Ryall Tony: Questions for Oral Answer — Questions to Ministers 
Text is incorporated into the Bound Volume 
Ryall Tony: Questions for Oral Answer — Questions to Ministers 
[Sitting date: 24 October 2007. Volume:643;Page:12645. Text is incorporated into the Bound Volume.] 
5.  
Hon TONY RYALL (National—Bay of Plenty) 
 to the  
Minister of Health 
: Does he have confidence in the quality of spending in the Ministry of Health; if so why? 
Hon PETE HODGSON (Minister of Health) 
: 
 Generally speaking I do. However I have no doubt that pockets of poor quality spending still exist somewhere in the system. 
Hon Tony Ryall 
: Will the Minister explain why despite Helen Clark’s pledge to cut a swathe through the health bureaucracy the payroll of the Ministry of Health has rocketed by over 55 percent in the last 6 years? 
Hon PETE HODGSON 
: I remind the member of two facts. The first is that the amount spent on the Ministry of Health in this country today is 1.82 percent of the total health budget. That means that about 98.18 percent of the health budget passes straight through the ministry and out into the sector. The second fact is that during the 1990s we had four regional health authorities then one Transitional Health Authority then one Health Funding Authority. That was big bureaucracy and it has all gone. 
Lesley Soper 
: How does value for money in the New Zealand health system compare with that of other Western nations? 
Hon PETE HODGSON 
: That is a very good question a very important question and the answer is that we compare very well. If we look at value for money in the New Zealand health system and compare it with that of the rest of the Western World we see that we are way ahead of the pack. One or two countries are better than us and Japan comes to mind but we are better than nearly all of them. What is more if we compare ourselves with the United States of America—and the National Party would have our health system head towards that of the USA—we find that per capita the USA expends almost exactly three times what we do on health but New Zealanders live a little longer than Americans do. 
Hon Tony Ryall 
: How is it cutting a swathe through the health bureaucracy as was promised by Helen Clark that over the past 6 years the Ministry of Health has employed an extra 250 staff—a 24 percent increase—but the payroll has gone up by 55 percent? 
Hon PETE HODGSON 
: The member just does not get it. The swathe that was cut through the bureaucracy of the health system was the taking out of the entire Health Funding Authority—the entire Health Funding Authority. Now we have all of the functions of the ministry—all of the policy functions all of the regulatory functions all of the payroll functions all of the information technology systems and much more than that—done for less than 2 percent of the health budget. I do not know another country that does better than that. I would like the member to point out one that can do as much as our Ministry of Health does on as little money as it gets. 
Hon Tony Ryall 
: Should not the Minister admit that he is being completely disingenuous because all the changes that he has talked about have happened already in the last 6 years; and why does he keep adding more very expensive bureaucrats to the Ministry of Health which Helen Clark described as bureaucratic and top-heavy and where the number of staff earning over $100000 a year has more than doubled in the last 6 years? 
Hon PETE HODGSON 
: Let me disturb the member with this further uncomfortable fact: not only is the proportion of health expenditure used by the Ministry of Health less than 2 percent—it is actually 1.82 percent—but it used to be higher. Only last year it was about 1.85 percent and earlier than that it was higher than that. And it is proposed that it will drop further. In fact there are 10 health targets for our health system and target No. 10 is that we reduce expenditure on the Ministry of Health even further to 1.65 percent. The member has decided to pick on precisely the wrong aspect of health expenditure in this country; we run a very cost-effective ministry. 
Hon Tony Ryall 
: Why has the Minister not followed Helen Clark’s diagnosis of the Ministry of Health: “Never have so many people been employed to do so little.” with the situation now being that if bird flu strikes there will be a public hospital bed for every bureaucrat in the health system? 
Hon PETE HODGSON 
: I am going to say it one more time: the Prime Minister said that a big swathe of bureaucracy needed to be taken out of the health system and it was: it was called the Health Funding Authority previously known as the Transitional Health Authority which was previously known as four regional health authorities. But whatever they were called those bureaucracies now do not exist. We have ourselves one ministry and 21 district health boards and that is that. 
Hon Tony Ryall 
: How is it cutting a swathe through the health bureaucracy which the Prime Minister promised that the Ministry of Health in the last 6 years has employed 250 staff—a 24 percent increase—but the payroll has gone up by 55 percent? 
Hon PETE HODGSON 
: I rather suspect that if the member looked at the expenditure on those of us in this Chamber he would find that the number of MPs has gone up by diddly-squat and the amount of pay that each of us receives has gone up by more than diddly-squat. We call it inflation.