Ryall Tony: Questions for Oral Answer — Questions to Ministers 
Ryall Tony: Questions for Oral Answer — Questions to Ministers 
[Volume:630;Page:2487] 
8.  
Hon TONY RYALL (National—Bay of Plenty) 
 to the  
Minister of Health 
: Has the Ministry of Health written to district health board chairs recently to express concern about a lack of satisfactory progress in elective surgery; if so which district health boards did the ministry write to? 
Hon PETE HODGSON (Minister of Health) 
: 
 No but the ministry did write to all district health boards to remind them of their obligation to meet their district annual plans regarding their surgical booking systems. 
Hon Tony Ryall 
: Why did the Government write to the district health boards last week complaining about worsening elective surgery figures and performance when the Minister gets up in this House every second day to defend the Government’s record on elective surgery? 
Hon PETE HODGSON 
: The letters were about installing what are called “ESPIs”—elective services patient flow indicators. That is what it is about. About six or seven of the district health boards look as though they are too slow in getting those indicators up. The rest of them— 
Hon Tony Ryall 
: Name them. 
Hon PETE HODGSON 
: I will name them. The ones that are a bit slow are the Auckland Waitemata Waikato Bay of Plenty Hawke’s Bay MidCentral Capital and Coast and Canterbury boards. This is not about surgery it is about measuring the surgery in a modern context. 
Ann Hartley 
: Has he received any reports about how New Zealand compares internationally on the provision of timely access to treatments including elective surgery? 
Hon PETE HODGSON 
: I have today received a report from the Commonwealth Fund in Washington that rates New Zealand as second out of six developed countries on the timeliness of treatment including elective surgery. It puts us ahead of not only Australia and the UK but also well ahead of the United States which came last and has a health system the National Party is keen to replicate here in New Zealand. 
Judy Turner 
: Will the Minister recommend to all district health boards that they at least consider the initiative proposed by the Hutt Valley District Health Board to contribute up to 30 percent of an operation’s cost at a private hospital; if not why not? 
Hon PETE HODGSON 
: I understand that idea was tossed out at a recent district health board meeting. It is not clear to me how far it was tossed. I remind the House that a Minister of Health in the then National Government lost his job about 15 years ago for attempting part charges. I think that the proponent of that idea who is now on the district health board and was in the House at the time should learn from history. 
Hon Tony Ryall 
: When the Government stated in its letter of last week to district health boards that it will put errant district health boards under intensive monitoring and investigation what will that actually mean for the 18000 New Zealanders who are sick enough to qualify for an operation but cannot get one in his 5½ out of 10 health system? 
Hon PETE HODGSON 
: The member continues to confuse two ideas—one hopes unwittingly. One is whether New Zealanders are accessing sufficient elective services and the long and short of it is that the numbers are getting better and better each year. The other is that we have decided to install over a number of years a new patient flow indicator system. Those letters are designed to go to the hospitals and district health boards that have not yet fully implemented such a system so that we can measure even more transparently what is being done and what is not. 
Judy Turner 
: Does the Minister agree in light of the case of 8-year-old Patrick Casey whose life was hanging in the balance while waiting for elective surgery that contracts between district health boards and private hospitals would reduce waiting lists speed up the process for elective procedures and potentially save lives; if so will he actively encourage district health boards to pursue contracts with private providers and if not why not? 
Hon PETE HODGSON 
: District health boards are fully entitled to contract with private providers now—and many of them do. Typically the private providers get the easy jobs and therefore the price per unit is a little lower than usual—and that is a good thing. But when I compare the member’s two questions I realise she does not seem to understand the difference between private provision and private funding. 
Judy Turner 
: I raise a point of order Madam Speaker. What I actually asked was whether he would actively encourage district health boards. I know that they are allowed to contract with private providers and that they do have that discretion but I want to know whether the Minister will actively encourage district health boards to do that. 
Hon PETE HODGSON 
: I am happy to answer that. 
Madam SPEAKER 
: I thought he had addressed the question. 
Hon PETE HODGSON 
: I thought I had too. District health boards are in charge of what they do. They are fully entitled to use private services if they wish to. I will not actively encourage them to use private services if they have no need to; that would seem to be a waste. But they are fully entitled to use private sector capacity if it exists—and often it does. 
Hon Tony Ryall 
: Has the Minister seen reports that the Hutt Valley District Health Board has agreed to investigate providing patients with a subsidy of between 10 and 30 percent to get an operation in the private sector as a way of reducing the growing backlog of elective surgery in the public system; if so will the Government permit district health boards to use their funds in that way to benefit patients who have enough points to get an operation but have been waiting too long? 
Hon PETE HODGSON 
: I thought I had addressed that in the answer to an earlier question from a member. This member apparently not only fails to listen to answers I give him but he fails to listen to questions that come from other parts of the House. I say to the member that that appears to be a very very early idea. I do not think it is a very very good one. It sounds like part-charging to me. National tried to pull that trick 15 years ago and its Minister of Health lost his job. 
Hon Tony Ryall 
: Can the Minister tell the House why after contact from his office to the Auckland District Health Board the board promised an 8-year-old boy with a life-threatening aneurism a new date within 2 days for his twice-cancelled surgery yet the boy and his family have still not been given a new date almost a week after that promise was given? 
Hon PETE HODGSON 
: I am not aware of the number of times that that young boy’s surgery date has been changed. What I will say about that young lad is this— 
Hon Tony Ryall 
: You do know. 
Hon PETE HODGSON 
: I do not. [ 
Interruption 
] The member can just accept my word on that. I do not know all the changes that have occurred in the Auckland District Health Board in respect of that case. I do not. Indeed the board may have made another change half an hour ago for all I know. But what I will say about that young boy is that whereas there is an annual risk from his not receiving the surgery—which is for a condition he has probably had for all of his 7 or 8 years—of 2 or 3 percent a year and of course the risk is now accumulating there is the risk of surgery itself which is by no means minor. So we would do well to wish him well. Finally that young lad requires as I understand it surgery on 2 consecutive days. There must be certainty of the availability of theatre staff and theatre space. The staff cannot begin that surgery unless they are sure they can complete it. 
Dr Jonathan Coleman 
: Why did the Minister say in a press release at 1.52 this afternoon: “It’s time for everyone to realise that a health system that leaves people behind is not a health system that should be advocated in New Zealand.” when the case of the boy in Auckland is an obvious case of a New Zealander requiring elective surgery and being left behind; and does that contradiction not further erode the Minister of Health’s credibility? 
Hon PETE HODGSON 
: No because the press statement referred to the proclivities of the National Party and its preoccupation with Americanising the New Zealand health system as the then National Government attempted to do in the 1990s. [ 
Interruption 
] The member may want to shout me down or he may want to listen to this: in the second half of the 1990s the number of children waiting for paediatric surgery exceeded 3000. 
Gordon Copeland 
: I raise a point of order Madam Speaker. I for one was interested in listening to the response but back here we had an exchange going on across the cross benches with people yelling from that side to people on this side. I think that is disorderly. 
Rodney Hide 
: That is true Madam Speaker and I apologise. It is just that Mr Peters was explaining to me that he had paid up the $40000 that he owes to Mr Bob Clarkson but I understand he has not. I was just checking that out. I apologise. 
Madam SPEAKER 
: That was not a point of order. We do not really need to hear the substance of the exchange. 
Rt Hon Winston Peters 
: I raise a point of order Madam Speaker. I think you do. Now that he has put that at question let me say what my response was. I said that unlike him and the ACT party who cheat the system I pay up my debts if they are so found to be. 
Madam SPEAKER 
: Well I am sorry. That is why— 
Hon David Carter 
: I raise a point of order Madam Speaker. 
Madam SPEAKER 
: No please. 
Hon David Carter 
: Winston Peters since 2004 has owed me for my legal fees. I am still waiting. 
Rt Hon Winston Peters 
: As every lawyer in the House would know if that were true he would have a cause of action. He does not because I am still suing him and he is trying to stop the case from going to court. 
Madam SPEAKER 
: Would anyone else like to share on this issue? 
Rodney Hide 
: I raise a point of order Madam Speaker. Unfortunately as a result of the election Mr Ken Shirley is no longer here. But he too I know would like to say that he is still owed money by Mr Winston Peters for his legal bills. 
Madam SPEAKER 
: Well he is no longer in the House. 
Rt Hon Winston Peters 
: I raise a point of order Madam Speaker. What is happening here is that Mr Hide joined by Mr Carter are making baseless allegations on the basis—[ 
Interruption 
] 
Madam SPEAKER 
: Order! The member is talking to a point of order. 
Rt Hon Winston Peters 
: I will back mine up with the court judgment and with the testimony of the lawyers in question not with baseless allegations made in this Parliament. But the bad news for Mr Carter and Mr Shirley is that I am suing them and I do not intend to stop. 
Gordon Copeland 
: I raise a point of order Madam Speaker. 
Madam SPEAKER 
: I wish to move on unless it is a totally different point. 
Gordon Copeland 
: I thought I had come to Parliament today but it sounds more like a new-age love-in. I am staggered by the interchange that you have allowed between members of those two parties who have simply used the House’s time to advance a personal quarrel. 
Madam SPEAKER 
: I thank the member for his observation and I am sure all members will take note of it. 
Gerry Brownlee 
: I raise a point of order Madam Speaker. I just hope that you will look at the  
Hansard  
of that exchange. It seems to us that repeatedly in this House disruption is caused by the Rt Hon Winston Peters. I do not know how long you can expect the House to allow that to happen. I think we have come with all due respect to your good humour dangerously close to the place going out of control. Mr Peters needs to be reined in quite considerably; otherwise when we come back after a 3-week recess we could well be in a permanent state of disorder. 
Madam SPEAKER 
: I thank the member for his observation. I may say that the Rt Hon Winston Peters is not the only one who sometimes contributes from the cross benches when others are speaking. I would ask all members to take note of what Mr Brownlee said so that we can of course have an orderly House. 
David Bennett 
: I seek leave to table question for written answer No. 4381 in regard to legal expenses. 
Madam SPEAKER 
: Leave is sought to table that. Is there any objection? There is objection. And I might say that comes very close to actually being a point of order that in the context and timing in which it was done brings this House into disrepute. [ 
Interruption 
] Would all members please be seated. I do not of course deny the right of a member to raise a point of order. But in the context of the previous debate on points of order when that point of order could be raised at any other time and when I have been invited by the House to ensure that we conduct the House in an orderly fashion I make that observation. I will allow no comment on my ruling on that. I wish to move on now please. 
Gerry Brownlee 
: I raise a point of order Madam Speaker. 
Madam SPEAKER 
: This point of order had better be on a different point. 
Gerry Brownlee 
: I do not think you can direct what my point of order is about. 
Madam SPEAKER 
: No I am not. I merely said it should not be on the matter I have ruled on—that is all. 
Gerry Brownlee 
: Well that is exactly the problem that we get into because it does not escape the attention of members on the Opposition side of the House that Mr Bennett got a stinging rebuke when day after day Mr Peters comes in here and has huge license to disrupt the place with barely a word said to him. 
Hon Dr Michael Cullen 
: That of course challenged the ruling that you just made. But more than that it was Mr Brownlee who just before took a point of order in my view quite rightly to call the attention of the House to the fact that there is far too much of that kind of pointless exchange going on. Immediately Mr Bennett took a point of order to repeat a request for leave which had already been declined on a previous sitting day to table a matter that is to be found in the lobbies at this time. On at least three counts that was a trivial point of order. 
Rt Hon Winston Peters 
: The best response to Gerry Brownlee would be an open admission from Mr Hide that he started it with his comment about paying some court bill. He knows that he started it. Those members know that and this sort of flatulent protection of Mr Hide will not do in this House. 
Madam SPEAKER 
: That is why I am asking members to move on please. 
Rodney Hide 
: I raise a point of order Madam Speaker. 
Madam SPEAKER 
: No I am asking us to move on. I have ruled on the matter. Would Mr Hide please sit down while I am on my feet. As I said I have ruled on that point. Everyone has had an opportunity to put a point of view on it. Now I think we should move on to the next question unless it is a totally different point of order—and I mean that this time. 
Rodney Hide 
: I raise a point of order Madam Speaker. It is absolutely a new one and it is this. This is quite remarkable. I do not think there is a more inoffensive MP in this House than Mr David Bennett. He stood up in the House— 
Madam SPEAKER 
: This is not a point of order Mr Hide. 
Rodney Hide 
: Yes it is. 
Madam SPEAKER 
: Well come to it quickly please. Points of order have to be given succinctly. 
Rodney Hide 
: If you allow me to I will. I just wish you would not try to sit down Opposition MPs. David Bennett got up and very calmly and correctly raised a point of order. It is about the second one he has raised since he has been here. He got a stinging rebuke from you Madam Speaker and what you said was in the context of others having been rebuked. Then Mr Peters got up and did exactly the same thing—in fact it was far worse than that because he accused me of some monstrosity in this House—and you did nothing. [ 
Interruption 
] 
Madam SPEAKER 
: No I do not need any more assistance on this matter. I have ruled on the matter and we will move on. 
Ron Mark 
: I raise a point of order Madam Speaker. I just draw your attention to and ask you to consider the fact that two of those points of order were direct challenges to your authority and judgment. 
Madam SPEAKER 
: I am aware of that Mr Mark. I have warned members about that. I do like members to have their say—perhaps a little too much at times—regardless of the allegations that I do not. This is a robust Chamber. I have always operated on that basis. But if my points and rulings are challenged again then members will be leaving this House. 
Hon Tau Henare 
: I raise a point of order Madam Speaker. I have just observed something in the House that I have not seen before. The Rt Hon Winston Peters was holding something up to David Bennett in a threatening manner. I do not know what was written on it but that is the sort of thing that brings the House into disrepute. When a longstanding member who should know better is up against a minnow— 
Madam SPEAKER 
: I ask the member to please be seated. 
Hon Tau Henare 
: We expect more from that member. 
Madam SPEAKER 
: Would the member please be seated. Does the member wish to remain in this Chamber? You will seated when the Speaker is on her feet Mr Henare. 
Hon Tau Henare 
: Well you should be doing your job. 
Madam SPEAKER 
: Would the member please leave the Chamber. I am doing my job. 
Hon Tau Henare withdrew from the Chamber.