Prevention better than cure in health budget?

More tax on tobacco - maybe a levy on sugar? Or perhaps an increase in state-funded lifestyle coaching?

Everyone's agreed smoking and bad food choices lead to patients filling up hospitals.

So which way will the Government's Budget go to reduce the strain?

Let's start with heart disease. It kills someone in New Zealand every 90 minutes.

It's a stark and disturbing statistic; perhaps one you've heard before, but isn't going away.

That's where today's Budget could come in.

The Heart Foundation says more funding is needed for public projects to encourage people to lead better lifestyles.

It's talking about Government plans such as Healthy Families, where community health providers work with people to cut out the cigarettes, drink less beer, wine and liquor, and do a bit of exercise.

The Foundation's Medical Director Gerry Devlin says slowly those initiatives will start to lift the burden from hospitals.

"Not only is it New Zealand's number one killer, we also have a number of people living with heart disease. A lot of them have a significant disability and they live with heart disease and I think we've got to actually make ourselves more relevant [in] how we help those people lead productive lives".

Then there's tax. Gerry Devlin's message: hit the unhealthy stuff hard - put a 50 percent duty on tobacco.

Tax or talking?

Making healthy food choices and staying active can prevent people getting Type 2 diabetes.

But the lobby group Diabetes New Zealand is not so keen on boarding the tax train to target sugar.

Instead its president Chris Baty wants money to be spent on a Government team to lead the fight against diabetes.

"That would look like anything from discussions with our food manufacturers around the reduction of sugar in products. Also, obviously fat and things like that...[through] to leadership in encouraging environments that are conducive to physical activity, and just a general education really"

And what about another mass killer?

Bowel cancer takes down 100 people a month.

Bowel Cancer New Zealand's Sarah Derrett says the charity would be blindsided if there isn't money to expand a screening pilot.

"If the minister wasn't going to announce the rollout of a screening programme we'd be wanting the minister to explain why not when we're losing 1200 New Zealanders a year to this condition. And the Waitemata DHB has demonstrated beautifully, as we knew would be the case all along, that lives that can be saved if a screening programme's in place".

Big bucks

Hospitals get the bulk of the health budget.

The senior doctors' union says $630 million is needed this year just to keep services running as they are. Although, the Association of Salaried Medical Specialists says in the past, funding has only ever totalled half of that figure.

Ian Powell, who represents the Association of Salaried Medical Specialists, says the dwindling number of consultants needs some serious attention.

'Utmost in the priority list needs to be investing in the specialist workforce. We simply have a system now that shortages of specialists have become entrenched and have become the norm and have been taken for granted. We have an overworked specialist workforce. The more you overwork a workforce the more that you stretch it, the more you run the risk of actually making mistakes in the treatment of patients".

Last year, the health sector was startled when the Government announced there would be free doctors' visits for children up to the age of 13.

Fresh, welcome surprises will be sought this time, too.