While Northland's health sector has some success stories to celebrate after last year's funding round, others are desperate for more money - especially aged care.
In the lead up to Thursday's Budget 2022 announcement, the Government has indicated that health along with climate change will be a major focus.
Aged care providers are among those asking the Government for more funding to provide their services.
The Mid North's largest rest home operator, Kerikeri Retirement Village, has come out saying aged care in Northland was at the "breaking point" facing a "dire" staffing shortage.
Chief executive Hilary Sumpter said an ever-increasing number of elderly people in need of an aged care provider mixed with difficulties to hire and keep trained nursing staff has led to a shortage of aged care beds.
According to Sumpter and the NZ Aged Care Association, the pay gap between aged care and hospital nurses has exacerbated the issue.
Aged care nurses currently earn around $10,000-$15,000 a year less and the gap is set to widen as current pay negotiations could see a wage boost for hospital nurses.
"Nurses in rest homes do exactly the same work as those in hospitals and, in fact, are experts at being able to do everything rather than specialise. What could possibly be the Ministry [of Health]'s justification for valuing their work any differently?" Sumpter said.
"Government is effectively outsourcing care for the elderly, then doing everything it can to ensure that we can't get the staff to provide that care. It's lunacy. And how does this speak to how our nation values its elders?"
There are currently not enough care beds in the Mid and Far North to meet demand.
Kerikeri Retirement Village has a waiting list of 120 people for its 66-bed care facility.
Meanwhile, care facilities are choosing to close their doors rather than compromise quality standards.
Aged Care Matters, a movement of members of the NZ Aged Care Association to escalate a national dialogue on the crisis in the aged care sector, recently commissioned research to highlight the stress the crisis is causing our industry.
According to the survey, about a third of aged care facilities said assuming current levels of Government funding continued over the next 12 months, is it "very likely" or "likely" they will have to close aged care facilities.
Sixty-five per cent of respondents said that based on their current funding, it is "very likely" or "likely" they will have to cease or restrict taking admissions into their aged care facilities.
"We are at a tipping point," Sumpter said.
"Around 500 beds have gone from the sector in the past six months alone and around 20 facilities have closed hospital-level beds. Once local aged care providers decide to close beds, it is hard to bring them back."
What did we gain from the 2021 Budget?
As aged care struggles and asks for more for their staff and to expand facilities, and senior doctors, nurses and allied health workers are bargaining for better pay, some Northland examples prove that investment in health can deliver good outcomes.
As part of the 2021 Budget, Northland received some of the $55.6m earmarked for the rollout of the national bowel screening programme in the region.
The programme launched at the end of last year is designed to save lives by finding bowel cancer early when it could often be successfully treated.
The Northland team of gastroenterological specialists has already successfully identified several cases of cancer earlier than usual due to the improved service.
Northland DHB estimates that in the first year of screening they would detect 41 cases of bowel cancer.
Government funding also helped launchMana Ake, a youth mental health scheme to provide early intervention to promote wellbeing and mental health support for 21,000 primary and intermediate aged children across 141 schools in Te Tai Tokerau.
Northland was among four districts that received a total of $12m to start the practice-based scheme.
Another $53m saw the rollout of a new primary test for cervical cancer screening that enables women to test themselves through their general practice or at home.
The self-test detects high-risk Human Papillomavirus (HPV), which is the cause of cervical cancer. Screening for HPV can detect pre-cancerous changes before cervical cancer develops.
Four Northland general practices including Whanau Ora Community Care, James Street Doctors, The Doctors Tikipunga and Hokianga Health are taking part in the initial trial part which was launched in February.
While Whanau Ora Community Care practice lead Mark Guadalupe said the takeup has been slow, he believed the self-tests would be beneficial to patients who have to travel long distances to see their doctor.
Northland DHB chair Harry Burkhardt said if you take on a macro-view there is always a requirement for more funding for health but it was about rationing.
He described the last year as "unusual" in financial terms as the Government stepped in to support the district health board through a $20m deficit.
With the 2022 Budget and the upcoming health reforms in mind, Burkhardt said it was his aspiration that New Zealand will be looked at for its best practice in terms of health care.