Little AndrewHon ANDREW LITTLE (Minister of Health): Thank you Mr Chairman. I thank the members for their contribution. To Brooke van Velden who asks about the structure of Health New Zealand in reference to the regions: the interim Health New Zealand as it is currently established as a ministerial committee has made it clear that it does intend to operate with a regional level. It has talked about coordinating networks of hospitals in particular regions. That's one level at which it will operate. Each of those regions will have at least one tertiary hospital as well as the others in it. So they will operate at that regional level and I think they also expect that certainly when it comes to primary care those commissioning decisions will be made at a regional level and that will make sense for the locality planning authority also to be coordinated at that kind of regional level. In the end you would expect an organisation a single organisation must be able to determine its structure and its organisation and it will do that.To Penny Simmonds with all due respect I think what Penny Simmonds is asking for is to legislate for perfection into the future and of course that's not going to happen. I think what I would say by way of reassurance is that we are in a transition. I would hate to think that Ms Simmonds and her party are arguing for us to slash the wages and incomes of nurses in the district health board (DHB) sector to avoid the problem that the aged residential care are talking about. There's always been a differential between nurses in the DHB sector and nurses in the funded sector: aged residential care and primary care. That differential has got a little bigger because we are desperately trying to catch up and make sure nurses in the DHB sector are properly paid because their pay went backwards in real terms under the previous Government and we've negotiated a pay equity deal and eventually that will come to fruition as well as we've been negotiating other pay equity agreements. We've made the commitment to then work with the funded sector to bring their rates up to speed as well. There needs to be a process for that and there is. They need to collaborate in that as well. I think what's important is that everybody all players in the sector focus on what is needed focus on what the goal is and that is to ensure that we to the best extent can avoid any undue disruption and any undue fracture of the labour market in that particular sector. That's important. That's what we're committed to. That's why officials and others have been engaging with the sector to make sure that that's what we are able to achieve. But we know that for the sake of retention and for the future workforce we have to substantially lift incomes. We do that through the pay equity process. For one thing we shouldn't have large chunks of the health workforce paid on rates of pay that are historically discriminatory and that's what we are taking the historic step of starting to turn back. We will go through a transition where there will be a little bit of unevenness but this is about lifting incomes in the health sector for those who for so long have been discriminated against and have been underpaid and undervalued for the work that they do.