Hodgson Pete: Estimates Debate — In Committee 
Hodgson Pete: Estimates Debate — In Committee 
[Volume:640;Page:10439] 
Hon PETE HODGSON (Minister of Health) 
: 
 At the change of Government there were 89000 New Zealanders on a waiting list who back then did not know what they would get from the health system or when they would get it. They did not know. They lay there stayed there and waited anonymously for the phone that did not ring and for the mail that did not come. There were 89000 of them. I know a man who waited for hip surgery for 12 years. Under this Government we decided to place a little bit of priority on to elective surgical services and the result is as follows: there are more New Zealanders getting elective surgical services now in the New Zealand public health system than ever and what is more they get it on the basis of?[ 
Interruption 
] They do not like it do they Mr Chairperson. It is a barrage of rabble-rousing. I sat in silence while I listened to the drivel that came from the Opposition benches; I am giving them a bit of a towelling and they cannot take it. 
What we have now in the public health system is people receiving elective surgical services on one criterion only and that criterion is need. It is not based on who one knows on how long one has been waiting or on where one lives; it is based on need. What is more nearly every New Zealander who is accepted for surgical services in this country receives that service reliably within 6 months. 
Hon Members 
: Oh! 
Hon PETE HODGSON 
: Oh members opposite have decided that that cannot be true. Well I have bad news for them. Nearly every New Zealander who is accepted for elective surgical services today will receive that surgery within 6 months. And what is more the information to prove that is on websites and it is available to any member of the public. Clearly National Party politicians feel quite OK about picking up their salaries without doing any work. They could have found that out for themselves. That is the fact of the matter and what is more the average wait time is not 6 months but closer to 3 months. Let us compare that with 89000 people on a waiting list who did not know when they were going to get anything from the health system. 
Or we could just change topics. Let us go to primary health care. Let us remind ourselves that at the time of the change of Government doctors’ fees were not only high they were rising. Do we know why? Yes we know why. It is because the general medical subsidy had been wallowing. It was not being increased by the National Government. The National Government was starving the primary health care sector which is why roughly the income of a doctor has increased by about 100 percent in the last 8 years which is not bad. It is not bad if one thinks that primary health care is at the heart of a good health system and that one would then set out to value that primary health care delivery and we have. But New Zealanders as a whole have seen a reduction in the cost of their general practitioner visits which is why more New Zealanders than ever before are now going to see their general practitioner. The pharmaceutical costs have come down—wait for it—from $15 per item to $3 per item. That is quite a big decrease yet we have had members of this House getting up and saying time and time again that they did not know where the money was going. Well there are a couple of things to think about. One is more elective surgical services on time than ever before. The other is cheap doctors’ fees. 
I will tell members what else happened with general practitioners in the 1990s. I do not think many people know this but after medical students graduate and do a couple of years in a hospital—they are up to their eighth year by then—those who want to become general practitioners then enter into a 3-year course. But you see National halved the number of training places. Let me repeat that. National slashed by half the number of training places for New Zealand’s general practitioners in about 1994 or 1995. It did it in two bits. It halved the number of training places so guess what general practitioners did not go into the training places. That is what happened. What has happened since is that Annette King has lifted the number of training places once; I have lifted the number of training places twice. There will now be more general practitioners in training from January next year than ever before. That is the difference between one party and another and that is where some of the money has gone. 
Let us pick up another example. I would like to thank Barbara Stewart from New Zealand First for her contribution which ranged across a number of topics but she certainly alighted on oral health. Let us quickly tell the story again. There was a time when dental nurses were trained in New Zealand. Then when they became dental therapists—they had a name change—there was a time when we stopped training them. We did not slow down the training. We did not halve the training. It got stopped. It is almost unbelievable that we would stop training an entire profession in this country but we did. National did that. National did that and it is reflected in measurable increases in diseased missing or filled teeth amongst our 6-year-old to 12-year-old kids. It is measurable and it is an outrage. Annette King herself a dental therapist got a school started soon after the change of Government and a few years later out came the graduates. She got another school started and a few years later out came the graduates. That is where New Zealand First picked up on this debate and said: “Thank you for paying attention to oral health.” Barbara Stewart said: “The money has come out. You’ll need to give more.” I agree with her but she forgot to tell the story that the original sin was that a silly Government stopped training an entire profession. It is almost beyond belief. That is the difference between National and Labour. 
We could go to any number of things. If we look at vaccination rates we see that in 1992 the vaccination rate for 2-year-olds in New Zealand was 60 percent. Today it is 84 percent; the goal is 95 percent. You see we are getting better. We are not good enough but we are getting better. The question is: how did it ever get so low? How could we have ever dropped our vaccination rate? It is one of the most cost-effective things one can do in a health system; how could we let it get down to a level as low as that? The National members are now silent. They are silent in shame. 
We could go to buildings. 
Hon Tau Henare 
: Have you been vaccinated for rabies? 
Hon PETE HODGSON 
: This Government has built buildings from Kaitaia where that loud-mouth comes from to Invercargill and places in between. It has built small little hospitals; for example in Clyde where I passed through the other day. In Wellington just down the road from here there is an example of a very big project. We have projects going now in Wanganui Blenheim Tauranga and Kaitaia. We have no shortage of ambition to build good facilities for our health care workers to work in. 
Talking about health care workers I point out that in the 1990s there was no planning. Not only did the National Government decide not to train any dental therapists at all not only did it decide to halve the number of general practitioner places and not only did it decide on one evening to slash the funding to the only dental school in this country by 38 percent which is unbelievable but also it did no workforce planning. That is why we ran out of radiation therapists. That is why we have difficulties with this speciality or that speciality. There was no training. You see we cannot proceed if we do not train. For example if this country decides to move to colorectal screening we will have to have colonoscopists. We have to have the money the workforce and the idea coincident. If we do not it will not work and under National it did not. Under this Government not only have Annette King and Steve Maharey when he was Minister for Tertiary Education increased the number of doctors in training in New Zealand but we have 1400 more doctors working in our system now than at the change of Government. There are either 3000 or 4000—I am embarrassed to say that I have forgotten—more nurses in the system since the change of Government. That is what happens when we pay attention to workforce planning. 
The other difference between National and Labour is that there is policy on one side of the House and on the other side of the House there is no policy. On this side of the Chamber we came into Government knowing that we were going to establish district health boards knowing that we were going to establish primary health organisations knowing that we were going to have an updated New Zealand Health Strategy knowing that we were going to have New Zealand’s first-ever Disability Strategy and knowing that we were going to pay attention to disparities in a variety of ways including through the Maori Health Strategy. We knew that we were going to pay attention to public health in a variety of ways such as the Tobacco Strategy and the Healthy Eating - Healthy Action strategy. We are not short of ideas. We knew that we needed to improve cancer control. We have the Cancer Control Strategy and on it goes. 
But 8 years after National was thrown into Opposition it has no policy. It has a five-point plan with four points on it and no policy. It has a discussion document that was due out in April that will now come out in September. That is 8 years after the change of Government. What has happened to it? The policy when it comes out will be underwhelming. It will be underwhelming because we know that our New Zealand health system though never good enough is better than it has ever been. 
 There is another difference between National and Labour. My Government is really happy about transparency. The previous Government was very happy with opacity. You see the booking system is on the web. It is available so that one can tell what is going on. There was no reporting of elective surgery under National. There were no standards to aspire to for example in ambulance services. There were no standards to aspire to in emergency department responses. The National Party gets up every 3 months and says that the emergency department responses are not good enough. We already know. We set the standards and we want district health boards to progress towards those standards. Under National there were no such standards and no such measurements. We do not have any shortage of transparency and we are not at all averse to the idea of having the light shine on our health system. 
Mr Coleman made a few remarks after his ad hominem attack. He always seems to want to start in the gutter and work his way up from there. His remarks on mental health do need a response. He said that the mental health services in New Zealand though he acknowledged they were better were not good enough. I agree with him because we are still putting in place a mental health blueprint that began under his Government. 
Hon Tau Henare 
: I raise a point of order Mr Chairperson. Can I just get some direction from you about the third call in a row from the Minister. Appendix A of the Standing Orders in respect of time limits for speeches in the Committee of the whole House states: “Multiple speeches of 5 minutes each but normally not more than 2 consecutive speeches”. I am not trying to put the Minister off; I am just interested. I have never heard three in a row. 
The CHAIRPERSON (Hon Clem Simich) 
: Thank you for raising that Mr Henare. I gave the Minister three calls. It is quite normal for a Minister to have three four or five calls. 
Hon PETE HODGSON 
: I just say to the member that I have a point of agreement with him that we are not yet finished with improving mental health in this country and I could go on about the areas that need particular improvement. 
He then raised the issue of the Zentveld case. He raised that in the Chamber as he raised it in the select committee and I do apologise that I misled the member in the select committee. It was a genuine error on my part. Yes the costs do come out of the health budget; they just happen not to come out of the mental health budget. I can assure the member that the Zentveld case will make its progress through to the people affected. 
Then we had Dr Blue who has basically spent her short parliamentary career so far painting herself as a friend of the drug companies and an enemy of Pharmac. Let me just say one or two things about Pharmac and one or two things to Jacqui Blue. 
Hon Members 
: More personal attacks! 
Hon PETE HODGSON 
: Again you see they do not like it. Again there is this big barrage. They are trying to shout the facts down. The facts are that Pharmac was begun under National as a result of 1993 legislation. Pharmac is a cost-effective purchaser of drugs for the New Zealand health system. That is where some of our value for money comes from and that is why people keep travelling to New Zealand to see how Pharmac works—it is regarded as a most cost-effective way of purchasing drugs. The member went on about Herceptin. I do not have time to engage on that—I can assure the member that I would be happy to do so at some other time—but I do want to reflect again on the remarks made by Barbara Stewart. 
Hon Tau Henare 
: When are you going to pay the Lake Alice money? 
Hon PETE HODGSON 
: I have actually answered that. If the member would keep his big mouth shut listen for just a little bit and try not to talk me down even as I answer his last question he would know that I answered it already. 
Dr Jonathan Coleman 
: When will you pay the money? 
Hon PETE HODGSON 
: Presently. 
Hon Tau Henare 
: You just said you already did. 
Hon PETE HODGSON 
: Well can I just— 
Dr Jonathan Coleman 
: I’m getting rung up by these people every day and they say: “When the heck”— 
Hon PETE HODGSON 
: Could the member just draw breath for 2 seconds? I would be happy to talk privately with the member and give him whatever information he wants. I am not worried about speaking publicly but I am trying to get on with this speech and get it closed. 
I thank Barbara Stewart very much for her remarks on the health of older people. Is it not interesting how difficult it is to improve the pay of low-paid New Zealanders? Is it not difficult when we have the money we offer it up and we say to the folk that they have to pass it through to the workers and they say they are taking us to court as well? Is that not interesting and do we not now start to learn some lessons about where the real power structures sometimes occur in health? I thought that her remarks on the health of older people on low pay were wonderful. 
I thought Heather Roy made an absolute mess of her speech when she managed to speak disrespectfully frankly of 147 people who are elected to district health boards every 3 years. She said they were there as Government plants. Well that will not go very well with them. Those people are elected by the public on a local ticket and I wish every one of them well who stands again in this forthcoming election. I distance myself seriously from those remarks that it is somehow a phoney election. I do note that she wants to get rid of elected health boards so that apparently is ACT policy—no more democracy in the health system; let us remember that when it comes up to our elections. But in the meantime I just say to her that if she has any conflicts of interest that she wants to talk to me about I am always open to hear about it.