Scott Lynda: Debate on Crown Entities Public Organisations and State Enterprises — In Committee Speaker Recalled In Committee 
Scott Lynda: Debate on Crown Entities Public Organisations and State Enterprises — In Committee Speaker Recalled In Committee 
[Volume:617;Page:13262] 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 The Labour Party speaker said I had been concentrating only on hospitals. That was because this speech will be about primary care. 
One thing we did hear from the Auckland district health boards that that member was so busy quoting was that they think it would be a really good idea if there were only one district health board for Auckland because the cross-boundary flow issues are huge. Following patients from one side of Auckland to the other moving money and patients around—if the patient moves the money follows—is hugely time consuming and costly for the Auckland district health boards. I have to say that if we have one district health board for 1 million people a quarter of New Zealand’s population—it is probably above that now; there are probably 1.3 million people in the Greater Auckland area—why have a whole lot more 18 others for the rest of the country? When we talked to the Otago District Health Board it also said it thought it would be a really good idea if there were one district health board for Otago and Southland. The district health boards are getting together on a lot of backroom functions. Having 21 boards causes a major increase in bureaucracy. 
But let us talk about primary health organisations. The member opposite was correct: National will not force the implementation of primary health organisations. Their funding is based on race and location and that has caused major implementation problems across New Zealand. I wonder whether Clayton Cosgrove would like to tell people in his electorate who happen to be poor and have high health needs why he backs a scheme that has people in Rotorua and Gisborne regardless of their health need or whether they can afford to go to the doctor paying $15 while his people are still paying $35 or $40. That is an unfair funding formula and we do not agree with it. 
I am absolutely astounded that the Minister of Health said that 3 million people are enrolled. For goodness’ sake! If you do not enrol you get no access to the new money. Does she not understand that financial incentives drive everyone? 
The CHAIRPERSON (H V Ross Robertson) 
: The member is bringing the Chair into the debate. 
Dr LYNDA SCOTT 
: The Minister of Health should wake up and realise that if she puts a financial incentive there of course people will join. Why would doctors not join if joining meant that their patients would get access to the new money? No one disagrees with the new money being put into primary care but it absolutely has to be based— 
Clayton Cosgrove 
: What’s the member’s position on primary health organisations? 
Dr LYNDA SCOTT 
: Instead of shouting and screaming across the House as that member is so wont to do he might like to get up and take a call—but he will not do that. 
The primary health organisations funding is based on race. Those organisations are wasting dollars. They have a bureaucracy. There are 84 of them—another Government structure. When New Zealand was told it would have 21 district health boards that would look after hospital care and primary care we were not told that this Government would set up yet another bureaucracy; that it would set up 84 primary health organisations all with a community governance board—yet another set of committees. This Minister of Health is the “Minister of Committees”. 
We have a major problem with the implementation of the primary health organisations. We have problems that the independent practitioners association system could have solved. If the Government had let the doctors get on with doing what they know and what they are good at doing—that is providing excellence in primary care in this country—if it had backed the doctors to do that it would have had a much better outcome for the money it spent. Actually it probably would not have needed to spend as much because it has set up a whole new bureaucracy. 
We heard about aged-care funding being devolved. Well every district health board that I have spoken to is shivering in its boots about the funding of aged care because those boards know that this Government has not put a penny into it for the 5 years it has been in Government. Why has it not done that? Because it is saving the money to fund its asset-testing promise—the asset-testing promise that it has not actually kept. So there are no new services whatsoever in aged care. We have not seen an expansion of care for Alzheimer’s patients. In fact I have just got a letter on my desk from the Minister saying: “Sorry we don’t have any psychogeriatric facilities in Wanganui.”