Wall LouisaLOUISA WALL (Chairperson of the Health Committee): Tēnā koe Madam Chair. It is my absolute pleasure to speak on this Estimates debate about Vote Health as the chair of the Health Committee. I want to acknowledge the Minister who's in the chair beside you the Hon David Clark for running an organisation that actually has been challenged and those challenges stem from underfunding over the last nine years. I say that because in our report we actually talk about the DHBs and their financial stability. As we know many of the district health boards have to deal with these legacy issues and we need look no further than Counties Manukau District Health Board. I highlight that because you can't actually deliver services if three or four of the buildings that are supposed to provide the context for us to care for New Zealanders are rotting are leaking had sewage had air quality problems. That's been highlighted by the Nurses Organisation and other health workforce organisations who are worried about their staff working in these conditions. I highlight that because the cost to ensure those facilities are sufficient and adequate for the health system to deliver to the health needs of New Zealanders has been severely compromised. The response from the Minister and from this Government was to invest an additional $850 million in the last financial year for capital investments in DHBs. This hasn't been done randomly because one of the other things the Minister did was develop a new infrastructure unit to support DHBs. We knew that we had to be more strategic in this area but the reality of hearing from our DHBs is many of them had no option under the last Government to highlight some of these issues because they knew they would get nothing. This Government has been incredibly responsive and increased funding in areas which we think are incredibly important. So in addition to more capital investment money we've also provided another $143.448 million to ensure that our staff who are working in our health sector are remunerated. That's a big deal for us because in addition to the infrastructure the other most important component of delivering a health service is having a quality health workforce who is valued and knows that they through their efforts are contributing to a great Government plan.And then the third area that I want to highlight is our mental health initiatives. Many of you came into the Grand Hall tonight and I want to thank colleagues who chose to do that. It was actually an acknowledgment of the prioritisation of mental health and addiction wellbeing that this Government did in having an inquiry that ensured that over 2000 New Zealanders who in 26 locations across Aotearoa New Zealand attended 400 meetings were part of a conversation about our mental health wellbeing and also how addiction contributes to our mental health wellbeing. So the Government have through that process and the leadership of Professor Paterson provided for the Government He Ara Oranga. Within that document there were 40 recommendations; the Government accepted 38 of those. So we have a commitment—a $1.384 billion commitment over four years—to ensure that we operationalise that plan. That plan isn't our plan; that plan is actually New Zealand's plan. One of the great things that we heard tonight was that for us to achieve the objectives of that plan we actually have to work together.Part of the I guess challenge we have—and especially in that mental health and addictions area—is that we don't have enough staff who have the skills to meet the needs of those mental health and addiction challenges. The Minister has been incredibly transparent and has said that we need 1600 additional staff; 25 percent will come from the existing workforce. So I guess this is a mihi to the people who work within our current health sector: our nurses our occupational therapists our social workers and our community workers who we think can contribute in another way. So I look forward to us working with the sector to ensure that we have the capacity to meet those mental health and addiction challenges going forward.I haven't got much more time but I do have to talk about some of the petitions that came before our committee this year and specifically those related to the availability of pharmaceuticals. I do want to acknowledge the petitioners; the Terre Maize petition in particular was one where we had incredible engagement from people who were most affected by a lack of access to advanced breast cancer drugs—and so I pay tribute to them. I pay tribute to them—Hon Michael Woodhouse: Pay tribute? Give them money. Give Pharmac more money.LOUISA WALL: —for putting the petition to the committee. I pay tribute to them for coming to talk to us. My colleague Michael Woodhouse is making some comments but the reality of our Health Committee report is that we said this Parliament should not determine what drugs should be funded. We were clear about that. That's a political process; we have a process in place where an independent entity does that. But in saying that I do want to highlight that we have issues about access to these new technology new treatment drugs and we will address that. I want to acknowledge the Minister and the ministry and Pharmac who have committed to addressing that issue going forward. Kia ora.CHAIRPERSON (Hon Ruth Dyson): Before I call the Hon Michael Woodhouse can I just apologise to the House for not setting the timer. So the Opposition are 45 seconds ahead but I took a minute off Jan Logie prior to dinner so I think we're about quits. The Hon Michael Woodhouse.