6. Hon TONY RYALL (National—Bay of Plenty) Link to this
to the Minister of Health
Is he satisfied with the level of hospital productivity and why?
Hon PETE HODGSON (Minister of Health) Link to this
I regret I cannot answer the member’s question because we cannot yet reliably measure productivity. However, we are making good progress in developing a variety of productivity indicators for the future.
What is wrong with the health system when official Treasury reports calling for value for money in the health sector show that hospital performance has plummeted during Labour’s term in office, with the reports suggesting that almost $3 of extra spending is now needed to get $1 of extra benefit for Kiwi patients?
The member, as usual, selectively quotes. What the Treasury report found was not that productivity has gone down, up, or sideways, but that productivity is difficult to measure. Let me just quote back to the member the substantive finding from the paper in question. Treasury states: “This research is useful as a case study that underlines how little is known about public sector activity.”
Sue MoroneyDoes he think that productivity means having fewer staff working harder for longer, or does the Government take a more enlightened approach?
The latter, I can assure the member. During the 1990s the National Government’s view was that productivity was about putting a competitive market model at the core of the health system, shifting costs on to individuals through part-charging, and deflating salaries. National’s aim was to have doctors and nurses running ever faster down corridors. The Labour-led Government, however, knows that achieving higher productivity involves better training, better facilities, and better technology. We are delivering just that.
Has the Minister read the Treasury report that states quite distinctly that hospital efficiency has fallen by 8 percent in a 3-year period, and, further, has he seen the Treasury report that states: “Although there has been an increase in staff numbers, hospital outputs have not increased commensurately.”, and “Output per full-time doctor and nurse has reduced.”; and could he explain to the House how come we have more doctors and nurses but less treatment?
Again, the member quotes selectively. He has not read out to the House the blizzard of caveats around the finding that the data may be wrong, that the quality may have improved, etc. In other words, for example, Treasury measured how many people were discharged from hospital but did not measure how many of them went on to live. Some of the things about productivity need to be examined a little more carefully than the member would have us believe.
How is it that Labour can put $4 billion extra into the health system and deliver fewer elective operations, fewer specialist appointments, and fewer day-stay operations, and call that a success?
The member straightforwardly makes it up as he goes along. I can say to the member, for example, in the totality of medical discharges, that it has increased by a third or more since the change of Government—and that is the bulk of the work that goes on in our hospitals. The member makes assertions repeatedly in the belief that someone will believe him; I do not.
Does he think that New Zealanders can be confident that the substantial additional resources that have gone into the health system have produced the best results for citizens?
I think the member now makes a good point, which is that if we cannot measure productivity in our health system—or, indeed, elsewhere in our public sector—then we should attempt harder to do so. This Government does not lack initiative in this regard. We are keen to measure productivity. We want to know that the taxpayer’s dollar is spent in the best way, and, in the case of the health system, I will repeat to the member that we are making good progress.
Does he stand by his statement: “One of my priorities for the health sector is achieving value for money …”, and can he explain how employing 2,000 extra hospital managers and administrators in the last 6 years is giving New Zealanders value for money for that extra $4 billion?
Again, the member quotes selectively. He says that we have this number of managers and administrators, but forgets to tell the House that on top of that we have 5,000 more doctors and nurses. I wonder which of those administrators the member would not employ. Would the member not employ the administrator who pays the staff? Would the member not employ the administrator who rings people to come in for the out-patient clinic? Would the member not employ the administrator who records the work done so that we can measure productivity? Which of those administrators would the member not employ, and would he like to tell the House whether the health system would be better off for that? The long and short of it is that this health system is bigger and better than it was when he was in Cabinet.
In light of the fact that the Government says that there is no problem, I seek leave to table nine detailed reports from Treasury showing that there is less being produced with more under the Hodgson health system.
Madam SPEAKER