King Annette: Oral Questions — Questions to MinistersText is incorporated into the Bound VolumeKing Annette: Oral Questions — Questions to Ministers[Sitting date: 07 April 2016. Volume:712;Page:10310. Text is incorporated into the Bound Volume.]2.Hon ANNETTE KING (Deputy Leader—Labour) to the Minister of Health: Does he agree with the New Zealand Medical Journal article dated 1 April 2016 which states research undertaken shows patients undergoing primary elective total hip and knee replacements in Otago in 2014 were more severely disabled than patients between 2006 and 2010; if not why not?Hon Peseta SAM LOTU-IIGA (Associate Minister of Health): on behalf of theMinister of Health: I cannot say whether I agree or disagree with that article in its entirety. There are some very complex data within the article and there is an ever-increasing need for more knee and hip operations. Southern has done very well with orthopaedic surgery with it being up 41 percent in the last 7 years—Hon Member: How much?Hon Peseta SAM LOTU-IIGA: —41 percent. And the number of hip and knee surgeries in the Southern District Health Board region has not decreased. In fact it has gone up 10 percent. But as always they can always do better.Hon Annette King: Does he agree with the findings from the same research that patients currently being returned to their GP without an operation would have qualified for publicly funded surgery between 2006 and 2010; if not why not?Hon Peseta SAM LOTU-IIGA: Well I cannot verify that but from the report the problems—Hon Annette King: It’s in the research.Hon Peseta SAM LOTU-IIGA: From the report the problems are longstanding in that in 2006 there was a well-publicised cull of patients and that member will know that there were 30000 patients culled nationwide.Hon Annette King: Does he recall research published in the New Zealand Medical Journal 18 months ago that showed 36 percent of patients recommended for hip and knee replacements were referred back to their GP without surgery because of a lack of funding and now with this latest research will he finally admit that the health budget is not meeting cost pressures or demand?Mr SPEAKER: Either of those two supplementary questions—the Hon Peseta Sam Lotu-Iiga.Hon Peseta SAM LOTU-IIGA: That member knows that health spending has gone up by over $4 billion since this National Government took the Treasury benches. She also knows that there are 50000 more surgeries done per year since 2008. In fact in the southern region that member will know that hip and knee replacements are up by 10 percent orthopaedic surgeries are up by 41 percent and in the last 6 years—[Interruption]; listen to this—there were over 639 more surgeries done for knee and hip than in the last 6 years of the Labour Government—shameful.Barbara Kuriger: What new initiatives has the Government announced to further improve the quality of life for people suffering muscle and bone pain?Hon Peseta SAM LOTU-IIGA: That is a good question. As well as delivering more surgeries we are implementing a new medical early intervention strategy named mobility action teams to help reduce suffering from muscle and bone pain. The Government has invested over $6 million during this term to set up these new mobility action teams. They will be locally driven. They will be made up of a number of health professionals including GPs physiotherapists chemists and other professionals. Seven mobility action teams have already been selected from 50 proposals and these will be commencing shortly.Hon Annette King: Why does he continue to make the misleading claim that there are 50000 more operations a year being done since National came into power by including operations performed under Labour’s last Budget which delivered over 12000 more in 1 year than his Government has ever achieved?Hon Peseta SAM LOTU-IIGA: That member knows the figures and that member knows as I have said—I will say it again for that member in case she did not hear it the first time—there are 50000 more surgeries. In fact in terms of hip and knee replacements which that member asked about earlier there are 2000 more today than there ever were under the Labour Government and she knows it.Hon Annette King: Is the research wrong when it states that a Budget increase from 2016 onwards which increases the number of hip and knee operations to be performed is inadequate to match demand and the problems identified in the study are likely to become increasingly widespread across New Zealand? Direct quotes from the research.Mr SPEAKER: Order! That is a very long question.Hon Peseta SAM LOTU-IIGA: It is a very long question. What I do have from the paper is that it notes—and I want to quote—that there is “excess demand in the public sector leading to some form of prioritisation”. But the paper says—and I quote—that “prioritisation is being implemented effectively”.Hon Annette King: Is he aware of the New Zealand joint initiative that ran from 2004 to 2008 which led to a significant increase in the number of joint replacements performed nationally meaning that fewer New Zealanders were disabled when they received their operations and that the decline occurred when funding was no longer ring-fenced after the election of a National Government?Hon Peseta SAM LOTU-IIGA: Well I do not have that research to hand and I do challenge the integrity of some of the figures that she comes up with sometimes. But I will say again that in the southern region there was a 10 percent increase in hip and knee surgeries over the last 7 years.Hon Annette King: I seek leave to table the research published in the New Zealand Medical Journal entitled “Rationing of hip and knee replacement: effect on the severity of patient …” dated 1 April. It is not widely available—Mr SPEAKER: Order! I need no more assistance. I will put the leave. Leave is sought to table that particular document. Is there any objection? There is none. It can be tabled.Document by leave laid on the Table of the House.Hon Annette King: Does he think that Arthritis New Zealand might know a thing or two about patients waiting in pain and disability for hip and knee operations and that the problem is not going to go away as stated by its chief executive Sandra Kirby just 6 days ago?Hon Peseta SAM LOTU-IIGA: Sandra Kirby is entitled to her own opinion but as I have said time and time again the number of surgeries has gone up for hip and knee replacements.Hon Annette King: I seek leave to table research published in the New Zealand Medical Journal entitled “The impact of the 6-month waiting target for elective surgery” dated 7 November 2014. It is not widely available.Mr SPEAKER: I will put the leave. Leave is sought to table that particular information. Is there any objection? There is none. It can be tabled.Document by leave laid on the Table of the House.