Woodhouse MichaelHon MICHAEL WOODHOUSE (National): Thank you Madam Chair. I must say I do commend the chair of the Health Committee Louisa Wall on her loyalty to her Government. Her rhetoric was just as far from the reality of what's going on in our health sector as the Minister Dr David Clark's is and the Government's who pretend that they are fixing nine years of neglect. Frankly this Budget shows more than ever that they are overseeing chaos and drift and an absolute crisis point emerging in our health sector. I want to deconstruct some of the things that the Minister told us in select committee in Estimates review and I will also focus very much not so much on what is in the Budget but actually what's not in the Budget.What's not in the Budget is what the Minister said he would do in reversing what he claimed was an $8 billion underfunding under National. Now I want to deconstruct the so-called $8 billion myth. The Government in Opposition put together a manifesto that had a fiscal plan that said that they would invest $7.925 billion over the next four years and somehow the perception was that that would be $7.925 billion more than a National Government would. Well that's not true that's not accurate and it was presumptive on National putting no more money at all into health over that four-year period. Indeed if you take the spending increase track at 2017 of 4.1 percent and just round it down to 4 percent there would have been $9 billion more put in by a National Government more than this Government is.And the evidence is plain to see in the haemorrhaging financial positions of DHBs. I said in January that they would get to $500 million in deficit and the Minister pooh-poohed it. In April when we saw that it was going to go to $390 million I said that was too low and it was going to go to at least $500 million. It's now being projected at $508 million and that is conservative. So let me make a prediction about where the actual deficits are going to end up in the 2018-19 year because this very much influences the Estimates for the next Budget year that we're talking about: it'll be a billion dollars. The Minister knows it's going to be a billion dollars because there's another one-off hit of about $500 million to $600 million for the DHBs' failure to comply with the Holidays Act; a Holidays Act that when I was the chief executive of a surgical hospital was being passed by the Clark Government and I submitted in committee and I said it was going to be a complete muddle. I hate being right about these things. The reality is the union movement has spent years saying that it was errant employers lazy employers lazy Australian-based payroll software providers that were the cause of the problems of employees not getting their entitlements under the Holidays Act. And then what happened? The police happened to have a $33 million underspend.Now the Minister is going to blame me actually as Minister for Workplace Relations and Safety. I can tell the House that at the time I was that and Minister of Police the committee of State sector Ministers on employment relations asked the Director-General of Health to go and explore with the DHBs what their situation was because as a 24/7 operation with lots of evening and weekend allowances the Holidays Act can be quite complicated. They came back and told that committee of Ministers that there was no problem. So we sent them away and we said Look harder." It was after we got taken out of office that the real situation emerged. Now I'm not going to blame the Minister for that. It's actually not the Government's fault. The Government can only act on the information that it is provided with. But I refuse to accept what Dr Clark will inevitably come out with and say: that it was the previous Government's fault.Hon Members: It was.Hon MICHAEL WOODHOUSE: It absolutely wasn't. I will table if the member wishes the letter from the New Zealand Council of Trade Unions saying there was no problem with the Act imploring the previous Minister not to change the Act. The moment that the Government gets into office Iain Lees-Galloway is saying he's going to have a review. It is a problem and it's a problem for hospitals but it is not a problem of the previous Government.What is a problem is the fact that that Minister talked a good game in Opposition. He said in May 2017 when the previous Government put in $459 million for DHB cost pressures that it was far too small; it was $650 million that was needed just to keep the lights on two years ago. Yet in this Budget we are exploring why two years later he only put in $549 million. Why is it that two years later he's put nearly $100 million less than he said was necessary in order to just keep the lights on in 2017? And we wonder why DHBs are haemorrhaging money. It's that reason it's talking a good game in Opposition but not delivering and it's also allowing DHBs to settle pay increases at 8 percent and 9 percent per annum and then not giving the DHBs the money to pay for it. It's simple arithmetic that when 75 percent of the cost base of the DHBs is people and pay goes up by 8 percent to 9 percent and then there's a 4 percent increase in the vote deficits will occur—and 19 of 20 DHBs are going to be in deficit if not 20.Now the chair of the committee has rightly pointed out a quite significant increase in the appropriation for mental health as part of the Wellbeing Budget and I certainly don't begrudge that. But what I would ask is this: how can we say that this is a wellbeing Budget when in order to pay for those mental health appropriations the rest of the health tin was raided? It was raided in pharmaceuticals and Louisa Wall says "Well you know we've heard a lot of petitions for cancer drugs and we're listening and it's not for the Government to interfere with drug-buying decisions." Couldn't agree more. What the Government can do is give Pharmac more money.When the Minister came to us he was quite proud of the fact that in the 2018 Budget not a single dollar of extra money was put into Pharmac. He talked about 331000 New Zealanders who had benefited from the drug-purchasing decisions that Pharmac had made despite getting no money. Well that 331000 was a result of the 2017 Budget Minister not the 2018 Budget and this penny-pinching Minister who needed to pay for mental health somehow raided the tin for Pharmac and they've had $10 million in the last two years—0.5 percent per annum. That's only one-fifth of the average annual increase of the previous Government. And he says we're to blame because drugs can't be purchased because people have to go to Australia because Givealittle pages have to be set up. It's a nonsense.But the real scandal of this Budget is the failure to address the growing crisis in maternity services. And independent midwives are leaving the sector in their droves. And I say to the Minister and I say to this committee that there will be a lot more said about this over the next 10 days as the crisis in maternity comes to fruition. The Minister had got a report in February 2018 that said that independent midwives were worth much much more than they were getting. He buried the report and he threw them crumbs in the 2018 Budget and in this Budget he threw them nothing—nothing but hot air and a promise.Kieran McAnulty: Well they're used to that.Hon MICHAEL WOODHOUSE: And maternity wards—what they were used to Mr McAnulty was being listened to which was why we set the mediation process up in the first place. They went to the High Court. They had that right. We listened. We waited for the report and by the time it came we were out of office. This Minister is the one with the cloth ears I must say.Then we've got the cancer plan. Where on earth is the cancer plan? This is fundamental to the Wellbeing Budget and we're still waiting. But it's not going to be a plan; it's going to be an interim plan. What we got—because the National Party made very sensible and strong announcements at its national conference—was a scrambled stand-up at Wellington hospital where the Minister announced linear accelerator purchases that were already on the list. So I'd heard the Minister say "Oh well they promise a lot particularly in roading." In fact the Government says this but there's no budget. I asked the Minister "Where is the capital budget here for the linear accelerators that were announced for the Hawke's Bay Northland and Taranaki?" And you know what the answer is—none. There isn't a single dollar of capital budget for the scrambled announcement that he and the Prime Minister made just so they looked like they were doing something in health. We know what they are doing in health. They're doing this and they're doing that [Covers ears and eyes] because there is a crisis emerging and their Minister doesn't want to know about it because he doesn't know what to do about it. Well it's pretty easy what he has to do. He has to set expectations for performance. Targets were removed. He has to fund things like Pharmac and midwifery and the GPs broken promise and the many other things that he said he would do but has gone silent on. And then he's got to hold the sector to account. And he has to lead because there's no leadership in the sector now. All we've got is a sea of red ink and some very angry people. The most benign industrial relations environment in the health sector was in the years 2009 to 2017. We've now had more industrial action in the last 18 months than in generations and that cannot be sheeted home at anybody else but the Minister."