Dunne Peter: Questions for Oral Answer — Questions to Ministers Questions to Members 
Dunne Peter: Questions for Oral Answer — Questions to Ministers Questions to Members 
[Volume:620;Page:16166] 
3.  
Hon PETER DUNNE (Leader—United Future) 
 to the  
Minister of Health 
: Does she stand by her statement last month that “I believe that through innovation and the commitment of those who work in the health system it’s becoming better all the time.”; if so why? 
Hon ANNETTE KING (Minister of Health) 
: 
 Yes because we are now seeing some exciting innovations particularly at the primary-care level aimed at keeping people well in their communities and out of hospital. That must be good for the individuals and ultimately the taxpayer. 
Hon Peter Dunne 
: Do the exciting innovations the Minister has just referred to include more steps towards the integration of the public and the private heath sectors; if they do include that can the Minister indicate to the House what precise steps she will take in the next 12 months to advance that policy? 
Hon ANNETTE KING 
: Yes a number of public-private partnerships have taken place over the last 4 years. In fact I have a letter from Andrew Blair President of the New Zealand Private Hospitals Association who wrote to me to showcase the successful public-private partnership in his area. I expect over the next year where public and private partnerships meet the protocols that were established in 2000 we will see such development. Where they do not meet those protocols we will not. 
Dianne Yates 
: What other examples can she give to demonstrate recent health innovations in both primary health care and the hospital sector? 
Hon ANNETTE KING 
: One does not have to travel far to see the new approach being provided—for example in the Hutt Valley nurse-led respiratory clinics are providing quicker diagnosis and better treatment for patients. They have gone from a 2-year backlog to a no-waiting list. The service provides immediate access to diagnostic tools such as blood tests chest X-rays and scans allowing for more timely management of the condition. I have many other examples but I suspect that you will stand up and not let me read them all out. 
Mr SPEAKER 
: That is correct. 
Judith Collins 
: Does she believe that more bureaucracy and increased and wasted funding that has led to fewer operations and a letter from the Hon Michael Cullen expressing concern about declining productivity in the public health system is in fact better for New Zealanders; if so why? 
Hon ANNETTE KING 
: I would just like to update the member on bureaucracy. If the member would like to look at the 1998 figures—figures that came from the Hon Bill English—she will see that 79 percent was clinical and 19 percent was non-clinical. I can tell the member that the split now is 83 percent clinical and 17 percent non-clinical—in other words bureaucracy has dropped. 
Peter Brown 
: Is the Minister aware that the countries that have the most effective health systems—that is have more doctors and nurses per capita and have the most sophisticated drugs available and the latest technology—spend between 9 and 10 percent of GDP on their health systems; and noting that we are way behind that are we on track to get there eventually; if so when? 
Hon ANNETTE KING 
: I would dispute the member’s figures. The highest expenditure of GDP on health is in the United States. Most of it is in the private sector. Their health outcomes are nowhere near as good as New Zealand’s as shown in the most recent Commonwealth Fund report. I direct the member to those outcomes and to compare our expenditure and our outcomes. He will see that New Zealand does very well indeed. 
Heather Roy 
: How can the Minister say that the health system is becoming better all the time when 56 percent more people last year waited over 6 months for surgery as shown by her own figures? 
Hon ANNETTE KING 
: It is becoming better because we are prepared to measure and tell the public exactly how long they will wait rather than having 89000 people on a waiting list some of whom had been there 7 or 8 years. The saddest case I heard was that of the person who had not taken a holiday for 4 years because of the fear that the operation might come up. We now make it transparent who will get operations and when. 
Mr SPEAKER 
: There is too much interjection. I remind those interjecting that interjections do not come across the air on radio or television. 
Hon Peter Dunne 
: Does the Minister’s commitment to innovation and a system becoming better all the time include a commitment to reviewing the operations of Pharmac to ensure that the funding decisions it reaches in respect of individuals’ entitlements to medications can be more individually tailored; if she does agree with that assertion what will she do about it over the next 12 months? 
Hon ANNETTE KING 
: No the Government has no intention of reviewing Pharmac’s operations at this point. I believe that we are very well served by Pharmac. For example Vioxx is one drug that Pharmac decided it would not subsidise and it is fortunate that it did not because the drug has had to be withdrawn from the market in countries that did subsidise and that affected many thousands of patients. 
Hon Peter Dunne 
: I ask the Minister again: does her commitment to an innovative system include recommending changes to her colleague the Minister of Finance regarding the eligibility of those over the age of 65 for tax deductibility for private health insurance premiums in view of reports that at the current rate of usage the system may well collapse within 10 years? 
Hon ANNETTE KING 
: I think that probably is a question for the Minister of Finance but I know of no work he is doing to subsidise medical insurance for people over 65 mainly I would think because it does not work but secondly because many people of 65 do not have medical insurance and have not had it since the 1990s. I heard a very important comment from Treasury to the effect that the effectiveness of an insurance model in holding down costs is very questionable. 
Judith Collins 
: I seek leave to table a letter from the Hon Michael Cullen to the Hon Annette King in which he expressed concern over the lack of productivity in the public health system. 
Document by leave laid on the Table of the House. 
Hon Peter Dunne 
: I raise a point of order Mr Speaker. It is in two parts. The first is that in response to an earlier question the Minister quoted from a letter and I wonder whether she should be prepared to table that. The second point is that in response to my last supplementary question she appeared to be reading from a Treasury document and I wonder whether she should table that. 
Hon ANNETTE KING 
: I am very happy to table the letter from the New Zealand Private Hospitals Association. The other thing I quoted from was my own handwritten notes. 
Document by leave laid on the Table of the House.