Dyson Ruth: New Zealand Public Health and Disability Amendment Bill — First Reading 
Dyson Ruth: New Zealand Public Health and Disability Amendment Bill — First Reading 
[Volume:663;Page:11020] 
Hon RUTH DYSON (Labour—Port Hills) 
: 
 This is a Tui billboard: “The New Zealand Public Health and Disability Amendment Bill is not about restructuring in the public health system and the reason for that is that National promised it would not restructure. The bill is about an administrative shake-up.” It is like the cuts in health services that every single week we have reported in the House. Every single week there are cuts to front-line health services and the Minister of Health says that they are not cuts; they are changes. 
Well the Minister of Health should tell that to the 3000 older people in Otago and Southland an area that is very familiar to your good self Mr Assistant Speaker Roy. He should tell them that the cut to their home support—which is no longer funded by Vote Health—is not a cut; it is just a change. Well change has been pretty awful for them. 
The other interesting thing is the sort of expectation the Minister built up. He did not build it up a lot in that speech actually. I was not sure that he would not doze off part-way through it. It was not a very lively presentation but he did talk about the huge savings potential to be made in health. He said that huge dollars would be saved by making more efficient use of our taxpayer dollar in the health system and he talked about all the things that we would be able to buy with that saved money. 
I refer to a similar report that was presented to this House and to the public of New Zealand and they fell for it only once. The report stated that savings made yearly by health reforms could provide an extra 10000 to 20000 coronary bypass operations or fix half a million children with glue ear. That was said by the then Minister of Health Bill Birch. Did we ever see any health savings in the 1990s? Did we see any New Zealander getting better access to more affordable public health services? 
What we saw in the 1990s and what we are seeing now are absolute cuts. In fact I have some very attractive cartoons and I am happy to present the Minister of Health with a copy of them after this debate. The cartoon I am holding is from the time of the National-led Government in the 1990s. It shows a surgeon with a facemask on but the mask is a $100 bill. The caption says “Welcome to your regional health authority. Pop up onto the bed and take off your clothes. One of our accountants will attend to you shortly.” That is the health system that the previous National Government foisted on New Zealand and it is the health system that Tony Ryall now wants to force on New Zealand. There will less access fewer services and it will be more expensive. 
Here is another very attractive cartoon. This is another one by Tom Scott. He will probably charge me for flashing his cartoons around tonight. It is headed “Behind the scenes in a typical New Zealand hospital.” It says “Scalpel. Clamp. Blood transfusion. Can we afford it? Calculator.” Do members remember the so-called great health reforms of the 1990s? All we got was cash registers in our public hospitals. New Zealanders did not like it. They did not think it was fair. They knew they had paid their tax dollars week in week out to get access to public health services and they did not want to pay again when they walked in the door of their local public hospital. 
Minister Ryall did not refer much to the bill. It was a political rant from the start to the finish dull though it may have been. But the bill does a couple of things. The first thing it does is establish a Health Quality and Safety Commission. This is the second new bureaucracy we have had in just 18 months under this Minister of Health. The National Health Board is chewing up thousands of dollars and we are not sure at all what it is doing at the moment other than replacing what the Ministry of Health used to do. So we are not quite sure what the Health Quality and Safety Commission will do but I imagine that it will have appointees from the Minister. The Minister’s handpicked personnel will be running the show and they will probably do the bidding of the people who are giving the Minister the key advice in the health sector. 
If the aim is to improve quality and safety in our health system in New Zealand then there would be no argument from this side of the House but it is not at all clear why a new body is needed to do that. Will it be just a new bureaucracy? Will it just chew up more of the precious health dollars that we are seeing taken away from our families and communities and will we see any improvement in health quality and safety as a result? That is not at all clear. 
We have heard some outrageous financial claims from the Minister and he made them again in his speech. Even though the key part of this bill is to set up a new bureaucracy the Minister was still claiming in his speech immediately prior to my taking the call that we would see $700 million saved in the health system over 5 years. Nowhere in this legislation is there any indication of exactly how that money will be saved. 
We have the idea of shared services. I am not quite sure what stage the establishment board is up to now. We have a ministerial dictate. No longer will the district health boards be required to work together until they get agreement on a pathway forward. If the Minister is intolerant of any disagreement then he will make the call and he will decide. So all our local democracy has gone out the window. 
If the people at Tairawhiti District Health Board are having a discussion with MidCentral District Health Board about how to provide better services locally and if the Minister decides that that is not what he wants to do then he can just step in and say that they have had enough discussion. He can tell them he does not want them to collaborate in that sort of way and he can tell them what they will do. 
That ministerial determination and dictate is something that we have not seen in New Zealand since the days of the Hon Bill Birch— 
Hon Member 
: Right Honourable. 
Hon RUTH DYSON 
: Correct; I thank the member—the Rt Hon Bill Birch. I offer my apologies for incorrectly appropriating his title to him. Actually his retirement was one of the best things that could have happened to the health system in New Zealand. 
It is not at all clear—the Minister did not elucidate on it at all—how the new Health Quality and Safety Commission will fit in with the Health and Disability Commissioner. We have recently had a new appointment. The Minister of Health announced a new appointment to the commissioner’s position but no relationship at all is explained in this legislation. It is a big puzzle as to why we need a new bureaucracy when a large part of the work that is described in the legislation is already under the mandate of the Health and Disability Commissioner. The idea of resolution of protection and of learning is the driving force behind having the commissioner and this just seems to be an absolute duplication of that. 
I thought that the Minister in his 10 minutes may well have had the opportunity to apologise to New Zealanders for the significant number of health cuts to front-line services that they have had to endure in the last little while. As I mentioned earlier we have seen huge cuts in Otago and Southland particularly to home support for older people. In South Canterbury health cuts for older persons have again been rife but we have also seen a significant reduction in the number of people who are being allowed to access the accident and emergency department at Timaru Hospital. In Gisborne a programme that worked with people with mental illness and people who had been violent—a community-based programme with extremely good results—has been cut because of health funding cuts.  
Mental health services in Nelson have been cut back. Gisborne Hospital decided to close its theatre for 6 weeks to save money. So for 6 weeks the people in the Tai Rawhiti district had no access to surgery. Of course that would save money. If every hospital in the country was closed it would save a huge amount of money but it would not do much to assist health outcomes for New Zealanders. 
In my own town of Christchurch we have seen week after week older people being treated in a disgraceful way because of the health cuts that Tony Ryall has signed off. At the MidCentral District Health Board—Palmerston North and Horowhenua—we are going through a consultation process now where one shift of the district nursing service an entire 8 hours of service provision will be cut and the assessment treatment and rehabilitation beds at Levin’s health centre are under threat. 
This bill does nothing to address that. I look forward to the debate at the select committee where local people will be able to tell the Minister of Health directly what they think of his health cuts.