1. Hon TONY RYALL (National—Bay of Plenty) Link to this
to the Minister of Health
How many patients does he expect this financial year will be removed from waiting lists and returned to their GP for ongoing care, and how does this number compare with the previous years?
Hon PETE HODGSON (Minister of Health) Link to this
First, let me thank the member for acknowledging that when patients are returned to general practitioners they are returned for ongoing care. About 5,000 a year have been returned to their general practitioners for ongoing care in previous years. So far this year it is about 6,500. Most of those have previously been placed in the active review category.
How can the Minister stand in this House and say that only 6,500 people have been referred back to their general practitioner this year, when we know that the Hawke’s Bay is about to send back 1,800, Waikato has sent back 3,000, Counties Manukau has admitted to sending 1,800 back, Canterbury has admitted to sending 2,000 patients back to general practitioner care this year, and there have been 400 in the Bay of Plenty; is the fact this, that this Minister does not want to admit that this crisis is getting beyond him?
No, that is not the fact. The fact is that the member who has asked the question has confused surgery and specialist waiting lists. I have answered in respect of surgical waiting lists and will happily answer in respect of specialist waiting lists should he wish to put down another question another day.
Maryan StreetThe main reasons are that their condition has not deteriorated as it might have—these are the people in the active review category that I mentioned in my first answer. This is the booking system, introduced by the former National Government, the active review category, introduced by the National Government, and the “return to GP” idea, introduced by the National Government. But there are two other reasons. One is that the patient is currently medically unfit for surgery, and the other reason is that the patient has changed his or her mind.
Is it not the case that this Minister does not know how many people have been dumped from waiting lists around the country—that the figure is up to 3,000 in the Waikato, 2,000 in Canterbury, 1,800 in South Auckland, 1,800 expected in Hawke’s Bay, and 1,100 in MidCentral District Health Board—and who is responsible for the fact that so many thousands of New Zealanders are being sent back to their general practitioners?
Now that it is clear that the member is talking about a specialist waiting list and not a surgical waiting list, I am happy to advise him as follows. There are 24,000 people waiting for a first specialist assessment who have been waiting for longer than 6 months. This is not satisfactory. Just to give the situation some context, however, I point out that when we became the Government the figure was not 24,000 but 41,000, and on top of that—
Madam SPEAKERMembers know—[ Interruption] Yes, members are losing control. Members are allowed to interject, but barracking so that others cannot hear is not permitted.
Not only were 41,000 waiting for more than 6 months but a further 51,000 had been waiting for God knows how long. That totals 92,000. Now, in respect of the 24,000—noting that we have three-quarters fixed the mess left to us by the previous Government, so how about a bit of credit—some proportion will be seen by a specialist and some proportion will be returned to their general practitioner. These are individual decisions by district health boards. In Hawke’s Bay, for example—the area the member refers to—1,800 have been returned to their general practitioners in recent weeks. The Southland urology service, to give another example, had a very serious backlog, and every one of those people was seen by a specialist and none were returned to their general practitioner.
Tariana TuriaIs the Minister aware of the first national cervical audit undertaken by Auckland University in 2004 that revealed that for 21 percent of Māori it took more than 6 months from their first high-grade smear until they were diagnosed, compared with 10 percent of non-Māori, and is the latest debacle at Waitematā another example of that systemic bias; if not, how can such delays be accounted for?
I regret to advise the member that I was not aware, but I do wonder, given the year that she spoke of, which of us was a health Minister at the time.
How many New Zealanders, many of whom, a specialist has said, need an operation, are now in the care of their general practitioner? How many people are in the care of their general practitioners—which has effectively become the waiting list to get on the waiting list to get on the waiting list?
Of course, one cannot answer that question except to say that there are approximately 16 million visits to a general practitioner each year, and that, I guess, is the starting point. Some of those visits might be for coughs and colds, however.
Has the Minister inquired as to how many people culled from waiting lists in the last year have actually died because they did not get an operation?
The issue of people dying while on, or off, waiting lists was raised by the ACT party approximately 18 months ago in this House. For some period of time the crisis makers of the day decided that people were going to die on a waiting list from the thing that was the reason they were waiting. Actually, when we go back over all of the details—and the Ministry of Health did so back then—we find that there were virtually no deaths on waiting lists from the thing that caused the people to be on that waiting list.
I raise a point of order, Madam Speaker. This question was quite specific in referring to general practitioner care. It is completely out of order, and in no way can be interpreted as addressing the question, for the Minister to give an answer to a completely different question that he did not receive. How many people have died while under general practitioner care because they were sent off a waiting list?
Hon Dr Michael Cullen Link to this
The Minister did give an answer to that, and the answer was that in terms of people dying of the thing for which they were on the waiting list, virtually none. The member might just as well ask how many people died who were not on a waiting list.
The Minister gave a very full answer. If he wishes to add anything more, I am sure the House would appreciate it.
What characterises the health policy of this Government is very substantial attention to primary health care. So if someone dies without seeing his or her general practitioner, or having seen his or her general practitioner only once, and having failed to go back to the general practitioner because of, for example, price, or whatever reason, then help is on the way. The most remarkable changes to our health system are in the primary health-care system. [ Interruption] I say to the member now—but he has to stop talking for a little bit while I am talking, because he cannot listen and talk at once—that we will discover in years to come, as the primary health-care strategy rolls out, that a whole lot of people will get care these days that they never would have received under a National Government.
Dr Jonathan Coleman Link to this
What would the Minister say to the people of Counties Manukau, whose children are getting less than half the number of elective tonsil operations they were getting 4 years ago; is that what he means by prioritisation—that as each year goes by, South Auckland kids get fewer of the tonsil operations they need—and does that not make an absolute mockery of his claim in his speech 2 days ago that child health is a priority under this Government?
Child health is a priority under this Government, and we are very proud of the programme of health care that we will roll out over the next 3 years in the child health area. As far as tonsillectomies are concerned, the member, who is himself a doctor, might like to advise the House whether the fashion for tonsillectomies is as high now as it was some years ago, and whether that might have anything to do with the change in provision.