King Annette: Debate on Prime Minister’s Statement 
King Annette: Debate on Prime Minister’s Statement 
[Volume:615;Page:10842] 
Hon ANNETTE KING (Minister of Health) 
: 
 That was a speech full of sound and fury signifying absolutely nothing. In the last week the latest Commonwealth Fund international health policy survey was released. It is the annual survey that compares the health systems of the United States of America the United Kingdom Australia Canada and New Zealand. It is carried out by the Commonwealth Fund which is an independent philanthropic organisation responsible for extensive research and is based in the United States of America. This year the survey was of the patients’ assessment of quality health-care in the five countries I have mentioned including New Zealand. It was not an assessment by doctors bureaucrats or politicians but it was the patients’ assessment of the health-care system. It was carried out in 2001 and 2002. The survey assessed six key areas: safety patient-centredness timeliness efficiency effectiveness and equity. It questioned patients about the quality of care they received from their doctor how long they had to wait for care the follow-up of their care and how often the care had to be repeated and it also measured to what extent patients’ incomes affected their ability to access care. 
I am pleased to inform the House that overall New Zealand ranked No. 1 of all the health systems that were surveyed—not by the Labour Government’s assessment not by the assessment of doctors or nurses but by the assessment of patients in New Zealand. It was followed by Australia the United Kingdom Canada and lastly the United States of America. Don Brash told us today that he wanted to close the gaps between Australia and New Zealand. I tell the member who has just spoken not only have we closed the gaps in terms of our health system but we have surpassed Australia the country the Opposition wants to close the gap with. [ 
Interruption 
] I say to the member who interjected that that is not my assessment; it is an independent assessment by patients in New Zealand. However that member would not believe New Zealanders; he would rather believe his own cant. 
One of the areas of measurement where we need to do better is in the area of equity. That is the gap that exists between low-income and high-income people when it comes to accessing health care. A lack of equity was reported with things such as people not visiting the doctor because of the cost people not getting follow-up care because of the cost people who did not get prescriptions filled because of the cost people who had trouble paying their medical bills and people who could not get care because of where they lived. That part of the survey was carried out in 2001. This Government has committed itself to improving that access and reducing the inequities based on need—affordable health-care for all New Zealanders. We have started off by saying that people should get the care in the areas that need it most first. If we are to bring affordable primary health-care back in—and let us remember we did have subsidised primary health-care in New Zealand until the “mother of all Budgets” of 1991 when Ruth Richardson got rid of affordable primary health-care—then we should start with those who need it most. 
How do we assess need? There has been a lot of debate in this House tonight about how to assess need if we are to roll out a policy and we want to get to the highest need first. First of all we have to understand the determinants of health and some are the measures like the lack of access to health care socio-economic status the environment in which people live the type of housing that people may be in and ethnicity. Research in New Zealand shows that the poorer people are the worse their health is. It is interesting that 72 percent of Maori happen to live in the areas of the highest deprivation. Another measure is how long people live—their lifespan—and what their lot is in life. Over the last century we have seen significant improvement in the health of our population. New Zealanders’ life expectancy at birth has improved at a generally increasing rate since 1970. For example life expectancy for males in 2001 was 76 years of age. Females do better; ours is 80.9 years. 
Hon Ken Shirley 
: We’re discriminated against. 
Hon ANNETTE KING 
: Yes the member is right. However we continue to face some very very important public-health challenges particularly in the widening of the gaps in terms of health inequality. 
Let me give the House a statistic. Life expectancy at birth for Maori is 9 years less than it is for New Zealand Europeans. For Pacific people it is 5 years less. If Don Brash were the average Maori male he would have 4 years left to live. He may have worked hard all his life he may have fought alongside his comrades at war and he may have paid his taxes but on average he would get 2 years of national superannuation. 
There is considerable evidence both internationally and in New Zealand of significant inequalities in health between socio-economic groups ethnic groups people living in different geographic regions and males and females. There are also inequalities in disease state in New Zealand. For example Maori happen to have the higher rates of lung cancer prostate cancer breast cancer and colorectal cancer. Maori and Pacific people have higher rates of cardiovascular disease. Maori have higher rates of respiratory disease and they have higher rates of suicide. When it comes to need-based policies all the evidence tell us that we have to do better for New Zealanders for Maori for Pacific people and for low-income New Zealanders. I do not believe that New Zealanders want to see their neighbours die 9 years earlier than them because of their health status. When people are looking at need they look at the figures and the research and say that they have to improve the health status for those people. I suggest that those who have made speeches today and talked about race-based policies should take a little time to read the  
Sunday Star-Times 
—no friend of the Government but it happens to sit down and do some work about where money goes whom it should go to and what it should do when it comes to health. 
We are committed to bringing back affordable primary health-care for all New Zealanders regardless of age race and the money in people's pockets. But it will take a few years to get there. Do members believe like ACT does that only the poorest should get some help and the rich should have to pay? That is National’s policy I understand because I can see what Don Brash is saying. He has said that millionaires should not be given any help to get health care particularly if they are Maori millionaires. If we follow that logic through why would any person with any money get free hospital care? After all hospital care in New Zealand is on the basis of universal access: people get it whether they are rich or poor. So the real agenda from the National Party is that it is going to charge the rich for hospital care. What is “rich” going to be? Is it going to be over the limit of the community services card: over $19900? I predict that National’s policy will be to charge for hospital services. [ 
Interruption 
] After all I say to Ken Shirley National did that last time it was in Government. National brought in charges for hospital services. 
We believe in universal access to health care and that is what New Zealanders will have. In the next 5 or 6 years they will have universal access to primary health-care and universal access to hospital care. I believe that is what New Zealanders want.