Hague Kevin: SuperGold Health Check Bill — First ReadingText is incorporated into the Bound VolumeHague Kevin: SuperGold Health Check Bill — First Reading[Sitting date: 24 June 2015. Volume:706;Page:4756. Text is incorporated into the Bound Volume.]KEVIN HAGUE (Green): The Green Party will be supporting this bill at its first reading. We believe that the kind of conversation that is just beginning perhaps in the House tonight would be advanced best by select committee discussion where we can actually listen to some evidence as well as argument.Health care should be a fundamental right for all New Zealanders. There should be no access barriers certainly not financial ones. Services should be universally available. Services should be preventive in focus. Services should be integrated. They are pretty good goals are they not? Those goals are not necessarily the Green Party’s goals; we did not invent them. They are actually the goals of the New Zealand public health system as set out by the Savage Government in the 1930s. The Savage Government set out in its establishment of the New Zealand public health system to actually make primary care—doctors’ visits as we would say now—free for all people who needed them.But it was blocked in doing so by the New Zealand chapter of the British Medical Association in fact. What we have seen over the years is a steady increase in what is called the co-payments—the amount of money that a patient has to pay when they go to see that doctor. With the capitation formula that we now have the district health boards are in a position to impose a cap on that but the cap tends to be still set at a pretty high level. Even those practices that are called very low-cost access practices which are located in parts of the country that have a very large proportion of their population on very low incomes still have a co-payment for patients of $15 a visit. The evidence is that even $15 per visit which is about the cheapest that you will find if you are over the age of 6 currently—even at that level that is prohibitive for many people seeking health care.That is a problem. It is a problem because our New Zealand Health Strategy and the health strategies that I am sure every party in this House would actually support are ones that attempt to prevent people from becoming ill in the first place and if they do become ill that seek to treat them in community settings close to where they live. So if you have that as your strategic intent but then the State places a financial barrier to accessing those primary care services it is a case of cutting off one’s nose to spite one’s face. It is a problem that we seem to have all too often in the health sector.Most of the people who are lying in the beds in our medical and surgical wards in hospitals are older people. If it is possible to actually stop them getting there by treating their problems in the community that would be a very good thing with health benefits and cost savings thereby distributing funds to other causes. Having said that it is certainly true that in the New Zealand Health Survey people over the age of 65 were numerically and proportionately the group that was least likely to miss out on primary care because of costs. However because of the number of older people and their frequency of requirement of primary care that is still a very substantial number.So our preference of course would be to return to a system in which primary care was completely free but failing the funds for that—and I rather suspect that the Government’s priority on new motorways for example means that probably we cannot possibly afford that—we actually need to prioritise how we best spend the money that is available to us. Making primary care more available to New Zealanders is a very sensible and wise use of health care dollars. It is an open question as to whether the universal age group - based subsidisation is the best way to do that as this bill provides or whether it is more targeted assistance based on socio-economic status. But that is the discussion that we need to have at the select committee and therefore we strongly support the bill at this stage and look forward to the Government perhaps changing its mind taking a more rational approach to this bill and one that is more conducive to discussion and debate.