Hague Kevin: Budget DebateText is incorporated into the Bound VolumeHague Kevin: Budget Debate[Sitting date: 28 May 2013. Volume:690;Page:10411. Text is incorporated into the Bound Volume.]KEVIN HAGUE (Green): It is my pleasure to take a call in this debate. I want to begin by recalling that when I was a kid at primary school one of the resources that our teachers used wasAesop’s Fables.Hon John Banks: That was a long time ago Kevin.KEVIN HAGUE: Yes it was a long time ago as Mr Banks said and I do not know whetherAesop’s Fables is still featured in our primary school curriculum. My favourite was the tale of the grasshopper and the ant. I want to say that this year’s Budget confirms once again that this is a Government of grasshoppers. It is a Government that is focused on short-term gain and in particular on short-term political gain at the expense of future generations and at the long-term cost to this country.There has been the disastrous asset sales programme. There has been the matter that has been discussed already this afternoon in this House which is the $61 billion—$61 billion—increase in New Zealand’s net international debt. There has been the charter schools experiment with our children. There has been the constant prioritisation of economic activity and private profit over environmental considerations and over the legacy in our natural environment that we will leave our children. There has been this Government’s not only inaction on climate change but also unwinding of even themodest action that the previous Government had taken on climate change. It is a Government of grasshoppers.If I can pay a backhanded compliment to my counterpart the Minister of Health it would be to say that he is a star in this Government of grasshoppers. He has genuinely increased funding and expenditure to some areas of the health budget but at the cost of everything else and at the cost of future generations and the future health of New Zealand. Take for example elective surgery. The Minister has genuinely increased funding to elective surgery and that is a great thing for people who will benefit from elective surgery—good on them—but he has done that at the expense of everything else and elective surgery comprises perhaps 5 percent of what the health system actually does for New Zealanders. That cost to everything else comes also against a backdrop of a sinking lid on health funding because in this year’s Budget as the Government has done in every other Budget in its tenure it has in real terms reduced the amount of funding that is going into the health sector. Within that sinking lid there have been some winners like elective surgery and that means that everything else has had to find even more just to try to tread water and it has been unable to do so.Some of the other winners have been the areas that the Minister has prioritised through his health sector indicators. Look I am not opposed to having indicators and targets for the health sector; I think that is actually a quite good approach. The UK has proved that that has been a particularly useful approach in fact. But what the Minister does not seem to have understood or perhaps he has understood and just does not care about is that when the Minister sets targets for the health sector those are the things that the sector will focus on and there is an opportunity cost to everything. If the sector is focused on achieving those particular things then it will be less focused on achieving everything else. What that means is that if the Minister is going to set indicators for the sector if he is going to set targets he has to be absolutely sure that he has set the right ones. Once again what we see is a Minister who has set targets that fit the things that he prioritised when he was in Opposition that fit the particular areas where he is able to make short-term political gain and are not well suited to measuring the health sector’s preparedness for the long-term needs of New Zealanders.Although there has been genuinely good progress on some of those health indicators that the Minister has set—and good on the sector for delivering on those—there are some other indicators that the Minister could have chosen. He could have chosen inequalities in health outcomes for example where the indicator would have shown that inequalities are increasing. The gap between say Māori New Zealanders and non-Māori New Zealanders in terms of their health status is getting greater and greater. That seems to me to be unacceptable. He could have chosen ambulatory sensitive hospitalisations. That is when someone gets admitted to hospital for something that could and should arguably have been prevented either by public health services—those that aim to prevent diseases—or primary care services. Once again this internationally recognised measure of how the sector is doing actually shows it is deteriorating. It is getting worse and it is particularly getting worse for Māori and Pacific Island people. He could have chosen—let us see—readmission rates: unplanned readmissions to hospital after a hospital stay. He did not choose that. Actually if he had done that too would have shown that our health sector against this internationally recognised indicator of performance is in fact deteriorating. It is in trouble. It is getting worse and it is particularly getting worse for Māori New Zealanders and for Pasifika New Zealanders.He could have chosen obesity rates. New Zealand has the second-highest obesity rate in the OECD and it is getting worse. He could have chosen—let us see—diabetes rates. We have just seen data published that shows that one in four adult New Zealanderseither has diabetes or has pre-diabetes—one in four. He could have chosen that but he chose not to perhaps because that again is getting worse particularly for Māori New Zealanders and particularly for Pasifika New Zealanders. Actually that one-in-four figure is even worse for older New Zealanders and for those groups that I have mentioned. The Minister has repeatedly chosen short-run political considerations over the long-term health of New Zealanders.The word “tsunami” is overused in relation to chronic conditions but I cannot actually think of a better word to describe the fact that there is going to be an absolute need among New Zealanders for health services related to the chronic conditions that are literally exploding in these populations that threaten to engulf our health services and are already doing so. We are already seeing renal services—transplantation and dialysis—really struggling to cope with diabetes. Diabetes heart disease cancer asthma depression dementia—this Minister is doing almost nothing about those things.A responsible Government a Green Government would be responding to the evidence. On obesity for example we would be using taxation measures to try to drive the eating and activity behaviour of New Zealanders. We would be putting restrictions on marketing and advertising of unhealthy foods. We would be ensuring that food in places that are controlled by the Government is healthy—like schools for example. We would be undertaking a major promotion of healthy eating and physical activity for people of all ages ensuring that what happens in schools is evidence-based. We would be ensuring that there would be a health workforce geared to meeting this growing demand.In contrast Minister Ryall has abandoned the healthy food requirements in schools. He has abandoned the healthy eating and healthy activity programmes. He has abandoned the “Get Checked” Diabetes Aotearoa programme and replaced it with something that well actually we still have not seen yet. He has ruled out using market measures. He has ruled out using regulatory measures to control the food industry. He has appointed the food industry’s lobbyist to the Health Promotion Agency. He has left the Public Health Bill languishing at No. 64 on the Order Paper—a bill that was reported back by the Health Committee in June 2008 and has yet to receive its second reading. He has axed health promotion programmes in order to undertake his pet projects. He is a Minister who has prioritised short-run considerations ahead of long-term health gain for New Zealanders. It is time for a decent Minister of Health and a reminder I think that inAesop’s Fables things did not work out so well for the grasshopper and winter is coming.