5. Hon RUTH DYSON (Labour—Port Hills) to the Minister of Health: What front-line health services are being cut?

Hon TONY RYALL (Minister of Health) : Front-line services overall are being increased, despite the significant financial challenges that face the country. As we move to fix our hospitals and take the public health service off the track to financial crisis, the Government has always said some programmes will be changed. Given that thousands of health services are delivered to over a million New Zealanders every year, it is not possible to determine all services that may have changed for these individuals. There is more money, and more front-line services are being delivered.

Hon Darren Hughes: I raise a point of order, Mr Speaker. That was a question on notice to the Minister of Health about front-line health services. Although we accept that he said there are thousands of cases that could not go through in terms of cuts to those front-line services, he must surely be able to offer something to the House for a question that was on notice, if there has been a reduction in front-line services.

Mr SPEAKER: I believe the Minister’s answer was perfectly in order. He argued that from his perspective, there was increased funding for more front-line services. It is a perfectly fair answer to dispute the question that was asked.

Hon Ruth Dyson: When he labelled cuts to home help for the elderly as a change, does he think that older New Zealanders who, 6 months ago, had their home help reduced will now congratulate him on the change announced by the Otago and Southland district health boards that will see 3,000 older people across that region have their home support completely cut?

Hon TONY RYALL: I have rung the chief executive of the Otago and Southland boards, and he advises me that everyone will be offered an assessment. While people await their assessment, their home cleaning hours will be maintained. We are dealing with a legacy of neglect at the Otago and Southland district health boards. The previous Government left those district health boards with over $20 million of unfunded services, which we have to fill.

Hon Jim Anderton: After explaining to the House on 13 October last year that cuts by the Canterbury District Health Board to home services for the elderly would not result in any less money being spent on home help by that board, what does he say now that the Otago and Southland boards are going through exactly the same cuts in order to save about $4 million a year, with further cuts to personal care and home assistance in the pipeline?

Hon TONY RYALL: In respect of the Canterbury situation, I think the member will be aware that although a number of people have been reassessed and have lost their home cleaning support, a significant number have actually had increases as a result of that process.

Hon Jim Anderton: Is the Minister aware that many of the elderly people affected by these cuts, many of them aged between 85 and 90, now have to pay between $25 and $35 per week for the same service that had previously been provided by the district health board, and that these extra costs impose a very heavy burden on our most vulnerable citizens?

Hon TONY RYALL: If the member has a specific instance of a case that he would like me to look into, I would be more than happy to do that. But if the member looks at Otago and Southland, he will see that the Government has increased the funding for those two district health boards by $28 million this year. That is a 4.4 percent increase. It compares with the $21 million increase they got under the last year of the previous Labour Government. We have inherited a very difficult situation in Otago and Southland, and we are endeavouring to fill the gap in unfunded services. That, frankly, is essential to securing services for people in those district health boards.

Hon Ruth Dyson: Does the Minister understand that for some older New Zealanders, having 1 or 2 hours’ home support a week is all that stands between them staying safely in their own home or having to move into a rest home; if so, how will he explain to those who are being forced out of their own home that this cut is just a change for them?

Hon TONY RYALL: If the member sincerely wants me to investigate a case of someone being forced out of his or her home as a result of this change, then I would be happy to look into it, as I do for other colleagues in her party. But I need to tell the member that I have been assured by all the district health boards involved that no one will be unsafe or unable to stay in his or her home as a result of these changes.

Dr Paul Hutchison: Could the Minister tell us again how much more in resources this Government has provided to Otago District Health Board and Southland District Health Board; and why, with this increase, are some services being re-examined?

Hon TONY RYALL: This financial year the National-led Government increased the funding for the Otago and Southland district health boards by $28 million, or 4.4 percent—

Hon Darren Hughes: Then why are there cuts?

Hon TONY RYALL: The member opposite asks why the changes are occurring. Well, although the previous Government increased the budgets of those boards by $21 million a year earlier, we have inherited from that Government a rapidly worsening financial position at those district health boards, with unfunded services of over $20 million. We are endeavouring to fill this gap steadily over the years with increased funding, because that is essential in order to secure the future of health services in Otago and Southland.

Hon Ruth Dyson: Is the Minister satisfied that the decision to cut domestic assistance to 3,000 residents in Otago and Southland—that is, doing laundry, house cleaning, shopping, and meal preparation—without any assessment of those people’s needs is fair?

Hon TONY RYALL: First of all, I am advised that meal preparation is unaffected by these changes. I can also tell the member, as I said earlier, that the chief executive has assured me that everyone who would like to have an assessment will be offered one, and that while people are waiting for it, their home cleaning will be maintained.

Hon Ruth Dyson: Is the Minister reassured by the letter from the district health boards that is being sent to Otago and Southland senior citizens, telling them that their home support has now been completely cut, but advising them on how to pay for that service if they are able to pay for it; if so, why does that reassure him?

Hon TONY RYALL: I am unable to comment on what the member has said, other than to say that the changes being made at Otago District Health Board and Southland District Health Board are not new. The Whanganui District Health Board, when facing considerable budget pressures, also looked at its home-based support services in 2006. As a result, the Whanganui District Health Board, under the previous Government, reassessed people with low levels of need and swiftly removed their services and tightened the access criteria. I think that this is a case of one thing that those members did while in Government but that they do not now want to do in Opposition.

Hon Ruth Dyson: How will the elderly resident who lives in an isolated area in Southland where no Meals on Wheels service exists, and who has been relying on 1½ hours of support per week, but who has now been told that that preparation for his meals has been cut, get along now that the help has been cut totally?

Hon TONY RYALL: If the member sincerely wants me to answer that question in respect of a personal case, then she needs to give me advance notice. If those facts are accurate, then I would be happy to take up the matter directly with the district health board, as I do for her colleagues opposite.

Hon Ruth Dyson: I seek leave to table four documents. The first is the case summary of an elderly resident from Southland who has cancer, angina, and osteoarthritis in both knees. He has just lost his 1 hour a week of home support.

Mr SPEAKER: The member has sought leave to table a document. Could she identify for the House who has prepared the document.

Hon Ruth Dyson: It is a case summary.

Mr SPEAKER: But I asked who had prepared the document.

Hon Ruth Dyson: I have, on the basis of information given to me—[Interruption]

Mr SPEAKER: A point of order is being heard.

Hon Ruth Dyson: —for advocacy.

Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is no objection.

• Document, by leave, laid on the Table of the House.

Hon Ruth Dyson: The second is the case summary of an elderly resident from Southland who has congestive heart failure and is both hearing and sight impaired, and who has just lost 1 hour a week of home support.

Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is no objection.

• Document, by leave, laid on the Table of the House.

Hon Ruth Dyson: The third is the case summary of an elderly resident from Southland who has Parkinson’s disease and osteoarthritis, who uses walking sticks to get around the home, and who had just lost 1 hour a week of home support.

Mr SPEAKER: Leave is sought to table that document. Is there any objection? There appears to be no objection.

• Document, by leave, laid on the Table of the House.

Hon Ruth Dyson: Mr Speaker—

Mr SPEAKER: Before I call the member I want to make a point. What is troubling me about the process we are going through at the moment is that it seems to set a precedent for any member in the House to prepare a document containing a summary of anything the member likes, and seeking leave to table it in the House. I do not believe that is in the spirit of the Standing Order that enables members to seek leave to table documents. I will allow the member to seek leave to table her final document, but I warn members that if this practice continues I may well take action to deal with it, because I do not see it as being consistent with the intention of the Standing Order.

Hon Ruth Dyson: I seek leave to table the case summary of a 79-year-old Dunedin resident who has renal failure and a pacemaker, and who has just lost 1 hour a week of home support.

Mr SPEAKER: Leave is sought to table that document. Is there any objection? There is objection.

Hon Trevor Mallard: I raise a point of order, Mr Speaker. I think Nick Smith has just indicated the proper course of action. I want to speak to the ruling you made before that application. I think that if all members of the House are unanimous that a document can be tabled, then it would be a very serious matter if you said it could not be. The matter is in the hands of the House. This is something that has been done on many occasions over the years, and it is seen as a legitimate way of getting particular cases on to the Table of the House.

Mr SPEAKER: I hear the honourable member. I must say I have been in this House longer than the honourable member has been himself, and I have not seen this practice be pursued in the way that it is being pursued at the moment. My concern is this: with regard to certain case summaries that have been described today, members would be very cautious about refusing leave to table them in case members were seen as being hard-hearted, uncaring, or that kind of thing. But this is not the intention of the process of tabling documents. Members’ own notes are not documents in the nature of the Standing Order. I just ask members to reflect on that. I have not ruled anything yet, but I warn members that if this practice is pursued too far my concern might grow in the matter, because I do not see it as being consistent with the intention of the Standing Order. But I have not ruled on anything as yet.