King Annette: Oral Questions — Questions to MinistersText is incorporated into the Bound VolumeKing Annette: Oral Questions — Questions to Ministers[Sitting date: 17 November 2015. Volume:710;Page:8020. Text is incorporated into the Bound Volume.]3.Hon ANNETTE KING (Deputy Leader—Labour) to the Minister of Health: What is the impact on patients and staff of not covering all inflationary pressures in health?Hon Dr JONATHAN COLEMAN (Minister of Health): The impact from increasing Vote Health by $4.1 billion over our 7 years in Government is 5500 more doctors and nurses pay rises for nurses and better access to services across the board. In recent years while many nations froze or cut health funding our increases have been amongst the biggest in the developed world.Hon Annette King: I raise a point of order Mr Speaker. It was a question on notice and I asked: what was the impact of not covering all the—Mr SPEAKER: Order! No. The question has been addressed although I accept not to the satisfaction of the member. I will allow the member one additional supplementary question if she wants to use it.Hon Annette King: In light of that answer why has orthopaedic surgeon Geoff Anderson spoken out publicly in the past few days saying that it is harder now to get a knee replacement on the public purse than it was 4 years ago?Hon Dr JONATHAN COLEMAN: I do not know Geoff personally but what I would tell him is that back in 2007 we were doing 8439 orthopaedic operations; we are now doing 10590. That is an increase of 25 percent. So I would be very happy to share those statistics with Mr Anderson. He is probably operating at the moment but if you give me his email address I will send them to him.Hon Paula Bennett: What reports has he seen that claim access to hip—[Interruption]Mr SPEAKER: Order! I am sorry to interrupt. I am just having trouble hearing the question. Would the Minister please start it again.Hon Paula Bennett: What reports has he seen that claim access to hip and knee surgery has got worse and how accurate are these?Hon Dr JONATHAN COLEMAN: Last Wednesday during question time Mrs King tabled Official Information Act documents that she claimed showed that access thresholds for hip and knee replacement had increased at the Auckland District Health Board. She then followed up with a press release that got wide coverage including a front page Dominion Post story. She claimed that the number of points needed for hip or knee access thresholds for replacement surgery had gone up from 50 to 70 points between 2013 and 2015. I was suspicious as the number of hip and knee surgeries at the Auckland District Health Board had increased 30 percent over 7 years. After receiving a statement from the Auckland District Health Board a few days later saying that the hip and knee threshold had not changed from 50 I checked the tabled Official Information Act documents—Mr SPEAKER: Order! The answer now is miles too long.Hon Annette King: Why would orthopaedic surgeon Geoff Anderson not tell the truth when he said he had one patient in her 50s in pain who risked losing her job and had been given the highest possible points he could give her but she was still told no?Hon Dr JONATHAN COLEMAN: Well I do not think the member should accuse Mr Anderson of not telling the truth but I am not familiar with Mr Anderson or his district health board. I would be very happy if Mr Anderson wants to contact me directly.Hon Paula Bennett: Could he please give an update of what the Official Information Act response that was tabled last week actually showed in its report to the House?Hon Dr JONATHAN COLEMAN: Tellingly the Official Information Act responses that Mrs King tabled during question time did not show that the threshold has gone up at the Auckland District Health Board between 2013 and 2015. Fifty was the threshold in 2013 and it was still the threshold in 2015. The figure of 70 that Mrs King used in the House was just plain wrong.Hon Annette King: I raise a point of order Mr Speaker. [Interruption]Mr SPEAKER: Order! [Interruption] Order! This is a point of order. [Interruption] Order! I have not heard from the member yet. This is a point of order. I wish to hear it in silence.Hon Annette King: The Minister has just said I was plain wrong—Mr SPEAKER: Order! I want the point of order.Hon Annette King: My point of order is that I wish to re-table the Official Information Act response showing—Mr SPEAKER: No. [Interruption] Order! No the member is now trifling with the Chair. [Interruption] Order! Does the member have a further supplementary question?Hon Dr JONATHAN COLEMAN: Speaking to the point of order.Mr SPEAKER: No there is no need to speak to the point of order.Hon Dr JONATHAN COLEMAN: I raise a point of order Mr Speaker.Mr SPEAKER: Yes if the Minister is raising a fresh point of order we will hear it but if the Minister is now—[Interruption] Order! My patience will not last much longer around this duel between the two. If the Minister has a fresh point of order we will hear it but if it is attempting now to relitigate discussions that occurred then I will take a very dim view of it. I would advise the member to remain in his seat.Hon Dr JONATHAN COLEMAN: I seek leave for Mrs King to be able to re-table the—Mr SPEAKER: Order! You cannot seek leave on behalf of another member.Hon Annette King: Has he seen the Official Information Act responses from district health boards that show that 48000 who needed a specialist appointment for orthopaedics have been sent back to their GP without having being seen since 2010-11?Hon Dr JONATHAN COLEMAN: No. As the member knows there is no complete data set. We are the first Government to put that data together. All we do know is that there has been a 25 percent increase in hip and joint replacements under this Government. That is the only fact in this debate.Hon Annette King: Does he realise that throwing around percentages and figures ignores the pain and suffering of people like Ken Smith of Napier who was unable to walk or drive but could not get an operation and has paid $23000 out of his retirement fund for knee surgery?Hon Dr JONATHAN COLEMAN: The only person in this House who throws around patients’ names here is Mrs King. All I can tell you is that the number of hip and knee replacements has increased 25 percent under this Government. We are doing more; that member was doing a lot less.Hon Annette King: In light of the growing number of people forced to pay for surgery—and Mr Smith made himself public not me—Mr SPEAKER: Order! Just ask the question.Hon Annette King: —are Professor Bagshaw’s comments correct when he said we are slowly creeping into a privatised health system?Hon Dr JONATHAN COLEMAN: Mr Bagshaw has been a Government critic since about 1998 and he is wrong. What is really a shame about that front-page article is that it is written on the basis of an incorrect tabling of an Official Information Act response and incorrect facts provided by Mrs King to the press. I do not think they would like that much.Hon Annette King: Is he being transparent with the public when he talks in percentage terms for increases in orthopaedic discharges when in reality the 34 percent increase since 2008 equates to an increase on average of 44 operations per year per district health board and includes all orthopaedic procedures not just hips and knees where the main problem is?Hon Dr JONATHAN COLEMAN: No the member is incorrect. Hips and knees—there were 8479 operations 7 years ago and today it is 10590. The only person who is not being transparent is the person who tables false Official Information Act—Mr SPEAKER: Order! That will not help the order of this House.Chris Hipkins: I raise a point of order Mr Speaker. We have had a series of issues over the past week about members making disparaging comments questioning the word of other members which has resulted in some fairly serious consequences for some members. Mr Speaker are those rules going to be applied consistently? Repeatedly through the answers that the Minister just gave he questioned the word of another member.Mr SPEAKER: Order! I listened very carefully to the answers. Apart from the very last comment by the Minister nothing in my opinion was out of order. The last comment made was not going to help the order of the House and I admonished the Minister at the time.