Barry MaggieHon MAGGIE BARRY (National—North Shore): Thank you Madam Chair. I rise to look at the health situation. I'm tempted to start with a remark about some doctors making you sick and some making you better but really there is much more interesting stuff to get on with here with the Estimates.It was very interesting for the Health Committee to confirm that Vote Health 2018 had the widest gap between the reality and the rhetoric—and it certainly did. The Minister David Clark talked about the challenges of facing a growing and ageing population with more complex needs. He was right about that one thing but what did he actually do to deliver in this health budget for that ageing population's needs? What did he do for example to look out and plan for the next 20 years when there will be 1.3 million New Zealanders over the age of 65?There is a very real need to front-load more money into healthcare particularly for our older and more vulnerable New Zealanders. Minister Clark said that there are challenges. Yes older New Zealanders are known to consume something like three to four times the amount of healthcare services and that rises dramatically from the age of about 50. Those are the international trends. We don't need to think too hard about it—there is certainly a need for a greater investment in that level of services. So what is he doing about it? Is he managing increased demand for elective surgery? No he is not. What provision is he making for providing greater access for primary care? As far as many senior New Zealanders are concerned nothing very much at all.We have palliative care which is incidentally expected to increase by about 51 percent over the next 20 years or so. Under a National Government we delivered an extra $150 million to hospices and into funding end-of-life care but what has this Minister done in this Budget to allow for it? Absolutely nothing. Palliative and end-of-life care is something that needs to be invested in at a more meaningful level. I think that the amount of money that is put into it at an earlier stage given that everybody has to die whether they're older younger whatever—sometimes unfortunately people are taken before their time. But there needs to be more consideration given to ensuring that end-of-life care is available to people wherever and whenever they need it—so whether it comes to boosting hospice funding for example.Thirty-four hospices do a remarkable job in New Zealand. Last year they made something like 145000 calls to people's homes. People being able to stay in their own homes is I would suggest to the Minister a very worthwhile investment. If that's where people who are dying want to stay and if that is where people who have dementia would like to stay—in their homes—for as long as possible again it requires a level of funding and a level of increase in that funding that will allow for caregivers the people who are responsible for really making the homes safer.I would urge the Minister to look at the ACC funding that the last Government put into falls prevention. More than $30 million was put in. When I search through the Estimates in Vote Health there is nothing that is going to be able to advance a safer and more preventative measure which has shown to be very worthwhile and saves a really difficult situation for older people particularly who have a fall and are then very high-needs.We also see people in that older age group who find that they don't have the level of resources that they need to stay in their own homes in terms of the budgets in terms of the increasing costs of rent. These are not necessarily within the health budget but again I would urge the Minister to be more of an advocate for health for older people. We're not seeing it from the current Minister for Seniors but perhaps the Minister of Health would like to pick up on that because it is something that requires a decent amount of money at an early stage.I think when I talk to seniors—particularly those with onset dementia—they are seeing no realistic funding or any kind of support through the health dollar for the wonderful work that is done by dementia and Alzheimer's groups around New Zealand. They need some leadership and guidance. If it isn't coming from the Minister for Seniors Tracey Martin then perhaps the Minister of Health could look again at making up the shortfall because there are vulnerable New Zealanders who need a leadership initiative from this Government. They are waiting to see it. They've been waiting nine months and they have received nothing not even an indication that it's really being taken seriously as a health concern. Dementia is arguably with our ageing population one of the more significant areas of need that this country needs to make a profound investment in. Therefore Vote Health is woefully lacking in 2018. Thank you.