Clark DavidHon Dr DAVID CLARK (Minister of Health): Madam Assistant Speaker there's a saying: lies damn lies and statistics. Look I'm not going to comment too closely on the previous member Michael Woodhouse's speech but a couple of things I will say. There is money set aside for the planning of the Dunedin Hospital rebuild; of course we're not going to put that number in anywhere other than in a contingency because you do not reveal how much you're going to pay contractors before you've contracted them. I would have thought they'd understood that but clearly not. That party over there claims to understand business but they simply do not.The other thing that they've claimed is that somehow last year's Budget was bigger for health. But if you look at the Vote Health lines last year they put aside 551 for Vote Health; this year you'll see it's 774. They've added in some other numbers from somewhere. This magical accounting they've done—somehow they've pumped up the healthcare out there. I think what they've done is they've tried to put the Terranova settlement in there—the settlement that they fought through the court system and paid money to Crown Law and others to fight all the way and eventually capitulated on. I think they've tried to add that into the health budget that they're talking about from last year even though it's not in Vote Health and they crawled over broken glass and were forced to deliver it. I just have to address those things.I mainly want to talk about our positive plan. This is very exciting. It's not every day you get to announce $3.2 billion worth of new spending in your portfolio. This Budget is the biggest for a decade. The last time there was operating spending like this it was the end of the three-year track in their very first year in Government when they inherited a three-year funding track from Labour. That's the last time we had this much operating spending in health—nine years ago. On top of that we've got capital spending—the biggest in over a decade. This is a big Budget for health—$2.3 billion for the district health boards (DHBs).What we're doing in this Budget is three main things. First of all we're getting on with fixing our hospitals. Rot and mould are well-known now unfortunately at Middlemore Hospital. There are so many building issues across our whole hospital system because of neglect. The closest they got with capital investment was when they came to do something for the Canterbury rebuild and even that doesn't come close to what we're putting in this Budget. Last year for example only $150 million went into capital. We're putting in $750 million—biggest in a decade; biggest in a decade—and that is because we care about the public delivery of health. We are going to fix our hospitals. These rundown hospitals through years of under-investment—we are going to do something about it and it's just the start too.We're going to make it also easier for people to get the care they need when they need it. Thanks to the coalition agreement between Labour and New Zealand First 13-year-olds across the country will get free doctors visits free prescriptions and free after-hours care. Thank you New Zealand First. That is a great call. Under-14s will get free doctors care under this Budget.On top of that we're slashing the costs for over 500000 New Zealanders—the most vulnerable—to get cheaper doctors visits. For some of those people the doctors visit will get $50 cheaper—$50 cheaper. For many it will be $20 to $30 cheaper—for over half a million New Zealanders. We're extending the range of people that can get the community services card and then they will have access to what is currently the case for Very Low Cost Access Scheme members. That is a fantastic move. It is the start of addressing the issue of unaffordability of doctors care. Doctors visits went up 44 percent under the last Government. We're doing something about it. Not only are those people able to get the care when they need it and where they need it but they will also keep costs out of the system further down the track because they won't get sick unnecessarily.This is a Budget that cares about people and starts the progress towards delivering more affordable care for everyone—quality care in a quality health system with hospitals that are being fixed.Budget 2018 gets real about the costs of an ageing and growing population. This Budget funds DHBs properly for the first time in ages. The staff working in our hospitals have been doing it under increasingly stressful conditions. They've been stretched further and further with the under-investment from those people over there when they were in Government. Those health workers I want to thank them today. I want to thank the allied health workers the nurses and doctors who for the last nine years in that increasingly stressed underfunded environment have continued to provide services for New Zealanders. Thank you all on behalf of New Zealand. We really appreciate it.We're going to invest properly now in healthcare. It's too long since that last happened. It is too long since our DHBs were funded properly so we are going to invest $2.3 billion over the next four years to make sure we are getting real about an ageing and growing population.I want to speak to a couple of the other initiatives that we've got under way. One of them is rolling out more nurses in our secondary schools. Decile 4 schools will receive the nurses in schools programme—a proven programme. There's evidence behind it—research out of Auckland University. We'll roll that out and a further 24000 secondary students will get access to the nurses in schools programmes and the mental health and other benefits that go with that proven programme.We're also doing a pilot on mental health for talking therapies free counselling and an evidence-based therapy service for young adults aged 18 to 25. That pilot will be rolled out in one location so we can learn from it. It's based on England's Improving Access to Psychological Therapies programme.The Disability Support Services fund gets the biggest boost in a decade—over $200 million over four years—to make sure that we are providing care for those who are caring. We are fixing up the problems of that previous Government. We are making sure we're covering population growth ageing cost pressures and the cost of the In-Between Travel Settlement so that we have a sustainable workforce so that they are properly looked after so that they don't have to go and quit their job caring for others to stack shelves in a supermarket because it pays better and they can feed their families and so that they can do the job that they are good at the job they care about and care for others. The Disability Support Services budget gets a well-needed boost this time around.We're also rolling out the next stage of the National Bowel Screening Programme. Bowel screening saves lives. New Zealand has one of the highest rates of bowel cancer in the developed world and we are determined to continue to roll out that programme. Despite the challenges and problems that we've found in the lack of planning by the previous Government for this programme we're getting on with delivering better bowel screening services. Five more DHBs will receive those services and into the money we've put the costs also for a national coordination centre for bowel screening regional centres and a national IT solution. We're rolling that programme out for New Zealanders.Midwifery: $103 million over four years. We want to support those midwives. Those midwives reached out. I have never received so much personal mail in my life—Dear David". We listened. As a Government we heard those midwives. We know they have been operating under pressure and they have been under pressure for a very long time—for nine long years. We have provided some money which will be a catch-up—effectively an 8.9 percent catch-up that for 1400 lead maternity carers brings them up to the level currently in DHBs for midwives there. There's also some money within that $103 million that will go towards supporting midwives who are out there in the field delivering babies for really long periods of time—a really long and challenging pregnancy. Currently when a midwife helps out in that situation they have to split their payment if they hand over to another midwife after sometimes more than 12 hours in a delivery. That just doesn't seem right so we've put some money aside to address that issue.Air ambulances—here's another thing that we're getting on and sorting out. They didn't sort it out. The average age of the air ambulance fleet in New Zealand is 29 years old—29 years. Even the gold-standard air ambulances will no longer have parts available in five to seven years. We need to get on and address this issue. We can't sit on our hands any longer; we need to fix it up. We're putting $82 million over four years into air ambulance services so that every region no matter how small can have access to a proper double-engine helicopter where patients can be treated during the flight by highly qualified clinical staff. I want to thank the current air ambulance service which has done a great job. We are planning for the future making sure we continue to improve clinical outcomes strengthen existing service levels and begin a programme of modernisation in our air ambulance fleet.There is so much more in this Budget but I'm just so proud of the money we're investing in health. It is long overdue. It is good to be on this side of the House to actually deliver for New Zealanders the healthcare that they expect and deserve. We're fixing our hospitals we're making it easier for people to get care when they need it with cheaper doctors visits for around 600000 New Zealanders. Budget 2018 gets real about the challenges of an ageing and growing population by funding our health services better. I am so proud to be on this side of the House investing in the healthcare that New Zealanders deserve and expect."