Stewart Barbara: Estimates Debate — In CommitteeText is incorporated into the Bound VolumeStewart Barbara: Estimates Debate — In Committee[Sitting date: 01 July 2014. Volume:700;Page:19089. Text is incorporated into the Bound Volume.]BARBARA STEWART (NZ First):I am very pleased to take a call on behalf of New Zealand First in the Appropriation (2014/15 Estimates) Bill. Each year in the estimates debate on the health budget we anticipate that it might focus on some preventative health measures. In this Committee we all know that prevention is far better than cure. We need that vision. We know that the health budget is reducing in real terms year on year and the Hon Annette King also spelt that out very clearly. Spending on prevention is logical. It will work towards preventing an increasing burden on our already strained health budget. Yet these estimates hold very few thoughts for preventative strategies which is a shame. We were expecting this. Why are there not any plans? We know that there is an obesity and diabetes tsunami actually coming to our country—just about to pass I would say. We must praise the Government in one area and that is for the free doctors visits for under-13s. That is a preventative measure. We are very pleased that National is looking at New Zealand First policy and starting to implement some of our health policy.We would also have liked to see in the estimates an attempt to reduce the hospital waiting lists perhaps by having additional staff to help out. We see the media highlighting the plight of people who require surgery but who do not qualify for the waiting list. Effectively they are waiting to get on the waiting list. Every member of this Parliament receives letters from people saying they have been waiting for months and months and some even for years. In the end they have to revert to living with pain or borrowing money to pay for the surgery that they need—some are lucky enough to go to a charity hospital to get the operation that they need.It is really disheartening that the Government has set a test for the level of need for surgery when clearly many thousands of people are actually left off the waiting list and yet are in dire need. The people who do not win this game of roulette often end up loaded up with painkillers and other drugs that they need. While they are waiting to go on the waiting list their health will deteriorate and their quality of life will be compromised. By the time they finally get to have the surgery the toll on the health system’s dollars will be vastly more than if the surgery had been done earlier or when it was initially dated for them to have it.The number of people waiting to get on the waiting list is a ticking time bomb and it really requires urgent action by the Minister of Health. The sad part of this is that nobody really knows the extent of this hidden list. Even the medical profession is speaking out and questioning the management of the health system pointing out that there is a hidden waiting list and saying that doctors themselves are very frustrated by the constraints imposed by the Government’s targets which looks at outputs rather than outcomes. This is a problem that disproportionately affects seniors which is particularly concerning given that we have an ageing population here in New Zealand.New Zealand First would rather see an ailment checked out with a general practitioner at an early stage before hospitalisation becomes necessary. It is far less expensive. The rising costs associated with this costlier health care will drive the district health boards’ books persistently into the red unless further action and fiscally neutral health plans are actually actioned. We know this is going to happen we have all the evidence and yet there is nothing on the books to try to sort this problem out. We pride ourselves on being a First World country so this level of Government disassociation around our health system is not good enough. Nothing appears to be planned either to ensure that we have a workforce for aged care. There does need to be parity between those who are working in private rest homes and those who are working in district health board rest homes. We all know that caregivers are absolutely essential in rest homes.