Vote Health. APPROPRIATION MINISTER(S): Minister of Health (M36) APPROPRIATION ADMINISTRATOR: Ministry of Health

Vote Health APPROPRIATION MINISTER(S): Minister of Health (M36) APPROPRIATION ADMINISTRATOR: Ministry of Health RESPONSIBLE MINISTER FOR MINISTRY OF HEALTH: Minister of Health THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 5

Overview of the Vote Vote Health ($16,773 million in ) is the primary source of funding for New Zealand s health and disability system (ACC is the other major source of public funding). It is a significant investment for the Crown, typically making up around a fifth of government expenditure. The services funded are intended to support all New Zealanders to live well, stay well, and get well, in a health system that is people-powered, provides services closer to home, is designed for value and high performance, and works as one team in a smart system. The Vote comprises: $12,683 million (75.6% of the Vote) is provided to 20 district health boards for services to meet the needs of each district s population, taking into account regional considerations, government priorities, and the strategic direction set for the health sector. Among the many services provided or funded by DHBs are hospital care; most aged care, mental health, and primary care services; the combined pharmaceuticals budget; and some public health services. $2,698 million (16.0% of the Vote) funds health and disability services, funded at a national level, and managed by the Ministry of Health, comprising: National Disability Support Services ($1,208 million or 7.0% of the Vote) Public Health Service Purchasing ($406 million or 2.4% of the Vote) National Elective Services ($347 million or 2.1% of the Vote) Primary Health Care Strategy ($196 million or 1.2% of the Vote) National Maternity Services ($147 million or 0.9% of the Vote) National Emergency Services ($110 million or 0.7% of the Vote) National Child Health Services ($85 million or 0.5% of the Vote) National Personal Health Services ($84 million or 0.5% of the Vote) National Mental Health Services ($62 million or 0.4% of the Vote) Other national services ($54 million or 0.3% of the Vote). $736 million (4.4% of the Vote) for the support, oversight, governance, and development of the health and disability sectors, comprising: Ministry of Health operating costs ($198 million or 1.2% of the Vote) and capital investment ($8 million or less than 0.1% of the Vote) Supporting Equitable Pay for Care and Support Workers ($279 million or 1.7% of the Vote) Health Workforce Training and Development ($187 million or 1.1% of the Vote) Monitoring and Protecting Health and Disability Consumer Interests ($29 million or 0.2% of the Vote) National Health Information Systems ($8 million or less than 0.1% of the Vote) Other expenses ($27 million or 0.2% of the Vote). $656 million (4.0% of the Vote) for capital investment, comprising: sector capital investment ($591 million or 3.5% of the Vote), technical expenditure ($15 million or less than 0.1% of the Vote), and a provision for deficit support for DHBs ($50 million or 0.3% of the Vote). Details of these appropriations are set out in Parts 2-4. 6 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

Details of Appropriations and Capital Injections Annual and Permanent Appropriations Titles and Scopes of Appropriations by Appropriation Type ed Actual Departmental Output Expenses Health Sector Information Systems (M36) This appropriation is limited to the provision of information technology services and the publication of data and information derived from these services to the health and disability system. Managing the Purchase of Services (M36) This appropriation is limited to purchasing services for the public and health and disability sector on behalf of the Crown, for those services where the Ministry has responsibility for the purchasing function (i.e. funding is not devolved to another entity). Payment Services (M36) This appropriation is limited to the administration and audit of contracts and payments on behalf of the Crown and Crown agencies. Regulatory and Enforcement Services (M36) This appropriation is limited to implementing, enforcing and administering health- and disabilityrelated legislation and regulations, and provision of regulatory advice to the sector and to Ministers, and support services for committees established under statute or appointed by the Minister pursuant to legislation. Sector Planning and Performance (M36) This appropriation is limited to advising on and co-ordinating health sector planning and performance improvement; and funding, monitoring, and supporting the governance of, health sector Crown entities, and sector co-ordination. 54,278 54,178 51,618 34,964 33,764 36,213 17,918 17,818 17,340 22,433 22,333 24,694 48,572 48,272 47,426 Total Departmental Output Expenses 178,165 176,365 177,291 Departmental Capital Expenditure Ministry of Health - Capital Expenditure PLA (M36) This appropriation is limited to the purchase or development of assets by and for the use of the Ministry of Health, as authorised by section 24(1) of the Public Finance Act 1989. 17,010 17,010 8,000 Total Departmental Capital Expenditure 17,010 17,010 8,000 Non-Departmental Output Expenses Auckland Health Projects Integrated Investment Plan (M36) The appropriation is limited to expenses incurred in developing an Integrated Investment Plan for Auckland Health projects. Health and Disability Support Services - Auckland DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Auckland DHB. Health and Disability Support Services - Bay of Plenty DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Bay of Plenty DHB. Health and Disability Support Services - Canterbury DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Canterbury DHB. Health and Disability Support Services - Capital and Coast DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Capital and Coast DHB. 720 320 650 1,195,267 1,195,267 1,239,980 664,890 664,890 694,230 1,335,697 1,335,697 1,375,372 702,655 702,655 738,901 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 7

Titles and Scopes of Appropriations by Appropriation Type ed Actual Non-Departmental Output Expenses - cont d Health and Disability Support Services - Counties-Manukau DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Counties-Manukau DHB. Health and Disability Support Services - Hawkes Bay DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Hawkes Bay DHB. Health and Disability Support Services - Hutt DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Hutt DHB. Health and Disability Support Services - Lakes DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Lakes DHB. Health and Disability Support Services - MidCentral DHB (M36) This appropriation is limited to personal and public health services, and management outputs from MidCentral DHB. Health and Disability Support Services - Nelson-Marlborough DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Nelson-Marlborough DHB. Health and Disability Support Services - Northland DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Northland DHB. Health and Disability Support Services - South Canterbury DHB (M36) This appropriation is limited to personal and public health services, and management outputs from South Canterbury DHB. Health and Disability Support Services - Southern DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Southern DHB. Health and Disability Support Services - Tairāwhiti DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Tairāwhiti DHB. Health and Disability Support Services - Taranaki DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Taranaki DHB. Health and Disability Support Services - Waikato DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Waikato DHB. Health and Disability Support Services - Wairarapa DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Wairarapa DHB. Health and Disability Support Services - Waitemata DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Waitemata DHB. Health and Disability Support Services - West Coast DHB (M36) This appropriation is limited to personal and public health services, and management outputs from West Coast DHB. Health and Disability Support Services - Whanganui DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Whanganui DHB. 1,321,735 1,321,735 1,377,805 470,212 470,212 484,193 372,955 372,955 388,121 298,534 298,534 310,096 482,764 482,764 499,456 403,203 403,203 418,304 536,635 536,635 557,165 171,495 171,495 178,097 818,589 818,589 852,087 154,032 154,032 160,113 324,724 324,724 338,959 1,088,800 1,088,800 1,134,739 130,946 130,946 136,657 1,391,675 1,391,675 1,450,808 124,489 124,489 128,823 210,551 210,551 218,859 8 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

Titles and Scopes of Appropriations by Appropriation Type Health Workforce Training and Development (M36) This appropriation is limited to the provision, purchase, and support of workforce development for people working in the health and disability sector and of services that support those workforces to be sustainable, flexible, and fit-for-purpose. Monitoring and Protecting Health and Disability Consumer Interests (M36) This appropriation is limited to the provision, purchase, and support of services that monitor and protect health and disability consumer interests. National Child Health Services (M36) This appropriation is limited to the provision, purchase, and support of child health services. National Contracted Services - Other (M36) This appropriation is limited to the purchase of other services directly by the Crown to support the health and disability services sector, including the national management of pharmaceuticals, and health research. National Disability Support Services (M36) This appropriation is limited to the provision, purchase, and support of disability support services. National Elective Services (M36) This appropriation is limited to the provision, purchase, and support of elective surgery services. National Emergency Services (M36) This appropriation is limited to the provision, purchase, and support of emergency services. National Health Information Systems (M36) This appropriation is limited to the provision of information technology services for the New Zealand health and social sectors. National Māori Health Services (M36) This appropriation is limited to the provision, purchase, and support of health and disability services that are either for Māori or by Māori. National Maternity Services (M36) This appropriation is limited to the provision, purchase, and support of maternity services. National Mental Health Services (M36) This appropriation is limited to the provision, purchase, and support of mental health services. National Personal Health Services (M36) This appropriation is limited to personal healthcare and support services purchased directly by the Crown, including mobile surgical services, telephone and online advice services, hospice services, sexual and reproductive health services, and services associated with the implementation of the Oral Health and Cancer Control Strategies. Primary Health Care Strategy (M36) This appropriation is limited to services to implement and deliver the Primary Health Care Strategy. Problem Gambling Services (M36) This appropriation is limited to the provision, purchase, and support of services that minimise the harm from gambling, in accordance with the Gambling Act 2003. Public Health Service Purchasing (M36) This appropriation is limited to the provision, purchase, and support of public health services. Supporting Equitable Pay for Care and Support Workers (M36) This appropriation is limited to costs related to workers in the care and support sector, incurred as a result of legislation giving effect to the pay equity settlement with care and support workers. Health Sector Projects Operating Expenses (M36) This appropriation is limited to operating expenses associated with the governance, planning and development of health sector capital projects. ed Actual 185,014 184,514 186,745 28,746 28,746 28,746 83,501 83,401 85,001 26,607 26,607 28,720 1,183,865 1,183,365 1,208,374 356,205 347,205 346,517 101,050 100,550 109,958 5,418 5,418 8,236 3,828 3,328 6,828 152,847 152,347 146,767 69,669 69,169 62,183 85,450 84,950 84,057 185,794 185,294 195,405 19,865 16,065 17,521 393,311 386,311 405,471 - - 279,000 6,252 6,252 - Total Non-Departmental Output Expenses 15,087,990 15,063,690 15,882,944 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 9

Titles and Scopes of Appropriations by Appropriation Type Non-Departmental Other Expenses International Health Organisations (M36) This appropriation is limited to the Crown funding New Zealand s World Health Organization (WHO) membership and contributing to specific WHO projects. Legal Expenses (M36) This appropriation is limited to funding the defence and settlement of health-related or disabilityrelated legal claims against the Crown. Provider Development (M36) This appropriation is limited to supporting the development of health or disability service providers, in particular, those supporting vulnerable populations, such as Māori and Pacific peoples. Repayment of District Health Board Loans (M36) This appropriation is limited to expenses associated with the early repayment at fair value of District Health Board Loans. ed Actual 2,030 2,030 2,030 1,028 778 1,028 24,434 23,434 24,289 275,000 75,974 - Total Non-Departmental Other Expenses 302,492 102,216 27,347 Non-Departmental Capital Expenditure Deficit Support for DHBs (M36) This appropriation is limited to equity injections to District Health Boards to address deficits. Equity for Capital Projects for DHBs and Health Sector Crown Agencies (M36) This appropriation is limited to providing capital contributions to health sector Crown entities or agencies for new investments and reconfiguration of their balance sheets. Health Sector Projects (M36) This appropriation is limited to the provision or purchase of health sector assets. Residential Care Loans - Payments (M36) This appropriation is limited to the provision of interest-free loans to people entering into aged residential care facilities. Loans for Capital Projects (M36) This appropriation is limited to the provision of loans to health sector Crown entities or agencies for new investments and reconfiguration of their balance sheets. Refinance of Crown Loans (M36) This appropriation is limited to refinancing existing Crown loans made to DHBs for the purpose of facilities redevelopment and other purposes agreed by the Crown including balance sheet reconfiguration. 74,624 74,624 50,000 2,722,345 2,682,345 303,388 241,059 211,059 288,108 15,000 15,000 15,000 85,000 85,000-204,214 204,214 - Total Non-Departmental Capital Expenditure 3,342,242 3,272,242 656,496 Multi-Category Expenses and Capital Expenditure Policy Advice and Ministerial Servicing MCA (M36) The overarching purpose of this appropriation is to provide policy advice and other support to Ministers in discharging their policy decision-making and other portfolio responsibilities. Departmental Output Expenses Ministerial Servicing This category is limited to the provision of services to Ministers to enable them to discharge their portfolio responsibilities other than policy decision-making. Policy Advice This category is limited to the provision of advice (including second opinion advice and contributions to policy advice led by other agencies) to support decision-making by Ministers on government policy matters. 20,709 20,509 20,991 4,706 4,606 4,702 16,003 15,903 16,289 Total Multi-Category Expenses and Capital Expenditure 20,709 20,509 20,991 Total Annual and Permanent Appropriations 18,948,608 18,652,032 16,773,069 10 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

Capital Injection Authorisations ed Actual Ministry of Health - Capital Injection (M36) - - - THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 11

Supporting Information Part 1 - Vote as a Whole 1.1 - New s Appropriation ed District Health Boards - Additional Support Health and Disability Support Services - DHBs Non-departmental output expense - 439,000 439,000 439,000 439,000 Equitable Pay for Care and Support Workers Disability Support Services - Additional Support Pharmaceuticals - More Publicly Funded Medicines Primary Health Care - Additional Support Emergency Ambulance Services - Additional support National Bowel Screening Programme Elective Surgery - Government s Health Target Disability Support Services - Enabling Good Lives Water Fluoridation (Assistance) Supporting Equitable Pay for Care and Support Workers Non-departmental output expense National Disability Support Services Non-departmental output expense Health and Disability Support Services - DHBs Non-departmental output expense Primary Health Care Strategy Non-departmental output expense National Emergency Services Non-departmental output expense Public Health Service Purchasing Non-departmental output expense National Elective Services Non-departmental output expense Managing the Purchase of Services Departmental output expense Public Health Service Purchasing Non-departmental output expense - 279,000 348,000 377,000 356,000-44,562 44,562 44,562 44,562-20,000 20,000 14,000 6,000-9,585 9,585 9,585 9,585-8,571 11,571 14,571 17,571 164 7,238 6,282 5,701 6,898-6,000 6,000 6,000 6,000-3,300 - - - - 3,000 3,000 3,000 3,000 Health Workforce Training and Development - Additional Support Health Workforce Training and Development Non-departmental output expense - 1,919 1,919 1,919 1,919 Contraceptive Services for Low Income Women Public Health Service Purchasing Non-departmental output expense Managing the Purchase of Services Departmental output expense - 1,380 3,880 5,880 5,880-120 120 120 120 12 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

Appropriation ed Organ Donation - National Strategy Total new operating expenditure DHB Capital Investment Pool National Personal Health Services Non-departmental output expense Equity for Capital Projects for DHBs and Health Sector Crown Agencies Non-departmental capital expenditure - 700 700 700 700 164 824,375 894,619 922,038 897,235-150,000 - - - Total capital expenditure - 150,000 - - - Total Initiatives 164 974,375 894,619 922,038 897,235 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 13

14 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 1.2 - Trends in the Vote Summary of Financial Activity Appropriations 2012/13 2013/14 2014/15 2015/16 Actual Actual Actual Actual ed Actual Departmental Transactions Non- Departmental Transactions Output Expenses 13,564,860 14,002,497 14,297,234 14,746,556 15,266,155 15,240,055 177,291 15,882,944 16,060,235 16,096,143 16,112,555 16,087,836 Benefits or Related Expenses - - - - - - N/A - - - - - Borrowing Expenses - - - - - - - - - - - - Other Expenses 26,100 27,873 26,480 25,307 302,492 102,216-27,347 27,347 27,347 27,347 27,347 Capital Expenditure 259,582 336,432 689,136 487,272 3,359,252 3,289,252 8,000 656,496 664,496 62,211 62,211 62,211 Intelligence and Security Department Expenses - - - - - - - N/A - - - - and Capital Expenditure Multi-Category Expenses and Capital Expenditure (MCA) Output Expenses 15,750 20,036 20,878 20,705 20,709 20,509 20,991-20,991 20,991 20,991 20,991 Other Expenses - - - - - - - - - - - - Capital Expenditure - - - - - - N/A - - - - - Total Appropriations 13,866,292 14,386,838 15,033,728 15,279,840 18,948,608 18,652,032 206,282 16,566,787 16,773,069 16,206,692 16,223,104 16,198,385 Crown Revenue and Capital Receipts Tax Revenue - - - - - - N/A - - - - - Non-Tax Revenue 625,524 655,187 669,571 687,880 659,638 659,638 N/A 748,686 748,686 772,866 794,560 794,560 Capital Receipts 25,645 375,698 147,800 24,648 27,499 27,499 N/A 27,499 27,499 27,499 27,499 27,499 Total Crown Revenue and Capital Receipts 651,169 1,030,885 817,371 712,528 687,137 687,137 N/A 776,185 776,185 800,365 822,059 822,059 Total VOTE HEALTH Note - where restructuring of the vote has occurred then, to the extent practicable, prior years information has been restated as if the restructuring had occurred before the beginning of the period covered. In this instance Total Appropriations for the ed and Actual year may not equal Total Appropriations in the Details of Appropriations and Capital Injections.

Adjustments to the Summary of Financial Activity Table Due to Vote Restructuring There have been no restructuring adjustments to prior year information in the Summary of Financial Activity table. 1.3 - Analysis of Significant Trends Total Vote: All Appropriations Vote Health has grown from actual expenditure in 2012/13 of $13,866 million to budgeted expenditure in of $16,773 million, an increase of $2,907 million over five years (around 4% per annum). This has mainly been driven by increases to the Vote s output expenses, which were $13,607 million in 2012/13 and are budgeted at $16,109 million in - an increase of $2,502 million. Output Expenses The growth in the Vote s operating expenses is driven mainly by additional funding provided to district health boards towards demographic and cost pressures. Their appropriations for are budgeted at $12,683 million, an increase of $1,792 million over the actual expenditure in 2012/13. In addition to this expenditure, district health boards are typically contracted by the Ministry of Health for additional national services of around $1,000 million per annum. In some cases, this funding is being devolved to district health boards, making them directly responsible for the services previously administered nationally. Also contributing to the growth are increases in funding for national services administered by the Ministry of Health, such as disability support services and various public and personal health services. The appropriations for these national services are budgeted for $2,698 million, which is $363 million greater than the actual expenditure in 2012/13 (an increase of around 2.8% per annum). The main drivers of the increase are the Crown s ongoing investment in: supporting equitable pay for care and support workers, which is a new investment of $279 million in additional elective surgeries, which has increased by $69 million (almost 25%) since 2012/13 disability support services, which has increased by nearly $180 million (or 18%) since 2012/13. Funding for the support, oversight, governance, and development of the health and disability sectors has also grown, from actual expenditure of $395 million in 2012/13 to budgeted expenditure in of $736 million. The increase has been driven mainly by additional funding for the training and development of the health workforce. Capital Expenditure The Crown continues to invest in sector capital. Appropriations for are $591 million, however, as in previous years, this includes funding for multi-year projects and provision for some future expenses or risks. Actual expenditure has typically been between $150 million and $200 million per annum. There is $65 million of other capital expenditure appropriated in the budget, comprising provisions for deficit support and for the rollover of Crown Loans to district health boards (the latter being technical expenditure). The expected actual capital expenditure for is $3,272 million, mainly due to one-off equity injections into DHBs, to allow their Crown loans to be repaid. THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 15

Part 2 - Details of Departmental Appropriations 2.1 - Departmental Output Expenses Health Sector Information Systems (M36) This appropriation is limited to the provision of information technology services and the publication of data and information derived from these services to the health and disability system. Expenses and Revenue ed Actual Total Appropriation 54,278 54,178 51,618 Revenue from the Crown 54,278 54,278 51,618 Revenue from Others - - - This appropriation is intended to provide information technology services and infrastructure to support the operation of New Zealand s health services. Assessment of Performance ed Actual Client Insight and Analytics Percentage of published Tier 1 statistics meet Statistics New Zealand standards within agreed timetable Respondent satisfaction with how the Health Survey is conducted is greater than - - 100% - - 90% National Infrastructure and Ministry Information Systems The percentage of time for which key sector- and public-facing systems are available (see Note 1) 99% 90% 99% Number of security breach incidents - - 0 Note 1: Key sector- and public-facing systems are National Health Index (NHI), National Immunisation Register (NIR), Online Pharmacy, Special Authorities, Oracle Financials, and Web Access. End of Year Performance Reporting The Ministry of Health will report performance information for this appropriation in its Annual Report. 16 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

Current and Past s Year of First Impact ed National Bowel Screening Programme Rollout 2,500 2,500 2,500 2,500 2,500 Electronic oral health record 2014/15 340 340 340 340 340 Population Health Data Warehouse 2014/15 136 136 136 136 136 Whānau Ora IT System - transfer to departmental expenses 2014/15 350 - - - - Managing the Purchase of Services (M36) This appropriation is limited to purchasing services for the public and health and disability sector on behalf of the Crown, for those services where the Ministry has responsibility for the purchasing function (i.e. funding is not devolved to another entity). Expenses and Revenue ed Actual Total Appropriation 34,964 33,764 36,213 Revenue from the Crown 34,964 34,964 36,213 Revenue from Others - - - This appropriation is intended to achieve the administration of health and disability services, purchased on behalf of the Crown in line with Government priorities and the Ministry of Health s strategic intentions (as outlined in the Ministry of Health s Statement of Intent). Assessment of Performance The Ministry procurement process is in line with government standards The ratio of departmental expenditure for the output class against relevant non-departmental expenditure Social agencies are required to move contracts with nongovernment organisations (NGOs) to the streamlined contract framework as they are renewed. The Ministry will move the following numbers of contracts The percentage of Ministry feedback to Crown Funding Agreement Variation (CFAV) monitoring reports that are supplied to DHBs within agreed timeframes (see Note 1) The percentage of complaints in regards to Disability Support Services (DSS) that receive either a resolution notification or progress update within 20 days of DSS receiving the complaint ed Actual Achieved Achieved Achieved 1:80 1:105 1:107 800 800 840 95% 100% 95% - - 95% THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 17

Note 1 - When a monitoring report is received at the Ministry, it is logged into an electronic system. This generates an automated letter to say it has been received. The formal response is the next contact the Ministry has with the provider when necessary. The formal response could be a phone call, email, formal letter or an actual visit. End of Year Performance Reporting The Ministry of Health will report performance information for this appropriation in its Annual Report. Current and Past s Year of First Impact ed Disability Support Services - Enabling Good Lives - 3,300 - - - Contraceptive Services for Low Income Women - 120 120 120 120 Proceeds of Crime 2016 - Methamphetamine Demand Reduction in Northland 120 - - - - National Bowel Screening Programme Rollout 2,945 2,645 2,415 2,340 2,340 Problem Gambling Services - Continued Support 260 293 293 - - Better Public Services seed funding: social bonds pilots 2014/15 360 - - - - Healthy Families NZ 2014/15 1,000 1,000 1,000 1,000 1,000 Memorandum Account Problem Gambling ed Actual Opening Balance at 1 July (515) (515) (515) Revenue (funded by Problem Gambling Levy) 1,001 1,001 990 Expenses 1,001 1,001 990 Transfers and Adjustments - - - Closing Balance at 30 June (515) (515) (515) 18 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

Payment Services (M36) This appropriation is limited to the administration and audit of contracts and payments on behalf of the Crown and Crown agencies. Expenses and Revenue ed Actual Total Appropriation 17,918 17,818 17,340 Revenue from the Crown 17,918 17,918 17,340 Revenue from Others - - - This appropriation is intended to provide for timely and appropriate payments to be made to eligible parties (including eligible health service providers and consumers) and contracts to be audited and processed efficiently and effectively. Assessment of Performance ed Actual The percentage of claims paid on time 95% 99% 98% The percentage of claims processed accurately 95% 99% 95% The percentage of all draft agreements prepared for funders within target timeframes 95% 85% 95% The percentage of agreements prepared accurately (see Note 1) 95% 98% 95% The percentage of calls to contact centres answered within service specifications for timeliness (20 seconds) The percentage of calls abandoned by callers prior to being answered by the contact centre is less than The percentage of enquiries resolved in under 10 business working days The total dollar value of payments made to those primary health and disability providers who have been subject to audit and compliance activities during the year, expressed as a percentage of the budget for those providers (see Note 2) Court written decisions and findings relating to concluded Ministry of Health Audit & Compliance initiated prosecutions contain no adverse judicial comment in regards to the evidential basis of the prosecutions Percentage of Health Integrity Line complaints that are evaluated within 10 working days of complaint being received is greater than or equal to 80% 80% 80% 5% 3.5% 5% 95% 95% 95% 80% 94% 80% - - 0 - - 95% THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 19

Note 1: All information is deemed to be processed accurately if agreements are legally binding and purchase order information is correctly entered. Note 2: Total dollar value of payments to primary healthcare and disability providers is approximately $6.900 million. End of Year Performance Reporting The Ministry of Health will report performance information for this appropriation in its Annual Report. Current and Past s Year of First Impact ed Free under 13s - Ministry payment system changes 2015/16 223 223 223 223 223 Regulatory and Enforcement Services (M36) This appropriation is limited to implementing, enforcing and administering health- and disability-related legislation and regulations, and provision of regulatory advice to the sector and to Ministers, and support services for committees established under statute or appointed by the Minister pursuant to legislation. Expenses and Revenue ed Actual Total Appropriation 22,433 22,333 24,694 Revenue from the Crown 9,192 9,192 10,653 Revenue from Others 13,241 13,241 14,041 This appropriation is intended to ensure that health and disability services are regulated so that appropriate standards are followed. 20 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

Assessment of Performance ed Actual The percentage of medium and high priority quality incident notifications relating to medicines and medical devices that undergo an initial review within 5 working days The percentage of all certificates issued to providers under the Health and Disability Services (Safety) Act 2001 within target timeframes The percentage of all licences and authorities issued to providers under the Medicines Act 1981 and Misuse of Drugs Act 1975 within target timeframes The percentage of all licences and consents issued to radiation users under the Radiation Safety Act 2016 within 10 working days of the receipt of all information and payment of the required fee The percentage of all New Medicines Applications (for ministerial consent to market) that receive an initial assessment within 200 days The percentage of all Changed Medicines Notifications (for ministerial consent to market) responded to within 45 days Average rating for statutory committee satisfaction with secretariat services provided by the Ministry 90% 95% 90% 90% 90% 90% 90% 90% 90% 90% 100% 90% 80% 80% 80% 100% 100% 100% greater than 4 out of 5 4 greater than 4 out of 5 End of Year Performance Reporting The Ministry of Health will report performance information for this appropriation in its Annual Report. Current and Past s Year of First Impact ed Radiation Safety Act - administration of new regulations 374 574 574 574 574 Regulation of Psychoactive Substances 2013/14 1,800 1,800 1,800 1,800 1,800 Reasons for Change in Appropriation This appropriation increased by $2.261 million to $24.694 for mainly due to a $1.700 million departmental output class budget adjustment (see Note 1). Note 1: In funding was transferred between the departmental output classes, so that the funding better reflected the outputs the Ministry expected to deliver during the year. This transfer was fiscally neutral to the Vote and to the Crown. THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 21

Conditions on Use of Appropriation Reference Medicines Act 1981 Hazardous Substances and New Organisms (Act) 1996 Health Act 1956 Biosecurity Act 1993 Mental Health (Compulsory Assessment and Treatment) Act 1992 All recommendations for appointments meet the requirements of health legislation Conditions The Ministry responds to incident notifications regarding the quality of medicines, medical devices and advertising. Section 100 of the Hazardous Substances and New Organisms Act 1996 sets out requirements for appointment of enforcement officers. Section 7A of the Health Act1956 sets out requirements for the designation by the Director- General of Health of medical officers of health. Section 28 of the Health Act 1956 sets out requirements for appointment by a local authority of environmental health officers. Section 121 of that Act provides that regulations may further prescribe qualifications which environmental health officers must possess. Section 69ZK of the Health Act 1956 sets out requirements for appointment by the Director-General of Health of persons or agencies as drinking-water assessors. Section 105B of the Biosecurity Act 1993 sets out requirements for appointment by the Director-General of Health of auditors under that Act. Section 103 of the Biosecurity Act 1993 sets out requirements for appointment by a chief technical officer of inspectors/authorised persons to administer or enforce that Act, and/or to carry out a national pest management plan or national pathway plan. Section 92A of the Mental Health (Compulsory Assessment and Treatment) Act 1992 sets out requirements for delegation by Area Mental Health Services Directors of their powers to a suitably qualified person. Section 93 of the Mental Health (Compulsory Assessment and Treatment) Act 1992 sets out requirements for designation by Area Mental Health Services Directors of health professionals as duly authorised officers. Crown Entities Act 2004 New Zealand Public Health and Disability Act 2000 Health Research Council Act 1990 Health and Disability Commissioner Act 1994. For regulatory authorities and committees: Health Practitioners Competence Assurance Act 2003 New Zealand Public Health and Disability Act 2000 Human Assisted Reproductive Technology Act 2004. Memorandum Account ed Actual Office of Radiation Safety Opening Balance at 1 July 1,019 1,019 989 Revenue 925 895 1,500 Expenses 925 925 1,500 Transfers and Adjustments - - - Closing Balance at 30 June 1,019 989 989 22 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

ed Actual Medsafe Opening Balance at 1 July 1,288 1,288 216 Revenue 9,305 7,613 9,305 Expenses 9,305 8,685 9,305 Transfers and Adjustments - - - Closing Balance at 30 June 1,288 216 216 Sector Planning and Performance (M36) This appropriation is limited to advising on and co-ordinating health sector planning and performance improvement; and funding, monitoring, and supporting the governance of, health sector Crown entities, and sector co-ordination. Expenses and Revenue ed Actual Total Appropriation 48,572 48,272 47,426 Revenue from the Crown 48,423 48,423 47,277 Revenue from Others 149 149 149 This appropriation is intended to achieve: health sector services are appropriately planned, funded, and monitored; health sector Crown entities, agencies, and companies are appropriately governed; and sector co-ordination is encouraged and assisted. Assessment of Performance Planning and funding advice for the financial year is provided to Crown entities by 31 December The Ministry provides the Minister with advice of all DHB annual plans by 30 June The percentage of monitoring feedback reports about performance supplied to DHBs within agreed timeframes The percentage of quarterly and monthly monitoring reports about DHBs provided to the Minister within agreed timeframes The percentage of quarterly and monthly monitoring reports about Crown entities (excluding DHBs) provided to the Minister within agreed timeframes Maintain the capability and capacity to respond to national emergencies and emerging health threats (see Note 1) ed Actual Achieved Achieved Achieved Achieved Achieved Achieved 100% 100% 100% 100% 65% 100% 100% 100% 100% - - Achieved THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 23

Assessment of Performance The percentage of appointments to DHBs and other health Crown entity boards where advice is presented to the Minister prior to the current appointee s term expiring (see Note 2) ed Actual 100% 100% 100% Note 1: Capability and capacity to respond means the Ministry has the necessary systems, procedures, facilities and staffing in place to initiate and manage at the national level the health response to a national emergency or emerging health threat. Note 2: Unexpected resignation or departure prior to the expiration of the term is not included. End of Year Performance Reporting The Ministry of Health will report performance information for this appropriation in its Annual Report. Current and Past s Year of First Impact ed Canterbury Earthquake Recovery Authority (CERA) transition of functions and funding 330 340 340 340 340 Cancer: next phase of Faster Cancer Treatment 2014/15 330 - - - - 2.3 - Departmental Capital Expenditure and Capital Injections Ministry of Health - Capital Expenditure PLA (M36) This appropriation is limited to the purchase or development of assets by and for the use of the Ministry of Health, as authorised by section 24(1) of the Public Finance Act 1989. Capital Expenditure ed Actual Forests/Agricultural - - - Land - - - Property, Plant and Equipment 9,386 9,386 1,000 Intangibles 7,624 7,624 7,000 Other - - - Total Appropriation 17,010 17,010 8,000 24 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

This appropriation is intended to achieve the renewal, upgrade, or redesign of assets to support the delivery of the Ministry of Health s core functions and responsibilities (refer to Part 2.1). Expenditure is in accordance with the Ministry of Health s capital asset management plan. End of Year Performance Reporting The Ministry of Health will report performance information for its departmental outputs in its Annual Report. Reasons for Change in Appropriation This appropriation decreased by $9.010 million to $8 million for mainly due to the Ministry of Health transitioning from owning information technology assets to purchasing them as a service. Capital Injections and Movements in Departmental Net Assets Ministry of Health Details of Net Asset Schedule Actual Projected Explanation of Projected Movements in Opening Balance 34,541 34,541 Capital Injections - - Capital Withdrawals - - Surplus to be Retained (Deficit Incurred) - - Other Movements - - Closing Balance 34,541 34,541 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 25

Part 3 - Details of Non-Departmental Appropriations 3.1 - Non- Departmental Output Expenses Auckland Health Projects Integrated Investment Plan (M36) The appropriation is limited to expenses incurred in developing an Integrated Investment Plan for Auckland Health projects. Expenses ed Actual Total Appropriation 720 320 650 This appropriation is intended to establish the Auckland Health Investment Planning Group to assist the Auckland metro DHBs to develop a comprehensive integrated investment plan to meet the forecast significant population pressures. An exemption was granted in under s15d(2)(b)(iii) of the PFA as the amount of the appropriation is less than $5 million. Current and Past s Year of First Impact ed Establish Auckland Health Projects Integrated Plan 1,370 - - - - Health and Disability Support Services - Auckland DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Auckland DHB. Expenses ed Actual Total Appropriation 1,195,267 1,195,267 1,239,980 26 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

This appropriation is intended to achieve services provided by the DHB that align with: Government priorities; the strategic direction set for the health sector by the Ministry of Health; the needs of the district s population; and regional considerations. Each DHB has a statutory responsibility to prepare: an Annual Plan for approval by the Minister of Health (Section 38 of the New Zealand Public Health and Disability Act 2000) - providing accountability to the Minister of Health a Statement of Performance Expectations (Section 149C of the Crown Entities Act 2004 as amended by the Crown Entities Amendment Act 2013) - providing financial accountability to Parliament and the public annually a Statement of Intent (Section 139 of the Crown Entities Act) - providing accountability to Parliament and the public at least triennially. In 2010 Cabinet determined that the documents could be brought together into a single DHB Annual Plan with Statement of Intent and Statement of Performance Expectations, to be known as the Annual Plan. The Statement of Performance Expectations provides specific measures/targets for the coming year, with comparative prior year and current year forecast (at a minimum). Four Output Classes are used by all DHBs to reflect the nature of services provided: Prevention Early Detection and Management Intensive Assessment and Treatment Rehabilitation and Support. End of Year Performance Reporting The DHB will report performance information in its Annual Report. Current and Past s Year of First Impact ed District Health Boards - Additional support - 41,419 41,419 41,419 41,419 Pharmaceuticals - More Publicly Funded Medicines - 1,887 1,887 1,321 566 DHB Efficiency Savings - (874) (874) (874) (874) DHB capital charge rate change 8% to 6% (9,096) (12,135) (12,135) (12,135) (12,135) Devolve Hospice Funding to DHBs 608 608 608 608 608 District Health Boards - Additional Support 45,255 45,255 45,255 45,255 45,255 More Publically Funded Medicines 3,650 3,650 2,714 2,714 2,527 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 27

Year of First Impact ed In-between Travel - Devolution 2015/16 2,438 2,438 2,438 2,438 2,438 District Health Board (DHB) Additional Funding for Pressures 2015/16 36,417 36,417 36,417 36,417 36,417 Improving Hospice Community Palliative Care Services 2015/16 1,211 1,211 1,211 1,211 1,211 Reprioritising DHB Savings Delivered by PHARMAC 2015/16 (1,217) (1,217) (1,217) (1,217) (1,217) DHB Demographics 2014/15 13,199 13,199 13,199 13,199 13,199 Contribution to DHB cost pressures 2014/15 8,745 8,745 8,745 8,745 8,745 Aged Residential Care - subsidy increase 2014/15 881 881 881 881 881 DHB Demographics 2013/14 12,068 12,068 12,068 12,068 12,068 Contribution to DHB cost pressures 2013/14 9,368 9,368 9,368 9,368 9,368 Aged Care and Dementia 2013/14 736 736 736 736 736 Long Term Conditions - Cardiovascular Disease (CVD)/Diabetes 2013/14 402 402 402 402 402 Reasons for Change in Appropriation This appropriation increased by $44.713 million to $1,239.980 million for mainly due to: $41.419 million for the 2017 initiative District Health Boards - Additional Support $1.887 million for the 2017 initiative Pharmaceuticals - More Publicly Funded Medicines. Conditions on Use of Appropriation Reference New Zealand Public Health and Disability Act 2000 Conditions Section 10(2) (Crown funding agreements) provides that the Minister may, on behalf of the Crown, negotiate or enter into a Crown funding agreement with any person, containing any terms and conditions that may be agreed. Health and Disability Support Services - Bay of Plenty DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Bay of Plenty DHB. Expenses ed Actual Total Appropriation 664,890 664,890 694,230 28 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6

This appropriation is intended to achieve services provided by the DHB that align with: Government priorities; the strategic direction set for the health sector by the Ministry of Health; the needs of the district's population; and regional considerations. Please refer to Health and Disability Support Services - Auckland DHB. End of Year Performance Reporting The DHB will report performance information in its Annual Report. Current and Past s Year of First Impact ed District Health Boards - Additional support - 24,622 24,622 24,622 24,622 Pharmaceuticals - More Publicly Funded Medicines - 1,122 1,122 785 337 DHB Efficiency Savings - (524) (524) (524) (524) DHB capital charge rate change 8% to 6% (1,736) (2,309) (2,309) (2,309) (2,309) Devolve Hospice Funding to DHBs 511 511 511 511 511 District Health Boards - Additional Support 28,836 28,836 28,836 28,836 28,836 More Publically Funded Medicines 2,188 1,627 1,627 1,515 1,515 In-between Travel - Devolution 2015/16 688 2,126 2,126 2,126 2,126 District Health Board (DHB) Additional Funding for Pressures 2015/16 19,107 19,107 19,107 19,107 19,107 Improving Hospice Community Palliative Care Services 2015/16 722 722 722 722 722 Reprioritising DHB Savings Delivered by PHARMAC 2015/16 (631) (631) (631) (631) (631) DHB Demographics 2014/15 14,657 14,657 14,657 14,657 14,657 Contribution to DHB cost pressures 2014/15 4,985 4,985 4,985 4,985 4,985 Aged Residential Care - subsidy increase 2014/15 530 530 530 530 530 Contribution to DHB cost pressures 2013/14 5,199 5,199 5,199 5,199 5,199 DHB Demographics 2013/14 5,133 5,133 5,133 5,133 5,133 Aged Care and Dementia 2013/14 441 441 441 441 441 Long Term Conditions - Cardiovascular Disease (CVD)/Diabetes 2013/14 111 111 111 111 111 Reasons for Change in Appropriation This appropriation increased by $29.340 million to $694.230 million for mainly due to: $24.622 million for the 2017 initiative District Health Boards - Additional Support $1.122 million for the 2017 initiative Pharmaceuticals - More Publicly Funded Medicines. THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6 29

Conditions on Use of Appropriation Reference New Zealand Public Health and Disability Act 2000 Conditions Section 10(2) (Crown funding agreements) provides that the Minister may, on behalf of the Crown, negotiate or enter into a Crown funding agreement with any person, containing any terms and conditions that may be agreed. Health and Disability Support Services - Canterbury DHB (M36) This appropriation is limited to personal and public health services, and management outputs from Canterbury DHB. Expenses ed Actual Total Appropriation 1,335,697 1,335,697 1,375,372 This appropriation is intended to achieve services provided by the DHB that align with: Government priorities; the strategic direction set for the health sector by the Ministry of Health; the needs of the district s population; and regional considerations. Please refer to Health and Disability Support Services - Auckland DHB. End of Year Performance Reporting The DHB will report performance information in its Annual Report. Current and Past s Year of First Impact ed District Health Boards - Additional support - 47,755 47,755 47,755 47,755 Pharmaceuticals - More Publicly Funded Medicines - 2,176 2,176 1,523 653 DHB Efficiency Savings - (1,055) (1,055) (1,055) (1,055) DHB capital charge rate change 8% to 6% (3,506) (5,069) (5,069) (5,069) (5,069) Devolve Hospice Funding to DHBs 937 937 937 937 937 District Health Boards - Additional Support 32,125 32,125 32,125 32,125 32,125 More Publically Funded Medicines 4,232 3,147 3,147 2,930 2,930 In-between Travel - devolution 2015/16 3,558 3,558 3,558 3,558 3,558 Improving Hospice Community Palliative Care Services 2015/16 1,422 1,422 1,422 1,422 1,422 Supporting Health Services in Canterbury 2015/16 5,480 5,480 5,480 - - District Health Board (DHB) Additional Funding for Pressures 2015/16 21,533 21,533 21,533 21,533 21,533 Reprioritising DHB Savings Delivered by PHARMAC 2015/16 (670) (670) (670) (670) (670) DHB Demographics 2014/15 18,889 18,889 18,889 18,889 18,889 30 THE ESTIMATES OF APPROPRIATIONS - HEALTH SECTOR B.5 Vol.6