Clark David: New Zealand Public Health and Disability (Southern DHB) Elections Bill — In CommitteeText is incorporated into the Bound VolumeClark David: New Zealand Public Health and Disability (Southern DHB) Elections Bill — In Committee[Sitting date: 10 May 2016. Volume:713;Page:10933. Text is incorporated into the Bound Volume.]Dr DAVID CLARK (Labour—Dunedin North): Thank you for the opportunity to speak at this Committee stage. I of course will be speaking in support of the bill—as my colleagues have done—and in support of the amendment put forward by the Hon Annette King which does give an opportunity to the Government to step up to the plate to restore democracy earlier if there is sufficient progress made by the commissioners on those issues which have really been concerning people in the South and across New Zealand I think in respect of the Southern District Health Board as a resource with ongoing financial difficulties and ongoing issues of capacity. I think it is helpful for the Committee to remember of course that part of the loss of capacity was due to people leaving when there was a great deal of uncertainty about Health Benefits Ltd and what it would achieve and about the centralisation of financial structures across New Zealand in what turned out to be a failed project. We know that people left Dunedin to be a part of that failed project so the Southern District Health Board actually bled capacity. It bled planning capacity and financial capacity around that time because of a failed experiment by this Government.We know that the Government had a Crown monitor on the boardbefore the commissioners were put in place. We know that for 6 years it had that Crown monitor who acted as a Government watchdog effectively on what was going on—a direct line if you will to the Minister to ensure that a board is performing its duties effectively and doing what is asked of it. Of course the Minister also chooses the chairman in a normally run board and five of the 12 board members. So the Minister and his predecessors have to take responsibility for the situation that the Southern District Health Board found itself in. Of course the Ministerthen stepped in and we have supported this and said: “We will appoint a commissioner. We are not happy with the progress and of course we must own the lack of progress in the Southern District Health Board in meeting its financial targets and also in meeting the expectations of New Zealanders for delivery of health care. The buildings have become run down. We are familiar with the fact that there is a major asbestos issue in the buildings in Dunedin and we have become aware of course of lower staffing levels and of various attempts to work with limited finances.”The Hon Annette King also referred to the funding model and the review that the Minister undertook. We on this side of the Chamber are not convinced that that funding review was sufficiently broad and sufficiently deep to really assess whether the district health boards are being funded fairly. And there is the very example that the Hon Annette King just used of the rural adjustor and the fact that South Canterbury actually receives more funding per capita for a rural population despite having a far smaller geographic area than the Southern District Health Board which covers a geographic area the size of Belgium. It just does not seem right. There are questions around whether the tertiary funding areais adequately compensated in terms of training and so on and those questions were not probed in sufficient depth in that review.In speaking to the amendment put forward by the Hon Annette King I want to say that if the Minister does take up that challenge I will be impressed. I will put that on record in advance. It is a way that the Minister can show he is committed to the restoration of democracy there which rightly has been raised as a concern because of the Government’s track record with Environment Canterbury and elsewhere and because of the sense that the Government seems increasingly out of touch with middle New Zealand—the sense that it is not genuinely concerned about democracy and about what middle New Zealand thinks about issues and would like to see happening in the country. If that is going to be the case I think we want to see a number of areas of progress before the intention of that amendment is realised through an Order-in-Council.The kinds of things that we would like to see of course are things like the finances coming under control for the district health board and either that consistent deficit disappearing immediately or a clear plan as to how that is going to be diminished. We would like to see some clear and measurable signs that that structure and capacity are there to deliver the health care in Otago that all New Zealanders would could and should expect of their district health board. We would like to see that that capacity is there at a planning level as we see the new hospital being planned for Dunedin and also at a governance level—that there is within the management structure the ability to report to governance effectively and also some confidence about the people the Government intends to appoint for its appointments in that process.I guess the other key indicator in that area would be a credible plan for the rebuild because that is something that southerners have been crying out for for some time—capital on the table and a date on which construction will begin. I actually have a petition running in the South that seeks a commitment by the Government to begin construction on a hospital rebuild by 2017. The previous Minister expected while he was still Minister for there to be a business case to Cabinet for that rebuild. All we have seen since then is duck-shoving. The time lines have been pushed out—they have been pushed out further and further and further. It is like this Government is simply not committed to that hospital rebuild. It is like it wants to push it on to some future Government and pretend the issue is not there. Well actually it is incredibly important for New Zealanders and particularly New Zealanders in the South Island who access those services that we have money committed—that we have capital committed—to that project and with it a start date for that physical rebuild because that is what really shows true commitment.Also we would seek from the Minister an assurance that the same tertiary level of hospital will be retained so that services will not be lost to people in the South. Health care needs will change. Ways of delivering services will change. Let us have a mature debate about this but we seek an assurance that the same tertiary level of hospital will be maintained by the Minister because we should not see falling levels of health care in New Zealand. In the meantime we want to see—and it was expressed in the select committee process—a commitment to increased reporting. There have been some moves made by the commissioners since that select committee debate to have more transparency in their discussions—to invite people to some of the sessions that the commissioners are running and have some more open discussion more like what there was when the board was in place. Locally I have certainly had feedback from people concerned that Labour has not just outright opposed this. We have taken a response that we believe is the right response: to support the Minister’s desire to get stuck in and make a difference here and to have commissioners who sort out the financial difficulties the planning difficulties and the capacity difficulties at the hospital—commissioners who will commit to the nature of the rebuild and the time frames—and we want to see the Government committed to that.That means the Minister has even closer responsibility than he used to. Let us acknowledge that he used to appoint the board members he used to appoint the chair and he had a Crown monitor on there. He now has his own commissioners reporting to him. We want to see the Minister commit to those time lines to commit to the financial health of the district health board being restored and to commit to funding it adequately. These are the commitments we seek from the Minister. If he does not achieve these things he will have failed. He is directly tied to the appointment of those commissioners he has skin in the game and the southerners want to see this Government delivering. It is Dunedin’s turn. Dunedin Hospital is the last major metropolitan hospital in the country to have a rebuild and it is simply unacceptable that the time frames for that rebuild continue to get pushed out and that southerners get lesser health care than people elsewhere in the country and less than any New Zealander should expect. Most New Zealanders are pretty reasonable. Most New Zealanders simply want an adequate level of health care. They want to know that the hospital will be there in their time of need and that the Government will be funding it adequately rather than a $1.7 billion shortfall that we have seen under this Government.As I said at the outset we will be supporting this bill. We do think that the Minister has the responsibility to step up with this support to deliver on the promises of the Government—to adequately fund health care and to drive forward the hospital rebuild and governance and management arrangements at the Southern District Health Board.