8. Hon TONY RYALL (National—Bay of Plenty) Link to this
to the Minister of Health
What is the total amount of public money spent on implementing the Primary Health Care Strategy since it began?
Hon PETE HODGSON (Minister of Health) Link to this
Over the years about an additional $1.2 billion, the majority of which lowers the cost to New Zealanders of seeing their family doctor and the cost of prescriptions—both moves opposed by the National Party.
How can it be that he has admitted to Cabinet in this report that the Government has failed to make any progress whatsoever in most of the objectives it set itself to improve the quality of primary health care in New Zealand under the Primary Health Care Strategy, despite spending hundreds of millions of dollars?
The member chooses again to mis-characterise and selectively quote. The long and short of it is that a Primary Health Care Strategy will take years to be fully embedded, because it does take a lifetime of good health-care to give someone a good experience in his or her later years. We are very proud in respect of this change to the primary health care system, and I say that there are already some health gain changes to hand.
Maryan StreetThe cost of going to a general practitioner for an ordinary practice has dropped from about $52 to about $26. In some areas, and the six practices in Taupō, Tūrangi, and Mangakino will do for an example, practices have agreed from 1 January next year that they will charge patients $10 if they are 6 to 17 years of age, and $15 if they are 18 years and older. That is the sort of thing one can do to improve access to doctors if one does not have reckless tax cuts on one’s mind.
Can the Minister confirm that the Primary Health Care Strategy foresaw the primary health care team expanding to a wider range of health professionals beyond doctors and nurses, yet the latest Commonwealth Fund survey of primary-care physicians across seven countries finds New Zealand general practice second to bottom for the use of multi-disciplinary teams, and how can it be that, after spending hundreds of millions of dollars and a huge ministry bureaucracy, he has told his Cabinet colleagues that progress in this area is limited to a small handful of primary health organisations?
The member refuses to get the point, or if he is not refusing then he does not understand fundamental health policy. Let me remind him that not only does that Commonwealth Fund survey put New Zealand primary health care up near the top but the very areas where New Zealand does not do well, including the one that he gave us an example of, are precisely the reason why the Primary Health Care Strategy was designed. The member will also notice that general practitioners’ preparedness to work with others in the health sector in the primary-care setting in that survey is the highest in the world. We can expect that position, therefore, to significantly improve—which is precisely what the strategy is designed to do.
Can the Minister confirm that he told Cabinet in this document that the Primary Health Care Strategy envisaged a wider range of services provided in the primary-care settings in doctors’ clinics, such as maternity, hospital follow-ups, and well child, and why, after hundreds of millions of dollars and years of promises, was he forced to admit that, in his own words, “co-ordination between the primary care and ‘hospital’ environment is still weak.”?
Madam SPEAKERPlease be seated. I am having a great deal of difficulty hearing. We have heard the questioner. He was given the courtesy of being heard in silence. Please do not interrupt the Minister beyond the normal level of interjection.
Thank you, Madam Speaker. I will be able to lower my voice a little. The member is correct. The linkages between primary and secondary health care in this country are still not good enough, but this Government never lacks ambition and is very happy to see continued improvement between primary and secondary health care. In fact, we think it is an area where there are very considerable gains to be made and we will continue to seek them year after year, for as long as we are in office—which will be a while yet.
Can the Minister confirm that he has warned Cabinet of the rising risk of a further fragmented health system, with so many areas doing their own thing on information technology, and despite hundreds of millions of dollars and a huge Ministry of Health bureaucracy, the development of common information technology systems across the health sector is poor, even if some of the people developing them are not?
Further improvements to our information technology are needed but, be very clear, the member has a habit of putting down a question then talking through an answer. I will just say to the member that if he does not want to listen to an answer, some of his colleagues might. Why does he not put a sock in it? The member is correct in—
Thank you, Madam Speaker. The member is correct in suggesting that there is still further improvement to be made in our information systems, which is why I have trebled the capital investment since 1 July—the sort of thing we can do when we do not have reckless tax cuts on our mind. I say again to the member that the reason our system needs further improvement is that during the 1990s, when his Government decided that the health system should compete against itself, we ended up with a Tower of Babel in our information systems, which this Government is proudly fixing.
Jo GoodhewCan the Minister confirm that now that he has confessed his Primary Health Care Strategy report card to Cabinet, describing his progress as “limited … still weak … poor” and lagging behind policy development, that the summary of his report card reads: “Lots of money, no progress, should consider a new job.”?
No, I do not. Instead, I assert that the New Zealand Primary Health Care Strategy is one of the more significant changes in our health system. It is one that I am very proud of and this Government is very proud of. Members like to quote selectively what is an honest appraisal of a strategy that is still in the implementation phase. I will say again—that member comes from a party that wishes to double the fees for going to doctors and increase prescription charges by 500 percent. I do not think it will ever get there.