Blue Jackie: Budget Debate 
Text is incorporated into the Bound Volume 
Blue Jackie: Budget Debate 
[Sitting date: 30 May 2012. Volume:680;Page:2705. Text is incorporated into the Bound Volume.] 
Dr JACKIE BLUE (National) 
: 
 Talofa lava Mr Speaker. It is a pleasure to speak in the Budget debate this afternoon. Budget 2012 was a Budget for our times our uncertain times and the Minister of Finance Bill English has made sure that we will be on track to surplus by 2014-15. That has been the theme for the last 4 years. It has been a sustainable Budget and it is one that ensures we can actually make our way in the world. We have to pay our debts and we have to make every dollar count and this is a Budget that will do exactly that so I say congratulations to our Minister of Finance.  
Obviously having been a health practitioner I focused on the health part of the Budget and I am delighted about Budget 2012 in respect of the health budget. It has been a challenging time for the health Minister but he has managed to put more money into certain areas and this made me reflect on how far we have come. In the lead up to the 2008 election the mantra going in was that it was harder to see a hospital specialist; in fact we had tens of thousands of people culled from waiting lists. The emergency departments were gridlocked. We had stories of patients on gurneys in the corridors of emergency departments and under bright lights. We had workforce shortages morale was extraordinarily low in the health workforce we had ballooning health administration and health professionals were basically seen as part of the problem not the solution.  
Well our health Minister Tony Ryall has carefully managed his way through that with careful leadership through successive Budgets and he has turned that round. He has got to be congratulated on the work he has done in the health sector. I am certainly proud of our successes in the health sector.  
Basically key to all of this and to turning it round is making clinicians part of the decision making. That has been quite crucial also in implementing health targets. The targets have been advertised quarterly; they are a way for district health boards and the public to benchmark their local hospitals. This has been welcomed by clinicians. It has not been seen as a threatening move. Basically district health boards have stepped up. Even this morning at the Health Committee hearing the Waitemata District Health Board which had had a bad patch only a few years ago and had gone through a rough time reported that it was leading in most of those six targets for the district health boards. So congratulations to the Waitemata District Health Board. I think that Lester Levy has been an inspired choice as chair of both the Auckland and Waitemata district health boards. 
I want to look at some specifics in the health budget. Basically at over $14 billion it is the biggest investment so far in health. There is $68 million for more operations scans and tests and that will also ensure we maintain our excellent levels of elective surgery. Compared with 2008 27000 more elective operations are performed per year more than 500 extra operations per week and under this Budget we are still going to be investing $48 million in elective surgery so that we can have a further increase of 4000 operations in elective surgery. That is an astonishing astonishing result and target. In my first term of Parliament as I said we had patients being culled from waiting lists. Tens of thousands went back to their general practitioners from the waiting lists and I recall many harrowing letters from patients and families about their relatives being culled off the lists—unacceptable. I am so delighted that we have increased elective surgery and will continue to do so.  
Also an area of quite some importance is diagnostic tests such as magnetic resonance imaging scans CT scans colonoscopies and angiograms. These are important tools in the diagnosis of disease and also in how we plan treatment. Minister Ryall has recognised that we need to speed up timely access to these important tests and tools. Therefore $16 million has been allocated for new IT systems which will create faster access to those tests. There will be $4 million for a national register for patients who have heart conditions. 
Importantly for me given where I used to work in the health sector $33 million has been invested in better faster services for cancer patients. Importantly and it has been alluded to by a previous speaker there has been more money to go to dedicated nurses to help patients and their families navigate their way through the health sector when they are diagnosed with a serious cancer diagnosis. You can appreciate that with a cancer diagnosis that is very serious it is confusing it is frightening and a navigator—a personalised service using a dedicated nurse—is a fantastic initiative. Also from July we are going to be able to collect key data on those points in that patient’s journey so that we can get a picture of a patient’s journey and it will also help when looking at coordinating services and improving services. 
I can only go back to 2007-08 when cancer waiting times were absolutely appalling. We had radiation waiting times and instead of what we have now as the gold standard of 4 weeks it was up to 16 weeks - plus which was dangerous. We had women going to Australia for radiotherapy having to leave their families and their jobs and their whole lives were being absolutely turned upside down. We will soon be having targets on chemotherapy waiting times and I am pleased to see that.  
The whole thing I think with health targets is that they do actually focus the mind and get people talking about how we can achieve that target and that is key to it all. I mean emergency department waiting times have been a fantastic success. Emergency departments do represent the barometer of how a hospital is functioning. If there is gridlock it represents systemic issues going on within that district health board such as poor patient discharge planning maybe poor design of the accident and emergency department and just general patient flows. The fact that 50 percent of our district health boards are now achieving the target of 95 percent of patients being processed within 6 hours is fantastic. You just cannot achieve that out of thin air. It takes planning it takes collaboration and it takes communication. 
I recall that in the last term of Parliament I went to the Counties Manukau District Health Board when it was celebrating achieving that emergency department target of 95 percent. It had taken 2 years to get to that point. It did not happen overnight. There were conversations about everyone’s role from the orderly to the personnel and so forth and that is what— 
Hon Trevor Mallard 
: OK that’s enough.  
Dr JACKIE BLUE 
: But no actually it is quite key. It is actually the care pathways that are key. The Canterbury District Health Board which is a hugely innovative district health board is doing care pathways. Basically it is getting people round a table and talking about what their roles are and how a disease or process needs to be managed. It is as simple as that. Communication is key and that was lacking before Tony Ryall took over his portfolio in health. It was lacking the morale was absolutely down low and clinicians were not feeling empowered. I tell you: to turn that round is all about communication. It is as simple as that and this Minister has done it.  
 Immunisation is a hugely successful target—95 percent of 2-year-olds to be immunised. Well we have almost achieved that. We currently have 92 percent coverage compared with back in 2007 when only 67 percent of 2-year-olds were immunised on time. That was a shocking statistic and we have done extraordinarily well. There is no doubt that health targets focus the mind and it is all about communication and achieving those targets. 
Getting smokers to quit is another target. I am really pleased with the Budget announcement of increasing the tobacco excise as that will mean we will have more and more people giving up tobacco and cigarettes in droves. We know that costing hikes make a difference in people not wanting to smoke in the first place or in people just making that decision to stop smoking. We know that it is an addiction so access to smoking cessation products and Quitline are so important. I see that the initiative in Budget 2012 with the increase in tobacco excise along with the health target will make sure that that statistic keeps improving and we will and I am sure we can be smoke-free by 2025. All of this is quite achievable. Smoking causes so much harm in our society and I am delighted to see that initiative. I commend this Budget. Thank you.