Lees-Galloway Iain: New Zealand Public Health and Disability Amendment Bill — First Reading 
Lees-Galloway Iain: New Zealand Public Health and Disability Amendment Bill — First Reading 
[Volume:663;Page:11024] 
IAIN LEES-GALLOWAY (Labour—Palmerston North) 
: 
 It is a bit of a novelty to speak on a health bill. As the Minister said it is 18 months into the term of this Government and finally we have health legislation before the House. But as the Minister said that is not to say that things have not been happening in the health sector. He took some time to discuss what he thought was happening out there in the health sector and I intend to follow his lead by talking about what is happening in my electorate. The cuts—changes as the Minister likes to euphemistically call them—that have been occurring at MidCentral District Health Board have been extensive and varied. They have all come about because the Minister wandered up to Palmerston North read the Riot Act to the district health board and then wandered back to Wellington to leave them to it. 
So it is good to finally see the Minister of Health taking some accountability for his efforts. But what is happening at MidCentral District Health Board? Well as Ruth Dyson said probably the biggest and most significant cut is that to district nursing services. We see a cut to the overnight service which is particularly important to those people who are most vulnerable and who receive palliative care from our district nursing staff. They are wonderful nurses who will respond to any call-out in the middle of the night and who will go and deal with people in their homes so that those people do not have to go through the discomfort the agony and the trouble of going all the way into hospital and being admitted. 
People do not want to see that service disappear. So instead of the district health board taking responsibility for it the core Government responsibility will have to be shifted to the hospice—a hospice that is already stretched and a hospice that welcomed the additional funding which this Government promised and this Government actually did give it. But of course the Government did not say that the hospice would have to fund a whole extra service with that money. The hospice thought that was a kindly gesture to help it balance the books and to help it maintain its current services but no it was not that at all it was a little sweetener before it got hit with the information that it was going to have to provide another service. 
Another service that is going is the Diabetes Lifestyle Centre along with sexual health services. That is about right for this Government because it seems to have no interest whatsoever in public health and health promotion. These are two facilities that help to keep our population well so that people do not end up having to go into hospital but this Government seems to have no interest whatsoever in keeping people well. It wants to see people arrive in hospital get an acute admission so that it is easy to measure and easy to tick the box to say that that person has been through hospital. 
Rehabilitation services will be cut as well in Palmerston North as are the assessment treatment and rehabilitation services in the Horowhenua. So yes the Minister is absolutely right there is a lot going on. There has been a lot going on in the health sector in New Zealand even though this is the first health bill we have seen before the House and none of it is good. It is all about cuts to front-line services. 
I suppose this is where we have to call into question the accountability of the Minister. The bill refers a lot to the accountability of the district health boards but what about the accountability of the Minister? He has studiously avoided any requirement to be accountable with nothing going through the House so we as MPs do not get to scrutinise his work. His work never goes to the Health Committee so the public do not get to scrutinise his work and all the difficult decisions and all the bad news are passed off to the district health boards. That is probably why we saw 500 people in Levin attend the MidCentral District Health Board meeting this week. Those 500 people wanted to go along to the district health board—the people whom they see as making the decisions—and plead their case. Why? Because the Minister is not listening. He does not accept responsibility for his actions and he would rather pass it off on to other people. 
But the Minister has responsibility because before the election National made two promises in particular—two promises to do with health care. One was about front-line services. Well we have seen so many cuts to front-line services it is not funny. And the second of course was less bureaucracy. What have we seen? We have seen the establishment of a National Health Board and now we are seeing the establishment of the Health Quality and Safety Commission. These are two more layers of bureaucracy flying directly in the face of the promises made by National before it was in Government—two more broken promises to add to all the other broken promises we have seen from this Government. 
Setting up the Health Quality and Safety Commission is one part of the bill and the other part includes amendments to support the provision of shared administrative support procurement services across the public health system. Listening to Dr Paul Hutchison and to the Minister members would imagine that this is something they just dreamt up all by themselves and that it was not happening in any way whatsoever before the National Government came into office. This is part of the mythology that the National Government is trying to create about the previous Labour Government which is that it was overloaded with bureaucracy and had no interest in effective outcomes and shared services. 
We have already seen the two district health boards down in Southland and Otago reach a point where they are in merger. That did not happen just overnight; collaboration between those two district health boards was happening long before National came into Government. It has not all suddenly happened since Tony Ryall became the Minister. It is an utter myth to say that there was no collaboration between district health boards before this Government came into power. Again in my own area in the lower North Island there is an awful lot of regional collaboration between Wairarapa Hutt Valley Capital and Coast and MidCentral district health boards all the way up to Wanganui Taranaki and Hawke’s Bay. They do an awful lot of collaboration and they have been for some time. In fact Wanganui and MidCentral entered into an alliance perhaps the first step towards merger—we do not know. That may or may not be the best thing for those district health boards. We would like to see more coming from the clinicians and from the public there to tell us what they think about whether this is the right path for them. 
But it is an utter myth—and Dr Hutchison attempted to reinforce it—that collaboration was not happening before the National Government came into power. So yes this bill does extend it and perhaps brings it into a more formal structure. I look forward to the opportunity to discuss it at the Health Committee. It is about time we had public discussion about what this Government is doing. 
But make no bones about it a lot of this bill is about coercing the district health boards into amalgamation—because another one of the myths is that 21 district health boards are too many. Well if that is too many how many is enough? What is the right number? If this Government thinks that the Labour Government brought in 21 district health boards and that was too many how many is enough? We have not heard from this Government how many it thinks is the right number of district health boards. But we are seeing through this bill and other measures a coercion of district health boards and primary health organisations—much more strongly amongst primary health organisations; if one wants a primary health organisation to merge according to this Minister one just cuts its funding off. Perhaps it is a little bit more subtle with the district health boards but that is the direction this Minister wants to go in. 
Well that is wrong. Our communities and our clinicians should have the say over the direction of our district health boards. If they think they would benefit from closer relationships with other district health boards or going as far as merger then that is fine. But as we have already seen from Southland and Otago if we do not get the consultation right then we will get a backlash from the clinicians and we will get a backlash from the public. 
I am very pleased to see the New Zealand Public Health and Disability Amendment Bill referred to the Health Committee. It is about time we got some public scrutiny of what this Government is doing in health and I hope we see many submissions from all the people who have expressed their concern to me and other MPs on this side about the disastrous direction in which this Government is taking our health sector.