Hutchison Paul: New Zealand Public Health and Disability Amendment Bill — Second Reading 
Hutchison Paul: New Zealand Public Health and Disability Amendment Bill — Second Reading 
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Dr PAUL HUTCHISON (National—Hunua) 
: 
 It is a pleasure to speak on the New Zealand Public Health and Disability Amendment Bill. One of the most profoundly important things about it is that 13 out of 13 of the submitters supported its intent. When those submissions cover such a spectrum—from the Council of Trade Unions to the Public Service Association the New Zealand Medical Association and the Nurses’ Organisation—it certainly says something. 
I think it is timely to thank the members on the Health Committee for very constructive collaboration during the hearing of submissions. I also thank the officials for their very helpful advice. 
I note that in the first reading of the New Zealand Public Health and Disability Bill 2000 Annette King said that district health boards would be expected to work together and enter into cooperation and collaborative arrangements to ensure service delivery to their populations. Sadly that has failed to happen over the last 9 years; we do not see good collaboration between the various district health boards. Sadly also Annette King missed out of her speech the fact that district health boards should have ensured efficient and effective service delivery. Instead over 9 years we have seen a burgeoning bureaucracy poor productivity in the health sector disempowered clinicians and a huge amount of money put into health with very little to show for it in terms of increased elective surgery. This bill is all about redressing that. It is about making the current system work better without revolution or major restructuring. That is why it is supported by all submitters and I sincerely hope that it is supported by all other parties in the House as it was in its first reading. 
In essence the changes are about having more effective coordination on a local regional and national level. It is about freeing up back-office bureaucracy so that services can be put to the front line and resources can be used more effectively. It is also very importantly about empowering clinicians and clinical networks so that they can once again take charge of running our health system after a long period when they have felt in many respects very helpless. 
One of the interesting things about this bill in terms of its support from all submitters—and hopefully from all political parties on this occasion—is that over the last 25 years and over the electoral cycle we have seen huge turmoil and restructuring in the health system. Way back in 1987 Helen Clark organised the Hospital and Related Services Taskforce report which was known as the Gibbs report and there was a realisation that we must have better monitoring and measuring. At the time there was no measuring of outputs or outcomes or of quality of service but there was an attempt to put that into place. It was the beginning of things happening. Sadly by 1989 things had become so dysfunctional that the Auckland District Health Board was actually disbanded by Helen Clark—and her own husband was a member of the board. 
The 1990s saw some radical changes not all of which were good. But by the end of the 1990s the Health Funding Authority which was run extremely skilfully by Dr Graham Scott had become a very effective efficient contracting agency. It was very sad in some respects that once again in 1999 with the change of Government there were radical changes and restructuring that led to massive bureaucracy the fragmentation into 21 district health boards and the disempowering of clinicians. This bill sets out to redress those problems. 
It is a huge worry that we have seen Murray Horn identify it as impossible to increase spending on health by 8 percent a year over and above inflation. It is just impossible for New Zealand to be able to sustain that spending. We have to drive efficiencies into the system. 
The Health Quality and Safety Commission is a very very welcome change and it is being ably led by Professor Alan Merry. As far back as 2002 Peter Davis pointed out that something like 12.9 percent of people admitted to New Zealand hospitals suffered an unintentional injury caused in the management of their conditions. That has huge repercussions both in terms of personal harm and the cost savings that could be attributed. In the order of $500 million a year to $800 million a year has been estimated as possible savings if the quality measures can be brought in successfully. 
During the Committee stage we will have the opportunity to debate issues that have been brought up by the New Zealand Medical Association such as an overarching health strategy clinical leadership and public consultation which I believe the Minister of Health very ably addressed in his earlier speech. 
It is vitally important that this bill is supported by all parties in this Parliament as it was by all of the submitters. I very much look forward to the Committee stage.