Scott Lynda: Appropriation (2002/03 Supplementary Estimates) Bill — Second Reading Imprest Supply Debate 
Scott Lynda: Appropriation (2002/03 Supplementary Estimates) Bill — Second Reading Imprest Supply Debate 
[Volume:609;Page:6389] 
Dr LYNDA SCOTT (NZ National—Kaikoura) 
: 
 I want to talk about the decline in the public health sector. Today at the Health Committee we debated the radiation waiting times. New research has come out and it shows quite categorically that if people wait more than 8 weeks for radiation therapy post-mastectomy or lumpectomy they have a far greater risk of local recurrence. A report was finished in 1999 by the oncology working party. The report is called the New Zealand Radiation Oncology Advisory Committee Report. The Minister of Health said that the reason she did not see the report for 2 years was to do with the Hon Wyatt Creech and was nothing to do with the ministry. I tell this House that Colin Feek set up that working-party that the Ministry of Health was totally involved and that the report went back to the Ministry of Health. The Minister of Health is continually trying to blame the National Party and is continually trying to pass the buck for what is going wrong in the health sector in this country and that is absolutely unacceptable to us. She should front up to the issues and instead of passing the buck she should tell us what she is going to do to improve things. But she does not do that. 
The radiation waiting times at the moment mean that women who know the risks of local recurrence are choosing to have a mastectomy and lose a breast rather than lose a life. This situation has been going on for the last few years with nothing being done to improve it. The Minister stood up in this House and said that nobody was waiting more than 12 weeks. That is not the case and she knows it. The individual cases that I have raised are the only way that we can get this Minister to take a look at the issue. Those people know that their lives are put at risk because of these delays. The public health system is in decline. Those women have no other choice because there is no private provision for this. We have to send patients to Australia to use its private hospital system. The Minister said today that she does not object to public-private partnerships. So I asked her how many new public-private partnerships had been set up in the last 4 years. How many do members think? 
Lindsay Tisch 
: I’ve got no idea. 
Dr LYNDA SCOTT 
: She could think of only one in the last 4 years. Before that under National there were public-private partnerships all over New Zealand and they were improving health services. We had it happening in radiology and in urology and it was happening in hospitals with private wards using spare space. Services were improving and we were keeping our consultants in rural areas. The incomes for staff were improving and we were not losing them overseas. 
The boards’ objections now to private involvement are simply and utterly ideology. If the Minister agrees with public-private partnerships then maybe she should not have appointed all those board chairs who do not—because they are totally ignoring her. That is absolutely why Capital Coast Health cancelled the Wakefield Hospital contract. It is why Waitemata District Health Board cancelled the birth-care contract. Contracts have been cancelled not increased. This country needs good public and good private health-care to be able to deliver for New Zealand. We are a nation of only 4 million people. We are the size of Melbourne yet we have 21 district health boards. The Minister trumpets the fact that this year the deficit will be only $194 million! Can members believe that? In 1999-2000 when she took over all bar two—they were hospital and health services then—were in the black and only two were in the red. What do we have now? Do we have any that are actually in the black? We have one breaking even—that is it. 
Opposition Member 
: Where’s that? 
Dr LYNDA SCOTT 
: South Canterbury. Huge amounts of money are being spent and that would be more acceptable if people were getting more service but 25000 patients have been culled off the waiting list. The Minister said that there would be no health cuts. In Canterbury alone 10500 received a letter saying: “Goodbye we aren’t going to treat you. There is going to be no publicly funded service for you.” One would think that the general practitioner who knows the patient best would actually know what is right for the patient and whether the patient had to have surgery. 
Today in the House I brought up the case of a patient who has a hernia and has been put on a disability pension because he cannot work. He cannot get his hernia fixed. He will never be able to afford to pay to have that hernia fixed privately. But the Waikato District Health Board the Northland District Health Board and the Canterbury District Health Board have all said that they will not treat people with hernias unless they strangulate which is a life-threatening situation. I am talking about a 42-year-old man who is the father of two children. He is a solo dad and he is working part-time. His employer has said: “I can’t employ you. You’re too unreliable. Every time you’re in pain you have to go home.” Do members know what the hospital said? It said: “Take a Panadol.” Well people cannot do that because they cannot swallow them. Pharmac has bought such a cheap one that people cannot swallow them. They are terrible to try to take. But that is what the hospital said. 
Darren Hughes 
: Tell us your policy! 
Dr LYNDA SCOTT 
: I will tell the member what our policy is. We want the general practitioner to have far more say in what— 
Darren Hughes 
: That’s not a policy. 
Dr LYNDA SCOTT 
: Yes it is. The member should ask the general practitioners. They want to have more say. The general practitioner I have referred to sent the patient back to Waikato Hospital but the hospital said no it was not even going to see him. Not only would it not give him surgery but it would not see him to assess him. That is unacceptable to us it is unacceptable to general practitioners and it is unacceptable to patients. 
Then there are all the other people who are being bumped off that list. What are general practitioners supposed to do with them? They have no solutions for this situation because their patients are just being bumped off the list. Another thing we talked about today was primary health organisations. Elective services are being severely rationed around the country—with no debate. There is no core health services debate with the local communities. Those patients have not been asked. The general practitioners have not been asked. They have just been told that no sorry the patient is off the list. At the same time that that is happening public health organisations this year alone are having $163 million poured into them in an untargeted unfair funding formula. The Government has changed the script for public health organisations about 16 times. Every time a new one develops there is a new script. It has not been trialled anywhere. 
I worked as a doctor in the Hokianga a few years ago. They had absolutely free health-care yet there is no research or study to show that the outcomes were better. Yet we are pouring money $163 million in an untargeted fashion just to a location. Do we think do we know whether it is of benefit? Is there any trail of this? Do we know that there is any evidence that it is going to improve health outcomes? No. 
Hon Tony Ryall 
: It’s just ideology. 
Dr LYNDA SCOTT 
: That is right. It is absolutely ideology. It is the socialisation of medicine. Medicine is being socialised in this country and because of that there are doctors’ practices that are worthless. There are doctors who have worked hard bought into a practice and now found that the practice is absolutely worthless. If we take the example of the Drury practice in south Auckland we can see the stupidity of what is happening. If those guys move their practice 2 kilometres down the road they would be inside the boundary and they would get cheaper care for their patients. But if they stay where they are they do not. Does that makes sense? So they either go broke or they move. It does not make sense and they have asked the Minister of Health to visit them and try to sort the problem out. But she does not. She just passes the buck. She just says it is the district health board’s problem. She is the Minister who has said that the buck stops with her but no no she just passes the buck to the district health boards every time she is asked a question. That is not right and we will hold her to account for that. 
Public health organisations have their funding untargeted. It is not based on need. A lot of it is based on the fact that an area has to have 50 percent Maori Pacific Island or low-decile people. The problem with that is that there are a lot of people in that area who do not have high need. So the Government is using a lot of funding to pay for those patients in places like Gisborne and south Auckland. 
Darren Hughes 
: But it’s a good start for Maori health needs isn’t it? 
Dr LYNDA SCOTT 
: No it is not a good start. If the Government wants to put money into primary health care it should target it to those in need. That is what it should do—target it to the individual need. Then it might get some outcomes. But the way it is happening is just pure ideology.