King Annette: Oral Questions — Questions to MinistersText is incorporated into the Bound VolumeKing Annette: Oral Questions — Questions to Ministers[Sitting date: 17 March 2015. Volume:704;Page:2261. Text is incorporated into the Bound Volume.]3.Hon ANNETTE KING (Deputy Leader—Labour) to the Minister of Health: What advice if any has he received on the causes of rheumatic fever?Hon Dr JONATHAN COLEMAN (Minister of Health): I am advised that rheumatic fever is caused by an autoimmune reaction to group A streptococcus bacterial infections such as a sore throat. It predominantly affects children aged 5 to 14. Symptoms usually start 1 to 5 weeks after the initial infection. We have invested more than $65 million to tackle rheumatic fever which includes a range of prevention and treatment programmes. Although there is clearly more to be done these programmes are starting to make a real difference.Hon Annette King: Does he agree with the recent research published in the Journal of Paediatrics and Child Health that showed there is an alarming rise in the rate of rheumatic fever amongst Māori and Pasifika people and significant and worsening ethnic disparities in New Zealand?Hon Dr JONATHAN COLEMAN: Obviously Māori and Pasifika are one of the target populations for the many initiatives we have but what I can say is the rate of rheumatic fever has dropped by 25 percent in the last year. It shows that compared with when Annette King was Minister and she said that rheumatic fever was a priority but did absolutely nothing about it—Mr SPEAKER: Order! That will be sufficient for that answer.Hon Dr JONATHAN COLEMAN: I raise a point of order Mr Speaker. So I do not get to finish my answer?Mr SPEAKER: No the member does not. The Minister has moved to where he does not need to to answer the question.Hon Annette King: Does he agree with Professor Baker who said in September last year that New Zealand may be throwing money at rheumatic fever and not making an ounce of difference because half of those with acute rheumatic fever do not have a sore throat and we are failing to address the causes of rheumatic fever?Hon Dr JONATHAN COLEMAN: That just is not correct because as I said the rate of incidence of new cases has dropped by 25 percent in the last year. What that shows is that our strategy which is based around prevention and around sore throat swabbing and walk-in sore throat clinics as well as a healthy homes initiative is starting to turn the tide. But there is no doubt there is more that needs to be done. It is a pity Labour never did anything.Hon Annette King: Why have 16 reports by the Ministry of Health and the Housing and Health Research Programme plus two action plans failed to motivate the Government into addressing urgently overcrowded households in New Zealand now recognised in the latest research as a risk factor for rheumatic fever?Hon Dr JONATHAN COLEMAN: I will refer the member to the analysis of household crowding published in December by the Ministry of Health. It shows that actually the only time that the proportion of New Zealanders living in crowded conditions has increased in the past 24 years was between 2001 and 2006 when Annette King was doing nothing as Minister of Health to address rheumatic fever. I would say furthermore that this Government is putting $2 billion into accommodation support and has insulated 300000 houses. We are addressing the underlying causes of rheumatic fever; Annette King did nothing.Hon Annette King: Supplementary question Mr Speaker. In light of—Mr SPEAKER: Order! I have not yet called the member.Hon Annette King: In light of the fact it is 10 years since I was Minister of Health is he aware that the rheumatic fever hospitalisation rate was 3.4 percent per 100000 population in 2014 but the notification rate was 4.5 per 100000 and why does the Government continually use the lower figure to disguise its failure to address the causes of rheumatic fever?Hon Dr JONATHAN COLEMAN: The first thing is look you always have to check Annette King’s figures. But what I can tell you is the figures from the ministry show that last year there were 194 cases of children admitted to hospital for the first time with rheumatic fever. That was 2013. That dropped in 2014 to 153 so that is nearly a 25 percent decrease. I can tell you that our programme is working. Labour did nothing.Hon Annette King: I have some very good information to table—Mr SPEAKER: Order! The member needs to know how to do this. She needs to rise to her feet and seek leave to examine the type of paper. There is no need for further explanation besides what the source of the document is.Hon Annette King: The source of the document is the Ministry of Health’s hospitalisation data showing the increase in acute—Mr SPEAKER: Order! It has now been described. [Interruption] Order! I just need to finalise—is that information publicly available to members?Hon Annette King: It is not easily available. I had to hunt for it.Mr SPEAKER: I will take the member’s word for that. Leave is sought to table that particular—[Interruption] Order! Leave is sought to table that particular information. Is there any objection to it being tabled? There is none. It can be tabled.Document by leave laid on the Table of the House.Hon Dr JONATHAN COLEMAN: I seek leave to table the declining rate of first-instance rheumatic fever between 2013 and 2014. That is a document prepared by the Ministry of Health. I also seek leave to table the analysis of household crowding which shows the increase in crowding between 2001 and 2006.Mr SPEAKER: Order! Again I just need to see—are those two reports freely available for members to obtain?Hon Dr JONATHAN COLEMAN: Not easily. I—Mr SPEAKER: I again accept the Minister’s word. Leave is sought to table those two documents. Is there any objection? There is none. They can be tabled.Documents by leave laid on the Table of the House.Marama Fox: Are you aware of the quote that was attributed to the former Associate Minister of Health Tariana Turia when she was described by an Australian conference as being “a shining light in a wasteland of neglect” for the work that she did in regard to rheumatic fever and is the Government prepared to continue with that work in the coming years?Hon Dr JONATHAN COLEMAN: I was not aware of that but thanks for enlightening me. We are also continuing with that work.