Chadwick Steve: Financial Review Debate — In Committee 
Chadwick Steve: Financial Review Debate — In Committee 
[Volume:624;Page:19410] 
STEVE CHADWICK (Labour—Rotorua) 
: 
 I am pleased to take a turn in the debate on the financial review of the Ministry of Health especially following the Minister of Health to address some inaccuracies from the Opposition spokesperson on health. I want to remind him that in 1995 85000 people were on the elective waiting list—and it was a waiting list not a booking system—and 50000 people were taken off it. We do not forget that. 
It was very interesting to find the Opposition spokesperson on health talking from a slash-and-burn perspective. Of course the member is a surgeon and can look at health only from a surgical perspective whereas this Government and this financial review of the Ministry of Health started to turn the tide to look at addressing the decade of disparities that we saw throughout the 1990s. We heard about the availability and the roll-out ahead of time of the primary health organisations which are starting to look at some very very exciting health disparities and that report affirms those disparities. The primary health organisation roll-out is ahead of schedule. It has already targeted the under-18s and the over-65s. We are now targeting the 18 to 24-year-olds. This year one of the interesting perspectives we heard from the Ministry of Health was about looking at some complex patterns of care Care Plus that are emerging from primary health organisations now that those organisations are getting on with doing the business. 
This financial review of the Ministry of Health was a very positive one. I have been at four such reviews previously and this is the first time the ministry has had an absolutely clear understanding of where it is coming from and where it is going to. That was absolutely clear in its presentation to the Health Committee because we actually got on to some rather small and insignificant points that were of interest to individual members without even worrying about or spending a lot of time on the big issues. We heard about aged care being devolved out to the district health board sector. The funding has been devolved; the issue is not about how it is being devolved. When we have gone to the district health boards they have said: “Good job. We’re glad it has come to us.” This is the last bit of the puzzle that they want to get right and why do they want to do it? It is because they have democratically elected boards. They know their communities. They go out and consult with our communities through some of the committees they have set up. 
I point out that the perception that there are burgeoning costs in the health sector in administration and management is simply turning out to be not true. In my own district health board Lakes District Health Board management costs in 2000 under the old Crown health enterprises were at 11 percent but now those management and administrative costs have dropped to 6 percent. I hope that the member opposite is listening. The drop in management and administrative costs in the district health board sector has been absolutely astonishing. Mark my word those facts are real. Management and administrative costs in the Lakes District Health Board went from 11 percent to 6 percent. It is a mean machine that is focused on keeping people well and not on obsessing on waiting times for surgery. 
In fact we heard from the Ministry of Health that it had started to look at the wonderful roll-out of orthopaedic surgery. Over the next 3 years $130 million will meet the demands we face in the electorate. No one at all has come into my electorate office concerned about the orthopaedic waiting time and I have a very busy electorate office. There is some degree of satisfaction too to see that after measuring transparent waiting times for surgery the Ministry of Health along with the Minister has agreed that the next chunk of work will focus on cataracts. That is something I am sure all of us will be very pleased to see. We want to keep people well and to reduce the disparities in health—the decade of disparities we inherited. 
I want to talk about the widening gap between health wellness and disease management and about the disparities in health under the previous administration which brought about bottom-line financial fatigue in Crown health enterprises. Now that district health boards are not focused on debt management alone—by being accountable as companies and by attempting to make a profit in the health sector which was what we faced for a decade—they are starting to say that they are getting out there with their annual district plans working with their communities and targeting the reduction of inequalities and disparities in health. We heard about targeted programmes for diabetes and cardiac disease. That was incredibly exciting. Morbidity and mortality are our indicators of effectiveness.