10. Hon TONY RYALL (National—Bay of Plenty) Link to this
to the Minister of Health
Is he satisfied that health expenditure is being prioritised appropriately; if so, why?
Hon PETE HODGSON (Minister of Health) Link to this
The Government has undertaken a historic reinvestment in our public health system and, yes, I am satisfied that on the whole it is being prioritised appropriately.
Is it the Government’s priority to fund race-based health programmes like this programme, which asks: “Are you male? Are you Maori? Are you aged 35 to 45? Would you like subsidised gym membership?”, and how does he square that with this Government’s undertaking to treat all New Zealanders fairly rather than on the basis of their race? [ Interruption]
Madam SPEAKERI presume the member is referring to a programme near his own home town of Tauranga, which is run out of the Western Bay of Plenty primary health organisation. The main cause of death in that district health board’s area is cardiovascular disease. It is the leading cause of death amongst Māori men. The primary health organisation is doing precisely what primary health organisations were set up to do, which is to reach into the population, find the people who are most at risk, and start to deal to them.
And what is more, the idea of having a free gym membership is, of course, no more than a thing called a Green Prescription, an idea that began under National when the member’s mate, three to the left of where he is sitting now, was Minister of Health. The member needs to become a student of history as well as a student of the portfolio.
Barbara StewartWhat funds from the health budget are spent annually on migrant health screening and the treatment of conditions exposed by screening; has that figure increased over the past 6 years?
I cannot give the member a precise answer to the question without notice, I am sorry. But I can tell the member that funding to better integrate migrant communities was disbursed by my predecessor, the Hon Annette King, about a year and a bit ago. The whole reason for doing that was to make sure that migrants, especially those from sub-Saharan Africa, were integrated into our health system as early as possible.
Why, when before the election this Government promised to do away with race-based funding, do the many thousands of other New Zealanders who are at risk from heart disease in the region not qualify for subsidised gym memberships, free lifestyle coaching support, and weight loss programmes; is that because they are the wrong colour under this Government?
It is a matter of fact that New Zealanders of Māori descent die around 7 years younger than New Zealanders of Pākehā descent. That is something that I find shameful. I am delighted that a primary health organisation in the member’s own electorate is keen to do something about that. I am delighted about that, and I would say to the member that this is not race-based funding. It, self-evidently, is needs-based. And as long as there is a need to pay special attention to Māori health in this or that area—or Pacific Island health, or male health, or female health—we will do so and do so proudly.
Hon Dr Michael Cullen Link to this
Is it correct that in the example the member has referred to there are three identifiers—age, sex, and race—and has he understood why so far the member has picked on only race and appears not to worry about age and sex?
Peter BrownDoes the Minister believe that the humanitarian policy announced today, which has the potential to increase the prevalence of AIDS in New Zealand residents by almost 10 percent and cost the health system $3 million extra per year, will be viewed by the public as an appropriate prioritisation of health expenditure; if he agrees with that, could he please explain why?
Not only do I agree with it but I warmly endorse it. I say to the member straightforwardly that by taking this step we do not increase the prevalence of HIV in this country; we, of course, decrease it. We decrease it because this virus always flourishes wherever there is denial and cover-up. Whenever one shines a light on it, is open, and goes for early diagnosis, one will always get better control. That is the history of HIV throughout the world, and it is time the member got his head around that.
Heather RoyDoes the Minister think the $3.9 million of taxpayer money spent over 6 years on the Health Workforce Advisory Committee was well-prioritised health expenditure, when it produced nothing of any benefit at all to assist workforce shortages; would that money not have been better spent on 312 hip replacements or 1,700 grommet operations for children with hearing difficulties?
When the Health Workforce Advisory Committee was set up by my—[ Interruption] I wonder whether the member would like to listen, given that she asked the question. [] When the member is ready, I will answer the question.
Would the Minister please be seated. Would members please lower the chit-chat across the Chamber, so that we can hear the answer.
When my predecessor, the Hon Annette King, established the Health Workforce Advisory Committee, New Zealand was coming out of a period when it was believed that there was no need to have a health workforce debate, and that somehow the market would take care of the situation. That is why this country has well insufficient dental therapists, for example; it is why we ran out of radiation therapists, for example. You see, the market, left to its own devices, does not work. The Health Workforce Advisory Committee has done this country an absolute favour by getting the health workforce on the agenda, to the point where even the ACT party is now asking about it.
Sue MoroneyIs the Minister satisfied that there is a broad appreciation of how to best balance competing priorities for health expenditure?
Sadly, I am not. I have heard calls to relieve the pressure on elective services by cutting primary health spending, which would, of course, make the pressure on elective services worse. I have heard calls to cut taxes but at the same time to provide more health services—go figure! I have heard calls to prevent disease, followed by calls to stop spending money on anti-smoking programmes. Today we have heard remarks like: “Let’s make sure we don’t deal to the most needy in our society.” All of those calls came from Tony Ryall. The more Labour does in health, the more bitter and strange that member becomes.
Those last comments were unnecessary. Would the member please be seated. This House is trying very hard to comply with the Standing Orders. Would the Minister please withdraw those comments.
Why is the Government continuing to fund race-based programmes when, before the election, it promised they would be stopped; will he tell primary health organisations and district health boards that they should stop dividing their areas on the basis of race and treat their patients on the basis of their need?
All personal health is done on the basis of need and all population health is done on the basis of what the population needs. The member really does need to begin to understand health policy.
If the Minister is so keen that these programmes be based on race, can he explain why this programme targets not the most at-risk racial group in the region, which is in fact Indians; can he also explain why the Government is pursuing the race-based funding of primary health organisations when Mr Mallard, before the election, said that these programmes would be stopped, yet after the election Helen Clark and the Labour Party are back to their old tricks of dividing New Zealanders on the basis of race?
The Bay of Plenty District Health Board has identified cardiovascular disease, diabetes, cancer, and renal disease as its highest-priority chronic conditions and has begun integrated programmes of care for all of those conditions for the four priority populations. They are children and young people, Māori, older people, and people with disabilities. If the situation for Indians in the Bay of Plenty has been overlooked by the district health board, then I am sure a very good local member would draw that to the attention of the district health board.
Dr Jackie BlueDoes the Minister agree that the Western Bay of Plenty’s race and gender-based initiative to reduce cardiovascular disease, which targets 35 to 45-year-olds, is in fact targeting the wrong group, when it is a well-known fact that here and now the people at greatest risk of dying of heart disease—and that includes Māori men—are those aged 45 to 64?
I myself do not make clinical decisions, but I am delighted that the member has decided that she should take a population-based approach to health. She should ask National’s health spokesperson to follow suit.
I seek leave to table two documents from before the election: first, a Cabinet paper that resolves that the Ministry of Health will be instructed to remove race-based funding from primary health organisations, and, second, a report from the Dominion Post of before the election in which the Minister, Mr Mallard, announces that race-based programmes are to be removed.
I seek leave of the House to table question for written answer No. 7868 from 2006, showing that the Health Workforce Advisory Committee was funded to the tune of $3.9 million, despite the fact that it achieved absolutely nothing in its 6 years of existence.