Woodhouse Michael: New Zealand Public Health and Disability Amendment Bill — Second Reading 
Woodhouse Michael: New Zealand Public Health and Disability Amendment Bill — Second Reading 
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MICHAEL WOODHOUSE (National) 
: 
 Last year during the financial review by the Health Committee of the Counties Manukau District Health Board for the 2008-09 financial year a single comment was made by the chief medical officer about doctor productivity that I think summed up the tangle that the New Zealand public health system had got itself into at that time. He pointed out that an analysis had been done of doctor productivity and the measurement of patient contact time by their specialists. In 2000 I think it was the specialists at Middlemore Hospital spent about two-thirds or 67 percent of the working week in front of a patient. By the end of 2008-09 that proportion had fallen to below half of their working week: to about 47 percent. I have no doubt that some of that was necessary and well intentioned but at a time when doctors at Middlemore Hospital were already spending one-third of their time away from patients and when there was a massive injection of cash that led to about 900 more Ministry of Health staff and about 3000 district health board staff in departments like funding planning information technology and data gathering—some of which should have meant less paperwork for doctors—despite all of that doctor contact time with patients went down massively. 
Billions of dollars were poured into Vote Health but services in real terms were static and in many areas were dropping. Doctors nurses and allied health professionals were becoming increasingly frustrated at the red tape that prevented them from doing better. They told me that they were feeling increasingly marginalised from the decision-making process in their public hospitals and that they really wanted to improve the quantity and quality of the care they were providing to their patients but they were being prevented from doing so. 
Yes it is about more bang for the buck. I make no apology for the comment made by my colleague. Whatever we call it—perhaps value for money—it is the responsibility of any Government to make sure that resources are spent in the right places. This Government has pushed resources from the back office to the front line. The Opposition might scoff at what that means but the results have been by any measure astounding. 
Surgery is something that I know pretty well and it has been static at about 125000 surgeries per year for the last 10 years. In the first year under the National Government the number of surgeries went up by nearly 13000. That is on a very small increase in the baseline relative to what had been the case in previous years. There have been very good improvements in the timeliness of patients receiving chemotherapy treatment. The number of publicly funded chemotherapy clinics is up by a quarter or 25 percent. Emergency departments are seeing their patients faster. Before this Government came into power 80 percent of patients were getting out of there within 6 hours; it is now 87 percent and climbing. That is because doctors nurses and our allied health professionals are now feeling more re-engaged more involved and more listened to when it comes to decision making in their district health boards. So we are already on that journey and the New Zealand Public Health and Disability Amendment Bill continues that process. 
I want to talk about planning issues because I have to laugh at the concerns about what changes will be made to the public consultation and planning process. I do not know whether anybody has been to one of those planning meetings but I used to go to them in the Otago area. I cannot remember a public meeting on the annual plan for the Otago District Health Board that had more than about 12 people at it. The fact is that it was more about process than it was about outcomes. One could pick up one of those plans and read it and be none the wiser about which district health board it was for because they were so generic 
I think these are really good improvements that will improve the quality of the planning and hopefully make the plans much more meaningful to the individual communities that boards are meant to represent. This is a good bill. I think there are still a few things we need to talk about in the Committee stage but I look forward to the bill’s progress and I commend it to the House.