5. Question No. 5—HealthHon MICHAEL WOODHOUSE (National) to the Minister of HealthQuestion No. 5—Health5. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: How many adult New Zealanders reported an unmet need for GPs due to cost in the past 12 months according to the results of the 2017/18 New Zealand Health Survey and how does that compare with the 2016/17 survey?Hon Dr DAVID CLARK (Minister of Health): I'm advised that an estimated 585000 people did not access GP services due to cost in 2017/18 though I would note that the survey was completed before the start of the Government's cheaper doctors visits policy in December last year which reduced the cost of primary care for approximately 600000 New Zealanders. Unmet need for GPs due to cost was an estimated 547000 in 2016/17. Hon Michael Woodhouse: Well does he believe that his policy goal of reduced barriers to access for all New Zealanders has been achieved when 38000 more people have unmet needs for GPs due to cost last year compared with the previous year? Hon Dr DAVID CLARK: I thank the member for his question and reiterate what I said in the response to the first one: that of course that result came in before the Government's policy change which has reduced the cost of going to a doctor for around 600000 New Zealanders—540000 community services cardholders can now access cheaper doctors visits that couldn't before. That is $20 to $30 cheaper on average for those community services cardholders for 540000 more New Zealanders. It's great news for those people who were struggling to access a doctor. On top of that and thanks to New Zealand First we have free doctors visits for 14-year-olds. So 600000 New Zealanders can now access cheaper doctors visits than before the time that the member's highlighting.Hon Michael Woodhouse: How does that figure of 540000 adult New Zealanders compare with his lofty promise that every single adult New Zealander would be getting a reduction in fees and when will that occur? Hon Dr DAVID CLARK: It is true that we have an ambition of making sure more New Zealanders can access affordable primary care. That is something this Government is absolutely committed to. I'd also note that the Families Package is helping 384000 New Zealanders and when it's fully rolled out it will be $75 a week in those households that they will benefit from. We're very clearly targeting a situation where more people can afford to go and get the primary care they need.Hon Michael Woodhouse: When the GP fees changes were implemented did his ministry tell general practices that they should increase the consultation fee for patients without a community services card and has that resulted in an increased number of adults saying they avoid the GP because of cost? Hon Dr DAVID CLARK: I think it would be very difficult to trace all of that causality. The member knows I'm sure that increases in primary care visit fees are agreed with district health boards (DHBs) each year and they are done within a range so that primary care providers cannot put up their fees by a dramatic amount from one year to the next. It's an incremental change as costs go up. The cost of visiting primary care can go up a little bit each year. That's the historic pattern; these are private businesses. But there is an agreement in place with DHBs to ensure that they don't rise rapidly.Hon Michael Woodhouse: Will he resign as Minister of Health if the next survey shows that the GP fees changes in Budget 2018 have not resulted in his expected reduction?Hon Dr DAVID CLARK: I think what is absolutely clear is that the New Zealand Health Survey has tracked a historic trend where people feel it has been unaffordable to get primary care. This Government is doing something about that. We are not afraid to tackle the big challenges that that Government sat on the sidelines and watched get worse for nine long years of neglect. Shame on them.