Blue Jackie: New Zealand Public Health and Disability Amendment Bill — Third Reading 
Blue Jackie: New Zealand Public Health and Disability Amendment Bill — Third Reading 
[Volume:667;Page:14576] 
Dr JACKIE BLUE (National) 
: 
 I am very pleased to speak in the third reading of the New Zealand Public Health and Disability Amendment Bill. This bill is the result of proposed changes that came about from the recommendations of the ministerial review group. I believe that it was a landmark document from the ministerial review group. It really discovered that the public sector was not working well. It was working in a siloed way and the group was concerned about the 21 different ways of doing things in the 21 different district health boards. Essentially there was competition and very little collaboration in some instances. This bill is not a major restructuring of the health system. It is about making things work better and making people work more collaboratively. The proposed changes will result in better value for money in our public health sector will enable greater national cooperation in the sector and will reduce duplication and bureaucracy. 
The ministerial review group comprehensively assessed the sector and I think it did an excellent job. I congratulate the group on the extremely impressive work that it did. It made 170 recommendations on how to reduce bureaucracy improve front-line health services and improve value in the public health and disability sector. This bill is about progressing some of those areas. 
The public health sector faces many challenges. New Zealand has an ageing population with more long-term and chronic health problems and it has a health workforce that has been dependent largely on staff trained overseas. This all comes with the backdrop of international workforce shortages. There are district health boards struggling to be financially sustainable there are concerns about the quality of care and preventable errors and there are concerns about the health indicators that we have had which have been quite a mixed bag when New Zealand is compared with other OECD countries. This bill is about ensuring that the public health system is better positioned to meet the growing need and demand for it while the world remains in an economically challenged position. 
There have been a number of amendments to the principal Act and I would like to deal with the establishment of the Health Quality and Safety Commission in Part 1 of the bill. The ministerial review group was very concerned about the quality of care and in particular about preventable and avoidable errors. It is estimated that avoidable and preventable errors—adverse events—cost around half a billion dollars each year which is staggering. This bill proposes the establishment of a stand-alone commission which could save up to $100 million each year. The commission’s objectives are to monitor and improve the quality and safety of health in the disability support sectors and to help providers to make improvements. New section 59B inserted by clause 11 of the bill defines the functions of the commission which cover the areas that were previously undertaken by the National Health Epidemiology and Quality Assurance Committee. The committee’s functions all relate to quality and safety indicators reports and the promotion and dissemination of information. 
Huge inroads have been made in productivity in the health area all under the leadership of our Minister of Health Tony Ryall. I will talk a wee bit about the six health targets which have been at the front of people’s minds in the public health sector and I believe that is important. It keeps the issues at the front of the mind of clinicians and district health boards so that they know what they critically and urgently need to be focused on. We have seen improvements in many areas and elective surgery is one outstanding area. The target for elective surgery was an increase in volume by an average of 4000 procedures. In the last year despite swine flu and the recession that target was exceeded by over 12000 procedures. That is a staggering result. 
There have been shorter emergency department waiting times. Emergency departments are the shop fronts of district health boards. The target is that 95 percent of people should be treated within 6 hours and it is pleasing to see that district health boards are stepping up. That target has been increasingly achieved by district health boards around New Zealand. I visited Counties Manukau District Health Board when it celebrated its achievement of that target. It did not happen just overnight. It was about consultation. Everyone from the orderly to the reception staff and the clinical team was involved and consulted. They were told exactly why it was important to reach that target. The issue was all about collaborating consulting and talking and that is how that district health board achieved that. 
The waiting times for cancer treatment are something that is particularly dear to my heart. Radiation oncology times have improved markedly since the previous term of Parliament. Virtually every district health board is achieving improvements. Every cancer centre is achieving the 6-week target and under Tony Ryall’s leadership not one person has had to go to Sydney for treatment. By December this year that target will be down to 4 weeks and there is every expectation that the cancer centres will achieve that target. That is also a fantastic result. 
Immunisation is another success story. The target is to have 85 percent of 2-year-olds fully immunised. We have achieved that. That was achieved 3 months sooner than had been expected. 
We have had a fragmented public health system and along with that district health boards have had to cope with significant financial and clinical challenges. There has been too much duplication and poor regional and national performance. This bill will go some way towards ensuring that the public health system is better positioned for the future. Thank you.