1. Budget 2016—Primary Care Rural Health Services and Very Low Cost AccessHon ANNETTE KING (Deputy Leader—Labour) to the Minister of HealthORAL QUESTIONSQUESTIONS TO MINISTERSBudget 2016—Primary Care Rural Health Services and Very Low Cost Access1. Hon ANNETTE KING (Deputy Leader—Labour) to the Minister of Health: Does he agree with the statement from the Chair of the PHO Alliance who said of Budget 2016 Primary care cannot deliver essential new models of care within existing and reducing financial resources"; if not why not?Hon Dr JONATHAN COLEMAN (Minister of Health): No; but I thought I had better go and read the full quote in context. It is from the Primary Health Alliance in which it also welcomes the bowel screening investment and the increased Pharmac funding. It observes that we have a great primary-care system but it also wants more detail on the money. The increase in total primary-care funding in Budget 2016 is estimated to be around $30 million. This means funding is up $233 million under National a 35 percent increase. Hon Annette King: Is the $6 million increase in the primary-care strategy in Budget 2016 from $180 million to $186 million adequate in light of the chair of General Practice New Zealand Dr Jeff Lowe's comments that primary care was hoping to hear of $20 million to $26 million more a year to address years of funding that has not kept up with inflation?Hon Dr JONATHAN COLEMAN: And indeed the funding increase is $30 million which is greater than $26 million. Hon Annette King: Is New Zealand Rural General Practice Network chief executive officer Dalton Kelly wrong when he said that apart from an increase in ambulance funding there is little else for rural health in Budget 2016?Hon Dr JONATHAN COLEMAN: Well I know Dalton Kelly well and he thinks that this is a very good Budget. He would be very pleased as are many many New Zealanders with the $2.2 billion going into health and the $1.6 billion going into district health boards—and many of those dollars of course will be spent in the rural sector. So I do not know; I wonder whether you are misrepresenting him.Hon Annette King: I raise a point of order Mr Speaker. You cannot have a Minister say that I misrepresent him and then when I want to table the evidence that comes from a paywall document—Mr SPEAKER: Order! If the member is now seeking to table a document that is a different matter but I just cannot pick what the point of order is that the member is trying to ask.Hon Annette King: I seek leave to table the page from New Zealand Doctor which is a paywall document—Mr SPEAKER: Order! Just keep the explanation simple and quick.Hon Annette King: It is the New Zealand Doctor magazine and it is dated 8 June and I correctly quoted Mr Dalton Kelly.Mr SPEAKER: Order! On the basis that this information may not be readily available to members I will put the leave. Leave is sought to table an article from the New Zealand Doctor magazine of June this year. Is there any objection? There is no objection. It can be tabled.Document by leave laid on the Table of the House.Hon Dr JONATHAN COLEMAN: I seek leave to table an article dated 15 June entitled "King clutching at straws".Mr SPEAKER: No I do not need that at the moment. I need to know the source of the article.Hon Dr JONATHAN COLEMAN: It is probably publicly available to be honest with you.Mr SPEAKER: It sounds like it is a newspaper article. I will not be putting the leave.Hon Annette King: I seek leave to table a document from the New Zealand Doctor—I am sorry; I do not have the date—where Dr Coleman is referred to as "Dr No". Mr SPEAKER: No I think that is not going to help to inform members at all.Hon Annette King: When was the report of the Primary Care Working Group on General Practice Sustainability which recommended changes to the Very Low Cost Access scheme delivered to him for consideration?Hon Dr JONATHAN COLEMAN: Oh a wee while ago.Hon Annette King: I raise a point of order Mr Speaker. Is that an adequate answer Mr Speaker?Mr SPEAKER: I think in this case it is when you look at where the primary question went. It is not a helpful answer but the member—Hon Annette King: No it is a smart-arse answer.Mr SPEAKER: Well the member may conclude it is a smart answer but it is one that has addressed the question.Hon Annette King: Does the chair of the New Zealand Medical Association's General Practitioner Council Kate Baddock reflect his position when she said of his decision to not fund changes to the Very Low Cost Access scheme that "There is no new money. We are stuck with the status quo and with the inequities that represents unless"—Mr SPEAKER: Order! Bring the question to a conclusion.Hon Dr JONATHAN COLEMAN: Well I am not going to comment on whether or not Dr Baddock said that but what I can say is the Very Low Cost Access scheme is only 6 percent of total primary-care money. As I can tell you the money for primary care has gone up $233 million under this Government. That is 35 percent and when you consider that the population has grown by 12 percent that is well ahead of population growth so there is plenty of money there—and plenty of good service as well.Hon Annette King: Because there is no new funding to address the inequities in the Very Low Cost Access scheme what will happen to the 600000 high-need low-income patients without affordable doctors visits which he last week said: "is not something the general population is excited about."?Hon Dr JONATHAN COLEMAN: Once again the quote is out of context. But look there is plenty of money. The member knows there is $2.2 billion over the next 4 years for primary care. If you want to talk about supporting access to primary care this Government has delivered to under-13s free general practitioner visits and free prescriptions benefiting three-quarters of a million children and families—something that the member never bothered to do when she had the chance which was a shame.Hon Annette King: Has he given up on addressing the most pressing need in primary health care which is the Very Low Cost Access scheme when he said to the New Zealand Doctor last week: "It could form part of a future Budget possibly under a new Minister of Health."?—I am happy to do the job.Hon Dr JONATHAN COLEMAN: Actually that is a complete misquote. Sorry but it is."