Tuesday 28th May 2019
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Leaked Budget documentation indicates the government is seeking to centralise health spending control in key areas such as mental health.
National’s release of what it says is an overview of the spending in some portfolios is impossible to verify until Budget Day on Thursday and Finance Minister Grant Robertson has said it does not include all the government’s decisions.
In the health portfolio, the documents released by National show Vote Health increasing from $18.2 billion in 2018/19 to $19.9 billion in 2019/20.
General funding for district health boards is set to increase from $13.2 billion to $14.0 billion. Most of this will be driven by population growth. The 20 DHBs’ share of the Vote slips from 72.6 percent to 70.4 percent. 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.
The funding directly administered by the Ministry of Health increases from $2.9 billion to $3.2 billion.
Significant increases are for:
· the Primary Health Care Strategy from $266 million to $331 million;
· National Emergency Services from $130 million to $150 million;
· National Child Health Services $89 million to $113 million;
· National Mental Health Services $68 million to $141 million.
If the documents are accurate, they indicate the current administration is struggling with the same problems previous governments faced in dealing with mental health spending.
In the past, increases for mental health funding disappeared into the DHBs and their predecessors. At one point a previous National government set up the Mental Health Commission to make sure ring-fenced mental health spending did the job it was meant to do. It had mixed success.
The doubling of spending in national mental services funding may point to the current government looking to make sure the money makes a difference. The question in the sector will be whether they have the capacity to deal with the increase.
The documents show costs of administration and support also increase from $783 million to $911 million, with this money being used to increase the Ministry of Health’s budget, notably “Supporting Equitable Pay” from $348 million to $414 million, and Health Workforce Training and Development from $187 million to $212 million.
Sector capital investment is also pegged to increase from $1.09 billion to $1.548 billion which will go towards renewing creaking infrastructure and building new hospitals.
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