Ryall Tony: Questions for Oral Answer — Questions to Ministers 
Ryall Tony: Questions for Oral Answer — Questions to Ministers 
[Volume:634;Page:5621] 
5.  
Hon TONY RYALL (National—Bay of Plenty) 
 to the  
Minister of Health 
: By how much money has the health budget increased since the year 2000 and how many more individuals got elective surgery annually in 2005-06 compared with 2000-01? 
Hon PETE HODGSON (Minister of Health) 
: 
 The Labour-led Government has invested an extra $3.2 billion in the 5 years ending 2005-06. This historic investment delivered the largest hospital-building programme in New Zealand history affordable primary health care for families the biggest mass immunisation campaign ever undertaken in the country and an extra 5000 doctors and nurses in our hospitals and has led to 6000 more people receiving elective surgery last year than in our first year in Government. 
Hon Tony Ryall 
: As a result of the Minister’s announcement of additional elective surgery and $30 million for the remainder of this financial year how many extra people will get elective surgery in the year ending 30 June 2007? 
Hon PETE HODGSON 
: It depends on negotiations with district health boards that are yet to be completed. 
Hon Tony Ryall 
: So you don’t know. 
Hon PETE HODGSON 
: No we do not know. We put out funding sufficient to manage 10000 operations per annum. I said at the time of the announcement that it will take district health boards a little time to gear up. I am expecting that several thousand New Zealanders will receive their surgery by 30 June 2007. 
Maryan Street 
: What reports has the Minister received on reform of the delivery of elective surgery at a local level? 
Hon PETE HODGSON 
: I have received reports that the Ministry of Health has been flooded with proposals from district health boards on ways to address disincentives in the delivery of electives and to make it easier for clinicians to treat more patients. Later this month I will announce the best proposals which will receive Government funding to implement these new ideas. It is clear that the Government’s reforms of elective surgery policy are already getting traction in our public hospitals and that the Opposition does not like it. 
Judy Turner 
: By how much money have district health boards’ budgets for private hospitals to provide elective surgery increased since the year 2000 and how many more individuals got elective surgery in private hospitals annually in 2005-06 compared with in 2001? 
Hon PETE HODGSON 
: I do not have either figure with me I am sorry but I am happy to say that the extra elective surgery that was announced last week will not only allow district health boards to provide themselves but also allow them to contract with other district health boards with primary health care providers—especially general practitioners with a special interest—and where spare capacity exists with the private sector. 
Hon Tony Ryall 
: When the Minister of Health has admitted in the House today that he does not even know how many extra operations he can promise the people of New Zealand despite issuing a press statement promising that 10000 extra people would get elective surgery how can anyone in this country believe a single word he says? This statement is spin and deception. He promised 10000 operations and he does not even know what he is going to get. 
Hon PETE HODGSON 
: Because this is a Government that is not preoccupied with reckless tax cuts and instead is wanting to place emphasis on the improvement of public health services we are in a position to invest more in elective surgical services for New Zealanders than a National Government could. The reason I do not know precisely what number will be done is that we actually will not know that until after 30 June has passed but I am expecting there will be several thousand such surgical operations in the remaining part of this year. I say again that we have funded district health boards to the tune of 10000 extra operations in any full financial year. 
Madam SPEAKER 
: I remind members that it is becoming increasingly hard to hear again. 
Hon Tony Ryall 
: If spending an extra $4 billion since Labour came to power means according to the Minister’s numbers 6000 additional people are getting elective surgery each year how can the Minister seriously say that spending $50 million means 10000 more people will get elective surgery each year—it just does not stack up? 
Hon PETE HODGSON 
: The gentleman’s strengths do not include straightforward accounting. What we do is buy on case weights and pay on delivery. I tell Mr Ryall that that is where we get our figure from. 
Hon Tony Ryall 
: If buying centrally and paying on delivery can for $50 million give an extra 10000 people elective surgery why does the Minister not adopt that approach for the rest of the hospital system? 
Hon PETE HODGSON 
: Because we are not a control and command Government. We are a Government that does not believe in saying that the health system should be run on commercial lines according to the whim of the National health Minister of the day. Au contraire we say it is a good idea to have district health boards with elected people from the community on them who are able to govern what sort of service they want in their region. What is more it looks as if the district health board model works pretty well because about 88 percent of New Zealanders say so. 
Keith Locke 
: I raise a point of order Madam Speaker. I found it rather difficult to hear from back here and it may be that there will be an extension of the waiting lists because some of us have to have operations on our eardrums if this continues. 
Madam SPEAKER 
: I think the member is correct I am sorry. I remind members for the last time that it was extremely difficult to hear what the Minister was saying. If this continues members will be progressively leaving the Chamber. 
Hon Tony Ryall 
: If buying centrally and paying on delivery can produce so many extra operations for $50 million when bulk funding of $4 billion produces so few operations why would the Government not do that; and will the Minister stand by his press statement and guarantee that $50 million will buy elective surgery for 10000 extra people when he says that out of that $5000 per person he will pay for the person’s first specialist assessment anaesthetic clinic diagnostic testing operation and follow-up outpatient visits and is that not just revealing that this Minister’s statement and pledge are all spin and deception instead of his caring for the sick people of New Zealand? 
Hon PETE HODGSON 
: The first part of the member’s question was actually embarrassing for the National Party. The second part was uncomplicatedly bewildered. I say to the gentleman that if he wants a lecture a seminar or even a brief lesson on how case-weighted purchasing works he can talk to his predecessor Dr Paul Hutchison who did understand how the New Zealand health system works. 
Hon Tony Ryall 
: I raise a point of order Madam Speaker. I realise that the Minister is under a lot of pressure but for what reason would you accept that answer when it was a commentary rather than an addressing of two very significant points? One is—it goes to the heart of Government policy—that the Government has always said— 
Madam SPEAKER 
: I thank the member. I do not need to hear any more. Would the member please be seated. I ask the Minister to give us that seminar but to do it in fact briefly. 
Hon PETE HODGSON 
: Maybe it would help if I were to gently remind the member that there is a good deal more going on in the New Zealand health system than elective surgery—a good deal more. Secondly I say to the member that we know what a case weight costs and when it is delivered we pay for it. 
Rt Hon Winston Peters 
: I raise a point of order Madam Speaker. What gives Mr Ryall the right to resume his seat having asked a question and spend the rest of the time shouting while his question is being answered? It is not just him; it is Gerry Brownlee as well and others. There has got to be some equivalent treatment around this House for every member and not just one group getting away with it every darn day. From our point of view we think that this is disgraceful and that some members of the National Party who are laughing as I speak and jeering should be sent out of this House rather than just warned every day when other members at the back of this House are expected to behave themselves. But they carry on as if somehow they are special. Madam Speaker I have never thought it right for someone to ask a question then shout the whole time it is being answered but that was from a member right next to you and you could not have missed hearing him. 
Madam SPEAKER 
: I thank the member. Interjections are permitted but members are bordering on making it very difficult for other members to hear. I thought we had an agreement. If we do not from here on in as I said members will be leaving. 
Hon Tony Ryall 
: I seek leave to table the ministerial press statement of the Hon Pete Hodgson promising to deliver elective surgery to an additional 10000 New Zealanders a year. 
Document not tabled.