Robertson Grant: Budget Debate 
Robertson Grant: Budget Debate 
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GRANT ROBERTSON (Labour—Wellington Central) 
: 
 Chris Finlayson once asked my colleague Charles Chauvel why he had taken an instant dislike to him and Charles said: “It just saves time.” That was in reference to the member who has just resumed his seat whom I shared a podium with on Sunday night when even the national secondary schools’ Shakespeare competition entrants booed that Minister because he was so nasty. He simply cannot deliver a speech without being nasty. [ 
Interruption 
] Mr Finlayson is correct; I presented the award that is in his name at the University of Otago Sheilah Winn Shakespeare Festival. It is the “Christopher Finlayson Award for Nastiness”. That is what the award is; that is what was read out. That is correct is it not I ask Mr Finlayson. 
We come here to debate the Budget and I am sure Mr Speaker you are glad that I will do that. This Budget was christened by John Armstrong as “a fairytale of high hopes”. That is certainly what it is: a fairytale of high hopes that has projections jobs in the never-never but no plan for growth no plan to lift New Zealanders out of poverty no plan to reduce the income inequality in this country and no proper plan to grow the economy in this country. I prefer another musical title for this Budget: “Bill English’s Fiddler on the Hoof”. That is what it was: a tinkering a fiddling but no real plan to drive this economy forward. There is no real plan to reduce social inequality in this country and no real plan to protect and enhance our environment. In short it is a failure of a Budget. 
What we saw today in the House on the health budget was I thought instructive. The Minister of Health Tony Ryall stood up in front of the House today and did not even want to own his own press release from Budget day. He did not even want to admit that his press release acknowledges that the health budget falls at least $170 million short of standing still. Mr Ryall stood up and claimed that more money has gone into health. He likes to claim that a record amount of money is now being spent on health. Well when I went to the supermarket the other night I spent a record amount of money on my groceries but that does not mean there were more items in the shopping basket and the same thing applies in the health system. 
The health system is falling behind. Two successive Budgets from this Government have got nowhere near meeting what the health system needs just to keep services at the level they are at now because we have an ageing and growing population health costs and health inflation rise faster than normal inflation and the cost of medical equipment and treatments is growing. Unfortunately this Government has failed yet again in this Budget to give district health boards the amount of money they need to provide services as they are now. That is the reality. There are now only two options available to district health boards: to cut services or to increase charges. Those are the two options that this Minister is leaving the health system. 
We all know that we live in tight financial times but what we could have seen from the Minister today was some honesty about that. He could have stood up in the House and said that he acknowledged that only $420 million extra was put in and that that is not enough to make ends meet. But we did not see that. We had obfuscation from the Minister on that score. 
It is difficult for people to look at the health budget and understand exactly where the cuts are but it is quite clear that in areas such as public health service purchasing we have seen cuts of about $38 million. National contracted services which sound benign but include Healthline and hospital chaplaincy services have been cut as well. We have also seen cuts in national mental health services in the Primary Health Care Strategy and in health workforce training and development. Those are the core elements of a Budget for health and they have been cut back and the Minister was less than up front in the House today about those cuts. That is $165 million worth of cuts that the Minister was not prepared to acknowledge today but the truth is that that is the gap in this health budget and he has not been able to fill it. 
What we saw in the Budget was no real commitment to primary care which is an area that members on this side of the House believe in. We believe that prevention is better than cure. We believe the bias of our investment should go towards primary health public health and our children’s health and we did not see that in this Budget. In fact we see that primary health care is still at 1.3 percent of the health budget. As a country we have to get it clear in our heads that health is not something that starts in a hospital. Health is something that starts in our homes our communities and our schools. That is where we need to be investing in the early interventions that will help Kiwis stay healthy rather than parking ever-flasher ambulances at the bottom of the cliff. We need an investment in primary health care and public health that is greater than the current 1.3 percent. 
We need to see health in a wider context. There was a very good project in this Budget; it was the rheumatic fever initiative. I congratulate the Minister on putting that money into the rheumatic fever initiative but in the end we will not address rheumatic fever—a disease that should not be present in New Zealand—without addressing overcrowded homes and cold damp housing. 
Health needs to be seen in a wider context than just initiatives hospitals and hospital services. We need to see the wider context of housing employment reducing inequality the taxation system public transport and eradicating poverty. Those things will make the fundamental difference to our health status and the health status of New Zealanders. This is recognised right around the world. In July Sir Michael Marmot will visit New Zealand from Britain and I encourage all members of the House to listen to what he has to say. In the UK he has put forward a comprehensive plan for addressing what we call the social determinants of health—that is the things that people experience in their lives that affect their health outcomes. 
The New Zealand Medical Association has picked up that plan in an excellent document its  
Health Equity Position Statement 
. In that document the New Zealand Medical Association which is not known to be the most left-wing of organisations acknowledges the importance of addressing the background causes of health status. I quote from one element of its statement: “The NZMA: … Believes that in order to eliminate inequities in health a whole of government approach will be required. In particular policies addressing education employment poverty housing taxation and social security should be assessed for their health impact. [The New Zealand Medical Association] Believes that economic growth should not be viewed as the sole measure of a country’s success and that the fair distribution of health well-being and environmental and social sustainability are equally important goals.” 
The message coming from the doctors of this country is that we must see health in a wider context. Economic growth is important to health reducing poverty is important to health and creating jobs is important to health and this Budget failed on almost every one of those indicators. 
When we look at the report from the Prime Minister’s Chief Science Advisor Sir Peter Gluckman he backs up the advice of the New Zealand Medical Association to invest in our children. That is why I am incredibly proud of the work that Annette King has been doing on the importance of children and on the agenda for children that will ensure we invest in children. We must make sure that children get the antenatal birthing and post-natal care they need. We must ensure that children are enrolled with well child providers and that B4 School checks are being undertaken. We must ensure that school health services are kept going unlike what is in the review that is being undertaken by the Minister at the moment. We need to make sure that we invest in the things that will allow our children to learn. School health services are brilliant not just because they make sure that people get the primary care that they need but because they allow children to learn. We know that if children do not learn that is the beginning of the slippery slope. That is what Sir Peter Gluckman is telling this Government. That is what the New Zealand Medical Association is telling this Government. 
From Labour’s point of view we know there is not a bottomless pit of funding for health expenditure. We will when we get into Government be looking to ensure we find the efficiencies and innovations in the health sector that will allow us to invest more money in keeping New Zealanders healthy. That should be the goal of our policies. 
I have one last point on that matter. The regional public health unit of the Hutt Valley District Health Board has estimated that it will cost a family living on the minimum wage 50 percent of their income to put a healthy meal on the table. That is not good enough. It will cost a beneficiary family 71 percent of their income to put a healthy meal on the table. We have to support families so that they can put healthy food on the table. Labour has policies to do that: we will take the GST off fresh fruit and vegetables and we will make the first $5000 of income tax-free. 
Labour will continue to advocate policies that are about keeping New Zealanders healthy in our schools our communities and our families. We will continue to invest in hospital services but Labour also believes that primary health care and public health are essential to the future well-being of our country.