1. Question No. 1—HealthDr SHANE RETI (Deputy Leader—National) to the Minister of HealthORAL QUESTIONSQUESTIONS TO MINISTERSQuestion No. 1—Health1. Dr SHANE RETI (Deputy Leader—National) to the Minister of Health: What is the latest estimate for the total cost of the health system restructure and what risks if any have been identified that could delay the new system being established by July next year?Hon ANDREW LITTLE (Minister of Health): Talofa lava Mr Speaker. In response to the first part of the member's question Budget 2021 provided a total of $485 million over the next four years which includes funding to establish the Māori Health Authority establish Health NZ build workforce capacity prototype localities and support the transition unit and Ministry of Health through the transition. In response to the second part of the member's question as would be expected for a reform of this scale there are material risks that need to be monitored and managed as we move towards implementation. These include disruption and uncertainty of the system and for those working within it. However I am confident that these risks are being managed and mitigated appropriately.Dr Shane Reti: If there is a business case for the health restructuring what does the business case estimate the total cost of the health restructuring will be?Hon ANDREW LITTLE: I thought I'd largely answered that question in my answer to his primary question but to the extent that the member asks for a business case the case for change was made in the report of the Health and Disability System Review that was published last year. And it's not only made there but it's made in the literally hundreds and thousands of people I come across pretty much every day who tell me it's time for change in our health system and to have a health system that serves the needs of all New Zealanders.Dr Shane Reti: When he was unable to name one health outcome yesterday that would be improved in the first year of the $485 million health restructuring can he today name one health outcome that will be improved in the first year of the restructuring?Hon ANDREW LITTLE: We will have a better health system as a result of these reforms.Dr Shane Reti: Is he really telling New Zealanders that for $485 million in health restructuring he cannot today name one single health outcome that will be improved in the first year?Hon ANDREW LITTLE: I can revert to the answer I gave in questions to the select committee yesterday and say that that member is being just a little bit cute. So for a party that when in Government successively underfunded the health system year after year after year and has left it to this Government to rebuild it and restore it and restore public confidence in it I'm just a little bit stunned that he is looking for those sorts of responses. The reality is we have a health system now that is not serving the needs of all New Zealanders and it needs to change and we are changing it.Dr Shane Reti: How will spending $485 million in creating new health agencies in Wellington make any difference to the outlook for a Māori patient in South Auckland on renal dialysis?Hon ANDREW LITTLE: The member clearly misunderstands what has been provided for in the Budget two weeks ago. Maybe he hasn't read it but actually what that funding will provide for just in relation to the Māori Health Authority is not just establishing that Māori Health Authority but actually working on some initial commissioning of Māori services and building the capability of kaupapa Māori health services. In addition to that it is providing for the establishment of Health New Zealand. Health New Zealand actually needs to be across Māori health needs as well. Because it's not going to be confined to just one single part of the health system. There are a number of things that that investment is going to purchase but in the end it will be about a well and much improved health system for all New Zealanders.Dr Shane Reti: How many extra years of life if any is it estimated that New Zealanders will gain from $485 million spent on health restructuring compared to $485 million invested in Pharmac?Hon ANDREW LITTLE: What will improve life chances and life expectations for New Zealanders is actually having a health system for the long term and the long sustainable term that provides for the health needs of all New Zealanders. That's why this Government has increased funding for the health system by more than 45 percent since it became Government has put more than $5 billion into health facilities since it's become Government. That's the stuff that over time adds to life chances.