Watts SimonSIMON WATTS (National—North Shore): Thank you very much Madam Chair and thank you to the Minister for those contributions. I want to dig a little bit deeper into Part 3 clause 62(1)(c) in regards to operational budget and I guess the broader theme here is in regards to—I think we'd all acknowledge one of the challenges with Pharmac and the way in which it operates. What I'm wanting in my question for the Minister is why haven't we gone further in regards to this aspect. Is it that when benefits are calculated in regards to the benefit payback from the introduction of a pharmaceutical drug the benefits generally are only those related to the health sphere related to that drug but do not go broader to other benefits? What I mean by that is the provision of pharmaceutical medication may in effect allow someone to go back into the workforce and so the benefits in terms of the economic benefit of someone working or not is not necessarily going to be felt within the healthcare system but it may be felt within potentially the welfare system because that person would transition from welfare into a paid job. The other aspect is in regards to pharmaceutical provision for mental health conditions or even those in regards to paediatrics and children and which allow them to have better outcomes in terms of their learning ability at school or the fact that a mental health condition may restrict their ability either to work or to contribute in terms of society. Again the way in which Pharmac assesses the benefit case for the investment regarding that pharmaceutical drug is solely restrained and constricted to the health sphere. In effect when you stand back and look at it you go Well that doesn't feel right." That doesn't meet that litmus test around the fact that benefits don't just derive within a single bucket; they actually fall across other aspects of our system and I think the Government have shown through the justice cluster that they've brought in in Budget 2022 a bit of an insight in terms of acknowledging that there are shared benefits across multiple sectors. I guess my question for the Minister is: can we expect to see something even within acknowledging health is a challenging area but with the Pharmac aspect in terms of a cluster because I think the reality of cost-benefit payback and benefit not just being financial but other aspects of course—around social particularly—is significant in the pharmaceutical space. When you weigh it up in terms of dollar for dollar for say road safety versus pharmaceutical and the benefit derived pharmaceuticals will trump most other elements nine times out of 10. So that's the first aspect.The second aspect is in regards to clause 64(1)(b) which relates to consumer advisory committees. The Minister will be aware that actually the legislative requirement around having a consumer panel has existed and is in place at the moment. The reality is though that Pharmac has just simply not taken that as far as it could have done and actually the reality of having the clinical committee has really trumped and the Consumer Advisory Committee while it has been there has really been not of any significant substance. But the challenge going back to point made by the Hon Michael Woodhouse around consumer input and being part of the Health Committee—I see Dr Liz Craig down the back a fellow member on the Health Committee last year with me—is that of the petitions that you would receive on that 90 percent of petitions coming through that relate to Pharmac and Pharmac-related drugs. So the element around consumer advice or the lack of that consumer input is a known significant gap in regards to the policy consideration but also I think the funding prioritisation of pharmaceutical drugs. My question for the Minister is: how are you going to actually measure or ensure that this actually occurs because that's the case today and it's not happening. So what confidence can we and consumers out there get in terms of whether we're talking about rare disorders or we're talking about type 1 diabetics looking for the provision of funding for continuous glucose monitoring systems which is the next phase above insulin pumps—what is the ability for those consumers to be able to have a voice as part of that process and what will change as a result of this legislation in particular in clause 64(1)(b) that actually will make that a reality? Those are the two points I wish to ask."