Goodhew Jo: Estimates Debate — In Committee 
Goodhew Jo: Estimates Debate — In Committee 
[Volume:648;Page:17644] 
JO GOODHEW (National—Aoraki) 
: 
 I rise in this estimates debate to speak about rural health. How interesting it is that in the appropriation for Vote Health there is $5 million for rural health. One might think that that would perhaps address some of the issues in rural health which include the safety of rural patients being compromised by shortages of general practitioners and long waits for people to see general practitioners. Can members imagine the situation in some parts of New Zealand—it does not sound like a New Zealand setting but it is true—where patients wait 2 weeks to get an appointment with a general practitioner? Is that the sort of system we are happy to accept? Of course it is not. There is a very heavy reliance on locums and rural health services have been described in a report by the New Zealand Institute of Rural Health as being in a “fragile” state. 
The institute has pointed out that despite any input by this Government—despite the doubling of Vote Health over the past 9 years—it has not resolved the most significant issues present in the rural health sector today. We may think an appropriation of $5 million might be quite useful but guess what? There is no idea in the Ministry of Health or on the part of the Minister as to what that money is for. It was just a way of saying to the sector: “Go away and keep quiet for a while.” That is not what the sector asked for or what all the recent reports have suggested is required. Those people are not quite sure what to do with the money. They know that the rural health sector needs money to be invested in it but they know also that this is not what they asked for. In fact they have completely lost faith in this Government. They used to think the Labour Government looked after rural health but they have most certainly changed their minds. 
Let me give one example of a symptom. When the Associate Minister responsible for rural health went to a conference recently where he was to be the lead speaker on one side of the debate up against myself on the other side he deferred to a medical student at the very last minute. What does that tell us about the Associate Minister’s confidence to address the issues in rural health today? He deferred to a medical student to be the lead speaker in that debate. That says a lot does it not? 
So what has this Government been doing for rural health? We know that three reports directly affecting the sector are still outstanding. The first is a report into the PRIME system—primary response in medical emergencies. The second is a report into the rural ranking scale which has been buried since the rural sector commented on it; it has been buried since last October. The latest we have heard from the Minister is that it will be out in November. That is funny—the election will be over by November so I find that rather strange. The third is a report on the after-hours service. This Government says it has prioritised the after-hours service and that it is right up there—so much so that it still does not have a full complement of district health boards reporting on what they are going to do about it! So it is now 3 to 5 years later in the case of each of those reports yet we do not see progress. 
But the Ministry of Health is doing something! We should not worry because on the ministry’s website we find 54 reports listed that deal with workforce issues! We would think that something must be happening but no nothing is happening. 
Lindsay Tisch 
: How many? 
JO GOODHEW 
: There are 54 reports on the website. 
Let me talk about the National Travel Assistance Policy. That policy was introduced in 2006 and was intended to deliver travel assistance to the rural people of New Zealand so that they can access health care. How has that policy been described? It has been described as “complex cumbersome and slow”. It is no wonder my constituents ask how to fill out the forms and how to access the money. Honestly most of them just give up and go away. But that must be what this Government intends them to do. 
National has some ideas though. We have had good support for our idea of voluntary bonding—note that I said “voluntary”—in return for student loan write-offs for doctors who agree to work in hard-to-staff areas. There was some confusion at first about the fact that it was to be voluntary but it was welcomed once we explained our intention that it would be voluntary. Ever since it has been shown to work internationally we have supported the immersion of medical students in rural areas for their training. It has been shown to bring extra general practitioners into rural areas.