Roy Heather: Estimates Debate —  
Roy Heather: Estimates Debate —  
[Volume:610;Page:7195] 
HEATHER ROY (ACT NZ) 
: 
 We have heard that Vote Health this year 2003-04 is going to receive $9.61 billion—an increase. If one listens to the Government one hears that this health system is working wonderfully well. Well I agree with Dr Scott: when we go out and talk to people that is not what we hear. More and more money of course is being thrown at the system. That is what the Government measures its success by; it is not worried about how the money is spent or where it goes. 
I want to talk in my brief time about accountability. I have just recently asked the Minister of Health some questions. I asked her where the money is going. I asked her to tell me where the money given to Maori health providers and non-Maori health providers is going. Do members know what the Minister’s answer was? It was: “I can’t tell you. You need to ask the DHBs.” This Minister does not know what is happening in the health system. Her ministry does not know because it has devolved everything to the district health boards. 
A while back we were able to get some information about two Maori health providers. One of them had spent $3.1 million in the previous year and the Ngati Whatua o Orakei health clinic has received $5.7 million since Labour came to power. We asked where this money had gone—we had a very short list with a few itemised bits and pieces—and then we asked what the health outcomes were. The Minister’s answer was this: “Health outcomes general health outcomes are difficult to assess.” That is code of course for “I don’t know.” The Minister does not know where this money is going. These Maori health providers may well be providing a wonderful service. In fact as I go around the country and visit some of them I see that some are providing a very good service to their communities. But there are also some that are not providing a good service. The question is how do we know which ones are providing a good service and which ones are not? They all say they have forms to fill in and send back to the Ministry of Health; the problem is nobody bothers reading them. The providers are expected to fill them in but nobody looks at them. We have no idea what the money for health is being spent on. 
It is interesting to move on to the primary health organisations and see where the money for them is going. Last year $50 million was earmarked for the primary health-care strategy implementation. This year it has been increased to $165 million. Taxpayer cash is being poured into the primary health organisations at the expense of the secondary sector. The hospitals are missing out and having to cut back their services. The Minister says that is not happening either—because nothing happens without her knowledge—but as we have just heard the accountability is non-existent. 
If we look at the funding formulas for the primary health organisations what we see is that we have race-based funding in this country. If a person is Maori or Pacific Island that person gets more funding than one does if one is European. If a person lives in a poorer area he or she gets more funding no matter what his or her health status. ACT says—and we agree with the National Party—that we need to have a health system that is funded based on need not on race or where a person lives. Under the new funding formula the interim—[ 
Interruption 
] Why does Mrs Pettis not stand and take a call seeing that she is such an authority on health? Under the new funding formula the interim formula the great majority of male Pakeha superannuitants who do not have a community services card are funded at $17 a year. The amount that a Maori or Pacific Island superannuitant is funded is over three times higher—$53 a year—no matter what his or her health status or need. Why is it fair that a young fit Maori like Christian Cullen for example should be funded at a higher rate than his Pakeha counterpart who is not well? What is fair about that? He has the wrong skin colour or he does not live in the right location so he misses out. Health funding must be based on need not on race or where people live. It must be determined on one’s need. 
I move on to deficits. The National Party speaker Dr Scott was correct in saying that deficits are important. She outlined a very good case as to why that is. The deficits of course have been speculated about for a long time. We hear a lot about the $400 million—the magic cure for the health system.