Stewart Barbara: Questions for Oral Answer — Questions to Ministers 
Text is incorporated into the Bound Volume 
Stewart Barbara: Questions for Oral Answer — Questions to Ministers 
[Sitting date: 24 July 2008. Volume:648;Page:17404. Text is incorporated into the Bound Volume.] 
7.  
BARBARA STEWART (NZ First) 
 to the  
Associate Minister of Health 
: Will his ministry be taking any action to address the concerns outlined in the discussion document recently released by the New Zealand Institute of Rural Health; if not why not? 
Hon DAMIEN O’CONNOR (Associate Minister of Health) 
: 
 Yes I can tell the member that the Ministry of Health has been taking action on the issues outlined in that discussion document since Labour came into Government. Every year we spend an additional $100 million through the rural adjuster to district health board funding. We have committed $150 million for safer drinking water and $173 million for sewerage schemes for small rural communities. Each year we commit $8 million for health workforce retention in rural communities. We spend $5 million for mobile surgical services. We spend $4 million for the rural bonus to rural general practitioners and nurses and $2 million for reasonable rosters for rural general practitioners and nurses. We have paid rural midwives a rural bonus and developed a Rural Innovations Fund. I could go on and on. We have an excellent track record in rural health compared with the National Party which has less than one page on rural health policy. 
Barbara Stewart 
: Does the Ministry of Health’s implementation plan for the rural sector date back to 2002; if so is it not time to formulate a new strategy taking into account factors such as workforce shortages and clinical safety in rural hospitals; if not why not? 
Hon DAMIEN O’CONNOR 
: A rural expert advisory group wrote a report for the Minister in 2002 on implementing the Primary Health Care Strategy in New Zealand. The vast majority of its recommendations as stated in the recent report have been addressed and implemented. For example the discussion document states that the Government has been focusing on workforce issues through that period. 
Lesley Soper 
: What is the Minister’s view of the value of the discussion document? 
Hon DAMIEN O’CONNOR 
: Although I acknowledge the good intent behind the document I have to question the accuracy of some of the data that are included. For example it refers to a downturn in the rural economy when in fact the rural sector has been thriving under high commodity prices in recent years. The discussion document also claims there has been a 32 percent reduction in the rural primary health care workforce when my figures show there has been an increase in rural general practitioners receiving the rural bonus from 415 in 2005-06 to 453 in 2007-08. I also note that the organisation that wrote the discussion document is soliciting a contract to write a rural health strategy. 
Jo Goodhew 
: Why after failing to complete the review of the rural emergency response scheme PRIME after failing to complete the review of the rural ranking scale and after failing to complete the review of after-hours services—all detailed in the discussion document—is this Labour Government so intent on hui and “no do-ey”? 
Hon DAMIEN O’CONNOR 
: I have to inform that member that I do not think there has been one hui on this particular issue. The vast majority of the health workforce in this country with a few exceptions of course is non-Maori—which is a little unfortunate I have to say. We have been working through a review of the rural ranking scale and the after-hours issues. Unfortunately such anomalies as the general practitioners in Queenstown receiving a significant rural bonus are things that I want to work through. I have every intention of paying including the $5 million allocated in this year’s Budget for after-hours services money to those rural practitioners who are under pressure. I am not prepared to commit money to rural practitioners who are not providing after-hours care or who are not working in rural areas but have somehow qualified through an inappropriate ranking scheme for a rural bonus. I am working through those issues as quickly as I can and I would welcome the opportunity to engage with the Rural GP Network on that. 
Barbara Stewart 
: Is he aware that the rural general practice workforce declined by 32 percent between 2000 and 2005 and will that hasten consideration of voluntary bonding initiatives by the Ministry of Health; if not why not? 
Hon DAMIEN O’CONNOR 
: I have to say that I do not accept those figures. There is some debate around the information on how many rural practitioners there are and I would welcome more cooperation with the Rural GP Network in that area to clarify those issues. In regard to rural bonding which the National Party has committed itself to can I just quote back from the Rural GP Network which says: “Don’t because it won’t work.” It supports incentivising because bonding does not work. It is an old-fashioned idea. That is classic National Party policy.