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Free prescriptions are gone for most people - but this year's health budget includes new money for training more doctors, increasing access to breast screening and putting security guards in emergency departments.
Pharmac's budget boost of $1.77 billion over four years will just cover ongoing costs for existing medicines - not the extra cancer drugs promised by the National Party pre-election.
The total health spend is now about $29.6b - up from $26.5b in the previous budget.
Health Minister Dr Shane Reti said the government was increasing overall health funding by $16.68b over the three budgets.
"We want the health sector to plan for the future with confidence, knowing our government will always prioritise increased investment for services it delivers.
"That's why we are confirming today not just health funding increases from this Budget, but pre-commitments for additional funding from our next two Budgets as well."
In her Budget address, Finance Minister Nicola Willis said the multi-year approach to health would give the sector "certainty".
"Make no mistake - boosting funding for health will always be a priority for this government," she said.
In response to questions about the "broken promise" to fund cancer drugs, Willis said the government remained "committed to increasing access to cancer treatments".
"We regret it hasn't been possible in this Budget."
Partly that was because it would have involved "a fundamental change" to Pharmac's operating model, which meant it had sole responsibility for choosing which drugs to fund.
"But we are committed to delivering on this policy in future Budgets."
New health investments over four years:
- $3.44b for hospital and health services
- $2.12b for primary, community and public health
- $1.77b for Pharmac "to ensure Kiwis can access the medicines they need" (previously announced)
- $31.2m to roll out breast screening up to 74 years (up from 69 years)
- $31m for increased security at emergency departments
- $22m to train 25 more doctors each year (through the existing medical schools at Otago and Auckland universities - Waikato University's plan for a new medical school - which had support from National - is not in the Budget)
- $24m for free counselling for young people through Gumboot Friday (previously announced)
- $9.7m to establish a National Health and Addiction Community Sector Innovation Fund
Just under $66m is ring-fenced this year for Covid-19 vaccines, anti-virals and public health surveillance infrastructure for pandemic preparedness - $232m over four years.
Cutting jobs and contractors at the Ministry of Health is set to save $12.6m this year, along with another $31.5m from the disestablishment of the Māori Health Authority Te Aka Whai Ora.
Reinstating $5 prescription charges for everyone except those under 14, pensioners and Community Service Card holders will save just under $71m.
Willis said the government's vision for health was the same as every New Zealander: shorter wait times for elective surgery, specialist appointments and other services.
"Those things will be achieved with relentless focus.
"We are a government that's measuring performance and we have high expectations of what Health New Zealand will achieve with those billions and billions of dollars."
In response to questioning about the defunding of initiatives specifically targeted at Māori, including Te Aka Whai Ora, Willis said patients at emergency departments "don't turn up thinking about their ethnic identity - they turn up thinking about their need".
The government was confident it would be "delivering for Māori", she said.
Reti said the Budget also retained "funding in contingency" in anticipation of pay equity settlements for staffed employed by non-government healthcare providers.
GPs and other primary care providers have been struggling to hold on to nurses, with the higher pay on offer in hospitals.
"Our government is prepared to make fair and reasonable contributions to supporting non-government healthcare providers to deliver ongoing services but we will not be committing to specific funding amounts in advance of settlements being reached.
"The value of those contingencies remains commercially sensitive."