11. Question No. 11—HealthMATT DOOCEY (National—Waimakariri) to the Minister of HealthQuestion No. 11—Health11. MATT DOOCEY (National—Waimakariri) to the Minister of Health: Is he satisfied that spending $486 million to restructure the health system is better value for money than using it to respond to frontline health workers' concerns that there is insufficient capacity in public hospitals to manage COVID-19?Hon ANDREW LITTLE (Minister of Health): Yes. I'm satisfied that this investment over a period of four years is value for money alongside the other Budget 2021 announcements for health which included $2.7 billion for front-line funding $516 million for digital and IT infrastructure $200 million extra for Pharmac and $100 million to improve road and air ambulances. No one wants to continue with a health system that offers inconsistent services across the country seeing some New Zealanders missing out and that sees growing inequity of access and outcomes. The reality is there is a cost to change. The Budget 2021 allocation to fund this much-needed change includes around $126 million for the Māori Health Authority to expand and improve front-line services.Matt Doocey: Is he comfortable with 1000 surgeries a week being cancelled and if not why has he spent the last year focusing on the disruptive health restructure instead of increasing hospital capacity?Hon ANDREW LITTLE: As I have indicated this Government has put record funding into the health system. So by way of comparison we are this financial year alone spending $7.6 billion more per year on health than in the final year of the previous Government. The previous Government increased spending in health over the full term of its Government—nine years—by $3.2 billion. The previous Government spent roughly $1 billion on capital expenditure in health during the full term of its Government. This Government now has a build programme worth $6 billion under way with a further nearly half a million dollars in IT. The member will remember the graph; the graph tells the story. That party in Government underfunds health. Matt Doocey: What is his response to ICU specialist Dr Paul Young who as Stuff recently reported went on the public record to call BS on the minister's [ICU] numbers."?Hon ANDREW LITTLE: I refer that member to the answer to the question I gave to his colleague last week and that is that Dr Young either misunderstood or misinterpreted what I had said. So this Government since last year in response to the pandemic has worked with DHBs to ensure that they can release additional ICU or high dependency unit (HDU) capacity or ICU- or HDU-level care for people who need it. So whereas before the pandemic there were roughly 243 ICU beds—that is to say beds in a designated ICU ward—actually there are other beds in other parts of hospitals such as in post-operative recovery that can be converted immediately into ICU- or HDU-level care and that increases ICU- or HDU-level care to somewhere between 320 and 340 beds across the nation.Matt Doocey: So how many severe COVID cases do our hospitals have capacity to handle without having to reduce services elsewhere?Hon ANDREW LITTLE: As I've just said the hospitals can increase their total ICU- and HDU-level care capacity to between 320 and 340 beds. They can by deferring or delaying or cancelling other hospital-level care increase that to up to 550 beds. That is the advice of DHBs to the Ministry of Health and that has also been overseen by intensive care specialists who have accepted that it is possible to make those conversions to increase that capacity to provide the care that is needed for those who need it in response to COVID-19. Matt Doocey: In light of that response of an awareness of delaying planned care why is the Minister continuing with a restructure in the middle of a pandemic?Hon ANDREW LITTLE: The country has seen what has happened to our health system largely because of successive years of underfunding by the previous Government—successive years of underfunding by the previous Government—operational funding and capital funding and after a review by the health and disability system review and by the Waitangi Tribunal that says we have extraordinary levels of inequity New Zealanders want change. As I get around the hospital network as I get around the health sector everybody is saying to me "Can we just get on with the change? This is the stuff we need." If you have a look and see how DHBs are behaving now in response to the pandemic collaborating with each other in a way they have not before drawing on the resources of others from right across the country to assist in the epicentre of the outbreak—which is Auckland at the moment—already senior clinicians and senior health leaders are starting to think as if they are part of a nationwide system which is what we want.Hon Chris Hipkins: Can the Minister confirm that DHBs have a longstanding practice of where necessary rescheduling planned care where there is a surge in demand for ICU such as in winter when there can be a surge in demand for ICU as a result of influenza?Hon ANDREW LITTLE: Yes I can confirm the standard hospital planning is to accept that there are seasonal fluctuations in demand and so the extent of planned care for particularly the winter months is always reduced in anticipation of people coming in with seasonal infections such as flu such as RSV and what have you—as we've seen this year—and DHBs are continuing to do that. But I am confident that with the planning that DHBs have done with the support of the Ministry of Health our hospital system is in good shape to respond to the COVID pandemic but also as a response to the $282500 million that the Government put into hospitals last year specifically for planned care catch-up that they will be able to over time catch up the care that many patients have experienced a further delay in.Matt Doocey: Why does the Minister refuse to name one health outcome that will be improved in the first year of this restructure?Hon ANDREW LITTLE: Well I'm not quite sure what the member is referring to. I've never failed to state that we will see greater equity of access to healthcare and health outcomes than we are seeing at present. But the combination of Health New Zealand operating a nationwide health system in conjunction with the Māori Health Authority with its ability to commission services and with both to cooperate with each other will significantly improve access to healthcare and significantly improve health outcomes. The reality is New Zealanders are waiting and have waited far too long for it and don't want to wait much longer."