Craig Liz; Tolley AnneDr LIZ CRAIG (Labour): Thank you Madam Chairperson. So when I was interrupted I was talking about targets and about how the fact is that in the health sector they're useful for focusing action in important areas but they can also be used to divert attention from things that we'd rather people didn't see. And I was also talking about how this Budget starts to address some of those real underlying drivers about what's really happening in our health system. So I want to talk a little bit about one of the targets: emergency department waiting times. Because what we're seeing is—you know with the previous Government's targets a lot of emergency departments (EDs) are working really hard to get patients through the system so they can meet the target of 95 percent admitted discharged and transferred within about six hours but the problem that these targets completely miss is why our EDs are bursting at the seams in the first place. This is something that the district health boards (DHBs) were talking about in their annual reviews with DHBs talking about this ongoing increasing relentless demand for acute services. The problem we've got is a lot of those conditions that people are coming in with are called ambulatory sensitive. What that means is that the hospitalisation could potentially be prevented if they had early access to primary care. What the New Zealand Health Survey is saying is that about 14 percent of people in the last year put off going to the doctor because of the cost but if you look at people living in the poorest areas that went up to about 20 percent. So what this Government wants to do is make sure that people can afford to go to the doctor when they need one. What Budget 2018 does is invest an extra $360 million over four years to extend access to Very Low Cost Access (VLCA) GP services to community services card holders. What that means is that for those who are not on a VLCA practice already their doctors visits will be about on average $20 to $30 cheaper. We're also going to be extending community service cards to all those on accommodation supplement or income-related rent so even more people can access affordable primary care and that's really important for ensuring that people can get to the doctor rather than having to turn up at A & E and end up in hospital. The area I was working in before coming to Parliament though was child health and again looking at targets there was this huge focus on immunisation rates. Indeed as we focused on that immunisation rates did improve because DHBs got together with public health organisations and GPs and worked out how we could improve timeliness and access to immunisation. But the problem is that that's only sort of a few hundred vaccine-preventable hospital admissions—maybe a couple of thousand. What it misses is that our whole hospital system is full of sick kids: on average there are about over 40000 hospital admissions every year for infectious and respiratory diseases a lot of them related to the economic conditions that the kids are living in. The problem we've got is that most of those conditions aren't actually vaccine-preventable. So when you've got to reduce this what you need to be doing is looking at housing looking at family income reducing child poverty and also making sure families can get to the GP when they need one.This Budget addresses all of those areas. With the Families Package we're looking at family income. We're also looking at housing with 6400 new houses—State or social houses—over the next four years. In the primary-care space what we're looking at is extending free GP services to all 13-year-olds and also extending the nurses in schools programme to all decile 4 secondary schools that are publicly funded. So what we've got is many more young people being able to access GP services.The problem we've also got with some targets—while a lot of the ones I've been talking about are tangentially related to targets there's others where the targets have completely missed what's going on the health sector and that's the state of our infrastructure our buildings. What we've seen is under-investment in our hospitals so we've got mouldy leaking buildings. We've got buildings that are completely out of date and need repair. A lot of this stems from the fact that we haven't got an asset management plan nationally so that was masking the fact that a lot of DHBs in the face of chronic underfunding may have been delaying their asset infrastructure. So what this Budget does is it adds 750 million—CHAIRPERSON (Hon Anne Tolley): The member's time—I'm sorry—has finished. We turned off the clocks so that the member didn't get confused.