This week I will be going into my first Budget lock-up. This reflects the fact that I am privileged to be the deputy leader. Health is the second most expensive component to the Budget behind social services and I hold the health spokesperson role, and one generally wants folks in the lock-up who have accounting backgrounds.
Budgeting for health is always complex. There is never enough funding and critical decisions need to be made around what is prioritised and what is not, especially when all options have some degree of validity. It is my observation critiquing multiple international health systems that prioritisation of scarce health resources is a worldwide phenomenon.
In the context of competing priorities it is however a good debate to set some expectations for what the health budget 2021 might deliver as maybe three manifesto projects separate to keeping hospitals and primary care up and running.
Increasing funding to Pharmac is a priority. Last year we proposed more than $200 million of new money for Pharmac and rare disorders and it would be good for the budget to at least match that.
This week I stood on the steps of Parliament and received a march from Patient Voice Aotearoa lobbying for more Pharmac funding. When I addressed the crowd I spoke about more funding, improved timing to decision making, benchmarking performance with international systems and asking the Government to reconsider stopping the Pharmac subsidy support for newly diagnosed cancer in children.
The circumstances shouldn't change to fit the policy, the policy needs to change to fit the circumstance.
Dental health continues to be an area that needs a lot more funding. I understand the need for emergency dental grants and maybe more mobile dental vans, but fundamentally better oral hygiene in childhood and healthy-eating education will touch more people for longer than an emergency dental grant for tooth extraction via the ambulance at the bottom of the cliff.
Last year we proposed a $120m supervised child tooth brushing and fluoride varnish programme for all primary and pre-primary school children modelled on the successful Scotland dental health initiative. Improving dental health is also to improve a key inequity driver.
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Cochlear implants have a dramatic impact on people's lives. My clinical observation is that cochlear implants and cataract repairs are some of the true miracles left in medicine with immediate effect.
Doubling the number of cochlear implants would have a wide ripple effect through many families and as we confront an increasing wave of dementia and Alzheimers in older people, let's also remember that poor hearing is a significant risk factor that is diminished with this procedure.
Some of the Budget announcements that have already been made are things we would do also. They just make sense. Last year we proposed to implement the new HPV cervical screening programme and I'm pleased this has been taken up and even more pleased with the inequities that will be reduced and the early cancer we can treat.
There are so many things we could and should do in the upcoming Health Budget and I am very much looking forward to the mystery and intrigue of the lock-up and unwrapping Budget 2021 for scrutiny and analysis.
• Dr Shane Reti is deputy leader of the National Party and a list MP based in Whangārei.