Wall LouisaLOUISA WALL (Chairperson of the Health Committee): Tēnā koe Mr Chair. It is my pleasure to lead the Estimates debate for Vote Health as the chair of the Health Committee. I have a few things I want to emphasise and I will start with the Budget appropriation which sits at $18.225 billion and represents a 10.2 percent increase in the estimated actual expenditure in the 2017-18 years. This was because of three main components: $549 million in non-departmental output expense for policy initiatives for district health boards (DHBs); a $750 million investment in policy initiatives through capital investments and I'll talk a bit more about that later; and it also represents $100 million for additional deficit support for district health boards.The Minister was very clear when he presented to the Health Committee about his focus areas and I do want to emphasise these. They are equity of outcomes in the areas of primary care prevention and mental health and he was also very focused on providing public health services. He emphasised during his session with us the challenges and those challenges have been about hospitals and facilities not being fit for purpose. What did that actually look like? Well it was discovered that buildings that service our families children and communities in South Auckland were full of rot and dangerous mould that could make people sick. And why was this? I want to quote directly from our select committee report: The Minister maintains that challenges in the sector can be attributed to the constrained funding environment in previous years." So within this context the Minister was reviewing the health and disability services to consider whether the current system facilities and approaches are fit for purpose.I particularly want to highlight an area—I'll call it "of contention"—that the committee had to deal with and it was actually in the review of the National Oracle Solution procurement system. There were some issues about what the system was doing but just for context it is actually used by DHBs to manage how goods and services are sourced ordered delivered stored used and paid for and it's jointly managed by NZ Health Partnerships and all 20 DHBs. The review will—and this is listed in our report—assess how the process has run it will confirm any issues and it will also look at whether to approve additional investment by DHBs and the long-term viability of the project. It's fair to say that this was an incredibly robust part of the Estimates process. Some of the issues that were discussed during that particular engagement with the Minister were around conflict of interest it was around what the review sought and it was whether the review would ascertain if the National Oracle Solution procurement system was fit for purpose.The other area I'd like to emphasise was the Minister's particular focus on mental health and addiction services and I want to put on the table that there was acknowledgment of the work that our colleague Matt Doocey is undertaking in this area and we know that he is incredibly interested in working with the Government and hopefully on the inquiry into mental health and addiction that is due back in October 2018. Other work that is being conducted in addition to this inquiry focuses on the Mana Ake programme in Canterbury nurses in schools and also integrated therapies for 18- to 25-year-olds. So it is fair to say that the issue of mental health and addiction services and the challenges that we face as a country were another area that was hugely discussed debated and focused on and I think it's fair to say that the reason that they are is because we seem to have a whole range of unmet needs. We have major challenges in this area so obviously as a committee we look forward to the report that we will receive in October."