<&>Wellington Corpus of Spoken New Zealand English Version One <&>Copyright 1998 School of Linguistics & Applied Language Studies <&>Victoria University of Wellington <&>side one <&>19:32 mister chairman i want to start my remarks by giving my thanks to the director general of health and his staff sir for their work in a very busy year in the health sector a year of considerable change there's been a lot of restructuring the move to the area health board system change within the department itself sir it has been a busy year and i pay tribute to staff for the considerable assistance they have given to me throughout that i also pay tribute <&>20:00 to the work of our area health boards to the very fine people we have who put themselves forward for election and appointment to those boards i mention particularly doctor beasley the chairman of the health boards' new zealand association which has superseded the hospital boards' association and thank him for the advice which he regularly gives me on the state of the area health boards sir and i also pay tribute to those many many thousands of new zealanders who work in the health service and do a very good job sir now it's always interesting to listen to the national party on health got a new slogan tonight a new slogan tonight and i say to them sir if if people think if people think that their slogan might have any merit wait till the national party get a go sir <&>21:00 and bring absolute chaos this is a party which in the time that i've been minister of health round about thirteen months sir has promised first to spend more on health then the same and spend it differently and now it's less sir plenty of evidence that the national party spends to its voc plans to spend less on health the member for albany only may last sir the national party has never promised more money for health it has consistently said that savings could be made in the existing system sir the member for raglan if national became the government it would be forced to cut state spending in health welfare and education now we know about their plans sir we know about the two billion dollar gap the round table's telling the country about the two <.>do billion dollar gap between promises and reality sir and <{1><[1>the poor old health system sitting there like a sucker for them if they got their way sir and people will see right through that they will see through the emptiness of promising more then the same then less then gibbs then moaning about the closure of some hospitals and ignoring the fact that the <.>and arthur anderson report on which the gibbs report which they've accepted was based involved the closure of another forty six hospitals and i ask the member for pahiatua to seriously consider whether the hospital that he visited was going to survive under those circumstances sir other members like the member for awarua the member for rangiora all sorts of members sir who trot around the country saying the gibbs report's has got the answer and then they want their little hospital saved despite anything the arthur anderson report had to say about that sir i say their position is hypocritical and they ought to work out what <&>23:00 embracing the gibbs report means it means chaos in our health system sir and that is what they have promised now the member for albany sir feels so strongly about the public health system that when i announced a service development grant for the auckland board recently he said complete waste of money he said why don't you sign the money out to the private hospitals cos they can do a cheaper <{2><[2>service a clear ideological <{3><[3>statement he'd rather the work went out to the private and the public the taxpayer paid for it sir and i direct him to the evidence coming in from overseas now which shows that there are no automatic savings to be assumed when you contract out that work certainly the british health service is showing that that is not the <&>24:00 case it is showing that it can be two to three times as much and i ask them sir to <{4><[4>make a few enquiries around the new zealand health service and ask where they have <{5><[5>contracted out surgery at savings because i know of no evidence i'm not opposed not opposed sir to area health boards putting their premises their staff through the exercise of fully costing and seeing whether it could be done cheaper elsewhere but i'm not going to stand here like the member for albany will and claim that the private sector always does it better because that is his basic position now i'm glad the member for albany albany i stress mentioned the hepatitis b programme because that sir is something that this government has put an immense amount of effort into slowly we now <&>25:00 have every child under sixteen covered by it we have done the newborns sir we have a programme <{6><[6>covering the sexual contacts and household partners mister <{7><[7>chairman household partners of hepatitis b carriers sir and this year the course the programme was extended to take in all the school aged children sir voc and i believe that we are going to get on top of the spread of that dreadful disease in new zealand because this government has put its money where its mouth is sir i want to thank the member for glenfield for her most constructive speech most constructive speech about the health services and particularly for what she said about auckland because the auckland health service sir has made a remarkable recovery that was a service which was on its knees it was a service <&>26:00 which in nineteen eighty eight suffered badly from the revelations in the cartwright report it suffered badly from what was in the mason report it suffered badly from the controversy over the whare kaia and that was topped off sir by a financial crisis where the board simply <.>cad could not carry on decisive moves were made to bring in a commissioner i commend mister titter for doing a tremendous job with the auckland area health board and showing sir <{8><[8>that you CAN get value for money from the public health system with logical organisation sir and mister titter did a marvellous job for auckland now the member for glenfield spoke as a north shore member and perhaps the member for albany might also like to give credit give credit sir for <&>27:00 what has been done for the north shore in the wake of the titter reorganisation because as the member for glenfield pointed out north shore has an upgraded obstetrics service it has more surgical services it has extended accident and emergency hours sir all things that were able to happen as the health service in auckland was reorganised to take account of the fact that the population wasn't solely centred on the isthmus but in fact spread out to the west and the north and the people out there deserved more services and they got it from the reorganisation swallows the same can be said of west auckland the member for glenfield asked about progress with cervical screening she asked how much money had been <.>a put aside for it this year money put aside sir was fourteen million in the current financial year eleven point eight million for the next and sir i <&>28:00 believe that already the greatly increased awareness of the need for cervical screening is bringing many more women forward to have that basic preventive health check and i expect that we will in this country see the numbers of women dying of that very largely preventable cancer declining quite dramatically because this government has been prepared to putey <&>blend of put and money with its put its money where its mouth is on that one sir the member for glenfield asked about the health commissioner i intend to introduce legislation this year for a health commissioner and a patient advocate system and i hope sir that it will get the support of the opposition it was something which was recommended in the cartwright report and something which i believe is broadly supported in the community the <&>29:00 member for glenfield also asked what other funding initiatives have been taken this year and i refer her of course to the recommendations in the mason report on psychiatric services to the need for more safe care <{9><[9>centres for mental health patients sir and of course the money has been voted for that and the first ones are starting to be constructed in auckland and elsewhere sir now the member for waipa mentioned as i clearly predicted that opposition members would the accident and emergency services sir that of course is a matter of concern that people at time of accident and emergency should have access to proper services and it is my intention that even where boards determine that they should provide only for serious <&>30:00 emergencies that they must ensure that before moving to that situation there are adequate services in place sir it might be a laugh but i actually found it very funny when the member for albany came along came along talked about a man turned away who'd been gashed it turned out he'd been grazed and the appropriate treatment was a bandaid so that the sooner he gets his facts straight about some of these things the better sir but i can tell you that on my instruction guidelines <{10><[10>are being issued to the area health boards <[1>order <&>22:00 <[2>order <[3>order <[4>order <[5>order <[6>order order <[7>right honourable helen clark <[8>order order <[9>order <[10>order order order which will provide as follows order that the base hospitals of course one has the power to instruct on section thirty seven don't be ridiculous the member for albany's a ridiculous member who knows very little about health sir <.>m mister chairman the guidelines will <{1><[1>provide that accident and <{2><[2>emergency cases must be <&>31:00 available for serious cases at all times that boards must ensure that where their hospital accident and emergency services for serious emergencies only there must be suitable and accessible round the clock g p or other services to handle the minor complaints they must ensure that medical and nursing staff will assess all cases before a treatment or referral decision is made and they should sir immediately review their public education programme for those services and take steps to educate the clients and the g ps about the alternative services sir now that is an example of clear guidelines being given i believe the boards will live up to them sir and i expect a good service to be provided <{3><[3>by our accident and emergency services <[1>clears throat <[2>the right honourable helen clarke <[3>clears throat mm yeah point of order roger mclay no <{><[>no the time <[>five thirty's come chop her off she's hopeless <&>31:55