Hague Kevin: Questions for Oral Answer — Questions to MinistersText is incorporated into the Bound VolumeHague Kevin: Questions for Oral Answer — Questions to Ministers[Sitting date: 05 September 2013. Volume:693;Page:13325. Text is incorporated into the Bound Volume.]11.KEVIN HAGUE (Green) to theMinister of Health: Does he stand by his statement that “the Government is committed to improving health services for diabetes and heart disease with a strong focus on prevention”?Hon TONY RYALL (Minister of Health): Yes. As just one demonstration of this in Budget 2013 we announced a $35.5 million boost of new funding over 4 years for New Zealanders with or at risk of developing diabetes pre-diabetes and heart disease. This is in addition to the other funding that the Government invests in initiatives to encourage New Zealanders to make healthy changes to their lifestyles.Kevin Hague: Does the Minister stand by his answer to my previous questions in the House that this Government is investing the exact rational amount of funding—around $60 million this year—into diabetes and obesity prevention even though his answers to my written questions show he has neither sought nor received any advice on the future costs of diabetes to New Zealand?Hon TONY RYALL: Well of course we are investing what we are able to invest in light of the financial constraints in which we operate. I have to say that in light of this year’s Budget investment of $35.5 million going into heart checks and diabetes management I think that is a pretty good investment in tight times.Kevin Hague: How can $60 million a year possibly be enough when current diabetes costs alone are already more than 10 times that amount and diabetes prevalence is growing rapidly; and how much of the $1.78 billion treatment costs projected by PricewaterhouseCoopers for 2021 does he anticipate preventing with that level of investment?Hon TONY RYALL: The Government’s investment in preventing diabetes and heart disease goes beyond the $60 million that he talked about. It also includes the $35 million that we announced in this year’s Budget. On top of that district health boards and primary health organisations are themselves investing in diabetes prevention. For example in Northland additional funding under the Diabetes Care Improvement Package has been used to increase the availability of nurses providing nurse education and realigningkaiāwhina in mobile nursing services and at the Whanganui Regional Primary Health Organisation it has begun a nurse-led clinical review to determine patient needs and tailor a package of care around the patients including group education self-management training community outreach clinics and workforce developments of multidisciplinary teams to support people in better managing their diabetes.Kevin Hague: Why then has he according to his own answers in this House and to written questions and according to the Ministry of Health’s answers to questions on the estimates in fact reduced funding for prevention from $70 million in 2008-09 to $60 million this year and of this reduced funding for initiatives intended to actually prevent obesity in the first place by 29 percent from $66 million to $47 million when all recent research shows that diabetes prevalence is much higher than originally thought and obesity rates continue to climb?Hon TONY RYALL: I just reject the characterisation of those numbers as the level of the Government’s investment in diabetes prevention. That is the reason why we do not use those figures; the investment is far beyond that. The reason why our prevention includes the significant boost of $35 million over 4 years in this year’s Budget is that we do want to assist in the identification of those with diabetes and pre-diabetes in particular not only as a way of assisting those with diabetes to better manage their diabetes but also to prevent people with pre-diabetes from moving into the diabetic state. That is the reason why this year’s Budget also included a big boost to Green Prescriptions which enable doctors to refer people to exercise and diet support programmes.Kevin Hague: Well can the Minister confirm to the House that of that reduced prevention investment of around $60 million a figure that prior to his answers today he has repeatedly used and the ministry has also used fully $10 million is being spent this year onbariatric surgery?Hon TONY RYALL: Yes the Government is determined to increase the availability ofbariatric surgery in New Zealand. We know that it has significant life-changing impacts for people and it seems to make a lot of sense to me that we continue to expand the availability of that service to patients who benefit.