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Health Services—Value for Money

Thursday 22 February 2007 Hansard source (external site)

Ryall3. Hon TONY RYALL (National—Bay of Plenty) Link to this
to the Minister of Health

Does he believe he is getting value for money in health; if so, where?

HodgsonHon PETE HODGSON (Minister of Health) Link to this

We are getting better value for money, but further improvement is always sought.

RyallHon Tony Ryall Link to this

Has he seen reports that a Te Kūiti primary health organisation practice is offering a cash bounty for people to enrol in the primary health organisation—inducements of $20 cash per person or $50 cash per family, and a prize draw of Warehouse vouchers—and is he satisfied that offering cash for clients is an ethical way of accessing public health subsidies?

HodgsonHon PETE HODGSON Link to this

My answer may be a little longer, if I may, Madam Speaker. The member will be aware that this health clinic has had longstanding financial and managerial problems; that it is under new management; and that, with the Waikato District Health Board, a marketing plan is in place to increase enrolments. The marketing plan involves many things—newsletters, public activities, open days, media publicity, and on it goes. Clearly, the health clinic went a step too far with its cash prizes. The district health board has already told it so—along with the Waikato primary health organisation, I would expect—and it will not do it again. There are two reasons to increase enrolments. The first is the viability of the health clinic. The second is as important. This part of the King Country has about 3,000 people who are not enrolled with anyone. That is out of a population of only 19,000. That is a very high proportion, and lots of people are intent on fixing it.

RyallHon Tony Ryall Link to this

That’s not right.

HodgsonHon PETE HODGSON Link to this

Yes, it is right.

TuriaTariana Turia Link to this

Tēnā koe, Madam Speaker, tēnātātou te Whare. Does the Minister believe he is getting value for money when it is alleged that patients normally required to stay overnight following surgery at Wanganui Hospital are discharged to motels, where family or health service providers are expected to care for them and return them to the hospital in the morning for post-operative examinations; and how safe is that practice?

HodgsonHon PETE HODGSON Link to this

I am not sure what the value for money of it is, nor am I sure of the safety of it, but I would be very happy to have the member raise the issue with me privately if she wishes. I am going to Wanganui in the next few weeks, I think.

HartleyAnn Hartley Link to this

Does the Minister know how this health clinic raised the prize money?

HodgsonHon PETE HODGSON Link to this

Yes I do. The prize money was raised at the local pig hunt where volunteers ran a canteen and sold raffles. Last night Mr Ryall rushed on to national television to breathlessly advise that the taxpayer would be upset. The taxpayer did not pay. Yet again he makes it up. Yet again he is wrong.

StewartBarbara Stewart Link to this

Can the Minister confirm that a significant amount of the increased health sector spending has gone towards paying nurses adequately in order to retain their skills here in New Zealand?

HodgsonHon PETE HODGSON Link to this

Yes I can, and as a result recruitment and retention of nurses in the New Zealand health sector has improved significantly. I am very proud of the pay increase to the New Zealand nurses who work for district health boards, and I thank them for their ongoing efforts.

RyallHon Tony Ryall Link to this

How is it that the Government’s policy rules allow primary health organisations or their practices to offer patients a cash bounty that gives the primary health organisation hundreds of dollars in taxpayers’ money for every person it has paid $20 or $50 to, which another primary health organisation has labelled discount marketing of health care?

HodgsonHon PETE HODGSON Link to this

This is a fast-moving portfolio. The member is not aware, apparently, that a stopper was put on that, weeks ago.

Hon Member

No.

HodgsonHon PETE HODGSON Link to this

Yes. Let me tell the member something else. Yesterday I had the opportunity or the pleasure of spending part of the day in my own electorate of Dunedin. There I found the Otago University health centre offering an iPod for registration. I doubt that the member would consider that unethical, and I wonder whether I might say carefully whether that is because it involves a very different demographic.

HartleyAnn Hartley Link to this

What value are New Zealanders getting from additional primary-care funding?

HodgsonHon PETE HODGSON Link to this

For mainstream New Zealanders—all of us—we are getting value for money from our primary health care strategy now. By and large what has happened is that a young family’s annual cost of going to a general practitioner has fallen from about $750 per year on average to about $200. An older couple who, on average, used to pay about $780 year, now pay about $340 a year—something to be proud of, I would say.

RyallHon Tony Ryall Link to this

Why, as this case demonstrates, does not he, as Minister, apply proper systems to the administration of this funding in the first place instead of spending days with his mop and bucket tidying up yet another mess he has created in the public health system?

HodgsonHon PETE HODGSON Link to this

The member continues to feign outrage. He should reflect on the fact that 94 percent of the enrolees in this practice are Māori, Pacific Island, and/or lowest deprivation profile. Some politicians use the word “underclass” to describe such a population and rush towards them with muesli bars. I would say that the member cannot have it both ways. Either his party has discovered what it calls an underclass and wants to brand itself as caring, or his party is prepared to take a swipe at those who are committed to the delivery of better health services to the so-called underclass whenever the opportunity arises. He cannot have it both ways.

RyallHon Tony Ryall Link to this

So is the Minister saying it is OK for a Māori primary health organisation to offer these sorts of inducements?

HodgsonHon PETE HODGSON Link to this

The member did not listen to my answer to his first supplementary question. It is not OK. It has been stopped. It ain’t gonna happen again.

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