Roy Heather: Questions for Oral Answer — Questions to Ministers 
Roy Heather: Questions for Oral Answer — Questions to Ministers 
[Volume:626;Page:21128] 
4.  
HEATHER ROY (ACT) 
 to the  
Minister of Health 
: What action is she taking to address Treasury’s serious concerns about the sustainability of the current rate of growth in Vote Health in particular the concern that if the current rate of increase is maintained Vote Health could be at least 13.6 percent of GDP by the year 2020? 
Hon ANNETTE KING (Minister of Health) 
: 
 High health spending especially growth in health spending is an issue that New Zealand does not face on its own. In fact both the level and growth in New Zealand’s health spending are in line with OECD norms and trends. However sustainability of health expenditure is a question this Government takes seriously. The Minister of Finance and I have commissioned a review of Vote Health expenditure and I have asked the Minister of Finance about the impact that tax cuts would have on health funding and about the cuts on health services that would be required to fund the Opposition’s tax cuts. 
Heather Roy 
: Why do those damning Treasury papers released under the Official Information Act repeatedly declare that there is an “unsustainable growth path of health spending over the longer term.” when there is little change to the number of 180000 patients on all waiting lists—leaving aside the Minister’s usual bluff and bluster answers? 
Hon ANNETTE KING 
: Considerable investment has been made into the health sector by this Government; we make no apologies for that. We have had to invest in new hospitals. We have had to invest in the wages and salaries of our health workforce in order to recruit and retain them. But we have also invested in more services. I do not wish you to stop me from answering Madam Speaker but if I were to repeat all the improvements then I am sure you would say that I was talking for too long. 
Dr Paul Hutchison 
: Will the Minister ever accept that the massive bureaucracy she has created—in the form of 21 district health boards with all their committees and over 76 primary health organisations with their mass of committees as well as through a 25 percent increase in staff numbers at the Ministry of Health—has contributed to the poor productivity and waste in the health sector as identified by Treasury; if not why not? 
Hon ANNETTE KING 
: That question is laughable. When it comes to health bureaucracy let me talk about 23 Crown health enterprises. Let me talk about four regional health authorities the Crown Company Monitoring Advisory Unit and Health Benefits Ltd. Let us look at the number of bureaucrats there were in the mid-1990s—it is about the same number as now. I can tell the member that there has been a 0.4 percent increase in the total number of bureaucrats in the last 5 years that Labour has been in Government. I ask National members whether they matched that in the 1990s. 
Mark Peck 
: How do New Zealand’s health expenditure and health outcomes compare with those of other countries? 
Hon ANNETTE KING 
: We compare very well with OECD countries. In the latest data available New Zealand’s total health expenditure was 8.5 percent of GDP. We ranked 16th out of 27 OECD countries. However on life expectancy New Zealand now ranks even better against OECD countries—but then we did see years of disparity when tax cuts in the 1990s were made at the expense of the length and quality of the lives of New Zealanders. We will see that again if Don Brash gets his way. 
Heather Roy 
: How has this Minister thrown a record extra $3.5 billion at health a record 57 percent increase in just 6 years yet her ministerial answers to me show that the number of operations from 2001 to 2004 has budged only 1.3 percent while the population has grown at the same time by 4.3 percent—which is an actual cut in operations per head of population—how can that be? 
Hon Dr Nick Smith 
: Because she’s hopeless! 
Hon ANNETTE KING 
: I can get the member an operation if he needs one. He should just tell me where he needs it. I do not know what part he needs it on. 
Rodney Hide 
: I raise a point of order Madam Speaker. That was an important question. I am quite pleased that Annette King is able to give out operations at a whim because no one else in New Zealand can get them. But her job as Minister is to try at least to answer what is a very serious question of concern to New Zealanders. I know that Annette King struggles in the job and that she does not like to give straight answers but it is your job Madam Speaker to ensure that she addresses the question. Her cheap shot across the House in no way did that. 
Madam SPEAKER 
: As has been noted those who make interjections are likely to have responses. As long as those responses are within the rules then they will be permitted. The Minister was about to answer the question and she is known for answering questions very fully. 
Hon ANNETTE KING 
: Yes I am and I was just going to give a full answer. In fact Treasury last year reported a 7 percent increase in funding and a 1.5 percent increase in outputs. Those outputs I have to tell the member explain only 44 percent of hospital costs. They are a poor indicator of the level of district health board output overall. The member has been told that over and over again. She likes to interpret figures for her own political purposes. 
Sue Kedgley 
: Why when the ministry’s own research shows that diet and poor nutrition are by far the leading cause of death—accounting for about 30 percent of deaths—is there no specific Ministry of Health funding allocated for implementing the flagship Healthy Eating - Healthy Action strategy other than a small fruit in schools programme; and why is the ministry not taking concrete measures to improve diet such as getting high fat and sugar foods known to be unhealthy out of our schools? 
Hon ANNETTE KING 
: The implementation of the Healthy Eating - Healthy Action strategy as the member was told at the Health Committee this morning is implemented through district health boards. If the member reads the district health boards’ annual plans she will see that they have plans proposals and policies in place to implement the strategy alongside the Ministry of Health’s public health funding that is going into the fruit in schools programme for example through health-promoting schools—something that has been very successful. 
Rodney Hide 
: How can the Minister explain that when in 1999 a tragic 96000 New Zealanders were queued up in pain waiting for their first specialist assessment— 
Steve Chadwick 
: Not in pain! 
Rodney Hide 
: Well members may want to call out from the back— 
Madam SPEAKER 
: I am sorry I did not hear that. Who intervened? Would the member please leave the Chamber. 
Steve Chadwick withdrew from the Chamber. 
Madam SPEAKER 
: Would the member please continue. 
Rodney Hide 
: I would like to start again. How come when 96000 New Zealanders were queued up in pain for their first specialist assessment the Minister could say it was “criminal” but under her watch and after spending an extra $3.5 billion a year by her own figures 120000 people are now queued up waiting for their first specialist assessment? 
Hon ANNETTE KING 
: The important thing is how long people wait for their first specialist assessment and the time they are waiting is considerably less than it was in 1999 and the number of people waiting is considerably fewer. So we have seen some real improvement in the number of people getting first specialist assessment. Over 400000 New Zealanders are getting first specialist assessment each year. 
Rodney Hide 
: Then given the Minister’s answer does she now accept that the number waiting for their first specialist assessment has indeed grown from 96000 to 120000 and that what she really meant to say when she was in Opposition was that it was not the number of the 96000 who were waiting that was criminal but how long they had to wait; and does she think that that is some cold comfort for the 120000 still waiting? 
Hon ANNETTE KING 
: It is certainly the length of time that people wait that concerns them. I was more concerned about the 89000 people who had waited on a list for operations in the 1990s. The National Party’s new policy as announced on Monday night is: “We’ll just put them on a list and miraculously they’ll feel better about it!”. 
Heather Roy 
: Why does the Minister persist with her bluff and bluster answers when it was announced in the Budget that deficits are blowing out to $100 million a year that 120000 people are waiting for first specialist assessments that Treasury has reported that productivity is collapsing and that the number of operations per head of population is reducing and there is now the most damning Treasury report on health ever produced—all of that despite her throwing a record $3.5 billion at health from when she was elected? 
Hon ANNETTE KING 
: It would be really good if the member were to read all the Treasury report. She loves to pick out the bits that suit her. What about some of the positive things Treasury had to say? What about some of the positive comments it makes? The member likes to run down the health system in New Zealand—a health system that is producing more operations more outpatient services more services for New Zealand and lower-cost primary health care. She blackens the name of doctors and nurses. She does not believe that they should get an increase in their pay and then she tries to tell us that we should be cutting taxes and cutting expenditure. One cannot have it both ways. 
Hon Ken Shirley 
: I raise a point of order Madam Speaker. The Minister ignored the question totally redefined it then gave us an extended blather about what she wanted to answer. The question from my colleague Heather Roy was very clear and very specific. The Minister changed the whole premise created a hypothetical question then went on with great gusto and at incredible length and did not answer the question. 
Madam SPEAKER 
: I thank the member. The question was quite long. It enabled the Minister to address it in the way she did which was in a general way. 
Rodney Hide 
: I raise a point of order Madam Speaker. I know that the Minister might think this issue is funny but we actually think it is serious. My colleague Heather Roy asked a very specific question. It does not matter about the length; it is the specificity of the question that matters. The question was clearly in order because you allowed it. Not once in the blather that the Minister delivered—and it was total blather—did she come anywhere close to answering a very specific question. There are people at home listening to this who are stuck on the waiting list. They would like to hear a Minister who fronts up and actually answers some questions rather than blathers on. 
Madam SPEAKER 
: The Minister did address the question. The answer may not have been to the member’s satisfaction but it did address the question. 
Rodney Hide 
: I seek leave to table the statement where Annette King said it was criminal that 96000 people were waiting for a first specialist assessment. That appeared in the  
Evening Post 
 on 19 August 1998. 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? There is objection. 
Heather Roy 
: I seek leave of the House to table two documents. The first is the  
Treasury Report: Budget Bilateral 2005 Health. 
Document by leave laid on the Table of the House. 
Heather Roy 
: The second document is a parliamentary written question I asked of the Minister of Health showing that the number of operations from 2001 to 2004 has increased only very slightly and showing that the total number of operations per head of population is actually down. 
Madam SPEAKER 
: Leave is sought to table that document. Is there any objection? There is objection. 
Sue Kedgley 
: I seek leave to table the Ministry of Health document  
Looking Upstream 
 confirming that 30 percent of deaths are caused by diet and poor nutrition. 
Document by leave laid on the Table of the House.