King Annette: Estimates Debate — In CommitteeText is incorporated into the Bound VolumeKing Annette: Estimates Debate — In Committee[Sitting date: 30 July 2013. Volume:692;Page:12078. Text is incorporated into the Bound Volume.]Hon ANNETTE KING (Labour—Rongotai):Surprise surprise here we are again. Five years this Government has been in office—five Budgets 5 years of National Party policies 5 years of the Minister of Health and 5 years of his control of the health system. I say to the Minister that it is time he took some responsibility for the health issues in New Zealand because 5 years of blaming the previous Government just does not wash out there with the public any more. It has passed its use-by date and makes him look like a weak Minister. It is just not credible. So it is time for Tony Ryall to man up and to answer some of the growing problems that are in our health sector. You see the “more good news” rhetoric that he rolls out every week is now seen for what it is—nothing but hollow rhetoric.I think it is time that we launched the Tony Ryall BS barometer. This is a barometer that measures his promises against the reality. Have a look at some real evaluation of what is going on in health based on the evidence based on his clinicians his doctors and nurses and their assessment of what is going on in our health sector. Let us start with his health targets. His four health targets are nothing more than political tick-box targets to make him look good. They are his league tables that he has printed every quarter to trumpet about how well the health system is doing. I have no problem with having targets but when they become the major driver of everything that happens in health to the extent that other things are excluded then you have to question those very targets.On Monday this week the director of the Association of Salaried Medical Specialists spoke to the Hospital and Community Dentistry Conference and he had this to say. This is from the representative of our most senior doctors in New Zealand. He said: “Stressed hospital staff being micromanaged to meet targets are putting patients’ lives at risk”. He said that “A combination of increased government expectations on hospitals and diminishing increases in funding meant resources were being stretched”. He said further: “Elective surgery was being pushed through as quickly as possible with shorter operations being given priority ‘so you are in luck if you have a simple fast operation and out of luck if it is complex.’ Post-operative care or post-clinic follow-up is being compromised because specialists are too busy. Mistakes by rushed staff in emergency departments mean patients are being sent to the wrong hospital department delaying treatment. Those with chronic illnesses are missing out. ‘Because chronic illnesses are ongoing and complex they don’t lend themselves to targets’.” He said that senior management and specialists were being bombarded with calls and texts from central government which meant they were constantly distracted to the point that mistakes were being made.That comes from the representative of the most senior doctors in New Zealand. If the Minister was in the chair answering these questions his answer would be: “Well he would say that wouldn’t he because after all they want a pay increase.” Mr Ryall will know that the pay round for senior doctors has now been settled so anything that has been said since the settlement of that pay round cannot be blamed on them grandstanding to get more money.I believe that those specialists in our hospitals are seeing the real financial stress that our hospitals are under and there is tremendous financial pressure. You are seeing it and members opposite cannot deny that they are seeing it. They have constituents who have received letters like the ones that I have in front of me. These are letters from district health boards that say: “Due to the demand of referrals being received for patients to have an orthopaedic assessment and the need forDHBs to honour their commitment to seeing patients within 5 months the orthopaedic service is only accepting urgent referrals.”—urgent referrals. What is happening up and down New Zealand is that thousands of New Zealanders are not even getting a first specialist assessment. They are receiving letters like this telling them that they do not meet the financial threshold.Here is another one from another district health board. This one is from Hawke’s Bay saying that they cannot see this patient within the current resources and capability. When the Nelson clinical director sent a letter to all the general practitioners of that region saying “Sorry with financial constraints we can only see your urgent patients.” the Minister then attacked the messenger.Sue Moroney: He always does.Hon ANNETTE KING: He always does—you are quite right. He attacks the messenger.There is huge financial pressure on our district health boards. What the members opposite might not know is that the district health boards in this Budget in this year received the lowest increase in funding that district health boards have had in a decade. They are not my figures. Those are Treasury’s figures—the lowest increase in funding that district health boards have had in a decade.We have mounting problems with the very staff who are needed to treat our patients in our hospitals. We heard at the select committee that the Minister had to confess that 30 percent of our graduate nurses are not getting jobs at the time they graduate. He likes to trumpet 1000 extra doctors and 2000 extra nurses since National became the Government.Dr Paul Hutchison: It’s true.Hon ANNETTE KING: Of course I actually do dispute the figures but let me answer Dr Hutchison who actually knows how long it takes to train a doctor. It does not take 5 years to train a doctor. It takes a minimum of 8 years to train a doctor and at least 3 years and more for a nurse. So nearly every single addition to our health workforce was trained under a Labour Government—not under a National Government but under a Labour Government.We have some looming problems in staff shortages in specialist areas but also in nursing. Nurses who are graduating and not getting employment is a waste of taxpayers’ money and a waste of a human resource. They had to admit at the select committee when nurses do not get a job 10 percent of them have decided after all that training that they are not going to take up nursing at all.I know that the Minister went on to say how good things were for nurses in the health sector. Maybe he ought to read the email that was sent to him not long after he said that. It was from the husband of a nurse. He said: “I object to your media release that nursing graduates can find jobs. My wife works as a nurse and is very often forced to workhours and hours for which she is not being paid because of low staffing levels. There are shortages of nurses in our hospitals and mistakes are being made because of this.” He went on to say to the Minister: “Your Government’s move to present legislation this year that takes away even our tea breaks shows what you think of our nurses.”Then there was a very interesting story about an A-grade nurse a top graduate nurse in New Zealand this last year who has applied and applied for jobs and has not even got an interview. There is a disconnect here between us having a job shortage and nurses not being able to get jobs. This is something that this Minister definitely needs to address.Then today on the front page of theDominion Post we saw the most disgusting of stories about aged care in New Zealand. This is a whole area that is not of importance to this Government.Dr Paul Hutchison: There were worse 6 years ago.Hon ANNETTE KING: They are not of importance to this Government. They are certainly not of importance Dr Hutchison for all the crocodile tears from the district health boards that say: “We’ve put in another $200000 for aged care.” I have to say then why are old people having their home care cut? Why have the district health boards still not provided proper travel allowances for those who provide the care?Rural Women New Zealand wrote to the Minister only a month ago and said that Rural Women New Zealand requests that district health boards urgently implement a sustainable consistent and fair travel policy for home support workers because they know that the very people who are caring for those older people are the lowest-paid workers who then have to pay for their own travel to get to their jobs. And nothing happens. In terms of quality of care it is time that this Government implemented the recommendations from the Human Rights Commission report.