Stewart Barbara: Estimates Debate — In Committee 
Stewart Barbara: Estimates Debate — In Committee 
[Volume:627;Page:22024] 
BARBARA STEWART (NZ First) 
: 
 On behalf of New Zealand First I rise to speak to the Appropriation (2005/06 Estimates) Bill. There is still a lot of work to be done in the health area and that was emphasised some time ago in the  
New Zealand Herald  
polls. We all know that health spending has increased but the outcomes in some areas have not increased proportionately. We are referring particularly here to children’s oral health and the adolescent oral health service. There is no money set aside in the Budget specifically for that service. On the Health Committee we were told that it would come from the health capital budget. We must hope that that money has actually been ring-fenced in the estimates for that particular area. The chronic shortage of resources for that service is a real concern and it should be of concern to the Minister and the Government because the bottom line is that children and teenagers need oral health-care. We do not want to see a return to the 1930s when those who could afford to have oral health care had it while those who could not had no teeth. It is interesting that there has been no announcement or any action taken on this issue. We want to know what has happened to the action that we were told was under way. We know that two reviews have been undertaken but we need to see action and we need to see some money being allocated to that particular area. 
It was very disturbing to see last month that there was a mass resignation of Southland dentists from a scheme providing free care for children referred from school dental clinics. That should send a message to the Government that action is urgently required in order to prevent the complete collapse of the scheme. We know that the subsidy for dentists to carry out work on children’s teeth has been inadequate for many years—we all know that in this Committee. The accident compensation fees of $67 per visit are about 75 percent of the average private fee charged in Southland but the Government has set the dentists’ fee for schoolchildren at around $33 for a basic treatment. That is obviously way below a level that is acceptable for dentists who are not charities. They require reasonable fees for the services that are carried out. We know in this Committee that school dental therapists do a great job but there is a time when they do need to refer children to dentists in order to have far more complicated work carried out. 
The parents of the Southland children who need dental care will now have to pay for it. If they cannot do so then their children will be added to the waiting list at Southland Hospital for that treatment and we all know what the waiting lists are like. They are often quite lengthy. It is difficult to tell a child who has toothache to wait for actual treatment. We know that the situation in Southland is not unique and that the dental care system for children and teenagers throughout the whole country is at risk of collapsing under the weight of inadequate funding. The Minister has done lots of talking about the system that she would like to see established and it is time that we saw some action before it is too late. We urgently need some action there. 
We were pleased to see that honouring the nurses pay settlement will be carried out in these estimates. That is essential because that will bring nurses’ pay up to a reasonable standard. But of course it does absolutely nothing to address the issue of staff retention and other areas where workforce planning is actually required for the future. Here we are talking about our medical workforce: our nurses our doctors our cancer therapists our dental therapists of course and many others. We need to retain their services because after all is said and done they provide the health services for our people. 
We note too that the funds allocated to rest homes are only enough to maintain the status quo. It is very unlikely that any money will filter down to the caregivers for the elderly who we all agree in this Committee are chronically underpaid. Another area that requires immediate action is the mental health services. The Ministry of Health has estimated that 3 percent of the population has a serious mental health problem and we know that there has been some increase in funding there.