Clark DavidHon Dr DAVID CLARK (Minister of Health): I want to address some of the points raised by members during this debate and make a few comments along the way about the overall health budget. This is the biggest investment a Government has made in nearly a decade into healthcare. Overall it's a $3.2 billion investment—represented in the documents in the Budget that we're examining—including $750 million in capital investment which is the most significant certainly in a decade. This is a big Budget for health and it needed to be. We have significant underfunding in the health sector and as my colleague Anahila Kanongata'a-Suisuiki noted when an emergency department is visited these days they're pretty busy places—they are very stretched.I want to particularly address the issue of health targets which has been raised and the honourable member who raised this talked about the progress made against those targets. It's true that some of those targets have driven good progress and I certainly have never denied that. The quicker emergency visits target is celebrated widely. The fact that faster cancer care should happen is true although I note that the target focuses on only 25 percent of cancers. The immunisation target was largely achieved a long time ago. But some of the other targets clearly are not ideal. An obesity target that simply stamps referrals—so that if I referred to a practitioner and they referred back to me that's two stamps on the book—doesn't actually reduce obesity. Nor too does a target on activity around tobacco control.So this Government is concerned to put a suite of measures in place that actually looks at how we improve the overall population health—measures that are broader and that can track the progress of district health boards (DHBs) rather than focusing on specific targets that can distort behaviour in the sector and can mean that investment isn't necessarily going where it produces the best value for the taxpayer dollar. Of course the pin-up for that is in the area of electives where we know that figures have been pumped up by Avastin injections and skin lesion removals that in many cases were previously done in primary care. So we want the best value for taxpayer money from the available health dollar. That's what this Government stands for and we're less interested in a particular narrow set of political targets.In response to the issue raised by Mr Reti around the Deloitte review I'm advised that it does catalogue the failures under the previous Government's watch. I'm surprised he wants to keep bringing it up when that's what it's actually a review about but there we are. They spent $119 million and have nothing to show with it—$119 million and nothing to show with it—and that is indeed recorded in the Estimates document. Why he keeps bringing that up is a mystery to many many people.Then Maggie Barry raised the issue of the health of older people and I want to congratulate the Hon Tracey Martin for the work that she's doing in that area. Health of course has invested in this Budget in preparation work for a SuperGold card check for all people and also the cheaper doctors visits initiative that will see community services card holders able to access cheaper doctors visits will affect hundreds of thousands of seniors in this country and will mean that they get doctors visits in many cases $20 to $30 cheaper. This is a good Budget for older folk.On top of that of course is the biggest investment into DHB funding in nearly a decade. This Budget is really significant in that respect: $549 million per annum is going to DHB budgets as compared to the previous Government's record which includes over the last period $439 million $400 million $300 million $275 million and $250 million—low numbers—going into the DHBs. I guess that's why they've been put under such strain. I do want to congratulate the health workers that continue to work in our health sector despite the underfunding over many years that they've struggled with.Mr Doocey's point—quickly—about the initiative and his mistake. I acknowledge that but we've put another $200 million into DHBs we estimate over the forecast period for mental health within the ring-fence. On top of that there is $49 million in new initiatives and we would expect more to come out of the mental health and addiction inquiry that's under way. This is a Government determined to deliver joined-up services and when he talks about pilot initiatives that never happened in the nine years they were in Government and says that somehow this is this Government's failure I want him to have a look in the mirror.Thank you for this opportunity. This is the best Budget for health in a decade.