Ryall Tony: Questions for Oral Answer — Questions to Ministers 
Ryall Tony: Questions for Oral Answer — Questions to Ministers 
[Volume:629;Page:1799] 
7.  
Hon TONY RYALL (National—Bay of Plenty) 
 to the  
Minister of Health 
: What is the number of individual surgical discharges for the calendar year 2001 and how does this compare with the number of individual surgical discharges for the calendar year 2005? 
Hon PETE HODGSON (Minister of Health) 
: 
 About 205000 people in both years. If the member had however asked about case-weighted discharges the answer would have shown a 7.5 percent increase and if the member wanted to go back to when he was last in Government the increase would be about 11 percent. 
Hon Tony Ryall 
: If the same number of New Zealanders are getting surgery as 5 years ago and the surgery they are getting is in fact more serious does this not reveal how much sicker people in this country have to be to get an operation in our public hospitals? 
Hon PETE HODGSON 
: I explained to the House yesterday the increase in case weights and I shall have another go. What has happened in recent times is that a lot of so-called low case weight surgery or simpler surgery has been carried out in out-patient services and in some cases even in primary health care settings and out-patients are not recorded as discharges for the very reason that the patient is not admitted in the first instance—or at least not reliably so. 
Moana Mackey 
: Is the Minister concerned that New Zealanders who have been clinically assessed as being above the threshold for treatment are not receiving treatment? 
Hon PETE HODGSON 
: Yes I am concerned and I think that is really the issue that shows us whether we are doing well or not well. The truth of the matter is that that figure has dropped by over a third in the last year and a half which I think is a tribute to the efforts of our world-class health workforce. I would say mind you that when National was in office the data about which the member asks were not even available because that Government had no appetite for transparency. 
Hon Tony Ryall 
: Why does the Government continue to use surgical discharge statistics as some sort of evidence that hospitals are performing more surgery when the Government has received advice from the Ministry of Health that says: “Discharges from surgical specialties simply indicate that a patient passed through a surgical service and was discharged from that service. They do not have to receive an operation to be included.”? 
Hon PETE HODGSON 
: And they never have had to. That is to say since the beginning of statistical collections surgical discharges have included things such as endoscopies. All I would say is that if endoscopies were included then and they are included now we have a reliable trend. What is really interesting is that when the National Government was in power it did include endoscopies and nowadays we include fewer because they are being done in out-patient services. 
Hon Tony Ryall 
: Can the Minister explain why the Government knowing that information continues to quote the information as justification for increased procedures in the hospitals when we actually have a system whereby someone can be admitted to hospital for an operation have the operation cancelled and be sent home and this Government counts that person as having had surgery? 
Hon PETE HODGSON 
: If that is the case it was always the case. The member thinks he has found something new. We have one of the most transparent systems in the world about what is happening and what is not happening and it has become more transparent under this Government than under his. 
Jo Goodhew 
: Does the information that the Minister has confirmed today mean that the poor unfortunate surgical patients who report that they have been sent home more than once because their surgery was cancelled could potentially be recorded up to three times in the surgical discharges data? 
Hon PETE HODGSON 
: If that is the case it was always the case. What is different about now from then is that these days more surgery is done and is not counted at all. It is done in out-patient services. That counting begins on 1 July this year. 
Hon Tony Ryall 
: So the Minister stood up in the House today and claimed that after 5 years of Labour Government— 
Hon Dr Michael Cullen 
: I raise a point of order Madam Speaker. I know it is hard for a relatively new member but we do usually start with a question word not a “So” and a statement while waving to a fellow giggling friend. 
Madam SPEAKER 
: I thank the member for that reminder. Yes the member will ask a question. 
Hon Tony Ryall 
: How can it be after 6 years of a Labour Government— 
Madam SPEAKER 
: If members wish to remain to hear the full question they should be silent while it is being asked. 
Hon Tony Ryall 
: How can it be that after 6 long years of a Labour Government and billions of dollars more being poured into the health system a Labour Party Minister of Health can stand up in the House today and say that no more people are receiving operations than there were 5 years ago and have to admit on the basis of his cooked figures that we could in fact have fewer New Zealanders getting operations than 5 years ago? 
Hon PETE HODGSON 
: I beg the indulgence of the House to try to explain to that member once more that— 
Hon Dr Michael Cullen 
: He’s got the Bill English disease. 
Hon PETE HODGSON 
: That is the Bill English disease. What is happening in our health system is that more and more people are having their surgical procedures undertaken in out-patient services. That means they are currently not counted at all. We are going to begin counting them from 1 July this year. What part of that explanation does the member not understand?