Craig LizDr LIZ CRAIG (Labour): I don't mind. DEPUTY SPEAKER: I'm sure.Dr LIZ CRAIG: Thank you Madam Deputy Speaker. Like my colleague Louisa Wall I want to focus on the huge impact that Budget 2018 is going to have on our ailing health system. Slightly different approach though—I want to talk about some of the reasons why we're doing what we're doing because I think within all the to and fro that you have in the House it's actually quite easy to forget that out in the real world winter's upon us and there's some really really big challenges that we need to fix.I think any time now it's likely that one of our hospitals somewhere around the country will be calling a code black. What a code black means is there's too many patients in a hospital and there's not enough beds to accommodate them. I remember Middlemore Hospital had to call a code black last year and they had to put up a sign saying the hospital's full and there's going to be big delays and you may not be seen for eight hours in A & E. Actually I've been in A & E departments where there is bed blockage happening and it's really really difficult because once the wards bank up what you've got is no more room because it gets gridlocked in A & E. Then what you're trying to do is assess new patients but you've got nowhere to assess them.I was in a hospital a little while back with one of my relatives being squashed up in a corridor right next to everybody else with them trying to assess her and everybody also being able to overhear her medical history. I think for doctors it's also really difficult because they've got to make some really really tough calls about who they give that last bed to versus who they send home and that's quite clinically challenging. This is something that the Health Committee heard quite a lot about in our district health board (DHB) reviews where DHB after DHB was saying we've got huge issues with overflowing A & Es and there's increase and surging in acute demand.So what's Budget 2018 going to do about this? Well I think after nine years of chronic underfunding what we're going to be doing is putting $2.2 billion over the next four years into our DHB system and that's going to be the largest increase in a decade. But to be honest I'm not sure if that's what's going to make the biggest impact because I think what it is going to be is the millions of dollars that we put into our primary care system.When you actually look at who's coming into A & E and what they're coming in for what you see is that a lot of the conditions are what we call in the sector ambulatory sensitive. What that means is if you had turned up early to primary care to your GP you could have probably prevented that hospital admission. So like if you get an insect bite and you kind of think Oh yeah I'm not going to do anything about it" it gets infected and you put off going to the GP and then all of a sudden you get a big infection and your whole arm swells up and you end up in hospital with IV antibiotics. We've got a lot of people coming into hospital with ambulatory sensitive conditions but the problem is: why are people putting off going to the GP? I think the New Zealand Health Survey talks a bit about that when it says that about 14 percent of adults in the last year put off going to the doctor because they couldn't afford to. If you look at people in the poorest areas that goes up to about 20 percent.So what's Budget 2018 going to do about that? Well what we're going to be doing is focusing on the very low cost access to GP services scheme. This is something we actually put in place back in 2006 when people understood what this issue was. It's a voluntary scheme and what it means is if a practice has got more than 50 percent high-need patients then what will happen is the Government will provide them with extra money if they agree to cap their fees. The current caps are free for kids $12 for young people and $18 for adults. What we're going to be doing for those who are eligible for a community services card is we're going to be making those Very Low Cost Access GP services available to them even if they might not be enrolled in a Very Low Cost Access practice. What that will do for those that aren't enrolled in those practices is on average make GP visits about $20 to $30 cheaper for those people. We're also going to be extending the community services card to anybody on an accommodation supplement or a low income - related rent subsidy.The other thing we're going to be doing is extending free GP visits by one year so that all kids under 14 can get access so that parents don't have to worry about the cost. What Budget 2018 is going to be doing is having a huge impact not only for our health system and for our A & E staff who are overwhelmed but also for families who up until now have had to really weigh up the cost before going to the GP. So here's to Budget 2018 and the huge impact it's going to be having on families in our health system. Thank you."