Labour's election promise to boost emergency dental grants has been pushed to the side in order to pay for its $486 million health system restructure.
In the lead-up to last year's election, Labour promised $176 million to increase grants for emergency dental care from $300 to $1000. It also promised $37.5 million to provide an additional 20 mobile dental clinics in remote areas.
But there was no mention of dental in Budget 2021, and a draft letter from Health Minister Andrew Little to Finance Minister Grant Robertson, obtained by National's health spokesperson Shane Reti, appears to show why.
In the draft letter dated December 4 last year, Little discussed how "trade-offs" would be required in the Budget to deliver on the Government's commitments, such as responding to the Health and Disability Review.
At the time of the letter, the reforms proposed in the Health and Disability System Review were "yet to be costed" but estimated to be "significant", and it was noted they "would best be actioned in subsequent Budgets".
Labour's dental policy was at that time described as a priority.
Four months later, Little revealed the Government's response to the review - a major shake-up of the health system that would see all 20 District Health Boards (DHBs) combined into a centralised model called Health NZ with a new Māori Health Authority.
By the time the Budget was announced, Labour's dental policy had been dropped while the health system shake-up was given $486 million. The health system overall got $4.7 billion over four years, including $2.7 billion for DHBs.
"The Budget shows where Labour's priorities really lie: It's more focused on centralising decision making and adding more layers of Wellington bureaucracy than improving the health of New Zealanders," said Dr Reti.
"It's incredibly disappointing the Government has chosen to once again break a promise to New Zealanders. In fact, there is nothing for oral or dental care at all in this Budget despite Labour campaigning hard on the issue during the election."
Little told Newshub the Government is still committed to its dental policy.
"That's our promise we went with into the last election, we haven't got it in this Budget, we've got two more to go, and I'm determined we will fulfil that promise," he said.
"We don't get to do everything in a single Budget. It remains a promise to be fulfilled by us but we're in Government for three years - this is the first Budget of that three-year period, and we'll come back again. We have that commitment and I'm determined that we will see it through."
National promised during the election to increase spending on childhood dental services by $30 million, but stopped short of offering anything for adults.
A Ministry of Health report in 2018 found that poor oral health "is largely preventable, yet it is also one of the more common chronic health problems experienced by New Zealanders of all ages".
It found that a "sizable proportion of the adult population does not access oral health care due to cost" and these adults are "more likely to be Māori, Pacific, or from deprived areas".
Māori weren't forgotten in the Budget, receiving more than $1 billion covering housing, health and reo initiatives. The Government is also lifting benefits with a $3.3 billion bump.
But the Government is axing free annual GP visits and eye checks for Supergold cardholders, as officials advised it is of limited benefit and the $197 million it would have cost over four years could be better spent.