Pillay Lynne: New Zealand Public Health and Disability Amendment Bill — Third Reading 
Pillay Lynne: New Zealand Public Health and Disability Amendment Bill — Third Reading 
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LYNNE PILLAY (Labour) 
: 
 I join my colleagues and indeed the whole House in supporting the New Zealand Public Health and Disability Amendment Bill but I put on record that I do so with some caution. No one would question the purpose of the bill which is to establish the Health Quality and Safety Commission and provide a mandate for collective purchasing which as the Minister says will save—I think the claim is—some $700 million. Certainly those sound like very appropriate purposes. The bill also allows for a system of arbitration where there is conflict over shared services. 
In terms of planning of health services within our hospitals no one in this House would argue about the need for efficiency. In fact when in Government Labour made many moves to ensure that the health system was more efficient. But we on this side of the House express some caution—and it is very appropriate caution given National’s history and its record in just this term of Government. 
I congratulate Kevin Hague as my colleagues have done on his successful amendment that went through. In fact it was agreed to without debate because it was so well-supported. The amendment removed the requirement for the commission to be self-funding. I quote Kevin Hague when he stated a concern that “usually with the best of intention there could be an incentive for service providers if they have to pay for quality improvement programmes and also have a constrained financial position”—which is indeed the case under this Government—“then they may well choose not to pick up all of the programmes and whilst we hope that service providers would usually prioritise quality and safety over financial cost the reality is that this will only occur through the ethics of the providers and their personnel because the incentives are generally set up in the system to focus on the dollar.” 
I say to Kevin Hague that that is very wisely put and I certainly agree. When we consider some of the cuts to programmes that we have seen in the short time this Government has been in power I agree with Kevin Hague and I reiterate how important it is to have those checks and balances. In terms of consultation I say that along with the checks and balances in terms of providing the best-quality health services which are what every New Zealander is entitled to I am in agreement with Women’s Health Action which was really concerned that “Consultation with communities should not be viewed as a nicety but rather as a fundamental part of the public health and disability system that ensures health and disability services are appropriate for and responsive to those who use them.” 
The purpose of my address this afternoon is to put the Government—and I say this along with my colleagues—on notice that Labour members will be watching we will be monitoring and we will be ensuring that we do not see this legislation brought in at the cost of consultation and at the cost of provision of quality services to people. 
One may ask why we would have these concerns. Well I think we only have to look at National’s record and we see a distinct change under this Government. The previous Labour Government was about promoting wellness in health and the very successful primary health organisations ensured that doctors’ visits across the board within primary health care were affordable and were contained at an affordable level. It is very disappointing that that is now not the case and we see the cost creeping up. 
We have seen real cuts to primary health initiatives that promote wellness and prevent major financial cost to say nothing of the cost to people’s quality of life later on or indeed the ultimate cost the cost of their life. Those supports the promotion of health initiatives have not been there at the important times. If members in the House or the Government were to ask where that could be seen I would have to ask for an extension to this speech to go through all the cuts that have occurred. 
If we look at the issue of obesity we on this side of the House are not of the view if we can go back that in terms of promoting wellness— 
Mr DEPUTY SPEAKER 
: This is a third reading speech. 
LYNNE PILLAY 
: Promoting wellness is very much part of what should happen in primary health care or in our health system. I know that district health boards are responsible for funding many of these health care programmes whether they are about drug or alcohol abuse whether they are about dependency or whether they are about things like smoking cessation programmes which are absolutely vital in terms of the health and safety of our nation. The cuts in these areas are to the mental health services and we know that due to the dramatic cuts in funding in those areas we will be paying the price much further along the way. With the best will in the world with the purpose of this bill to establish the Health Quality and Safety Commission many of these cuts have been at the cost of health and safety to all New Zealanders. So there is a certain irony there. 
The mental health service is really important to invest in as well as healthy eating programmes. If we look at initiatives that are often provided or funded through the district health board we see the cuts to healthy eating programmes in school such as Fruit in Schools to sexual and reproductive health services and to support for Alzheimer’s disease. All of these services are effectively getting the chop. There is some misgiving and much concern—I see Paul Quinn over there sharing his concern as well. Paul Quinn is someone who often does not act entirely in a partisan way. He often has the courage to speak out and say that he agrees with the Opposition in some instances when there are concerns about what is being cut certainly in the area of health care. 
We in Labour are putting the Government on notice. We will be monitoring this efficiency. We believe that if we got our calculators out and looked at the millions in savings at the moment that this Government has brought in we would see that the savings are from cuts to services—cuts to vital services that should be provided. These savings of efficiency cannot be at the cost of quality. 
So certainly this bill is supported and it is enhanced by the Green Party’s amendment. I congratulate Kevin Hague; he has had lots of accolades today in the House and I think that is very fitting. So along with my colleagues I do support this bill but certainly give notice that Labour members and I know the very hard-working members on the Health Committee will be taking a real interest in this bill. Thank you very much.