Street Maryan: Debate on Prime Minister’s Statement 
Text is incorporated into the Bound Volume 
Street Maryan: Debate on Prime Minister’s Statement 
[Sitting date: 12 February 2013. Volume:687;Page:7718. Text is incorporated into the Bound Volume.] 
Hon MARYAN STREET (Labour) 
: 
 First in this reply to the Prime Minister’s statement I would like to extend my congratulations to Mr Speaker on his ascension to that throne. I hope he enjoys the position. If he does not I understand there is a vacancy coming up in Rome towards the end of the year and he might find that of some interest. But I hope he also takes the opportunity to review conventions and definitions and to make his own imprint on the House. I wish him well. 
In reply to the Prime Minister’s speech I want to spend some time going to the heart of people’s needs and that is their health and the health of their children. In his speech in this debate 2 weeks ago the Minister of Health Tony Ryall trumpeted his Government’s so-called successes in health. He trotted out the things he usually trots out: more doctors and nurses—although those figures have been roundly disputed and comprehensively debunked by the Association of Salaried Medical Specialists together with the Minister’s own ministry—and he talked about more elective surgical procedures. Those are the things that one gets when one pays the district health boards to provide them. These are the easy wins which is what this Minister focuses on. But what are the statistics that the Minister of Health hides from? First of all 3701 more children were admitted to hospital last year than the year before. Nearly 4000 more children with preventable respiratory infections preventable skin infections and even some vaccine-preventable diseases were admitted to our hospitals around New Zealand last year than in 2011. This is not what success looks like; this is what failure looks like. For every 100 Pakeha children admitted to hospital there were 156 Maori children admitted and a staggering 251 Pacific Island children admitted. This is not a successful health system; this is a failing health system. Health inequalities such as those that are demonstrated by the admission of children to hospitals equal a bleaker future for our children and not National’s much-vaunted brighter one. 
 Health targets are by and large a good idea. We introduced them when we were in Government and this Government has continued them. But they need constant revision. I want to refer to a particular example that has come to my attention in recent times. An ophthalmologist was to operate on a small boy who had a genetic but surgically correctable sight problem. The boy was booked in for surgery on a Thursday afternoon I think it was. At the last minute the ophthalmologist had to cancel that boy’s operation because the hospital needed to do two cataract operations in that period in order to meet its elective surgical targets. In other words the number crunchers came before that specialist’s clinical decision on who was the priority for surgery that afternoon. When we see this kind of thing happening in our hospitals we know that the health targets which the Minister is trumpeting on a daily basis are in fact distorting the delivery of health services and not improving them. In that story the specialist told me that he felt demoralised—demoralised by the compulsion to cancel that little boy’s surgery so that he could do two much quicker cataract operations in its place in order to meet the Minister’s elective surgery targets. These are targets gone mad if that is what is happening. I understand that this is not an isolated incident. So although the Minister wants to get up and talk about particularly elective surgical procedure targets then let him also say to this House what has to be cut in order to allow hospitals to meet those targets. 
Let me give another example. At Counties Manukau District Health Board it takes now depending on who you talk to somewhere between 2 weeks and 8 weeks to get a hip operation—at Counties Manukau it takes between 2 weeks and 8 weeks to get a hip operation. It has almost got to the stage where it is going out into the highways and byways seeking out the halt the lame and the blind—let us throw in some cataract operations as well—and saying “Have you got a dodgy hip? I have got a deal for you.” If that is not skewing the purpose of health targets I do not know what is. In fact recently the Government was reported to be eyeing axing some of the elective surgical procedures on the basis of some advice from the National Health Committee which comprises people for whom I have a great deal of respect. However the particular procedure that it identified as possibly being one of the ones that could be taken out was the insertion of grommets. The insertion of grommets for children—babies usually; infants with ear infections—sets them up to be able to hear properly to get past their glue ear or their otitis media infection which causes them not to be able to hear and then paves the way for them to learn at school to be responsive to their environment and to not be problematic. This Minister is compelling advice to be brought to him—he is compelling advice that he wants to hear. In other words whatever you do do not cut elective surgery to people who can vote. Do not cut elective surgery to the elderly but go and ahead and sacrifice elective surgical procedures for children because they do not vote. This cynical approach to the delivery of health care is the hallmark of this Minister and needs to be stopped. It is time to revise these health targets. 
Children’s health is our best investment. Nearly 4000 more admissions to hospital of children with preventable or poverty-related diseases in 2012 than in 2011 is not success in the health system; it is failure. This Government is failing our children. Housing is one of the keys to this and this Government has done nothing in 4 years now in its fifth year to improve health inequalities that stem from poor housing. This Government also has a black hole where its plan for an ageing population should be. This is not success; it is failure. For all of Tony Ryall’s shovelling of negative questions off to other lesser mortals in his caucus people are now seeing beyond this teflon veneer and the evidence of failure is piling up. Child poverty is something that needs to be addressed. Health intervention can stem the worst impacts of child poverty but it is not a cure in itself. So the Minister of Health needs to get alongside the Minister of Housing and say “How can we knit our policies together so that they give our children the best chance?”. Opposing a decent living wage and opposing realistic minimum wage increases year on year are the things that will not improve the health of our children in this country. They will only make it worse. The Government is not a success; it is a failure.