Hutchison Paul: New Zealand Public Health and Disability Amendment Bill — First Reading 
Hutchison Paul: New Zealand Public Health and Disability Amendment Bill — First Reading 
[Volume:663;Page:11022] 
Dr PAUL HUTCHISON (National—Hunua) 
: 
 It is with great pleasure that I speak on this very timely New Zealand Public Health and Disability Amendment Bill. But it is with profound regret that I had to listen to the Hon Ruth Dyson give a speech that she probably gave in 1992. She has failed to move on to the reality of the legacy of the previous Labour Government which basically left our health system bloated with bureaucracy and absolutely fragmented all over the place. It had the lowest productivity score that one could possibly imagine and I will go on to that in just a minute. 
It is highly relevant that this bill is a response to many of the recommendations of the ministerial review group that was so ably led by Murray Horn. In that review he pointed out that the sustainability of our public health and disability system is under serious threat. That by no coincidence follows the 9 long years of the previous Labour Government. The review group noted a variety of things. It noted that New Zealanders want to have a public health and disability system of the same standard as that of other OECD countries yet we do not earn as much as those countries so our system needs to be more effective and productive than the OECD average in order to bridge the gap. That is exactly why we have this bill today and why the National Government will be introducing tomorrow a Budget that is committed to putting in a system that focuses on achieving economic growth and on encouraging saving exporting and investing rather than the rampant consumption and spending seen under the previous Labour Government. In order to achieve a sustainable health service we need firstly sustainable economic growth which we did not have under the Labour Government and secondly an efficient and effective health system which was totally forgotten during the 9 years of the previous Labour Government. 
The ministerial review group also said the public health system still struggles to sustain itself financially despite the substantial increase in funding over recent years. In 2009 the district health boards were running deficits of about $150 million and had significant unfunded capital requests. It is absolutely rich for the Hon Ruth Dyson to go back to the 1990s given the abysmal performance under Labour during the previous 9 years. In fact the Treasury review report of 2005 showed that real hospital expenditure between 2001 and 2003 was 13.4 percent higher than at the beginning of Labour’s term in Government which basically meant that hospital efficiency fell by 7.7 percent between 2001 and 2003. During the previous 3 years it had had a modest increase in efficiency of about 1.1 percent. But that absolutely clearly outlines the problem of the Labour legacy whereby hospital efficiency fell by 7.7 percent and consequently cost billions of dollars to the New Zealand taxpayer. We know that during that time an extra $6 billion was put into the system and we know that there was hardly any increase in elective surgery. Yet in the last year under this National Government there has been an increase of 11800 elective surgeries carried out. 
But to emphasise the point ever further it is relevant to look at the Auditor-General’s report on primary health care in 2008. Primary health care was going to be one of the flagships of the previous Labour Government. I freely acknowledge that an extra $1 billion worth of funding made access to primary health care more affordable. However the Auditor-General points out the hopeless lack of tools that Labour put in to accurately measure the result of its investment. In fact Labour brought in a radically new system but failed to ensure that there was value for each health dollar spent. 
If Labour members are to be critical of this bill’s aims—which include amending the objectives and functions of district health boards to ensure that they work together for the most effective and efficient delivery of health services to meet national regional and local needs; and supporting the provision of shared services across the public health system—I remind the Hon Ruth Dyson of what Annette King said in August 2000 in the first reading of the New Zealand Public Health and Disability Bill. She said “District health boards will be expected to work together and to enter into cooperative and collaborative arrangements … to ensure service delivery for their populations.” That failed to happen under the 9 years of the previous Labour Government. Annette King said that back in 2000 but she missed out the words “efficient and effective” before “service delivery”. That is precisely what Labour failed to achieve in its 9 years in office and precisely what this bill is about: efficient and effective health service delivery to individual patients throughout New Zealand. 
But more than that this bill is about the National Government’s determination to develop new modules of care that see the patient rather than the institution put at the centre of service delivery and that emphasise clinical leadership. This bill is also highly appropriately creating a Health Quality and Safety Commission to improve the quality of individual patient care. I very much look forward to this bill progressing through the House to the Health Committee and being enacted in a timely manner.