Woodhouse Michael; Dean JacquiHon MICHAEL WOODHOUSE (National): Thank you Mr Chair. I want to move to clause 16 of Part 2 and in particular the requirement to operate in a fiscally responsible manner and it goes on to say for this purpose endeavours to cover all its annual costs (including the cost of capital) from its net annual income". There's a similar clause at clause 24 for the Māori Health Authority.Now I'm advised by Pae Ora Legislation Committee members that very little cognisance was paid in the deliberation to the financial management of the sector. What we have at the moment is 20 district health boards (DHBs) and a plethora of other organisations all required to furnish financial accounts to this House and most of them have made thumping-great losses. It's a peculiar feature of the health system where that seems to be tolerated to a far greater level than for example other public sector agencies—if the fire service or the New Zealand Police said "Look we know we only got $1.5 billion this year but we knew you know to run an effective service it was going to cost $1.8 billion so here's a bill for $300 million Government." But Governments of both colours have had this problem albeit that the combined financial deficits of DHBs when we left office was $90 million. We've got individual DHBs with greater deficits than that now. Budget 2022 I do acknowledge had a thumping-great envelope of money to clear those deficits and to prevent to the degree possible that happening in the future.But my questions are really around the financial management at a hospital level in particular the capital. So what responsibility for fiscal prudence and working within one's means are the individual hospitals going to have and what level of autonomy for things like capital maintenance upgrade replacement—you know if an MRI needs replacement is that decision going to be made in Dunedin or Wellington? It seems a very very murky picture of an extraordinarily large organisation now with a massive network of service-delivery places and I'm advised by the select committee that there was very little reference to how this is all going to be managed. Now I think all of us agree with the endeavour—in fact I think the idea that it should be an endeavour rather than an absolute requirement speaks to the reality that health is a bit different. But I do want to get some sort of picture of what we are going into in the next year about prudent fiscal management.We've got a pile of people right across the DHB network right now whose sole job is the management of accounts accounting functions asset registers building maintenance—where are they all going to go? Are they going to be needed in the future? Ultimately who is responsible Wellington or Christchurch or the individual organisations for actually making sure money is not spent excessively? But if demand exceeds the financial allocations that are granted to individual hospitals if there are at all who decides whether or not that money should be spent and how quickly will those decisions be made?I think the committee of the whole House deserves a bit more sort of insight into actually how this thing is going to run because I feel like we're building the plane as we're flying it and that this particular weakness in our health system where they can't seem to work towards a break-even position needs to be fixed but I can't see how. In fact there is a risk that it could get worse not better. So I'd be interested in the Minister's insights and expectations for how that will run particularly on asset management because that's a very rapidly changing picture in a sector that is driven by technology—medicine technology high-tech radiology a plethora of surgical technologies. Who's going to decide when it's the right time to upgrade or invest in new technology and how quickly will that happen?CHAIRPERSON (Ian McKelvie): I call the Hon Michael—Andrew Little; don't know who I was calling then!"