7. Hon RUTH DYSON (Labour—Port Hills) Link to this
to the Minister of Health
Does he stand by his commitment to move health resources to the front line?
Hon TONY RYALL (Minister of Health) Link to this
Yes, especially so when the outgoing Labour Government slashed $150 million out of health just before the election. It left district health boards on a track towards financial crisis, with around $160 million of deepening deficits. But the good news is that the new Government—
Mr SPEAKERThe question asked was actually a very simple question, Mr Ryall, and I think that you answered it fairly early on.
Su’a William SioDoes the Minister agree with front-line staff at the Counties Manukau District Health Board, who warn that health cuts will reduce participation in health programmes by most at-risk groups?
The Counties Manukau District Health Board has carried out a major review of all its contracts, using a systematic approach that aims to put funds closest to the front line and reduce duplication. I am advised, for example, that in a number of Māori provision programmes the service contracts have increased by an overall 42 percent this year, and one of the reasons that the board has been able to do that is a Government funding increase of $66 million, or 7 percent, despite the fact that the previous Government cut $113 million from programmes last year.
Did the Minister sign his name to slashing $4.8 million for diabetes checks before or after he posed for photographs with front-line diabetes and renal services staff at Counties Manukau District Health Board?
That member might not realise this, but his party quietly, before the last election, cut over $3 million from diabetes programmes and $10 million from chronic care. I tell the member that the saving he refers to did not affect any front-line service, at all.
Hon Pete HodgsonI raise a point of order, Mr Speaker. The issue is whether the supplementary question was addressed, and I give a little reminder that the question was phrased about timing: whether the Minister had cut funding before or after a certain event. The Minister has to address that issue of timing, or his alternative is to say that the question is wrong in its construction. He has done neither of those things, and I think he should be invited to do so.
The member will see that in two recent answers I have stopped the Minister because I believed he was going over the top, and I asked another Minister to answer a question. If the Minister believes that that part of that question was crucial in terms of the public interest, then forgive me; I must be in the wrong place. As far as I was concerned, the Minister answered the question in a reasonable manner.
Does the Minister understand that thousands of undiagnosed diabetics will stay unaware of their condition unless they are checked by front-line health workers, or will he rely on the emergency front-line health workers to treat them when their condition overtakes them?
I think that is a very relevant question, and that condition is a matter that the Government is putting resources into. It is a shame that the member did not ask those questions when the colleague who is sitting near her cut $3.3 million from the “Get Checked” Diabetes Aotearoa programme; cut $17.5 million from primary health organisation performance programmes, which encouraged that diabetes work; and cut $10 million from a funding pool for people with disabling medical conditions. It is all very well for members opposite to take about what may or may not happen under National, but they do not want to talk about what the previous Government got up to.
Does the Minister share the concern of senior doctors that his insistence on moving some hospital services to primary care has serious risks of clinically inappropriate transfers being made?
This Government is seeking to implement the Primary Health Care Strategy, which members opposite think is so fantastic. Fundamental to that strategy is that there should be more hospital-based services in the community. Of course, there are always issues of clinical sustainability, and those are what this Government is tackling. For example, we are tackling the problems we have inherited at the Whanganui District Health Board, where we have real problems with maintaining our workforce and maintaining services. But at least this Government is prepared to deal with them.
Jo GoodhewWhat significant announcements is the Minister able to make that support front-line services in public hospitals?
Junior doctors are important members of the team that delivers front-line services in our hospitals. This afternoon I will be releasing the report of the RMO (Resident Medical Officer) Commission, chaired by a former State Services Commissioner, Don Hunn. The commission’s report paints quite a grim picture of junior doctors’ experience in our public health system and calls for immediate change. Some research, for example, suggests that junior doctors spend 80 percent of their day doing work for which a medical degree is not necessary. The report calls for urgent improvements to the apprenticeship model and calls for a single, national training body to ensure the training and apprenticeship model drives junior doctor experience.
Does the Minister believe that patients of the MidCentral District Health Board, Whanganui District Health Board, Taranaki District Health Board, South Canterbury District Health Board, Tairāwhiti District Health Board, Counties Manukau District Health Board, Otago District Health Board, and Southland District Health Board, as well as those patients who are affected by the Minister’s cuts to mental health services and diabetes and cardiovascular services, are receiving the “more convenient health service” he promised?
This Government is tackling incredibly big problems that were inherited from the previous Government. That Government cut $150 million from the health budget, very quietly, before the last election. It cut over $110 million of programmes last year, and members opposite do not want New Zealanders to know that this Government has to deal with Labour’s legacy of mismanagement of the New Zealand public health service.
What action is the Government taking to respond to concerns about the front-line health services that are detailed in the report of the RMO (Resident Medical Officer) Commission, given that endless reports have called for the rationalisation of the funding and planning of health workforce training and for focusing resources on the front line?
It is correct that we have inherited a disjointed and uncoordinated set of resources to deal with the serious and longstanding health workforce crisis. Over the years a raft of reports has been critical of this duplication. The Government is responding to these calls by establishing a Clinical Training Agency board to unify workforce planning in New Zealand. The purpose of the board is to work with the Government to rationalise the myriad of committees, structures, and work groups involved in the funding and planning of health workforce training, to improve front-line services. That training will ultimately be consolidated within the Clinical Training Agency. The Medical Training Board has been disestablished.
What reports has the Minister seen about district health boards and their decisions about how they allocate their funds in relation to services?
I have seen a range of reports about the need for district health boards to live within their means. Some of those reports are from Michael Cullen, the previous Minister of Finance, and some are from Annette King, the previous Minister of Health. But probably the most interesting report is one by an Associate Minister who, in July 2004, was defending claims of negligence by the Wellington City Mission relating to the funding for aged care. The then Associate Minister said the way that district health boards allocated funding was not her responsibility. That Associate Minister was Ruth Dyson, yet she stands up every day in this House to ask the Government to take responsibility, when she never would.