9. Question No. 9—HealthHon MICHAEL WOODHOUSE (National) to the Minister of HealthQuestion No. 9—Health9. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: Is he satisfied that the medicines funding provided for in Budget 2018 contributes to ensuring all Kiwis get world-class cancer treatment?Hon Dr DAVID CLARK (Minister of Health): Mr Speaker fakalofa lahi atu. Budget 2018 included a record $985 million for the combined pharmaceuticals Budget. I'm advised that for each of the last two years spending on cancer drugs exceeded $200 million and that figure will continue to increase as more medicines become funded and more patients access new treatments. It is completely understandable in my view that people suffering from cancer want access to the latest treatments. There is rising demand for cancer medications and there will always be pressure to fund more drugs. Decisions on which drugs to fund are rightly left to the experts at Pharmac. Pharmac is a world-leading funding model which allows more New Zealanders to get access to more drugs at lower costs than would otherwise be the case.Hon Michael Woodhouse: Isn't it true that Budget 2018 provided not a single dollar of extra funding for new medicines and indeed was reduced by $200 million?Hon Dr DAVID CLARK: By its very nature the Pharmac model delivers savings. As drugs come off patent and generic options become available money is freed up allowing Pharmac to buy more drugs. The Pharmac savings identified in Budget 2018 will be kept within Vote Health. This will be used to deliver better health outcomes for Kiwis.Hon Michael Woodhouse: Has he spoken with any officials about the $200 million in reprioritised funds in Budget 2018 being redirected to nurses' pay increases rather than the purchase of new medicines?Hon Dr DAVID CLARK: There have been numerous discussions about different issues and where savings might be used. It is my understanding that the district health boards (DHBs) have the autonomy to spend that money and they make the decision on where it goes. The issue is health funding and making sure that the money is retained within Vote Health to deliver better outcomes for New Zealanders.Hon Michael Woodhouse: I raise a point of order Mr Speaker. The question was very specific about whether he has had a conversation about the reprioritised funds being used for nurses' salaries specifically and that wasn't addressed.SPEAKER: I think in the two parts the Minister answered it. He said in part one that there'd been numerous discussions and in part two that the DHBs had the discretion to do it.Hon Michael Woodhouse: Speaking to that point there was only one part to the question—SPEAKER: No—and two parts to the answer.Anahila Kanongata'a-Suisuiki: Why is it important to protect the independence of Pharmac?Hon Dr DAVID CLARK: Drug funding decisions should not be made at the whim of politicians. They need to be based on good evidence and expert clinical advice. We don't want to make drug funding decisions into a political football—for example I agree with the commentator who responded to a question about whether it was right to override Pharmac and extend the funding of Herceptin from a nine-week programme to 52 weeks: I don't think it was actually and I think history has shown that." The comment of course was made by my predecessor in the health role National's Jonathan Coleman.Hon Michael Woodhouse: Did he speak with any officials about the $200 million in reprioritised funds being redirected to nurses' salary increases rather than the purchase of new medicines?Hon Dr DAVID CLARK: I don't have that detail with me today. I've certainly had conversations with people in my office and I'd want to check whether that was an accurate representation of them. We did talk about different places the savings could be directed and where New Zealanders would see the best value in the health system from those savings.Hon Michael Woodhouse: Is he aware of any briefings aides-mémoire or other documents that reference recommendations that the reprioritised funds be used for salary increases for nurses?Hon Dr DAVID CLARK: I will have to check that because as I say I can recall having conversations about the savings as I've noted in my previous answers and I'd want to give the member an accurate response to that question.Hon Michael Woodhouse: Will he heed the petition of Terre Nicholson supported by 36000 other New Zealanders online for the funding of Ibrance and Kadcyla both effective in extending the lives of women with advanced breast cancer?Hon Dr DAVID CLARK: My understanding is that Pharmac do have a process under way to look at Ibrance and the other relevant drug the member just mentioned. They're in a process now for assessment for funding."