11. Health Services—Specialist Appointments and Demand and FundingRON MARK (Deputy Leader—NZ First) to the Minister of HealthHealth Services—Specialist Appointments and Demand and Funding11. RON MARK (Deputy Leader—NZ First) to the Minister of Health: Is he concerned about the Government's ability to meet New Zealanders' need for specialist appointments; if not why not?Hon Dr JONATHAN COLEMAN (Minister of Health): I am always concerned about meeting the need for specialist appointments. That is why this Government has lifted the number of first specialist assessments from 404000 per year to 552000 per year over the last 9 years an uplift of 36 percent—well ahead of population growth. While that is hugely positive of course there is always more we can do.Ron Mark: If that is the case Minister then why did Hutt Valley District Health Board (DHB) turn down a patient because Public hospitals have limited resources including funding. Currently we receive more requests for specialist appointments than we are able to provide."?Hon Dr JONATHAN COLEMAN: That has always been the case whoever has been in Government. There has always been more demand for appointments in surgery than any Government has been able to meet. I would welcome a constructive meeting with the member so we can get the details of that case and work through exactly what has happened.Ron Mark: Is it not a fact that most DHBs cannot cope with current levels of requests for specialist appointments because they do not have the funding or the resources?Hon Dr JONATHAN COLEMAN: No it is not a fact. The allocation to district health boards has increased by $439 million this year including the situation around first specialist assessments at the member's own DHB Wairarapa. They have gone up from 6400 to 8700 a rise of 36 percent over the last 9 years including a rise of nearly 1000 since Mr Mark left the DHB—possibly a coincidence but definitely a fact.Ron Mark: When Hutt Valley DHB told a patient "That it is important to be honest with our community about the services we can and cannot provide." why can he not do the same and admit that DHBs are not adequately funded and are struggling to cope with the current demand?Hon Dr JONATHAN COLEMAN: If you look at the funding that has gone to Hutt Valley DHB this year—look there has been an extra $15 million in this Budget and $100 million extra over the last 9 years taking it to a total of $428 million. So that is plenty of money. There are obviously more appointments more elective surgeries more doctors and nurses—actually it is a very positive story in the Hutt Valley.Ron Mark: I seek leave to table a letter from Hutt Valley DHB dated 25 May 2017 stating in part that it cannot keep up with the demand.Mr SPEAKER: Leave is sought to table that particular letter from Hutt Valley DHB. Is there any objection? There is none; it can be tabled.Document by leave laid on the Table of the House.Ron Mark: If DHBs are properly funded then why did 16 DHBs including Hutt Valley and the Wairarapa respond to an Official Information Act (OIA) request stating that elective treatment is outsourced because they either do not have the resources to meet the current demand or cannot meet the targets set by the Government?Hon Dr JONATHAN COLEMAN: There is nothing wrong with those services being outsourced. The key thing is that we are providing more elective surgery all the time. We are doing an extra 50000 operations per year. So if the local DHB cannot meet the uplift target that it has been set which is 4000 nationally it makes sense that people get their operations paid for by the State done down the road at the private hospital. We are interested in the outcome.Ron Mark: I seek the leave of the House to table two OIA requests from Hutt Valley DHB dated 13 June 2017 and from the Wairarapa DHB dated 7 June 2017.Mr SPEAKER: Leave is sought to table those two OIA responses. Is there any objection to them being tabled? There is no objection; they can be tabled.Documents by leave laid on the Table of the House."