Heather Roy's Diary
Heather Roy's Diary
Friday 11 November 2005
Today I attended the Armistice Anniversary Ceremony at the National War Memorial. At 11am we remembered the signing of
the Armistice at the 11th hour of the 11th day of the 11th month, 1918 that signalled the end of World War I.
It is of course co-incidental that this anniversary fell in the same week as the opening of the 48th Parliament but a
timely reminder to an incoming government that the freedoms our servicemen and women fought so hard for should not be
taken for granted.
Parliament resumed this week with the accompanying traditional ceremonies at the start of the new Parliamentary term. On
Monday all Members of Parliament were "sworn in". Before any member can speak or vote in Parliament they must take the
oath of allegiance or affirmation.
This is normally an upbeat ceremony but was this time a sombre occasion due to the sudden death of Green Party co-leader
Rod Donald. The swearing in was followed by the election of the speaker. Margaret Wilson was re-elected to the position
and then as tradition dictates presented herself to the Governor General at Government House.
On Tuesday we had the State Opening of Parliament. The Governor General summons the MPs from the debating chamber by
sending the messenger Black Rod - so named because of the black rod he carries - to knock on the door of the debating
chamber and deliver the directive. MPs then file through to the Legislative Council Chamber to hear the "Speech from the
Throne", written by the Prime Minister but delivered by the Governor General.
The speech traditionally outlines the government's programme for the next three years. The speech was unremarkable with
little detail and no great vision for the future. Next week when the house sits again we will have the Address and Reply
debate. This debate lasts for 19 hours and will consist of speeches from all parties in response to the Speech from the
throne and will also include the maiden speeches of all new MPs - 4 Labour, 20 National (Anne Tolley, Tau Henare and
Eric Roy all gave their maiden speeches when they became MPs previously) and 3 Maori Party.
During a recent inquiry into the death of two newborn babies in 2001 and 2003, Wellington Coroner, Garry Evans, was
critical of the provision of maternity services for pregnant women. His report noted that maternity services "were not
in good shape" and called for an urgent review of the whole system including reintegrating family doctors into maternity
services to allow more joint care.
If the coroner's recommendations are to be acted on, then things are going to have to change a great deal because there
are now only 20 GPs in the country involved in obstetrics. This is a strange situation given that most readers will have
been delivered by their mother's GP.
When talking to older GPs it is common for a gleam to come into their eyes as they talk about their obstetric practice.
Some of the old hands talk of the pleasure of having delivered a baby from a woman who they had themselves delivered a
generation ago. The late Dr Elder, a distinguished Southland practitioner, had delivered grandchildren of women he had
My own experience is now not typical. My children, born in the 80's and 90's, were all delivered by my GP who worked
co-operatively with both hospital and community based midwives. They shared the ante and postnatal care to provide an
The retreat of GPs from obstetrics began with Helen Clark's decision to recognise the College of Midwifery. The College
had excellent feminist credentials. They lobbied to have the law changed so that midwives could work independently
whereas previously they had been required to work under the supervision of a doctor.
The midwives managed to negotiate salaries commensurate with those of doctors - a reimbursement rate of around $120 per
hour plus an allowance for mileage. As many attended deliveries lasting up to 36 hours the costs soared and the
obstetric budget blew out. To be fair to Helen Clark this was not her intention and she had hoped that the injection of
some competition into the system would reduce costs.
The incoming National government toyed rather ineffectually with the system, reducing the rate of reimbursement to $90
per hour but the problems continued. At the time hospital midwives were earning between $15 and $20 per hour so the
incentive to establish themselves in private practice was nearly irresistible.
It was this loss of staff from hospital wards that resulted in a declining level of service. In 1996 an attempt was made
at reform by introducing the "lead maternity carer" (LMC) system.
This was essentially a voucher for pregnant mothers and they could choose the lead maternity carer they wanted. However
the sum of money was fixed and had to be shared if more than one practitioner was involved. Midwives were the favoured
LMC and family doctors abandoned obstetric care in their droves leaving women with very little in the way of choice.
This was a commercial model applied to a non-commercial situation. If a midwife gets into difficulties she can call an
obstetrician and the obstetrician is ethically and legally bound to take over the care of the patient. If the
obstetrician is unhappy with the midwife's actions he/ she has no say over her subsequent practice. Commercial models
only apply to a willing-seller, willing buyer situation. The problem was and is that the obstetricians carry the
responsibility but have no power.
Health Minister Pete Hodgson has said that the coroners report would be referred to the peri-natal and maternal
mortality review committee - a newly convened committee. I hope Minister Hodgson intends giving the committee strong
direction to look carefully at the role of family doctors in maternity services. His bottom line should be maximum
choice for women resulting in excellent care for both women and their babies. Given the very nature of committees
however I suspect there will be a prolonged review with the inevitable consultation resulting in a long report and
absolutely no change.
In last weeks diary I quoted the Prime Minister's comments about golden handshakes when she was in Opposition. She
promised that Labour would stop the practice, saying: "I've had a gutful. I don't intend, if I'm Prime Minister, to have
to sit there and suffer one humiliation after another because of a culture of extravagance, which has been allowed to
grow in the public sector. Whatever is in there and hidden, we want out."
I thought it would be interesting to see just how successful Miss Clark had been at eliminating this 'culture of
extravagance'. A relatively quick search of media reports since Labour came to power in 1999 revealed the following
golden handshakes: -
TVNZ Chief Executive (Ian Fraser) - $420,000
Families Commission Chief Executive (Claire Austen) - $50,000
NZQA Chief Executive (Karen van Rooyen) - $50,000
Labour Department (unnamed senior position) - $160,000
Industry NZ Chief Executive (Neil McKay) - $120,000
NZ Post General Manager (Robert Lake) - $208,858
Auckland DHB Chief Executive (Graeme Edmond) - $30,000
Sport, Fitness and Recreation ITO Chief Executive (Judy Smith) - $50,000
NZ Police Commissioner (Peter Doone) - $137,500
Airways Corporation Legal Counsel (Ezequiel Trumper) - $160,000
Transend Managing Director (Drew Stein) - $80,000
NZ Post Human Resources Manager (Robyn Leeming) - around $150,000
Healthlink South Chief Executive (Jane Parfitt) - $265,000
Victoria University Vice-Chancellor (Michael Irving) - $420,000
Local Government New Zealand Chief Executive (Carol Stigley) - $140,000
I suspect there are many more payouts that could be added to the list. The objection I have is that the taxpayer is
footing the bill.