Hague Kevin: Medicines Amendment Bill — In Committee Third ReadingText is incorporated into the Bound VolumeHague Kevin: Medicines Amendment Bill — In Committee Third Reading[Sitting date: 19 November 2013. Volume:695;Page:15060. Text is incorporated into the Bound Volume.]KEVIN HAGUE (Green): This Medicines Amendment Bill is a good bill. It is largely technical in nature and it is one that we are happy to support at its third reading. But like the Hon Annette King I want to provide a little bit of context as is appropriate at the third reading. As Iain Lees-Galloway described in the Committee stage the progress of this bill has been extraordinary and also chaotic. Certainly this morning I had to refresh my memory on much of the content of the bill because it has been so long since we last debated it in the House and to now be progressing it through all of its remaining stages under urgency is a little extraordinary. One of the things that I noticed was the commencement date and the change to the commencement date made by the Health Committee which has turned out to be fortuitous. If we had not done that the bill was due to have commenced in July of this year. At the time the select committee was considering it we had no idea that it would take the Government this long in fact to come to finalise the bill.It is hard to know whether that chaotic nature is a reflection of Minister Ryall’s political lens as Maryan Street has described it in the House. He is a Minister whose first instinct is to ask: “Does this win my party votes or does it lose my party votes?”. He is not a Minister who asks: “Is this measure good for New Zealanders’ health or bad for New Zealanders’ health?”. I think that is a sad thing but we do not know whether the chaotic nature of this bill is a reflection of that or of a more general incompetence either in the health portfolio specifically or around the Government’s management of its House programme more generally.Part of the context for this bill that I want to talk about is the workforce. Minister Ryall has for example trumpeted an increased number of doctors an increased number of nurses both of which have been shown to be outlandish claims that are not supported by the evidence. For example when asked about increased specialist numbers he included in his new doctor numbers a very large number of junior doctors who are not in fact specialists. His increased nurse numbers include a very large number of nurses who previously worked in our hospitals under contracts and are now employees so do not reflect any increased nursing capacity. It is a certain disingenuous use of data. Neither of those numbers reflects the maldistribution of those health professionals.Why this is important is that New Zealand is going to be facing—and indeed already is facing—a massively increased burden of disease particularly associated with chronic conditions. I have used diabetes in this House on a number of occasions as an example of an area where New Zealand is already facing this massively increased burden. If New Zealanders today require renal services they will be lucky to receive them. They will be lucky to receive them because those services are already being overwhelmed by the burden of disease associated with diabetes. That burden of disease is due to increase even more rapidly both because of the ageing New Zealand population but also because of the burgeoning incidence of type 2 diabetes. It is burgeoning to the extent that it seems likely based on the PricewaterhouseCoopers projections and based on the work done by the University of Otago researchers on the current prevalence of type 2 diabetes and pre-diabetes that in just 8 short years—by 2021—New Zealand will have moved from spending around half a billion dollars currently to spending around $2 billion each year on type 2 diabetes treatment alone. That is a massive increase in the burden of disease that our health services will face. It is an increase that we are ill-equipped currently to bear and this Government is doing precious little about preparing us for that impact. In fact in the face of that impact this Government and this Minister of Health Tony Ryall have actually slashed spending on preventing type 2 diabetes which is a massive massive problem.Against that extremely worrying picture the one bright light that I can pick from the Government’s performance is in fact this bill because clearly one of the things that New Zealand will need to do in the face of this impact from chronic conditions is to use our health workforce more intelligently and more flexibly. That will mean health professionals doing things that they are competent to do and that lie within their expertise but which they are not currently doing. Part of the recipe for reaching that point is to change the regulatory framework that may be preventing them from working to the full scope of their expertise. That is one of the things that this bill does accomplish. It will see a wider range of health professionals being able to prescribe and actually use a greater part of their expertise to the advantage of New Zealanders’ health. I already see it in the rural area that I come from the desperate need—and I spoke earlier in this contribution about the maldistribution of health professionals around the country—to be doing that in order to provide for the needs of rural New Zealanders. But that need in rural New Zealand is effectively the thin end of the wedge. What we are experiencing in rural areas will be experienced right through the country as a result of this burgeoning chronic disease burden. A bill like this which enables that stretched New Zealand workforce to work to the extent of its capacity is a welcome contribution and the Green Party will vote for it.