King Annette: Estimates Debate — In CommitteeText is incorporated into the Bound VolumeKing Annette: Estimates Debate — In Committee[Sitting date: 01 July 2014. Volume:700;Page:19087. Text is incorporated into the Bound Volume.]Hon ANNETTE KING (Labour—Rongotai):Can I first of all say how much I enjoyed Scott Simpson’s speech because he did talk to the estimates and he did talk to achievement and he did not go into a mad rant and rave of personal abuse of the Opposition. That man should be a Minister. But he made one mistake. It is not “Team Key” or “Team Justice”; it is “Team Toadies”. That is what they are—“Team Toadies”. They are a whole lot of toadies all bowing and scraping to Mr Key.I want to talk about the health estimates 2014/15. I want to talk in these estimates about the health workforce. The cost of our health system is made up by our health workforce. About 80 percent of the costs of health come from our health workforce those who provide our health services. Just recently health workers in New Zealand were offered a 0.7 percent pay increase.Hon Trevor Mallard: 7.0?Hon ANNETTE KING: It was a 0.7 percent pay increase. They are rather upset about that because our health workforce believes it is competent it is quality it is professional and it is providing incredibly good health services to the people of New Zealand. I agree with it.But you have to ask why such a small increase is being offered to our health workforce. It is because the truth is the health budget has been reduced in real terms. The members do not like to hear this but before they say I am wrong I suggest they read the Budget documents. The health budget was reduced in real terms by 2.3 percent. They are Treasury figures. They are in the Budget documents. But worse than that go and look at the graphs in the Budget documents. Treasury is saying that in 2015/16 health will be reduced by 3.7 percent in real terms in 2016/17 it will be reduced by 3.6 percent in real terms and in the 2017/18 financial year by 3.1 percent. So we have a pathway for health under a National Government of year-on-year cuts in real terms.So I am saying to the health workforce in New Zealand that it is going to be a rocky road should this Government be re-elected and it is going to be a rocky road for New Zealanders receiving health services. We are facing some huge health workforce shortages. I draw the attention of members opposite to the Ministry of Health’s report that it put out just last week. It is warning that there will be a serious shortage of cancer specialists looming in this country. It has said that over the next decade cancer in New Zealand is going to increase by almost a third and by 2022 there will be a shortfall of seven radiation oncologists 30 medical physicists and 25 radiation therapists. It said that there were only three trained in New Zealand but we would need six in every year to cope with the demand over the next 10 years. It said that since 2009 six of the 13 medical physicist graduates had gone straight overseas. It said it had been warning of this problem since 2012. What we do know about a health workforce is it takes times to train them—you just cannot pluck them out of the air—and there is an international shortage of a cancer health workforce.What I say to the Minister of Health is can we not learn from the past? I have had to listen to the Minister of Health say how under a Labour Government cancer patients had to be sent to Australia. I tell the members opposite that one of the first decisions I had to make as Minister of Health was to approve sending patients to Australia in early 2000. Why? Not because of anything a Labour Government had done but because report after report on the health workforce had been provided in the 1990s to the previous Government about the shortage of radiation therapists—that we were not training enough that we had ageing linear accelerators and that we needed to take this issue seriously. We did not.It was not until 2000 when we increased the number of radiation therapists who take 3 years to train and we started to buy new linear accelerators that we were able to start to cope with our own treatment of cancer. I am asking why we have not learnt. Why did we not look ahead and see what was happening? We are now told that we are facing a serious nursing shortage in New Zealand—a serious nursing shortage—not a serious doctor shortage. There is a shortage of general practitioners yes but there is not a shortage of doctors overall and there is going to be a surplus out of Australia anyway. But we face a serious nursing shortage and we are told that we should have started providing for that in 2012.I have to say that I am really disappointed in Health Workforce New Zealand. We were told that it was going to be the organisation that would solve all our problems for our health workforce. I have to say that it has come up pretty much with a lemon because there have been no serious decisions made around our nursing workforce. It is still deciding on that. There have been no serious decisions made about how we are going to be able to offer cancer services going forward. I have to tell you: this is an organisation that is costing taxpayers an awful lot of money for a few pieces of paper and some ideas about physician assistance some American idea that it wanted to try when we ought to be building our health workforce training them and upskilling them here in New Zealand.I was staggered to read that over the last 5 years the chair of Health Workforce New Zealand has been paid $743138—$743138—in fees and in reimbursements. The chair of Health Workforce New Zealand is paid $13000 a month. Our senior citizens single superannuitants or old veterans are paid $19000 a year. So we are paying all this money for an executive chairman of an organisation that is not addressing the health workforce issues this country faces—serious issues. I have not even talked about what is called the unregulated workforce the place where most of our health care is provided—in the home and in the community for our older people. Almost no work has been done by Healthcare Workforce New Zealand on that issue. It is not good enough. I think it is time that we took health workforce issues seriously because we do have highly competent highly trained and quality health care workers in New Zealand whom we need to value. But we will not if we underpay them and if we do not value them. They are overworked and stressed because there are not enough of them.Unfortunately that is the picture that is emerging under Minister Ryall so I would like to put to rest once and for all this nonsense that a Labour Government left a shortage of a workforce. We were the first Government in living memory to try to address the health workforce by increasing the number of doctors. The first increase in the number of doctors training was in 1981 until we became the Government. We increased the number of radiation therapists nurses nurse practitioners and many others including dental therapists my own old profession. We took the health workforce seriously. That has not been what has happened under this Government. So if we are facing according to Treasury year-on-year cuts in the health budget under a National Government the ability to pay and hold that health workforce will diminish year on year. Once again we will be forced to send people to another country.