King Annette: Questions for Oral Answer — Questions to MinistersText is incorporated into the Bound VolumeKing Annette: Questions for Oral Answer — Questions to Ministers[Sitting date: 13 February 2014. Volume:696;Page:15924. Text is incorporated into the Bound Volume.]6.Hon ANNETTE KING (Labour—Rongotai) to theMinister of Health: Is he satisfied New Zealanders are receiving timely and affordable healthcare?Hon JO GOODHEW (Associate Minister of Health)on behalf of theMinister of Health: I am satisfied with the average $500-million-a-year increase in Vote Health despite tight financial times while recognising that health can always make use of more resources. I am particularly satisfied that affordability for families with under-6-year-olds has improved under this Government with almost all under-sixes able to access 24/7 free general practitioner care. I am also satisfied with the progress in reducing waiting times at emergency departments and faster access to elective surgery. Howeverthere is always room for improvement and we are focused on delivering even better services for New Zealanders.Hon Annette King: In light of that answer is he satisfied that district health boards and general practitioners are now advising patients who do not qualify for an operation to “seek alternative provision”—in other words pay for it themselves—as Agnes of the Southern District Health Board found recently when her general practitioner advised her to pay for her first hip replacement so she could have a better quality of life while waiting for a second hip replacement in the public health system some time in the future?Hon JO GOODHEW: I would have to ask the member to forward to the Minister those particular circumstances so they could be looked into. However I do need to impress upon the member that under her Government when it went out of office there were 118000 “Agneses” getting elective surgery; there are now 158000 “Agneses” getting elective surgery.Hon Annette King: Does the fact that the Auckland District Health Board reduced the number of cataract operations carried out in 2013 account for Mrs Wilson of Helensville being told that she would have to pay for her two cataract operations at the cost of $10000 which she said would have to “come out of the savings put aside for our retirement”?Hon JO GOODHEW: What I am aware of is that the Auckland District Health Board has had a funding increase of $180 million. I am also aware that there have always been people waiting for surgery in New Zealand. Under the previous Labour Government there were people waiting longer and people not getting certainty of surgery. I am in fact aware that under this Government we have certainly increased the number of people getting elective surgery.Hon Annette King: In light of the fact that this Government has been governing for over 5 years is he satisfied that South Canterbury District Health Board did only 18 more orthopaedic operations in 2013 than it did in 2010 and does that account for Grey Power Timaru calling a meeting next Wednesday to discuss access to orthopaedic waiting lists which—according to the president of Grey Power Timaru—“is leaving so many of those requiring total hip and knee replacements in limbo” and in pain?Hon JO GOODHEW: What I am aware of is that compared with the previous Labour Government’s provision this Government has managed 175 more orthopaedic operations than were happening under the previous Government so actually the people of South Canterbury are most definitely better off under this Government. [Interruption]Mr SPEAKER: Order! I will just assist the member here.Hon Annette King: Thank you Mr Speaker. In light of the fact that this Government has been in office for over 5 years is he satisfied—Hon Gerry Brownlee: I raise a point of order Mr Speaker. That is the second or third question that the member has begun with those words. They are not in line with the Standing Orders and I suggest that someone of her experience is abusing the House by trying to put in a comment that has nothing to do with the question.Hon Annette King: I feel that it is acceptable for me to add those words in light of the fact that the Minister in every answer has gone back to when I was Minister 8 years ago to add to her answer.Mr SPEAKER: Order! I need no more assistance. The member Mr Brownlee is strictly correct that supplementary questions should be kept far briefer than we are seeing from the member at this stage. However I accept that it is a particularly important year to all members and I am not ruling the question out of order in any way at all. But I do warn all members who ask supplementary questions that are quite verbose and leave attack lines within them that they can expect a relatively politicalanswer back and I will not take kindly to members then questioning whether the question has been adequately addressed.Hon Annette King: Thank you Mr Speaker. And I have not done that you would note. Is he satisfied that a 62-year-old registered nurse who has worked for 45 years in public hospitals and who has been diagnosed with osteoarthritis cannot even get a specialist appointment because the district health board has told her that “Currently we receive more requests for specialist appointments than we are able to provide. Therefore we have to limit referrals to those most urgent.” and has been sent back to her general practitioner for increased pain medication?Hon JO GOODHEW: I would invite the member to forward that case to the Minister. However because I have this page open in front of me I will say that if we use South Canterbury as an example that the member has previously raised there have been 2331 more first specialist assessments under this Government. So things have improved under this Government.Kevin Hague: What specific actions has he taken to address the disturbing findings in the Auditor-General’s 2011 reportProgress in Delivering Publicly Funded Scheduled Services to Patients which found a poor relationship between how sick a person is and how quickly they get their surgery and does this problem still exist?Hon JO GOODHEW: I am going to have a go at this although I can tell you that I do not have a briefing in front of me on that particular report. So what this Government is doing is we are looking at the standardised results across district health boards for rankings per 10000 about how people are actually getting access to it. But there are standardised ways of assessing in each district health board in this country how a person will actually qualify for access to services so that those who need it most will get it first. That is not an arbitrary system; that is a carefully clinically assessed way of dealing with patients who need the surgery who need the appointment most.Kevin Hague: I do appreciate the difficulty the Associate Minister has. Is he concerned that according to his own answers to written questions the average case weight or complexity of elective surgery being carried out has been declining under his watch; if not why not?Hon JO GOODHEW: I cannot respond based on the written answers that the Minister has actually provided but I can tell you that under this Government 40000 more people a year are actually getting access to elective surgery.Kevin Hague: How will he ensure that the sickest patients with the greatest needs stop missing out on surgery given that it is his simplistic targets that are causing them to be left off surgical lists in the first place?Hon JO GOODHEW: I would have to say that every single case in this book that tells me someone has had orthopaedic surgery does not sound like simplistic surgery to me. Therefore I would doubt that the member is correct in his assertion.