Hague Kevin: Questions for Oral Answer — Questions to Ministers Questions to MembersText is incorporated into the Bound VolumeHague Kevin: Questions for Oral Answer — Questions to Ministers Questions to Members[Sitting date: 30 May 2013. Volume:690;Page:10585. Text is incorporated into the Bound Volume.]11.KEVIN HAGUE (Green) to theMinister of Health: How many New Zealanders are expected to have diabetes in 2021 and what is the expected cost of providing health services for them?Hon TONY RYALL (Minister of Health): A number of studies have attempted to estimate the number of people who may have diabetes in the future. It is a very complex issue to calculate and I am advised there is not yet an agreed methodology amongst the experts. I am advised by officials that a report produced by PricewaterhouseCoopers in 2008 has put the cost of diabetes rising from approximately $600 million in 2008 to $1.5 billion in 2022. A New Zealand study by Jo Tobias and Yeh predicts a 20 percent increase in the prevalence of diabetes from 2012 to 2021 which would mean 271000 New Zealanders. I am aware of further advice from the head of the diabetes advisory committee that the number could be 386000 if there is no change in practice or management. The Government is committed to improving health services for diabetes and heart disease with a strong focus on prevention. In Budget 2013 we announced a boost of new funding for New Zealanders with or at risk of developing diabetes and heart disease.Kevin Hague: Does the Minister dispute the PricewaterhouseCoopers estimate of $1.78 billion in expenditure in 2021; and does he accept the findings of the University of Otago research recently published showing that a much higher prevalence of diabetes and pre-diabetes in the New Zealand population currently one in four adult New Zealanders and a higher prevalence in other population groups means that that is likely to be a significant underestimate?Hon TONY RYALL: I think that the answer I gave to the member indicates that depending on the assumptions that you use and the various numbers that you put in you can get a range of results. What I do think the member has touched on quite rightly though is the importance of investing in prevention but particularly in theidentification of pre-diabetes. The biggest-increasing pressure in much of this space is pre-diabetes and that is the reason why achieving 90 percent of New Zealanders getting a heart and diabetes check means that we can actually identify those at risk of pre-diabetes and enable them to make the vital lifestyle changes needed in order to prevent themselves from getting that disease.Kevin Hague: What is the likely availability of funds to meet the costs of diabetes treatment services that should be anticipated in 2021 which are likely to more than treble over that 8-year period and exceed $1.78 billion in 2021 alone?Hon TONY RYALL: The advice that I have is that those numbers are premised on no change in the way that we manage diabetes or the activities we have in order to prevent diabetes or more important in many ways the development of pre-diabetes amongst individuals. That is why the Government is focused very much on increasing the number of heart and diabetes checks in order for those people at risk to have that identified by their general practitioner and be able to get the lifestyle changes that they need. Also in this year’s Budget the Government has invested significant new money in expanding local diabetes care improvement programmes. We have provided additional money for encouraging more checks and also a very significant investment in doubling the number of green prescriptions that general practitioners can refer patients to.Kevin Hague: I raise a point of order Mr Speaker. My question related to the availability of funds to meet the sum PricewaterhouseCoopers anticipated would be required—and I think most would accept it is going to be more than that $1.78 billion in 2021. The Minister in his earlier answer indicated that there was some dispute about what the number was but that did not prevent him in fact from responding about what the likely availability would be say on a range of—Mr SPEAKER: Order! I accept the point of order the member is making. To be fair to the Minister he tried to very adequately address the question but if the Minister wants to address just the part about the availability of additional funding that would be helpful.Hon TONY RYALL: What will be important for the availability of funds for affording the demands of diabetes and any other health disease is that New Zealand has a strong growing economy—an economy where taxes are low where regulations are under control where Government spending is well spent. I do not think we will meet those costs by printing the money in 2021.Kevin Hague: In light of the Minister’s apparent confidence that there will be available funds to meet a $1.78 billion health services bill for diabetes in 2021 alone could I ask the Minister how much money would it have been rational to invest in obesity prevention in this year’s Budget and how much would it have cost to reinstate the healthy food requirements in schools?Hon TONY RYALL: Look I think it would have been rational to have the investment that this Government is making in the area of diabetes and helping people manage their weight. The Government is spending $60 million a year on prevention initiatives which include Fruit in Schools the funding for which was going to be stopped under Labour; a range of nutrition and breastfeeding programmes; and a very significant investment in Kiwisport. So it is across the range and across the life course.Kevin Hague: I raise a point of order Mr Speaker. Can I clarify whether the Minister’s answer is that the Government invested the perfect rational amount in obesity prevention?Mr SPEAKER: That is how I took the answer effectively yes.Kevin Hague: I seek leave to table two documents. The first is the PricewaterhouseCoopers report for Diabetes New Zealand entitled—Mr SPEAKER: Can I just clarify how available that is for members?Kevin Hague: It is not readily available.Mr SPEAKER: OK I will take the member’s word for it.Kevin Hague: That is from September 2008. The second document is the report of the research by Coppell Mann and others entitledPrevalence of diagnosed and undiagnosed diabetes and prediabetes in New Zealand: findings from the 2008/09 Adult Nutrition Survey.Mr SPEAKER: Leave is sought to table those two documents. Is there any objection? There appears to be none. They can be tabled.Documents by leave laid on the Table of the House.Hon Annette King: I seek leave to table a report from Stuff where the Minister of—Mr SPEAKER: No Stuff is—[Interruption] Order! Stuff is freely available.Brendan Horan: Does the Minister expect that the hundreds of thousands of New Zealanders forecast to have diabetes by 2021 should have access to accurate and reliable blood sugar kits and is he aware of the many expressions of concern from both health professionals and diabetics around the new sole supply CareSens kits with life-threatening reports of inaccurate meter readings and faulty test strips?Hon TONY RYALL: Pharmac has moved to a sole supply arrangement for most people for their blood glucose testing kits. I have to say that as I have been travelling around the country I think the transition has gone remarkably well actually. About 90 percent of those people on the previous meters have now transitioned and I think that most people are finding the service is up to what they might have expected. We have had very very little feedback counter to that in the last few months.