Dunne Peter: Questions for Oral Answer — Questions to Ministers 
Dunne Peter: Questions for Oral Answer — Questions to Ministers 
[Volume:626;Page:21123] 
1. Hon PETER DUNNE (Leader—United Future) 
 to the  
Minister of Health 
: Does she believe the New Zealand public has confidence in the ability of the health-care sector to continue to provide quality services in light of the survey published by the  
New Zealand Herald 
 recently showing 73.8 percent of people believe Government-funded health-care has remained the same or worsened since 1999; if so why? 
Hon ANNETTE KING (Minister of Health) 
: 
 I believe the public can be confident. The poll refers only to part of the public health system. It does not take account of the fact that more than 50 percent of New Zealanders now receive cheaper primary health care and prescriptions and we can be proud of our doctors and nurses in hospitals for what they are achieving. We are performing 44000 more medical and surgical case discharges this year than we were in 1999. We are doing 27500 more day procedures. I have to say that all of that would be at risk if tax cuts come at the expense of health spending. 
Hon Peter Dunne 
: Does the Minister believe that the same 73.8 percent of people would feel similarly about Pharmac particularly given today’s announcement that it has backtracked on its decision regarding sole supply of Salamol and has instead extended the provision of Ventolin as well for a further period and given also the fact that that comes on top of back-downs over the sole supply of flu vaccine and cholesterol medication; when will she stop those cowboys acting in the way they are in playing fast and lose with people’s health? 
Hon ANNETTE KING 
: I think most New Zealanders will be very pleased at the work that Pharmac does. We have in terms of access to pharmaceuticals 80 percent of our medicines subsidised and we have one of the highest ratios of publicly subsidised access to pharmaceuticals of any country in the world. I am pleased however that Pharmac listened to the advice it got from the public which is what it has to do—it does have a consumer advisory committee as well. I think we should applaud Pharmac for listening. I would hate to see what would happen to Pharmac if we have the tax cuts that some people here in the House are proposing. 
Steve Chadwick 
: Has the Minister read any other polls recently concerning public satisfaction with the health system? 
Hon ANNETTE KING 
: Oh yes. The poll that is mentioned today surveys people on their perceptions of hospitals rather than on their experiences. I think the polls that people ought to look at are those that survey patient satisfaction with New Zealand hospitals. They show a consistently high rating by people treated as inpatients and outpatients. The latest poll shows 88 percent of patient satisfaction. That is extremely high but I would say that patient satisfaction will go out the window as soon as we get tax cuts. 
Dr Paul Hutchison 
: Why does she continue to deny the opinion of the New Zealand public as per the  
New Zealand Herald  
when medical experts such as Dr Jonathan Simon have concluded: “When we look at the significant investment in the health sector over the past four years it is devastating to see how little effect it has had.”? 
Hon ANNETTE KING 
: I have to say that I am rather disappointed in Dr Jonathan Simon’s comments. However I do note that he was often a critic of the 1990s as well. I would say in respect of the money we have put into primary health care—and it has been put in over only the last 3 years—it will take a little time till we get the full result but we are already starting to see results. I do not have time to go through them but I know they are at risk if we have the tax cuts that National is proposing. 
Peter Brown 
: Is the Minister aware that the recent Budget raised health-care expenditure only to the level as a percentage of GDP that it was at when the Government came into power and is she aware also that private health care has gone down—is shrinking—as a percentage of GDP and what will she do about that; will she compensate one for the other or will she just let things go? 
Hon ANNETTE KING 
: Private medical insurance has been decreasing in New Zealand since 1990 when 50 percent of people actually had medical insurance. It is below about 30 percent now. Those are choices that people make; it has nothing to do with the Government. Probably people have more confidence in what this Government is providing because they know that we have invested more in health. We have had to invest more in health to rebuild the health infrastructure of this country—that is hospitals the health workforce and wages and salaries to ensure that we can provide health care. I tell that member that everyone would be at risk if money was taken out in tax cuts. 
Hon Peter Dunne 
: Does the Minister’s answer to my earlier supplementary question mean that Pharmac will now be deciding its policy on the basis of the feedback it gets from the public; if it does mean that will the Minister therefore give the House an absolute assurance that we will not see any repetition of the types of events we have seen this year with regard to the flu vaccine and now with regard to asthma inhalers? 
Hon ANNETTE KING 
: Pharmac will make its decisions based on evidence and consultation as it always has done. It does not intend to change that approach. It has worked well for us in the past; I expect that it will work well for us in the future. 
Gordon Copeland 
: I raise a point of order Madam Speaker. I ask you to reflect on this question in light of the fact that this is an election year. We have been asking questions of the Minister of Health and in every single one of those answers except where she had a slip of the tongue and referred to health cuts when I think she meant tax cuts she has answered about tax cuts in addition to the main answer. She is not the Minister of Finance; she is the Minister of Health. If she wanted some advice on tax cuts I would be happy to give it to her at any time. But it seems to me to be a risk that from now on till the election it does not matter what questions we ask the Government on any subject because we will get back the same litany. 
Hon ANNETTE KING 
: Speaking to the point of order I point out that as Minister if Health in any answer I give I must consider the impact of taking money out of health and the impact that would have on our ability to provide health services. [ 
Interruption 
] 
Madam SPEAKER 
: No I do not need any more help with this. I do listen carefully to the answers for the very reason the member has raised. Often the questions are multi-pronged in their approach but the Minister addresses the questions. There are and I will be careful about them irrelevant comments that do come in that do not relate to the question. 
Rt Hon Winston Peters 
: Does the Minister now admit the serious mistake of her so-called reforms which have seen an increase in health expenditure yet a lessening in the number of operations delivered to the people of this country and whilst I am at it where is my answer on Risperdal Consta she promised me weeks ago? 
Hon ANNETTE KING 
: The member is incorrect. There are not fewer operations than there were. There were 44000 additional medical and surgical case mix discharges now than there were in 1999 27500 more day-cases of surgery done than before and over 100000 more outpatients in accident and emergency alone. That does not add up to a cut in my book. In terms of the drug I will make sure that the member gets an answer soon. I do not have it with me. 
Judy Turner 
: Does she still stand by her comments in the House yesterday that after 6 years of her stewardship there is actually leadership of health workforce development when her own Health Workforce Advisory Committee report states: “What seems to be missing is leadership and supporting infrastructure and tinkering ad hoc approaches will not suffice. It is time for concerted action.” and does she take that as a personal failing? 
Hon ANNETTE KING 
: No because as the member will be aware the Health Workforce Advisory Committee was set up by this Government. Before that there was no health workforce planning at all. In fact Bill English rejected the health workforce planning that had been done in the past. The committee has come out with a report that gives direction in terms of medical training. We accept that direction which is something that did not happen before. 
Barbara Stewart 
: Does the Minister consider that the health-care sector will continue to provide quality services despite the fact that New Zealand does not have a nationally coordinated recruitment and retention strategy for medical staff in order to prevent future shortages? 
Hon ANNETTE KING 
: We do extremely well at providing services even though we do have shortages in the medical and nursing workforces. This Government has put in a lot of effort into recruitment and training and I think that we do very well. However we can do better and we will do better and I think that people have seen a commitment from this Government that they have not seen from any other Government in the past. 
Judy Turner 
: Why has she handed the responsibility for health workforce development and planning to the district health boards when they have no control over national policies that directly impact staff numbers such as tertiary education and student loans and why has she refused to own the situation by heeding the recommendations of the report when the only appropriate body to lead workforce development is her own ministry? 
Hon ANNETTE KING 
: The member is incorrect. Health workforce planning is in the hands of three organisations that work together: the Health Workforce Advisory Committee which gives the broad overview district health boards which must do the recruitment—after all they employ the people and know whether they need another dozen nurses three doctors or whatever; it cannot be done by the Ministry of Health—and they also work with the Ministry of Health which over time has done considerable health workforce planning in mental health and in nursing. 
Dr Paul Hutchison 
: I seek leave to table an article from the  
New Zealand Herald  
of 4 May which quotes Dr Jonathan Simon as saying: “When we look at the significant investment in the health sector over the past four years it is devastating to see how little effect it has had.” 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? Yes there is.