Chadwick Steve: Debate on Crown Entities Public Organisations and State Enterprises — In Committee Speaker Recalled In Committee 
Chadwick Steve: Debate on Crown Entities Public Organisations and State Enterprises — In Committee Speaker Recalled In Committee 
[Volume:617;Page:13259] 
STEVE CHADWICK (Labour—Rotorua) 
: 
 I am delighted to follow the National spokesperson on health and to come out fighting by saying that hospitals are all that that member mentioned. We already know that this Government has created a stable and an effective health service something that we did not have in the 9 years Labour was in Opposition. We are putting resources staff funding and infrastructure in place. We are building a public health system that people can trust and that is transparent and has community involvement in the democracy of the district health boards. That health service will be there for people regardless of their ability to pay. We know that that member of the Opposition has already talked about what she would do if she were ever to become the Minister of Health. We should be afraid—be very very afraid—because she says that National would discontinue the forced implementation of primary health organisations. Everything that this Government is focusing on will build a robust and healthy community based on health and wellness which that spokesperson would scrap. She has also gone on to say that the whole primary health organisation system would go and that we are forcing the model on communities. But it is interesting to see how communities are responding to us. That whole speech was about the morale of hospitals productivity cuts in hospitals and operations. This Government is focused on the community and on the primary health organisations. 
But I want to look at the focus on district health boards because—good news—in the first three-quarters of this year they have reduced their deficits quite markedly. The deficits are 20 percent better than the boards had stated they would achieve. We have put 43 percent more funding into the health sector since 1999. We are spending more money on operations. Operations are not measured properly—the member knows that—and we are doing work to look at that. Does the member know about the innovation of the surgical bus? There are new technologies allowing surgery to be done out in the primary health sector. They are not even measured in the productivity of hospitals let alone the outcome measures in terms of health and wellness that we are focusing on now. One of the most profound statements in our financial review of the Auckland district health boards came from the chair of the Waitemata District Health Board who said when the health boards got together: “We’re moving to survival of the patient rather than survival of the organisation.” I was very proud to hear that statement. 
When we did the financial review of the district health boards we looked at innovation. District health boards talked about managing chronic disease outside the hospital setting and they were looking at parish nursing ideas to manage obesity and diabetes in the church community in south Auckland. That type of innovation was never in the health sector before. District health boards are involving the non-governmental sector and they are looking forward to managing devolution of the services for the elderly which they have responsibility for now. Even with the difficulties they say that they want to manage services for the elderly in their own communities. We heard all the Auckland district health boards talk about the population-based funding formula. They said we should not get rid of the formula but that we needed to tidy it up a bit and we should look at quaternary and tertiary services. They said that we needed to look at interdistrict flows and patient movement but they liked the formula and said we should not change it. 
One of the formulas from Dr Brash that we need to be very afraid of is a comment from him that shielding people from the consequences of their actions has costs and sometimes substantial costs. He suggested that a Government under his leadership would not provide free kidney dialysis to those who over many years of overeating had substantially increased their risk of type 2 diabetes. He said he would not provide hospital care for somebody who had a road accident while driving under the influence of alcohol. Those are appalling statements. People should be very very afraid. National would continue to make cuts based on a market model that the Leader of the Opposition feels he knows. He can only look at pricing economic value units in health care while we get on with the innovation. 
We saw some wonderful things happening in the South Island when we looked at the Otago District Health Board. The chair of that district health board said that the boards talked to each other.