King Annette: Questions for Oral Answer — Questions to MinistersText is incorporated into the Bound VolumeKing Annette: Questions for Oral Answer — Questions to Ministers[Sitting date: 26 June 2013. Volume:691;Page:11274. Text is incorporated into the Bound Volume.]6.Hon ANNETTE KING (Labour—Rongotai)to theMinister of Health: What recent reports has he received on affordability of health care for New Zealanders?Hon TONY RYALL (Minister of Health):I have received a range of reports including one from the OECD the world’s leading economic research and advisory organisation which advises that New Zealand had the world’s third-largest increase in public health spending. The facts show that we have increased Vote Health operational funding under this Government by an average of $500 million per year and despite tight times we are investing more in the changing needs of our population thanks to strong financial management.Hon Annette King: What reports did he read before he decided to increase the cost of prescriptions from $3 to $5 per item and did his reading include the recent Treasury report entitledHealth Projections and Policy Options for the 2013 Long-term Fiscal Statement  which states there can be unintended consequences from increasing co-payments?Hon TONY RYALL: A range of reports were considered in making those decisions in respect of the increase in the pharmaceutical charge and included in that was advice from Treasury. What we do know is that no family need pay more than an additional $40 a year and they can get a pharmacy subsidy card. Also if they are having troublemaking ends meet in respect of those prescription charges they can talk to Work and Income.Hon Annette King: In light of that answer was it an intended consequence that a growing number of sick older New Zealanders are now unable to receive part or all of their prescriptions because of—Hon Dr Nick Smith: It’s $2.Hon Annette King: It is only $2 to Nick Smith but it is a lot of money to pensioners in New Zealand like the pensioner from Flaxmere who had to pay an extra $39 just to pick up the prescription which was the difference between being able to buy her groceries that week or not.Hon TONY RYALL: Clearly I have to look at the facts behind that because if the prescription charge has gone from $3 to $5 it is hard to rationalise how it would be $39 more when no person need pay more than $40 a year by getting a prescription subsidy card.Hon Annette King: Why after all his announcements and reports about increased funding and more doctors have three medical centres providing services to high-need patients and rural New Zealand been forced to close in the past few weeks stating their reasons as a lack of funding and a shortage of doctors—they include the Pētone health centre Te Atiawa Medical Centre and SouthCare Medical Centre?Hon TONY RYALL: SouthCare Medical Centre may have closed but the doctors have opened up next door but the member does not want to tell people about that. This Government has invested an additional $130 million in primary care and we have also been the first Government to make after-hours care free for under-sixes.Rt Hon Winston Peters: That’s rubbish.Hon Annette King: It is rubbish. Is he aware that the increased funding that a small low-cost health centre providing services to the poorest sickest patients got out of his Budget was around $15000 in total and how many more medical centres will be forced to close through a lack of funding and a lack of doctors when he has been telling this House that there are 1000 more of them—and where are they all?Hon TONY RYALL: Those 1000 extra doctors are with the 2000 extra nurses working in our public hospitals today. They are delivering record elective surgery and more specialist appointments and that just goes to show—when that member was the Minister of Health she doubled the health budget and fewer people got operations.Hon Annette King: Where are the extra doctors for primary health care—because in his answer he mentioned more specialists and more hospital doctors but where are the extra doctors he promised for primary health care? We are seeing practices around New Zealand that are unable to carry out their work because of the shortage something he said—Mr SPEAKER: Order! We are now getting a very long question being delivered to the Minister.Hon TONY RYALL: I think the member will find that there are actually more general practitioners registered than there were when she was the Minister of Health. We have put additional money into primary care. We are providing more funding. We are getting a very very good service for New Zealanders and in fact we have put in extra money to have free after-hours visits for under-sixes. When that member was the Minister of Health she never provided free after-hours general practitioner visits to children under 6.Brendan Horan: Would the Minister agree that New Zealanders with diabetes deserve accurate and reliable medical devices to measure blood glucose levels as afforded in previous health budgets?Hon TONY RYALL: Yes. That is the reason why Pharmac has undertaken quite an extensive and clinically-led process in respect of the new meters that it has brought in.