Roy Heather: Points of Order — Member’s withdrawal from Chamber ; Debate on Crown Entities Public Organisations and State Enterprises 
Roy Heather: Points of Order — Member’s withdrawal from Chamber ; Debate on Crown Entities Public Organisations and State Enterprises 
[Volume:609;Page:6222] 
HEATHER ROY (ACT NZ) 
: 
 I rise to speak about the state of health in this country. I am seriously worried about it. The other day I was reading in one of the community papers in Auckland about the mental health services in this country provided through the district health boards. The psychiatric nurses who were also Public Service Association delegates described the conditions they worked in as “beyond crisis”. I have frequently said that parts of our health system are in crisis and in particular the mental health system but they described it as “beyond crisis” and this is why. They are seriously understaffed. In the past year 33 staff members have left of whom only 13 have been replaced. Yet they are expected by the Minister of Health to provide top-notch services. They do not have enough acute mental health beds and they are frequently confronted with visiting their patients in prison cells. This is unacceptable because prison and police cells are no place for the mentally ill yet every weekend somewhere in this country mental health patients are detained in prison cells while they await a bed in an acute mental health facility. This is shameful. 
These union delegates and psychiatric nurses described how patients were frequently in tears because they did not know which way to turn. They have no beds and they are understaffed yet the pressure is on them. They know that if something goes wrong they will be the ones who will be held accountable. We have a mental health system that is failing the truly vulnerable in our society. It is a fragmented system that provides no continuity of care and it does not flow. The patients are not able to enter and exit the system where they need to and it is failing the truly vulnerable. This Government should be truly ashamed of that system. 
That is just a part of the district health board system that I have great concerns about. District health boards are now responsible for everything. The Minister has devolved just about every single thing that is possible to be devolved on to them except for disability support services’ health for the elderly funding which is set to be devolved to the district health boards. They are now these huge umbrellas that are expected to cope with everything and the Minister has devolved responsibility for everything to everybody. Why has she done that? So that she is not accountable for anything—not one single thing about this issue. 
So we have a health system in which some parts are beyond crisis and other parts are in crisis. We have the primary health strategy which was discussed in question time today and which we discovered was based on race-based funding. We have an access formula for primary health organisations by which 50 percent of the population covered is Maori or Pacific Island. We have access funding that is much more generous in funding for other primary health organisations but the problem with that funding is that it is not needs-based. It is based entirely on where one lives or whether one is a Maori or Pacific Island patient. It is not based on the needs of the population. Other primary health organisations are expected to get by on interim funding which is no better than what they currently have. However we have general practitioners who have elected not to go into primary health organisations yet or who are trying to get into them who are severely disadvantaged in terms of funding and the patients are leaving in droves to go to where they can get the cheaper care—whether they have the need for that or not. 
Hospitals too should be looked at. Much of the money at the moment is poured into the primary sector in health leaving the secondary sector in dire straits. It is all very well and we all agree that money needs to be spent more at the primary edge and on prevention but just because we are doing that today does not mean that the need suddenly goes from the hospital system. We still have patients with heart attacks. We could get on to the subject of waiting lists in that regard and go on and on about those for ever. But when money is being taken from hospitals and being poured into primary care we are seeing crises happening now in our hospitals. 
With regard to waiting lists every area now is participating in the booking system including Christchurch which did not want to because the system was felt to be unfair and that is quite right too. This new booking system has the effect of hiding patients who were there previously on waiting lists. The system was not perfect but now if people are not eligible for treatment in 6 months they are bumped into a position of active review so that they are being hidden by the system. Worse still—and I have asked parliamentary questions about this matter—is the case of patients who are transferred to general practitioner care because those patients are not counted at all.