Little AndrewHon ANDREW LITTLE (Minister of Health): Thank you Madam Chair. I thank again Simon Watts and Brooke van Velden for their questions. Simon Watts covers three points. He asked whether such as we have seen in the justice sector we will see something like a cluster around Pharmac. I think this will be a common theme in my answers for this next section but both this bill and the effect of the sort of integration of Pharmac within all the entities that make up the public health system means that they will have to operate in a way that engages actively with each so the bill will drive them to be part of the health cluster. The health cluster is effectively defined in the clause dealing with definitions under the term health entity". So I'm confident that they will.Secondly Mr Watts notes and shares his observations about the Consumer Advisory Committee and whether or not it is really being allowed a voice to be provided by consumers to Pharmac. I think the review report makes it pretty clear that actually Pharmac in its decision making has really—to be charitable—struggled to incorporate the input of the Consumer Advisory Committee and indeed other groups that they've set up like the rare disorders committee that they set up. That met infrequently it didn't have somebody with lived experience on it—those sorts of things. So I think that's out now and that's recorded in the review. I think that's an area that does need to change and we made it clear as a Government in our response that we needed to see change in that. Again I'm confident that the way the health sector principles will apply to Pharmac will ensure that that will happen too. So those were the two points that Mr Watts raised and then turning now to Ms van Velden she's made an assertion that nothing really has changed. Actually a lot has changed. That might be her cursory reading of things but the reality is that following the interim report which really highlighted Pharmac's inability to perform well when it comes to equity it was at that point that given the health sector principles and the legislation was in the House by that time it was pretty clear that we could actually address that by bringing Pharmac into the rubric of health entities which the select committee subsequently did and I was very supportive of that. So that happened. That will make a significant difference—just requiring Pharmac to satisfy those health sector principles will make a significant difference. So I'm sure that it will.The member asked how Pharmac will operate with Health New Zealand and the Māori Health Authority. Well they won't have a choice but they will have to and they will be dealing with formidable organisations. Health New Zealand is a significant organisation. They will have to have a relationship; it's a working relationship and a constructive one. The Māori Health Authority with its roles as a sort of intellectual policy grunt shop as well as a commissioner of services—it will bring extraordinary insights and Pharmac will need to incorporate those and actively listen to those as the Māori Health Authority brings their wisdom to bear upon decisions about pharmaceuticals and medicines.The review makes it very clear that Pharmac should not be solely responsible for strategies for medicines or for rare disorders. That is the role of the ministry and the ministry will pick that up and it will actively involve Pharmac in that because they will remain the procurement agency. They are a very good procurement agency. They've got great capability. It was interesting being at the World Health Assembly last week with the number of countries that said "Gee we wish we had something like a Pharmac." So there is a lot to be pleased about and proud of with Pharmac but improvements need to be made as the review says and we will ensure that those changes are made."