Scott Lynda: Questions for Oral Answer — Questions to Ministers 
Scott Lynda: Questions for Oral Answer — Questions to Ministers 
[Volume:609;Page:6208] 
9.  
Dr LYNDA SCOTT (NZ National—Kaikoura) 
 to the  
Minister of Health 
: Why will heart patients needing a bypass operation be able to access that surgery more easily in Auckland and Waikato needing only 35 points to qualify than in Wellington Christchurch or Dunedin where they need at least 50 points? 
Hon ANNETTE KING (Minister of Health) 
: 
 I am advised that the treatment of patients requiring cardiac bypass surgery is being performed at the same level of acuity throughout New Zealand. 
Dr Lynda Scott 
: How can she justify returning to a health structure that allows district health boards to set up different criteria—regardless of her comments about acuity—for access to surgery which means that if one lives in the lower North Island or in the South Island one is more at risk of dying from heart disease due to inability to access bypass surgery than if one lives in the upper North Island? 
Hon ANNETTE KING 
: I can justify putting in place a system that implements clinical assessment criteria. It was promised by Jenny Shipley in 1996. 
Dr Lynda Scott 
: Thirty-five points. 
Hon ANNETTE KING 
: No it was never ever implemented under a National Government. 
Dr Lynda Scott 
: Yes it was. 
Hon ANNETTE KING 
: No it was not ever implemented. The first time the clinical priority assessment criteria were implemented in New Zealand was in the year 2000. 
David Benson-Pope 
: Has the Minister been advised of any possible anomalies between regions in the use of clinical assessment tools for cardiac procedures? 
Hon ANNETTE KING 
: Yes the Ministry of Health has advised me that it believes the clinical conditions of patients requiring cardiac surgery within 6 months are the same but the points system as utilised by clinicians may not be being used uniformly. I am having that investigated. 
Pita Paraone 
: Does she agree with the statement made by Christchurch surgeon Phil Bagshaw on 29 May 2003 that the points system adopted by Christchurch Hospital is bureaucratic and that people in genuine need of operations are missing out; if not why not? 
Hon ANNETTE KING 
: No I do not agree with Phil Bagshaw. The booking system started to be implemented in 1996 and the aim of it was to give patients certainty that they would receive an operation. This Government has ensured that they receive certainty that they will get an operation within 6 months. Christchurch was the last district health board in New Zealand to implement such a programme. 
Heather Roy 
: How does the Minister explain the fact that heart patients are being discharged from hospital without the treatment they need when the reason for that is that the Auckland District Health Board receives funding of $2261 per person compared with the Southland District Health Board receiving $993 per person because the health funding is based on race? 
Hon ANNETTE KING 
: I totally reject the assumption that that member has made. 
Sue Kedgley 
: Why does the Minister not simply step in and require all district health boards to operate the same points system for eligibility for heart surgery given that she is explicitly required under section 9 of the New Zealand Public Health and Disability Act to ensure there are nationally consistent standards and nationally consistent performance monitoring in place for all health services including heart surgery? 
Hon ANNETTE KING 
: First of all there are not nationally consistent criteria throughout New Zealand. Since 2000 we have been trying to implement them. The member takes a very simplistic approach if she thinks that I can order clinicians to do exactly the same thing in every hospital. All that we can do is to provide the assessment tools and to ask the boards and clinicians to work with them. 
Dr Lynda Scott 
: How can the Minister expect this House and New Zealanders to believe that heart patients’ clinical conditions are the same but their points are different; and can she explain exactly how she intends to ensure national consistency of health care across New Zealand when 5 years ago Labour was describing the cardiac points difference as “scandalous” and when in 1998 she severely criticised it by saying it was “unacceptable that accidents of geography can determine who lives and who dies”—which is exactly the system that she set up and that the country has gone back to? 
Hon ANNETTE KING 
: The former Minister of Health who put in place the booking system under a National Government led New Zealanders to believe that a clinical assessment criteria system had been put in place. That was not true; in fact there were no clinical assessment criteria. There were no points being used—although that Government said there were. They did not even start to be used until the year 2000 so the people of New Zealand were duped by the previous Government. Let me read this to the House: “Bill English said the booking system was working very well in 1998”. That was the year that 28 people died on the cardiac waiting list. 
Heather Roy 
: What does the Minister say to the families of heart patients who are denied treatment because the health dollars for their heart operations have been diverted to race-based funding irrespective of need simply in order to buy this Government votes? 
Hon ANNETTE KING 
: I would say to the people who said that that they were plain wrong.