Ryall Tony: Supplementary Estimates — Imprest Supply Debate 
Ryall Tony: Supplementary Estimates — Imprest Supply Debate 
[Volume:632;Page:3713] 
Hon TONY RYALL (National—Bay of Plenty) 
: 
 If Phil Goff is in his caravan this afternoon with the transistor turned on I think he will be sitting there—having heard from Minister Maharey one of the pretenders who offers no hope for the future of New Zealand—and thinking: “I haven’t got long to wait.” The House is sitting at a time of untold industrial strife within the public health service and at a time when fewer and fewer New Zealanders are getting the services they want. Listeners would have been angry at Mr Maharey’s comment that this Government was investing in social infrastructure in this Budget. Minister Maharey should tell that to the 8-year-old girl who cannot get plastic surgery for a smile. He should tell that to the women of New Zealand who cannot get breast reconstruction following their mastectomies. He should tell that to the New Zealand women who have been told they were culled off the radiotherapy waiting list during the radiotherapists’ strike. Those women have still not been given a date for their treatment and they have heard the Minister of Health in the House today say some patients may wait 2 months to get back on to the theatre list. How do those women feel given that they need to have their treatment now? What about their social structure? What about those women who are waiting? 
What will happen to the thousands of New Zealanders who have been dumped from hospital waiting lists in the last few months? What about the 20000 New Zealanders who will be dumped from hospital waiting lists in the next financial year because of the Minister’s edict? We know that that is what New Zealanders are facing. In the Health Committee that considered the issues of the estimates in Vote Health last Wednesday Ministry of Health officials said that it was their expectation that the district health boards would cull their waiting lists down to the targets set by the elective service indicators—that is a 6-month waiting list—and officials said that that added up to around 25000 New Zealanders— 
Anne Tolley 
: Off the list. 
Hon TONY RYALL 
: Twenty-five thousand more New Zealanders will be off the list. That should be set within the following context: the Minister has admitted in this House that fewer New Zealanders received elective surgery in the last financial year than received it 5 years earlier. That is what the Minister of Health had to admit. He can stand up in this House and talk about case-weighted this and all that but when it boils down to who got an operation he had to say that fewer New Zealanders were getting elective surgery in the last financial year than they did 5 years earlier. 
Anne Tolley 
: So what happened to the money? 
Hon TONY RYALL 
: That is the issue. Four billion dollars has been spent and fewer people are getting elective surgery. The Government says that is not a problem. If it is not a problem why did Michael Cullen point this out as a major problem in the health sector and why is a team of Treasury officials working on value for money in Vote Health if the Government does not believe that this is an issue? The Government does believe it is an issue. The first person to blow the whistle on the issue of productivity was in fact the outgoing Minister of Finance. He said it was an issue and we have been looking at those figures to see what services New Zealanders have got. Even the Minister of Health was forced to stand up in the House and say fewer people got elective surgery in the last financial year as compared with 5 years earlier. 
In this forthcoming Budget year what action will we see on the workforce issues in the health sector? What indications are there that the Government values general practice—general practitioners family doctors? Members should remember that the Government is putting an awful lot more pressure on the family doctor. What does the Government say about the 20000-odd people culled off the waiting list? It says: “Go back to your general practitioner.” What did the Government say to the 17000 people who could not see their specialist or have elective surgery because of the strike? It said: “Not a problem. Go back to your general practitioner.” What does the Government say to the general practitioner workforce in New Zealand? 
Anne Tolley 
: “Do what we say.” 
Hon TONY RYALL 
: It says: “Do what we tell you to do. Set the fees according to our requirement.” But the Government has backed down on that in the last day. Minister Hodgson can chuckle but we know that that is the case. 
In respect of the general practitioner workforce so many sensible things could be done to get more family doctors. This is the Labour Government that is apparently investing in social structure. Its members should tell that to the almost 800 people on the Kapiti coast who cannot get on a general practitioner’s books. They should tell the people of Timaru that they cannot see a general practitioner—and that is investing in the social structure—and they should tell that to the people of Gisborne who it has been reported cannot get on to a general practitioner’s books. 
One might ask what the problem is if someone cannot get on to a general practitioner’s books and that that person should go to accident and medical. The problem is that if one is not registered one will not get cheaper doctors’ visits—one pays the full price. So the almost 800 people on the Kapiti coast who cannot get registered—many of them are people of low income—are facing the barrier to access that the Government identifies with high general practitioner fees. 
There is another disconnect that nothing in this Budget will do anything about. The Government is telling New Zealanders that it wants them to see their general practitioner. So it is lowering the cost of going to the doctor for some of the wealthiest people in New Zealand and is telling people to see their general practitioner. But the disconnect is that if those people see their general practitioner there is no way they will get anywhere near the hospital if they are sick. If people are sick and need to see a specialist and have elective surgery those people will find that the Government is making it harder for them to get there. 
In fact the Government will make it a lot harder because I can tell the House that the consequence of the Government’s policy to cull hospital waiting lists is that the thresholds needed to get surgery in New Zealand are going up. District health board after district health board has come before the parliamentary select committee and said the patients they are treating have to be sicker to be seen in their hospital. The people that they are dealing with have to be sicker to be treated. In fact did not the cartoonist in the  
Press 
 sum it up best with the picture of Mr Hodgson sitting at his desk as Minister of Health saying that the trouble is now that patients have to be as sick as the health system to get any care? That is the situation we are in. 
This Budget offers no hope for the parlous state of the New Zealand health service mainly because it presents no vision or coherence as to how to deal with the very fundamental issues facing the system that need to be dealt with—that is we need more elective surgery and we need to deal with the waiting lists professionally. 
One of New Zealand’s leading breast cancer surgeons Belinda Scott says that the health service has fallen to Third World standards we have the head of the Royal Australasian College of Surgeons saying that the system is a disaster and the head of plastic surgeons in New Zealand is talking about the fact that New Zealanders are missing out on the sort of care that is the basis of any other system around the world—and that party opposite calls itself a Labour Government. The problem is that those members have become completely tied up in a system that is not working they have a huge focus on bureaucracy they think that a strategy a hui and a plan— 
Anne Tolley 
: A review. 
Hon TONY RYALL 
: —or a review—will fix everything rather than taking any action. The wages and salaries of bureaucrats and managers are now over $500 million for the first time. We know that for every 2.5 nurses the Government has employed an extra manager. That is ridiculous and that is why we have a Minister of Health who is being routinely mocked by the media by the surgeons and—more important—by patients around this country. After 6 years of Annette King keeping a lid on this issue Mr Hodgson is showing himself to be as incompetent with health as he was with New Zealand’s greenhouse gas policy when he promised that the Kyoto Protocol deal was worth a $500 million cheque—and it was worth a $500 million bill.