to say whether he agrees or disagrees with the statement I put to him. How can both sets of answers be correct? 
Mr SPEAKER 
: I just put it to the member that when members seek opinions in questions as to whether Ministers agree with something then unless it is absolutely at the heart of their portfolios in terms of something they have done or they have said themselves it is hard for me to be too pedantic about answers to such a question. Where I insist on Ministers answering a question from an Opposition member I want to be satisfied there is a genuine public interest in this and it is not political point-scoring about whether a Minister agrees with it. The Minister is not strictly responsible for what Kate Wilkinson says; that is another difficulty I have. The Prime Minister is responsible for what his Ministers say but the Minister of Health is not at all responsible for what the Hon Kate Wilkinson might say. That is why it is difficult for me to insist on any particular answer. I am allowing time for this to explain why I am ruling the way I have and I do not intend to take a lot more time on it. 
Hon Trevor Mallard 
: I raise a point of order Mr Speaker. I will not take much time but I ask you to consider whether Ministers in fact can take their hats off and be speaking not as Ministers. The Minister Kate Wilkinson was quoted. She had been talking on an area for which Mr Ryall was responsible but the way that we were taught constitutional law and again when we first became Ministers was that Ministers are always Ministers and when they speak wherever they speak they speak on behalf of the Government. 
Mr SPEAKER 
: I will hear the Hon Gerry Brownlee because I have heard the honourable member. 
Hon Gerry Brownlee 
: You will recall the various disruptions that occurred under the Helen Clark - led Government in the early part of 2002 where the House turned itself inside out on this issue of what hat someone was wearing. At the time there was considerable disagreement between the Hon Jim Anderton and the Hon Laila Harré when the Opposition attempted to find out which public positions each of those Ministers was taking represented a Government position. It was made abundantly clear by then Speaker Jonathan Hunt that when Ministers were speaking in a capacity as a member of Parliament they were not bound by that convention. For Mr Mallard to want to un-turn something— 
Mr SPEAKER 
: The member will not criticise another member during a point of order; he had done well until that point. It is interesting. I accept that the points of order are well grounded and it is an interesting point that has been raised but I stick with my ruling that were the Hon Kate Wilkinson an Associate Minister of Health—and I do not believe she is—then the member’s point of order would have been absolutely right because the Minister would have some responsibility for what an Associate Minister has said. If the member was speaking within her portfolio area then that would be a different matter. But I do not believe that the Minister is responsible. That is why it is difficult for me to pin down a Minister with that kind of question because the Minister is not responsible for what another member says particularly when that other member is not an Associate Minister or in any particular role like that. We must move on. 
Hon Trevor Mallard 
: I raise a point of order Mr Speaker. Can I then ask you to have a look at the general rules for authentication of substantive questions? It has long been ruled that Ministers can be asked whether they agree with particular statements not only said by members of Parliament but also said by people outside of Parliament. For as long as this Parliament has been here Speakers have ruled that Ministers can be asked whether they agree with things relating to their portfolios. No matter who made those statements they are responsible for whether they agree even if they are not responsible for the statement being made. 
Mr SPEAKER 
: I hear the member; indeed he is correct. But likewise with that kind of question the answer that is given can cover a wide range. I did not rule out the member’s question. He is perfectly entitled to ask it but the specificity of the answer will always be constrained by the fact that the Minister has no responsibility for what someone else might think. The questions are indeed allowed; the member is absolutely right. However in terms of the Speaker then insisting on any particular answer I cannot insist on a particular answer with that kind of question. It limits the value of that kind of question and I think some members should reflect on that a little. 
Hon Trevor Mallard 
: I raise a point of order Mr Speaker. I have one last point. I think you have made considerable progress away from addressing questions to answering questions in your time as Speaker. This ruling that you have just made effectively means that you have gone back a long way and that Ministers do not even have to address the question that was asked. 
Mr SPEAKER 
: I thank the member for his lecture. I assure him that I shall not be letting Ministers escape from sharp questions. 
Hon Clayton Cosgrove 
: I raise a point of order Mr Speaker. I want to take up with you two points you made and perhaps you may want to give them a considered ruling. The whole thrust—[ 
Interruption 
] 
Mr SPEAKER 
: I ask members to please respect the point of order process. 
Hon Clayton Cosgrove 
: The whole thrust of the question centred around cuts to health. It then gained further specificity as the supplementary questions went on to an argument if you will between both sides with the Minister saying there were not cuts at the district health board and our side claiming that there were. The point I made through you in the question was that a colleague who I agree does not have responsibility for health but is a Minister in the Government of the Minister made an absolute claim—and I can table the quote but you will not allow me to because it is a matter of public record; I accept that—that the service was diminishing and that the district health board was being required to do more— 
Mr SPEAKER 
: The member is now debating the issue— 
Hon Clayton Cosgrove 
: No I am not sir. 
Mr SPEAKER 
: The member will resume his seat— 
Hon Dr Nick Smith 
: Sit down for a change. 
Mr SPEAKER 
:—and there will be no interjection on the matter I say to the Hon Dr Nick Smith. I apologise to him if I am pinning the interjection on the wrong member. The member Clayton Cosgrove is now getting into debate. I have made it very clear that the Minister is not responsible for comments that someone else might make. With this kind of question as the members acknowledge there is a difference of view as to whether cuts have been made. Members have asserted “cuts” in their questions; the Minister has refuted that. But when the member then wants the Minister to comment on whether a Minister agrees with a comment of another Minister that the Minister is not responsible for I cannot require any specific answer from the Minister with that kind of question. If he had asked the Prime Minister it would have been a little different because the Prime Minister is responsible for what all Ministers say. But a portfolio Minister does not have responsibility for what other Ministers say unless he or she is an Associate Minister.