King Annette: Debate on Crown Entities Public Organisations  and State Enterprises — In Committee 
King Annette: Debate on Crown Entities Public Organisations  and State Enterprises — In Committee 
[Volume:626;Page:21313] 
Hon ANNETTE KING (Minister of Health) 
: 
 I thank members for their contributions to the debate on the performance of Crown entities public organisations and State enterprises. It was interesting that both the National member and the ACT member raised the much-maligned Treasury report. Of course if we were to believe Mr Hide everything that Treasury wrote would be absolute gospel although I note that he does not take much account of Treasury’s report when it comes to its views on private insurance. However those members quoted the much-maligned Treasury report and talked of falling productivity. Of course what that report tells us and what Treasury says is that at this stage it is able to measure only about 46 percent of hospital activity and it is not able even to measure what happens in the primary health sector. 
It goes on to state that 60 percent of the costs are the wages of those who work within the health sector. I make no excuse for saying that the wages in the health sector have gone up—so they should. I think it was Barbara Stewart—and she always makes a considered intervention in this House—who said how important it is for us to retain our health workforce. Well we do not retain our health workforce in an international market if we do not increase wages and salaries. So the settlement for nurses which is backdated to last year and going forward is half a billion dollars. It is the biggest increase that nurses in this country have had at any time and they have fought for it for a decade. Past Ministers of Health know exactly what the campaign has been over that time. It has been settled and I am proud that nurses will have that increased pay—they deserve it. I also tell members that over the last 3 years doctors in the hospital system have had about a 50 percent increase in pay. We needed to do that to retain our medical workforce. I make no apologies for spending health money on that either. 
I also make no apologies for investing in new hospitals and rebuilding old hospitals. It was absolutely crucial because in terms of the hospital sector we actually have to have the bricks and mortar in order to provide the health service. We have put money into that. I believe that we are now seeing a health system that has had the investment in it that it needed. In fact if we look at investment in health throughout the 1990s we can see that in comparison with OECD countries we under-invested in health. We needed to catch up and we certainly have been doing that. 
Dr Hutchison talked of deficits. I remind the Committee that under the previous Government deficits reached 5 percent of the Health vote. They are now 1 percent of the Health vote. By anyone’s measure that is an improvement. We have seen nearly every board in New Zealand reduce its deficit with the exception of Auckland and Auckland remains a particular problem. Many issues impact on Auckland not least the impact of a building project that did not realise the $80 million of saving that was promised. It did not come about. However the board is working very carefully on the issue and we believe that it will reduce its deficit this year as well. 
Dr Hutchison mentioned the booking system. I think Bill English will be very disappointed in Dr Hutchison’s view on this. After all it was introduced in 1998. I think the booking system is a good system because it is honest and it is fair. It tells people whether they will get an operation— 
Hon Bill English 
: That’s not what you used to say. 
Hon ANNETTE KING 
: It certainly is. Let me tell the member this: in 1999 40 percent of those who were waiting for their first specialist assessment waited longer than 6 months. That figure now is 21 percent. It is getting better. I admit that when we started we started from a low base and it had to be built up. The system I believe is one of the best we can have in terms of being fair about elective surgery. 
Dr Hutchison mentioned bureaucracy. There has been an increase in staff of district health boards. In fact the biggest increase has been in nurses. The next-biggest increase has been in doctors. In fact the total increase in the number of bureaucrats in the health system has been 0.4 percent. Those are the facts. Opposition members talk about the bureaucrats but the people they call bureaucrats are those who book the operations answer the telephones and help to run the system. Those members would have us get rid of people who help to make the system work. National would turn the funding for that handful of people into “funding for health”. Well it would be lucky to get much out of that I have to say. 
I then heard Barbara Stewart talk about workforce issues. I agree with her. We have put a lot of investment into trying to improve our health workforce. To begin with we reopened two training schools for dental therapists in 2001 and 2002. I know that it sounds amazing to the member but all the training schools were closed in the 1990s; no dental therapy training schools were left in New Zealand. I am not quite sure how we were going to provide the service. Perhaps we were going to employ therapists until they were 99 years old; we certainly were not going to produce any more. It now takes 3 years to train a dental therapist—there is a degree course. We had our first graduates out of the Otago school last year and we had our first graduates out of the Auckland school this year but we need at least 40 graduates per year to provide oral health to the children and adolescents of New Zealand. We will get there but we have to invest in training. We have to be committed to training. 
We have also increased the number of medical students by 40 per year—the first increase since 1981. We actually have a much better grasp on those health workforce issues. We were training only 16 radiation therapists per year; we now train 38 and for the first time we can provide radiation treatment in New Zealand within the guidelines. It is fragile. We have to keep training and producing them for our own needs. It has taken a huge investment of money and energy to try to rebuild our health workforce. 
Then we heard from the very very sad member Rodney Hide. I actually pity that member. I have great pity for him because he is now a very bitter twisted and thwarted man. He has been thwarted by his own party actually. He had to spend the whole weekend stopping his members from getting rid of him. He has decided that he will go on a crusade on health. The unfortunate thing is that he is unable to put the facts out in a straight manner which means that people do not believe him. He over-exaggerates and overcooks everything and the consequence is that nobody believes him and nobody takes notice of him. 
He talked about the sustainability of health expenditure. Certainly there has been a big investment in health over these 6 years. I have already talked about the need to invest in our health workforce infrastructure and so on and also in our primary health care where we will get the results we want. But there does need to be a look at the sustainability of health funding in the long term. The Prime Minister announced at the beginning of this year that work would be done on the long-term sustainability of health funding. That work is now under way. It will be done properly and I can assure this Committee that the Government will go through each part of that expenditure in order to get the best use of it. It will not be done with slogans and smart statements. 
I conclude with reference to the Green member Sue Kedgley. She talked of the Healthy Eating - Healthy Action strategy. It is a nationwide strategy. It is not about a few people in the ministry trying to run a strategy around healthy eating and healthy action. It actually happens out in our communities in homes and in schools. It is about engaging all those players in getting through the message on healthy eating and healthy action. I believe that as one of the first countries—if not the first country—in the world to put such a strategy in place we will address those issues over time. But there is no quick fix solution to the fact that there are obese and overweight people in New Zealand. We have a growing number of them. 
Gerry Brownlee 
: Oh where? 
Hon ANNETTE KING 
: I say to Gerry Brownlee that I could not possibly say I see any of them in this Chamber—I know that he is asking where they are. We have a few folk who are overweight and unfortunately far too many children are overweight. There is funding and action taking place. 
I conclude by saying that very rarely do I agree with Sue Kedgley in any debate but that I totally agree with her comments about Pharmac. She said that she supports Pharmac that it does a very good job and that there is a campaign to get it. I support her and I believe that she is correct. 
Reports noted.