Ryall’s style


Photo by Mark Mitchell, NZ Herald.

It was very amusing to see almost every male National MP yesterday, from the PM down, wearing a bright shirt and tie combination mimicking the trademark style of who gave his valedictory speech yesterday. A fair few of the female MPs also wore a garish tie.

Some extracts from Tony’s speech:

 I want to acknowledge Dame Jenny Shipley who, as Prime Minister, promoted me to Cabinet in 1997. It was my great privilege to play a part in delivering New Zealand’s first woman Prime Minister, and it was a great privilege. We were a group, as we were planning that, called the “Te Puke Bypass Committee”, as some will remember, and it is a great pleasure to me that we are now spending $400 million on the proper * Te Puke bypass, and that will be opening shortly. 

The hilarious thing about the coup committee calling themselves the Te Puke Bypass Committee is that when a meeting was scheduled in Jenny Shipley’s diary (she was the Transport Minister) her ever efficient SPS proactively asked the Ministry for background papers for the meeting on the Te Puke bypass. A puzzled Ministry informed him that there was no bypass planned, and should they start work on one! 🙂

The Prime Minister also gave me the job as Minister of Health. I have got to say this has been the best job in the Government. You work with quality people every day who are dedicated to the welfare of New Zealanders. I wake up most mornings and I turn to my wife and say: “Ugh, imagine being Minister of Education.” 

Heh. The laughter of Hekia was noticeable at this point!

I think over the last 6 years our doctors and nurses in the team have delivered exceptional results for New Zealanders across quality, productivity, and the financial domains within constrained funding—those six national health targets. You know, doctors and nurses are very competitive people, and no one likes being at the bottom of those national health targets. That has really driven much better performance—40,000 extra elective surgeries, quicker emergency departments, and much faster cancer treatment. Immunisation—I noted Dr Hutchison talked about the fact that in 10 of our 20 district health boards, the 2-year-old Māori immunisation rate is now higher than the Pākehā immunisation rate. No one would ever have thought that that was possible in New Zealand. 

That is a huge turn-around.

Tobacco smoking—fantastic work that we have done there. I went to the * World Health Assembly in Geneva—I have got to say, I have taken only two overseas trips, Prime Minister, as Minister of Health. I was there talking about this work that we are doing in smoke-free New Zealand by 2025, a programme that we have systematised across the whole country called ABC—ask if you are a smoker; if you are, it is a “b” for a brief conversation, because that is quite effective in getting people to quit; and, “c”, offer you cessation medicine—ABC. So I went to the World Health Assembly and I was giving a talk about this. I do not know how many people in this House have ever given a speech where you lose your audience—it had never happened to me before that time. Everyone from Africa started talking amongst themselves, and I thought “Oh my goodness, I have caused an international incident.” So I completed my contribution and I sat down next to a lady from Jamaica, and I said “Why was everyone from Africa sort of quite dislocated by my speech?”. She said “Well, in Africa, they have ABC for HIV Aids—“a” for abstinence, “b” for being faithful, and “c”, if you cannot be faithful, use a condom.”, and they could not work out how that stopped smoking.


It always pays to be very careful. Jo Goodhew, as the Associate Minister, is doing this hand hygiene thing. I was visiting an endoscopy suite a couple of years ago and I thought, well here is a great photo opportunity with the hand gel, which I did, and proceeded to rub my hands, to which every person in the endoscopy suite theatre gasped in horror. I thought “What is all the worry here?”. Of course, it was lubricating gel.

This was my favourite joke.

I think there are five big mega trends and it is just the interaction between all of them is going to change health care completely. The first of the five is care closer to home. All this care is coming out of hospitals into communities, into people’s homes, pharmacists, general practitioners, home care workers, nutrition advisers—all these people are playing a greater role, and there is going to be this much greater responsibility that we are all going to have to take for our health care in something that they call self-care. It is a bit like Air New Zealand—it is getting us to do all the work and we like it. This is where we are going to have to take responsibility. Sir Ron Avery is developing a piece of technology the size of your wrist watch, with a beam that comes on your wrist and measures your temperature, your blood pressure, and your pulse, and that information is then transmitted to a device that can be monitored by your general practice.

So you can imagine this technology thing is going to change everything. That is my second point—that this anywhere, anytime use of innovative technology is going to change our health care. It is this device it is just going to help change everything over the next 5 years to 10 years. You are going to be able to plug your own personal ultrasound device into your cellphone. You can imagine beaming that message to your local general practitioner. These advances are incredible. Thirdly, intelligence and insight from big data—this work that we are doing, collecting information across Government departments, across patients, across people with all the privacy protections, is going to allow us to build a picture on how health care interventions change people’s lives, and the best place to do it. Fourth is personalised medicine. All this knowledge about your genome and your biomarkers is going to allow clinicians to develop very personalised therapies solely to you. They are going to be able to provide you with information about your risk factors into the future. These have huge ethical issues about whether we actually want to know these risks, but this personalised medicine is going to be amazing. I think the fifth big trend that is going to affect health care is that we are going to have this expanding role of non-physicians and payment that actually rewards the quality of care and the outcome that people provide.

It was fascinating to hear Tony talk of the big picture in health and where he sees the future.

But I cannot finish off without acknowledging my three comrades, Bill, Nick, and Roger. You know, Parliament can be a very lonely place. It can be full of self-doubt and frustrated ambition. I think it is pretty unusual for any member of Parliament to have had three very close friends throughout their whole career. The relationship with those guys has been enduring and sustaining. They are extremely capable people who have continued to be friends over the last 25 years. Contrary to public opinion, we have never worked as a group. Frankly, we can never agree on anything. On any issue, it is always 2:2, and the two always varies. So it has been wonderful to have that association with them. It has just been the most fantastic association anyone could have in Parliament, and I have just really appreciated the support that those guys have given. 

MPs may often have lots of friendly colleagues, but quite rare to have them become life-long friends. It was quite cool to see not just the Ryall family in Parliament for the valedictory, but the wives and kids of his friends also.

Tony’s departure does leave a big gap in National’s ranks. His successor as Minister of Health will have a very challenging time.

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