4. Question No. 4—HealthHon MICHAEL WOODHOUSE (National) to the Minister of HealthQuestion No. 4—Health4. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: How many DHB-funded elective surgical procedures have been performed in the six months to 31 December 2018 and how does that compare with the corresponding period ended 31 December 2017?Hon Dr DAVID CLARK (Minister of Health): The previous Government chose a narrow definition for elective surgeries that excluded a range of procedures such as carpal tunnel surgery while including others such as Avastin injections that could be more appropriately delivered in out-patient or primary care settings. While we continue to count electives as the prior Government did this distortion is the reason why we are moving away from a narrow set of political targets toward ensuring the best overall value for the taxpayer within the available health dollar. In terms of that measure—that we are still counting—in the six months to 31 December 2018 there were 100339 elective surgical discharges delivered. In the six months to 31 December 2017 there were 103041 elective surgical discharges delivered.Hon Michael Woodhouse: Doesn't data show that after years of steady increases in both the volume and the case weight of discharges his first year in charge saw nearly no growth in throughput and in the year to date the numbers are now going backwards? Hon Dr DAVID CLARK: No. Hon Michael Woodhouse: Well can he confirm that nearly 2000 fewer case weighted orthopaedic procedures have been done this year to date than what is required to simply be the same as last year? Hon Dr DAVID CLARK: What I can confirm is that we are looking to see more procedures performed in the appropriate settings. We want to see those procedures that could be performed in surgical settings being performed there—those ones that are more appropriately performed in out-patient and primary care performed in those settings so we get better value for the taxpayer from the available health dollar.Hon Michael Woodhouse: Goodness me he knows how to run a health system. Does he think it's acceptable that hundreds more women requiring gynaecological procedures— Hon Grant Robertson: I raise a point of order Mr Speaker. I just wanted to draw your attention to the fact that we had a little chapeau to that question there from Mr Woodhouse—I'm not sure if you picked it up—and also in question No. 1 today we had interjections from Mr Woodhouse as well. I'm just wondering at what point your normal system applies. SPEAKER: When I decide it will. Hon Michael Woodhouse: Does he think it's acceptable that hundreds more women requiring gynaecological procedures are still waiting because of a drop in throughput for those procedures in district health boards?Hon Dr DAVID CLARK: I have not seen a particular cut of the figures that the member is using. I'm happy to answer questions if he wants to put down a specific question on those issues.Hon Michael Woodhouse: Can he confirm the Government appropriated $126 million in last year's Budget to meet growing demand for elective surgery and what is he doing about the fact that that increasing demand is not being met with any more surgery? Hon Dr DAVID CLARK: The Government inherited a public health service that has been underfunded for years. I take full responsibility for tackling that legacy. Hon Michael Woodhouse: In view of that answer to the Minister: is he telling the House that his response to what he describes as years of underfunding" is to do less not more?Hon Dr DAVID CLARK: No."