<I>

  <&>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</&>
  

  <WSC#DGU003:0005:HC>
      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

  <WSC#DGU003:0010:HC>
      a year of considerable change

  <WSC#DGU003:0015:HC>
      there's been a lot of restructuring

  <WSC#DGU003:0020:HC>
      the move to the area health board system

  <WSC#DGU003:0025:HC>
      change within the department itself sir

  <WSC#DGU003:0030:HC>
      it has been a busy year and i pay tribute to staff for the
      considerable assistance they have given to me throughout that

  <WSC#DGU003:0035:HC>
      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

  <WSC#DGU003:0040:HC>
      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      boards' new zealand association which has superseded the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

  <WSC#DGU003:0045:HC>
      and i also pay tribute to those many many thousands of new
      zealanders who work in the health service and <slowly>do a very
      good job sir</slowly>

  <WSC#DGU003:0050:HC>
      now it's always interesting to listen to the <laughs>national
      party</laughs> on health

  <WSC#DGU003:0055:HC>
      got a <laughs>new slogan tonight a new slogan tonight</laughs>

  <WSC#DGU003:0060:HC>
      and i say to them sir if if people think if people think that
      their slogan might have any merit wait till the <laughs>national
      party get a go</laughs> sir <&>21:00</&> and bring absolute
      chaos

  <WSC#DGU003:0065:HC>
      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

  <WSC#DGU003:0070:HC>
      plenty of evidence that the national party spends to its <O>voc</O>
      plans to spend less on health

  <WSC#DGU003:0075:HC>
      the member for albany only may last sir <quotes>the national
      party has never promised more money for health

  <WSC#DGU003:0080:HC>
      it has consistently said that savings could be made in the
      existing system</quotes> sir

  <WSC#DGU003:0085:HC>
      the member for raglan <quotes>if national became the government
      it would be forced to cut state spending in health welfare and
      education</quotes>

  <WSC#DGU003:0090:HC>
      now we know about their plans sir

  <WSC#DGU003:0095:HC>
      we know about the two billion dollar gap

  <WSC#DGU003:0100:HC>
      the round table's telling the country about the two <.>do</.>
      billion dollar gap between promises and reality sir and <{1><[1>the
      poor</[1> old health system sitting there like a sucker for them
      if they got their way sir

  <WSC#DGU003:0105:HC>
      and people will see right through that

  <WSC#DGU003:0110:HC>
      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

  <WSC#DGU003:0115:HC>
      and i ask the member for pahiatua to seriously consider whether
      the hospital that he visited was going to survive under those
      circumstances sir

  <WSC#DGU003:0120:HC>
      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 <laughs>got the answer</laughs> and then they
      want their little hospital saved despite anything the arthur
      anderson report had to say about that sir

  <WSC#DGU003:0125:HC>
      i say their position is hypocritical and they ought to work out
      what <&>23:00</&> embracing the gibbs report means

  <WSC#DGU003:0130:HC>
      it means chaos in our health system sir and that is what they
      have promised

  <WSC#DGU003:0135:HC>
      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

  <WSC#DGU003:0140:HC>
      he said why don't you sign the money out to the private
      hospitals cos they can do a cheaper <{2><[2>service</[2>

  <WSC#DGU003:0145:HC>
      a clear ideological <{3><[3>statement</[3>

  <WSC#DGU003:0150:HC>
      he'd rather the work went out to the private and the public the
      taxpayer paid for it sir

  <WSC#DGU003:0155:HC>
      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

  <WSC#DGU003:0160:HC>
      certainly the british health service is showing that that is not
      the <&>24:00</&> case

  <WSC#DGU003:0165:HC>
      it is showing that it can be two to three times as much and i
      ask them sir to <{4><[4>make</[4> a few enquiries around the new
      zealand health service and ask where they have <{5><[5>contracted
      out</[5> surgery at savings because i know of no evidence

  <WSC#DGU003:0170:HC>
      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

  <WSC#DGU003:0175:HC>
      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

  <WSC#DGU003:0180:HC>
      slowly

  <WSC#DGU003:0185:HC>
      we now <&>25:00</&> have every child under sixteen covered by it
      we have done the newborns

  <WSC#DGU003:0190:HC>
      sir we have a programme <{6><[6>covering the sexual</[6>
      contacts and household partners mister <{7><[7>chairman
      household</[7> partners of hepatitis b carriers sir

  <WSC#DGU003:0195:HC>
      and this year the course the programme was extended to take in
      all the school aged children sir <O>voc</O> 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

  <WSC#DGU003:0200:HC>
      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

  <WSC#DGU003:0205:HC>
      because the auckland health service sir has made a remarkable
      recovery

  <WSC#DGU003:0210:HC>
      that was a service which was on its knees

  <WSC#DGU003:0215:HC>
      it was a service <&>26:00</&> which in nineteen eighty eight
      suffered badly from the revelations in the cartwright report

  <WSC#DGU003:0220:HC>
      it suffered badly from what was in the mason report

  <WSC#DGU003:0225:HC>
      it suffered badly from the controversy over the <indig=Maori><?>whare
      kaia</?></indig=Maori>

  <WSC#DGU003:0230:HC>
      and that was topped off sir by a financial crisis where the
      board simply <.>cad</.> could not carry on

  <WSC#DGU003:0235:HC>
      decisive moves were made to bring in a commissioner

  <WSC#DGU003:0240:HC>
      i commend mister titter for doing a tremendous job with the
      auckland area health board and showing sir <{8><[8>that you CAN
      get</[8> value for money from the public health system with
      logical organisation sir

  <WSC#DGU003:0245:HC>
      and mister titter did a marvellous job for auckland

  <WSC#DGU003:0250:HC>
      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 <laughs>sir</laughs> for <&>27:00</&> what has been
      done for the north shore in the wake of the titter
      reorganisation

  <WSC#DGU003:0255:HC>
      because as the member for glenfield pointed out north shore has
      an upgraded obstetrics service

  <WSC#DGU003:0260:HC>
      it has more surgical services

  <WSC#DGU003:0265:HC>
      it has extended accident and emergency hours sir

  <WSC#DGU003:0270:HC>
      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
      <O>swallows</O>

  <WSC#DGU003:0275:HC>
      the same can be said of west auckland

  <WSC#DGU003:0280:HC>
      the member for glenfield asked about progress with cervical
      screening

  <WSC#DGU003:0285:HC>
      she asked how much money had been <.>a</.> put aside for it this
      year

  <WSC#DGU003:0290:HC>
      money put aside sir was fourteen million in the current
      financial year

  <WSC#DGU003:0295:HC>
      eleven point eight million for the next

  <WSC#DGU003:0300:HC>
      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

  <WSC#DGU003:0305:HC>
      the member for glenfield asked about the health commissioner

  <WSC#DGU003:0310:HC>
      i intend to introduce legislation this year for a health
      commissioner and a patient advocate system

  <WSC#DGU003:0315:HC>
      and i hope sir that it will get the support of the opposition

  <WSC#DGU003:0320:HC>
      it was something which was recommended in the cartwright report
      and something which i believe is broadly supported in the
      community

  <WSC#DGU003:0325:HC>
      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</[9> for
      mental health patients sir

  <WSC#DGU003:0330:HC>
      and of course the money has been voted for that and the first
      ones are starting to be constructed in auckland and elsewhere
      sir

  <WSC#DGU003:0335:HC>
      now the member for waipa mentioned as i clearly predicted that
      opposition members would the accident and emergency services sir

  <WSC#DGU003:0340:HC>
      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

  <WSC#DGU003:0345:HC>
      it might be a laugh but i actually found it very funny when the
      member for albany came <laughs>along</laughs> came along

  <WSC#DGU003:0350:HC>
      talked about a man turned away who'd been gashed it turned out
      he'd been grazed and the appropriate treatment was a bandaid

  <WSC#DGU003:0355:HC>
      so that the sooner he gets his facts straight about some of
      these things the better sir

  <WSC#DGU003:0360:HC>
      but i can tell you that on my instruction guidelines <{10><[10>are
      being issued</[10> to the area health boards <latch>

  <WSC#DGU003:0365:XS>
      <[1>order</[1></{1> <&>22:00</&>

  <WSC#DGU003:0370:XS>
      <[2>order</[2></{2>

  <WSC#DGU003:0375:XS>
      <[3>order</[3></{3>

  <WSC#DGU003:0380:XS>
      <[4>order</[4></{4>

  <WSC#DGU003:0385:XS>
      <[5>order</[5></{5>

  <WSC#DGU003:0390:XS>
      <[6>order order</[6></{6>

  <WSC#DGU003:0395:XS>
      <[7>right honourable helen clark</[7></{7>

  <WSC#DGU003:0400:XS>
      <[8>order order</[8></{8>

  <WSC#DGU003:0405:XS>
      <[9>order</[9></{9>

  <WSC#DGU003:0410:XS>
      <[10>order order</[10></{10>

  <WSC#DGU003:0415:XS>
      order <latch> which will provide as follows <latch>

  <WSC#DGU003:0420:XS>
      order <latch> that the base hospitals

  <WSC#DGU003:0425:HC>
      of course one has the power to instruct on section thirty seven

  <WSC#DGU003:0430:HC>
      don't be ridiculous

  <WSC#DGU003:0435:HC>
      the member for albany's a ridiculous member who knows very
      little about health sir

  <WSC#DGU003:0440:HC>
      <.>m</.> mister chairman the guidelines will <{1><[1>provide</[1>
      that accident and <{2><[2>emergency cases</[2> 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

  <WSC#DGU003:0445:HC>
      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

  <WSC#DGU003:0450:HC>
      now that is an example of clear guidelines being given

  <WSC#DGU003:0455:HC>
      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</[3>

  <WSC#DGU003:0460:XS>
      <[1><O>clears throat</O></[1></{1>

  <WSC#DGU003:0465:XS>
      <[2>the right honourable helen clarke</[2></{2>

  <WSC#DGU003:0470:XS>
      <[3><O>clears throat</O> mm yeah</[3></{3> point of order

  <WSC#DGU003:0475:XS>
      roger mclay

  <WSC#DGU003:0480:XS>
      no <{><[>no the time</[>

  <WSC#DGU003:0485:RM>
      <[>five thirty's come</[></{> chop her off

  <WSC#DGU003:0490:RM>
      she's hopeless <&>31:55</&>
</I>
