10. KEVIN HAGUE (Green) Link to this
to the Minister of Health
How many operating theatres in publicly owned New Zealand hospitals worked at full capacity in the 2007-08 year?
Hon Dr JONATHAN COLEMAN (Associate Minister of Health) Link to this
The definition of full capacity is a complex matter. However, there has been significant modelling done to assess operating theatre utilisation rates. Although the work is ongoing, it is fair to say it shows in general that city-based theatres are approaching optimal utilisation rates, while many rural operating theatres are not.
Is the Minister aware that the Ministry of Health has assessed operating theatre utilisation in New Zealand public hospitals and found that 10 out of 26 have been used at less than 60 percent capacity, while just four have been used at full capacity?
Hon Dr JONATHAN COLEMAN Link to this
Well, the member is right in that we need greater productivity from existing theatres, and the new Government sought advice from the ministry regarding the need for new operating theatres. Even assuming we get greater productivity, New Zealand would still need around 20 to 26 more theatres over the next 18 years to meet a huge rise in elective surgery need because of population growth, population ageing, and a large amount of unmet elective need. We need to raise productivity in existing theatres, but we need to do more again on top of that.
Dr Paul Hutchison Link to this
Why has the Government committed to building 20 additional elective operating theatres?
Hon Dr JONATHAN COLEMAN Link to this
Over the last 8 years the average increase in the number of patients getting elective surgery each year was a slow average 1,400. This was below the rate of increase in the population and took no account of extra operations needed to meet population ageing or unmet need. In short, access to elective surgery was cut in real terms, and that was why the then Government resorted to culling thousands of people from waiting lists. New Zealand needs to lift its elective surgery rate by around 50 percent by 2026 if we are to meet population growth and address unmet need. That is around 4,000 more operations each year, and that is why we have to build those extra theatres.
Before deciding to encourage district health boards to contract out more surgery to the private sector, what evidence did the Minister have about operating theatre use in New Zealand public hospitals, given that he was unable to provide any when he appeared before the Health Committee just 1 month ago?
Hon Dr JONATHAN COLEMAN Link to this
We had evidence from a number of district health boards, most notably the West Coast District Health Board, of which that member was the chief executive officer for a number of years. They must have been at full capacity down there, because that member was responsible for culling 300 patients from the waiting list back in 2006. We looked at the evidence and, as I outlined in my previous answers, there is clear evidence that the new theatres need to be built.
I raise a point of order, Mr Speaker. I asked a straight question about the evidence that the Minister had prior to making the decision, given that there was no evidence provided at the Health Committee meeting. The Minister has not responded at all to that point.
Mr SPEAKERWith respect, I think the Minister has cited evidence. It may not have been the evidence the member was seeking, but I think the Minister cited evidence that guides his thinking on the matter.
Hon Dr JONATHAN COLEMAN Link to this
That is an interesting question. I believe that is a decision for the individual to make.
Is it not absolutely clear, given the Minister’s evidence-free, headlong rush into greater private sector provision of surgery, and his unwillingness to answer a straight question about his own attitude to health insurance, that his Government is hell-bent on greater privatisation in the New Zealand health sector?
Hon Dr Nick Smith Link to this
I raise a point of order, Mr Speaker. You have raised concerns about Ministers in respect of the tone of their answers. There were three highly loaded statements in that question, suggesting dishonesty of Ministers, misrepresentation, and hidden agendas. If members want to ask questions, the Standing Orders clearly state they are not to include such statements.
Dr Russel NormanAll my colleague said was “unwillingness”; he never made any allegations about dishonesty or any of the matters the member raised. He simply spoke of the Minister’s “unwillingness to answer”. That is not a pejorative statement and it is not an abusive statement; it is just a statement of fact that the Minister has an unwillingness to answer the question.
Hon Trevor MallardI do not need to hear any further on this matter. In fairness, I say that the question did not contain excessive inferences that could have caused offence. What is more, one has to try to balance things in this House, and the honourable member who raised the point of order may reflect that the Minister, in answering an earlier question, was not exactly without some criticism in his answer. Members cannot have it all one way. I think the Minister should answer the question from Kevin Hague.
Hon Dr JONATHAN COLEMAN Link to this
What I will say is that if that member had managed to break out of his ideological shackles and had thought about the needs of the people of the West Coast at the time, he might have been prepared to use capacity in the private sector to get operations for those 300 people he culled off the West Coast District Health Board waiting list.