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Crown Entities Reform Bill

First Reading

Tuesday 4 October 2011 (advance copy) Hansard source (external site)

Debate resumed.

HagueKEVIN HAGUE (Green) Link to this

Tēnā koe, Mr Assistant Speaker Robertson. Tēnā koutou e te Whare. I will take what may be a brief call on behalf of the Green Party to say that we will oppose the Crown Entities Reform Bill, and to set out some of our reasoning. This bill is one of those bills that is good in parts, but overall we believe it is not worthy of support.

I will touch on the elements of the bill that we like, to begin with. The first element I want to acknowledge is the ending of the Crown Health Financing Agency. This agency has been extremely important to the health sector. It has been, effectively, the sector’s bank for some years now, and I believe that Graeme Bell is deserving of considerable praise for the way he has carried out that work. Certainly, it is an agency that was absolutely essential in times past, but, for the most part, the role it has been performing is now over. We are able to move forward without that agency, but we note the positive contribution it has made.

The second aspect of the bill that I think is very positive on balance is the creation of a Health Promotion Agency. Again, it is no slight at all on the various entities that are being rolled into this new agency, because each of them has done some sterling work for New Zealand and New Zealanders, over many years in some cases. What I hope will transpire, should the bill be passed and this new agency created, is that the new agency will build on the work carried out by those agencies, rather than start from square one.

One of the things that the new agency will have the potential to provide is a unified approach to health promotion. Health promotion, I need to remind the House, is all about keeping people well in the first place. There is a well-established formula for the actions that Governments need to take to be able to do that: the promotion of healthy public policy, the creation of supportive environments, the strengthening of community action, the development of personal skills, and the reorientation of health services. The most important of those from the point of view of the Government, and the one where the Government is most directly able to change outcomes, is that of developing and promoting healthy public policies.

The new Health Promotion Agency will have greater clout and greater ability to be able to influence public policy, although I note that that is one of the functions that is not explicitly set out in the bill. I hope it is one of the matters that is addressed during the consideration of the bill by the Government Administration Committee.

I also want to draw attention to another function that is not clearly set out in the bill, and that is the funding of health promotion activity and public health work. The bill transfers some functions of the Ministry of Health to the new agency, but it is unclear about what will happen to the funding of public health.

I urge the Government and the select committee to very strongly consider adding the funding of public health services into the functions of the new agency, and I fear that the alternative may be for the ministry to devolve funding of public health services to district health boards. In my view, and in the view of the Green Party, that would be a grave error, in that it would run some of the risks that have befallen mental health funding, where funding intended for a particular purpose is in fact transferred over and used for another purpose.

Perhaps I might move on to mental health funding now. One of the aspects that we oppose in the bill is the rolling of the Mental Health Commission into the Office of the Health and Disability Commissioner. We oppose that for a variety of reasons. One is that it will weaken the focus on mental health.

Mental health has had an interesting journey in the health sector. It was very clearly a Cinderella service in the health sector—one that was underfunded and under-recognised by mainstream services—but through the work of the Mental Health Commission it has developed a greater prominence. Our awareness of mental health needs is much greater, and mental health services have become much better.

The development of the blueprint for mental health services was a very important landmark event in health services development in this country. Still, however, at this point, when the Mental Health Commission is to be rolled into the Office of the Health and Disability Commissioner, the Mental Health Commission has not completed its task. What we still see from district health boards is that money that is reserved—ring-fenced, in fact—for mental health services is being used outside of the ring-fence and for other services.

That is occurring at a time when all bar one, I think, of our 20 district health boards have not yet met their blueprint volumes for mental health services. In other words, they are not yet providing all of the mental health services that the blueprint says they ought to be. So this is not the time to risk the Mental Health Commission’s mission by this kind of change, and that is what the bill does.

The Office of the Health and Disability Commissioner is another institution within the health sector that does a splendid job, but it is a very different job from the one that the Mental Health Commission performs. Our fear, from this party, is that this change will undermine the work of the Mental Health Commission, and we do not believe that is appropriate.

The other significant change that is intended by this bill is to roll the Charities Commission into the Department of Internal Affairs. We believe that that would be a terrible mistake. We would be probably the first party in this House to have some criticisms of the way that the Charities Commission has gone about its work, but nonetheless we believe that the institution of the Charities Commission is an important one, and here is the reason. Charities—the community sector; that third sector—are explicitly not part of the State sector, and part of the whole rationale for the development of a Charities Commission in the first place was to ensure that that third sector, the community sector, did not become hostage to ministerial whim. We said that the policing of that sector, the regulation of that sector, needed to be independent from ministerial intervention and ministerial control. By rolling the Charities Commission into the Department of Internal Affairs, that separation is entirely lost. The door is again opened to political interference and to political decisions about that third sector and its own regulation. We believe that is inappropriate.

So, on balance, the bill is a mixture of some things that have some promise and are actually very positive, and some things that are the wrong way to go. On that basis we cannot support the bill. We hope that some changes will be made at the select committee to enable us to support the bill in its future stages, and we are very happy to work with other parties to enable that to occur. Thank you.

GoudieSANDRA GOUDIE (National—Coromandel) Link to this

I am very pleased to speak to the Crown Entities Reform Bill. I am not surprised that on the one hand the Green Party is supporting the bill and on the other they say they are going to oppose it. That is really in line with the muddled thinking that continues to be exhibited by the Green Party.

I say that I am just delighted with the bill, what it brings to this House, and the changes it makes. The purpose of this bill is to amalgamate certain functions of existing agencies for greater efficiency and effectiveness. That is absolutely necessary. It is one of the hallmarks of the current Government. It is about the coordination and quality of public services and the streamlining of bureaucracy, and we want to place a great deal of emphasis on this. I say that the changes are anticipated to save $19.6 million in the 4 years from July 2012, with an ongoing savings after that of $4.1 million. So although there will be small transition costs of about a million dollars, I think that the savings overall will be of huge benefit to the Government and to the taxpayers of New Zealand.

We want the State sector to be based on the following principles: clear priorities, high-quality services, and reduced waste. I cannot understand why any political party could not support that and vote for the bill accordingly, but that is not the case, of course, with the Greens. Currently, we have 38 Government departments, over 150 Crown entities, and more than 200 agencies, and we need to make sure they are efficient, robust and effective, and that they provide quality services. We need to make sure that we get bangs for our bucks and get the best outcome possible for every single dollar we spend. That is why I absolutely applaud the provisions of this bill.

Lees-GallowayIAIN LEES-GALLOWAY (Labour—Palmerston North) Link to this

It is interesting to follow on from that contribution from Sandra Goudie on the Crown Entities Reform Bill, because in her short contribution the bulk of the content of the speech was about improving the efficiency, reducing the waste, and reducing the cost of the State sector.

GoudieSandra Goudie Link to this

Labour increased it by 50 percent.

Lees-GallowayIAIN LEES-GALLOWAY Link to this

It is true that Labour took a public sector that had been cut back to its absolute bone and actually put a little bit of meat and muscle on it again. I do not think there is much fat that can be trimmed from the public sector. But a public sector that is trimmed back to its bone is not capable of running efficiently and I think Labour had an excellent track record of restoring and rebuilding the public sector. It was not nearly the size it was when National first took the knife to it in 1990. All Labour did was restore it to a reasonable size and make it effective and efficient once again.

In fact, the sector is regarded as being so effective and efficient internationally that rating agency Standard and Poor’s said it does not regard the New Zealand State sector as being either bloated or inefficient. One of its analysts said: “Generally, we look at the Government in New Zealand as being relatively small and compared to its peers it’s quite efficient.” So one has to wonder exactly what the problem is that the Government is trying to solve. [Interruption] I know, it is a minor detail like evidence, as my colleague Charles Chauvel points out. But I would have thought that the Government at the moment would be trying its damndest to get into Standard and Poor’s good books. But again the Government has just completely overlooked what Standard and Poor’s had to say; it knows best, and it has its ideology that it has to follow. That really, at the end of the day, is what this bill all about.

I think most of the arguments about where this bill is lacking have been reasonably well traversed by my colleagues in Labour, and I appreciate the excellent contribution from Kevin Hague from the Green Party as well. We do understand that Governments do not have a bottomless pot of gold and decisions have to be made about where a Government’s priorities lie. That, ultimately, is actually what this bill is all about—it is about priorities.

We know that the Government does not prioritise mental health and it does not prioritise addiction treatment. We know that not just from this bill, although what it does is disestablish the Mental Health Commission prematurely and also disestablish the Alcohol Advisory Council (ALAC) of New Zealand. But we already knew that because where once the Government had targets for mental health and addiction treatment, it no longer does. It no longer has those targets because neither of those things is on the Government’s health priorities.

So we know full well from the Government’s own lexicon, if you will, that mental health and addiction treatment are not a priority for this Government. The result of the removal of both of those from the Government’s list of health priorities is that district health boards have in many cases—not universally across the country, but in many cases—cut funding to services, both mental health services and addiction treatment services. That is because the district health boards have to follow the priorities that are set by the Government. They will make their decisions based on what the Government will mark them on. Unfortunately, mental health treatment and addiction services do not list on the Government’s league tables, the outcomes and the effectiveness of those treatment services are not published in our daily newspapers quarterly as are some other things, and therefore the district health boards, quite understandably, have retracted their funding back to the ring-fenced funding that is available—and Kevin Hague even indicated that in some cases, beyond that—and that they have found ways to divert the ring-fenced funding into other areas. That is where the Government’s priorities lie and some district health board chief executives and chairs probably feel as though their job is on the line, depending on how they measure up according to those things that are the Government’s priorities.

So I suppose it comes as no great surprise that this legislation finds its way into the House and that the Government is actually legislating out of existence both ALAC and the Mental Health Commission. Both of those are considered to be, I suppose by many people, the poor cousins of the health system. Mental health is the poor cousin of the health system, addiction treatment is often the poor cousin of the poor cousin, and this legislation reinforces that view.

We see plans by the Government to bury the country’s alcohol watchdog within the new Health Promotion Agency as being contrary to the advice we have heard from the clinicians who are working at the coalface. They see the usurping of ALAC’s role into a broader health promotion agency, as positive as that concept is, as undermining the focus we need in New Zealand both on the health promotion aspects of alcohol addiction and alcohol misuse and also on the treatment side. It seems bizarre, frankly, when we have put so much attention on alcohol abuse, and when we have an alcohol reform bill making slow passage through the parliamentary process, that at the same time we should be removing the agency that is specifically mandated to involve itself in health promotion activities and in education activities around the sensible use of alcohol and reducing the harms associated with alcohol. It just seems counter-intuitive, given how important that issue is seen to be by the public in New Zealand.

That is one aspect: ALAC is gone. The Mental Health Commission, on the other hand, is also going. It was supposed to be around until 2015. Mental health is, I suppose, unfinished business in the health system. The blueprint was an excellent step forward. It brought mental health up to the level of acknowledgment in the health system that it needed. But the job certainly is not done. We have done a lot over the last 15 years or so to focus on the 3 percent of New Zealanders whose mental health needs are most acute, but we need to look beyond that into the 20 percent of New Zealanders who at some point in any given year have need for mental health services. This sends completely the wrong signal—

RobertsonThe ASSISTANT SPEAKER (H V Ross Robertson) Link to this

Honourable members, there is too much background noise. It is discourteous to the speaker. If people want to have private conversations, then they are welcome to do so, but it is usually reserved for outside in the lobbies.

Lees-GallowayIAIN LEES-GALLOWAY Link to this

Closing the Mental Health Commission 3 years earlier than it was supposed to be closed sends completely the wrong signal to the health system about where mental health services should actually lie in the list of priorities for district health boards. I suppose that, again, is reflective of how seriously the Government takes mental health and addiction treatment services.

With that, I reiterate what my colleagues have said. Labour is opposed to this bill. We will work constructively in the Government Administration Committee to try to improve the bill, but, frankly, I would be very surprised if we could improve it to the point where Labour would find itself in a position to support it.

Link to this

A party vote was called for on the question,

That the Crown Entities Reform Bill be now read a first time.

Ayes 67

Noes 53

Bill read a first time.

Bill referred to the Government Administration Committee.