Chadwick Steve: New Zealand Public Health and Disability (Enhancement of Competition) Amendment Bill — First Reading 
Chadwick Steve: New Zealand Public Health and Disability (Enhancement of Competition) Amendment Bill — First Reading 
[Volume:629;Page:1830] 
STEVE CHADWICK (Labour—Rotorua) 
: 
 I am delighted to get an opportunity to speak on this bill. Labour does not support this bill because Labour and this Government believe in delivering health to all New Zealanders in the most cost-effective manner. In our model of health the Primary Health Care Strategy is not measured on the basis of throughput in hospitals. As the health spokesperson from the Opposition said spending on pharmaceuticals has dropped. What a good thing that is if we are starting to focus on keeping people well and getting people to a doctor at a more affordable rate. That is what the New Zealand Health Strategy is all about. 
Labour does not support this bill at all because we do not want the free market to reign over pharmaceuticals in this country. We absolutely do not want that. In 1993 the model of Pharmac was introduced into this country in order to stop litigation between the major pharmaceutical companies. Evidence has been tabled here today about the litigation up to 2000. It cost a lot of money—it cost Pharmac money to fight that litigation. Thank goodness a court ruling has since stopped the litigation and Pharmac can now spend its budget which may be quite well-controlled and capped on accessing more subsidised pharmaceuticals for people in New Zealand not on health money for drug companies. The court ruling has enabled Pharmac to operate a national pharmaceuticals schedule. It has not ruled out access to the market. If people want to have unsubsidised pharmaceuticals they can have them. It has not capped access to them at all but people have to pay for them. This issue is about funding the subsidised pharmaceuticals available to New Zealanders. It is about containing our costs. 
I went to Australia where we were asked how on earth we got the Pharmac model set up in this country. Those on the Health Committee will remember that trip. Pharmac is a fantastic model because it controls uncapped expenditure by pharmaceutical companies. It is a model that we would not want to get rid of. It is of global envy that we have a model with robust structures for getting drugs through subsidisation consideration by experts in the field. We go through the Pharmacology and Therapeutics Advisory Committee to get experts to give advice on the quality of life given by the drugs that people are asking to be subsidised. We would not want to get rid of a model like that which is the envy of everybody. 
The repeal of section 53 of the principal Act proposed by a very good member of ACT who understands the health environment is actually very very flawed. Labour does not support this bill at all. The important thing about the exemption and why we need it for Pharmac is simply that as a small country we need interconnectedness between Pharmac and the district health boards. That is what the exemption allows. It was set up for the four regional health authorities. They have gone. We now have 21 district health boards and the exemption needs to cover that breadth for this country and for our health system as it stands now. It does not protect other organisations that have entered into agreements with Pharmac; those can stand. 
Pharmac’s objective—and I think this is a really noble move—is to look at health gain not just at cost minimisation. We as a Government find that very important. We certainly do not support this bill. It would unravel the excellent work done by Pharmac. I am sorry to say that the bill certainly does not have our support.