Hague Kevin: General Debate 
Hague Kevin: General Debate 
[Volume:655;Page:4835] 
KEVIN HAGUE (Green) 
: 
 I have previously spoken in this House about the Government’s ideological daftness in reducing investment in programmes to keep people well. We know that health services are facing a floodtide of need in the coming years with an increasingly elderly population a constant increase in the availability of new technologies—mostly expensive ones—and epidemics of chronic disease such as diabetes and cardiovascular disease. Yet the Government’s Budget is projecting after a one-off significant increase in funding for the current year a decline in health spending in out-years. 
The only rational response to this growing gap between need and health service provision is investment in public health which is designed to keep people well in the first place. Yet as the Public Health Association has pointed out this week and as I have spoken about in the House previously this is the very area where funding cuts are already being felt. This strongly suggests short-term rather than long-term thinking. When I asked the Minister of Health at the Health Committee about the evidence base for reducing investment in the Healthy Eating - Health Action programme he confirmed that there was no evidence base and that essentially that had been a political decision. 
Another matter I asked the Minister about was the one area of significant new investment in health for this year: extra spending on building new elective surgery theatres and now on contracting out services to the private sector. I asked what evidence he had about the utilisation of our current theatres and he confirmed that there was none. Once again that was an ideologically driven decision. The private surgical hospitals at their request recently presented to the select committee seeking essentially two things. They wanted the Government to increase district health board - funded surgery contracted out to the private sector and they wanted Government action to encourage people to take out private health insurance. Well the Government has just delivered on the first of those. I wonder how long it will be before it starts on the second. I would guess not long judging by the Government’s Budget intention to give the public system less resource and therefore less capacity in the future. Of course there is an interaction between the public and private sectors on elective surgery and the Government intervenes in that at its peril. I would have thought that a better message for New Zealanders to hear is that our health services are generally very good and that the Government is committed to funding the health services people need as of right. 
The Association of Salaried Medical Specialists essentially the senior doctors working in our hospitals has criticised the Government’s announcement of this new contracting to the private sector on a number of grounds. Firstly that association was not consulted which I say is a damning indictment. But it is worse than that because the Government has also removed the requirement for district health boards to consult their workforces when they are contemplating the contracting out of services. Secondly the initiative is being implemented in a cavalier manner. Thirdly the Government seems blind to the workforce issues involved. A likely consequence of the decision is that surgeons anaesthetists and other theatre teams will move from the public sector to the private sector thus further undermining the capacity of the public sector. Oh but of course that is right—that is what the Government is trying to achieve. That is why it has budgeted less. 
What instead needs to happen is proper logistics planning in the public sector. Rather than planning out the logistics of surgery 21 different times with 21 different queues let us instead plan that in a coordinated collaborative way matching patients who are waiting for surgery with theatre teams and theatres that are underutilised. The Minister talks all the time about the importance of collaboration and I support him in that but here is an actual opportunity to make that happen. Instead of policy driven by ideology populism and the short term let us instead see a commitment to system-wide planning that shows some responsibility for the future that is based on the best evidence available and that makes the best possible use of the resources we already have.