Clark David: New Zealand Public Health and Disability (Southern DHB) Elections Bill — Third ReadingText is incorporated into the Bound VolumeClark David: New Zealand Public Health and Disability (Southern DHB) Elections Bill — Third Reading[Sitting date: 12 May 2016. Volume:713;Page:11084. Text is incorporated into the Bound Volume.]Dr DAVID CLARK (Labour—Dunedin North): We on this side of the House will be supporting the New Zealand Public Health and Disability (Southern DHB) Elections Bill as the Minister of Health indicated. But that across there is a Minister under pressure.Hon Dr Jonathan Coleman: Not from you buddy.Dr DAVID CLARK: The clock is ticking Dr Coleman—the clock is ticking. He says: “Not from me.” He makes it personal. This is actually an issue about the people of the south being able to access adequate health-care. That is why on this side of the House we are putting the politics aside for a while to give the Minister the opportunity to make real progress because his Government unfortunately has let the situation become so dire in the south.This problem that exists in the Southern District Health Board—where it has struggled to meet its financial targets where the building of a substitute hospital has been pushed out and pushed out and pushed out and where the Government itself has failed to commit fully to a rebuild—is an ongoing matter—and it did not start last year. It started with this Government years ago. It has had a Crown monitor on the board for 6 years. It appointed the previous board chair and five of the 12 board members. This Government has been all over the Southern District Health Board for 6 or more years and is worried about the status of the progress down there on the issues that matter for the south.Of course the Government must take some blame. The failed Health Benefits Ltd proposal which dragged capacity out of the south in terms of financial planning was an initiative of this Government. It failed in producing what was promised with that initiative and eventually it folded. But the damage was done. The capacity the management capacity the planning capacity that existed in the south—some of that was leached away during that period. The Government has only made the situation worse so far. And finally the Minister has said that this is starting to reflect badly on him—goodness knows why it took him so long to come to that conclusion—so he has appointed some commissioners to step in to try to rectify this situation.Of course some of the fundamentals that contribute to it the Government is not going near. The underfunding—this Government has underfunded health by $1.7 billion. That is independent analysis using Treasury figures which have determined that although the costs of health have been rising this Government has not funded it adequately and so health care around the country is suffering. That $1.7 billion is no trifling amount and it is no wonder that Kiwis are struggling to get the health care that they normally would get. Middle New Zealanders are suffering while the Government is more focused on the interests of those at the very top—the very wealthy the mega-rich. Middle New Zealand is suffering.So here we have finally an intervention that says: “Well maybe we do care about health.” It has come late and we support the fact that the Government is saying that it is going to do something. But it comes of course with strings attached. Our support is there because we want to see progress. Our support is there because we want to see good health-care for the south. The Minister is now under pressure the clock is ticking and we have not seen much progress to date—we have not seen much progress to date.In the Health Committee the issues of transparency were raised. On this side of the House we want to see measurable progress. We want to see measures put in place that we can measure progress against. So far the commissioners have produced a one-page strategic planning document that looks more like a Christmas card than a plan. We have got a partnership group in place that is supposed to be designing the new hospital and from it we have seen very little. It has been asked to produce very little to be fair to the group and it has obliged thus far. We have not seen real progress on the hospital rebuild. We have not seen a commitment from the Government in terms of capital and a start date for a rebuild. All we have heard about are some amorphous kinds of projections that a new hospital will be there in 10 years’ time. Well for goodness’ sake that is pushing out the obligation to a future Government.This Government does not seem fully committed to health care in the south but here is the Minister saying that he is going to do something about it. He has appointed his own people. They have been in place now for coming up on a year—it will be a year at the end of June; it will be a year—and then we will expect to see real progress. So far we have not seen much. So that is why that Minister is under pressure and he is feeling the heat and so he should be. Annette King has him under pressure every day in the House. The Government is failing to deliver and it is that $1.7 billion of underfunding that means that it is going to continue to struggle to deliver. But Mr Coleman has nowhere to hide. He is now tied to the commissioners he has appointed—he is now tied to those commissioners.Of course we know that the situation came about because in part when the Southern District Health Board came out of the merger of two health boards $30 million was lost with the removal of the boundary. We will hear shortly the member for Clutha-Southland Todd Barclay get up and say the funding is adequate. He will ignore his constituents who are concerned that they are not getting the operations that they ought to be getting. He is not concerned about middle New Zealand. He is not concerned about the people who need the health care but who are no longer getting it. He is not hearing those concerns. He says all his rich mates can get every operation they need whenever they need it. They can get private health-care if the public health-care system is not delivering. That is the increasingly out-of-touch Government we see opposite us.We know that funding matters and we on this side of the House also know that democracy matters. In the select committee stage the Hon Annette King—the formidable Hon Annette King—put forward a wonderful amendment that would have given the Government the opportunity through an Order in Council to restore democracy sooner if it thought real progress was being made. Government members declined that opportunity. They did not want to have that opportunity put in play. They wanted the full term. They will have the full term with this commissioner in place and we expect real progress as a result.We want to see the finances coming under control but we also want to see the delivery of services. We want to see structure and capacity rebuilt. We want to see good governance in our local district health board and we want to see capital commitment from this Government—capital commitment and a credible time frame that starts with a rebuild start date. When will the first sod be turned? Will the Government commit to a tertiary-level hospital of the same quality that Dunedin has historically enjoyed? And will we have services such as training restored? That has been removed because our buildings are decrepit and no longer fit for purpose. They were designed over 50 years ago so it is no wonder—modern hospitals are different. We would expect something different. It is Dunedin’s turn. It is the last major metropolitan centre in New Zealand to get its hospital rebuilt and this Government seems shy of committing to it.We know that the funding formula is flawed. It needs a deep and full review. For example the southern district covers an area roughly the size of Belgium but it does not have a sufficient rural funding component. South Canterbury has a much bigger one. How can that possibly be? It makes no sense. There are some anomalies that need a proper and full review. We know that older styles of building require more money to run because they are less efficient. The operations that are run are less efficient than the modern practices. There is no compensation for that in the case of the south.The major tertiary hospital is out of date and people are forced to make do. We know that leads to stretched staffing ratios and we know that leads to stress in the workplace. So we want to see some progress on the hospital rebuild and measurable time frames put around that and a commitment of capital up front. In the meantime we have got problems with asbestos in our local hospital and we have got concerned citizens who recognise that they are not getting the same service that those in other district health boards around the country are. This is a Minister under pressure. He is not addressing these issues as quickly as he should be.But we are supporting this bill. My colleague Clare Curran said—I read her comments in the newspaper the other day where she said them and she will correct me if I am wrong—that it was somewhat galling to have to support this bill. I think that captures it because here we are with a situation where democracy has been taken away from the people the citizens in the south because of this Government’s failures. It is very hard to support democracy being taken away even if only for a short period of time. It is hard for us to do that but we are doing it because we think it ties the Minister so closely to the outcomes.The Minister is under pressure—the clock is ticking. We want to see real progress on planning on financial stability on capacity on governance and on a rebuild. We need these commitments from the Minister and we need to see real progress. He is being watched in the south. Health care affects every New Zealander and it affects people in the south no less. For decades this hospital has been moving closer to its end date and the regional neglect of this Government is something that has only contributed further to that. In conclusion I want to say that people in the south pay their taxes and the Government cannot for ever put off the commitment to making sure the services that are desired and needed and reasonably expected in the south are delivered.