King AnnetteHon ANNETTE KING (Deputy Leader—Labour): I want to begin by saying that unfortunately at the moment we do not have on the Table the report from the very good Health Committee so I look forward to it being tabled in a moment so that everybody can read the report that came from our committee. I want to start off by saying that we looked at Vote Health and the amount of money that had been put in this Budget 2016 to see whether there was sufficient money being put in to the Budget to keep up with health demographics and inflation. Unfortunately the Budget does not meet all the demands in health in demographic pressures aged care and cost pressures. What they really needed in this Budget was an additional $635 million just to keep up. I am going to go on to more about that in a moment because I think the Minister of Health himself has recognised that the health sector is under tremendous pressure. What this Budget did not do was address that pressure by putting in sufficient money to cover what are the basic costs: population growth the cost pressures and demographic ageing. So although the Minister said There's more money in health than there has ever been before." it is a hollow hollow cry if it does not meet the needs in the health budget. The Minister himself I might remind him said very recently that "… the country's 20 district health boards are under more financial pressure than ever largely because of the population boom." I am reading directly Minister from your very interesting interview with the Listener where you are quoted. You also said and here is a quote from the Minister: "They are going to have to absorb a record amount of pressure—no question about that". So the Minister himself has acknowledged in a frank interview in the Listener—perhaps he was not aware of what was being recorded. He has admitted that they are going to have to absorb a record amount of pressure. That pressure comes from cost pressures it comes from population growth and it comes from ageing. So that is the first point I want to make. I then want to go on to one particular part of the health budget which I did raise when the Minister came to the select committee and that is the amount of money that is being put in to primary health care. Primary health care received $186 million up from $180 million. That is $6 million of additional expenditure. The Minister said that it had plenty of money. That was his response when questioned about it. It was not a very good select committee hearing I have to say. The Minister came in in a very bullish mood and argued with most members of the Opposition. But the Minister was asked about the $186 million going into primary health care. He said that it had plenty of money. Well I would find it very interesting to know now that the Budget is out there and the primary health care sector is looking at the Budget whether it is saying that it has plenty of money. Of course the Minister went off to meet with the doctors at their conference recently and it is interesting to see what the New Zealand Doctor said about that and the Budget for 2016. They headed an article "To the bedside manner born". It said his "bedside manner was the pits. His delivery of bad news on funding was far from textbook … he was decidedly Martin Clunes—aka Doc Martin—in his …" approach. It said: "He is failing to acknowledge the estimated 600000 people classified as high needs …" I raised this with the Minister—Scott Simpson: Who wrote this nonsense?Hon ANNETTE KING: This is written by a very good person Mr Simpson—Barbara Fountain who does write for the New Zealand Doctor magazine. She is usually very very supportive of the National Party but this was her editorial following the Budget. She said that "He is failing to acknowledge the estimated 600000 people classified as high needs but unable to get general practice care at a reasonable price because their practice is not VLCA funded." New Zealand Doctor said in this article: "Their blissful ignorance is less of a political liability than what would rise up from the murk if better-off voters lost the subsidy on their patient fees." It said that the Minister was more concerned about that than he was about the 600000 people who do not receive a subsidy. "Dr Coleman's announcement"—it went on to say—"at the Rotorua GP CME … left his primary care listeners stunned and largely speechless." The reason why is that the Minister decided not to address an inequity which I raised with him at the select committee for 600000 low-income New Zealanders who do not get the subsidy. I am not saying it was going to be easy but the Government had a report that made recommendations to the Minister to address this issue in the Budget. Unfortunately the Minister did not address it. Today we had the latest comments from the primary health sector. It comes from the largest primary health organisation in New Zealand ProCare Health. It is demanding to sit down with the Minister over funding fears coming from this 2016 Budget. The chair said it fears—listen to this Mr Chair and the Minister—for the viability of general practice if problems with the very low cost access subsidy and capitation were not resolved. The ProCare Health board is extremely disappointed with the health Minister Jonathan Coleman. Dr Harley Aish said this: "Combined with the flawed process for determining annual fees increase and the Government's proposed uplift in capitation payments for the coming year of just 1 per cent we believe there is a genuine threat to the viability of comprehensive equitable and high-quality general practice". He said that the working group in its report which the Minister got and he could have addressed in this Budget noted that capitation had not kept pace with inflation over the past decade. Eight years of that have been with the National Party in Government—Hon Member: How many years?Hon ANNETTE KING: —and if the Minister wants to raise it—it is 11 years since I was the Minister. Also ProCare Health said that it then had refuted—Hon Bill English: How come you did so much damage?Hon ANNETTE KING: Bill English was Minister of Health I have to mention that. He was the Minister of Health who left the health sector in disarray and we had to then spend the 9 years in Government straightening out his mess. So the primary health care sector has asked to have a meeting with the Minister to put these issues to him and I say to it: "Don't hold your breath. Don't hold your breath because I happen to know many health groups that have asked to meet with the Minister that are still waiting for the phone call. They are on the never-never." The Minister is not so keen to meet with people who might disagree with him. And that is what the primary health care sector—his own profession of general practice the GPs who do the front-line role in health care—is saying Mr English. Maybe Mr English would like to read it because if he does not want to believe me then they are practitioners. He might even hear it at home because primary health is being starved of funds and practitioners are now saying this is the worry. Meanwhile ProCare Health has been encouraging its own very low cost access practices to go for cap-busting fee increases. What does that mean? It means cap-busting fee increases are paid by the patient. They are paid by patients who are very low cost access—people who do not get a subsidy. That is what ProCare Health is saying because it has insufficient funding. I think that we have got a problem in the health budget under this Government: $1.7 billion is missing from the health budget.Dr David Clark: How much?Hon ANNETTE KING: $1.7 billion and by stealth—by stealth—this Government has been running down the health system of New Zealand. Then we hear of some its mad off-the—Meka Whaitiri: Shelf.Hon ANNETTE KING: No not even off the shelf; they are its out-of-this-world ideas. Bill English's mad ideas of social bonds—social bonds that play—Hon Bill English: Fantastic idea!Hon ANNETTE KING: Fantastic—and it fell over Minster. It fell over and you said: "Oh no it's going to work." It fell over in mental health because why would you not pay the providers of mental health services the very good NGOs? Pay them direct and cut out the middle man. The middle man was the ANZ bank. The Government wanted the ANZ bank to fund mental health services and if the NGOs delivered the outputs and the outcomes then the bank got a dividend. Have you ever heard of anything so damn stupid in your life? I have to say—"