1. District Health Boards—Funding and Service DeliveryHon ANNETTE KING (Deputy Leader—Labour) to the Minister of HealthORAL QUESTIONSQUESTIONS TO MINISTERSDistrict Health Boards—Funding and Service Delivery1. Hon ANNETTE KING (Deputy Leader—Labour) to the Minister of Health: Does he believe that DHBs have enough funding to meet the needs of the public in a fair and equitable way?Hon Dr JONATHAN COLEMAN (Minister of Health): And happy New Year to you too. Yes under this Government Vote Health has increased by $4.3 billion. In terms of fairness and equity funding is distributed to district health boards (DHBs) via the population-based funding formula introduced by health Minister King nearly 20 years ago.Hon Annette King: Is it a fair and equitable system when 20 percent of people refused a first specialist assessment under his funding are people needing orthopaedic operations—in other words older New Zealanders living in pain and disability?Hon Dr JONATHAN COLEMAN: The member is focusing on the small percentage of people who are not getting a first specialist appointment but the wider picture is actually that first specialist appointments under this Government have gone up massively by about 110000 per year. In fact I think it is actually even more than that. In terms of hip and knee surgery for older people there has been a huge uplift in joint replacements over the last 8 years from 8800 in our first year in Government to over 11000 now. So we are doing more all the time helping more New Zealanders to get the services they need. The member should be positive and focus on the good things that are being done rather than nit-pick around the fringes.Hon Annette King: Does he stand by his statement that the answer to increased demand is to do more when the increase in hip and knee surgery was a mere 2.7 percent over the previous year and eight—eight—district health boards are doing fewer hip and knee operations than before while the demand and need for surgery is exceeding the funding he is putting in?Hon Dr JONATHAN COLEMAN: The member wants to be cheerful and focus on the big picture which is actually that hip and knee surgeries have gone up 8 percent over time. In terms of doing more I agree that we should be doing more. That is why I was very disappointed that when Mrs King was Minister she managed to deliver 7500 fewer operations each year. [Interruption]Mr SPEAKER: Order! Can we just have the supplementary question please.Hon Annette King: When he said on 2 November that eye treatment in the public health system was actually pretty good" was he aware that the College of Ophthalmologists estimated that more than a hundred people could lose their vision or go blind because of delays in treatment?Hon Dr JONATHAN COLEMAN: Once again the member should not be so gloomy. When you are looking at eye assessments and eye surgery let us look at the bigger picture—the facts. Ophthalmology assessments are up 40 percent in the last 8 years and ophthalmology surgeries are up a whopping 57 percent. Of course there is always more to do and that is what we are doing—unlike of course when Mrs King was Minister when she did less.Hon Annette King: Is the hastily-put-together $2 million package announced 2 days before Christmas realistic when the College of Ophthalmologists estimate that up to 21000 people are overdue for follow-up eye appointments from the five main centres and the only people who are gloomy are those who are not seeing properly?Hon Dr JONATHAN COLEMAN: Oh no I know a lot of thought went into that $2 million package—$100000 for each district health board. It was consulted with the ophthalmologists and they thought it was an excellent initiative that is going to benefit a lot of New Zealanders.Hon Annette King: Was it acceptable to him to sit on his hands and do nothing denying warnings that the college gave him a year before of the massive failures in follow-up eye treatment and watch an estimated hundred people lose their vision or go blind on his watch?Hon Dr JONATHAN COLEMAN: As Mrs King knows that just did not happen."