O'Connor SimonSIMON O'CONNOR (National—Tāmaki): I am very pleased to take a call in this debate particularly to follow on after the Minister of Health. [Interruption] In fact it is a debate because there have been so many inaccuracies coming from the other side. We will put paid to a few of those as well as going through some of the great successes. I will say right from the outset that the New Zealand health care system is in excellent shape—the best shape it has been in for many years. I think a lot of that acknowledgment goes to the current Minister. I want to acknowledge here the very positive working relationship that the Health Committee has most of the time bar when selective choices are made out of the New Zealand Doctor. I am sorry that I have not brought my copies from the last few weeks here to be able to actually table those positive stories as well. Very very good news: Vote Health has increased 4.8 percent.Scott Simpson: How much?SIMON O'CONNOR: There is a 4.8 percent increase in this Budget which means spending of $16.142 billion. That is an enormous—enormous—spend the largest it has ever been. In fact a huge amount of money is actually going towards the district health boards (DHB). I am not going to break down every cent of it but two mistruths have to be immediately noted. The first is that funding as it is calculated has not fully accounted for all the demographic and cost pressures. In fact all the demographic and cost pressures over the last 8 years have been completely and fully put in. We also have to put paid to the absolute falsity which is put out from the Labour Party in particular that there is an underspend of $1.7 billion—is that the figure they are up to at the moment? It is an absolute falsity for two reasons. First and foremost it is absolutely matter of fact ipso facto that when you are increasing the budget by 4.8 percent—taking it to its largest amount; $16 billion—you cannot be in deficit of $1.7 billion. The second element very clearly comes down to how the money is actually spent. The dollars are increasing but as the Minister himself indicated a little bit earlier it is a question of how it is spent. We knew before we came into Government that to our shame all the money that was thrown into the health care system did not fix the problems. It did not increase the number of surgeries. It did not improve the hospitals. It did not increase the vaccination rates. It did not improve immunisation. In fact I mention those negatives because since 2008 and continuing in this Budget bid there have been positive increases into the health system. I just want to touch on a few of those. We are continuing down the line of free health-care for those under 13—an absolute recognition of the importance of those first 13 years of life. That is of course not only for visiting a general practitioner but also for getting the pharmaceutical products that are needed. We have heard a lot about bowel screening. In fact we heard from the previous member that bowel screening was Labour's idea and was implemented but that would be pretty remarkable if it did not have a Tardis seeing that it is in fact this Government that started trialling it in the Waitematā and it is this Government in this Budget that has found the money to roll it out across New Zealand. A couple of us were at a talk tonight with some doctors from the New Zealand Medical Association. They were highlighting to us amongst other things the real importance of screening programmes and we spent a little bit of time talking around the whole question of bowel screening. Bowel cancer is one of the top five reasons that men die. In fact it is one of the top five reasons for both men and women but higher for men. This bowel screening—Dr David Clark: Worse in the south. It's a long time coming. When will it be delivered in the south?SIMON O'CONNOR: The whole point of bowels is that they are down to the south but we are not going to get into the medical stuff here. This is a fundamentally important programme and the money has been fronted up to assist this. Importantly too there is money for the other forms of screening that are required here in New Zealand. Money has been put aside—I think really importantly—for primary care particularly around that of mental health care. I know members on the committee have raised issues around mental health care. Having worked in that sector indirectly over the years there is an understanding that there is always going to be more to be done. But I think that this Government through this Budget has actually shown a real commitment first and foremost by an overall increase in funding for mental health care and as I am articulating here particularly the $35 million into primary care. That is where often issues are manifested are first detected and I think the ability for GPs obviously to assist in that pathway is important. That funding is actually going to enable and strengthen the GPs themselves. Again it is not simply about the money. In fact I can link it back to what we heard a little bit about earlier. We were looking into the science of happiness tonight when we were talking to a medical doctor who was saying that simply having money is not going to make you happy. In fact service and connection are going to make people a lot more happy and I think there is a direct metaphor if you will in this Budget: it is not simply about spending more money but how you actually increase the connections. We are going to see that I believe with this funding around primary care and mental health support. We have seen already the connections through—is it something like 50000 extra elective surgeries? And even more money has been allocated for more surgeries. If you have had any engagement in the health sector including my very short time in the private health care sector you will know there is an enormous amount of work to be done—hips joints rotator cuffs the whole lot—and this Government is spending the money required. But it is not spending just on that; it is also spending on elements of pain management. There has been funding in this Budget to increase how we work with pain management and that manifests itself in two important areas. Firstly there was the creation of pain teams. This was an announcement in the last Budget but it has been increased and is further increased in this current one. Pain teams are bringing doctors nurses and other care professionals of excellence to help people manage their pain. Again this is not simply about replacing the hip but about how you get an orthopod an occupational therapist a nurse or your GP to help you manage through that. The second is around something very dear to my heart which is palliative care. There is more money for palliative care. In fact we have a programme in place at the moment engaging with the sector. I would be remiss if I did not raise Pharmac and the enormous amount of extra funding that has gone into Pharmac. Look we could do enormous—well we are doing an enormous amount in this space already. A number of us had the privilege of listening to Pharmac last week when it came and gave a briefing to all MPs. It is remarkable what is already funded but in this Budget there are millions and millions more dollars going to Pharmac to bring about a change particularly in—well actually seven areas. I am not going to go into all of them. The most notable is around melanoma. Of course remarkably this Government has not only been able to fund Keytruda or pembrolizumab but is also funding Opdivo from another company enabling a very comprehensive—very comprehensive—approach to this. Important too—and we have discussed it in the past in this House—are new treatments for hepatitis C and Health Committee members here in the Committee will absolutely be aware particularly when we went through the Health (Protection) Amendment Bill of the cry the call from the community for these drugs. Pharmac can now fund those along with five other drugs and is continuing to look at positive ways forward. That has been enabled not only by the hard work of the people at Pharmac strongly negotiating and engaging with the sector but by the extra funds allocated in this Budget. I want to talk about immunisation next—it is not quite Pharmac directly although naturally it touches on it. Pharmac buys the immunisation products required the vaccines but actually it is this Government that has successfully targeted not only the flu sector—that is for everyone—but also rheumatic fever and the variety of other vaccinations that are required. There are stunning results through extra funding not just across the sector but particularly in Māori and Pasifika communities which often statistically lag miles behind. In fact I believe—I am happy to be corrected—that particularly around rheumatic fever Māori and Pasifika immunisation rates are higher than Pākehā rates and I think that is absolutely fantastic. Meka Whaitiri: They're living in cars and garages.SIMON O'CONNOR: I am thinking of the immunisation factor. I would be interested to hear more on that. That is my understanding. I am talking of just my general thoughts and what I have read rather than specific notes but I think there have been remarkable results there. We are seeing more and more funding into areas such as the work on the Healthline. We are seeing more funding into the district health boards. They are going to go from strength to strength. One of the elements I am seeing is strong and positive communication with the sector not only with us as members of the Health Committee but with the Minister and we must continue to be as responsive as we can. I am conscious that I am going to run out of time which is unfortunate seeing there is actually a whole lot more to be said but one thing I find manifests itself in my own electorate is the $18 million for healthy homes.