For four years in a row, the Government's press release on Budget day has been identical: "Health budget increases to record high".

National has lifted spending on health in each of the last four years, hitting $16.1 billion in 2016 - a 1.3 per cent increase.

Another record spend is possible on Thursday, as the Government's books continue to improve.

Analysis by trade unions and Opposition parties, however, gives a different slant to the Government's annual headline.


According to a report released by the Council of Trade Unions, the NZ Nurses Organisation and Public Service Association this week, the Government needs to lift funding by $720m just to "stand still", or keep up with population growth and rising costs.

Another $375m is needed to cover the costs of a equal pay agreement with aged care and home support workers over the coming year.

That total of $1.1 billion does not cover estimated shortfalls from previous years.

Labour health spokesman David Clark said his party also wanted the Government to begin "back-filling" the health sector's $1.7 billion gap in funding since 2010. This estimate by analysts Infometrics is based on the increase in Crown expenditure relative to inflation and population growth.

"It seems that over the course of this Government's time, it has starved healthcare," Clark said.

"It hasn't delivered sufficiently to maintain the current level of service. Add the number of people the population is growing by, and the Budget has not grown commensurately.

"That means each person can expect a lower level of service from the health system than they used to get."

Public Service Association head Erin Polaczuk said funding shortfalls were being felt on the front line. Stress levels and workplace pressures were "more intense than ever", she said.


The unions' analysis said around $580 million more funding was needed for district health boards - up from $400m last year.

Association of Salaried Medical Specialists Ian Powell said there was particular need for more hospital specialist places. A survey by the association taken in July and August last year found half of specialists - includes surgeons and physicians - had experienced burnout.

Labour also wants a greater focus on primary care in the Budget, in particular more affordable GP appointments and adequate NGO funding.

"That's where the preventative stuff goes on," Clark said. "We feel the Government has had an exclusive focus on short-term targets at the expense of preventative areas with long-term costs."

One of those targets is elective surgery, which the Government has poured money into in successive budgets. National has a target of increasing elective surgeries like hip and cataract operations by 4000 a year - which was easily exceeded in the last quarter.

Also on Labour's wish-list is a funding boost for mental health, which is emerging as a key issue in election year. The party wants a broad review of the mental health sector. But in the meantime, it has proposed putting dedicated mental health teams into GP clinics in eight centres around the country - at a cost of $43m.

Labour could get its wish, possibly as soon as Thursday. Health Minister Jonathan Coleman hinted that the Government is looking at a similar initiative, which has been called for by professionals in the mental health sector.

The Green Party supports Labour's proposals on mental health and filling the funding gap. Health spokeswoman Julie Anne Genter said her party also wants measure to address child obesity, including a tax on sugary drinks, healthy food in schools and public buildings, and measures to make it safer for kids to cycle to school.

New Zealand First wants adequate funding for the free GP consultation scheme, which was extended by National from under-6s to under-13s in 2015. It also wants three free GP visits a year for SuperGold card holders.

Ahead of the Budget, the Government has announced a $60m boost to Pharmac to allow greater access to medicines. Another $59.2m will be put towards emergency services, which will allow all road ambulance call-outs to be double-crewed.

Announced so far: $60m over four years more for drug-buying agency Pharmac. $59m over four years make sure all road ambulances are double-crewed.

Total health budget: $16.1 billion
$124m for Pharmac to provide more access to medicines. $96m for more elective operations. $39.3m to roll out a national bowel screening programme for people aged 60 to 74. $18m to help insulate homes to prevent illnesses like rheumatic fever.

Total health budget: $15.9 billion
Extra $320m for district health boards. $98m for more elective surgeries. $76m to expand palliative care services. $12m to extend bowel cancer screening pilot programme.

Total health budget: $15.6 billion
Free GP visits and prescriptions extended to under-13s, at cost of $90m. $320m for district health boards. $112m for disability support services. $110 more for elective surgeries. $96m for home-based support services.

Total health budget: $14.7 billion
Extra $250m for district health boards. $100m to address cost pressures in disability support services. $70m for aged care and dementia services. $48m for more elective surgery like hip operations and cataracts. 25m for more for increased breast cancer screening.