6. Hon PETE HODGSON (Labour—Dunedin North) Link to this
to the Minister of Health
Will he take the final decision on the future configuration of South Island neurosurgery services if wide consensus cannot be reached; if not, why not?
Hon TONY RYALL
Mr SPEAKERI apologise for interrupting the Minister, but I say to the Labour Party front bench on this occasion that one of its colleagues asked a perfectly fair question on which there is considerable public interest. Before the Minister could say a word in answer there were numerous interjections from the Labour front bench. I ask members on the Labour front bench to please be a little more reasonable so that I do not have to force them to be a little more reasonable. I do not want to have to do that.
This is a hypothetical question. As the member well knows, all of the South Island district health boards agreed to ask the Director-General of Health to arbitrate on the best configuration of neurosurgical services for the South Island, and the director-general has set up an expert panel to advise him on the matter.
Is the Minister aware that the Acting Director-General of Health has stated publicly that the final decision is the acting director-general’s to make, not the Minister’s; if so, does he agree or disagree?
It is correct that all of the South Island district health boards have asked the Director-General of Health to arbitrate the decision on the configuration of neurosurgical services, which indicates that they will stand by that decision. The challenges facing neurosurgery in Dunedin have a long history. The Dunedin unit had three neurosurgeons until October 2006, when one of the three neurosurgeons resigned. There was a further resignation in early 2008, then the sole remaining neurosurgeon resigned just before the election to move to Christchurch. Dunedin has maintained its service by using locums and the support of Christchurch.
I raise a point of order, Mr Speaker. I wonder whether you believe that the question has been addressed. I remind you that I am seeking the Minister’s advice as to whether his acting director-general is correct or not correct in asserting publicly that it is the acting director-general’s final decision to make, not the Minister’s.
I believe that the Minister did in his answer say that he understood that the decision of the director-general would be accepted by the district health boards. I believe that that is a reasonable answer to the question.
In the event of wide consensus not being reached on the future configuration of neurosurgical services in the South Island, is it his intention to take the issue to Cabinet at any point?
That is a hypothetical question. The district health boards have inherited a situation whereby Dunedin has lost three neurosurgeons in 3 years. The district health boards are now looking at, and have agreed on, a whole-of-the-South-Island service, and a panel has been established to advise the director-general, who has been asked to arbitrate. I think that everybody in this process would want to ensure that there is a safe and reliable service for the people of Otago, Southland, and the rest of the South Island.
Is he therefore leaving open the possibility that a final decision on the future configuration of neurosurgical services in the South Island may be made by an unelected official; if so, what does that say about his accountability?
As that member would know, wherever a decision is made in the public health service, and by whomever, the Minister of Health always has to stand up in Parliament and give an answer. But let us be clear here: the South Island district health boards cannot agree on how the service should be configured, and the doctors cannot agree on how the service should be configured, so they have asked the director-general to arbitrate and make that decision on their behalf.
How is the Minister able to consider himself an accountable Minister, when perfectly reasonable media inquiries to his office are deflected routinely to officials, when countless communications to his office have gone unanswered, and when he declines to become involved in one of the most important decisions his portfolio faces?
This is indeed an important matter, because when that member was a Minister three neurosurgeons left the service in Dunedin. We have got to a situation where Dunedin is relying on locums and support from Christchurch. The district health boards have now agreed they should have a whole-of-the-South-Island service, but they cannot agree on how it should be configured, and the doctors cannot agree, so they have asked the director-general to arbitrate on their behalf.