Ngarewa-Packer Debbie; Little AndrewDEBBIE NGAREWA-PACKER (Co-Leader—Te Paati Māori): Thank you. Tēnā koe te Minita. Just a couple of questions I'm going to try and pull them out really quickly—not like housie but short of—specifically around inequities and Pharmac.In respect to the report that came back from Pharmac what changes have been made to the powers and functions of the Māori advisory board following reports that they found it challenging to engage with the organisation at the right level?A medicines strategy has been mooted as helping to identify inequities. Will the Minister be directing the ministry to develop an updated medicines strategy in consultation with stakeholders including Māori Pasifika and disabled people? On its contents over the next 12 months actually—to add to that question—was a budget bid put in that would have been sufficient to totally clear Pharmac's options for an investment list or wish list and if not why not? Does the Government have a target for when they intend all drugs on the wish list to be funded by?We saw the COVID process—vaccine and drugs were able to be actioned within two to three months. Does the Minister think that it's acceptable that we're still lagging behind comparable countries on funding lifesaving medicines and if not why aren't we seeing the urgency that our whānau with life-threatening conditions need? And just to add to that we know that—and I hope you can do shorthand—Pharmac has a chronic shortage of Māori representation. How many Māori are members of Pharmac's staff? How many Māori Pasifika and disabled people are on Pharmac's pinnacle advisory committees? Thank you.Hon ANDREW LITTLE (Minister of Health): Thank you Madam Chair. I thank the member for her questions. Just on the last question she asked: I'm sorry I don't have specific figures on that. What I can report however is Pharmac is aware that the number of Māori for example in their workforce in advisory positions—in fact right throughout the organisation—is disproportionate. Māori are underrepresented in that workforce and they know they have work to do in that respect and that was evident from the review. But I'm also confident that now with the effort that they're making as a consequence of the review in terms of their relationships with other entities and specifically in relation to its workforce issues with the ministry that they know they need to get on—in terms of recruitment—and work harder to recruit more Māori in a whole range of positions through that organisation.Which I guess comes back to the member's first question which is in relation to the Māori advisory board. I'm not aware of changes to the functions and powers of that board. What I do know is that with Te Aka Whai Ora now being established it's my expectation that Pharmac will establish a very close relationship with Te Aka Whai Ora because we know in terms of its equity performance Māori have done particularly badly in that respect. If you look at the cancer treatments that they have given priority to they're typically cancer treatments that are not the ones that Māori are more statistically susceptible to. So in my engagement with Pharmac yesterday I made it clear that in terms of strengthening relationships I expect them to draw on for now the skills and mātauranga that will be reposed in Te Aka Whai Ora - Māori Health Authority.In relation to a medicines strategy I can confirm for the member that it is my expectation that the ministry will lead a medicine strategy—or lead the development of one—that came out of the Pharmac review as well. It's appropriate that the ministry provide that leadership drawing in Te Aka Whai Ora Te Whatu Ora as well and naturally Pharmac as the procurement agency for it. And putting together a medicine strategy will necessarily entail good quality engagement with Māori with Pacific with the disabled community and with other relevant health communities and so on as well. So I think that has been made pretty clear following the Pharmac review.In terms of the options for funding list the last assessment I saw—if funding were to be provided to fully fund the options for funding list it would add about $450 million a year to funding for Pharmac in order to do that. Pharmac's current budget is roughly $1.1 billion to $1.2 billion; that has increased 44 percent since we have been in Government. So we have increased it and we've had a significant increase this year and in this budget—$71 million this year $120 million next year; those are quite significant increases. I simply don't think we would have the means in a single year to increase its baseline by $450 million. That is the challenge always with an area like health but all of the health budget within Government but within health itself: making the decisions setting the priorities and making the trade-offs for where funding goes. I think one of the challenges we have as we think about health funding is you know there's a lot that a lot of people would like us to do. There's a lot we would like to do but there are always going to be limits and it's a question of how we articulate those limits; how we make those decisions on those limits. But Pharmac is required to work within the limits that it has got and it is doing that.