8. Mental Health Services—FundingDr DAVID CLARK (Labour—Dunedin North) to the Minister of HealthMental Health Services—Funding8. Dr DAVID CLARK (Labour—Dunedin North) to the Minister of Health: Does the funding that district health boards receive per head for mental health services fully cover their mental health and addiction services' ring-fenced expenditure?Hon NICKY WAGNER (Associate Minister of Health) on behalf of the Minister of Health: Usually but not necessarily always. You cannot compare mental health ring-fenced expenditure with the modelled mental health funding under the population-based funding formula (PBFF) as a ring-fence takes a provider view; the PBFF takes a population view. The member may not be aware that district health boards (DHBs) are bulk funded on a population-based formula—the PBFF—and this does not disaggregate funding across mental health services. But what I can tell the member is that every DHB has more funding per person above population growth and inflation than under Labour.Dr David Clark: What does he intend to do about the fact that Capital and Coast District Health Board is struggling to deliver mental health services this year because its mental health ring-fence requires $251 per person when they are only funded $213 per person by the Government?Hon NICKY WAGNER: It is up to individual DHBs to decide where to spend this funding. The Government expects it to be targeted in the areas of most need. This includes funding for mental health services. As a general rule the mental health ring-fence means that although a DHB has discretion over where it allocates its funding—and it can increase its allocation to mental health—it cannot spend less than the previous year on mental health. There can be an occasional drop—although it is unusual—because some of the services may be delivered nationally such as John Kirwan's programme on depression. Normally they could be added or taken out but the ring-fenced spending should be spent every year.Dr David Clark: I seek leave to table a letter from Capital and Coast District Health Board detailing the Government expectation that required that mental health spending exceed funding in the current financial year obtained under the Official Information Act.Mr SPEAKER: Leave is sought to table that particular letter. Is there any objection? There is none.Document by leave laid on the Table of the House.Dr David Clark: With eight bed closures last September at Waitematā's mental health unit and now three at Capital and Coast's unit does he think that temporary bed closures due to a lack of safe staffing are a trend or a coincidence?Hon NICKY WAGNER: I have already explained that funding for DHBs has increased every year but also that the number of registered mental health nurses has also increased. These are the nurses who are working both in mental health and in addiction services. They have increased from 3583 to 4206 in the last 5 years—that is 623 extra nurses or 17 percent.Dr David Clark: I raise a point of order Mr Speaker. My question was around the lack of safe staffing and bed closures. I do not believe that was addressed.Mr SPEAKER: Well the question as I understand it particularly about the bed closures was about whether there was a trend or a coincidence. I think the question has on balance been addressed but I will allow the member an additional supplementary question as a way forward.Dr David Clark: I would prefer to ask the same one again Mr Speaker.Mr SPEAKER: The member is welcome to do that.Dr David Clark: With eight bed closures last September at Waitematā's mental health unit and now three at Capital and Coast's unit does he think that temporary bed closures are a trend or a coincidence?Hon NICKY WAGNER: As I have explained we have increased both funding and staffing for DHBs across the country and that the ring-fence should be maintained. So therefore I think it is unfortunate but it should be improved.Dr David Clark: With a zero percent increase in full-time equivalents since 2014 and a 10 percent increase in bed nights over the period does he agree that one of the reasons Capital and Coast District Health Board is struggling to recruit staff for mental health services is that its mental health unit is over-worked and under-resourced?Hon NICKY WAGNER: The Government is very aware of the pressures on mental health across New Zealand and is committed to providing quality mental health support to all New Zealanders. In terms of Capital and Coast its funding this year has been $785 million; and of that $18 million has been specifically for mental health.Dr David Clark: I raise a point of order Mr Speaker. My question did relate to some of that detail but it asked whether the Minister thought it was because of over-work and under-resource—Mr SPEAKER: And the Minister answered by giving you the funding amounts including the amounts—so that addresses the question.Dr David Clark: But those were in the question Mr Speaker. I was—Mr SPEAKER: Order! That question has without doubt been addressed. Does the member have further supplementary questions?Dr David Clark: Does he think it is acceptable that last year in the same Capital and Coast acute mental health unit there were 60 occasions when staff worked over 60 hours per week and can he rule out that limited funding for mental health services at Capital and Coast contributes towards workforce burnout?Hon NICKY WAGNER: I can only repeat that the funding that there has been for Capital and Coast is $785 million; and of that $18 million has been for mental health. Actually in terms of Capital and Coast we have increased the funding per person in the area by 22 percent. I would just like to repeat to the member that every DHB has more funding since this Government has been giving Budgets for it—per person above the population and group and above inflation; much more than under Labour.Dr David Clark: Can he confirm that staff shortages are so bad at Te Whare o Matairangi Wellington Regional Hospital's acute mental health unit that staff are working back-to-back shifts and can he guarantee the safety of staff and patients in those circumstances?Hon NICKY WAGNER: I can only repeat that this Government is committed to quality mental health services for New Zealanders that we are increasing the funding every year and that the number of staff has increased consistently over the last year.Dr David Clark: I raise a point of order Mr Speaker.Mr SPEAKER: If the member is now saying that the question has not been answered I absolutely agree. I will invite the member to repeat that question.Dr David Clark: Can he confirm that staff shortages are so bad at Te Whare o Matairangi Wellington Regional Hospital's acute mental health unit that staff are working back-to-back shifts and can he guarantee the safety of staff and patients in those circumstances?Hon NICKY WAGNER: I can confirm that we have funded these services and that we are supporting the staffing of them but I cannot give you details of that particular service.