5. Question No. 5—HealthHon MICHAEL WOODHOUSE (National) to the Minister of HealthQuestion No. 5—Health5. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: Does he stand by all of his statements and actions around Vote Health in Budget 2019?Hon Dr DAVID CLARK (Minister of Health): Yes and in particular I stand by my statement that with the Wellbeing Budget this Government is taking mental health seriously and at the same time investing $1.7 billion in hospitals and other health facilities.Hon Michael Woodhouse: Does he stand by his assertion to the Health Committee this morning that a 1.1 percent increase in Pharmac funding is enough to deliver appropriate access to medicines for New Zealanders?Hon Dr DAVID CLARK: The member uses his own words rather than mine but I do stand by the statement that last year over 100000 New Zealanders gained further access to medicines through the broadening of availability and so on. So that is a lot of people helped by the Pharmac model last year. On top of that of course we've invested $40 million extra in the current Budget to further increase access to medicines for New Zealanders.Hon Michael Woodhouse: Would he agree that an increase in Pharmac funding above the just 1.1 percent appropriated would mean considerably more New Zealanders would be able to access lifesaving drugs and if so why was there an increase of just 1.1 percent in this year's Wellbeing Budget?Hon Dr DAVID CLARK: Of course everybody in this House will acknowledge that health got a considerable chunk of the Wellbeing Budget because mental health in particular was prioritised and also the longstanding underfunding of district health boards (DHBs) was prioritised so that people can access services in our DHBs—$2.8 billion over four years. These are the trade-offs that we make when we put a Budget together as any Government does and in this Budget we decided to invest further in Pharmac and we did invest $40 million further over four years meaning more access to more medicines. Of course it is logical that the more money you put in the more benefit that can be derived but I would say that Pharmac is very clear that for the list of medicines it has it is prioritising those top medicines which will bring the most value to New Zealanders.Hon Michael Woodhouse: Which one of his statements to the committee this morning is correct: that the elective surgery number as at the end of March is not a good proxy of full-year throughput because of a rush of sorts that occurs in the last quarter or the DHBs won't achieve their budgeted elective surgery figures due to industrial action?Hon Dr DAVID CLARK: I reject the member's characterisation of my comments again in select committee this morning.Hon Ruth Dyson: He just makes it up.Hon Dr DAVID CLARK: There is an upturn in elective surgery outputs typically in any given year in the DHBs' performance and they are working currently to deliver to the contracted volumes. Of course we acknowledge that interruptions with industrial action—because those staff working in hospitals have been underfunded for so long—did disrupt planned care during the course of the year. Fortunately those things have been settled. We have a nurses' settlement for example that is worth more than the last three settlements combined that were done under the previous Government—more than the last three settlements combined. That historic underfunding is being addressed. Those health professions are now more attractive to join and be a part of. We are determined to invest to make sure that the systemic underfunding that happened for so long does not destroy our health system because we believe in public health services available and accessible to more New Zealanders.SPEAKER: Before the member has a supplementary we're going way back to early in that supplementary answer. The Hon Ruth Dyson made an unparliamentary interjection; she will stand withdraw and apologise.Hon Ruth Dyson: I withdraw and apologise.Hon Michael Woodhouse: Given the Minister's reference to attractive professions why given the Ministry of Health had to apologise for their failure to prepare a 2018 Budget bid for community midwives given their obligation to do so was a 2019 Budget bid to reflect the co-design recommendations not made?Hon Dr DAVID CLARK: This Government has continued to lift the fees available to midwives recognising that a long period of under-investment does put in jeopardy the sustainability of the midwifery workforce. In the last Budget there was an 8.9 percent uplift in fees for midwives; this Budget an uplift of 4.93 percent and that is without the additional wraparound material in the midwives' package because we recognise that we do need to fund this service sustainably to ensure the safety of mother and midwife and child. We are proud to be investing more in our midwives and we recognise that that has been a long time coming.Hon Michael Woodhouse: I raise a point of order Mr Speaker. The question which was not addressed was a budget bid to reflect the agreed co-design process" and the Minister did not address that part of the question.SPEAKER: That's a fair comment. He will address it.Hon Dr DAVID CLARK: There was a co-design process which happened under the previous Government. The Director-General of Health has written to the College of Midwives apologising for the way in which that played out. My view: it was a very messy process because of how the last Government ran it. That is their failure. He's trying to weaponise the incompetence of his own caucus.Hon Michael Woodhouse: Isn't it true that he and his Labour colleagues in Government haven't delivered on their promises in Budget 2019 particularly in the area of medicines cancer care elective surgery and community midwifery?Hon Dr DAVID CLARK: Absolutely not."