Dyson Ruth: New Zealand Public Health and Disability Amendment Bill — Third Reading 
Dyson Ruth: New Zealand Public Health and Disability Amendment Bill — Third Reading 
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Hon RUTH DYSON (Labour—Port Hills) 
: 
 I am very pleased to stand in support of the third reading of the New Zealand Public Health and Disability Amendment Bill. I begin by commending the way in which the Health Committee considered matters during its deliberations on this bill. The select committee has three parties represented: National the Green Party and Labour. On many issues we have worked I think in an exemplary fashion. We should actually be given a gold star by the Clerk of the House and probably by the Speaker for the way in which we intelligently and seriously consider submissions. It is to the benefit of legislation that that is able to happen in the select committee process. 
I also commend the officials who assisted us with this bill. There were some political tensions in relation to both the major parts of this bill. The advisers took those issues very seriously particularly given that the concerns raised by both the Green Party and the Labour Party were backed up by an overwhelming majority of the 13 submitters. I think the advisers were really helpful in that regard. I also acknowledge the submitters. 
There was no disagreement on the two primary purposes of the bill. The first one was to establish the Health Quality and Safety Commission. My recollection is that every single submitter who commented on the establishment of the commission supported it. The second primary purpose was to give a mandate for collective purchasing across district health boards or arbitration when district health boards had any conflicts or disputes over shared services and a mandate for the Minister of Health to require district health boards to plan in unison. So that is a much more centralised directive from the Minister in regard to purchasing and planning between the district health boards. Once again every submitter said that that was an important step forward. The district health boards have made considerable progress in that regard voluntarily but if there was one that was not happy to be part of that united picture then that really held up progress so having a clear legislative back-up for that desire is a good thing. Those are both good aims and Labour supports the intent of the legislation. 
As I said concerns were raised about both of the primary purposes. The first was in relation to the Health Quality and Safety Commission. I guess I could sum up by saying that submitters the Greens and Labour felt that a commercial model just was not a suitable model for the commission. That was the funding model in the original legislation; it is no longer in the legislation. I pay huge tribute to my colleague Kevin Hague from the Green Party for his tenacity in not only having his typescript amendment submitted during the Committee of the whole House but also his ability in persuading every other party in this House to support it. Kevin Hague’s amendment was passed unanimously. I think that was an excellent move. I am sure that he will speak to it further. It is not a very common occurrence that a member from a smaller party gets through a quite significant change to a funding model in legislation. This was clearly a different ideology from what the Minister had intended and it got unanimous support from this Parliament last week. So I acknowledge Kevin Hague’s work and congratulate him on it. 
At an earlier stage of the bill the Minister commented that the primary purpose or overall aim—not its specificity—was to ensure that we had better planning for a more efficient health system whereby we would reduce waste and deliver better services. Who could argue with that? But my concern is that the statement is frankly just not true and the bill will not deliver what the Minister sets out. We have heard a lot of this stuff before from the National Government. We have heard a lot about the delivery of more front-line services but in the last 23 months we have seen about 110 cuts to front-line services. There have been well over 100 cuts to front-line services whereas the Minister promised to improve front-line services. So how do those two statements—the opposite in terms of facts—relate to each other? The answer is that they do not. 
We have also heard the Minister say on numerous occasions that the Government will cut down on bureaucracy as part of getting more of these services to the front line. However we have seen not only cuts to front-line services but also an increase in bureaucracy. There is a huge new bureaucracy in Wellington called the National Health Board. It has really undermined the Ministry of Health even though the health board is technically a unit of the Ministry of Health. The National Health Board is calling the shots. We know that the Minister has appointed people who favour his ideology rather than favouring independent Public Service advice. We know that the people who run the National Health Board and the people who used to be employees of the Ministry of Health—who are now consultants to the National Health Board—are costing us huge amounts of money. 
We know that Murray Horn was being paid $1500 a day to prepare a report that was basically laughed at by the health sector as being a massive leap backwards. When it comes to saving money and decreasing bureaucracy let alone getting more services to the front line where people in New Zealand badly need them this Minister achieves zero out of three on all three counts. He has failed miserably. It is very obvious from the increase in public concern about cuts to front-line health services that people are becoming very annoyed and feel that this is not what they voted for and that it is not what the Minister promised. It is exactly the opposite. 
In question time today I raised my concern about an entire service that is being exited from the Capital and Coast District Health Board. The Minister did not seem to be aware of that issue. He started saying that the Capital and Coast District Health Board is now in the same league as every other district health board. But that is not true because the Capital and Coast District Health Board has said that elderly people who get no personal support at all but just get home support for laundry meal preparation or house cleaning will have their home support cut from their assessment. That practice will be rolling out from 1 December. That is exactly what has been happening in Otago and Southland. Members of Parliament from that region will tell this House that it has been an absolute nightmare for them in terms of elderly people coming to them with deeply distressing stories of their unfair treatment at the hands of the Minister of Health. Those people had been getting only 1 or 2 hours of home support a week—$30 worth—but that tiny bit of help makes the difference between those people being able to stay happy well and safe in their own home or having to go reluctantly into a rest home which would cost the taxpayer around $1000 a week. 
Although the intent of this legislation is good in theory we have been waiting for 2 long years to see some responsibility shown by the Government and some delivery on its promises. We are frankly sick of seeing the opposite of what National promised before the election. We have seen no reduction in bureaucracy. We have seen hundreds of front-line services cut. We have seen nurses community health workers social workers and mental health support teams lose their jobs. We have seen home support cut. We have seen over a hundred other front-line health services cut at the same time as the Minister is saying the Government is bringing this bill in so the sector can be more efficient and deliver more front-line health services. The question that remains—and it was certainly not answered by the Minister when he read that dreadful speech just prior to my taking the call—is how this move will be judged. Nothing at all in this legislation holds the Minister accountable for the promises he made. We have heard those promises before from a National Government. We saw cash registers in public hospitals in the 1990s. We are seeing a creeping move to privatisation by stealth in our health system now and we are seeing cuts to front-line health services. Those are the concerns that submitters raised about this legislation. We have heard nothing from the Government to reassure us.