King Annette: Financial Review Debate — In Committee 
Text is incorporated into the Bound Volume 
King Annette: Financial Review Debate — In Committee 
[Sitting date: 12 March 2013. Volume:688;Page:8436. Text is incorporated into the Bound Volume.] 
Hon ANNETTE KING (Labour—Rongotai) 
: 
 The ministry at the 2011-12 financial review made the claim that the health sector was well managed and although some OECD countries were forced to cut Government health spending New Zealand had slowed expenditure growth without needing to reduce health services or cut the numbers of clinical staff. That was what was written in the financial review. 
So let us examine those claims that were made in the financial review. It is not easy to get the information that I would like to share with you because unfortunately we have a Minister who has been very very clever at keeping information very quiet. I did receive a letter that I thought might put it into perspective. This letter is from someone who works in the health system who wrote to me and said: “There is a climate of fear bullying and intimidation from the Minister and the national health board personnel that is destructive and into micro detail and management.” That was followed up by a comment from the Association of Salaried Medical Specialists who said recently that the Minister had in fact intimidated a doctor into not speaking. So we do have this climate of fear that exists in the health system. 
I think it is important that I read to you from this letter what this person said about our health system. It reads: “The absolute focus on the Minister’s health targets and the counting numbers is unwinding much of the improvements that have been made previously. Most of the increase in elective services was the result of work done under the Labour Government and was just starting to work. The health target comparisons by DHBs are so totally meaningless they do not reflect anything to do with real care or quality of outcome. This will only get worse as financial pressures build in the last quarter of this financial year.” That comes from somebody who works in the health system. 
So let us go over those things that were said in the financial review. It was said that the health system is well managed. What did the Health Committee itself say in its report to this House? It said this: “We were concerned about the ministry’s capacity for delivering projects and meeting output targets as reflected in the 7.6 percent reduction in operating costs and the 21 project delays that occurred in 2011/12. We note that almost half of these delays were because of staff vacancies and redundancies.” 
So is our system working well and is it well managed? Well if the way to manage it is to delay up to 21 projects because there are staff vacancies and redundancies it does not seem to me to be a very good way to manage it at all. Then you have a look—and I know Dr Hutchison will be interested in this—at what some of those 21 projects are that we were told at the select committee had been delayed. 
Well when I looked at this list an alarm bell went off for me because unfortunately I was the Minister of Health in February 2000 who was required to present the report on the under-reporting of cervical cancer rates from Gisborne. A ministerial inquiry had been carried out because of failures in the cervical screening programme. So one of my first duties as a new Minister was to present a damning report on our cervical cancer screening programme in New Zealand where New Zealand women had died. But what has been delayed in 2010-11 and 2011-12? These are the projects: the National Cervical Screening Programme monitoring data—why was it delayed? Because there are vacancies not filled—the development a review and the update of the policies and standards within the national screening programme; the monitoring and improvement of the quality of ethnic data on the National Cervical Screening Programme register; and the high-grade analysis report on women with high-grade lesions on the National Cervical Screening Programme. Those are examples of some of the 21 projects that have been delayed in the financial year that is under review—delayed all of those delayed—because of vacancies because they have to save money. Dr Hutchison you will know that it is not acceptable to put on hold important monitoring and evaluation of a programme like the Cervical Screening Programme. Have we not learnt from what we did in the past? So when it comes to saying that the Ministry of Health and the health sector are well managed they not well managed when those vital programmes are delayed because the vacancies have not been filled. 
Then let us look at “no cuts to services”. Well that is blatantly untrue—blatantly untrue—and anyone who lives in provincial New Zealand in particular will know that that is untrue. The ministry is required to save $700 million over 5 years covering the financial area we are looking at. So I want to give you just one little example of a cut in health services. It comes from a little place called Westport. What has happened in Westport? They have had no orthopaedic clinics at Buller Hospital for the last 6 months—none. Why? Because there is nobody to send there. And did the Government tell the people that the clinics had been cut? No it did not. The people of Westport did not know that their orthopaedic clinics had been cut. It was withheld from them and they found out only when the  
Westport News 
—the little newspaper down there—looked to see what was happening. I could give you many examples. I am sure Minister Goodhew knows quite a few of them because quite a lot of them are actually in her area of responsibility. She shakes her head but I am happy to share them with her at a later date. 
We also have from this Government what I call smoke and mirrors. Let us have a look at the claim that we have more doctors in our health system. That has been claimed by the Prime Minister and that has been claimed by Tony Ryall. Well what does the Association of Salaried Medical Specialists say? Of course members opposite are scoffing at it. It is a union I suppose. 
Dr Paul Hutchison 
: That’s it. 
Hon ANNETTE KING 
: Of course I suspect Dr Hutchison that you were once a member of that very good union. It said at this repeated claim by Minister Ryall that there are 800 senior doctors that the doctors “erupted with disbelief and anger.” The association said: “this 800 number has been completely discredited and disproven by using official DHB and government data.” There are no extra 800 doctors in our hospitals. That is absolutely wrong. In fact we have 373 over the 3-year period. “Hospital specialist numbers have increased but not fast enough to keep up with increasing demands … Furthermore” said the Association of Salaried Medical Specialists “in the three year period Mr Key referred to”—as has Mr Ryall—“the rate of hospital specialist increases fell by 25% from the three years immediately before his government took office.” So there you have it. The claims that there are more doctors and that the Government has not cut the numbers of clinical staff are not to be believed. 
We also have the claims that the Government has reduced costs. Well let us have a look at some of the costs it has reduced because when you look at them you will find that it might have reduced costs in the ministry but it has now extended costs into some new organisations: Health Workforce New Zealand—how many people are employed there—the Health Quality and Safety Commission Health Benefits Ltd and so on. So when you start to look at the bodgie figures—OK so they might not be in the ministry but they have been moved into other areas. Let us take the Minister’s own office. He has got only the same number that we had when we there: eight ministerial staff. When we were there they were paid a total of $349000 in salaries. What are they paid now 4 years on? There are $746000 in salaries in the Minister’s own office. So all this talk about cutting costs does not apply to the people who work for him but it certainly applies to those who work in the home-care sector who have not seen increases in their salaries. 
So I have to say that when I look at what the ministry said about the health sector and what it claims were the things that were happening and when you examine them in just a little more detail you will find they are based on smoke and mirrors some bogus figures and fiddling and twiddling with those figures. You will hear much more about the health sector over the next year or so because at least people know that we are prepared to stand up for them in places like—