9. Question No. 9—HealthDr SHANE RETI (National) to the Minister of HealthQuestion No. 9—Health9. Dr SHANE RETI (National) to the Minister of Health: How many people with bowel cancer at Tauranga Hospital are estimated to have progressed from curative to palliative treatment plans due to patients having been on the waiting list for months longer than the recommended times?Hon ANDREW LITTLE (Minister of Health): The member's question relates to a letter written by a number of clinicians last year at what was then the Bay of Plenty District Health Board to their chief executive at the time regarding concerns about what they described as 15 years of failing to plan for the health needs of that region as well as other issues. That 15-year period encompasses the entire time the previous National Government held office. The letter was subsequently passed to Te Whatu Ora Health New Zealand when the new health system took effect. One of the statements made in December last year in that letter was that Patients are being diagnosed with bowel cancer having been on our waiting lists for months longer than the recommended times and this is leading to palliative rather than curative treatment plans." Officials have advised me that the only way to answer the member's question would be a manual review of every patient's clinical notes. Even if a meaningful assessment could be made in each case the member's question has no time frame on it and it is therefore not possible to answer. What I can tell the member is this: in December 2021 when the letter was sent 88 percent of patients in the Bay of Plenty District Health Board region who received treatment for upper and lower gastrointestinal tumours did so within the target of 31 days. Secondly in the most recent reported period ending in August 2022 96 percent of patients in that region received treatment within 31 days and this compares to 88 percent nationally. It's important to note both that the rates of bowel cancer diagnosis have been trending upwards while diagnosis in emergency departments has been declining. I am advised that this is almost certainly because of the success of the National Bowel Screening Programme which this Government has invested $203 million into after the previous Government didn't properly fund it and which we have now rolled out nationwide.Dr Shane Reti: Is it correct that only cancer patients who were able to receive chemotherapy were offered a cancer specialist appointment at Tauranga Hospital and others went to their GP?Hon ANDREW LITTLE: I can't comment on that but given that member's long track record of getting his facts wrong I would say it's more likely wrong than right.Dr Shane Reti: Has he seen the letter that he just reported to in his first answer from medical oncology saying that only patients who are to receive chemotherapy are offered first specialist assessment; all other patients are to be managed by a GP without the opportunity to discuss their case with a specialist?Hon ANDREW LITTLE: I point out and the member is well aware that the letter was addressed to the then chief executive of the Bay of Plenty District Health Board and effectively called upon that chief executive to remedy a number of issues. But the letter was also very clear that the issues that they were dealing with as many clinicians today are dealing with is the consequence of a system that was routinely underfunded for many many years including the entirety of the previous Government's period of time. The reason we are making the changes we are is that we needed to see change and improved performance. This Government inherited a bowel screening programme that had such limited funding and no chance of being rolled out nationwide. We have now committed more than $200 million. We now have a nationwide bowel screening programme that is making a significant difference because when it comes to the National Party they are all talk and no trousers.Dr Shane Reti: Why did the chair of his waiting list task force say on TV ONE last night that targets were a distraction; yet as the acting medical officer of Counties Manukau in the board meeting of 23 February this year that same person accepted a report titled Metrics that matter describing surgical targets and why then were targets metrics that mattered in February but at the Minister's task force stand-up yesterday the exact same targets are now a distraction?Hon ANDREW LITTLE: So that question just demonstrates the sheer and utter confusion that that member dwells in. I think the main point is this: it is widely accepted by many clinicians that targets are not a plan. Targets don't deliver service. Targets don't improve services. What you need is a plan. The National Party thinks that if you have a target magically things will happen. What we do know from the 2019 research into the National Party health targets is that they were manipulated and dodged and did not deliver good healthcare.Dr Shane Reti: Did he support the COVID vaccination target?Hon ANDREW LITTLE: This Government follows clinical advice and there is epidemiological research that says that in order to reach a level of herd immunity there is a level that you have to reach and we followed that clinical advice. But when we are running services when we are operating services we focus on having a plan and resourcing it not like the National Party that declares they're going to do bowel screening doesn't resource it doesn't fund it and lets it flounder."