Hutchison Paul: Questions for Oral Answer — Questions to Ministers 
Hutchison Paul: Questions for Oral Answer — Questions to Ministers 
[Volume:626;Page:20880] 
8.  
Dr PAUL HUTCHISON (National—Port Waikato) 
 to the  
Minister of Health 
: Does she continue to stand by her statement that “people are not culled. They are sent to their general practitioners to be monitored”; if not why not? 
Hon ANNETTE KING (Minister of Health) 
: 
 Yes. The principles of the booking system were put in place in the mid-1990s with implementation commencing in 1998. One of the principles is that people must be told if they are going to get an operation and when. People whose condition meets the priority criteria must be either booked for an operation or given certainty for an operation within 6 months. If a person is not operated on within that time he or she is placed on active review. Under active review a hospital specialist assesses the patient’s condition at 6-monthly intervals. If the patient’s condition changes he or she will be booked or given certainty. If a person does not meet the priority criteria that person is returned to his or her general practitioner. That is how the system has worked since 1998. 
Dr Paul Hutchison 
: Why does the Minister continue to think patients culled from the waiting list like Mrs Peggy Griffiths are monitored when despite my bringing her case to the attention of the House 2 weeks ago Mrs Griffiths told me yesterday that she still remains in agony hardly able to walk across the floor and nobody has told her how when or by whom she will be monitored? 
Hon ANNETTE KING 
: I can tell members why I think that the system is working as the previous Government envisaged. I am informed that Mrs Peggy Griffiths whose case the member raised in the House recently will have confidence in the system because she has been reassessed and she has been given certainty of an operation. 
Nanaia Mahuta 
: Has the Minister seen any reports suggesting that the current booking system should be or would be changed? 
Hon ANNETTE KING 
: No. Although Dr Hutchison makes a lot of noise about elective operations he has not proposed a single change to the current system because members opposite know that the system is fair that people who need operations get them first and that people whose conditions do not enable them to get access to publicly funded services are not misled into thinking they have a chance of an operation and spend years languishing on a waiting list like the case that Dr Hutchison sent to me of a person who had waited 12 years. 
Barbara Stewart 
: Is the Minister aware that the hospital system in Christchurch cannot deal with routine cases because its emergency department is frequently inundated with hundreds of waiting-list patients seeking urgent attention who have to be stabilised and who are then sent home to resume waiting; if so does she consider that that state of affairs is acceptable? 
Hon ANNETTE KING 
: I am informed that over 65000 people go through the emergency department at Christchurch Hospital and that there are many people who need urgent attention. I have been told that about 1200 of those people were on a waiting list and it was concluded that maybe 400 of them had something related to their condition when they turned up at the emergency department. The department is required to manage that and the staff must also see those people who have had an accident or are having a heart attack. They do the best they can. There are troughs and flows of people—sometimes there are many sometimes there are not so many and the staff do very well. This happens around New Zealand and around the world. 
Dr Paul Hutchison 
: Why are things so bad under Labour that Mr Leon Draper a patient with a serious deteriorating arterial condition has after over a year of waiting been notified that he cannot even have a first specialist assessment when he has written to Counties Manukau District Hospital Board saying: “You do not have to go through constant pain and clutch for support when walking to the shops only 100 metres away.” and he also has no formal monitoring? 
Hon ANNETTE KING 
: I am advised that Mr Draper was referred to a vascular specialist at Middlemore Hospital by his general practitioner. His general practitioner said in a letter to the specialist: “I would be grateful for your assessment and advice regarding further management of Mr Draper.” Based on this information from the general practitioner the specialist decided based on his clinical assessment that the patient should be referred to the general practitioner for monitoring. So the member is not being quite straight with the House. 
Dr Paul Hutchison 
: I raise a point of order Madam Speaker. The Minister has just said that I am not being quite straight. Fourteen months ago when Mr Draper was first assessed he could not walk 200 metres without having severe pain in his legs. Today he cannot walk 100 metres without severe pain in his legs. I am being absolutely straight; this is right from Mr Draper’s mouth. 
Madam SPEAKER 
: That is not a point of order. It is a matter of debate. 
Hon ANNETTE KING 
: I am speaking from the general practitioner’s letter. 
Peter Brown 
: Will the Minister tell me whether Mr Anthony Russell of Harrybrook Road Green Bay a case that has just come to my attention was culled from the waiting list; he was assessed in early 2000 as in need of operations to ease his feet and ankle problems and waited only to be told in May this year by the Counties Manukau District Health Board that although he would benefit from an operation there are limited resources and there are others whose needs are greater and therefore he has been taken off the waiting list—has he or has he not been culled? 
Hon ANNETTE KING 
: I cannot speak about an individual patient in that way although if the member is prepared to give me the name and I am aware of the case I can then look into it for him and give him the information. However in principle I would say that if the patient has been told that he does not meet the criteria for priority for an operation at the moment that is correct. He will be under the care of his general practitioner until such time as his condition changes and he is entitled to an operation. Everybody knows that not every case has the same priority and that everybody cannot get an operation at the same time. 
Stephen Franks 
: Can the Minister tell the lay people in this Chamber why she says that the sick people who have been “sent back to their general practitioners to be monitored” are wrong to think they are waiting and what sort of list made up of waiting people is not a waiting list? 
Hon ANNETTE KING 
: No they are not told they are waiting; they are told that if their condition deteriorates they will be assessed to see whether they need an operation. This is different from taking everybody who ever came into the health system and putting them on a list—89000 of them by the mid-1990s many of whom never had an opportunity to get an operation. This system is much more open honest and transparent. I challenge the Opposition to give us one policy that tells New Zealanders it would change a single thing. 
Nanaia Mahuta 
: Can the Minister tell us what is happening to the 15 people who have been waiting in the active review category? 
Hon ANNETTE KING 
: This was raised in the House last week I believe. These are people who have been waiting for 5 years. First of all the national reporting database is a relatively complex system and one cannot always assume that each number actually represents a person. The 15 people actually turned out to be 12. Of those four had received operations one no longer needed an operation three had had their conditions reassessed and four had conditions below the treatment threshold and were returned to their general practitioner. 
Dr Paul Hutchison 
: Does the Minister deny that senior Ministry of Health officials have informed district health boards and orthopaedic surgeons that they must manage their waiting lists by culling patients or risk not receiving funding for the orthopaedic initiatives and that the reason orthopaedic surgeons are deeply concerned by this unethical coercion is that they do not believe that suitable protocols are in place to monitor the culled patients safely? 
Hon ANNETTE KING 
: First of all priority for an orthopaedic operation is given by the orthopod himself or herself. So if a case is a top priority the orthopaedist has said that that case is a top priority. Health officials are not telling boards that they must cull people and that if they do not they will not get the extra orthopaedic money. The whole programme is based on doing additional operations. So if a board does 1000 hip replacements this year it must do 1000 hip replacements and it will get the extra money when it reaches 1001. We will not do what was done in the 1990s when waiting time money was put in for extra operations but no extra operations—over and above the normal number—were done because the money went into operational costs not operations. 
Nanaia Mahuta 
: Has the Minister received any feedback on the current booking system from Age Concern? 
Hon ANNETTE KING 
: Yes. Age Concern believes that the current system—which to be fair it knows was started by the National Party—is much fairer more transparent and more honest because people know when they will get an operation and how long they will wait. 
Hon Dr Nick Smith 
: No they get deferred forever. 
Hon ANNETTE KING 
: Yes they do know that because they are either booked given the certainty of an active review or returned to their general practitioner. They know exactly what is happening to them. Compare that to the old system—which the previous National Government rejected because it knew it did not work—under which people did not know whether they would get an operation and many people were still waiting for their operation years after they had been put on a list. Some of them would not even take a holiday in case their name was drawn out of the hat and they missed out. 
Dr Paul Hutchison 
: Does the Minister deny the recent  
New Zealand Herald  
survey that stated that 73.8 percent of people think that the health system is the same or worse under Labour when she has created a system that culls patients such as Mrs Griffiths and Mr Draper from waiting lists to make her waiting lists look good? 
Hon ANNETTE KING 
: I will first of all say that the Labour-led Government did not devise the system. I must give credit to the National Party for not only devising it but for implementing it. With regard to the second part of the question—that 73 percent of people think that the health system is the same or worse—I remind members of the TV3 poll of 1996 in which 75 percent of New Zealanders said the health system was seriously worse under a National Government. 
Peter Brown 
: I seek leave to table some documents that outline the circumstances around Anthony Russell which the Minister said she was interested in. 
Document by leave laid on the Table of the House. 
Dr Paul Hutchison 
: I seek leave to table a letter from Mr Leon Draper to Chris Fleming general manager of surgical ambulatory care in which he states: “You are writing me off as a human being in the great hope that this condition will kill me and you will get a pat on the back for saving the country another pension.” 
Document not tabled. 
Dr Paul Hutchison 
: I seek leave to table an article from the  
New Zealand Herald 
. It outlines that 73.8 percent of people think that the health system is the same or worse under Labour. 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? There is. It will not be tabled. 
Hon ANNETTE KING 
: I seek leave to table the TV3 Gallup poll of 1996 which showed that 75 percent of New Zealanders thought the health system was seriously worse than it had been before. 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? There is. [ 
Interruption 
] I remind members that they would have all been excluded from the Chamber for talking during that point of order. Can we please settle down.