10. Southern District Health Board—Funding and Access to ServicesDr DAVID CLARK (Labour—Dunedin North) to the Minister of HealthSouthern District Health Board—Funding and Access to Services10. Dr DAVID CLARK (Labour—Dunedin North) to the Minister of Health: Does he agree with the New Zealand Medical Association's president that district health boards were grossly underfunded" and that "there's just not enough money in the system no matter how you cut your cloth you just can't do what's required of you when there is not enough money going in"?Hon Dr JONATHAN COLEMAN (Minister of Health): No but it is election time and a range of views start coming to the surface.Dr David Clark: After 9 years will he listen to orthopaedic surgeons who are saying that one-third of patients at Dunedin Hospital are not receiving the surgery that they need to cope with chronic hip knee and other joint pain?Hon Dr JONATHAN COLEMAN: Obviously there have been issues at Southern District Health Board (DHB) which have been addressed and are in the process of being addressed. I mean for instance in orthopaedics there has been a 40 percent rise in specialist appointments over the last 9 years; that is a considerable increase. In terms of elective surgery at Southern DHB that has increased by 33 percent over the last 9 years. So there is a huge increase in operations and appointments way ahead of the population growth. The member needs to cheer up and stop talking down the hospital on a continual basis.Dr David Clark: What does he say to Dunedin man Stuart Neill who observed an understaffed and under-resourced Dunedin Hospital last week when he was called in for urgent surgery for advanced bladder cancer after his file had been misplaced for months following a prostate examination?Hon Dr JONATHAN COLEMAN: I am not familiar with Stuart's case but what I would say is that it is imperative that Southern DHB continues to lift its game. Obviously there have been issues there over time. That is why we had to sack the board in 2015. The commissioner has got a task ahead of her which she is getting into and she is turning the place around but it is no easy task; not helped by the member.Dr David Clark: Does he still stand by his answer in the House last Thursday that there were no financial penalties for Southern DHB for not achieving surgical targets when one of his commissioner team has now admitted that due to this failure $1 million is being withheld from the DHB by the Ministry of Health?Hon Dr JONATHAN COLEMAN: Obviously as with everything this member puts up I would have to go back and check the transcript but the fact is that Southern District Health Board is not being punished financially.Dr David Clark: After 9 years does he think it is acceptable that last year nearly 60000 New Zealanders did not receive the specialist appointment at the hospital that their GP recommended?Hon Dr JONATHAN COLEMAN: At which hospital?Dr David Clark: Hospitals in New Zealand—Mr SPEAKER: Order!Hon Dr JONATHAN COLEMAN: Well what the member actually knows is that in total only 5 percent of people were turned away from a hospital appointment. Eighty-seven percent of GP referrals went straight to the specialist appointment; another 8 percent were inappropriately referred perhaps to the wrong department; 5 percent did not get their appointment. But the bigger picture is that there has been a 150000 increase in specialist appointments across the country and a 50000 increase in elective surgeries so the member really needs to get on board and cheer up. It is a lot better than he is saying."