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: 15 May 2013. Volume:690;Page:9939. Text is incorporated into the Bound Volume.]9.Hon ANNETTE KING (Labour—Rongotai) to theMinister of Health: What progress if any has been made towards providing more health care in the community?Hon TONY RYALL (Minister of Health): Very good progress has been made—for example in relation to home support in the community. The Government expects to spend $251 million on home support for older people in the 2012-13 year—that is $30 million more than in 2008-09. Although most district health boards are delivering more hours and one or two are delivering fewer overall in 2012 district health boards purchased over approximately 10 million hours of home support which is 1.4 million more than in 2008. However like so much in the work that we do there is always room for improvement for New Zealand patients.Hon Annette King: Is Dr Paul Ockelford of the New Zealand Medical Association correct when he said this morning that if the Government wants doctors to provide more health care in the community rather than in hospitals Government funding should follow?Hon TONY RYALL: Mr Ockelford certainly presents a view that if additional services are to be purchased from doctors and general practices then funding should follow. In many ways that is why the Government has invested so much in the public health service over the last few years and New Zealanders will see tomorrow that this Government remains very strongly committed to protecting and growing the New Zealand public health service.Hon Annette King: Does he intend to inform New Zealanders that in fact moving health care into the community can actually mean moving the cost on to the community which is happening now under his policy and impacting on older people in particular?Hon TONY RYALL: The Government remains very committed to improving services in the community. I can tell that member that for example we have been increasing the funding that is made available to general practices. We have made funding available so that doctors and nurses have additional time to provide mental health services in the community. We are actually seeing quite a lot of additional services provided for New Zealanders across a whole range of areas.Hon Annette King: Is he aware that the impact of moving health care from hospitals into the community without funding has meant that Mr David McFarlane a 75-year-old pensioner from Kaiapoi has to pay $200 to his general practitioner to have skin cancer removed—a procedure previously carried out without cost in the public hospital?Hon TONY RYALL: In many parts of the country people may pay for some skin lesion services; in many parts of the country they may not. But certainly what we are doing is providing more services in our public hospitals. We are providing more operations than at any other time in the history of New Zealand. We have increased the funding and more services are being provided unlike the situation in the 2000s when the budget doubled and fewer people got operations.Hon Annette King: Is it the Government’s intention that New Zealanders now pick up the cost of health care provided in the community that was provided free of charge in public hospitals?Hon TONY RYALL: The vast majority of services provided in our public hospitals—in fact virtually all of them—are provided free. This Government is very focused on making sure that the services that New Zealanders receive are improved. They will see in the Budget tomorrow continuing strong commitment—Hon Annette King: I raise a point of order Mr Speaker. I am sure you listened to the question. I did not ask whether they were provided free in the public hospital; I asked whether the community is now going to pick up the cost of health care that was provided free in the public hospital.Mr SPEAKER: Order! That is not the way the question was originally asked but if the Minister—Hon Annette King: Mr Speaker I will repeat it if you would like so you can see exactly how—Mr SPEAKER: No that is not necessary at all. Does the Minister now want to answer further? No.Hon Annette King: I seek leave to table a letter from Mr David McFarlane with his approval saying that he now has to pay $200—Mr SPEAKER: Leave is sought to table that letter. Is there any objection? There is none. It can be tabled.Document by leave laid on the Table of the House.Hon Annette King: I seek leave to table a report from his doctor saying that he needs to have these skin cancers removed because if they are not removed they will invade surrounding tissues.Mr SPEAKER: Order! And again that is with the patient’s approval?Hon Annette King: It is all with his approval.Mr SPEAKER: Leave is sought to table the doctor’s report as well. Is there any objection? There appears to be none.Document by leave laid on the Table of the House.Hon Annette King: I seek leave to also table two receipts from Mr McFarlane showing that he paid $200 to have skin cancer lesions removed.Mr SPEAKER: Leave is sought to also table the receipts. Is there any objection? There appears to be none.Documents by leave laid on the Table of the House.Brendan Horan: What would the—[Interruption]Mr SPEAKER: Order! [Interruption] Order! Would the member just proceed with his supplementary question.Brendan Horan: What would the Minister say to the Bay of Plenty mother who approached me yesterday concerned when told—[Interruption]Mr SPEAKER: Order! The member has every right to ask his question. Would the member please ask his supplementary question. [Interruption]Brendan Horan: How dull some of their comments are on that side but never mind.Mr SPEAKER: Order! If the member just proceeds to ask his supplementary question we will get to the further business of the House far more quickly.Brendan Horan: What would the Minister say to the Bay of Plenty mother who approached me yesterday concerned when told by her doctor that her 11-year-old son will have to wait 6 months to see an ear nose and throat specialist for treatment for a respiratory condition which will likely require an operation and whose condition may worsen with risk of infection whilst on the waiting list? What would the Minister say to that Bay of Plenty mother?Hon TONY RYALL: I would say to that Bay of Plenty mother to make sure that the general practitioner refers her to Tauranga Hospital because I could tell that mother that more services are being provided to children and adults in the Bay of Plenty District Health Board region than ever before and the services are being provided faster thanthey were before. This Government has invested strongly in the Bay of Plenty District Health Board unlike the previous Government when the budget doubled and fewer people got operations. We are providing record numbers of specialist appointments and a record number of operations and that mum should be very happy with the increased services we have provided.