Craig LizDr LIZ CRAIG (Chairperson of the Health Committee): Thank you Madam Chair. It's an absolute pleasure to as chair of the Health Committee provide an overview of the health Estimates hearings for this year. Health is an incredibly busy sector. There's a lot going on and the total appropriations for Vote Health this year were just under $24.4 billion. Within that the Minister of Health is responsible for the appropriations of just over $23.5 billion and also the Minister for COVID-19 Response is responsible for the multi-category appropriation called National Response to COVID-19 across the health sector of $894 million. So what we did is we had separate hearings this year from the Minister of Health and the Minister for COVID-19 Response and so today's debate will focus on the non-COVID appropriations with the appropriations relating to COVID-19 and managed isolation and quarantine being covered in another debate.So basically we had a whole range of discussions in our Estimates hearings on health and that included the upcoming health and disability sector reforms funding and the roll-out of mental health services quite a bit of discussion around cost and volume pressures for DHBs and primary care. We talked about cyber-security we talked about improving health outcomes for Pasifika communities and we also talked about capital and operating expenditure and how we can fund some of that—you know our buildings and infrastructure. We also talked about progress on the New Zealand Upgrade Programme. We also focused on some of the new spending that we're going to be looking at in terms of expanding cancer screening—HPV screening for cervical cancer for example—extra funding for road and air ambulance services establishing an Aged Care Commissioner and also extra funding for Pharmac.In the time available I'd like to just go into a bit more detail on a couple of those starting with the health reforms. As we know in April this year in response to the Health and Disability System Review the Government announced reforms of the health sector. This includes disestablishing our 20 DHBs and establishing two new entities: Health New Zealand and the Māori Health Authority. As many are aware Health New Zealand will assume a lot of the functions of DHBs taking over their contractual arrangements and their assets and also assume functions of the Ministry of Health. The Māori Health Authority will lead the commissioning of Māori health services and co-commissioning services which significantly impact on Māori. So we heard that Budget 2021 includes $486 million over four years to implement these reforms and that not only includes cost of restructuring but also includes the commissioning of some services. When the Minister was talking to us he was talking about the fact that establishing these structures and looking at the respective governance and decision-making arrangements would need to be rolled out over a four-year period.Some of the Budget is for the Ministry of Health to establish these new entities—Health New Zealand Māori Health Authority—and some of the associated functions but there's also some other spending: for example for Health New Zealand some funding to pilot the local network planning approach that sits and underpins those health reforms and also funding over four years for the Māori Health Authority. The Minister talked about how Tā Mason Durie is leading the steering group of Māori leaders and having discussions within Māori communities about how the Māori Health Authority might operate. He also gave examples of for example screening campaigns for cancers that disproportionately impact Māori as an example of where the Māori Health Authority could advocate for policy that addresses disparity for Māori.Some of the members that were present asked given that we've got a big piece of work in terms of the health reforms but we've also got equally big pieces of work around rolling out the response to COVID-19 and the vaccination programme whether we could do both together. Certainly what the Minister responded with is that he'd had extensive discussions with the Director-General of Health and with the Ministry of Health and he believed that we could be doing both simultaneously—particularly given that we've got additional resourcing in Budget 2021 to assist with that. We also had a lot of discussions around mental health services given the increasing demand for mental health services across the country and discussed the funding of a number of various programmes. There was a range of other issues that I've highlighted in the beginning of my speech but what I will do is leave my colleagues in the Health Committee to ask the Minister further questions in these and other areas. Thank you.