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: 20 March 2014. Volume:697;Page:16908. Text is incorporated into the Bound Volume.]6.Hon ANNETTE KING (Labour—Rongotai)to the Minister of Health: Does he stand by all his statements?Hon TONY RYALL (Minister of Health):Yes within context. I especially stand by the statement that despite tight times this Government has increased health funding by an average of $500 million a year and that we have 1300 more doctors over 3000 more nurses and 1000 fewer managers and administrators.Hon Annette King: Does he stand by his statement regarding elective surgery that “These decisions are made by clinicians within the funding that they’ve got”; if so is funding sufficient in light of the comments by the chair of the New Zealand Medical Association who said this week that patients who needed surgery were being told they did not qualify; Arthritis New Zealand which said current funding levels are not meeting need; and specialists who are frustrated because they are turning away patients in pain and disability unable to treat them with the level of funding they receive?Hon TONY RYALL: Yes. The Government is putting a huge effort into providing more elective surgery because the history of it is that we inherited a situation where when that member opposite was Minister of Health the health budget increased dramatically but she cut the amount of elective surgery in New Zealand.Hon Annette King: We have got a patient in the front row. Is it ethical for Auckland District Health Board—[Interruption]Mr SPEAKER: Order!Hon Annette King: I am going to start again. Shall I Mr Speaker?Mr SPEAKER: If the member could start again but just start the question straight away without an interjection. [Interruption] Order! If the member could just ask her question I think it would assist me in establishing some order.Hon Annette King: Is it ethical for Auckland District Health Board to make cuts to cardiothoracic surgery vascular surgery neurosurgery orthopaedic surgery gynaecology general surgery respiratory medicine and intensive care because to quote its chief executive officer these are “services where we make a significant loss” and patients are now figures on a profit and loss ledger?Hon TONY RYALL: It is an unusual way to describe a service. I presume what the member was saying is that it is not meeting budget. The Auckland District Health Board has total revenue of $2 billion a year. The chief executive has expressed some concern that one part of the service is $12 million off budget. That is equivalent to about 2 days’ funding at the Auckland District Health Board. I support district health boards as they try to live within their budgets because if they live within their budgets they are able to make decisions for the people of their communities to improve services. I do not think I want our system heading along that road to financial ruin that I had when I became Minister of Health 6 years ago.Hon Annette King: Does he have confidence in the chair he appointed to Auckland District Health Board whose chief executive officer has sent out a panicky email to senior staff that has caused widespread alarm because it requires significant changes and “quick wins” to reduce the $12 million deficit by taking staff out of theatres and out of children’s and older persons’ health services?Hon TONY RYALL: Yes. I have the utmost confidence in Dr Lester Levy. I have to say that hospitals trying to balance their budgets is nothing new. In fact it even happened 30 years ago when that member was running her first election campaign against Sir Robert Muldoon Brian Talboys and Lance Adams-Schneider.Hon Annette King: In light of that answer I could point out that that member has been in Parliament only 3 years less than me.Mr SPEAKER: Order! We are going to call it one all and we are going to move back to question time.Hon Annette King: I’ve still got all my hair. [Interruption] And a good thing too!Mr SPEAKER: Order! Now we will have the question. Otherwise we are moving on.Hon Annette King: Does he think it is acceptable for district health boards to take on average 5 months to fill a senior medical officer vacancy—but it can take up to 8 months before they actually start work—in an effort to save money and what is the impact on patients and staff with such long delays?Hon TONY RYALL: Filling some roles does take a long time. I only look at the Leader of the Opposition role for the Labour Party. It has taken a long time—Hon Bill English: Chief of staff.Hon TONY RYALL: And in fact the chief of staff took months. So some of these roles are quite difficult and challenging and certainly I am sure with that member’s experience over the last 30 years she has seen many of them come and go.Hon Annette King: How does his promise of more operations stack up with the fact that Auckland District Health Board has managed to increase the number of orthopaedic operations carried out by only 28 since 2011-12 and now it wants to make cuts to orthopaedic surgery according to the chief executive officer’s recent email which I am happy to table because the Minister obviously has not read it listening to all his answers?Hon TONY RYALL: I am pleased that I always check anything that that member says in the House. Since we had the doctored Official Information Act response I have always checked. The information I have is that in fact it has done over 1200 more orthopaedic procedures compared with when Labour was last in office in 2007-08. I think it is doing a lot of very good work in Auckland under a lot of pressure. It is a fast-growing population but that is the reason why this Government has put in $180 million extra into the Auckland District Health Board in the last 5 years.Hon Annette King: I seek leave to make a personal explanation.Mr SPEAKER: In that case—[Interruption] Order! If we could just briefly have what it is regarding and then you need to seek leave so I will put leave.Hon Annette King: I seek leave to make a personal explanation regarding repeated accusations by Tony Ryall that I have doctored figures.Mr SPEAKER: Leave is sought to make this personal explanation. Is there any objection? There is not.Hon Annette King: In July 2013 I called a reporter at the Timaru Herald with figures that I had received through an Official Information Act response from South Canterbury District Health Board on the number of people waiting for a range of endoscopy procedures including colonoscopies. I informed him that I believed that the number of people waiting for a colonoscopy should be 495 people not 280 people as stated in the document. I explained the way that I had calculated the figure and handwrote what I believed to be the correct figure on the copy of the document provided by South Canterbury District Health Board. I then emailed it to the reporter for him to check. I phoned again once he had received the document and he agreed with my assessment of the total provided based on the way the figures were presented.He then contacted South Canterbury District Health Board and showed it what we believed to be the correct number of people waiting for a colonoscopy. At that point South Canterbury District Health Board informed him that the figures provided for other endoscopy procedures had been added up as a total number. The number of people waiting for a colonoscopy was presented in a partly accumulated way. This was not made clear in the figures provided. The reporter advised me of the South Canterbury District Health Board’s explanation which I accepted.I subsequently phoned the chief executive of South Canterbury District Health Board and asked him to provide a new answer to my request for the number of people waiting for a colonoscopy. I received a letter with the changed figure on 11 July. The letter read: “The numbers for the second question on colonoscopy procedures in the table included in the letter was partly accumulated. This was not stated in the response and made the table difficult to add. We have amended the table so it is not accumulated.”At no time did I distribute doctored figures as claimed by Tony Ryall. The only people to receive a copy of my handwritten total were the reporter who sent it to South Canterbury District Health Board and Tony Ryall to ask them to explain the apparent mistake. I seek leave to table the two documents I received and a note of explanation from the South Canterbury District Health Board on 11 July of the error it made when it provided me with the original figures.Mr SPEAKER: Leave is sought to table those two documents so described and a note of explanation. Is there any objection? There appears to be none. They can be tabled.Documents by leave laid on the Table of the House.Hon Trevor Mallard: Point of order Mr Speaker. [Interruption]Mr SPEAKER: Order! [Interruption] Order! I have a point of order.Hon Trevor Mallard: I seek leave to table two documents from the Parliamentary Library showing that Sir Brian Talboys and Lance Adams-Schneider retired from the House 3 years before Mrs King contested an election as evidence of the accuracy of the statements and the reliance that we can place—Mr SPEAKER: Order! We do not need any more. On the basis that the member thinks that is important knowledge for the House I will put the leave. Leave is sought to table that Parliamentary Library information. Is there any objection? There is none. It can be tabled.Documents by leave laid on the Table of the House.Hon Clayton Cosgrove: I raise a point of order Mr Speaker. Could you advise of the rules in respect of once a personal explanation has been given and a member then repeats immediately the allegation afterwards as the Minister of Health did and what the process is? My understanding is that a member’s word has to be accepted. A personal explanation deals with the matter. To repeat the allegation as he did immediately afterwards breaches the Standing Orders.Mr SPEAKER: A member’s word certainly must be accepted. Despite the detailed personal explanation there could still be some matters of debate within that. The member’s word must be accepted but I do not think there is any matter I need to take any further at this stage.