Watts Simon; Little AndrewSIMON WATTS (National—North Shore): Minister I've got two areas of questions that I want to go through: one around workforce and the second aspect around infrastructure. I have three questions in each of those areas. The first is on workforce. In regards to the conversations we had through the Estimates process how much in the Budget will specifically go to engage new healthcare workers given the increase in workforce crisis and has he been discussing this issue with any other Ministers? Our second question: has he asked the Minister of Immigration to expedite residency processes for the thousand or so registered doctors and nurses who are currently in limbo in the residency queue and if not why not? Lastly we covered in Estimates the ambulance operations. What I'm interested in is whether he has received any briefings or correspondence from ambulance emergency service operators about staffing shortages in their sector? Hon ANDREW LITTLE (Minister of Health): I thank the member for his questions. In relation to how much is in the Budget for new healthcare workers can I just say this. First of all in the last three years this Government has funded an additional 3000 nurse positions—that's just nursing—and there is a range of other additional clinical roles that the Government has funded as well. But the reality is as the member identifies that there are vacancies and when it comes to the nursing workforce we know there's roughly across the DHBs 1450 nurse vacancies. Those roles are funded but they're not filled and so the challenge is not so much getting additional funding; it's actually getting on with filling those roles. There's a bit of a vicious circle there too and I suspect—and not just I suspect" but some of it will have to do with pay. That's why the pay equity claim is so important and getting that into the next phase which is negotiating it and then getting that concluded and in place and the conditions. So we know that the hospitals in particular have been under extraordinary pressure partly because of the shortages of workforce and then the shortages of workforce relate for some who used to work there to just how unattractive it became. We've got to address all of those things and we're going to address those serious workforce issues. In terms of building that future pipeline of work we have funded in terms of the mental health funding the longer-term work of additional clinical specialists. That work is under way and we continue to work with the training providers to make sure that we are supporting that future pipeline. In relation to the immigration issues the member raises and I have had the discussions with the immigration Minister to make sure that the ability to get healthcare workers and healthcare specialists across the border is as easy as possible. The reality is with COVID19 it will arrive—it is very difficult. But when you look at the exemptions granted to non-residents and non-citizens of those coming across our border 43 percent are healthcare workers from your senior clinical specialists to a variety of others. For those who are already here but who are wondering about either renewing their visas or trying to get residency that is a piece of work under way right now and again I've made my representations to the Minister of Immigration. We need to hold on to those that we've got and I have had contact from many in that situation who are waiting patiently who are doing an amazing job and who we all understand that we need to make sure we have a very clear pathway for and I'm confident that we will. In relation to ambulance operations the most recent advice I've had was actually in relation to the negotiations with the ambulance service and the road ambulance service providers so that is under way. We're renewing their agreement for a period at the moment and then we'll kind of review generally what is needed. But we continue to support those ambulance service providers including providing support outside of budgeted appropriations. So in each of the last couple of years we have provided top-ups to make sure that those services have attracted the people they need to fill the gaps that they've got and provide the high-quality service that New Zealanders expect of their road ambulance services."