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Improving the health of all New Zealanders

Don Brash MP National Party Leader

10 August 2005

Improving the health of all New Zealanders

National Party Leader Don Brash says the next National Government will make "careful change over time" to the health system.

"Labour has implemented massive and costly restructuring of the health sector, creating a maze of bureaucracy and limited accountability. Future changes must be undertaken with great care and fully involve health professionals.

"There will be no major restructuring of the health sector under a National Government. In respect of primary care, because of the scale of the investment that has gone into it, National will retain the PHO system.

"Under Labour, the vast increase in new spending, but little increase in output, is what can only be described as a collapse in productivity.

"This productivity collapse is occurring during a time when our economy has been the beneficiary of some of the best export prices we've seen for many decades. And the economic prosperity which those prices have created has enabled New Zealand's health budget to be increased by more than 50% - from $6.1 billion to $9.7 billion in the six years to this current 2005-06 year.

"But the number of operations has barely increased during that time. The latest figures indicate that total surgical case-weighted discharges remain almost static.

"The chronic failure of the health system to meet the reasonable expectations of all tax-paying New Zealanders is there for all to see.

"Faced with a productivity collapse of this magnitude, it is tempting to seek solutions in the form of dramatic overhauls and restructurings. But major structural change could further destabilise and undermine a health system already in crisis."

In tonight's speech to the New Zealand Medical Association, Dr Brash flagged changes to the universal subsidy scheme.

"Universal subsidies mean support is spread very thinly. It is one thing to be taxed to help the needy - and nobody would quarrel with that - but it is quite another thing to be taxed merely so that you can receive part of the money back by way of subsidy.

"The question really is this. Do Helen Clark and Don Brash, and indeed probably all of you in this audience, need a $26 subsidy each time you require the services of a GP?

"We will soon be announcing a comprehensive policy in this area, including a clear indication of priority areas for new spending."

Dr Brash identified three key steps in National's approach to its yet-to-be announced health policy:

* A full review of the functions performed within the Ministry of Health and the various entities which report to it, to streamline operations and improve efficiency. This review is not the precursor to yet another major restructuring of the health sector.

We simply cannot afford to do that with a system that is in such a fragile state. The entire focus of this review is to get more money through to the frontline services in the health sector, and to reduce the form-filling culture of bureaucracy that is stifling enterprise, creativity and innovation.

* We should be seeking, as a matter of plain common sense, to remove unnecessary administration, duplication and fragmentation by better planning on a local, regional and national level. That will involve gradually rationalising bureaucratic waste and duplication, as it is identified, within the 21 District Health Boards and 79 Primary Health Organisations. But I would emphasise the word gradual.

National is not seeking to shake-up the system. Rather, we will search for the sort of cost-saving measures that will endure, because they make sense.

Rather than putting roadblocks in the way of patient choice, we need to encourage the provision of greater choice by ensuring that where the public system lacks the capacity to deliver services, recourse is available to other service providers. Clearly, this needs to be done in a way which does not undermine the ability of our public hospitals to fully utilise the investments they have made.

But Labour does seem to have an obsession with blocking any useful innovation that might arise out of public-private partnerships in our health sector, and that is an ideological conviction that comes at the expense of patients on our waiting lists. Thus, a National Government will seek to expand partnership between the public and private health sectors to improve the overall productivity of the health sector, to get better utilisation of resources, and thus better value for taxpayers' money.


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