"\u003C!DOCTYPE html\u003E\u003Chtml xmlns:xlink=\u0022http://www.w3.org/1999/xlink\u0022 xmlns:xsi=\u0022http://www.w3.org/2007/XMLSchema-instance\u0022 xmlns:mml=\u0022http://www.w3.org/1998/Math/MathML\u0022\u003E\n  \u003Chead\u003E\n    \u003CMETA http-equiv=\u0022Content-Type\u0022 content=\u0022text/html; charset=utf-16\u0022\u003E\n    \u003Cmeta name=\u0022viewport\u0022 content=\u0022width=device-width, initial-scale=1\u0022\u003E\n  \u003C/head\u003E\n  \u003Cbody style=\u0022font-family:sans-serif; font-size:100%;\u0022\u003E\n    \u003Cdiv class=\u0022HpsHansard\u0022\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000001\u0022\u003E\u003Cspan class=\u0022HpsProceedingHeading\u0022 id=\u002230964819300f4878b1a640d7cc9cf7d3\u0022\u003EWEDNESDAY, 1 JUNE 2022\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000003\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u002235cb2ddd7e9c40109b6d5d17578ec954\u0022\u003EWEDNESDAY, 1 JUNE 2022\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000002\u0022\u003EThe Deputy Speaker took the Chair at 2 p.m.\u003C/p\u003E\n    \u003C/div\u003E\n    \u003Cdiv class=\u0022HpsHansard\u0022\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000004\u0022\u003E\u003Cspan class=\u0022HpsProceedingHeading\u0022 id=\u0022085072069bed4e9ea5edc31d33bc41e9\u0022\u003EKarakia/Prayers\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000006\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u0022900e374210b94d3ea2d24f97f460629e\u0022\u003EKarakia/Prayers\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002261725fea-7d5e-4d1f-8fd3-e5779bb7a14d\u0022 data-id=\u0022d70c3bfe513e48c193c96a35add0d281\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000005\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002261725fea-7d5e-4d1f-8fd3-e5779bb7a14d\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022d70c3bfe513e48c193c96a35add0d281\u0022\u003EBARBARA EDMONDS (Labour\u2014Mana):\u003C/span\u003E Tatou ifo ma tatalo. Le Atua Silisili ese e, matou te sulaina lau Afio mo fa\u2018amanuiaga ma tofi ua e fa\u2018au\u2018uina ai i matou. E lafoa\u2018i ni o matou lagona ma manatua ta\u2018ito\u2018atasi i le amana\u2018iaina o le Masiofo o Peretania. Matou te tatalo ina ia tonu ma fa\u2018amaoni fuafuaga ma fa\u2018ai\u2018uga uma i totonu o lenei Maota Fono. Ia talosia ta\u2018ita\u2018i o lenei M\u0101l\u014D ina ia maua le t\u014Df\u0101 mamao, le fa\u2018apalepale ma le agamal\u016B, au\u0101 le manuia ma le filem\u016B o Niu Sila. O le matou tatalo lea, e ala atu i le suafa pele o Iesu Keriso. Amene.\u003C/span\u003E\u003C/p\u003E\n    \u003C/div\u003E\n    \u003Cdiv class=\u0022HpsHansard\u0022\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000007\u0022\u003E\u003Cspan class=\u0022HpsProceedingHeading\u0022 id=\u0022051563d0a9124744a82e22a3d3e4403e\u0022\u003EPETITIONS, PAPERS, SELECT COMMITTEE REPORTS, AND INTRODUCTION OF BILLS\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000009\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u002208a1040823114e50b6494d7d00a0dfaf\u0022\u003EPETITIONS, PAPERS, SELECT COMMITTEE REPORTS, AND INTRODUCTION OF BILLS\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022 data-id=\u00229e85fa2d22924417be7aa9284f7c7912\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000008\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00229e85fa2d22924417be7aa9284f7c7912\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Fa\u2018afetai lava. Members, no petitions, papers, or select committee reports have been presented, and no bills have been introduced.\u003C/span\u003E\u003C/p\u003E\n    \u003C/div\u003E\n    \u003Cdiv class=\u0022HpsHansard\u0022\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000010\u0022\u003E\u003Cspan class=\u0022HpsProceedingHeading\u0022 id=\u0022812422bab93d4424a96d209520d75ae8\u0022\u003EOral Questions\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000011\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u002214adc50df7a349bfb46c4c8b97d3ed32\u0022\u003EQuestions to Ministers\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000012\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u00224651095d8eea46a4be116d3630bb5c45\u0022\u003EQuestion No. 1\u2014Prime Minister\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022ea31fdd3-90e9-47d7-92a4-20b6a3109eef\u0022 data-id=\u0022e9333a915c2a4064ab75aee0c726e456\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000013\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ea31fdd3-90e9-47d7-92a4-20b6a3109eef\u0022\u003E1. \u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e9333a915c2a4064ab75aee0c726e456\u0022\u003ECHRISTOPHER LUXON (Leader of the Opposition)\u003C/span\u003E to the Acting Prime Minister: Does he stand by all of his Government\u2019s statements and actions?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022 data-id=\u0022ba16027325174d75b125924494fb953d\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000014\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022ba16027325174d75b125924494fb953d\u0022\u003EHon GRANT ROBERTSON (Acting Prime Minister):\u003C/span\u003E Fa\u2018afetai tele lava. Yes. Today, the draft Advanced Manufacturing Industry Transformation Plan was launched at the EMEX trade show in Auckland. The advanced-manufacturing sector is not only our largest contributor to exports, accounting for 73.5 percent of goods exports; it accounts for more than 10 percent of both our economy and workforce. This plan works in partnership with business to increase investment in new technology and processes to lift productivity, exports, and wages; better support innovation, research, and development; and work to reduce waste and emissions, and attract and develop a diverse, high-skilled, and high-wage workforce.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000015\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ea31fdd3-90e9-47d7-92a4-20b6a3109eef\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002217b3f4cb247444dca9a1bac4f5dd8186\u0022\u003EChristopher Luxon\u003C/span\u003E: Can he confirm this Government has overspent every operating allowance it has set itself for five Budgets in a row?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000016\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00229abad1f4512e4ebab0b6bdfcfa392c19\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: What I can confirm is the Government is invested in making up for the nine long years of neglect from the National Party, and the member might care to remember the arrival of a certain thing called COVID in the middle of all of that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000017\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ea31fdd3-90e9-47d7-92a4-20b6a3109eef\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00221607197161b84466ad1573452c04f881\u0022\u003EChristopher Luxon\u003C/span\u003E: Is it correct that this Government has overspent its operating allowances by an average of $2.7 billion per Budget and, if so, does he plan to overspend next year\u2019s operating allowance as well?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000018\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00228adcff94ea8c4dac9acb90f1bcf867cd\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: What I can confirm is that this Government has made sure that New Zealand has kept one of the lowest levels of public debt in the OECD, has been able to both run surpluses and, then, once we reached COVID, manage down deficits to a low level compared with the rest of the world. We\u2019ve also seen strong average annual growth. Each year, the Government has to assess the expenditure that it needs to undertake, such as making sure that we invest in health, making sure that we invest in education. The outcomes matter, and New Zealand has one of the strongest economies in the world.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000019\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ea31fdd3-90e9-47d7-92a4-20b6a3109eef\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022e63a5099d1114adab68834d17fc24fd2\u0022\u003EChristopher Luxon\u003C/span\u003E: Can he confirm reports that Government spending, excluding COVID support, has increased by nearly 10 percent per year between 2020 and the latest Budget?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000020\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002226156373a5be4655995872f276db437b\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: What I can confirm is that Government spending coming off the back of a one-in-100-year economic shock has been at around 35 percent of GDP. That is a very similar percentage to what the previous National Government did in the face of the global financial crisis, and in the Budget we have the projections we will return to around the long-run average of 30 percent of GDP.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000021\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ea31fdd3-90e9-47d7-92a4-20b6a3109eef\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00227dc6898ea4e642339b30b853a7f8bc90\u0022\u003EChristopher Luxon\u003C/span\u003E: Why should New Zealanders believe his finance Minister when he promises to limit non-COVID spending increases next year to less than half of recent increases?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000022\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022b8eaf6aa310146b1a4e7c97fbaf30c85\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: My finance Minister is a modest person who wouldn\u2019t want to blow his trumpet in the way that the member is inviting him to do. What we do know is that the IMF, the OECD, Standard \u0026amp; Poor\u2019s, and Moody\u2019s have all come, assessed the New Zealand economy, and said that we have come through COVID stronger than almost any other country in the world.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000023\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ea31fdd3-90e9-47d7-92a4-20b6a3109eef\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022706f7b994ae24a428fdf1d461edb6708\u0022\u003EChristopher Luxon\u003C/span\u003E: Does he agree with economist Cameron Bagrie that this Government\u2019s Budget documents \u201Cnow face credibility challenges because spending projections are becoming ridiculously disconnected from recent spending reality\u201D and, if not, why not?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000024\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022908e0e9339484adeac2e4bcf0a7ad9ab\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: Again, the Government\u2019s Budget is based on Treasury\u2019s projections and forecasts, as every Government\u2019s Budget has been in New Zealand\u2019s history. We rely on those forecasts, and again, I repeat, our record coming off the back of these Budgets is that our net debt level is lower than almost any other country in the world, that we have had average annual growth over 5 percent, and that we\u2019ve got unemployment down to 3.2 percent. If the member wants outcomes, those are good outcomes.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000025\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ea31fdd3-90e9-47d7-92a4-20b6a3109eef\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022c22dc8fbf299408cbd5fc23333a9e115\u0022\u003EChristopher Luxon\u003C/span\u003E: How can New Zealanders have any confidence his finance Minister will be able to help himself from overspending next year, an election year, when he\u2019s spent more than he said he would every year he\u2019s been in Government?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000026\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022cb0b6f531caa4fda95c9a1f68b054009\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: I\u2019m really interested to note that the Leader of the Opposition\u2019s definition on overspending is actually investing in a health system that delivers for New Zealand\u2014is actually investing in an education system\u2014and what we have from the Opposition is the continuation of the Bermuda Triangle, where they somehow think they can cut taxes, reduce debt, and increase spending. Just today, Mr Luxon said he wanted to increase defence spending. Where\u2019s that money coming from, Mr Luxon?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000027\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00225ca40f5f3a6e42c1b91c5ce7e198b0a3\u0022\u003EKieran McAnulty\u003C/span\u003E: Does he stand by this Government\u2019s record investment in schools, which has recently funded a covered courtyard in Pahiatua School, who are with us here today?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000028\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022a5983aa6bf024e8db9c69d9aaa4b0fe4\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: Yes, I do stand by that, and in fact, the excellent advocacy of the MP for Wairarapa was a significant factor in that occurring.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000029\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u00228406ddd1979c42519eb0b5fd0495a64a\u0022\u003EQuestion No. 2\u2014Research, Science and Innovation\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022cc477162-e622-4c94-add7-36a586729e51\u0022 data-id=\u00220e71f957f84f498f8146ad5cec49fb73\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000030\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022cc477162-e622-4c94-add7-36a586729e51\u0022\u003E2. \u003Cspan class=\u0022HpsByToc\u0022 id=\u00220e71f957f84f498f8146ad5cec49fb73\u0022\u003ENAISI CHEN (Labour)\u003C/span\u003E to the Minister of Research, Science and Innovation: What action is the Government taking to accelerate innovation in New Zealand businesses?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002237a99b65-4919-4800-830d-3dd7c920d5cd\u0022 data-id=\u00225047c91a54fd4ccab720e2bd6e091058\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000031\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002237a99b65-4919-4800-830d-3dd7c920d5cd\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00225047c91a54fd4ccab720e2bd6e091058\u0022\u003EHon Dr MEGAN WOODS (Minister of Research, Science and Innovation):\u003C/span\u003E Last week, I announced two new competitive grants to support more innovation-led growth. Over the next four years, the Government will invest $250 million into supporting around 500 additional businesses. The New to R \u0026amp; D Grant will help to jump-start more businesses into R \u0026amp; D, and provide an on-ramp to the research and development tax incentive (RDTI). The \u0100rohia Innovation Trailblazer Grant will provide extra help with the cost of activities that don\u2019t fall within the definition of R \u0026amp; D, such as precision manufacturing for robotics applications, or digital product development. When we introduced the research and development tax incentive, we said we would work alongside businesses to build additional support. We are delivering on that promise. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000032\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022cc477162-e622-4c94-add7-36a586729e51\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00228652aa20f0f7437b8db88c1b8cdcaadc\u0022\u003ENaisi Chen\u003C/span\u003E: How has the introduction of the research and development tax incentive stimulated innovation in New Zealand? \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000033\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002237a99b65-4919-4800-830d-3dd7c920d5cd\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022929159ef398246c6ade1086ba28e61cc\u0022\u003EHon Dr MEGAN WOODS\u003C/span\u003E: Since we took office, the Government has partnered with innovative New Zealand businesses to help them thrive, including through the introduction of the research and development tax incentive in 2019. More than 1,500 businesses are enrolled in the RDTI, and it has generated over $788 million in private investment in R \u0026amp; D. There are now more than three times as many businesses being supported through the tax incentive as on the old Callaghan growth grant, and the uptake continues. Overall spending on business expenditure on R \u0026amp; D increased to $2.8 billion in 2021. This continues the trend of business spending\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000034\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00224f1c092c1df440d584d0e2d64da3092f\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Order! The Minister has definitely answered the question.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000035\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022cc477162-e622-4c94-add7-36a586729e51\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00227ee9f54e48b543a694c8d355e52b42a4\u0022\u003ENaisi Chen\u003C/span\u003E: How else is the Government supporting New Zealand\u2019s innovators?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000036\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002237a99b65-4919-4800-830d-3dd7c920d5cd\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022dcedae4ef5f9402ea6236ec8c380efc7\u0022\u003EHon Dr MEGAN WOODS\u003C/span\u003E: Last week, Minister Nash and myself announced a Startup Advisors Council to help identify and address the opportunities and challenge our high-growth start-up businesses. We will work closely with the council, chaired by Phil McCaw, to support often high-tech and rapidly growing businesses to generate significant levels of research and development, and to drive economic growth. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000037\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u00226be05a1f4ebd41d5aec9265d30c33502\u0022\u003EQuestion No. 3\u2014Finance\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022 data-id=\u0022bc92d5ae5b034345b2f1515e4d5d9e57\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000038\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022\u003E3. \u003Cspan class=\u0022HpsByToc\u0022 id=\u0022bc92d5ae5b034345b2f1515e4d5d9e57\u0022\u003EDAVID SEYMOUR (Leader\u2014ACT)\u003C/span\u003E to the Minister of Finance: Is he comfortable with New Zealand\u2019s economic performance in comparison with Australia\u2019s since this Government took office?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022 data-id=\u002290fc56872e514aa1853fe77aefd3f000\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000039\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002290fc56872e514aa1853fe77aefd3f000\u0022\u003EHon GRANT ROBERTSON (Minister of Finance):\u003C/span\u003E Fa\u2018afetai tele lava. In general, yes. For example, since the September 2017 quarter New Zealand\u2019s unemployment rate has fallen from 4.7 percent to 3.2 percent, compared to Australia\u2019s unemployment rate of 3.9 percent. New Zealand\u2019s economy in the December 2021 quarter was 11.8 percent larger in real terms than in the September 2017 quarter, compared to 8.7 percent in Australia. There is always more to do, but I\u2019m satisfied with New Zealand\u2019s economic performance in the wake of a one-in-100-year economic shock. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000040\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022e8d3690a2ac440a6bd4e830867f6bee3\u0022\u003EDavid Seymour\u003C/span\u003E: Can he really find comfort in those short-term measures, when the median wage in Australia has grown $6,600 a year more in Australia than for workers here since he became Minister of Finance in 2017; and if he can\u2019t take comfort from those figures, was it a mistake\u2014in hindsight\u2014that this incoming Government in 2017 made a Speech from the Throne 4,465 words long, but mentioned productivity only once?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000041\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022101e8d4284f6470bb4aeebeb73302642\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: What I would say to the member is that there are many different ways of measuring and comparing us. If we compare, for example, two indices that are similar\u2014the Labour Cost Index in New Zealand and the Wage Price Index in Australia\u2014over the period of time we\u2019ve been in Government that\u2019s increased 2.2 percent in New Zealand versus 2.1 percent in Australia. The Government is extremely focused on improving New Zealand\u2019s productivity; it\u2019s why we\u2019ve invested in skills and training, it\u2019s why we\u2019ve supported research and development, and it\u2019s why we\u2019ve got alongside our partners across the world in terms of free-trade agreements, and we continue to build on all of those things. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000042\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002287cbcc8b21384cdc913637a1dfffe7cb\u0022\u003EDavid Seymour\u003C/span\u003E: Is he comfortable that inflation for the last quarter was 6.9 percent here compared with 5.1 percent in Australia, and that floating mortgage rates there are 2.59 percentage points lower than here, meaning an Australian with a half-million-dollar mortgage pays $249 less every week than a New Zealander with a half-million-dollar mortgage?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000043\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00223ca605b927c743b4b43a6528ece401e8\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: Well I would note, actually, in the March 2022 quarter, for that quarter, inflation in New Zealand was 1.8 percent and in Australia it was 2.1 percent. I also note that the member\u2019s advocacy of policies with respect to housing in Australia I presume must also include a capital gains tax, since they\u2019ve got one.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000044\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022c7c0a98c5fd44cbbbd7ef47929986a2e\u0022\u003EDavid Seymour\u003C/span\u003E: Is he comfortable with New Zealanders paying 33 percent of their income in tax while Australians pay 29 percent in the year to June 2021, according to Statistics New Zealand and the Australian Bureau of Statistics using IMF methodology, meaning New Zealanders not only earn less but pay a significantly higher portion of their income in taxes?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000045\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002259d798f32ff94dd29610df65ef53a0d9\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: In fact, when we look at the OECD tax wedge which looks, obviously, at the impact of tax on labour income overall, New Zealand\u2019s tax wedge in 2021 was 19.4 percent; Australia\u2019s tax wedge was 27.1 percent. Again, I obviously note the member\u2019s enthusiasm for policies from Australia, so presumably ACT will now advocate for a 45 percent top tax rate.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000046\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022843a7a11589d438985d93a29e8dd2230\u0022\u003EDavid Seymour\u003C/span\u003E: Is he comfortable that foreigners choose to invest 80 percent more per person in Australia than in New Zealand; and if he\u2019s not comfortable with that will his Government get around to reforming the Overseas Investment Office so we\u2019re not the fourth most hostile country in the OECD to foreigners who want to send capital and ideas for our economy?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000047\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002277d2e14ce700437bbdfe0c42e9978279\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: The Government has indeed reformed the Overseas Investment Act and we continue to have strong levels of foreign direct investment into New Zealand.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000048\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022168279b861504ca4a658611303f43dab\u0022\u003EDavid Seymour\u003C/span\u003E: Is this Minister ever going to take responsibility for the fact that wages are lower, inflation\u2019s higher, mortgage rates are higher, and yet the best he can do is blame the past, other parties, and cherry-pick figures to evade the real issue facing New Zealanders?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000049\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002225bfd7dd908c43f5bda69bc127da1c94\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: What I will take responsibility for is a Government that has helped New Zealanders through a one-in-100-year economic shock, and seen us come out the other end with 3.2 percent unemployment, growth averaging over 5 percent, debt at one of the lowest rates in the rest of the world. There are all sorts of comparisons we can make between Australia and New Zealand, but for me, for one, I\u2019m very proud of New Zealand.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000050\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u0022a1765dd86acf448089228b7184d0dd4b\u0022\u003EQuestion No. 4\u2014Social Development and Employment\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022e7bab061-0905-44a1-a4ec-cf89b58a1baf\u0022 data-id=\u0022d975eb117bee4f0f9669848ef4608dda\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000051\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e7bab061-0905-44a1-a4ec-cf89b58a1baf\u0022\u003E4. \u003Cspan class=\u0022HpsByToc\u0022 id=\u0022d975eb117bee4f0f9669848ef4608dda\u0022\u003ESARAH PALLETT (Labour\u2014Ilam)\u003C/span\u003E to the Minister for Social Development and Employment: Talofa, Mr Speaker. How is the Government supporting beneficiary sole parents through Budget 2022?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c3a88c42-f60b-4cf9-8065-8bfb80a020eb\u0022 data-id=\u00223ba75db41d4948d7b7fa45d3d05228dd\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000052\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c3a88c42-f60b-4cf9-8065-8bfb80a020eb\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00223ba75db41d4948d7b7fa45d3d05228dd\u0022\u003EHon CARMEL SEPULONI (Minister for Social Development and Employment):\u003C/span\u003E Talofa lava, Mr Speaker. Budget 2022 removes the discriminatory policy which saw families on a sole parent rate of benefit not receive the child support paid by the other parent. Instead, the child support was claimed by Inland Revenue. From mid-2023 child support payments for sole parent beneficiaries will be passed on directly to them by Inland Revenue and treated as income for benefit purposes. This will align with what already occurs for other partnered beneficiaries raising tamariki. It is estimated that 41,550 sole parent families will be better off with a median gain of $24 per week. Removing this policy will lift an estimated 6,000 to 14,000 children out of poverty, using the BHC 50 measure. It is also anticipated it will encourage more parents to pay child support as they know it will go directly to their children.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000053\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e7bab061-0905-44a1-a4ec-cf89b58a1baf\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022b71801858419485d8995e54b71746066\u0022\u003ESarah Pallett\u003C/span\u003E: Why is removing this policy so important?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000054\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c3a88c42-f60b-4cf9-8065-8bfb80a020eb\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022045d932d9e984a909ff1dd0989a749f0\u0022\u003EHon CARMEL SEPULONI\u003C/span\u003E: Removing this policy will provide more money to parents so they can provide more support to their children. There is also evidence from overseas suggesting that passing on child support can result in an improved relationship between the child and the non-custodial parent who makes the payment. This is essential in helping our tamariki have the best possible start in life. There will be 20,300 M\u0101ori who will be impacted by this change. The vast majority of them are M\u0101ori women\u2014given that 88 percent of all sole parent beneficiaries are women. Overall this is a positive change which removes a policy which has unfairly discriminated against sole parents for decades.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000055\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e7bab061-0905-44a1-a4ec-cf89b58a1baf\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00222c7b08fc51864d98baaf52bf53c6c56a\u0022\u003ESarah Pallett\u003C/span\u003E: What feedback has she seen on the change?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000056\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c3a88c42-f60b-4cf9-8065-8bfb80a020eb\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022428dc8fe177640cfb833c8f06034baa5\u0022\u003EHon CARMEL SEPULONI\u003C/span\u003E: The move to make this change has received a lot of very positive feedback. This includes Dr Ang Jury, the CEO of Women\u2019s Refuge, who said, \u201CThis is a positive move which has the potential to significantly benefit these women and their children.\u201D Also, Children\u2019s Commissioner Judge Frances Eivers said she welcomes it hugely and that passing on child support would help to reduce poverty and improve the lives of some of society\u2019s most vulnerable. Overall, this is a long-overdue move, and I now look forward to introducing the legislation into the House to make this a reality.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000057\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002219ed20db-5d6c-4464-9327-6cdd072bb4fe\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00226047df2a4cfb4001a3ebb505434f29f7\u0022\u003ERicardo Men\u00E9ndez March\u003C/span\u003E: Would the Minister agree with 63 percent of New Zealanders who believe that beneficiaries including sole parents receiving a main benefit should receive the $350 cost of living payment?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000058\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c3a88c42-f60b-4cf9-8065-8bfb80a020eb\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022039f3df8ab7b444586b7028398454a98\u0022\u003EHon CARMEL SEPULONI\u003C/span\u003E: What I agree with are the social services who I\u2019ve had the opportunity to speak with over the course of the last two years, and particularly the last year, with respect to the number of families that they have been seeing who are on low to middle incomes and who they believe have received no assistance during this period, particularly as we\u2019ve entered into this phase where because of international impacts or influences we\u2019re seeing inflationary increases that are affecting the cost of living. We needed to move quickly to ensure that they were able to receive some support as well, and that is why we made the decision to introduce the cost of living payment in the way that we did.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000059\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u0022564725f9e36d4af3814d54e9bda87bb1\u0022\u003EQuestion No. 5\u2014Finance\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022f12da0af-dc73-4870-8f77-1d50a75eb44c\u0022 data-id=\u0022a0d64653db694ed48961e9fa3b7f39ba\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000060\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f12da0af-dc73-4870-8f77-1d50a75eb44c\u0022\u003E5. \u003Cspan class=\u0022HpsByToc\u0022 id=\u0022a0d64653db694ed48961e9fa3b7f39ba\u0022\u003ENICOLA WILLIS (Deputy Leader\u2014National) (remote) \u003C/span\u003E to the Minister of Finance: Is he concerned to see ANZ\u2019s Business Outlook survey showing business confidence at its lowest since April 2020, and does he agree with the BNZ that \u201Cthe economy\u2019s wheels are beginning to fall off\u201D?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022 data-id=\u00220f81206c60534c789a4e1694863c1dfb\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000061\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00220f81206c60534c789a4e1694863c1dfb\u0022\u003EHon GRANT ROBERTSON (Minister of Finance):\u003C/span\u003E Talofa lava. I have seen the latest ANZ Business Outlook survey which does indeed show that firms are concerned about the economic outlook, but it also notes that employment and investment intentions are holding up relatively well. The business confidence indicator is an assessment of mood but has tended to be an unreliable forward indicator of economic performance; better measures include employment figures and job ads, both of which have remained positive. As to the second part of the question, as I have acknowledged many times in this House, 2022 is a tough year and is a volatile and uncertain environment for businesses and households. Global growth has been revised downwards due to the Ukraine war, supply chain disruptions, and key trading hubs like China in the ongoing pandemic. BNZ\u2019s economists note that these global factors are contributing to much of the negativity among business. However, New Zealand finds itself in a strong position as we deal with these challenges, including having record low unemployment, a growing economy, high export returns, substantially lower debt than the countries that we compare ourselves against, and triple A credit ratings from Standard and Poor\u2019s and Moody\u2019s.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000062\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f12da0af-dc73-4870-8f77-1d50a75eb44c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022b83b764cac83419e9efea84be86493ec\u0022\u003ENicola Willis\u003C/span\u003E: Is he concerned that plummeting business confidence, reduced economic growth forecasts, and record-high inflation mean New Zealanders\u2019 living standards will go backwards this year?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000063\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00225b4794df7dd941ff885bc291fd78a461\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: As I\u2019ve said on a number of occasions, we are concerned about the impact of rising global inflation, coming off the back of the COVID pandemic, on households and on businesses. It\u2019s the reason why we\u2019ve stepped up to support households in a targeted way and it\u2019s the reason why we will continue to support businesses through this difficult period.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000064\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f12da0af-dc73-4870-8f77-1d50a75eb44c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00229e1e3e4581a84d18b041261223340c20\u0022\u003ENicola Willis\u003C/span\u003E: Did he see a BBC report with comments from a New Zealander named Harmony who has moved her family to Australia saying, \u201CYou can\u2019t make a living in New Zealand. There is no living. You just go backwards.\u201D and how many more New Zealanders does he expect will depart New Zealand this year in search of a way out of the cost of living crisis?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000065\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002201803ee32e684084bbebd15874ca0088\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: In answer to the question: no, but what I can say is that New Zealand is among all countries in the world dealing with spikes in global inflation. In New Zealand, we have one of the strongest economies in the world, that has come through COVID well with low unemployment, and there are good prospects in New Zealand.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000066\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f12da0af-dc73-4870-8f77-1d50a75eb44c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022eab1cfa954094a089386b98b3ecd9d4e\u0022\u003ENicola Willis\u003C/span\u003E: Isn\u2019t Harmony correct to say New Zealanders are going backwards when, under Labour, prices are rising faster than wages and incomes aren\u2019t keeping up with basic household costs?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000067\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002224b9eab02d8a4605a7e017ebfe2037b9\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: What we do know is that wages have run in front of inflation in the period leading up to this year, and in 2023 they will again run ahead. In 2022, it is a very difficult and challenging year and it is the reason why we have supported New Zealanders through the cost of living, both with the package on 1 April and the cost of living payment, and measures such as increasing the minimum wage\u2014which the National Party oppose.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000068\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f12da0af-dc73-4870-8f77-1d50a75eb44c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022244afcd008ef445f824bcf5fa5ab95f8\u0022\u003ENicola Willis\u003C/span\u003E: Well does he continue to believe his big-spending, high-regulation approach to the economy is working when ASB reports that, \u201CThe general explosion in costs, supply problems, difficulties sourcing staff, and squeezed profitability are all combining to push business sentiment to extremely depressed levels.\u201D?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000069\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00224898a443b23840929eebe7f84ea8d81c\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: As we\u2019ve traversed many, many times, this is a global phenomenon of inflation coming off the back of a global pandemic. What New Zealanders know is that we came through COVID better than most, and, in fact, the ASB themselves said in the report that was released yesterday, \u201CThe economy has weathered the Omicron outbreak with far less disruption than COVID outbreaks caused in 2020 and 2021.\u201D It is tough going for many businesses and households at the moment; that is why the Government is backing them.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000070\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f12da0af-dc73-4870-8f77-1d50a75eb44c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00220e88d08f1e8742349d2b668275078002\u0022\u003ENicola Willis\u003C/span\u003E: Well, what responsibility, if any, does he take for failing to create confidence in this country\u2019s economic prospects, and does he understand that Kiwis don\u2019t want his excuses, they just want to see a credible path out of the cost of living crisis, not one that leads to Australia?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000071\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002292df1f51297b42eb81fc2879003486a1\u0022\u003EHon GRANT ROBERTSON\u003C/span\u003E: What the New Zealanders are seeing from this Government is support through the cost of living pressures that they\u2019re facing, with a cost of living payment, with the fuel excise duty being cut by 25c, with the half-price public transport, with the 1 April package that\u2019s lifted incomes, with the winter energy payment. These are all practical things that we can do here in New Zealand, along with the announced reform to supermarkets to make sure that people are paying fairer prices. They\u2019re practical things that this Government is doing to support New Zealanders through these cost of living pressures.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000072\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u00224439b68442e441daad7d6938f2f48a66\u0022\u003EQuestion No. 6\u2014Justice\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c21f4beb-20c4-4b12-bc6f-fdc931e2dc96\u0022 data-id=\u0022c868f3146a884e8fac0f3168b3d28a96\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000073\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c21f4beb-20c4-4b12-bc6f-fdc931e2dc96\u0022\u003E6. \u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c868f3146a884e8fac0f3168b3d28a96\u0022\u003EGINNY ANDERSEN (Labour\u2014Hutt South)\u003C/span\u003E to the Minister of Justice: Talofa lava, Mr Speaker. How has Budget 2022 strengthened New Zealand\u2019s legal aid scheme?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022 data-id=\u0022075d97d64c7148e8b5b0aaebe2e56c36\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000074\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022075d97d64c7148e8b5b0aaebe2e56c36\u0022\u003EHon KRIS FAAFOI (Minister of Justice):\u003C/span\u003E Talofa, Mr Speaker. New Zealand\u2019s legal aid scheme will be significantly strengthened with the investment of $119 million from Budget 2022. This means we\u2019re helping 93,000 more Kiwis become eligible for legal aid, fulfilling our election promise to make improvements to our court system so everyone has appropriate access to justice. Legal aid is essential to ensuring equity in New Zealand\u2019s justice system, and by making this investment we are ensuring people on low incomes are able to access justice.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000075\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c21f4beb-20c4-4b12-bc6f-fdc931e2dc96\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022506747be1e6041058fc3cb7be8f01aa5\u0022\u003EGinny Andersen\u003C/span\u003E: What further measures are supported by Budget 2022 to bolster New Zealand\u2019s legal aid scheme?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000076\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00220b2fb0649346425e8ae6e161d3491e1e\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: Talofa lava, Mr Speaker, again. Budget 2022 will also provide funding to increase hourly rates for over 2,400 legal aid lawyers by 12 percent. This is essential for maintaining the legal aid workforce. We\u2019re also increasing debt repayment thresholds by 16.5 percent from 1 January next year, relieving financial pressures for around 16,000 low-income and vulnerable New Zealanders per year. And we\u2019ve locked in annual increases to both the eligibility and repayment thresholds for the next three years.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000077\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c21f4beb-20c4-4b12-bc6f-fdc931e2dc96\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00225b01976370924156b6865d35d1ab0c6e\u0022\u003EGinny Andersen\u003C/span\u003E: How do these changes ensure the ongoing viability of the legal aid scheme?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000078\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00229aee089a14db434b970db4e9dce2372d\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: The Budget 2022 investment change is needed so the legal aid scheme can keep doing what it was designed to do. Eligibility for this scheme had become outdated, while hourly rates for legal aid lawyers have remained static since 2008. The effect of this was New Zealand was running out of legal aid lawyers willing to do legal aid work. As the number and cost of legal aid cases are projected to grow, we must be able to fund them. Budget 2022 provides that funding to cover the costs of existing demand for legal aid services based on projections through to 2024-25.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000079\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u00224cef91956d314ee5bf8050b2954ff48a\u0022\u003EQuestion No. 7\u2014Health\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u002224fc40dc64ef4472bdaed2a50e7586b5\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000080\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E7. \u003Cspan class=\u0022HpsByToc\u0022 id=\u002224fc40dc64ef4472bdaed2a50e7586b5\u0022\u003EDr SHANE RETI (National)\u003C/span\u003E to the Minister of Health: Talofa, Mr Speaker. Does he stand by all of his statements and actions?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u002255435d3ba9554eacad6cb2631645a87d\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000081\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002255435d3ba9554eacad6cb2631645a87d\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Talofa, Mr Speaker. Yes. In particular I stand by the actions this Labour Government has taken to ensure that our health system is properly funded to provide quality care services to all New Zealanders when and where they need them.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000082\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00224964c49f962040038267be4a3fead140\u0022\u003EDr Shane Reti\u003C/span\u003E: When he said of the health system in February, \u201CWe are well prepared.\u201D, can he explain, then, why a woman with typhoid is reported as being asked to sleep in her car outside Middlemore Hospital because of a lack of hospital beds?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000083\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022db90331e57bc4905b15461c0c9c77835\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: One of the things, as the Minister of Health, I cannot do is inquire into the individual circumstances of individual patients, because that would be a breach of patient confidentiality. I have been assured by the Counties Manukau District Health Board that they treat all patients with respect and provide them with options, and I\u2019m satisfied that the Counties Manukau District Health Board did all they could to ensure the right treatment was available to that particular patient.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000084\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00222476b821cb5747c08f6428f325563484\u0022\u003EDr Shane Reti\u003C/span\u003E: Did Counties Manukau provide a vehicle as an option to a woman with typhoid?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000085\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00223c9f4fe1a3104d899a157cc9ac145875\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: As I said in my previous answer, I\u2019m satisfied that the Counties Manukau health board, in providing treatment to this particular patient over a lengthy period of time, did all that was clinically and ethically required of them.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000086\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00228f951cd363894ff5ab8e5230ed8bdf54\u0022\u003EDr Shane Reti\u003C/span\u003E: Does he think our international health reputation is damaged by reports of people with typhoid being asked to sleep in cars outside hospitals?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000087\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022ffe572defad143308859a278c4f2e6c7\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: What I do think most people will do when they look at media reports citing anonymous sources is treat them with great scepticism.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000088\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022baf81bdb81ea46a8803ce4d03dfc4f79\u0022\u003EDr Shane Reti\u003C/span\u003E: Is his restructuring during a pandemic contributing in any way at all to Christchurch and Auckland hospitals reporting today that they are cancelling surgeries?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000089\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022df90362305f346bf89f42a23b4108bc3\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: It is true that in this House you hear absurd things being said, including in question time, and that would be one of the more absurd ones. I\u2019m happy to assist the member and point out that during winter time, the health system receives a spike in people with flu conditions, with respiratory conditions, and, more recently, with COVID, and part of the preparation that the health system undergoes is to foresee that and prepare accordingly. But the health system is typically put under pressure during winter time. It is under pressure now and it is coping.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000090\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022d8be3fb18b904314bdae340f5c69d1dd\u0022\u003EHon Grant Robertson\u003C/span\u003E: What support has the Minister seen for the health reforms from the health workforce?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000091\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002205b02700aec440028e7c184b8a087b04\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: Everywhere I go, members of the health workforce, right from senior clinicians to those in the front line and other roles, say this change is long overdue. They want to be part of a unified, well-coordinated, and, I might add, well-funded health system and that\u2019s what they are getting under this Government.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000092\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022d939af61717e464cae55ae76130e423b\u0022\u003EDr Shane Reti\u003C/span\u003E: Can you guarantee, then, that his restructure, which will begin next month, won\u2019t make the current crisis in our health system even worse?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000093\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022daba063b3e3d493fb8d4be495494792c\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: We have a health system that responds very well to the needs of New Zealanders but can do a lot better, and the changes that we are putting in place, subject to the passage of legislation that is yet to complete its journey through this Parliament, will make things a lot better in terms of the ability for health service providers to meet those needs consistently across the country and to improve the equitable supply of health services right across the country as well.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000094\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u00229cc107d471fd4261a92db66bea426a66\u0022\u003EQuestion No. 8\u2014Environment\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022e122e0e6-61c6-4d17-9a79-6ad2ac7d127e\u0022 data-id=\u00222beefd13c69048dab29c91aa679d1aeb\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000095\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e122e0e6-61c6-4d17-9a79-6ad2ac7d127e\u0022\u003E8. \u003Cspan class=\u0022HpsByToc\u0022 id=\u00222beefd13c69048dab29c91aa679d1aeb\u0022\u003EHon EUGENIE SAGE (Green) (remote)\u003C/span\u003E to the Minister for the Environment: Talofa, Mr Speaker. Thank you. Is dilution the solution to agricultural nitrate pollution, or is there a need to reduce nitrate leaching into groundwater in regions such as Canterbury to reduce risks to drinking water and freshwater from farmed areas?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022f5d71749-ae91-4af7-b2bd-77260398912a\u0022 data-id=\u002220a7be5e5c564952bb913f98c482efe2\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000096\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f5d71749-ae91-4af7-b2bd-77260398912a\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002220a7be5e5c564952bb913f98c482efe2\u0022\u003EHon DAVID PARKER (Minister for the Environment):\u003C/span\u003E The Government is committed to promoting freshwater ecosystem health throughout the country, including in Canterbury. Our essential freshwater work programme was set up in response to poor environmental outcomes, including the effects of excessive nitrogen on aquatic environments. Under the 2020 National Policy Statement for Freshwater Management, councils are required to improve water quality to meet a range of water-quality indicators, including for nitrates. I suppose increasing the amount of water entering an aquifer could, theoretically, reduce nutrient concentrations in groundwater downstream of that point if the new water wasn\u2019t, itself, contaminated by nitrates\u2014but I\u2019m not suggesting this is either a practical or desirable solution. Nitrate leaching into groundwater can be reduced through changing farm practices; we\u2019re supporting farmers to do this through the development of a nutrient risk index tool, improvements to OVERSEER, and freshwater farm plans.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000097\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e122e0e6-61c6-4d17-9a79-6ad2ac7d127e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022d5322fb03ae5466f810667c4ba0f3fce\u0022\u003EHon Eugenie Sage\u003C/span\u003E: Is he concerned that intensive dairy farming in Canterbury is causing a significant legacy effect of nitrate contamination of groundwater and drinking-water sources, and, if not, why not?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000098\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f5d71749-ae91-4af7-b2bd-77260398912a\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00228ef0bfd3bc2348008eb636969c61b063\u0022\u003EHon DAVID PARKER\u003C/span\u003E: Well, in respect of the effect on drinking-water sources, that\u2019s an issue that falls to the Associate Minister for the Environment, Minister Allan. In respect of whether that breaches standards for consumption of drinking water, that\u2019s a matter for the Associate Minister of Health. In respect of the broader issues as to whether there are environmental consequences from intensive dairying in parts of the country that still need to improve, then, yes, I agree with that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000099\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e122e0e6-61c6-4d17-9a79-6ad2ac7d127e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00225463e34c992b4b249c070a2680d0ec6e\u0022\u003EHon Eugenie Sage\u003C/span\u003E: What is the Minister\u2019s response to research by Dr Mike Joy and others\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000100\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022097cc303a73b4c75abbb75dff3ddf357\u0022\u003ENicola Grigg\u003C/span\u003E: Oh, \u201CMike Misery\u201D\u2014\u201CDr Mike Misery\u201D!\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000101\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e122e0e6-61c6-4d17-9a79-6ad2ac7d127e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022928e1938e4ad4f0d9cc93e064e05b3b0\u0022\u003EHon Eugenie Sage\u003C/span\u003E: \u2014showing that dairy farming in Canterbury is expected to result in steady state nitrate concentration\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000102\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002203a12574d55949a7b2ec82bd04103c83\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Order! Sorry for interrupting the member, but interjections while a question is being asked is out of order. So please stop doing it. I didn\u2019t catch all of the question, so if the Hon Eugenie Sage would ask the question again.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000103\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e122e0e6-61c6-4d17-9a79-6ad2ac7d127e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00227d606ea9c0734d92a120d7121f66c2bc\u0022\u003EHon Eugenie Sage\u003C/span\u003E: Thank you, Mr Speaker. What is the Minister\u2019s response to research by Dr Mike Joy and others, showing that dairy farming in Canterbury is expected to result in steady state nitrate concentrations averaging 21.3 milligrams per litre in groundwater coming from farmed areas that renders much of that water undrinkable and impacts the ecosystem health of spring-fed streams?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000104\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f5d71749-ae91-4af7-b2bd-77260398912a\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00225a0f9e60a7644f1fa9f3835cf4efc33c\u0022\u003EHon DAVID PARKER\u003C/span\u003E: I respect the role of science. Whilst I don\u2019t always agree with Dr Joy\u2019s statements, I agree with many of them and I thank him for his advocacy in these areas. I haven\u2019t read that research, but if that was the effect, I would share his concerns.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000105\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e122e0e6-61c6-4d17-9a79-6ad2ac7d127e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022504ccb78936d4f199c745529f8017d0c\u0022\u003EHon Eugenie Sage\u003C/span\u003E: Is he concerned that nitrate contamination was increasing in 47 percent of the 322 groundwater wells that Environment Canterbury monitored from 2010 to 2020, and, if so, is he confident that the current national direction is strong enough for Environment Canterbury to take all the necessary steps to control the land-use activities that cause this contamination?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000106\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f5d71749-ae91-4af7-b2bd-77260398912a\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022919863c126bf44ff91d00ab8484dba49\u0022\u003EHon DAVID PARKER\u003C/span\u003E: The first point I would make is that there has never been a need for national direction in order for regional councils to do their job to stop improper levels of pollution adversely affecting the environment. So they don\u2019t rely upon national direction to do their job; national direction does help them do their job and prescribes minima that would not otherwise apply.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000107\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e122e0e6-61c6-4d17-9a79-6ad2ac7d127e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022672b99e1b8f74ae49a93eb6a1582c05b\u0022\u003EHon Eugenie Sage\u003C/span\u003E: What will he do to change business as usual and stop the increasing nitrate pollution of groundwater caused by the 629 percent increase in fertiliser use in New Zealand between 1991 and 2019, and the 82 percent increase in dairy cow numbers to 6.3 million cows over the same period?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000108\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f5d71749-ae91-4af7-b2bd-77260398912a\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00223c12bcd529594ac7a19b1396c34f11b8\u0022\u003EHon DAVID PARKER\u003C/span\u003E: In respect of the issues that the member refers to as to the very high increases in the use of synthetic nitrogen, we\u2019ve already moved to take the top off that by introducing a per hectare annual cap of synthetic nitrogen application that is legal. That limit is set for review in about two years\u2019 time, but, for the first time in the history of New Zealand, we\u2019ve already got one.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000109\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022325325\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022979cf528c954440b976f9d6d70bacd44\u0022\u003EHon Eugenie Sage\u003C/span\u003E: Will he consider reducing that regulated 190 kilogram per hectare cap on synthetic fertiliser use to help reduce dairy cow numbers and the amount of urine causing nitrate pollution of groundwater and spring-fed streams, and, if not, why not?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000110\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f5d71749-ae91-4af7-b2bd-77260398912a\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00229cf9ecfce225420c95004410b52aa681\u0022\u003EHon DAVID PARKER\u003C/span\u003E: The review of that level implies that those issues would be considered at the time of the review.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000111\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u0022be4366641b4c4ab08c107de4fe71195c\u0022\u003EQuestion No. 9\u2014Transport\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00226590faa0-f76b-4386-84f3-9b06296cc772\u0022 data-id=\u00224350bde9670742f0a476577d92b97944\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000112\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226590faa0-f76b-4386-84f3-9b06296cc772\u0022\u003E9. \u003Cspan class=\u0022HpsByToc\u0022 id=\u00224350bde9670742f0a476577d92b97944\u0022\u003ET\u0100MATI COFFEY (Labour)\u003C/span\u003E to the Minister of Transport: Fa\u2018afetai, Mr Speaker. Manuia le aoauli. What action is the Government taking to regenerate New Zealand\u2019s coastal shipping sector?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022098b8334-57f8-4062-bac6-bfbc3474e88e\u0022 data-id=\u0022ab757fdd2f454d4a8e67eeb96d750a8a\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000113\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022098b8334-57f8-4062-bac6-bfbc3474e88e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022ab757fdd2f454d4a8e67eeb96d750a8a\u0022\u003EHon MICHAEL WOOD (Minister of Transport):\u003C/span\u003E Last week, I announced the selection of four preferred suppliers which Waka Kotahi will work with to invest in new and enhanced coastal shipping services around the country. Each of the four suppliers will bring at least one additional coastal shipping vessel into service, meaning that the Government and industry will be investing over $90 million together to unlock marine transport opportunities and grow our use of the blue highway. By investing in coastal shipping, we\u2019re reducing emissions from the freight sector, providing greater resilience for our supply chain, and also improving employment opportunities for mariners and supporting regional development. This investment is a win for resilience, a win for the climate, and a win for regional New Zealand.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000114\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226590faa0-f76b-4386-84f3-9b06296cc772\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022b85a0ff6bec949a48f970cb6e4625731\u0022\u003ET\u0101mati Coffey\u003C/span\u003E: How does this futureproof New Zealand\u2019s national supply chain?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000115\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022098b8334-57f8-4062-bac6-bfbc3474e88e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00228f87c54f78ac4542bbb54a8acc29f9a0\u0022\u003EHon MICHAEL WOOD\u003C/span\u003E: Events like Russia\u2019s invasion of Ukraine have shown New Zealand\u2019s vulnerability to supply chain shocks, which are felt more acutely at our end of the supply chain. Investing in alternative modes of transport in the freight sector provides more options for goods to get to where they need to, and, in doing so, helps to keep downward pressure on costs that are ultimately paid by the consumer. Regional New Zealand also stands to benefit, with Nelson, New Plymouth, the East Cape, and the West Coast, amongst others, gaining new and enhanced coastal shipping services.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000116\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226590faa0-f76b-4386-84f3-9b06296cc772\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022e53081e1778742219d958b4482979ce7\u0022\u003ET\u0101mati Coffey\u003C/span\u003E: How does this initiative contribute towards New Zealand\u2019s goal of net zero carbon emissions by 2050?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000117\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022098b8334-57f8-4062-bac6-bfbc3474e88e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022572df1c132d54418a7af4b6171a2c120\u0022\u003EHon MICHAEL WOOD\u003C/span\u003E: Once fully operational, this initiative is expected to remove around 35 million kilometres of truck travel from New Zealand\u2019s roading network every year. In the emissions reduction plan, we have introduced a target to reduce emissions from our freight sector by 35 percent by 2035. Growing our coastal shipping sector will be critical to helping us achieve this target and this investment marks an important step on that journey.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000118\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u0022a7b3cf359e1543f88976bcaed326d6f9\u0022\u003EQuestion No. 10\u2014Police\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002248a02a21-c1ac-4159-8789-485ad614bd01\u0022 data-id=\u0022f4d86f292d834e24adeaae7a213a41ab\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000119\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002248a02a21-c1ac-4159-8789-485ad614bd01\u0022\u003E10. \u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f4d86f292d834e24adeaae7a213a41ab\u0022\u003EHon MARK MITCHELL (National\u2014Whangapar\u0101oa)\u003C/span\u003E to the Minister of Police: Why are firearms prohibition orders still not in place despite Police recommending them in October 2017?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022 data-id=\u0022f46e2c0d9dc143dba11ff6f8abc62dc7\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000120\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f46e2c0d9dc143dba11ff6f8abc62dc7\u0022\u003EHon KRIS FAAFOI (Minister of Justice)\u003C/span\u003E on behalf of the Minister of Police: Talofa, Mr Speaker. On behalf of the Minister of Police, since taking office, this Government has established the strongest firearms control regime in our country\u2019s history. We have banned military-style semi-automatics, we have bought back over 60,000 prohibited firearms and magazines, we strengthened the fit and proper person test, toughened licensing rules, and introduced new penalties under the Act. This Government has also legislated for a new fit for purpose firearms registry, which has been fully funded and is now under development. On top of that, we will pass the Firearms Prohibition Orders Legislation Bill, which will be reported back to this House in August of this year. In the wake of the March 15 attacks, we prioritised these measures appropriately, and we stand resolute on our record on arms control.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000121\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002248a02a21-c1ac-4159-8789-485ad614bd01\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022356eb22198864707a04b820fcfc32ac2\u0022\u003EHon Mark Mitchell\u003C/span\u003E: What does she mean when she says, \u201CThe effect of the FPO will be tougher\u201D, given it does not have or include warrantless search powers?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000122\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00229f3e21d5aedc47a195e9e31e98b07b78\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: I think the member might want to have paid attention to previous answers around warrantless search powers. The Minister has made it quite clear that the Search and Surveillance Act has allowed the police to undertake over 700 warrantless searches as part of Operation Tauwhiro. It\u2019s already happening.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000123\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002248a02a21-c1ac-4159-8789-485ad614bd01\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022258097e4018444c49ca5c57f6eb0265e\u0022\u003EHon Mark Mitchell\u003C/span\u003E: So what is the legal test currently required for a search to take place in the Government\u2019s Firearms Prohibition Orders Legislation Bill?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000124\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022a376dc9a82444515a1eb78800edb4eea\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: I think under the search and surveillance regime there, there has to be a suspicion that firearms might be present, or the suspicion of that. I notice the member was asking where the firearms protection orders are. As I\u2019ve mentioned to the member, that bill will be presented back to the House in August of this year. I\u2019d also point out to that member that the previous National Government promised firearms protection orders twice, in 2014 and 2016. It had nine years in order to do that, and they got nothing. I can guarantee New Zealanders that in August of this year\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000125\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00220c5f04702fa84f95988cc9c11fb03747\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Order! The Minister has definitely answered that question.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000126\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002248a02a21-c1ac-4159-8789-485ad614bd01\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022338b9e17f93146338d71a710263d0609\u0022\u003EHon Mark Mitchell\u003C/span\u003E: Did the Government ever vote down any National Party members\u2019 bills around firearms prohibition orders (FPOs)?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000127\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022074e9333ca2141b4aa414a3c54fd8c56\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: I\u2019m not sure the Minister has responsibility for that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000128\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022d5e886f309c04fd6bba5be05f06bf9b3\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: In some of those instances, the member who was responsible for those bills didn\u2019t do their homework. Despite being helped by the select committee, that bill continued to fail to meet the mark, but again, I\u2019ll remind the House of the National Party\u2019s record on this. Back in 2014, when Michael Woodhouse said that officials were providing advice by the end of the year on options around firearms prohibition orders, what happened? Nothing. And back in 2016\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000129\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022ffc2e68a5dc6494ab9e62f490833f9ac\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Order!\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000130\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00227037ee54317c4b789ae23616e132279f\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: \u2014when Judith Collins said firearm protection\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000131\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00220223dc02cf15497088baddad6e2ca018\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Order!\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000132\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022937e3aab374140f591a9fc42ebbfb75b\u0022\u003EDavid Seymour\u003C/span\u003E: The Government\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000133\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022d061cb23e6c043e8a50a441fc3f128d7\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: No\u2014I\u2019m still standing. The Hon Kris Faafoi will stand, withdraw, and apologise first. Then I\u2019ll take the point of order.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000134\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002287dd49920d4a473788a68d773157ceb8\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: I withdraw and I apologise.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000135\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227e22bb95-9afb-449c-bcd2-de9fd4f2277c\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022276e0810ad0e44ea8cc5ece111fdc6ac\u0022\u003EDavid Seymour\u003C/span\u003E: The Government has no responsibility for voting on a member\u2019s bill, and certainly not for any of the attacks on another party that we just heard from the Minister. He sounds like he\u2019s out of his depth.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000136\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002244d405291dcf4f189553e11670807b30\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Well, notwithstanding the last part of the point of order, I did at the beginning say \u201Cin so far as the Minister had responsibility\u201D, however I probably should have ruled it out of order in the first instance, so that was my fault.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000137\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002258baa209-edaf-42a5-92d6-b2613c144bfb\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022446266226c404821b114bd2500be7f14\u0022\u003ENicole McKee\u003C/span\u003E: This question is in relation to the answer to the first question that the Minister gave. If Labour has introduced the toughest gun laws in New Zealand, why is it that gun crime is up 47 percent under Labour\u2019s watch?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000138\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00228323a2fd6c404744bb1501c3d59fddd5\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: I will reiterate some of the measures that I mentioned in my initial answer. The fact that we will be having a registry available to know where guns are, as of June 2023, will allow us to track who has guns and, if they get into the wrong hands, what is the responsibility of the people to get there. We have taken measures since 2019 to make sure that we make our streets safer from gun crime. We\u2019ll put our records up against the previous Government\u2019s record any day of the week.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022344344\u0022 data-id=\u0022581c9c583bb04ce5b2f4317a819e6a65\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000139\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022344344\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022581c9c583bb04ce5b2f4317a819e6a65\u0022\u003EDavid Seymour\u003C/span\u003E: The question was about the effectiveness of the policies and the outcomes they\u2019ve had. It wasn\u2019t an invitation to repeat the same policies that the Minister listed in the answer to the question that the supplementary question was about.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000140\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00223e5073bc4c694302b82919029eb6ce4b\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Yeah. None the less, it was addressed.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000141\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002248a02a21-c1ac-4159-8789-485ad614bd01\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022de0a5fe8c27c4426adf4d077f6a3d620\u0022\u003EHon Mark Mitchell\u003C/span\u003E: Will she, in light of the 12 gang-related shootings in the last week, put the Firearms Prohibition Orders Legislation Bill through the House under urgency; and if not, why not?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000142\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002290ea1538-43e8-4257-bd80-df3ccd1e5f27\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00221ff234d042754beeba486c269c8aa297\u0022\u003EHon KRIS FAAFOI\u003C/span\u003E: We acknowledge that there are difficulties that those incidents may have caused the people involved. I reiterate to the member that the bill will be back before the House once it comes out of the select committee in August. This Government will make sure that FPOs come into place. Despite the promises of the previous Government\u2014twice\u2014it never delivered.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000143\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u002278122abf3ecf4eef8998832fe518908d\u0022\u003EQuestion No. 11\u2014Health\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a503e324-3a0b-4efd-bf44-ec6740ec9a62\u0022 data-id=\u002205578b1147eb44debb88f6e42e83bf97\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000144\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a503e324-3a0b-4efd-bf44-ec6740ec9a62\u0022\u003E11. \u003Cspan class=\u0022HpsByToc\u0022 id=\u002205578b1147eb44debb88f6e42e83bf97\u0022\u003ECAMILLA BELICH (Labour)\u003C/span\u003E to the Associate Minister of Health: Talofa, Mr Speaker. How will Budget 2022 help strengthen eating disorder services?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022aed260be-c954-464b-bb75-85579e53d05a\u0022 data-id=\u00221ed1cd36b37b455cb2b9a71f1f00356c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000145\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022aed260be-c954-464b-bb75-85579e53d05a\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221ed1cd36b37b455cb2b9a71f1f00356c\u0022\u003EHon Dr AYESHA VERRALL (Associate Minister of Health):\u003C/span\u003E Eating disorders are one of the most serious mental health challenges a person can face. We have incredibly skilled specialists working to support people with eating disorders but there\u2019s an increasing demand for their services, particularly from young people. Budget 2022 includes new funding of $3.9 million to expand and improve eating disorder services so that people can get the help they need. Eating disorders are an area of cooperation with the Green Party as part of our wider work with youth mental health, and I want to acknowledge the Greens\u2019 mental health spokesperson, Chl\u00F6e Swarbrick, for her work on this issue.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000146\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a503e324-3a0b-4efd-bf44-ec6740ec9a62\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022ea5f818062ee45f482362af9269710af\u0022\u003ECamilla Belich\u003C/span\u003E: How will this new funding be used?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000147\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022aed260be-c954-464b-bb75-85579e53d05a\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00223335e143b17249beba49ec8c3379fe97\u0022\u003EHon Dr AYESHA VERRALL\u003C/span\u003E: Improving eating disorder services is a priority for me, as Associate Minister of Health. This funding will mean we can hire more clinicians and treat more people. It will also be used to help address the current variability of services across the country. Once funding is fully rolled out, it is projected to support about 200 more people per year to get treatment from specialist eating disorder services.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000148\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a503e324-3a0b-4efd-bf44-ec6740ec9a62\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022f7660b5734084e6e8f7c82d83f4fa00c\u0022\u003ECamilla Belich\u003C/span\u003E: Are there plans to expand peer support for people with eating disorders?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000149\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022aed260be-c954-464b-bb75-85579e53d05a\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00222bbafbd8f39d491db64bc2e5e8198e1c\u0022\u003EHon Dr AYESHA VERRALL\u003C/span\u003E: Thank you\u2014whenever I meet with people working in this area, I hear about the importance of peer support. Having people with lived experience available to work with people living with eating disorders can make a real difference. So we will also use the additional funding in Budget 2022 to look at the potential to further develop peer support networks.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000150\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022e78dcceded2a44afb34e17e2694105a3\u0022\u003EMatt Doocey\u003C/span\u003E: What is her response to Eating Disorders Association New Zealand\u2019s reaction to her funding announcement, \u201Cuntil the system is reviewed and changes are made, we risk throwing good money after bad and perpetuating the current sub-optimal outcomes for individuals and their wh\u0101nau.\u201D, and does she support the sector\u2019s call for an independent review into eating disorders?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000151\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022aed260be-c954-464b-bb75-85579e53d05a\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022e6a5afc25b304937878ef9c2d1b90565\u0022\u003EHon Dr AYESHA VERRALL\u003C/span\u003E: It was on the basis of those concerns raised by eating disorder advocates, and awareness of the waiting times for specialist appointments, that we put this funding in place. As a part of the movement of the transition of this service to Health New Zealand, we will be having a look, overall, at the quality of services across the country.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000152\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u0022f5832cbb48664b5ca4d51ef28d1632c1\u0022\u003EQuestion No. 12\u2014Health\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022 data-id=\u0022b8e7060ad69c470db5adca7128fc2ff4\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000153\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E12. \u003Cspan class=\u0022HpsByToc\u0022 id=\u0022b8e7060ad69c470db5adca7128fc2ff4\u0022\u003ERAWIRI WAITITI (Co-Leader\u2014Te Paati M\u0101ori) (remote)\u003C/span\u003E to the Minister of Health: Talofa lava, Mr Speaker. Fa\u2018afetai i le Atua ua atoa nei le 60 tausaga talu ona tutoatasi Samoa. Malo lava, o le vaiaso o le gagana Samoa. Does he stand by his statement that \u201CIf we\u2019re going to have a M\u0101ori Health Authority, I\u2019m determined that it genuinely has the authority to really make a difference for M\u0101ori\u201D; if not, why not?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00221e0075f2cf974635872ec5c56cfeea54\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000154\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221e0075f2cf974635872ec5c56cfeea54\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Yes.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000155\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002236c8a9681c404c0198bd737e6318bf51\u0022\u003ERawiri Waititi\u003C/span\u003E: How can he stand by his statement when the Government consistently blocked attempts at select committee to include greater recognition of M\u0101ori authority in the Pae Ora bill, such as acknowledging tino rangatiratanga and establishing a M\u0101ori Director-General of Health?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000156\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022aca27ca2c53444e990ce80e266b293bb\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: It\u2019s a matter for the select committee to determine how it deals with the bill and the changes that it recommends back to Parliament. The bill has had its second reading and, today, Parliament will be able to examine closely the bill as it has been reported back from the select committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000157\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002208a9a9fa5a944405b6cb727e911cde58\u0022\u003ERawiri Waititi\u003C/span\u003E: Will he support Te Paati M\u0101ori amendments during the committee stage of the Pae Ora bill to strengthen the M\u0101ori Health Authority\u2019s powers, acknowledging tino rangatiratanga, and establish a M\u0101ori Director-General of Health; if not, why not? \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000158\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00224f23dbd21131488cbe0945debd741b37\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: No, I won\u2019t be supporting the proposed amendments from Te Paati M\u0101ori. We do not want or need two directors-general of health. We have the Ministry of Health, which is headed by the Director-General of Health, and we will have Health New Zealand and the M\u0101ori Health Authority, who already have established a track record of working closely together. The M\u0101ori Health Authority will be supported by iwi M\u0101ori partnership boards whose membership will be determined by iwi and urban M\u0101ori. The M\u0101ori Health Authority Board will be the subject of advice from the Hauora M\u0101ori Advisory Council to the Minister. And so the input of M\u0101ori, I am satisfied, will be consistent with the Crown\u2019s obligations under Te Tiriti o Waitangi.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000159\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002239130064aff741eeb5027fd71a029309\u0022\u003ERawiri Waititi\u003C/span\u003E: Can you explain how the M\u0101ori Health Authority will have the authority to really make a difference for M\u0101ori, when in Budget 2022 it only receives 0.6 percent of the Vote Health budget, despite M\u0101ori making up more than 17 to 19 percent of Aotearoa\u2019s population?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000160\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00229f208157241549b6998007a6a3abdf7d\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: A number of points on that. Firstly, the funding in Budget 2022 for the M\u0101ori Health Authority was additional funding on top of what had been appropriated for the health reforms in Budget 2021. In addition to that, the current funding that DHBs and the ministry manage for funding kaupapa M\u0101ori health services will transfer to the M\u0101ori Health Authority. That\u2019s roughly $1.2 billion over four years. And the third point I would make is that funding for health services in the Budget is funding for health services, not for any particular health entity, and it\u2019s my expectation that, as Health New Zealand and the M\u0101ori Health Authority get to work on the health plan and work out the various activities that they will each undertake, there will be agreement over funding that the M\u0101ori Health Authority will have sole responsibility for to continue its commissioning work and also to grow and develop kaupapa M\u0101ori health services.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000161\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022a3ed07526a0f42348a93e409ffa016e6\u0022\u003ERawiri Waititi\u003C/span\u003E: What is his response to the many M\u0101ori health experts who have come out since Budget 2022 to challenge Government on the M\u0101ori Health Authority being short-changed and that it will mean the health system will continue to fail at eliminating entrenched inequities in M\u0101ori health?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000162\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022857ae39dae5143a3b1e018abf6a7a45d\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: To the extent I\u2019ve seen some of that commentary, my observation is that much of it is ill informed. And to the extent that I\u2019ve seen well-informed commentary that takes into account the points I made in answer to the previous question, what I\u2019ve seen is expressions of support for the M\u0101ori Health Authority and the new regime that the Pae Ora (Healthy Futures) Bill, if enacted by this Parliament, will herald.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000163\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cbr\u003E\u003C/span\u003E\u003C/p\u003E\n    \u003C/div\u003E\n    \u003Cdiv class=\u0022HpsHansard\u0022\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000164\u0022\u003E\u003Cspan class=\u0022HpsProceedingHeading\u0022 id=\u00223d5fc277c88b47e3b12b26275902f4a6\u0022\u003EBudget Debate\u003C/span\u003E\u003C/p\u003E\n    \u003C/div\u003E\n    \u003Cdiv class=\u0022HpsHansard\u0022\u003E\n      \u003Cp\u003E\u003Cspan class=\u0022HpsProceedingHeading\u0022\u003EBills\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000165\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u00222058b655d3ed4728afd263283be3fe94\u0022\u003EAppropriation (2022/23 Estimates) Bill\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000166\u0022\u003EDebate resumed from 31 May on the .\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022 data-id=\u00227d1f719303ae4b46b80e430c057ad670\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000167\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227d1f719303ae4b46b80e430c057ad670\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Members, when we were last having this debate, we were on the second of a split call. I call Tangi Utikere.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002262ff759d-9586-405a-a6e6-208ad65adeb5\u0022 data-id=\u00222fdd63ef745a45b187f4da33498b911a\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000168\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002262ff759d-9586-405a-a6e6-208ad65adeb5\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00222fdd63ef745a45b187f4da33498b911a\u0022\u003ETANGI UTIKERE (Labour\u2014Palmerston North):\u003C/span\u003E Talofa lava, Mr Speaker, and thank you. It\u2019s a pleasure to rise and take a call in the Budget debate this afternoon. In doing so, can I acknowledge our hard-working Minister of Finance, Grant Robertson, for pulling together a Budget that seeks to secure the future for all Kiwis. While members on the opposite side of the House are not supportive of securing a future for all Kiwis, we certainly are.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000169\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002262ff759d-9586-405a-a6e6-208ad65adeb5\u0022\u003EBudget 2022 was pulled together in a difficult global environment, and if we look at the context beforehand I want to acknowledge the fact I was able to host the Minister of Finance and also the Minister for Social Development and Employment, the Hon Carmel Sepuloni, when they were visiting Palmerston North last week. As part of that visit we were able to meet with the not-for-profit sector, and specifically with the Palmerston North Community Services Council, an organisation doing fantastic local work on the ground. It represents more than 100 community organisations within Palmerston North, and they were so positive about the Budget\u2014particularly, two things. One is the change to child support payments that Minister Sepuloni touched on in question time today, because it will pull between 6,000 and 14,000 children out of poverty. Also, when it comes to dental care, we\u2019re providing increased provision, accessibility, and availability to dental grants for low-income families, and that is also something that was well received.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000170\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002262ff759d-9586-405a-a6e6-208ad65adeb5\u0022\u003EWhen we\u2019re talking about context, let\u2019s remind ourselves that this Government has delivered on increases in the 1 April package, increases to main benefits as a result of the recommendations from the Welfare Expert Advisory Group, increases to family tax credits, and increases to superannuation that will make a difference. Why will they make a difference? They will make a difference because they\u2019re an adjustment and increase for an individual of $52 a fortnight and for a couple of $80. It\u2019s not just tinkering on this side of the House but, rather, initiatives that are supported by local communities.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000171\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002262ff759d-9586-405a-a6e6-208ad65adeb5\u0022\u003EOn top of that we can look at the reintroduction of the winter energy payment back in May, creating real opportunities and difference in supporting those on low incomes and also for our seniors. Half-price public transport fares are continuing, specifically also for community services card holders. In terms of context again, in my city and others, if you hold a Bee card like I do, if you jump on to our local service provider in the Horizons region in Palmerston North, you will pay $1. One dollar with a Bee card for that public service, and actually that\u2019s less than some councils have charged for car-parking. That\u2019s been delivered by a Labour Government\u2014a Bee card for everyone in Palmerston North.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000172\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002262ff759d-9586-405a-a6e6-208ad65adeb5\u0022\u003EThis is a fantastic Budget that we should all be very proud of. I am proud of the largest investment in health ever\u2014over $11 billion. Members in the National Party are more focused on other priorities. They\u2019re not interested in health. We don\u2019t hear them talking about the spend in health. We don\u2019t hear them being supportive of investment in health\u2014rather, it\u2019s under-investment on that side of the House. This particular investment from a Labour Government is aimed at providing better care at that primary and community level, helping and supporting our M\u0101ori and Pasifika community members, amongst others as well.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000173\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002262ff759d-9586-405a-a6e6-208ad65adeb5\u0022\u003EThere has been investment in ambulance services\u2014assistance for those first responders, those on the ground; the front-liners. We have added 61 motor vehicles to the fleet and 248 more crew members on the ground. Last week I had the opportunity to meet with local folk at the Palmerston North rescue helicopter. They will benefit from this Government\u2019s additional investment of $90 million over four years. Listening to the difference that will make to not just my community but the regional community as well is something that I am extremely proud of.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000174\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002262ff759d-9586-405a-a6e6-208ad65adeb5\u0022\u003EI want to conclude my contribution this afternoon with two things. One is to say that I\u2019m proud to be a member of the 11-strong Pasifika caucus within the Labour Party. Last week we took the opportunity to meet with communities in Auckland but also in the \u014Ctaki electorate as well, hearing about the difference that Tupu Aotearoa and STEAM academy funding will make for that community. The second thing is that I am so proud of the ongoing support for the Apprenticeship Boost funding. In previous general debate slots I have talked about that. I have talked about a local company, Norwood, in my city and I\u2019ve talked about how valued that support was. What was exciting was the chief executive of that company, at their chamber of commerce lunch last week, was able to directly share with the Minister of Finance his appreciation for the support of the Government for the ongoing nature of that initiative. I am proud to commend this Budget to the House.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022 data-id=\u0022a2a4a90fa74346519b1e8540d95577ae\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000175\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022a2a4a90fa74346519b1e8540d95577ae\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: This call is a split call. I call Penny Simmonds.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022 data-id=\u0022d8f0148effcd48d183f83dfa6ce48e44\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000176\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022d8f0148effcd48d183f83dfa6ce48e44\u0022\u003EPENNY SIMMONDS (National\u2014Invercargill):\u003C/span\u003E Thank you, Mr Speaker. After the Budget announcement, I had, along with colleagues, a Zoom meeting with a number of aged-care providers across Otago and Southland. These providers are at their wit\u2019s end. This is a sector that has not been looked after by the Government\u2019s so-called wellbeing Budget; it has provided no relief for that sector at all.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000177\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003EThis is a big sector. They provide 36,000 beds across New Zealand. If you compare that with the public hospitals, they have 12,500 beds across New Zealand. Aged-care facilities range from small family-run, stand-alone businesses to large, publicly listed, collocated sites of care services and retirement villages. But be very clear: 50 percent are small, individual, family-run businesses, and this is a sector in crisis, both financially and related to that through the lack of registered nurses. This is leading to beds being closed; it is leading to whole facilities being closed. Registered nurses are being enticed to district health boards (DHBs) because of the pay difference, which is currently a $15,000 pay difference. The pay equity deal to be finalised will bring that pay difference up to somewhere between $23,000 and $30,000 per annum.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000178\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003ENow no one\u2014no one\u2014is disputing the nurses\u2019 pay increases wasn\u2019t needed; they are the hard-working backbone of our DHBs, and we welcome that their pay increases occurred. The problem is the Government has not extended an increase in funding to the aged-care sector to be able to match the funding or the pay of the registered nurses in the aged-care sector with the DHB, and so they are losing nurses week after week. They can\u2019t put up their fees; the Government price caps what they can charge. So they are squeezed by no additional income, no ability to put up their fees, and this competition from the DHBs\u2014that is taking our registered nurses out of aged-care facilities.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000179\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003EI\u2019ve heard Government MPs say \u201Cbig corporates should be cross-subsidising from the retirement village income.\u201D Well, that misses the point that 50 percent of our aged-care facilities don\u2019t have retirement villages attached, and those that do, they are running separate operations and there is no reason why retirement villages should be cross-subsidising our aged-care facilities.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000180\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003EThe situation, as it is now, is that we have got beds and facilities closing. Over 700 have closed in the past few months; 180 beds in Otago and Southland alone have closed. Residents are being relocated some distance away or being put in hospitals. This is turning into a health issue. If we cannot take referrals for new patients from hospital or the community and we are moving aged-care residents into hospitals and out of care homes because there are no registered nurses available, we are creating a health problem.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000181\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003EIf this keeps going\u2014and the extrapolation from the sector is\u2014this could get to around 5 percent of those 36,000 beds being closed. That\u2019s 1,800 beds that could be taken up in our hospitals for people that should be in our aged-care facilities. This is going to cause a health crisis because this Government will not fund the aged-care sector appropriately to attract and retain registered nurses in the sector.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000182\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003EOur aged-care facilities are being put in a position where they must shift their residents out or they are putting these vulnerable citizens at risk. People who have worked hard, paid taxes, contributed to this country for decades are being put at risk by this Government by not providing sufficient funding for them to be able to keep sufficient registered nurses in the aged-care sector.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022 data-id=\u00221b394bd45b26470ab039c25a2f2f87d1\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000183\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221b394bd45b26470ab039c25a2f2f87d1\u0022\u003ESIMON WATTS (National\u2014North Shore):\u003C/span\u003E It is an absolute pleasure to take the final call on this Budget on behalf of the National Party, a Budget, this year, that represents Government spending in the region of $9.5 billion per year\u2014$38 billion over the next four years. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000184\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThis is a Budget in which Kiwis are going backwards. We\u2019ve got a Minister of Finance who is absolutely addicted to spending, and Kiwis know it. Kiwis around this country, hard-working Kiwis, are suffering from a cost of living crisis, and you know what? The solution that this Government put on the table was a payment of $27 a week for a three-month period that you can\u2019t even get if you\u2019re on the average wage in this country\u2014one block of cheese and one packet of Weet-Bix from the supermarket. This is a Government that is out of touch with hard-working Kiwis in regards to the cost of living crisis that they are facing and a Budget in which is spent the most amount of money out of any Budget in history. You would expect it would come up with some solutions, some substance to deal with the issues Kiwis are facing. But, no, this Government has squandered the opportunity and missed the potential that they could have created, and, as a result, hard-working Kiwis are paying. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000185\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe issue is we are now in an inflationary environment, at 6.9 percent, when the Reserve Bank had meant to keep it between 1 and 3 percent. This Government is spending like there is no tomorrow, and what is even more concerning is the New Zealand Institute of Economic Research in June said\u2014and I quote\u2014\u201Csigns that long-term inflation pressures are becoming unanchored\u201D. For those at home, what that means is inflation is not going to magically disappear. Inflation is not a spike, as the Minister continues to say in this House. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000186\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EInflation is going to persist and inflation is going to be around, eating away at Kiwis\u2019 back pockets and the money in it every single day, and the more that this Government spends\u2014and the non-tradable inflation portion of that 6.9 percent is 6 percent. That is domestically driven inflation. This is not all because of global supply chain issues or the war in Ukraine, as this Government would like us to believe. No, they have some responsibility around this inflation level, and they need to take accountability for where this country is heading, because the reality is the gap between earnings and the costs that Kiwis are paying at the supermarket and at the pump is going up and getting wider, and there is no solution on the horizon in terms of how this Government is going to provide solutions around that. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000187\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EHard-working Kiwis who own a home are paying more in mortgage payments as their mortgages are starting to renew. Nearly 50 percent of mortgages will renew in the next six months, and the impact on the average mortgage for Kiwis of a 1 percent increase is $150 more that they will pay on their mortgage every single week. That is the reality of what Kiwis are facing and this Government has squandered an opportunity to deal with the underlying issues that we have within this economy and put money back into the hard-working Kiwis\u2019 pockets that they so deeply need. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000188\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EMortgage rates are impacting the economy and hard-working Kiwis, and we\u2019ve got a Minister of Finance\u2014Grant Robertson\u2014who is absolutely addicted to spending. I want to give you a bit of an insight in terms of what we can expect this time next year. When we are sitting, looking at where we are in terms of an economy, it is no doubt going to be in a significantly worse position than where we are today. The Government has only got around $2.5 billion to spend next year, and that is still a huge amount of money. But I can pretty much give some idea around the fact that I bet you that with this Minister of Finance, there are going to be more taxes for hard-working Kiwis, there\u2019s going to be more debt in this country for a country that can\u2019t afford it, and there\u2019s going to be more Government spending. That is the reality of what we are going to face in 2023.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000189\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EWe\u2019ve got a finance Minister that is addicted to spending, we\u2019ve got a cost of living crisis, and we\u2019ve got a Labour Government that does not understand the principle of prudent economic management. What Kiwis need is a National-led Government that has a plan in order to deal with the issues that we need to fight around inflation, a fiscally prudent Government, and I\u2019m looking forward to 2023, when National is back. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022 data-id=\u0022418f5fa9f5e74c2ba19cdee582d1058b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000190\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022418f5fa9f5e74c2ba19cdee582d1058b\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: I call Kieran McAnulty. You\u2019ve got about 3\u00BD minutes.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022 data-id=\u00226cdc168d6195475c8f78bf2dafa1e683\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000191\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00226cdc168d6195475c8f78bf2dafa1e683\u0022\u003EKIERAN McANULTY (Labour\u2014Wairarapa):\u003C/span\u003E Oh well, I\u2019ll make them good, Mr Speaker. If anybody wants to see how disjointed the National Party\u2019s response to the Budget has been, rewind Parliament TV and watch the last 10 minutes. We\u2019ve got two members sitting right next to each other. The first five minutes says we need to spend more; the next five minutes says we\u2019re spending too much. They are the Tweedledum and Tweedledee of politics in New Zealand, and that, I think, just sums it up.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000192\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003EWhat we have in this Budget is a Budget that delivers for Kiwis and plans for the future. Actually, I think this Budget is a Budget that delivers for rural New Zealand, because the money that is going into our health system will mean better services in rural areas, and what do they say? \u201CNo.\u201D This Budget will deliver more police in rural areas. What do they say? \u201CNo.\u201D That is how the National Party are trying to weave an argument for the New Zealand people. They\u2019re trying to say that we\u2019re spending too much, but they won\u2019t tell us what they will cut, because the last speaker from the National Party, Simon Watts, said that they have a plan. Well, I haven\u2019t heard it. All I\u2019ve heard is whinging. Whinging about what this Government is doing. Whinging about our investments for the future, about our investments in climate change, about our investments in education\u2014delivering for rural New Zealand. They say they don\u2019t like it, but they haven\u2019t come up with an alternative.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000193\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003EI\u2019ll give the ACT Party credit: at least they\u2019ve come up with an alternative. They\u2019re up front with the New Zealand people; they have said that they will scrap the winter energy payment. When Chris Luxon was asked about that, what did he say? \u201CI\u2019m not going to say.\u201D The ACT Party have said they\u2019re going to scrap the first-home grant, which we have increased in this Budget. When asked about whether the National Party will support that, they say \u201CWe\u2019re not going to say.\u201D How can you take a party seriously when all they\u2019re doing is whinging about a Budget that is delivering for New Zealanders\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000194\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022b450642f682f48958781c87dfbdca080\u0022\u003EMatt Doocey\u003C/span\u003E: What are you doing?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000195\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022683a1880de8e4a29a1ca9c9a5ec6004c\u0022\u003EKIERAN McANULTY\u003C/span\u003E: \u2014but refuse to bring up an alternative of their own? And I\u2019m pleased that Matt Doocey is piping up right now\u2014the ultimate whinger. The ultimate whinger that is constantly sitting there complaining that not enough is being done with mental health, but will not commit to doing more\u2014it\u2019s just complaining for the sake of it.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000196\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003ENew Zealanders saw opposition for opposition\u2019s sake at the last election, and they totally rejected it. As we get closer to the next election, my pick is they will reject it again\u2014because the National Party cannot keep this dance up for much longer. They cannot criticise spending while promising to spend more. They cannot promise tax cuts while not telling us what they\u2019re going to cut in order to pay for it. The New Zealand people are not dumb, they will see right through that. They will also see that this Budget actually delivers.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000197\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003ETake the cost of living assistance, for example\u2014the exact thing that the National Party said they would deliver. This Government does it in a way that is more targeted, less inflationary, and actually helps the people that need it. What do they say? \u201CIt\u2019s not good enough.\u201D What will they say that they\u2019d do instead? \u201COh, we\u2019ll cut taxes to those earning $180,000.\u201D\u2014how is that targeted? And when faced with the question of what would those earning $180,000 do with their tax cuts, Chris Luxon says, \u201COh, they\u2019ll probably save it.\u201D How on earth is that targeted? How is that supposed to be a cost of living assistance when those that don\u2019t need it are going to get it? \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000198\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003ENew Zealanders will see through that nonsense. They\u2019ve seen this Budget. They\u2019ve seen that we\u2019re committed to the people of New Zealand, and they\u2019ll see the National Party for what they are. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022 data-id=\u002259526812f969428ab3c7215d03bb5b19\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000199\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002259526812f969428ab3c7215d03bb5b19\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: I call the Minister of Finance, the Hon Grant Robertson\u201410 minutes in response. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022 data-id=\u002261e40205621142158ff11938dab5425e\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000200\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002261e40205621142158ff11938dab5425e\u0022\u003EHon GRANT ROBERTSON (Minister of Finance):\u003C/span\u003E Thank you very much, Mr Speaker, and can I begin by thanking colleagues across the Chamber for their contributions in response to the Budget debate. I want to particularly acknowledge the contributions made by my colleagues in the Labour caucus. I have listened to them stand in this House and consistently be positive about our country and be positive about the security that we can provide New Zealanders.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000201\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EThese are tough times for many New Zealand businesses and households, and what those businesses and households know is that there is a Government that is backing them\u2014backing them in exactly the same way that we did through COVID-19. I have had the privilege of going on the road after the Budget all around New Zealand, listening to New Zealanders and meeting with people to hear from them, and one of the consistent themes was the fact that people around the country are grateful for the fact that the Government stood alongside them through initiatives like the wage subsidy scheme, like the resurgence support payment, and like the small business cash-flow scheme. These are the things that got businesses and households through COVID-19. That\u2019s because the Government backed New Zealanders: to give them cash flow and confidence, and those New Zealanders know that we will back them again as we go through this challenging year that we\u2019re facing in 2022.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000202\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EPutting this Budget together required a very careful balance of three things. The first of those is: supporting New Zealanders in the here and now, because the global inflation spike that we are seeing is affecting New Zealanders when they go to the supermarket and when they\u2019re at the petrol pump. What this Government has done is respond with practical measures that actually address the issues where inflation is hitting and the causes of inflation, not the things we\u2019ve heard from the other side of the House: the untargeted ideas that they have about tax cuts for those who earn more than $180,000, or somehow the idea that we could cut health spending and that would lower prices at the supermarket. That is the logic that we are hearing from the National Party. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000203\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EInstead, what we have done is made sure that we are supporting people\u2014in particular, with the cost of living: the payment that starts on 1 August of $350, or $27 a week. Here\u2019s my prediction: the people who get that will think, \u201CThank you, that is actually a contribution. It\u2019s not going to make up for every single thing that\u2019s happening, but it is a contribution.\u201D\u2014and it is a lot better than 2 bucks a week that someone earning $40,000 would be getting from the National Party, while people earning over $180,000 would be getting significantly more. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000204\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EIt comes on top of the package on 1 April that lifted main income benefits. That means that this Government has lifted benefits in 2020, 2021, and 2022, and any crocodile tears from the National Party about what they would do for low-income New Zealanders\u2014they need to remember that they opposed every single one of those increases, just like they opposed the minimum wage, just like they\u2019re opposing the fair pay agreements. Anything that we do on this side of the House to lift the incomes of New Zealanders gets opposed by the National Party.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000205\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EBut along with that, we\u2019ve extended the fuel excise duty cut, the road-user charges cut, and half-price public transport. I am very proud of the fact that this Budget means that half-price public transport will extend for community services card holders for ever. That is the beginning of the commitments that we\u2019re making to make sure that New Zealanders are supported to make sustainable transport choices.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000206\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003ESo supporting people in the here and now matters, and on Budget night, we did introduce legislation to stop the land banking done by the duopoly in our supermarkets, to make sure that competitors have the confidence that they can come in, and now the Government has come further forward with our responses to the Commerce Commission market study. This means that we\u2019re opening up wholesale. It means that consumers will have transparency around prices. It means that suppliers have a guarantee of a code of conduct. These are the things that mean we will see competitors in our market and we will see fairer grocery prices: practical initiatives from a Government focused on supporting people with cost of living pressures.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000207\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EThe thing that we always need to balance alongside the here and now is how we invest in the future\u2014how we invest in the economic security of New Zealanders\u2014and as part of this Budget, the Climate Emergency Response Fund does a very important thing: it begins our journey to making sure that not only do we meet our net zero emissions goals but that we take the opportunities that come with climate again. Again, as I travelled around the country, I met people in Christchurch, in New Plymouth, and all over New Zealand who want to be a part of this, who want to be driving forward in the hydrogen economy, and who want to be making sure that our industrial plants are heated efficiently, because it makes economic sense as well as it makes environmental sense and it\u2019s where the high-wage jobs come from.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000208\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EIn contrast, we hear from the National Party that \u201CYes, we support the goal; we just don\u2019t support any actions to actually reach the goal.\u201D As one of my former colleagues said, \u201CAll map and no compass.\u201D That\u2019s what you get from the National Party, because they say they support the goal, just like they did in 2016 with Paris, and, actually, they\u2019re not prepared to take any actions to go towards that, whereas in this Budget, we have a significant package of initiatives through transport, through forestry, through agriculture, through economic development and industry, and through the wage strategy to actually get on top of that and create the high-wage jobs that we need.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000209\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003ETangi Utikere mentioned this in his speech just before, but the fact that we are continuing to invest in the skills and the training of New Zealanders is significant in this Budget. The extension of the Apprenticeship Boost means another 36,000 New Zealanders will be able to stay in apprentices; 190,000 New Zealanders have been backed by free apprenticeships and free targeted trade training, and it won\u2019t come as a surprise to anyone listening to this speech to learn that the National Party opposed that as well when we brought that in in July 2020.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000210\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EAlongside that, the Budget lays out the plan for $61 billion of spending in infrastructure over the next five years in New Zealand. That is investment in transport. That is investment in housing. That\u2019s building schools, that\u2019s building our hospitals, and it\u2019s building up all of the assets that New Zealanders will rely on to make sure that we can indeed be a more productive economy, a high-wage economy, and a low-emissions economy that provides economic security.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000211\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EThe thing that all Governments have to do is balance what we\u2019re doing in the here and now\u2014the future investments\u2014with upholding our strong fiscal position, and this Budget does that. That has been reinforced time and time again by the OECD, by the IMF, by Moody\u2019s, and by Standard \u0026amp; Poor\u2019s. They\u2019ve all said that the Government\u2019s books are in good shape: surplus by 2024-25, five years after COVID came along, compared to six years after the global financial crisis for National. Debt is at 19.9 percent, one of the lowest in the world. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000212\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EYes, Government spending increased because we helped New Zealanders get through COVID. I sat in this House and heard National Party members say, \u201CSpend more.\u201D Now, they come in today and say, \u201CNo, no, no, you shouldn\u2019t have done that.\u201D Let\u2019s be really clear: when they stand up and talk about the fact that the Government shouldn\u2019t be spending this money, they\u2019re saying to New Zealanders, \u201CWe wouldn\u2019t have backed you with the wage subsidy scheme.\u201D Now, they did at the time. They said that they wanted it at the time, but now they\u2019re saying they wouldn\u2019t\u2014that is the real meaning of that. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000213\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EWe are bringing Government spending back down, as you would expect, once we get through that period. That requires a disciplined approach and a careful approach, and we have got that balance.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000214\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EBut when I take a step back from this Budget and the work that the Government has been doing over the previous Budgets that I\u2019ve had the honour to present to this House, it is not just the fact that we are providing economic security and that we\u2019re working towards high-wage jobs with low emissions. It is that we are genuinely involved in nation-building\u2014nation-building that happens not only through the assets that we build, the infrastructure that we support, and the people who we develop the skills with but the way that we recognise where New Zealand is today, in 2022. So there is funding in this Budget for Matariki\u2014the fact that we have an indigenous public holiday. There is funding in this Budget to recognise and reconcile from the Dawn Raids. We recognise that when we do well in New Zealand, we build a nation. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000215\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EI look across the House to see a group of people who, once again, want to divide a nation. They think that tax cuts for those earning more than $180,000 is the way to be able to get a more fair and more equal New Zealand\u2014that is rubbish. We know, on this side of the House, that the way we do that is that we invest in our people. We support those with the least so they can do more. We all have a shared responsibility to look after one another in this country.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000216\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00226007dc96-f459-4cdd-9972-4fde2c994088\u0022\u003EI am extremely proud of Budget 2022. It comes at a difficult and tough time for many New Zealanders. What New Zealanders know when they see this, our previous work, and the work to come is that we have their back\u2014we have their back\u2014to make sure that we create a secure future for every single New Zealander.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022dcfb2e30142a472985665f83124cf33b\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment in the name of the Leader of the Opposition be agreed to, to replace all words after \u201CThat\u201D with \u201Cthis House, and the people of New Zealand, have lost confidence in this Government, because this Budget takes them backwards. Households are going backwards. The books are going backwards. Outcomes are going backwards. The country is going backwards.\u201D \u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 75\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022771499c79b604588a8ee3d3c2ea6ba76\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the Appropriation (2022/23 Estimates) Bill be now read a second time.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EMotion agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000217\u0022\u003EBill read a second time.\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022 data-id=\u00227dddb71020f948cdae5e8c0838ee8b47\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000218\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227dddb71020f948cdae5e8c0838ee8b47\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: I declare the House in committee for consideration of the Pae Ora (Healthy Futures) Bill.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000219\u0022\u003E\u003Cspan class=\u0022HpsSubjectHeading\u0022 id=\u00222058b655d3ed4728afd263283be3fe94\u0022\u003EPae Ora (Healthy Futures) Bill\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000220\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u00229d72f0c98fa74c0bbf5c0c4c380cbf97\u0022\u003EIn Committee\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000221\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u002277a9e2ef6e6243ada36f7845a3f210d9\u0022\u003EPart 1  Preliminary provisions\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022808cb89048024efda8f1d5c0fa742410\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000222\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022808cb89048024efda8f1d5c0fa742410\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Members, the House is in committee on the Pae Ora (Healthy Futures) Bill. I remind members that they are able to participate remotely. If you\u2019re on Zoom and want to take a call, please type \u201Ccall\u201D into the chat function. You should also use the chat function if you want to raise a point of order. If we receive new tabled amendments, I will advise members so that they can refresh the \u201CHouse papers\u201D page to see the new amendment. Finally, it would be helpful for members to ask multiple questions, if they have them, so that the member in charge can answer during the call. We come first to Part 1.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002261725fea-7d5e-4d1f-8fd3-e5779bb7a14d\u0022 data-id=\u0022c0b72dcd3db4421b9eefdde0f2f078f3\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000223\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002261725fea-7d5e-4d1f-8fd3-e5779bb7a14d\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c0b72dcd3db4421b9eefdde0f2f078f3\u0022\u003EBARBARA EDMONDS (Associate Whip\u2014Labour):\u003C/span\u003E Point of order. I seek leave for all provisions to be taken as one debate. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00223fd484d3f8964297b568a3f60fb33df6\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000224\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00223fd484d3f8964297b568a3f60fb33df6\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Leave is sought for that motion. Those of that opinion will say Aye. Is there any objection for the motion? There is objection. The question is that Part 1 stand part.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022e930dcfabc3c4bbfb4ef8a08fe6349d8\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000225\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e930dcfabc3c4bbfb4ef8a08fe6349d8\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair. I\u2019ll just speak briefly to this part, but this is a critical part because this part of the bill contains the commitments of the Crown, or the Government, to the Treaty of Waitangi and sets out not only the commitment that the Crown is obliged to make under the Treaty of Waitangi but actually incorporates a set of principles that were taken from the Wai 2575 interim report of the Waitangi Tribunal, which is about making sure that our health system is equitable to M\u0101ori and to all New Zealanders.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000226\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe opening\u2014the kind of starting point for this bill\u2014is that we have a health system that is based on health need, but we also have a country where we know that health need is met inequitably across different population groups, principally M\u0101ori and also Pacific. So this is about setting up a set of commitments and principles upon which our health system will be based that better drives towards greater equity. So the combination of the Te Tiriti o Waitangi principles and the health sector principles are a vital underpinning to the way decisions are made in the provision of health services from here on, or at least from the enactment of the bill. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u002275c27001820f4769a01209b34ade1727\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000227\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002275c27001820f4769a01209b34ade1727\u0022\u003EDr SHANE RETI (National):\u003C/span\u003E Thank you, Madam Chair. I rise to speak to Supplementary Order Paper (SOP) 160 on behalf of the National Party, which puts a flag in the sand for rural communities under clause 7 and challenges this Labour Government to vote it down today. I\u2019m speaking, today, on behalf of the 194 rural practices serving 728,154 rural people across rural zones 1, 2, and 3, and we seek to have their voices recognised in this bill. Locally, I challenge the local Labour MP to vote down this bill, and failure to offer protection to important rural communities\u2014such as Hikurangi, Maungatapere, Waip\u016B, Langs Beach, Ruak\u0101k\u0101, Parua Bay, Matap\u014Duri, T\u016Bt\u016Bk\u0101k\u0101, and Whang\u0101rei Heads\u2014and to vote this down would be to say that you just don\u2019t get it and you just don\u2019t care. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000228\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThis SOP requires the bill to ensure that rural communities have three things, and we\u2019ve placed it high up in the bill in amongst the principles attendant to clause 7. The first is we require rural communities to have access to services in proportion to their health needs. The health needs of rural communities are high end and unique. Access, distance, communication, and workforce are all magnified in rural communities. I\u2019ve been privileged to be a GP in rural communities, such as Rawene and Dargaville, where you travel long distances for home visits\u2014there were no x-rays or laboratory services at night\u2014where you were the only one doing after-hours, at some distance to a main hospital, where you get up to road accidents at midnight on Te K\u014Dpuru Hill, not because you\u2019re on duty but because you\u2019re part of a rural community\u2014it is what you do. More recently I\u2019ve vaccinated in rural communities.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000229\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003ERural health is different and needs to be recognised and futureproofed in this bill. The New Zealand Rural General Practice Network said this after the second reading of the bill: \u201CThe Minister was unwilling to define rural communities as a priority population in the legislation. It was further galling to see the Minister interviewed on TV3\u2019s Newshub and asked to comment on the fact that rural-health professionals were concerned that they were not identified in the draft legislation, the Minister commenting that the problem with rural practice is that they are old-fashioned business models that don\u2019t work anymore. That disrespects rural practices.\u201D\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000230\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EParts 2 and 3 of my SOP demand equitable services to achieve equitable outcomes. National, in health, wants to talk the language of outcomes, not the language of bureaucracy. We understand the unique needs of rural communities. The strategic priorities for rural health providers are: (1) to improve rural M\u0101ori health outcomes; and (2) to grow the rural health workforce from within the heart of rural New Zealand. And the three principles in our SOP serve all those agendas. I note, today, that late in the piece, an SOP has appeared on the table from the Minister that seeks to recognise\u2014surprise, surprise\u2014a rural health strategy in amongst, I believe, clause 40A\u2014very late in the piece on the day. I think he\u2019s recognised the pain from rural communities in excluding them and having them invisible in this bill.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000231\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThis SOP and the National Party recognise the 194 rural practices serving those 728,154 patients, and we say, \u201CWe hear your voice. We want to hear that voice in this bill.\u201D And we challenge the Government to vote down this SOP. Thank you.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022 data-id=\u00225341c3223ca94eee9c4dc7123091f13c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000232\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00225341c3223ca94eee9c4dc7123091f13c\u0022\u003EMATT DOOCEY (National\u2014Waimakariri):\u003C/span\u003E Thank you very much, Madam Chair. I just want to follow on from my learned colleague Dr Shane Reti in exploring the Minister\u2019s Supplementary Order Paper (SOP) 169 that we found on the Table. What a difference it makes when the polls are tanking for the Government. They spent the whole time and expense of the select committee saying, \u201COh, no, you can\u2019t define rurality. You can\u2019t do a rural strategy.\u201D They said, \u201CNo, we\u2019re not going to prioritise rural.\u201D, and here we are, mea culpa, on the first part of the committee of the whole House, and here we have a rural health strategy, after denying it for weeks.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000233\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EI say well done to the Opposition, because we got accused in the last debate of whingeing. This is what whingeing does. It delivers for New Zealanders. And, funny enough, the last speaker from the Government who accused the Opposition of whinging was from a rural seat, and he knows that rural communities were upset about this. And, of course, for a while, this Government didn\u2019t care. They thought they knew it all, until they started to cede control. And that\u2019s what they\u2019re doing here.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000234\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EThey try and tell us this bill is about equity. But when it comes to equity of certain groups like rural communities, their equity didn\u2019t count. And that\u2019s why it\u2019s not in the bill, and that\u2019s why this Minister has been dragged kicking and dragging his feet to the committee of the whole House and finally puts up that he concedes the Government was wrong. And, quite rightly, 800,000 rural New Zealanders, who deliver 50 percent of this country\u2019s GDP\u2014quite rightly\u2014deserve a rural strategy. So, yes, we accept that there\u2019s going to be a rural strategy, but also we say, let\u2019s back Dr Shane Reti\u2019s SOP, because he was the one championing for the rural communities, as other MPs in the Opposition were. And I expect we\u2019re going to hear from those MPs as well over the course of the debate.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000235\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EThis committee of the whole House is about questions, and my question simply is to the Minister. It would be nice to hear an explanation for the House today, why we spent so much time and expense on the Pae Ora (Healthy Futures) Bill at select committee, who were told, no, we\u2019re not going to have a rural health strategy; why those submitters had to go through the anguish of seeing that bill put out in a draft form, where they had not been listened to. So it would be interesting to hear from the Minister, what has changed? When did he decide\u2014or, in fact, when was he told that now we\u2019re going to have a rural health strategy? What has changed? Why was that group told, \u201CNo, no, it\u2019s all right; you\u2019ll be covered under the health strategy that the Minister would determine.\u201D? But now we see there is going to be a rural strategy.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000236\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EThis is a good starting point for what is going to be a long debate tonight, because, of course, there\u2019s several other population groups that aren\u2019t represented in here as well, and one of them that I\u2019m going to be talking about in my future calls is mental health. So I\u2019m very much looking forward to the Minister\u2019s explanation. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022 data-id=\u002256dda432aec8416cbea999aeaa343ab3\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000237\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002256dda432aec8416cbea999aeaa343ab3\u0022\u003ERAWIRI WAITITI (Co-Leader\u2014Te Paati M\u0101ori) (remote):\u003C/span\u003E Thank you, Madam Chair. T\u0113n\u0101 t\u0101tou. Well, it\u2019s a pleasure to speak today during the committee stage of the Pae Ora (Healthy Futures) Bill, on behalf of Te Paati M\u0101ori and my colleague and health spokesperson Debbie Ngarewa-Packer, who is currently sick with COVID and is quite gutted that she won\u2019t be able to be in the Chamber for this debate. But Debbie has told me how frustrating it has been on the Pae Ora Legislation Committee as Government members refuse to even include simple acknowledgments of tino rangatiratanga in the legislation. We should not have to scrap for what should be the bare minimum in all legislation that goes through this House, let alone a bill as important for M\u0101ori as this one.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000238\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EWhile we continue to acknowledge the Government for adopting\u2014in part\u2014our 2020 policy to establish a M\u0101ori health authority, I think the Government should have read the policy a little bit more closely. That policy made clear how crucial it was that the authority had statutory independence and that it be funded to an equitable level. We have just seen in Budget 2022 how new funding entrenches inequities and actually widens the funding gap with the P\u0101keh\u0101 system. The Minister has said he wants the authority to really make a difference for M\u0101ori, but how can it when it only receives 0.6 percent of the Vote Health budget, despite M\u0101ori making up more than 17 to 19 percent of Aotearoa\u2019s population? How can it, when it doesn\u2019t have the same functions and powers as Health New Zealand? I\u2019ve just heard the Minister talk about the importance of Te Tiriti o Waitangi going hand in hand in the whole development of what is supposed to be the biggest health reforms in nearly a century. But Te Tiriti o Waitangi promises parity, and promises equality, and we\u2019re not seeing any of that in this particular bill.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000239\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EThe passage of this bill and establishment of the M\u0101ori Health Authority will make a huge impact in reducing M\u0101ori health disparities. That is why we will continue to support the bill through the House. But it must be funded for what it is supposed to do. At the moment it will be funded to fail. However, this House must not set up tangata whenua to fail in the new system. We must ensure the legislation helps guarantee success. Under the current funding it will not be successful. Therefore, we have to put several amendments to strengthen the bill.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000240\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003ESupplementary Order Paper 168 amends Part 1 to recognise our people\u2019s tino rangatiratanga. It does this by inserting a new clause that requires the legislation to uphold the tino rangatiratanga of tangata whenua in Aotearoa. It also replaces all references to the Treaty principles with references to the articles of the Treaty. For legislation to be compliant with Te Tiriti o Waitangi it must implement the actual text of the agreement that was signed in 1840\u2014the articles which include the reaffirmation of the tino rangatiratanga of hap\u016B and iwi. References to the Treaty principles in law have been used to water down the Crown\u2019s commitments to its relationship with tangata whenua. Te Tiriti o Waitangi was a contractual agreement, not a statement of principles. We must not allow the Crown to pretend otherwise.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000241\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EWe are calling on the Government to admit they made a mistake in the drafting of the bill and at select committee, and we must do the right thing. This is a straightforward amendment that will make the bill more compliant with Te Tiriti o Waitangi, if that is the priority of the Minister and this Government. Parties across the House have the opportunity to show that they are committed to upholding our nation\u2019s founding agreement, and I look forward to the Minister\u2019s comments in this particular area. Kia ora t\u0101tou.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u0022e34a4dcc70844679a8c4b8da764e255a\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000242\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e34a4dcc70844679a8c4b8da764e255a\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Madam Chair. I would just like to start my contribution today by congratulating the Minister of Health for adopting the ACT Party\u2019s amendment to the pae ora legislation. And I note that a few months ago, the ACT Party said that there are serious flaws with this legislation, with the health reforms, and that it ignored a substantial number of New Zealanders. Under Supplementary Order Paper 151, in my name, we adopted a rural health strategy to make sure that rural New Zealanders\u2019 voices are not overlooked in the health reforms, and I\u2019d like to congratulate the Minister for adopting a sensible piece of policy that will make this health reform better, because we know that the Government quite often overlooks the needs of rural New Zealanders, and I think that is a shame.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000243\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EI\u2019d also like to question what on earth changed the Minister\u2019s mind. Was it really the letter that I sent him a few months ago? Or was it the question I put to the Minister in the House a few weeks ago, when I said, \u201CDoes he stand by his Government not including a rural health strategy, for the approximately 750,000 New Zealanders who live rurally or remotely, in the Pae Ora (Healthy Futures) Bill?\u201D I wonder what the answer was. He said, \u201CYes.\u201D\u2014yes\u2014\u201CThe Government was pleased to see a wide range of submissions\u201D, etc., etc., but it wasn\u2019t necessary to have a rural health strategy. So I would put it to this House that, if it was not for the ACT Party listening to the needs of rural New Zealanders, we would not have a rural health strategy in this bill.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000244\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003ERural New Zealanders are quite often overlooked, but the ACT Party constantly is on the road, we\u2019re constantly out meeting the needs of New Zealanders\u2014listening to the concerns of rural New Zealand. Just recently, we\u2019ve been up and down New Zealand on our Real Change Tour, being part of the community, listening to cares and concerns, and something that\u2019s come out, which has stuck with me, is from people saying that this health reform is unnecessarily divisive, it doesn\u2019t focus on health needs, and it has overlooked a substantive part of New Zealand\u2014rural New Zealand.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000245\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EWe know that the Health and Disability System Review identified that people living in small towns and in rural towns can have poorer health outcomes and lower life expectancy. Rural populations were mentioned over 80 times in that health and disability review, and yet, when it came to the health system reform that this Government put forward, they were barely mentioned at all. If it was not for the ACT Party standing up for rural New Zealand, we would not be here congratulating the Minister on finally adopting a sensible change. We certainly hope that it will go some way to helping people get more access to midwives, to better healthcare, to better mental health care and mental health nurses, and to better mental health technology\u2014a whole range of systems that can help rural populations. But I would also question why it was that only a few weeks ago, the Minister seemed to think that localities were the answer to rural New Zealand\u2019s problems. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000246\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003ESo what is it, Mr Little? Is it that the localities have lost your faith, or have you really been swayed by the ACT Party\u2019s proposition?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00229b263de9d6b64a61918eb471cdd5490c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000247\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00229b263de9d6b64a61918eb471cdd5490c\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair. I\u2019ll take this opportunity to respond to the first handful of contributions to date, to the extent that there are questions in them. I note in relation to Supplementary Order Paper (SOP) 160 that Dr Shane Reti is effectively seeking to legislate for health outcomes, and, unfortunately, it simply is not possible, credible, or realistic to legislate for health outcomes.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000248\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe role of the Government and the role of Government agencies is to put in place measures that seek to achieve particular outcomes but there can necessarily be no guarantee about that. The measures we\u2019re putting in place, the structural reforms, give us a much better chance to get better decisions, better resource allocation, greater consistency, and greater coherence across the health system to ensure that there are better health services and, ultimately, that more people have access to health services, particularly those who don\u2019t currently have access to them\u2014that is the basis on which we can improve health outcomes. Simply legislating to say we will achieve equitable health outcomes doesn\u2019t do it. You\u2019ve actually got to have measures.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000249\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWe know that the problem the National Party has is getting to grips with wanting a particular outcome and then being prepared to back it with action and resources. We know that their fundamental problem\u2014and their track record in Government\u2014is that they underfund and under-resource health and they cut taxes and wonder why everybody else is left to pick up the pieces. So we won\u2019t be supporting SOP 160. It is meaningless and does not help.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000250\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI see that members have referred to the rural health strategy in my SOP, and although that applies to a different part of the bill, I will address some of the comments that have been made. I can say that the one party that has the strongest rural representation in Parliament is the Labour Party. We have a very strong rural caucus with whom I meet regularly, and have met, and they pointed out an obvious thing\u2014the bill having been reported back from the select committee with the addition of a women\u2019s health strategy. When you look at the provision in the Government Policy Statement on Health, the policy statement in the original draft bill, and indeed in the draft that was reported back to Parliament, referred to a number of population groups: M\u0101ori, Pacific, disabled, women, and rural communities. Rural communities were always specifically and explicitly identified in the bill. When the select committee recommended an addition to the range of discrete strategies that should be in the bill, and added women to it, the only community that was listed in the Government policy statement provision that was not then the subject of a discrete strategy were rural communities. That was an obvious inconsistency, and the very dynamic and very influential rural caucus in the Labour Party caucus came to me and pointed that out, and we agreed that that is an anomaly and it is the right thing to make sure that rural communities were provided for.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000251\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI can say, however, that I\u2019m satisfied with the practical provisions in this bill, particularly around locality planning as rural communities will be way better served under this set of reforms than they have in the health system previously. Rural communities will know that Labour Governments fund health. They don\u2019t de-fund health, which is what the previous Government did. Labour Governments fund health infrastructure, not de-fund it like the previous Government did. Labour Governments back communities to determine their own health needs, not turn their back on communities, whether it\u2019s those with mental health issues or those rural communities. Labour doesn\u2019t turn their back on them like the previous Government did\u2014and it left this Government to pick up the pieces.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000252\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo our colleague Rawiri Waititi, who has raised this issue, I know that Te Paati M\u0101ori would like to have a reference to tino rangatiratanga or rangatiratanga\u2014and I\u2019m now turning to Part 1 of the bill\u2014but the reality is that when you put language in legislation we have to assume that the courts will understand it and know it and apply it, and the reality about terms like \u201Crangatiratanga\u201D and indeed \u201Ck\u0101wanatanga\u201D, which is the counterpart to \u201Crangatiratanga\u201D, is the courts have demonstrated increasingly, and most recently in the Ng\u0101ti Wh\u0101tua \u014Cr\u0101kei case that the P\u0101keh\u0101 courts are reluctant to apply P\u0101keh\u0101 interpretations to te reo terms. So we would be entering a period of considerable uncertainty if we were to use that language. In reality what\u2019s most important is that when we articulate and adumbrate the principles that we want to adhere to, it\u2019s the practical provisions that actually make the difference, and when you look at the architecture of this bill and the architecture of the systems we\u2019re putting in place, this is about embracing m\u0101tauranga M\u0101ori, giving M\u0101ori a seat at every table in the health system, partnering with M\u0101ori, with a combination of Health New Zealand and the M\u0101ori Health Authority, to make decisions and to fundamentally change the approach we take to ensure that health services to M\u0101ori are more accessible, achieve better health outcomes, and lift the health of M\u0101ori in general.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000253\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo that is what we\u2019re doing. I know that our colleague Rawiri Waititi referred to the statutory independence for the M\u0101ori Health Authority. The M\u0101ori Health Authority, without wanting to break into other parts of the legislation, is a statutory body. It is not a Crown entity. It\u2019s a statutory entity, although it will adhere to some of the obligations of entities under the Crown entities legislation.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000254\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo my colleague Brooke van Velden, who notes the addition of the rural health strategy to the list of discrete strategies that will be provided for, again I reiterate that the reason I have agreed to make that change is on the advocacy of the rural members of the Labour caucus who said there was glaring inconsistency. Every other group referred to that was required to be the subject of elements of the Government policy statement had a discrete strategy, but not rural communities, and that was an inconsistency that, on the face of the bill, could not and should not stand, and that\u2019s why that gap has been filled. I\u2019m very thankful to the members of the Labour caucus\u2014those with rural electorates and rural responsibilities\u2014for their advocacy in that respect.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000255\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI reiterate what I say: when you look at the way we\u2019re setting up the locality networks, of the first nine that we are now in the process of developing, seven of them have substantial rural elements to those areas, and we will continue to roll out that, and that will make a difference to health services in rural areas. To Dr Shane Reti\u2019s apparent criticism of me for criticising the business models of some rural health providers, I say that that is a challenge we had. Some of those business models are not sustainable, and we had to find different ways of providing services\u2014and not only providing services but attracting the health workforce into rural communities, and it will not be in some of the health services or health organisations that are in those rural communities at the moment. So that is a challenge to rural health leadership.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000256\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThere\u2019s a new organisation that\u2019s going to be launched soon, and when you set yourself up to be a leader of a community, what goes with the claim to leadership is the need for responsibility and responsibility to those communities. Any claimed rural health leader who says that nothing needs to change is not a leader, and they would be an obstacle to leadership and to positive change for rural communities.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000257\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ENow, I\u2019m a Minister; I listen to advocacy groups. I spend a lot of time with advocacy groups. I don\u2019t always agree with them. Sometimes I disagree with them quite vehemently, but the interests of advocacy groups should not get in the way of an objective and sensible analysis of what the challenges are now and the reasonable steps that need to be taken to address those challenges. This bill does that and gives the impetus to the health administration to enable us to lift health services and health outcomes for all New Zealanders.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022 data-id=\u0022d2dd77d87f58404c98b2ec513b059ef3\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000258\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022d2dd77d87f58404c98b2ec513b059ef3\u0022\u003ENICOLA GRIGG (National\u2014Selwyn):\u003C/span\u003E Thank you, Madam Chair. I want to start my contribution this afternoon with reference to the Hippocratic oath, and I would like to acknowledge Dr Shane Reti, Dr Liz Craig, and Dr Gaurav Sharma for the work that you\u2019ve all done in the health sector.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000259\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003EThe Hippocratic oath is recognised universally: first, do no harm. It is an oath of ethics historically taken by physicians. It is a seminal articulation of principles that continue to guide and inform medical practice. I submit to the committee this afternoon that without the inclusion of a rural health strategy, harm would be done.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000260\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003EWe have seen for a number of years now a real decline in the health network around rural New Zealand, a network that is there to serve and service about 750,000 New Zealanders who, as Matt Doocey pointed out, contribute 50 percent of the GDP of this country. When we look to the inclusion of a rural health strategy in this pae ora legislation, the Minister has referenced the fact that he negotiates and meets regularly with industry groups and stakeholder groups. So I wonder if it was the Rural Health Alliance that may have swayed his opinion when they said that they were \u201Cvery concerned with the lack of focus on rural communities\u201D, that \u201Cit is well-documented that rural communities have poorer health outcomes than urban communities\u201D, and that inequity needs to be addressed in these reforms. Or, in his multitude of meetings, was it the Rural General Practice Network that persuaded him when it said, \u201CRural New Zealanders need to be added to the list of priority populations.\u201D, \u201CHealth inequities will remain and might well worsen as focus shifts elsewhere.\u201D, and, finally\u2014to quote\u2014\u201CChange can only occur if this group is identified,\u201D.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000261\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003ESo when I refer to the Minister\u2019s own Supplementary Order Paper (SOP) No. 169 and the inclusion of the \u201CRural Health Strategy\u201D, I can\u2019t help but notice the similarities with Dr Shane Reti\u2019s SOP 160 and I find it quite intriguing that this nine-page document landed on that very Table there about 60 minutes ago. I\u2019m quite sure that I\u2019d be casting aspersions if I was to suppose that this was pulled together at the last minute.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000262\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003EBut I was very interested in the Minister\u2019s previous comment that Dr Shane Reti\u2019s SOP 160 would not achieve equitable health outcomes. Well, Minister, my question to you is if you are as derisive of outcomes as you appear to be, how about targets? How about targets for introducing rural maternity carers into the network? \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000263\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003EHow about targets to introduce rural GPs into the network, or professional mental health service providers, maternity beds, or aged-care beds, because, Minister, in my own electorate in Selwyn, as a result of the pandemic, we\u2019ve had two rural hospitals closed. That has taken about 10 beds for aged-care residents out of Darfield and another 10 beds out of, in a little town called Leeston, the Ellesmere Hospital. These\u2014what would we call them\u2014clients, or patients, have been transferred to other hospitals because these too-small hospitals have not been able to staff them. In that period of time, I know that the residents or the patients in Ellesmere Hospital\u2014out of about 10 of them, four have actually passed away. They weren\u2019t able to die surrounded by their friends and their family in their own community, and I think that\u2019s a travesty.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000264\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003ESo, Minister, I am very interested in how, when incorporating a rural health strategy, that will be well-serviced by personnel in rural health.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00225357215a7aa84ae38b1864c37a3bd521\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000265\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00225357215a7aa84ae38b1864c37a3bd521\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: I call Dr Michael Woodhouse.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022 data-id=\u00221f231c67ecba46bcba63b0cd0450d058\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000266\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221f231c67ecba46bcba63b0cd0450d058\u0022\u003EHon MICHAEL WOODHOUSE (National):\u003C/span\u003E Oh, I\u2019ve got a promotion. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000267\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022b8ad5d57cdda427c8350cc3d34c0a21f\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Sorry\u2014the Hon Michael Woodhouse.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000268\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00228fdb08124989478ba45a7ac17e8fee64\u0022\u003EHon MICHAEL WOODHOUSE\u003C/span\u003E: That\u2019s quite all right, Madam Chair. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000269\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EThey say that imitation is the most sincere form of flattery, and that being the case, Dr Reti should be extremely flattered, because, as Nicola Grigg said, a Supplementary Order Paper (SOP) fell on the Table a considerable period after Dr Reti\u2019s which does essentially the same thing. I was fascinated by the Minister\u2019s explanation in answer to Mr Doocey\u2019s question of how on earth this came about, and, apparently, it was obvious. It was an obvious inconsistency, and it was the rural backbench Labour MPs that implored him to make the change, only I\u2019m reliably informed that that was anything but the case at select committee, where Labour backbench MPs did their level best to block important, meaningful changes that would improve the health of rural New Zealand. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000270\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003ESo I\u2019m really pleased that it\u2019s here, but let\u2019s not gild the lily, Minister. The people who, I think, as Mr Doocey said, really should take the credit for this amendment are Messrs Kantar and Morgan and Ipsos and Reid, because they\u2019ve had more influence on this Government than the Labour backbench MPs. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000271\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003ENow, I want to go back, as Nicola Grigg did, to SOP 160 in Dr Reti\u2019s name. The response from the Minister was extraordinary\u2014the fact that he could only fixate on the term \u201Coutcomes\u201D and took it as a disparaging thing. He said to Dr Reti, \u201CYou can\u2019t write a law for outcomes.\u201D, but you can write a law for the expectation of equity. The key word in this amendment to clause 7 is \u201Cequitable\u201D, and it is about equity, where the good people of Lumsden don\u2019t have a maternity centre any more and the people in any aged-care facility are having their nurses pinched away by the DHBs because they\u2019re not being funded to compete on salary. That\u2019s a question of equity, Minister. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000272\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EWe know from a plethora of research that coronary care, diabetes management, and renal management are all much poorer in regional and rural communities, because they don\u2019t have as close an access geographically to secondary and tertiary care. That\u2019s equity, Minister, and if the Minister believes his own rhetoric that this is about avoiding and eliminating the postcode lottery, this SOP must be supported. He talks a good game, but when it comes to black-letter law, which sets an expectation for outputs and outcomes, he isn\u2019t\u2014nor was his predecessor, Dr David Clark\u2014prepared to say that \u201CWe will set an expectation, yes, for output, but yes for equity.\u201D, and if they believe that, they must support Dr Reti\u2019s SOP.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000273\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003ENow, I\u2019ll conclude this call with a point I want to make in relation to Schedule 1, an amendment to Schedule 1 as set out in the Minister\u2019s SOP 169 about visas. It\u2019s in new clause 11A in Schedule 1, which is a transitional\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000274\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002261725fea-7d5e-4d1f-8fd3-e5779bb7a14d\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022593415b0dc794671a2bd65d1ec056e22\u0022\u003EBarbara Edmonds\u003C/span\u003E: Point of order, Madam Chairperson. Thank you, Madam Chair. We sought leave at the beginning of the debate to be able to debate all the provisions as one. The reference that the member has just made is to Schedule 1. Yes, it\u2019s in SOP 169, but it\u2019s not part of the debate on Part 1.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000275\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022bd5f02cf77d64f4ba7e2827ab74507a2\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Unfortunately, it is actually part of Part 1. So in Part 1, we have clause 3, clause 6, clause 7 and Schedule 1.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000276\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00224d2803fca5484e0ead69d70ef85aa2c7\u0022\u003EHon MICHAEL WOODHOUSE\u003C/span\u003E: Thank you, Madam Chair. The issue I have with this amendment\u2014I understand what the Government is trying to do. For the sake of those listening, what this amendment will do is if a visa is granted under the Immigration Act 2009 for what would be an employer-assisted work visa, a temporary work visa, and if it has a reference to a DHB as a condition imposed on it\u2014as most essential skills work visas do. Often it\u2019s the employer or the geographic area in which the individual is able to work. Now, there are 20 district health boards and they\u2019ll be gone in about six weeks, so what this will do is say that if it says \u201Ca DHB\u201D, it should refer then, instead, as a reference to Health New Zealand. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000277\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003ENow, the problem with that is that that potentially gives carte blanche to individuals who were recruited under a visa that said that you need to work\u2014[Time expired]\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022 data-id=\u0022e4874492e4e9486abf88651260a6b6ba\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000278\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e4874492e4e9486abf88651260a6b6ba\u0022\u003EDr ELIZABETH KEREKERE (Green):\u003C/span\u003E Kia ora. T\u0113n\u0101 koe e te M\u0101ngai\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000279\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022aa0863b2262b41a2b5dcbeb5488145ea\u0022\u003EHon Michael Woodhouse\u003C/span\u003E: Point of order. I will be seeking another call, but I would note that, during the point of order that took place, the clock did not stop and continued to count down.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000280\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022effa145d534f400b94766a7c7d0a9faa\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: I will come back to you right after this call, the Hon Michael Woodhouse.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000281\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002207ff874cbdfa466db76268abedca69ea\u0022\u003EDr ELIZABETH KEREKERE\u003C/span\u003E: T\u0113n\u0101 koe. Many thanks to the Minister, to the officials who are here. I was a member of the Pae Ora Legislation Committee, and I know how much work that you all did on this. It\u2019s a huge, massive piece of work, with massive implications for all of us. Firstly, I wanted to speak to a rainbow strategy. Now, I have recommended this, I have advocated for this\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000282\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00222a1f696bf7f94070bf58b4cc649508bc\u0022\u003ENicola Grigg\u003C/span\u003E: Nothing if not consistent.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000283\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022baa703a6b34648e1981769eb11f44425\u0022\u003EDr ELIZABETH KEREKERE\u003C/span\u003E: \u2014in many parts of our community. This will be a surprise to people! Many parts of our community advocated through this submission process, and have been lobbying me ever since. When I first put up, some time ago, the Supplementary Order Paper 154 for this, I got a lovely letter back from the Minister and I was going to speak to this anyway, but I accepted the fact that it wasn\u2019t going to be part of this bill. However, I come here today and suddenly there\u2019s a rural strategy, and so I am emboldened to start again. And I just want to acknowledge, too, about the rural strategy, how much we support that, and that when our colleagues have raised this in the select committee and through this process\u2014because so many of our people who are M\u0101ori, Pasifika, a range of all of our people who live in rural areas who are most affected by the postcode lottery, and who will have the most difficult time in making this new system work, without a clear strategy, so I\u2019m very thankful. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000284\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003EI note that, and I want to mihi, then, to the Labour members that the Minister referred to who advocated for that. But I want to acknowledge my colleagues cross the House. I want to acknowledge the people in the community who actually have incredible expertise, incredible knowledge\u2014they\u2019re the ones out there doing the work, so their advice is something we take very, very seriously.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000285\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003ESo a rainbow strategy. I figure I\u2019ve got a couple more hours for this to maybe come to being. I\u2019ve just come out of a webinar, \u201CTe \u0101niwaniwa takat\u0101pui wh\u0101nui: Te aronga taera m\u014D ng\u0101 rangatahi - Sexual attraction and young people\u2019s wellbeing in Youth19\u201D. Some of you will be familiar with the Youth2000 series which, every few years, interviews thousands and thousands of young people\u2014mainly students. Most things we know about young people in this country have come out of that body of work, and so the most recent one was in 2019. So this part is one half\u2014kind of the \u201Crainbow report\u201D\u2014of that data, and so this is particularly for people who are same-sex, multiple-sex attracted, or not sure either way. What we saw in that just reiterates every piece of research we have; everything we know about the impacts of discrimination for people with diverse genders, sexualities, and sex characteristics. But there was an entire section on health, and so it\u2019s very fresh in my mind: statistics that show\u2014especially for young people, but we know that it flows on through other ages; for those who don\u2019t feel safe going into a health setting\u2014their identities are not recognised, they\u2019re not valued, and the health conditions that they\u2019re presenting with, the people don\u2019t have the expertise to deal with them. There are, in most parts of this country, no solid guidelines, no strategy for people to work towards. So we have advocated a strategy as, in this piece of legislation, the main mechanism by which such a thing could be created.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000286\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003EI\u2019d like to ask the Minister, then, if not a strategy, and if we take a step down from that, what is the solution, so that people in Invercargill, people in Gisborne, people in Wellington Central\u2014when they present into our health services\u2014those GPs, those doctors, those nurses, those counsellors, and those allied care health workers know what to do? They know who to call. They know the community leadership that they can tap into. That\u2019s what I\u2019d like to ask you to respond to. Kia ora.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022 data-id=\u002246328705eb4a47f2a944b90ad56f49ec\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000287\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002246328705eb4a47f2a944b90ad56f49ec\u0022\u003EHon MICHAEL WOODHOUSE (National):\u003C/span\u003E Thank you, Madam Chair. I\u2019ll just conclude my question about Schedule 1, the amendment to clause 11. If an essential skills work visa has been granted conditional upon a person working in a particular DHB, and then we superimpose that and we make reference now to Health New Zealand, there is a risk, I think, that the geographic requirement disappears, and, therefore, while it\u2019s a problem right across the country now\u2014we\u2019ve got a shortage of doctors and nurses and allied health professionals everywhere\u2014there is still a risk that in smaller and more remote DHBs, like Southern, West Coast, Tair\u0101whiti, and so on, that those temporary visa holders could be attracted to main centres. I wonder if thought has been given to either a tabled amendment or some kind of reassurance that the committee can get that, even though it\u2019s a reference to Health New Zealand, the locality requirement remains the same\u2014if one was recruited on a visa that said Tair\u0101whiti DHB, they still need to stay in the Poverty Bay area\u2014because I do think this could be an added problem for those DHBs that are heavily reliant on temporary work visas.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022f8bce13e917943d19d51864960675178\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000288\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f8bce13e917943d19d51864960675178\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair. I\u2019ll respond to the more recent contributions, but I particularly want to respond to the Hon Michael Woodhouse\u2019s point, because I think it\u2019s an important point and he raises a very good point, and I thought very carefully about this. It kind of cuts two ways. Obviously, with the removal of the DHBs we need to make a change so that those with working visas who have a specific DHB mentioned as a condition of their visa, we\u2019ve got to have that changed to Health NZ. I thought very carefully, do we provide for a further condition that they\u2019re still tied to their locality. I\u2019m satisfied that just through normal human resource management that that issue can be managed and those on those visas will stick with the particular hospital that they\u2019re working at. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000289\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThat said, there is a further proviso that I think is actually potentially helpful. One of the benefits of the whole of the public health workforce, or at least the hospital workforce working for a single employer nationwide, means that there is the potential for greater flexibility to deploy staff when needed, whether on a temporary basis or even on a permanent basis to allow career progression. We saw this during the COVID pandemic, and when the Auckland hospitals were at the peak of the pandemic, particularly last year, reached out to other DHBs to say, \u201CLook, we need some more nurses or we need some more SMOs. What can you do to help?\u201D, there was a real spirit of collaboration. Other DHBs did provide the opportunity for staff to go and there were obviously some negotiations about how that would happen. But they were able to draw staff from other parts of the country. It was all done; there were no secondments or anything. So they didn\u2019t make it technically difficult on that occasion, because of the nature of the need. But it did illustrate, actually, with a single employer across the country, how it would be easier to arrange those deployments, including with people on a work visa. I\u2019m confident that Health NZ will manage that very carefully. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000290\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI think this is the issue that we were grappling with\u2014if I could just diverge for a moment\u2014with those, particularly nurses, employed in the private sector under a working visa, and the immigration changes we\u2019ve made that allows some categories of work, including health work, to immediately apply for residency, we still stuck, at least with nurses, many categories of nurses, to have a two-year working requirement before they get their residency for that very reason\u2014that we didn\u2019t want a private employer who employs a nurse from overseas to then suddenly lose that person within the two-year period probably to a DHB or to somewhere else. But I think the member raises a good point, and I assure the member that it has been carefully thought of, and I also assure the member of my confidence in Health NZ to manage that particular issue appropriately.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000291\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ECan I go back to Nicola Griggs\u2019 point. I know she asked about targets. That tends to be a management issue, as opposed to something you would legislate for, and she went on to refer to particular facilities, particularly maternal facilities. She will be aware, of course, that the bill now has provision for a women\u2019s health strategy. So that\u2019ll be an opportunity to deal with making sure that, along with the maternity action plan that my colleague Dr Ayesha Verrall is responsible for, we can work with communities where there is a gap to better provide for those sorts of services. In the end, that\u2019ll be for the strategy to work out, and it\u2019s not a matter that we would want to try to develop here in the committee stage of the whole House. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000292\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe Hon Michael Woodhouse, in addition to his immigration issue, raised the issue of equity. Just for the benefit of all members of the committee, I just point out that in clause 3, the purpose of the Act, the opening lines of that clause states: \u201CThe purpose of this Act is to provide for the public funding and provision of services in order to\u2014(a) protect, promote, and improve the health of all New Zealanders; and (b) achieve equity in health outcomes among New Zealand\u2019s population groups,\u201D. That\u2019s the purpose. That is already there. So members who are concerned about whether we\u2019re taking equity seriously or whether we\u2019re providing for it, whether it is about health need, those are the opening words of the legislation.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000293\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EFinally, to Dr Elizabeth Kerekere, I know this is not strictly part of Part 1, but the rainbow strategy, we\u2019ll come to that when we deal with the list of strategies, I\u2019m sure. But in terms of what else can be done, I think there is great scope, including in the locality planning processes, which is very much community driven. The locality planning process is very much drawing on health provider input from health providers in the community and community input to see what can be done, particularly on issues like that.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022 data-id=\u002256abfc0053b849c99436b2c7cdf9d7b0\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000294\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002256abfc0053b849c99436b2c7cdf9d7b0\u0022\u003EMATT DOOCEY (National\u2014Waimakariri):\u003C/span\u003E Thank you very much, Madam Chair. Well, it\u2019s impressive, isn\u2019t it? The Opposition on a bit of a roll. If it wasn\u2019t for the Opposition, we wouldn\u2019t have got the $350 payment in the last Budget, and now, thanks to the Opposition, we\u2019ll get a rural strategy. And I want to drill down on the Minister\u2019s comments because I think he gave a fascinating process into the internal working of the Labour Party caucus. Because what he told the House today, was\u2014well, the bill just ended up in some sort of shape during the select committee. People weren\u2019t too worried about it. All of a sudden it popped out the end, and the rural Labour members\u2014first time they\u2019ve seen it apparently: shock, horror, \u201CNo rural-health strategy?\u201D So they rushed up to the Minister and said, \u201CSir, we\u2019d like one.\u201D And he said, \u201CNo problem. I\u2019m here to help.\u201D\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000295\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EBut when you wind that back a bit, obviously, every party takes the proposed bill back to their caucus for deliberations. What happened at the deliberation stage? Why didn\u2019t the rural Labour members stand up for Labour in their caucus? Well, whether they do or not\u2014maybe they don\u2019t. So it didn\u2019t come back through there. So then you start to say, \u201CWell, even before that deliberation stage, why didn\u2019t the Labour MPs stand up for a rural health strategy during the select committee stage?\u201D So I think it would be interesting to hear a bit more from the Minister, especially when we go back to the departmental report, Subpart 5. It talks about how many submissions sought the requirement of additional strategies on specific issues, such as women\u2019s, rural, mental health and addiction, the rainbow community, rare disorders.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000296\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EAnd it makes a very clear statement in the departmental report: \u201CMinisters have instructed us to put forward an amendment creating a women\u2019s health strategy.\u201D So in that stage in the select committee, the departmental report clearly states the Ministers instructed us to put forward an amendment creating a women\u2019s health strategy. So that poses the question: why did the Minister not instruct a rural health strategy at that stage, and why did the Labour rural MPs or why did any Labour MP\u2014and I mean this is very interesting because they\u2019re sitting there very quietly, but when you work through what the Minister said, he basically threw every Labour MP who was on the Pae Ora Legislation Committee under the bus, because he basically said it took a group of Labour MPs who weren\u2019t even on the select committee to raise this glaring issue that, for some reason, had been missed out.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000297\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003ESo what were the Labour MPs doing on the select committee? We sat for hours. I can tell you what: probably, what happened is they did raise it\u2014they did raise it\u2014and they got told to sit back down. And in fact, that\u2019s why, in the departmental report, the Minister only instructed a women\u2019s health strategy. And, of course, what we know is when the bill came out of select committee, there was a lot of ruckus by rural health providers, but the Minister will go and have a look. He was in the media, and he was very clear this wasn\u2019t a priority group that was going to end up in a strategy. But all of a sudden, the Minister decides he\u2019s going to listen to his backbenchers. Finally, the backbenchers are speaking, but I\u2019ll let you into something: you should have done that in the select committee stage; it would have saved a lot of heartache of rural people who had to get out, because\u2014I\u2019ll tell you what\u2014rural people don\u2019t often speak up, and that\u2019s probably their own worst enemy because they don\u2019t. They have to watch environmental groups and every other group smash them, and here they thought, \u201COh, the Minister wants to stand up and say, \u2018Well, we\u2019ve got a lot of rural MPs.\u2019 \u201D Well, why didn\u2019t they stick up for rural people during the select committee stage? Because we know, and we want to hear from the Minister what happened and why the rural strategy was not put in. What changed after the select committee stage?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u0022cc728df0dfe843dcaabc659b274e22bf\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000298\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022cc728df0dfe843dcaabc659b274e22bf\u0022\u003EDr SHANE RETI (National):\u003C/span\u003E Thank you, Madam Chair. I\u2019d like to first address the comments that the Minister of Health has made that the Supplementary Order Paper (SOP) in my name can\u2019t legislate health outcomes\u2014that can\u2019t be correct. We\u2019re looking to insert into clause 7\u2014in that very same clause, clause 7(d)(3)\u2014\u201Cthe health sector should provide choice of quality services to M\u0101ori and other population[s] ... including by\u2014harnessing clinical leadership, innovation, technology, and lived experience to continuously improve services, access to services, and health outcomes;\u201D. That\u2019s almost verbatim what my SOP says, so I\u2019m afraid his commentary that you can\u2019t legislate for health outcomes is neither persuasive nor interesting. I think the second part where he talks about listening to key stakeholders\u2014that\u2019s also tenuous. I\u2019ve just texted the royal GP network, who are astounded\u2014pleased but astounded\u2014that this is now an SOP flip-flop from the Government. So I would suggest that key stakeholders haven\u2019t actually been involved.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000299\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EI want to talk to SOP 159\u2014an SOP on behalf of the National Party\u2014an insertion into clause 7, Part 1, which seeks to recognise that the only democratic utility in health is health need. It can only ever be health need. To choose anything else, including a Treaty response, as the foundational principle to our health system is to actually invite inequities and unfairness that daren\u2019t be imagined. If M\u0101ori allow anything other than health need to be at the core of our health system, then they\u2019ll be doomed to a fate that chooses a Treaty response today but the depths of one\u2019s pockets tomorrow, and one\u2019s value to society the next day. Do not be swayed by strangers bearing gifts. Meningitis doesn\u2019t care about a Treaty response. Meningitis is agnostic to party colours, age, colour, gender, or race. It is simply an urgent health need that trumps all else.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000300\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThis SOP 159 acknowledges the other principles set out in paragraphs (a) to (e), but affirms the primacy of health need above all other principles. I absolutely acknowledge\u2014and myself and my team will bring every skill we\u2019ve ever learnt to address\u2014the inequities that M\u0101ori have in the health domain. They are true; they are real. But they best sit under the principle of health need, under which, it turns out, M\u0101ori have the highest health need for nearly every single metric you want to choose. Ethical issues of distributive justice talk about how scarce resources should be ethically distributed. In this context, all paths lead to health need. I encourage the Labour Party to support this SOP 159, and I challenge the Labour Party to vote down a health system that is not funded on health need. Thank you, Madam Chair.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022 data-id=\u0022b82361cd8d6f445f9bc22ff7617ddae0\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000301\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022b82361cd8d6f445f9bc22ff7617ddae0\u0022\u003ERAWIRI WAITITI (Co-Leader\u2014Te Paati M\u0101ori) (remote):\u003C/span\u003E Thank you, Madam Chair. I too found it difficult to hear the answer of the Minister around our Supplementary Order Paper (SOP) 168 to recognise our people\u2019s tino rangatiratanga in this particular bill, after saying that Te Tiriti o Waitangi plays one of the most crucial parts of making up this particular bill. In that particular area, I thought it was\u2014the only word I can find is\u2014\u201Ccaucacity\u201D that my indigenous language is being determined by non-indigenous speakers, in terms of rangatiratanga being incorporated into this particular bill. I also find it very difficult that \u201Crangatiratanga\u201D is a key word in Te Tiriti o Waitangi, and this Government and the Minister have said how important Te Tiriti o Waitangi is in terms of the articles in the make-up of this bill\u2014being ignored. So I just don\u2019t get\u2014this should be a straightforward SOP supported by this Government.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000302\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EI just want to bring to light that, in 2017, the Court of Appeal confirmed that it can be stated with confidence that even where the Treaty is not specifically mentioned in the text of particular legislation, it may, subject to the terms of the legislation, be permissible intrinsic aid to statutory interpretation. Further, in 2021, the Supreme Court put emphasis on the need for Parliament to be clear if it intends to constrain Te Tiriti. So if the Minister is here to constrain Te Tiriti and not allow it to be the guiding light to the way a M\u0101ori health authority is established\u2014the biggest health reforms in a century, for M\u0101ori\u2014this is going to be an issue.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000303\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003ESo the biggest issue is we\u2019ve got P\u0101keh\u0101 telling M\u0101ori how we see the health inequities and the M\u0101ori health index improve because we have not been given the chance. So we just find that Te Tiriti o Waitangi has just been thrown out there. This confirms the M\u0101ori Party\u2019s perspective on the Budget, which was a vanilla cake with chocolate sprinkles\u2014at the moment, we\u2019re not seeing any chocolate sprinkle on it at all! So we\u2019re getting an under-investment and we\u2019re getting a watered-down version of what Te Tiriti o Waitangi means in terms of developing the greatest, and probably an opportunity for the biggest health reforms for M\u0101ori in this country.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000304\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EThe courts will not easily read statutory language as excluding consideration of Te Tiriti o Waitangi principles. It is a statute. It is silent on the question. It ought to follow, therefore, that Treaty clauses should not be narrowly construed; rather they must be given a broad and generous construction in intention to constrain the ability of statutory decision-makers. To respect Treaty principles should not be ascribed to Parliament unless that intention is made quite clear. So we are not clear. We\u2019re, on one hand, saying it is playing an important part of the establishment of the Pae Ora bill and the M\u0101ori Health Authority but we cannot include the words in it like \u201Crangatiratanga\u201D and \u201Ctino rangatiratanga\u201D. It doesn\u2019t make sense. It\u2019s absolutely glaringly obvious that this bill will continue, like many other bills and legislation in this House, to neglect Te Tiriti o Waitangi.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000305\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003ESo, Minister, I want you to clarify that for me and for Te Paati M\u0101ori, and the reasons behind our SOP 168, which amends Part 1 to recognise our people\u2019s tino rangatiratanga, which is a word that is used in Te Tiriti o Waitangi, the very Te Tiriti o Waitangi that you said was going to play a big part in forming this M\u0101ori Health Authority, and, in actual fact, should not be ignored or neglected any more by this House. So I look forward to your commentary in this particular space. Thank you, Madam Chair.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022e33ba70214c74c2e82f49e5fe369014a\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000306\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e33ba70214c74c2e82f49e5fe369014a\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair. Just to deal with the last three contributions; Mr Doocey\u2019s repeated himself and there\u2019s nothing much really to add apart from what I\u2019ve said earlier, that in order to make the bill in its totality consistent, and referring to the provision providing for the Government policy statement that makes the commitment to rural communities, amongst others, it made sense\u2014given that all of the other population groups referred to would have their own strategy\u2014for there to be a discrete strategy for rural communities. It\u2019s no greater than that, and I don\u2019t really intend to repeat that argument again, even if members opposite wish to keep pressing that point. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000307\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Dr Reti; effectively, he argued that because his Supplementary Order Paper (SOP) is provided for, therefore, you know, his SOP should also stand. So it\u2019s actually not correct. Clause 3 of the legislation is very clear. It provides for the provision and promotion\u2014if you like\u2014of health services, with a view to achieving outcomes. His SOP requires that the health sector should ensure that the rural communities achieve equitable health outcomes. My earlier argument stands, and, again, I won\u2019t come back to this argument, for the sake of avoiding repetition. In his Supplementary Order Paper 159, Dr Reti refers to \u201Chealth need\u201D. I\u2019ll just point out that right throughout the Pae Ora (Healthy Futures) Bill there is reference to what that bill is about, which is ensuring that health services are provided, and there are mechanisms for providing health services that are relevant to communities and relevant to the country as a whole. That is a theme right throughout the legislation. So I reject Dr Reti\u2019s claim that the bill isn\u2019t predicated on meeting health need; it absolutely and utterly is. That\u2019s why we have it.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000308\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Rawiri Waititi, and his argument about needing to fulfil the Crown\u2019s obligations under the Treaty. I refer the member to clause 6 of the bill. It makes it very clear in the opening lines: \u201CIn order to provide for the Crown\u2019s intention to give effect to the principles of te Tiriti o Waitangi \u2026, this Act\u201D\u2014and it spells out what the Act does, and critical amongst those is adherence to the health sector principles. The health sector principles are provided for in clause 7. Those health sector principles are based on the principles adumbrated by the Waitangi Tribunal and the Wai 2575 claim. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000309\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI think there\u2019s always a difficulty with legislation adopting passages from the Treaty. I take the view the mana of the Treaty stands on its own, and the Crown is obliged to meet its obligations under the Treaty regardless of what appears in any legislation. Legislation should reflect\u2014to the best extent possible\u2014what the Crown practically needs to do to fulfil its obligations, and that\u2019s what this legislation does. But the Crown\u2019s obligation to fulfil the Treaty remains, regardless. And that is why we have Waitangi Tribunal inquiries and why there are claims made to the Waitangi Tribunal to make sure the Crown does that. It\u2019s why the courts recognise the Treaty of Waitangi and apply it in the way that they do. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000310\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EBut the courts have increasingly shown their reluctance to take te reo terms from the Treaty\u2014or te reo terms generally\u2014and apply an interpretation within the Crown\u2019s courts when the interpretation may not be easy to pin down, may be richer than te reo P\u0101keh\u0101 can allow for it, and ultimately seeking to avoid disrespect to M\u0101ori and to te reo M\u0101ori. So I think we are at a point in our history, at a point where we are making legislation where we proceed cautiously, knowing that the obligations of the Treaty stand now, knowing the status that the Treaty has in our jurisprudence. But we approach cautiously references in our legislation to it. This legislation is very explicit about the way we intend to uphold our obligations under the Treaty in relation to the provision of health services, and I hope that assists the member.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u0022b88ecc1cb6f24e41818dc233894f94fe\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000311\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022b88ecc1cb6f24e41818dc233894f94fe\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Madam Chair. I\u2019d like to now turn to Supplementary Order Paper 152, in my name. It calls for the Minister to amend the Pae Ora (Healthy Futures) Bill to include a \u201CMedicines Strategy\u201D. My hope is that, given ACT\u2019s success in our rural health strategy being amended, that the Government will now move to adopt our medicines strategy.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000312\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EI hope that the Minister would seriously consider this, because many people might not yet be aware, but the Minister of Health today released the Pharmac inquiry\u2019s final report. This was an issue that the ACT Party campaigned on. We put forward, saying that we needed to review Pharmac. It had been too long, and there was a lack of transparency coming from Pharmac and its decision making, and we really needed to look into whether Pharmac was still fit for purpose. Thankfully, the ACT Party was able to get the Minister to agree that we also needed a review into Pharmac.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000313\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EBut there is an element of this Pharmac review that I think needs to see the light of day, and in this report, it said that, \u201CThe Ministry of Health is responsible for developing health-related policy for the Government. In our view, the ministry needs to develop a replacement medicine strategy to guide the sector, including Pharmac, in its decision making.\u201D It goes on to say, \u201CWe consider the absence of an up-to-date principles-based medicines strategy to be a crucial omission and one that will disrupt Pharmac\u2019s integration into the new health system. With health sector reforms not far away, now is an ideal time to update the strategy to define medicines priorities. We consider the ministry should make updating the medicines strategy a priority.\u201D\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000314\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EWell, thankfully we have the ACT Party, because we may be debating these particular clauses in the health reform today, and the Minister may feel like it\u2019s too late to include a medicines strategy, given that the final report has only been released today, but I look right here at the ACT Party\u2014No. 152\u2014we\u2019ve got one ready to go. It wouldn\u2019t take much for the Minister to adopt the medicines strategy that the ACT Party has already put forward into the legislation\u2014just as the Pharmac inquiry believed we needed to have.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000315\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EBecause, I don\u2019t believe it is possible that we can reform the entire healthcare sector and not touch on medicines access at all. Hundreds of New Zealanders go without the medicines they need to live healthy, productive lives\u2014currently. We know that we need better access to new modern medicines and we need it faster. And throughout all of this talk about reforming the healthcare sector, we\u2019ve been talking a lot about administrative reform, and we haven\u2019t been focusing on the outcomes. We know that medicines are changing. They\u2019re changing all the time. New medicines are turning up. Over the last decade, we have invested the least into modern medicines in the OECD. We have fewer new modern medicines in the last decade than the rest of the OECD. I think we need to have a medicines strategy that actually plans out, for the next coming years, what we want New Zealanders access to modern medicines to look like.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000316\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EI think having a medicines strategy within the Ministry of Health that actually contains an assessment of the current state of medicines; the performance of the health sector to do with acquisition and provision of medicines; what the medium trends are, what the long-term trends are for medicines access and health sector performance; and setting out some priorities for improving access to medicines would go some way to making sure that New Zealanders can live healthier, more productive lives. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000317\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EI think it\u2019s a shame that it was missed out of this health reform in the first place. But it wouldn\u2019t take much for the Minister, in the same way that he\u2019s adopted our rural health strategy, to also adopt our medicines strategy, because I think that\u2019s the right thing to do for all New Zealanders and their healthcare.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00221fc8e765b4a84984b36441bcf4d0a9f8\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000318\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221fc8e765b4a84984b36441bcf4d0a9f8\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Before I take the next call, I would like to warn members that the debate on this part, Part 1 and Schedule 1, is getting repetitive.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022 data-id=\u0022c8a8b14e7de542a1bf6d8c610a606108\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000319\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c8a8b14e7de542a1bf6d8c610a606108\u0022\u003EMATT DOOCEY (National\u2014Waimakariri):\u003C/span\u003E Thank you very much, Madam Chair. I want to shift the debate, although it\u2019s been very interesting hearing about the machinations of the internal Labour caucus on how they decide things\u2014it\u2019s all a bit finger-to-the-wind, and I think the public is clicking on that a lot of this is policy on the hoof. I want to look at the Supplementary Order Papers in my name, of 170 and 171. This is about a mental health strategy. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000320\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EIf it\u2019s an issue that is emblematic of this Government talking out both sides of its mouth, it\u2019s a Government that promises to transform the mental health system, yet in its once-in-a-generation\u2014or so they tell us\u2014reform of the health system, what we find is exactly what submitters said in the select committee stage: that mental health was invisible. Who would\u2019ve believed it? A Government that claims to be transforming the mental health system, yet they\u2019re reforming New Zealand\u2019s health system and the peak bodies. I mean, this is the Mental Health Foundation, this is the Mental Health and Wellbeing Commission, the leading NGOs, and the common theme that came out of submitters is that they said mental health was invisible in this bill. How could we end up in a position where mental health is invisible? They also talked about how the Mental Health and Wellbeing Commission was not even an entity that the Minister needed to consult in developing not only the health strategy but, I would argue, the mental health strategy.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000321\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EThe Mental Health and Wellbeing Commission was a recommendation of Labour\u2019s own mental health inquiry, to establish the commission as a voice for mental health in New Zealand. Yet, in this bill, they don\u2019t even include it as an entity that the Minister needs to consult. Of course, we know the Mental Health and Wellbeing Commission put out its first report, which actually was very critical. It said that, despite the announcement of $1.9 billion for mental health, there was no material improvements. Yet, this Government wants to say \u201CTrust us with a billion-dollar reform.\u201D, and how is this going to improve health?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000322\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003ESo my question is: why is there not a mental health wellbeing and addiction strategy? Why is it not a requirement? Is it because the Mental Health Commission\u2019s actually been doing its job too well and it is critical of the Government\u2019s performance in delivering nothing for their $1.9 billion?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000323\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EBut listen to the comments from the Mental Health Foundation about mental health being invisible in this bill. It says, \u201CThis would appear to be symptomatic of the absence of any ownership and leadership built into the new health structure for the transformation process\u201D. Of course, one of the findings of the commission\u2019s report was saying that, in mental health, we need leadership, we need a well-managed, clear plan that would execute change, and here we have, again, no ownership, no leadership of mental health in the bill in front of the committee today. The Mental Health Commission and the Mental Health Foundation are saying in their submissions that it needs to be a requirement and they want it legislated for this strategy to give people with mental health issues equal legal standing with other strategies mentioned in this bill.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000324\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EWe know, it\u2019s been canvassed in the Chamber this afternoon, it is not too late to put a mental health and wellbeing strategy in; in fact, it is not only not too late, it\u2019s actually the right thing. I think, when you go out there and you ask thousands of vulnerable New Zealanders who pitch up to your own inquiry and they tell their personal and, often, traumatic stories about how they wanted mental health to change\u2014and there was a point here where this Government could have brought in a mental health and wellbeing strategy that would have driven transformation\u2014[Time expired]\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u002259723c993071403a8680131ba6cc4773\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000325\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002259723c993071403a8680131ba6cc4773\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair. Just the last couple of contributions, I think it\u2019s appropriate to respond to. To Brooke van Velden and her call for a medicine strategy\u2014indeed there are many Supplementary Order Papers calling for all sorts of strategies and, indeed, as I think Ms van Velden will know, at the select committee, there were many calls for different strategies. One of the reasons why we\u2019re trying to chunk down and limit the number of discrete strategies is that you could have the ministry or Health New Zealand or the M\u0101ori Health Authority spending all their time developing dozens and dozens of strategies, all cross-cutting, all needing their own attention, but it\u2019s not going to change things. Just having a statutory obligation for a strategy will take up a lot of time and resources. But actually what you want to do is get folks focused on the health services that are needed, getting resource devoted to that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000326\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe member referred to elements of the Pharmac review. What the Pharmac review actually said is that the Ministry of Health should take responsibility for some medicines strategies, particularly in relation to rare disorders, because what they were saying was that Pharmac, as a procurement agency, should not be the sole arbiter of what a medicines strategy should be. And that is the recommendation we\u2019ve accepted, as I\u2019ve announced today, and we will do that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000327\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI would refer the member to the definition part\u2014I think it\u2019s clause 4 of the bill, which refers to health entities. Pharmac is part of those health entities. Pharmac is required to observe the various requirements and obligations that would apply once this bill is enacted into law. What came out of the review and what I confirmed today is that Pharmac needs to be better integrated into the rest of the health administration. So I know the member wants a medicines strategy. The Labour Party will be voting against it, but I can assure the member that where we are going with the range of changes and the recommendations we\u2019ve accepted from the Pharmac review is that Pharmac will be better integrated into the policy work\u2014properly the responsibility of the Ministry of Health but contributed to as necessary by Pharmac\u2014and Pharmac will remain with its very strong capabilities in procurement as the procuring agency. And if the member is wondering why we have fewer modern medicines, she might want to talk to her colleagues in the National Party and ask why they froze funding for Pharmac for three years in a row.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000328\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Matt Doocey\u2019s contribution in relation to a mental health strategy, the same sort of principles apply. We could have a statutory obligation for strategies for all sorts of health conditions and diseases and infections, and they\u2019d run to a large number. That doesn\u2019t change the ability to deliver on the ground. What changes is when you have a Government that properly funds health and doesn\u2019t underfund it, that doesn\u2019t freeze capital spending, that doesn\u2019t underpay staff, and those sorts of things. So that just happens to be the difference between the two sides of the House at the moment.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000329\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe member, I think, misunderstands the status and role of the Mental Health and Wellbeing Commission. If he looked at the Mental Health and Wellbeing Commission Act 2020, he would see that the Mental Health and Wellbeing Commission is an independent statutory entity. It is independent because it provides a monitoring and oversight function, and it must stand apart in order to play its critique role and its advocacy role; so it advocates. In putting together any planning or strategy, naturally, I would expect Health New Zealand, the M\u0101ori Health Authority, where the ministry in its revamped form might take responsibility for development of plans and strategies\u2014they\u2019re going to engage with relevant communities, with those with lived experience. And to the extent that the Mental Health and Wellbeing Commission is an advocate, it has a statutory right to be that advocate and to be consulted, that is already provided for and isn\u2019t needed in the member\u2019s Supplementary Order Papers.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022 data-id=\u0022574c55513e8c4d87afab116350a2bdec\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000330\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022574c55513e8c4d87afab116350a2bdec\u0022\u003EKIERAN McANULTY (Chief Whip\u2014Labour):\u003C/span\u003E I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022783c0e00f7a64aa4a0c2d1d933a51b5d\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000331\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022783c0e00f7a64aa4a0c2d1d933a51b5d\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that the motion be agreed to. All those in favour will say Aye, to the contrary, No\u2014\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022 data-id=\u00224762fb73926a4f0fbcc1633061013829\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000332\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00224762fb73926a4f0fbcc1633061013829\u0022\u003EKIERAN McANULTY (Chief Whip\u2014Labour):\u003C/span\u003E Madam Chair, point of order. Can we just clarify? I\u2019m just putting that the question be now put, and I was just confused by\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000333\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e6b4dc55-3561-49a8-a871-ae005354ef90\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002260bedc3fe9854e38972bcae39d4f14b4\u0022\u003EHon Gerry Brownlee\u003C/span\u003E: We can\u2019t hear you. Take your mask off.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000334\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a1f7bbd1-b6ae-41c0-963b-dbe1251f5540\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022827c4ef0fc874113bfa87bb46528f94e\u0022\u003EKIERAN McANULTY\u003C/span\u003E: Apologies. I\u2019d moved that the question be now put, but what you said was that the motion be agreed to. So I just wanted to clarify, because there didn\u2019t seem to be any response. So\u2014\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022 data-id=\u00224a17e01e0bf4413ab67d3e9f58c83f73\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000335\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00224a17e01e0bf4413ab67d3e9f58c83f73\u0022\u003EHon MICHAEL WOODHOUSE (National):\u003C/span\u003E Speaking to that point of order. Two things, Madam Chair. Firstly, it\u2019s customary, when the Minister has addressed an issue, that the debate not end. I didn\u2019t take a point of order then, but I will just point that out. Secondly, your question was perfectly put. Nobody on the other side said yes to it, so, clearly, the Noes must have it.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022dba1ce2d7c0d4bef8463f770a7c024af\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000336\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022dba1ce2d7c0d4bef8463f770a7c024af\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: No one said yes and, actually, no one said no, so let me\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000337\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e6b4dc55-3561-49a8-a871-ae005354ef90\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022c271ec7851ba4874b84bf4a9b6f54c25\u0022\u003EHon Gerry Brownlee\u003C/span\u003E: I said no. I know when I say no.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000338\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002260e4f4d26396416c830b5a47dd7e1cfc\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: I\u2019m sorry, the Hon Gerry Brownlee?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000339\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022e6b4dc55-3561-49a8-a871-ae005354ef90\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022115b6094f61a4a218fab617d8bbadc7c\u0022\u003EHon Gerry Brownlee\u003C/span\u003E: I just said, \u201CI know when I say no.\u201D, Madam Chair. I\u2019m sure if you go back\u2014\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00225b6b1d74-9e5e-42ba-a922-85b0ea7f5ab6\u0022 data-id=\u002257325eaf7fad48118c97ac67cd9bc4d4\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000340\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00225b6b1d74-9e5e-42ba-a922-85b0ea7f5ab6\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002257325eaf7fad48118c97ac67cd9bc4d4\u0022\u003ESIMON O\u2019CONNOR (National\u2014T\u0101maki):\u003C/span\u003E Point of order. Thank you, Madam Chair. It is just to seek your ruling on the first part of the Hon Michael Woodhouse\u2019s notion that, after a Minister speaks, there has been a tradition or a convention in this House that further calls could be had. It would be useful, if you\u2019re going to continue to put the vote, to indicate to the committee if that convention is going to change.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u002248b9506e16684ce5a2b068dd6f87ebf7\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000341\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002248b9506e16684ce5a2b068dd6f87ebf7\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Well, actually, what had happened here is I had put the motion to the committee. You\u2019re right in pointing out that there were some Noes, but I actually didn\u2019t hear one Aye, so I will give another call if someone wants to take a call. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022 data-id=\u00228c7f948cabde45c9a37fe74578a84f23\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000342\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00228c7f948cabde45c9a37fe74578a84f23\u0022\u003EDr ELIZABETH KEREKERE (Green):\u003C/span\u003E Kia ora. I\u2019d like to point to two Supplementary Order Papers (SOPs) in my name, Supplementary Order Paper 164 and Supplementary Order Paper 166. We wanted to perhaps change some of the wording where we talk about engaging with M\u0101ori. If a core part of the health system is to eliminate the huge disparities for health for M\u0101ori, then we\u2019re suggesting that there should be more partnering with M\u0101ori and less engaging\u2014just being much more specific about M\u0101ori being part of the solutions. In the same way rural people must be part of the solutions for rural issues, so must M\u0101ori be part of this. Of course, I\u2019m not denying at all the establishment of a M\u0101ori Health Authority\u2014that is well under way.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000343\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003EI wanted to pick up on the point that the Minister had made about the law interpreting terms like tino rangatiratanga, because I think this is quite important. We suggest, in SOP 164, that the words \u201Cdecision-making authority\u201D be changed to \u201Ctino rangatiratanga\u201D. I just wanted to point out that that is a term that was in Te Tiriti o Waitangi. It was 50 years ago this year that a protest\u2014a peaceful protest\u2014was held, a petition was put to this House to make te reo M\u0101ori be taught in schools, because of decades and decades of M\u0101ori being beaten up, being hurt for speaking M\u0101ori\u2014so 50 years ago. The M\u0101ori Language Act came into place in 1987. That recognised te reo as an official language of Aotearoa, and it founded Te Taura Whiri i te Reo M\u0101ori, the M\u0101ori Language Commission.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000344\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003EIt seems to me long past time that core and common M\u0101ori words don\u2019t have proper interpretation in our law, aren\u2019t included in our legislation. Some words are and then some words are not. So because Te Taura Whiri i te Reo M\u0101ori is available, we have many M\u0101ori language experts that could support the Government, including inside this House\u2014incredible people with expertise in te reo that could help with that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000345\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00227ec53e32-05ab-4c6b-a080-4024e72a9099\u0022\u003EThe second thing I wanted to point out\u2014and I want to acknowledge the Human Rights Commission. In particular, this SOP 166 is to reflect something they had added in their submission, which we supported, which was the introduction of, and I quote, \u201Crespecting and upholding human rights, including the right to healthcare and health protection as set out in the International Covenant on Economic, Social and Cultural Rights.\u201D It just acknowledges that in this country, we acknowledge that we sign up to a number of United Nations instruments, and that when we are restructuring our entire health system, acknowledging the one that identifies a person\u2019s right to health. Kia ora.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00223c5917bd-9c2f-4bdf-af2f-b13cd1a2c8bb\u0022 data-id=\u0022b4e99ba0011c4f42908b22582f9ab135\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000346\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00223c5917bd-9c2f-4bdf-af2f-b13cd1a2c8bb\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022b4e99ba0011c4f42908b22582f9ab135\u0022\u003EDr LIZ CRAIG (Labour):\u003C/span\u003E Thank you, Madam Chair. I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022cf7ceda61cf847e8abeff70f4f7a3ebe\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the question be now put.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EMotion agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000347\u0022\u003EThe result corrected after originally being announced as Ayes 75, Noes 42.\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022 data-id=\u00226e46baed1dda428eaa5d6bf749cd5150\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000348\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00226e46baed1dda428eaa5d6bf749cd5150\u0022\u003EHon MICHAEL WOODHOUSE (National):\u003C/span\u003E Point of order. Madam Chair, there is a convention that when a motion is put there are no other speech words. That convention was breached. We didn\u2019t take a point of order at that time\u2014we were likely to have been defeated\u2014but we will be wanting the rules of the committee to be followed more closely in future motions.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022631f1832f24348e99497af66fa1a4504\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000349\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022631f1832f24348e99497af66fa1a4504\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: It is also up to the Chair to decide when to put the call, and I had actually put through the call and it was actually agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022 data-id=\u00226ffff1e6fd184b028fa759adac9df242\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000350\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00226ffff1e6fd184b028fa759adac9df242\u0022\u003EHon MICHAEL WOODHOUSE (National):\u003C/span\u003E Speaking to that, Madam Chair, that is absolutely true, but the House has Standing Orders and Speakers\u2019 rulings for a reason, and we would expect that on procedural matters relating to motions they are followed.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022c4a009ca1ea44c01903f3c7dffaf62ca\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000351\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c4a009ca1ea44c01903f3c7dffaf62ca\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: It is not always the case that when someone seeks the call that a question is put and then it\u2019s actually, you know, that we continue to debate. It is actually up to whoever the Chair is whether or not the question is put. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022 data-id=\u00225027df9909374179b5b6aede4c0a631e\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000352\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00225027df9909374179b5b6aede4c0a631e\u0022\u003ERAWIRI WAITITI (Co-Leader\u2014Te Paati M\u0101ori):\u003C/span\u003E Point of order, Madam Chair. I tried to vote but I couldn\u2019t unmute myself. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000353\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022afcd97a38575496fbc6379746d772bae\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Would you like to share your vote with us now, Rawiri Waititi?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000354\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00228d5f4bb975e14af1a12a314a1935f22f\u0022\u003ERAWIRI WAITITI\u003C/span\u003E: Yes, it\u2019s two votes in favour.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022e598bdef977d44e58ea18f0b7bdcc980\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000355\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e598bdef977d44e58ea18f0b7bdcc980\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Two votes in favour. Can I ask the Clerk to recount the votes, please? May I seek leave to correct that vote to add the M\u0101ori Party\u2019s two votes in favour? No objection. Can I ask the Clerk to please recount the vote and add two votes in favour. The Ayes are 77. The Noes are 42. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000356\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EMotion agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00226e49ae88f5f949b89f575c5d3b955bc7\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000357\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00226e49ae88f5f949b89f575c5d3b955bc7\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that the Minister\u2019s amendment to Part 1 set out on Supplementary Order Paper 169 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000358\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EAmendment agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00229f25c7e661dc46acba2f99af5c07767c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000359\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00229f25c7e661dc46acba2f99af5c07767c\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Debbie Ngarewa-Packer\u2019s amendments to include a commitment to uphold tino rangatiratanga and give effect to the articles of Te Tiriti o Waitangi as set out on Supplementary Order Paper 168 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00228ba4fd34480849e2bb5af820768946ca\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 22\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EACT New Zealand 10; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 97\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; New Zealand National 32.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00223aae13b35f8d438c981c0e6f789ea6e2\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000360\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00223aae13b35f8d438c981c0e6f789ea6e2\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Brooke van Velden\u2019s amendments to Part 1 deleting \u201Cthe M\u0101ori Health Authority\u201D as set out on Supplementary Order Paper 153 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022aa14c4f32d8a4036922b8f43af7739e4\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00226647faa8bd2143a89bbd025d7b0c542c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000361\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00226647faa8bd2143a89bbd025d7b0c542c\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Matt Doocey\u2019s amendment to clause 4 inserting \u201Cthe Mental Health and Wellbeing Commission,\u201D into the definition of \u201Chealth entity\u201D as set out on Supplementary Order Paper 171 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022ede8fc8d2cca45fd92a784915e665784\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 54\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; ACT New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 65\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00225b000fe1172a4e9282df5ad37a1b3405\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000362\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00225b000fe1172a4e9282df5ad37a1b3405\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The ruling is that Brooke van Velden\u2019s amendment to clause 4 relating to a rural health strategy as set out on Supplementary Order Paper 151 is ruled out of order as being the same in substance as a previous amendment.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000363\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EThe question is that Brooke van Velden\u2019s amendment to clause 4 relating to a medicines strategy set out on Supplementary Order Paper 152 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u002209b1c5819ebe42d39e53a3ff4d400203\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 52\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 67\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00228124d2ce29fe4e299147bcbef46a7300\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000364\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00228124d2ce29fe4e299147bcbef46a7300\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Dr Elizabeth Kerekere\u2019s amendment to clause 4 relating to a rainbow health strategy as set out on Supplementary Order Paper 154 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u002231e93b4f1e364dc586ce1e108b302dc0\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 44\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 75\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u002234c20d3397c14709b7b1fbfa02bbd93c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000365\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002234c20d3397c14709b7b1fbfa02bbd93c\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Dr Shane Reti\u2019s amendment to clause 4 relating to an older people\u2019s health strategy set out on Supplementary Order Paper 157 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u002214b0b49c457f458cbea6531a5dc37edc\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022423d038f8c8942e1a310ae8949fcd701\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000366\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022423d038f8c8942e1a310ae8949fcd701\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Dr Shane Reti\u2019s amendment to clause 4 relating to a health workforce development strategy set out on Supplementary Order Paper 158 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00220d5875caf4594bfb8d4d2bb1173a7cc1\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 54\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; ACT New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 65\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022fca2d231e0a042b789dbc9033223d27e\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000367\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022fca2d231e0a042b789dbc9033223d27e\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Matt Doocey\u2019s amendment to clause 4 relating to a mental health and wellbeing strategy set out on Supplementary Order Paper 170 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022122494564530453eb902d1bd6f2f65f9\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 54\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; ACT New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 65\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022ba638edda25e4ec0a11f3649273eb3aa\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000368\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022ba638edda25e4ec0a11f3649273eb3aa\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Debbie Ngarewa-Packer\u2019s amendment to clause 4 relating to a M\u0101ori director-general set out on Supplementary Order Paper 167 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u002263678f1aa67248529395ea1547d606f2\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 12\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EGreen Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 107\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; New Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u002233a9c6b42c8a4f37addf0f8ee0eb7bdf\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000369\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002233a9c6b42c8a4f37addf0f8ee0eb7bdf\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Dr Shane Reti\u2019s amendment to clause 7 to insert health need as to overriding health sector principles set out on Supplementary Order Paper 159 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00222452df216be141be8353f5c334723f51\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00228a19596c6c544bbf9cb26ef47b1c7e2a\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000370\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00228a19596c6c544bbf9cb26ef47b1c7e2a\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Dr Elizabeth Kerekere\u2019s amendments to Part 1 to require partnership with M\u0101ori and opportunities for M\u0101ori to exercise tino rangatiratanga set out on Supplementary Order Paper 164 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u002234d1a3e57e624823be9fd1747bdedf28\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 12\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EGreen Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 107\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; New Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00224cdebde685ad4549a07e65986d9c92c6\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000371\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00224cdebde685ad4549a07e65986d9c92c6\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Dr Elizabeth Kerekere\u2019s amendment to clause 7 to insert a reference to the International Covenant on Economic, Social, and Cultural Rights set out on Supplementary Order Paper 166 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00227e4d4a25f5584301b45f0b6472497add\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 12\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EGreen Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 107\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; New Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00223fa8a1cd79144830b04413c6c8d7075b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000372\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00223fa8a1cd79144830b04413c6c8d7075b\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that Dr Shane Reti\u2019s amendments to clause 7 to recognise rural communities in the health sector principles set out on Supplementary Order Paper 160 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022eb58145d410e4894a00e1c4486156fab\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 52\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 67\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022bce987ef2df24d2f9d24cf22fe5e6854\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Part 1 as amended be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EPart 1 as amended agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000373\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u00227705c4c154c2443da319bd1ab922ad54\u0022\u003EPart 2  Key roles and health documents \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022a61513a4fb0f4feca76667a02ca4a945\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000374\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022a61513a4fb0f4feca76667a02ca4a945\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Members, we come now to Part 2. This is the debate on clauses 10 to 59, \u201CKey roles and health documents\u201D, and Schedule 3, relating to iwi-M\u0101ori partnership boards. The question is that Part 2 stand part. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u002212c133ab1f154665abffd67582a9baa0\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000375\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002212c133ab1f154665abffd67582a9baa0\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair. I\u2019ll just make some sort of opening remarks, if you like. This really is the meat of this legislation, apart from the Hauora M\u0101ori Advisory Committee, which is the subject of a different part of this legislation. This sets up the new health entities, Health New Zealand and the M\u0101ori Health Authority. These will be the new beasts, if you like, that will be the engine room of our health system, not only providing greater coherence and better coordination across our public health system but also really driving a better equity performance than we\u2019ve seen in the system. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000376\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWe know that M\u0101ori have been under-served by our health system for decades and decades and decades, and we know the Crown has obligations under Te Tiriti that we owe better. We have an obligation to do better, but it\u2019s more than just doing better. It\u2019s also recognising and incorporating, as a partner, the voice of M\u0101ori into our health system. The M\u0101ori Health Authority does that. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000377\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe M\u0101ori Health Authority is not a Crown partner, but it is the vehicle through which the Crown\u2019s obligation to meet its obligations to M\u0101ori are met. The M\u0101ori Health Authority also draws on the input of the iwi-M\u0101ori partnership boards. The iwi-M\u0101ori partnership boards are a product of iwi. That is where the nexus between M\u0101ori and Te Ao M\u0101ori and the health system really sits, and they are involved in helping to establish, or at least to appoint, the board members of the M\u0101ori Health Authority. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000378\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe M\u0101ori Health Authority carries the mana of iwi M\u0101ori and urban M\u0101ori as it prosecutes its task of working with the rest of the health system to drive good performance for everybody and better equity for M\u0101ori. That\u2019s what that does, and these provisions, clauses 10 to 59, set out the obligations of each. It should be pointed out that the M\u0101ori Health Authority is not a Crown entity for the purpose of the Crown Entities Act, but, as a statutory entity, it will observe many of the obligations of the Crown Entities Act. But it is its own thing. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000379\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EIn addition to that, the M\u0101ori Health Authority and Health New Zealand have an obligation to put together a range of documents. They have to agree on those documents. If they cannot agree, there\u2019s then a process for dealing with any disagreements, largely by coming to myself as Minister of Health and for the Minister of Health referring to the Minister for M\u0101ori Development and the Minister for M\u0101ori Crown Relations: Te Arawhiti. So that M\u0101ori influence in the M\u0101ori decision-making\u2014the M\u0101ori voice\u2014is strengthened at every step of the way.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000380\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThis is the part of the legislation that incorporates a number of strategies and we\u2019ve now added, through my Supplementary Order Paper (SOP) 169, a rural communities strategy. I should add, my SOP reverses a piece of work that the Pae Ora Legislation Committee put in place, which was to change the order on the document of the Government Policy Statement (GPS) and sort of everything else. The GPS is the principal document that the Government produces to set direction for the health system, so we\u2019ve put that back into its rightful place through my SOP. But otherwise, it is all there.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000381\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe other thing this part of the legislation does is to establish the requirement for localities and for the development of locality plans, and although there\u2019s only a small number of provisions in the bill for this, this is an absolutely crucial part of the machinery of the health system of establishing health need and engaging with both health providers and communities about how health need can be met and what health services should be put in place. So these are significant changes that will make a significant difference over time when it comes to health provision across Aotearoa New Zealand.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u00221b6f96fc0273418f8a8d820bf76b1ea3\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000382\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221b6f96fc0273418f8a8d820bf76b1ea3\u0022\u003EDr SHANE RETI (National):\u003C/span\u003E Thank you, Mr Chair. The National Party desires to recognise the importance of the health workforce across the health sector by requiring the formation of a health workforce strategy. One of the key rate-limiting factors for today\u2019s health system\u2014which, as we speak, has cancelled surgery at Auckland and Christchurch hospitals\u2014is a lack of health workforce. During the peak of Alpha, Delta, and early Omicron, it was a lack of ICU nurses that became a key rate-limiting step. Protecting the health system was code for protecting ICU beds and the 5.2 ICU nurses required for each ICU bed. New Zealanders paid a high price for a shortage of ICU nurses. Surgeries were cancelled so that unexpected delivery to ICU didn\u2019t happen. Travel restrictions occurred, firstly, to assist infection control and, secondly, to reduce road accidents ending up in ICU as well.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000383\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EToday, we have a health workforce crisis in nearly every part of health. In terms of GPs, we\u2019re 500 short and there\u2019s a tsunami of soon to be retiring general practitioners. Senior medical officers, 1,500 short; registered nurses, thousands short; and aged residential care nurses, a thousand short. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000384\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EWe sought to change in our Supplementary Order Paper the part of this bill that looks specifically at six parts of the health workforce that we think need to be attended to. We were keen to do this very quickly in the first 100 days, which is almost as long the Minister let the Pharmac report sit. In the first 100 days we would be looking to bring in information and actually enact a policy that would be implemented within the first year.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000385\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThe first point we\u2019re looking at doing is an assessment of the current state of the health workforce. The second point is to provide pathways in collaboration with relevant agencies such as Immigration New Zealand to improve our immigration settings. It is still unclear to me whether someone who comes in on the recently announced immigration pathway to residency\u2014like a nurse on a two-year pathway\u2014is committed to staying with the one employer or not. We would appreciate some clarification of that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000386\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EWe would be providing pathways for international medical graduates who are already in New Zealand and driving Uber Eats\u2014how can we allow that? How can that happen? How can we allow qualified doctors who have sat their New Zealand Registration Examination and paid a large amount of money to do so not find a pathway into postgraduate year (PGY) 1 and PGY2? That seems disingenuous to take their money and know there is no hope for them to go into their intern years. Maybe we need to look at saying, \u201CIf you pass NZREX, we guarantee and commit to an intern year.\u201D The same with the many nurses, the hundreds of nurses who are here\u2014well qualified, and a $10,000 competency assurance examination becomes the hurdle. Surely, we can figure out a way for that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000387\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003ENo. 4: we would provide pathways to increase the number of graduates, turning on our domestic pipe so we have more culturally competent practitioners that we\u2019ve grown ourselves. No. 5: we need to take into account urgent workforce requirements for senior medical officers, GPs, critical care nurses, the rural care space, and the aged residential care sector as a whole. The sixth point we need to take into account for a health workforce strategy is that we clearly need to focus on pay equity, and when the DHB pay equity negotiation goes through, I have grave concerns for aged residential care. Then there\u2019s pay parity: the issues we have with registered nurses out in the community, community nurses, GP primary care nurses, and, again, aged residential care nurses. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000388\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThen there\u2019s primary-care funding. The health workforce cannot stand alone. It must look at primary-care funding. General practice is broken. The gateway to expensive hospital care, and what many believe, including myself\u2014and, indeed, this bill is a key solution. The propensity for primary care to do more to keep people out of hospitals and to reduce the length of stay\u2014how can we do that when there is no alignment of funding with costs, funding with complexity, and any funding that takes into account the high-quality provision of care that general practice brings?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000389\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThis Government has shown its real intent around general practice funding in an advertisement a few weeks ago, requesting that GPs and other primary-care practitioners contribute their time to help the Government figure out what the health reforms look like and to do it for free. To put aside fulltime-equivalents to do for free what the Government hasn\u2019t figured out is a disrespectful embarrassment to primary care and shows their real intent. This part of the bill needs a health workforce strategy, and the National Party will stand for that.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022 data-id=\u002238e48a7561184aa8b0fecd9bac945325\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000390\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002238e48a7561184aa8b0fecd9bac945325\u0022\u003EMATT DOOCEY (National\u2014Waimakariri):\u003C/span\u003E Oh, thank you very much, Mr Chair. It\u2019s a pleasure to take a call. Wow, what an absolute shambles. I mean, first they try and pass a motion to be taken in one debate\u2014couldn\u2019t even get that through. Normally, when you take a one-debate call it\u2019s because you want to expedite the bill as quickly as possible. Here we are with their flagship health-restructure bill, and they want to expedite it as quick as possible, because as we knew about the Supplementary Order Paper (SOP) of the rural community strategy\u2014and then we had the Government members trying to move a motion that they forgot even to vote for. There was no voice\u2014a bit like the no voice from rural Labour MPs who sat on their hands and saw a bill being put in the House in first reading with no rural strategy. They sat on their hands during the select committee stage and didn\u2019t even raise the issue about a rural health strategy, so it came out again without a rural health strategy. And then we now find out from the Minister that he had an epiphany where he woke up one day and realised, \u201COh, I need rural health strategy.\u201D\u2014might have been the morning after the poll, I think. And it was all down to his Labour rural MPs. Well, I know myself, Dr Shane Reti, Nicola Grigg, we\u2019re getting the texts now, and we\u2019re getting the emails from senior rural health leaders who know exactly who has been instrumental in getting that changed, and that has been the Opposition. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000391\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003ESo I want to look at clause 10 because I want to ask why the Minister is not determining a mental health strategy. If we look at this bill being proposed around a lens of equity, then why would you not have a strategy around mental health? When you look at the submissions with one of the leading NGOs, who said, \u201CThere is no explicit mention or prioritisation of health equity for people with mental health and addiction challenges, yet this group as a whole experience some of the most serious health inequalities.\u201D\u2014\u201Csome of the most serious health inequalities\u201D in New Zealand. People with mental health issues have a life expectancy 20 years shorter than the average Kiwi\u2014they have huge health inequalities. Yet we are told by this Government this is a bill about equity\u2014equity when it suits them. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000392\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003ESo we have a Government that came in promising to transform the mental health system, in fact, asked thousands of Kiwis to go to their own inquiry hearings and tell their very personal and traumatic stories about their experiences in the health system. They have a once-in-a-generation chance for the health restructure, and this bill\u2014well, what did most of the submitters call it? The Mental Health and Wellbeing Commission and the Mental Health Foundation said mental health was invisible. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000393\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003ESo how have we ended up in a situation where there is no strategy under clause 10 in Part 2 for mental health, addictions, and wellbeing? My final point is, and I\u2019d like the Minister to answer, when you look at those groups\u2014M\u0101ori, Pasifika, our disabled community, the women\u2019s community or population\u2014you\u2019ve got to ask yourself whether mental health would be one of the quietest voices. Is that the problem here? Is it because people with mental health issues haven\u2019t yelled enough or haven\u2019t threatened electoral pressure? Why have they been left out? Because I would have thought the voice that came through the thousands of submissions in this Government\u2019s own mental health inquiry would be a very strong voice. Why would you, when you came into Government promising to transform the mental health system, not have a mental health strategy under clause 10 that says the overview of the Minister\u2019s role includes determining the following health strategies?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022 data-id=\u00223f3194bfe1d2450aa3fd2904ee82a750\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000394\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00223f3194bfe1d2450aa3fd2904ee82a750\u0022\u003ENICOLA GRIGG (National\u2014Selwyn):\u003C/span\u003E Thank you, Mr Chair. I\u2019d also like to refer to clause 10 of Part 2 of this bill. To the Minister, I don\u2019t know how aware you are of the state of health services in Christchurch. If you think back to all of the earthquakes that our city and our region suffered since September 2010, and indeed February 2011, it has left our health sector very, very short on infrastructure and resource. And while the Canterbury District Health Board (CDHB) has built a new wing of Christchurch Hospital, it has had a very delayed opening and a very delayed capacity because of the very fact that the CDHB could not resource it with people. So, in reference to the overview of the Minister\u2019s role in determining the following health strategies, including the New Zealand Health Strategy, I would ask the Minister to consider the inclusion of Dr Shane Reti\u2019s Supplementary Order Paper 158, which would include a health workforce development strategy.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000395\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003EIn Christchurch at the moment, surgeries are being deferred from Christchurch Hospital. The hospital is at 112 percent capacity. The DHB estimates that there is anywhere between 170 and 200 staff either off sick or off isolating. Ten minutes up the road, St George\u2019s private hospital is likely to lose the remaining dozen or so maternity beds. Now, I understand that the story that is not reported in the media is this is actually due to the fact that they cannot staff these beds with midwives. CDHB has been promising for some time to build a maternity wing somewhere near Christchurch Women\u2019s Hospital. I had a letter from the CEO just recently confirming it would be available by 2023. Thus far, I haven\u2019t seen any indication any property has been bought, any tenders have gone out; there don\u2019t seem to me to be any plans for the build of this facility. I hope I am proven wrong. Ashburton Hospital is only able to cater for very, very uncomplicated births. So that leaves the eyes of Canterbury and parents of Canterbury looking at my own electorate, Selwyn.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000396\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00225b6b1d74-9e5e-42ba-a922-85b0ea7f5ab6\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002267f86af62cdf46e7a6f39c2562dc085a\u0022\u003ESimon O\u2019Connor\u003C/span\u003E: What a great electorate.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000397\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002293272d4e-6912-4148-8b35-c9622e18b814\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022603f9110eb4d4947a780aafbb9456b5b\u0022\u003ENICOLA GRIGG\u003C/span\u003E: Thank you. In a very novel business proposition, the Selwyn District Council has acted as a developer and has built a health centre that includes about a dozen maternity beds that it\u2019s now leasing out to the CDHB. As I referred in my submission earlier, we\u2019ve also had the closure of the Ellesmere Hospital and the Darfield Hospital. Again, we know that that is primarily due to the fact that there is not the workforce available. So in the Minister\u2019s ruminations over the New Zealand Health Strategy, I would ask that he consider the inclusion of a health workforce development strategy with some urgency. All the issues that we face in Canterbury are absolutely and utterly due to the short-staffing of the facilities and resources available. I would also like to know, if there is to be an inclusion of a workforce strategy, how will that possibly dovetail in with a rural health strategy? Because where we see the shortages in the urban centres, they are absolutely exacerbated in rural areas. So I thank the Minister for his consideration.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00221c0a77f5fa5c4656ad9f4a84ef943a46\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000398\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221c0a77f5fa5c4656ad9f4a84ef943a46\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Mr Chair. If I just respond, as I can, to the most recent contributions.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000399\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo to Dr Shane Reti and, perhaps, to Nicola Grigg as well, who put the case for a workforce strategy\u2014I do refer those members to clause 14 of the bill, which was amended by the Pae Ora Legislation Committee, and I\u2019ll refer them to subclause (1)(fa) and (fb), which spells out, as part of the functions of Health New Zealand, in subparagraph (fa), \u201Cundertake health workforce planning; and (fb) collaborate with relevant entities to improve the capability and capacity of the health workforce;\u201D. So that is a statutory function of Health NZ, and there\u2019s a further obligation for them to cooperate with the M\u0101ori Health Authority on that. Because this is a Government that likes to back up its words with resources and action, the members will be aware from the Budget two weeks ago that we have put additional resources into workforce development for the M\u0101ori workforce, for the Pacific workforce, and for the health workforce generally, just in the way we have done with the mental health workforce that had been left pretty run down for nine years in a row by the previous Government.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000400\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EIt\u2019s interesting that Mr Doocey should talk about epiphanies. I think the biggest epiphany is the National Party realising, in Opposition, that we actually have mental services. Having neglected them for so long, they now are in a dire state. It is this Government, in the last five years, that has actually taken the action to really boost them by adding more than 900 people to the front line of those mental health services and starting to make a real difference. But I\u2019ll come back to Mr Doocey\u2019s points in a minute because, as always, he\u2019s got things wrong.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000401\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI just want to say, in terms of the state of the workforce, the members are right: there are some real challenges for the health workforce at the moment, not helped by the fact that the health workforce was also the victim of underfunding for many years by the previous Government. Indeed, you\u2019ve got things like nurses. Nurses\u2019 remuneration went backwards in real terms under the previous Government. They simply did not give pay increases to nurses that matched the rate of inflation. We\u2019ve turned that around. Even before the pay equity claim, if and when that ever gets resolved with the Nurses Organisation, we\u2019ve increased pay by 20 percent in the first four years that we\u2019ve been in Government. But through the pay equity settlement, when that does come on stream, that is a significant change in remuneration for nurses. A nurse with seven years\u2019 experience on a basic salary, a full-time salary of $95,000, and with the benefit of doing overtime and what have you, it will push it well over $100,000\u2014that\u2019s the sort of stuff to do, because we know that for nurses, they\u2019ve been undervalued and, therefore, underpaid for so long. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000402\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EBut many of the challenges we have with the workforce is because there is a worldwide shortage of health workers, whether it\u2019s at the senior medical officer end, whether it\u2019s nurses, or whether it\u2019s healthcare assistants. We\u2019ve done a lot of work to support health entities, both public and private, to make sure that they can recruit offshore, but also investing and developing our own workforce. So, this year, we put 1,700 New Zealand graduate nurses into our health system just from last year\u2019s production from the tertiary system, and we will continue to invest in that and grow places.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000403\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe member did raise an interesting point about overseas-qualified medical officers struggling to get supervised places for their postgraduate year 1 and 2, and I know the member is genuinely concerned about this, as we all are. One of the challenges we\u2019ve got is, again, with the vacancies we have in the health system, arranging supervision. We\u2019ve got to have enough senior medical officers who are prepared to provide that supervision to allow that to happen. I can say to the member that I am aware both the ministry and people on behalf of the DHBs have been working with the Medical Council and others to talk about ways in which that supervision can be provided that isn\u2019t in the traditional form but can get those qualified graduates, who are driving Ubers and what have you, into a health system where they are desperately needed. The other aspect of that is that some of those graduates, because they\u2019ve got family here, they\u2019re very clear about where they want to go, and it\u2019s not necessarily where all the vacancies are. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000404\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo look, these are challenges, but the member will be aware that is what goes with workforce management, much less with workforce planning. But the member will see from clause 14 in the bill that there is a statutory obligation on those entities to do workforce planning and the capability development that goes with it. I\u2019m satisfied that those provisions close off the things that he would want in his Supplementary Order Paper (SOP).\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000405\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo address Mr Doocey\u2019s ongoing claims with his SOP for a mental health strategy, the health strategies that are referred to in there are population strategies. These are populations that, typically, have been underserved by the health system previously. We know M\u0101ori and Pacific and, actually, the disabled community\u2014if you look at the responses they get, many of them struggle to get the health services they need. Many of them actually are very clear that their issues are not just about health services; it\u2019s about the full range of services, which is why, as part of the reforms, we\u2019re establishing a separate ministry for disabled people\u2014it\u2019s a working title at the moment. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000406\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EBut when it comes to a mental health strategy, that is a requirement of the health entities. I refer the member to clause 7(1)(e)(iii), where it refers to \u201C(e) the health sector should protect and promote people\u2019s health and wellbeing, including by\u2014 \u2026 (iii) working to improve mental and physical health and diagnose and treat mental and physical health problems equitably;\u201D\u2014that is to say that we don\u2019t treat mental health services or the needs of those with mental health issues as somehow inferior or secondary to those with physical health challenges. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000407\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThat has been the culture of our health system. It\u2019s been the culture of the previous Government. That\u2019s why this Government has worked so hard to address the challenges we have in our mental health system. That\u2019s why we\u2019ve added more than 900 people to the front line of mental health services, providing talk therapies and other assistance to those with mild to moderate mental health issues. It\u2019s why we put another $100 million into mental health services for specialist and acute services in the Budget two weeks ago, where we can start to address those shortages in those services, where we can start to beef up the services available for those with eating disorders, and where we can start to provide places in the community for those who, having been through an acute episode and who would best recover in the community, will have places to do so. That is our commitment to mental health services.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000408\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo far, the only plan that the National Party has for mental health services is to appoint a Minister for mental health services, which tells you that the National Party is only interested in window dressing. They haven\u2019t spelt out a single plan or a single thing they would do for mental health services, assuming that is different to what we would do. They are the party of window dressing when it comes to these sorts of things. Their track record in Government is to run down health services and to neglect mental health services. So I stand by what this Government has been doing and is doing, the commitments that we\u2019re making, and I\u2019m confident that the statutory commitments that are provided for in this bill means that our health services will be well looked after.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000409\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ENicola Grigg talked about workforce development. She seems to want me to start doing the work of those who will be responsible for putting together the women\u2019s health strategy and others; I\u2019m not going to do that. There is a statutory requirement to have a women\u2019s health strategy, that will include maternity services.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000410\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWhat we won\u2019t do is we won\u2019t allow a repeat of what has happened in Canterbury before, and that is to have, in that case, a DHB that overspent its budget significantly year after year after year. If the member\u2019s worried about what has happened to Canterbury health services, she should ask \u201CWhat is the DHB doing?\u201D They not only spent what they were asked to spend and appropriated to spend, they spent a heap more besides, and still they struggled to get the health services. This Government has been committed to Canterbury health services. It\u2019s why we\u2019ve approved additional buildings and why we\u2019re backing the Canterbury District Health Board in its current form to continue to provide services.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000411\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe staffing shortages that are evident throughout are staffing shortages that not only are we experiencing across the country but the rest of the world is experiencing too. We hold our head up high in terms of the investments we\u2019re making and the efforts that we\u2019re making to fill the gaps that are there at the moment.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022860503c92ebd458a8cf6a13b7c10146b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000412\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022860503c92ebd458a8cf6a13b7c10146b\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: I call Brooke van Velden, and, in doing so, I just put Rawiri Waititi on notice that I haven\u2019t forgotten him. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u0022e2de0dc23e744f1f92de6a2b3a4789c7\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000413\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e2de0dc23e744f1f92de6a2b3a4789c7\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Mr Chair. I\u2019d like to speak to Supplementary Order Paper (SOP) 153 that the ACT Party is putting up. This SOP is fundamentally why we oppose this health reform. In this SOP we are asking for the Government to remove the M\u0101ori Health Authority. Now, we believe that behind this health reform there are no better outcomes. All that this health reform is is an exercise in co-governance rather than in healthcare. We think that we need to get back to basics and understand what our healthcare is supposed to deliver. Will this legislation actually lead to better treatments, faster, for more patients, or will it simply deliver a co-governed system that will divide New Zealanders based on their race rather than on their health needs? That goes far\u2014too far\u2014away from the understanding that all New Zealanders have equal rights under the law, and that\u2019s what the ACT Party proposes: that we consider healthcare as part of healthcare, rather than co-governance and race-based healthcare. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000414\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EWe put forward a minority view during the select committee, because we don\u2019t believe that restructuring the healthcare sector, and saying that we need to remove the district health boards because we\u2019re trying to get rid of a postcode lottery, and putting in place one Health New Zealand will make it better. But then, having the Government acknowledge that, no, they don\u2019t want just one healthcare system, it would be better if there are two\u2014two healthcare systems, Health New Zealand plus the M\u0101ori Health Authority, and to make it even more complicated, \u201CWhy don\u2019t we put in place locality structures that are put in place by iwi-M\u0101ori partnership boards?\u201D\u2014the Government still can\u2019t answer the question of how many iwi-M\u0101ori partnership boards there will be, how many localities there\u2019ll be\u2014he says up to 80\u2014and how they\u2019ll be structured. They\u2019ve been given up to two years to create localities, and then another year for a locality plan. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000415\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EThen, on top of all of that, you\u2019ve got the iwi-M\u0101ori partnership boards, who are unelected people, who are self-selecting, who go to the M\u0101ori Health Authority and say, \u201CWe\u2019d like to be in charge of this entire area.\u201D They then have to work with Health New Zealand and the M\u0101ori Health Authority to create locality plans for all of New Zealand. Now, tell me: how is that any less bureaucratic than the system that we currently have? \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000416\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EYou know, I\u2019ve spoken to many, many healthcare providers and patient groups. Nobody can tell me how this new system will work, and they believe it will actually make their lives worse off, because not only do we not know who the iwi-M\u0101ori partnership boards currently are\u2014and we still might not in two years\u2014but we don\u2019t know who the M\u0101ori Health Authority is going to be, we don\u2019t really know how we\u2019re going to work with Health New Zealand, we don\u2019t know how the iwi-M\u0101ori partnership boards and the M\u0101ori Health Authority will work together, and if in any case something terrible happens, all of a sudden the Minister of Health has to get involved and arbitrate between all of these groups who have to decide on a healthcare plan. I think it is going too far away from looking at the basics of health needs of New Zealanders and putting patients first at the heart of our healthcare sector. All we\u2019ve done is created a bureaucratic mess in an exercise of co-governance, and it has to go. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000417\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EThe ACT Party asks the Minister of Health to remove the M\u0101ori Health Authority, make our system less bureaucratic, put patients back at the centre of our healthcare system, and actually ask the simple questions of what health outcomes we will see from this health reform. We\u2019re spending hundreds of millions of dollars in an exercise in co-governance and not in any better health outcomes for New Zealand. It has to go. Thank you, Mr Chair. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022 data-id=\u002258a5e01966f240e784039ddc725232ac\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000418\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002258a5e01966f240e784039ddc725232ac\u0022\u003ERAWIRI WAITITI (Co-Leader\u2014Te Paati M\u0101ori) (remote):\u003C/span\u003E Thank you, Mr Chair. How appropriate to follow that speaker, Brooke van Velden, from that party. It\u2019s weird how the party of property rights and law and order isn\u2019t really into upholding contracts like Te Tiriti o Waitangi, the founding documentation and contract of this country. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000419\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EAnyway, moving on to the adults, just to say that this still feels like the great white shark and the kahawai scenario, where Health New Zealand is the great white shark and the kahawai is the M\u0101ori Health Authority. We\u2019re trying to find a partnership here, so what that great white shark does is eat the kahawai and say, \u201CWell, now we are one.\u201D You don\u2019t have the two entities\u2014it\u2019s not independent, it doesn\u2019t have the right to veto, and it actually doesn\u2019t allow us to come up with our own health strategies, as promised in the contract that this country signed. You know, we\u2019re consistently hitting our heads against the wall. I heard the Minister say that this Government backs up its words\u2014just not the M\u0101ori words, from a document written by the Crown, whom this Parliament represents. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000420\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003ESo our amendments would strengthen the bill by ensuring it better reflects Te Tiriti o Waitangi and our mana motuhake as tangata whenua. Our Supplementary Order Paper (SOP) 167 would establish a M\u0101ori Director-General of Health. If it was a true Tiriti-centric model, it would have a mirror. So whatever New Zealand health has, the M\u0101ori Health Authority should also have. So a M\u0101ori Director-General of Health would lead the operational management of the Ministry of Health alongside the Director-General of Health. So you would have two. Just like the M\u0101ori Health Authority and Health New Zealand, you would have two working side by side, working together to ensure that there is not a mismatch in the direction of trying to close health inequities for M\u0101ori. As I\u2019ve heard the mono-health approach by ACT\u2014you know, we would start to close where M\u0101ori die seven to 10 years earlier than everybody else. So the two key roles would work together and have the same powers, duties, and functions. All key decisions previously made solely by the Director-General of Health would be made by both positions, and if they cannot reach agreement on giving decisions then the decision will be referred to the Minister of Health for resolution. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000421\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EThis is far from any kind of equality\u2014or equity, as I\u2019ve heard the National Party talk about\u2014and we are totally supportive that equity must prevail and equity must be at the forefront of the roll-out of the M\u0101ori Health Authority and Health New Zealand, but it is not. We would have been better to just receive the targeted funding under the district health board (DHB) model, because it was more than the 0.6 percent that we\u2019re getting under this current model. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000422\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EThe establishment of the M\u0101ori Health Authority and Health New Zealand is the biggest reform of the health system in generations. We have an opportunity to finally address the institutional racism and systemic barriers for M\u0101ori, which have led to persistent inequities and entrenched health disparities for tangata whenua. Therefore, this House must not, yet again, set up M\u0101ori to fail under a new system. I totally agree with that: tangata whenua must have our decision-making authority recognised in the legislation.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000423\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EThese are rights guaranteed in Te Tiriti o Waitangi. It is time this country grew up and honoured that particular document. One of the best ways to do this is by establishing a M\u0101ori director-general of health, so that the success of the M\u0101ori Health Authority is not prevented by P\u0101keh\u0101 bureaucrats\u2014I agree with ACT there\u2014in the Ministry of Health, as we saw during the pandemic. Even when Ministers instructed the release of M\u0101ori data\u2014the courts backed it\u2014the director-general was able to block it from happening. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000424\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EOur other SOP would amend Part 2\u2014SOP 172. This amendment strengthens the language in the bill so that Health New Zealand will require the agreement of the M\u0101ori Health Authority before carrying out its functions, such as services provision and health workforce planning, and I agree with National in that particular space. Rather than just being required to work with them, this would be a common-sense but significant improvement to the bill which would help ensure tangata whenua are not sidelined once again in the operations of the health system or in the new local bureaucracies that will replace the DHBs. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000425\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00220f7d126e-c18d-4466-9ebe-d424ae5c4bf6\u0022\u003EThis new model must be better than the old one. Proposing a mono-system is not going to work. We must have equity, it must be funded equally, it must have a mirror image of what Health New Zealand is getting for it to succeed, and we must honour Te Tiriti o Waitangi as true partners. Never mind this co-governance rubbish. We\u2019re into partnership, and the partnership is what is promised in Te Tiriti o Waitangi, and that\u2019s what needs to happen. Kia ora t\u0101tou.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022aa7aacd6f97e4080ab8d2ea7f4e9303f\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000426\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022aa7aacd6f97e4080ab8d2ea7f4e9303f\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Mr Chair. I appreciate the opportunity to respond to the last two contributions.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000427\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Brooke van Velden\u2014and I know the ACT Party has never been shy about saying they want to remove the M\u0101ori Health Authority\u2014it\u2019s interesting that she talks about all New Zealanders being treated equally, but the reality is the health system does not currently, and has not ever, treated every New Zealander equally, and you cannot say everybody is treated equally when M\u0101ori, on average, die seven years earlier than European P\u0101keh\u0101. You cannot say everybody is being treated equally when M\u0101ori are twice as likely as European P\u0101keh\u0101 to die of cancer. They are not being treated fairly or equitably. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000428\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EEquity isn\u2019t about everybody being treated the same; it\u2019s about everybody being treated according to their needs. That is why I\u2019m very proud that in the Budget a couple of weeks ago\u2014and we\u2019re proud of the work my colleague the Hon Peeni Henare did in making sure that the bowel screening programme is changed so that M\u0101ori, who statistically and epidemiologically\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000429\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c3a88c42-f60b-4cf9-8065-8bfb80a020eb\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022115c595924d444669d1c2b669a1ebed1\u0022\u003EHon Carmel Sepuloni\u003C/span\u003E: And Pacific.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000430\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022e4d11641c2c145eb9fe22a5d77919eb3\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: \u2014and Pacific\u2014get bowel cancers earlier in life, now will enter the bowel screening programme earlier than others, because that\u2019s the sensible, but, most importantly, equitable, thing to do. That\u2019s what health equity looks like.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000431\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ENow, you can all ask about how we got to this point, but the reality is the Crown has not honoured its obligations under Te Tiriti. It hasn\u2019t not listened to M\u0101ori. M\u0101ori need to be at the decision-making table and will be, and this is where I disagree with my friend Rawiri Waititi. Actually, this model\u2014this structure that this bill provides for\u2014puts M\u0101ori at every decision-making table in the health system that they need to be at.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000432\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThis is a partnership, and we can see it in action already in the interim M\u0101ori Health Authority and interim Health New Zealand. The way that they have been operating has, in my view, exceeded my expectations. They are working hand in glove. They are the partners\u2014not the Treaty partners, but they are partners in delivering health services with a very strong M\u0101ori voice, and they\u2019re still strengthening, they\u2019re still building, they\u2019re still working, and Health New Zealand is inheriting all the palaver from the DHB system.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000433\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EIt\u2019s interesting that Brooke van Velden should ask who the M\u0101ori Health Authority is. I can give her a hand: it\u2019s a co-chaired by Sharon Shea and Tipa Mahuta, two outstanding M\u0101ori leaders. Both with quite different styles, but outstanding M\u0101ori leaders. Do you want to know who\u2019s on the board? Dr Sue Crengle, outstanding health practitioner from down South. Dr Mataroria Lyndon, a really talented, young health practitioner. I see his name all over the place these days; I\u2019m sure Dr Shane Reti knows him\u2014a very talented and very high-powered intellect in Dr Mataroria Lyndon. I\u2019m not going to mention every name, but I will mention one other, who Rawiri Waititi might know, and that\u2019s Awerangi Durie. She\u2019s also on the board\u2014\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000434\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f317ee7d-f040-44ec-8f2f-ad0a9f206d75\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022ea2b720104544586ab6a291d1224207b\u0022\u003EHon Willie Jackson\u003C/span\u003E: His family. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000435\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022f7c48b13884b4521b91a8ef57a800e8b\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: \u2014turns out to be wh\u0101nau of Rawiri Waititi. These are the really talented leaders in Te Ao M\u0101ori. As I get around and I meet health leaders of all stripes and all kinds, I can tell you, the M\u0101ori health leaders\u2014and we\u2019ve always had excellent M\u0101ori health leaders. You go back to the Sir M\u0101ui P\u014Dmares and the Sir Peter Bucks. This is a country that has been blessed with outstanding M\u0101ori leadership in health. We\u2019ve got them in bucket-loads, and they will now have a place to stand and a place to be and an authority now that will take M\u0101ori health and drive it and make it better for everybody.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000436\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo to Rawiri Waititi, I would invite him to look at the total structure that is being established here: the M\u0101ori Health Authority, supported by the Iwi M\u0101ori Partnership Boards\u2014that is driven right out of iwi and urban M\u0101ori. Then the Hauora M\u0101ori advisory committee, which is not in this part; it\u2019s in a different part, but it stands with that sort of structure. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000437\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI am required, as Minister, to refer to the Hauora M\u0101ori Advisory Council. When I exercise various of my powers, particularly those where I do continue to exercise them under the Crown Entities Act and the powers I have in relation to the M\u0101ori Health Authority under this bill, I have to refer to the Hauora M\u0101ori Advisory Council. That strengthens the M\u0101ori voice. That brings the M\u0101ori voice close to, or right alongside the Minister when it comes to making those decisions. If there are disagreements between the M\u0101ori Health Authority and Health New Zealand\u2014because there\u2019s a lot of stuff they have to work together on and agree on\u2014then I don\u2019t get to resolve that alone. I refer to my colleagues the Minister for M\u0101ori Development and the Minister for M\u0101ori Crown Relations: Te Arawhiti.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000438\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe voice of M\u0101ori is strengthened at every step and at every level of the health system. That is what we need to drive health equity for M\u0101ori, and I stand very proud of these provisions in the bill that do that. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u002286592a7542314256995b7b0b2f3280fa\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000439\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002286592a7542314256995b7b0b2f3280fa\u0022\u003EDr SHANE RETI (National):\u003C/span\u003E Thank you, Mr Chair. Supplementary Order Paper (SOP) 157 in my name, and on behalf of the National Party, recognises the importance of the healthcare of older people by requiring this to be a specific strategy in the Pae Ora (Healthy Futures) Bill. I\u2019m becoming increasingly concerned about the aged residential care sector as a sector that is very close to breaking. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000440\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EAt an overview level, the long-term importance of the magnitude of the approach and quantum of care required for older people was evident in the 2021 Treasury document He Tirohanga Mokopuna. This described a long-term fiscal position over a 40-year horizon. The care of older people was highlighted specifically in the statement: \u201CThe most significant spending pressures come from a combination of healthcare and [New Zealand] Superannuation, which we project will increase by 6.4% of GDP from 2021 to 2061.\u201D Those are the two long-term fiscal concerns of Treasury: superannuation and care of older people. You\u2019d think with that that we might want to include it as a strategy in the Pae Ora bill. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000441\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThe care of older people is an approach, a reality, and a privilege. Living arrangements range from independent living, aged residential care, support, and care. My concern is for the caregivers and the aged residential care workforce and the shortage we have right now of a thousand registered nurses, and we know that there\u2019s a significant shortage of healthcare assistants\u2014the two big groups in the aged residential care category. We know that when fully staffed, there are 5,000 registered nurses working in aged residential care. Nearly 50 percent of these are actually on a visa. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000442\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EI come back to a previous discussion the Minister had and ask him to clarify the current settings for nurses who are not available for the shortened residency pathway. If they are on the two-year pathway, are they required to stay with one employer, because Megan Woods and Kris Faafoi said something different. That\u2019s part of the concern of the sector initially that a nurse would be able to come in, work with aged residential care, and then move to a DHB. The Minister has said here, \u201CNo, that is not correct.\u201D I need some clarity on that because I don\u2019t quite understand how we can have a difference of views. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000443\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EAt the moment, there\u2019s a shortage of, roughly, a thousand registered aged residential care nurses. We\u2019ve got that perfect storm approaching, and amongst us we\u2019ve got COVID, we\u2019ve got immigration settings, vaccine mandates, work conditions, increasing acuity in the sector, sector funding, and pay parity. There\u2019s a combination of forces coming together here, and I\u2019ve mentioned the recently announced immigration settings which are not friendly to nurses wanting to work, not just in older people settings but in healthcare overall.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000444\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EWhat will happen here if we don\u2019t figure out a strategy for the care of older people? Particularly in aged residential care facilities, the facility owners only have a couple of levers they can pull. They can increase prices, and that\u2019s really not tenable, or they can just start peeling back their high-resourced, expensive residential beds. Those are dementia care, and you can\u2019t just build a granny flat for someone with dementia if they\u2019re kicked out of their aged residential care facility. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000445\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003ESo I\u2019m very, very concerned about this sector\u2014concerns that Age Concern are expressing to us. They\u2019re worried, Grey Power are worried, social workers are worried, New Zealanders with older parents are worried, and Treasury are worried. I would submit we require this Labour Government to include an older people\u2019s strategy, as described in my SOP, to deliver genuine care to older people. Thank you. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u0022f0ddd9a94fa14c2eb498371a0f9ce5cf\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000446\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f0ddd9a94fa14c2eb498371a0f9ce5cf\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Mr Chair. I would hope, with the time that we have left in this Part 2 debate, that the Minister would be able to provide some clarity about the iwi-M\u0101ori partnership boards, because it doesn\u2019t matter who I talk to in the healthcare sector, nobody seems to understand yet how these iwi-M\u0101ori partnership boards would work.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000447\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EI have a few points that I\u2019d like some clarification on, and it\u2019s that iwi-M\u0101ori partnership boards must be recognised by the M\u0101ori Health Authority before they can be established as an iwi-M\u0101ori partnership board. That would help create a locality plan, and part of one of its criteria is that \u201Cthe boundaries of an area covered by the organisation do not overlap with the boundaries of any area covered by any iwi-M\u0101ori partnership board\u201D. So every iwi-M\u0101ori partnership board has to have its own specified locality area, and these localities cannot overlap.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000448\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EI\u2019ve had a query about what happens if over time we may have iwi-M\u0101ori partnership boards that go to the M\u0101ori Health Authority and say that they\u2019d like to be established as the iwi-M\u0101ori partnership board for a particular area, a geographic area, but then in a few years\u2019 time, say, we end up with another iwi group or another hap\u016B saying that they are the people who are engaged with the local marae and the local concerns of that particular area. How this would work when a particular iwi-M\u0101ori partnership board would be defined by the M\u0101ori Health Authority as the particular group for that whole area, and would there be any right for another group to claim that they, in fact, are the iwi-M\u0101ori partnership board who could apply to the M\u0101ori Health Authority? Is it possible that we could have multiple groups all claiming that they are the people who should be the iwi-M\u0101ori partnership board for a particular area, whereby we actually have overlapping conflicts of interest with different groups in different areas?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000449\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EHow do those types of conflicts get reconciled? I do note that if you just look at the Treaty settlement process, Ng\u0101puhi have not signed a Treaty settlement because different groups within Ng\u0101puhi cannot determine who it is that is in charge to be able to negotiate with the Crown. So in that particular element, do we end up with all of Northland not having an iwi-M\u0101ori partnership board, or could we end up with one group determining that they are in charge of the iwi-M\u0101ori partnership board for an entire area? Or is it that you could have eight different groups or 10 different groups all saying that their particular group has claim to a particular area, and they know the local groups? \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000450\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EHow will this work? The Minister has said in the media that you\u2019ve got potentially up to 80 groups, but he doesn\u2019t know. So could the groups change over time? How will this work, especially when they have to be acknowledged that they\u2019re established by the M\u0101ori Health Authority? Who is actually in charge of determining who the iwi-M\u0101ori partnership board for a particular locality is, and, if they\u2019re established within a particular locality, can that change over time? And if that is true, who is arbitrating? Is it the M\u0101ori Health Authority that is determining that one particular group of people does not lay claim to a particular locality? In some ways, there\u2019s a conflict there with the Treaty settlement process. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022e541a2d6194b4c04b270ec9da76db076\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000451\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e541a2d6194b4c04b270ec9da76db076\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: Members, the time has come for me to leave the Chair. The committee will resume at 7 o\u2019clock.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000452\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003ESitting suspended from 5.58 p.m. to 7 p.m.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u002259aa38ff0be44556811d28c5ccbdf415\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000453\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002259aa38ff0be44556811d28c5ccbdf415\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: Members, before the dinner break we were debating Part 2 of the Pae Ora (Healthy Futures) Bill.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00227ee7d0cc9dbb4d00a41b5acb5af31151\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000454\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227ee7d0cc9dbb4d00a41b5acb5af31151\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Mr Chairman. I just thought I would take the opportunity to respond to some of the contributions just before the dinner break.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000455\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EDr Shane Reti had referred us to his Supplementary Order Paper (SOP) 157 and the call for an older person\u2019s strategy. And I just draw his attention in that respect to clause 43C(1)(a) of the bill, which requires the Government\u2019s policy statement on health to include \u201Cthe Government\u2019s priorities and objectives for the publicly funded health sector:\u201D So that would also include parts of the health sector that receive public funding, as well as what we would currently call the district health boards (DHBs). So it is a requirement, when we set out our Government policy statement, that we also clearly refer to all parts of the health sectors that are in receipt of public funding. And that makes sense. It would make sense for the Government, if we\u2019re going to fund activities, regardless of who\u2019s providing it, that we do so in the context of a strategy and a plan, a set of values, and a set of principles. And that\u2019s what this bill will do.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000456\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI note what the member says about the challenge with, particularly, the nursing workforce because of the large number of vacancies. Something in addition to the vacancies: one of the challenges we have that\u2019s exacerbating things is the fact that we have a high incidence of absence for sickness, because, as you would expect, the health workforce is exposed to more sickness, and not only them but their families and wh\u0101nau as well. And we\u2019re seeing an elevated level of absenteeism for that reason. But we need them to be absent because when people are unwell or associated with people who are unwell, we need to make sure that they\u2019re not putting other patients at risk.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000457\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe member expresses concern about facility owners, and the member can be assured I hear from the facility owners on a reasonably regular basis and hear their concerns. We will continue, the ministry and, I expect, Health New Zealand and the M\u0101ori Health Authority, when it is there. They have the authority to do so. We\u2019ll continue to engage with those aged residential care services to make sure, to the best extent we can, particularly in these straitened times, we offer them the support and the help that we can. That\u2019s what we have continued to do. I think, too, just more generally, I recognise the point the member is making is that, actually, that sector, to the extent that it provides important levels of care\u2014hospital care and dementia care\u2014it\u2019s actually a very important part of our total health services, our total health offering. And so we do need to make sure that as we make strategies, as we make plans, as we set policies, we\u2019re properly incorporating them and their interests.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000458\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Brooke van Velden, who raised the issue of the iwi-M\u0101ori partnership boards, just a couple of things. First of all, iwi-M\u0101ori partnership boards are in existence at the moment, have been for some years. They haven\u2019t had statutory recognition, but they have evolved under the current DHB model, as DHBs were required to find a basis on which they could engage with local M\u0101ori through iwi. So these boards have been set up. They have worked to varying degrees across the country, but we undertook, as we\u2019ve set up these reforms, to actually (a) recognise them and (b) ensure that they are supported to be established to do the job that iwi want them to do and urban M\u0101ori want them to do, and, in a sense, sort of charging them up with a little more energy than perhaps they\u2019ve had previously.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000459\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ENow, the way that these things are, it is M\u0101ori that will decide how they wish to organise their representation. That is the right thing to do. The M\u0101ori Health Authority has a role to assist them in that, to support them in that, and they will do that. It will emerge over time how many there will be. Currently, as I understand it, there are about 14. That may be the limit of it. There may be one or two more. There may even be one or two less. Some may consolidate over time. But they will work out the way they will organise that, and then how they will interact with Health NZ both at a regional and a national level, and then feed into the various work that has to be done. So I am quite confident that they will work that out.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000460\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ELikewise, they will work out their relationship to the locality planning process. They are an integral part of that. We need their voice in locality planning, and they will work that out because there will be the kaupapa M\u0101ori health providers and there will be plenty of other health providers providing services to M\u0101ori, where iwi and urban M\u0101ori organisations will want to and should properly have a say on what happens there. So no further changes are required, and so we won\u2019t be supporting the member\u2019s SOP on that. We think that what is in place in the bill at the moment will do the job.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00224d83c8a5-2f48-4991-9c45-b1a6060daedd\u0022 data-id=\u0022f593af24b1c649e0b7adadf603505ced\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000461\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00224d83c8a5-2f48-4991-9c45-b1a6060daedd\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f593af24b1c649e0b7adadf603505ced\u0022\u003EMAUREEN PUGH (National):\u003C/span\u003E Thank you, Mr Chair. Thank you. I\u2019ve been trying to get a call on this bill all afternoon. Thank you. I\u2019m speaking to the Pae Ora (Healthy Futures) Bill, Part 2, and I want to focus on Subpart 2, which is \u201CHealth New Zealand\u201D, Minister. Some of the activities that are listed in the bill about the functions of Health New Zealand are seen to omit the focus that some of the Health New Zealand responsibilities and, in particular, the ownership of district health board (DHB) practices\u2014and I\u2019m not sure if the Minister is aware, but at last count, and I do stand to be corrected, 10 of the 12 clinics and practices on the West Coast were actually DHB-owned. So I wonder if the Minister could explain: what is the future for these practices and, then, how is the current relationship with the primary health organisation (PHO) going to work in terms of the funding arrangements? Because, as you will be aware, the funding comes via the Ministry of Health through contracts with the DHB and is, then, on-funded through capitation and contracts and programmes into the practices, and also undertaken by the PHO. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000462\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00224d83c8a5-2f48-4991-9c45-b1a6060daedd\u0022\u003ESo there are some things that the PHOs are doing now with their GP practices, and some of those are becoming quite challenging. As we know, the workforce issues which have been spoken about today is a big part of that. So, in terms of the Minister\u2019s responsibility that it talks about in here as part of Subpart 1 is around developing those strategies, and we learn today that there is going to be a rural health strategy. Can the Minister tell us and the communities how long it will take to develop that strategy and, then, after that, how long it will take to implement that strategy and, inside of that, what will the measures be for success and how long will the Minister anticipate it will take to recognise the success in that particular strategy, and will the Government agree, if that rural health strategy does not measure and deliver success, to unwind this legislation?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000463\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00224d83c8a5-2f48-4991-9c45-b1a6060daedd\u0022\u003EAnd one of the things that I am concerned about with the DHB-owned practices is the workforce, but also some of the other contracts that are funded to deliver services into the very outreach areas. And one of the issues that was raised with me was midwifery services and the struggle that it is for midwives to service areas for the likes of Haast. So a midwife may have to travel 3\u00BD hours to visit one woman and 3\u00BD hours to come back. So, basically, that\u2019s a whole day, and the payment for that is recognised at the end of that service when the delivery happens\u2014literally. So will the rural health strategy actually recognise the time constraints involved with delivering services in rural areas and compensate those practitioners adequately for the service that they provide in those areas?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000464\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00224d83c8a5-2f48-4991-9c45-b1a6060daedd\u0022\u003EWhen I was discussing this with some colleagues, I thought, \u201CWell, the best thing for me to do is to actually contact my PHO and ask them how the new structure is going to impact on them come 1 July when the changeover is likely to happen.\u201D And to my surprise, the manager told me that she had absolutely no idea\u2014no idea what was going to happen to her team and to all of the service providers. And I thought that was quite telling in terms of the contact that obviously has happened\u2014or lack of contact that has happened\u2014with those front-line workers. Now, she was quietly confident, because they are the only act in town\u2014they have the workforce teams\u2014but actually they didn\u2019t know what their role was going to look like when this new system was put into place. And I just think, Minister, perhaps there needs to be a bit more liaison with the people on the coalface as this is rolled out. Thank you.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u0022c7826b7b5e334c7eabe639882e392160\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000465\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c7826b7b5e334c7eabe639882e392160\u0022\u003EDr SHANE RETI (National):\u003C/span\u003E Thank you, Mr Chair. I want to pick up on a previous point. Rawiri and myself will stand on different sides of the M\u0101ori Health Authority, that\u2019s quite clear. But in conversations, we\u2019ve both expressed concerns about whether the M\u0101ori Health Authority is being set up to fail. And the discussions tonight around Schedule 3, the \u201CIwi-M\u0101ori partnership boards\u201D, are something that needs some explanation back to those entities\u2014initially as iwi M\u0101ori relationships, actually. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000466\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EWhat happened was they came into select committee named and written in the schedule. I was called by a number of them as the select committee process was finishing, and they were actually proud to be named in the legislation. They said, \u201CShane, we\u2019re named. We\u2019ve got real pride here. Our name appears in the legislation in the House. Tell us what happens as we come out of select committee.\u201D Within 24 hours of coming out of select committee I\u2019d been contacted by the chair of one of the iwi-M\u0101ori partnership boards saying, \u201CShane, are we still there? Are we still in the legislation?\u201D And my answer to him was, \u201CNo you\u2019re not. You\u2019ve got a red line through you, actually. You\u2019ve been deleted. Or in fact, if you look at the text, you\u2019ve been \u2018vacated\u2019 \u201D. And they were hugely disappointed. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000467\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EWhat do I say to them? They now have to apply. They\u2019ve been vacated. What do I say to them? How else could they draw the conclusion that they also had been thrown under the bus, that they don\u2019t exist in a form that either they\u2019d been promised or that they hoped to be, that they\u2019ve just been nonchalantly deleted and, as I say, what the text describes as \u201Cvacated\u201D and they now need to apply. So I\u2019d like the Minister to help me with an explanation so that I can explain to them what\u2019s happened. Thank you, Mr Chair.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00225ca2eb3abded4a18a825a423bad680ce\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000468\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00225ca2eb3abded4a18a825a423bad680ce\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Mr Chairman. And I\u2019ll just grab my notes. I just want to thank Maureen Pugh and Shane Reti for their latest contributions.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000469\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EMaureen Pugh has, first of all, asked about the functions of Health New Zealand\u2014and I think they\u2019re pretty clearly set out in clause 14 of the bill\u2014and referred to the West Coast, the clinics that are owned by the district health board (DHB). That is correct. That was in order to ensure there were good primary care services. The DHB, frankly, had to step in where other primary care providers, particularly GPs in private practice, were not prepared to go. And they\u2019ve developed what, in my observation, is an excellent model, where they can train aspiring GPs in the hospital and put them out into their practices, and they can move them around as needs must. So I think\u2014and I see Ms Pugh nodding\u2014she should be very happy. I think there\u2019s a great set of services there. Not to say they\u2019re not under pressure, because, I think, like everywhere, they are.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000470\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI think the question Maureen Pugh raises about primary health organisations (PHOs) is\u2014I mean, it\u2019s interesting; I\u2019ve done a number of meetings, roadshows, and PHO representatives have been there, so I\u2019m not quite sure what\u2019s happened to the PHO on the West Coast. But here\u2019s the thing: PHOs are not recognised in current legislation. They were a beast that kind of evolved under the current legislation, under the DHB model. They offered themselves as the ability to support multiple GP practices and to help them in back-office functions, provide a bit of coordination, and all the rest of it. Some PHOs have done an excellent job. There are some that have done a pretty darn hopeless job, to be honest, and really are in the business of ticket-clipping.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000471\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWe haven\u2019t recognised PHOs in this legislation. What happens with them in the system is really entirely up to them. No one is abolishing them, but, actually, we\u2019re not giving them statutory recognition, because they haven\u2019t had it before. But it\u2019ll be up to them. Now, some PHOs, I think, will step up and be able to do what is required of them. I know for a fact that there are PHOs saying, \u201CWe would like to be the locality planning coordinator for our area.\u201D, and they are the PHOs who\u2019ve got good leadership, they\u2019ve got good data, and they\u2019re well connected not just with the practices that they\u2019re responsible for in channelling the funding to but connected with other health services as well. And that\u2019s what we want. Ultimately, what we want is health providers in communities being supported and connected with each other and offering services that are coordinated and joined up.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000472\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo I guess I would say to Ms Pugh, it\u2019s really in the hands of PHOs what they are prepared to do. There are opportunities there for them, but if they\u2019re not prepared to step up and be part of the local locality planning process then they may find there is no role for them. Our critical objective is to get support, particularly for primary care. We want to beef-up primary care because it\u2019s being underdone at the moment. Yep, we\u2019ve got some major workforce challenges, but we\u2019ve got to create a primary care working environment that is attractive to more medical graduates to work in primary care and to be GPs. So that\u2019s what we want it to do.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000473\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Shane Reti and his concern about iwi-M\u0101ori partnership boards: let\u2019s be clear, iwi-M\u0101ori partnership boards are not recognised statutorily at the moment, and they weren\u2019t previously. They weren\u2019t in the 2001 legislation, which is the current legislation, and even though they\u2019ve been around for a while, the previous Government\u2014and nor this Government; well, we weren\u2019t because we were looking at reforming the sector anyway. But, certainly, the previous Government took no steps to give them statutory recognition. We have, because we think iwi-M\u0101ori partnership boards are a vital component to what we want to do in terms of enriching the M\u0101ori voice when it comes to health decision-making. But we need to leave it to M\u0101ori, iwi and urban, to come together and make their judgment about how best they think that can work. That\u2019s how the Treaty partnership works. We don\u2019t have the Crown telling them, \u201CRight, we\u2019ll have one here and we\u2019ll have one there, and it\u2019ll be you and it\u2019ll be you.\u201D Actually, we need to empower iwi M\u0101ori and urban M\u0101ori to make those decisions themselves, as, in fact, they have done up to now without the benefit of any statutory recognition.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000474\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EHowever, because they are an integral part of the future of the system and will be supported by the M\u0101ori Health Authority, and because we\u2019ve appropriated money to support them and give them a bit of capacity, it is appropriate that we do accord them their existence in a schedule. But once we know who they are, who they cover, what they do\u2014in terms of which areas they cover, which they will determine\u2014then they will appear in the schedule and they will be given the recognition that they seek.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022 data-id=\u0022945e68b2bc3a4a6185fcb1e8bdf9af22\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000475\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022945e68b2bc3a4a6185fcb1e8bdf9af22\u0022\u003ESIMON WATTS (National\u2014North Shore):\u003C/span\u003E Thank you very much, Mr Chair. Stiff competition over on this side. I do appreciate the opportunity for a short call. Thank you, Minister, for the contributions to some of the questions. I want to come back to Supplementary Order Paper 157 in the name of Dr Shane Reti, in regards to the insertion in clauses 4, 10, 29, and new clause 40B around the older people\u2019s health strategy. Dr Reti referenced it in his point, and it\u2019s something that I\u2019m reasonably familiar with, around the long-term fiscal plan that Treasury has completed, which they do every four years in regards to looking forward 40 years for New Zealand. As Dr Reti articulated, the two key components that were highlighted significantly in that report was, one, in regards to climate change, but the other was in regards to our ageing population. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000476\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe statistic that Treasury quotes is that in New Zealand, like many other countries, we\u2019re seeing a major shift in terms of the age of our population and by 2070, I think they reference, 25 percent or one in four Kiwis will be over the age of 65. So the absence of a specific focus around older people\u2019s health is going to be a significant area of growth and importance, as the years progress. And, no doubt, the intent of this legislation is to be sustainable in terms of the future, but one of the key aspects it looks like it is missing\u2014and I\u2019m keen for the Minister\u2019s perspective on that\u2014is how much thinking was put into play between the Ministry of Health and Treasury in regards to this? Because I must say, on looking, it looks like it\u2019s potentially\u2014some would say it could have been done in silos, in terms of the context around that. Because, on one side, the Government is saying this is a major area; on the other side, it\u2019s not a priority. So I\u2019d like a little bit of context in terms of the work that\u2019s gone on between those two agencies in particular, around that specific point that relates to Dr Shane Reti\u2019s Supplementary Order Paper.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000477\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe other aspect, as the Minister will know\u2014and the questions I\u2019ve asked him in the House in oral questions in the past, last year particularly, in mid last year around the health workforce related to the aged-care sector, which this Supplementary Order Paper refers to\u2014is the significant workforce crisis that we have in that space. I guess, the question, really, there was: if this new health entity structure is genuinely going to work to try and address some of those workforce gaps, why have we not seen any change, really, in terms of that dynamic? Probably some, in fairness would say, actually a worsening of that situation and also, in the recent Budget that was out 12 days ago, very little funding in regards to staff retention. As the Minister will be aware, our health workforce is like a leaking sieve, and that will only be exacerbated by our borders reopening and people going overseas because of the higher salaries and\u2014actually, not just salaries\u2014the working conditions as well, which is an issue for those who are based here and do a great job within our health system in New Zealand. So a little bit of context around why retention of existing staff hasn\u2019t been prioritised, as and where it relates to, particularly, the aged-care sector. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000478\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe third question is in the context of the significant scale of change that is currently under way within the healthcare system. And I think no one would argue; there\u2019s a quote \u201Cnever a right time to blow up the health system\u201D. You probably wouldn\u2019t choose to do it at the same time as a pandemic, but that\u2019s necessarily where we are here. What aspect, in terms of the aged-care sector in particular, because it\u2019s a mixture of private and public funding\u2014what confidence can Kiwis have out there, particularly those elderly that are within care homes that are currently dealing with the impact of lower quality of care because of lack of staffing, and probably leading to adverse events in terms of clinical outcomes and the health outcomes? What confidence can they have that they\u2019re actually going to see any change in terms of their position in the next two to three years\u2014I\u2019ll be generous\u2014as a result of this structural change that is being proposed and the fact that, as number 157 states, there isn\u2019t a specific health strategy for older people? Thank you, Minister.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022 data-id=\u0022450d3c63932f415d877e6f9d10dd99d0\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000479\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022450d3c63932f415d877e6f9d10dd99d0\u0022\u003EHon MICHAEL WOODHOUSE (National):\u003C/span\u003E Thank you, Mr Chair. I want to move to clause 16 of Part 2 and, in particular, the requirement to operate in a fiscally responsible manner, and it goes on to say, for this purpose, \u201Cendeavours to cover all its annual costs (including the cost of capital) from its net annual income\u201D. There\u2019s a similar clause at clause 24 for the M\u0101ori Health Authority.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000480\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003ENow, I\u2019m advised by Pae Ora Legislation Committee members that very little cognisance was paid in the deliberation to the financial management of the sector. What we have at the moment is 20 district health boards (DHBs) and a plethora of other organisations all required to furnish financial accounts to this House, and most of them have made thumping-great losses. It\u2019s a peculiar feature of the health system, where that seems to be tolerated to a far greater level than, for example, other public sector agencies\u2014if the fire service or the New Zealand Police said, \u201CLook, we know we only got $1.5 billion this year, but we knew, you know, to run an effective service, it was going to cost $1.8 billion, so here\u2019s a bill for $300 million, Government.\u201D But Governments of both colours have had this problem, albeit that the combined financial deficits of DHBs when we left office was $90 million. We\u2019ve got individual DHBs with greater deficits than that now. Budget 2022, I do acknowledge, had a thumping-great envelope of money to clear those deficits and to prevent, to the degree possible, that happening in the future.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000481\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EBut my questions are, really, around the financial management at a hospital level, in particular the capital. So what responsibility for fiscal prudence and working within one\u2019s means are the individual hospitals going to have, and what level of autonomy for things like capital maintenance, upgrade, replacement\u2014you know, if an MRI needs replacement, is that decision going to be made in Dunedin or Wellington? \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000482\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EIt seems a very, very murky picture of an extraordinarily large organisation now, with a massive network of service-delivery places, and I\u2019m advised by the select committee that there was very little reference to how this is all going to be managed. Now, I think all of us agree with the endeavour\u2014in fact, I think the idea that it should be an endeavour rather than an absolute requirement speaks to the reality that health is a bit different. But I do want to get some sort of picture of what we are going into in the next year about prudent fiscal management.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000483\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EWe\u2019ve got a pile of people right across the DHB network right now whose sole job is the management of accounts, accounting functions, asset registers, building maintenance\u2014where are they all going to go? Are they going to be needed in the future? Ultimately who is responsible, Wellington or Christchurch or the individual organisations, for actually making sure money is not spent excessively? But if demand exceeds the financial allocations that are granted to individual hospitals, if there are at all, who decides whether or not that money should be spent and how quickly will those decisions be made?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000484\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EI think the committee of the whole House deserves a bit more sort of insight into actually how this thing is going to run, because I feel like we\u2019re building the plane as we\u2019re flying it and that this particular weakness in our health system, where they can\u2019t seem to work towards a break-even position, needs to be fixed, but I can\u2019t see how. In fact, there is a risk that it could get worse, not better. So I\u2019d be interested in the Minister\u2019s insights and expectations for how that will run, particularly on asset management, because that\u2019s a very rapidly changing picture in a sector that is driven by technology\u2014medicine technology, high-tech radiology, a plethora of surgical technologies. Who\u2019s going to decide when it\u2019s the right time to upgrade or invest in new technology and how quickly will that happen?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00224a25943b-cb3b-49c3-bd10-74316fae17f1\u0022 data-id=\u0022ae0047c308aa4168be5928c50ad8c766\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000485\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00224a25943b-cb3b-49c3-bd10-74316fae17f1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022ae0047c308aa4168be5928c50ad8c766\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: I call the Hon Michael\u2014Andrew Little; don\u2019t know who I was calling then!\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022f57eeaeeaf0a442a9b7cd40d4c0d3878\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000486\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f57eeaeeaf0a442a9b7cd40d4c0d3878\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E We often get mistaken, Michael Woodhouse and I. Thank you, Mr Chairman. Thank you, Mr Watts and Mr Woodhouse, for their queries. Simon Watts raised three questions, I\u2019ll see if I can dispose of those quickly. Mr Watts is right about\u2014we all foresee the shifting age-profile of our population and therefore that is going to have an impact on health services. Part of what has driven the whole reform process is the need for sustainability, knowing that in our current shape we\u2019d be struggling with sustainability.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000487\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EAs we look at 20 to 30 years out with an ageing population, the way we deliver services is going to have to change. We will end up delivering more services in the home\u2014that\u2019s not a bad thing; there\u2019s a lot of people who want to stay in their home. We know for M\u0101ori and Pacific populations, actually, they prefer to be in their home and be around family and wh\u0101nau. We\u2019ve just got to make sure that the health services and support that allow that to happen are there. And so that, I expect, will have to be part of the planning that goes on.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000488\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EBut I can assure the member that\u2014in terms of Government, whether it\u2019s the Ministry of Health, Treasury, and others whose job it is to look out\u2014thinking about what we need to be doing in 20, 30 years\u2019 time is very much driving what we\u2019re doing. It\u2019s helping drive the structure and helping drive our thinking about what future financing looks like\u2014because the problem\u2019s not going to go away.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000489\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EIn terms of health workforce, again, the member and others in the debate so far in this committee stage have raised the challenge that we have with workforce that are being compounded by a number of issues. In terms of retention, one critical factor is remuneration. We\u2019ve seen the significant shift in remuneration for nurses. We\u2019ve got admin clerical workers who now have agreed on and, in fact, have ratified, their pay equity deal\u2014so that will be implemented. We have allied health workforce about to vote on a routine collective agreement renewal but with commitments about pay equity, and we\u2019re in the process of setting that up.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000490\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThose things will help with retention. But I think the other point the member makes, too, is it\u2019s not just pay, it\u2019s conditions as well, it\u2019s the environment in which you work, it\u2019s making sure that you\u2019re working in a health service that is fully staffed\u2014or as close as possible to it. So filling the existing gaps and future gaps remains that challenge, and that\u2019s why the workforce planning and development element of this\u2014and I\u2019m very pleased that the Pae Ora Legislation Committee added in those as statutory requirements for Health New Zealand and the M\u0101ori Health Authority to be planning for and be across; it\u2019s very important. So I think the bill covers those needs off.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000491\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe third point that Mr Watts raised was just about aged care. I\u2019m confident that we will see a change. There are some short-term challenges, again, around staffing. I think the big challenge that aged care has is the growing differential between the health workers\u2014nurses, health care assistants\u2014who work in the public system versus those who work in aged residential care in the private system. I have made the commitment and we stand by it\u2014we know we have a job to do in terms of pay parity and we\u2019re working on a plan to make sure that that happens. That\u2019s not something that can be dragged out for ever and a day, but there is a commitment to see that through.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000492\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Mr Woodhouse\u2019s questions about meeting the obligation under clause 16 to be effectively fiscally responsible. Look, the challenges that Mr Woodhouse raises are there today. In terms of capital spending, that is heavily centralised anyway. Capital spend is the responsibility of a combination of the ministry and its capital investment committee. The ministry has their health infrastructure unit as well, and the data and digital section of the ministry is responsible for the big IT system investments and what have you. So across the 20 district health boards, and across the multiple hospital campuses we\u2019ve got, there is a prioritisation given; there\u2019s something of a national asset management plan\u2014even if not fully developed\u2014being developed. That sort of device will continue because it will need continue with Health New Zealand.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000493\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI think the benefit of Health New Zealand\u2014it can actually start to streamline some of these processes. It will still rely on those with front-end knowledge at each hospital campus. So many of those staff who are there processing payments and dealing with both capital spending and operational spending decisions\u2014they will still be needed and they will feed into the Health New Zealand financial operations system that will be in place to make sure that there is good reporting, good information, and that both the board and the senior management of Health New Zealand are getting the information to make those decisions.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000494\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EIn the end, there is one entity. We will hold that entity to account for effective financial management. And it will leave Health New Zealand to internally manage the various cost centres that it will have. I\u2019d be surprised if it discontinues cost centres around each hospital\u2014it\u2019s essentially the way to set it up. But, in the end, that will be for Health New Zealand. And whatever Health New Zealand does in that respect, they will be judged on the quality of the services given which will reflect the decisions made and the ability for relevant managers, at all levels, to make those decisions with confidence.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000495\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo, again, I\u2019m confident. When I look at the team that is assembling within Health New Zealand\u2014and, for that matter, the M\u0101ori Health Authority\u2014I\u2019m confident that they will be completely across that. But we must have this discipline around financial management that we\u2019ve struggled to get up to now. We have that now written into the legislation. I think that will help enormously.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022 data-id=\u00229bbcc6598c134afebe4abc6b49641b0f\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000496\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00229bbcc6598c134afebe4abc6b49641b0f\u0022\u003EHon MICHAEL WOODHOUSE (National):\u003C/span\u003E Thank you, Mr Chair. I do appreciate Minister Little\u2019s reply; it was helpful. I would make one observation and ask a question. Firstly, he was absolutely right: the Capital Investment Committee and the health infrastructure board are there, but they\u2019re there for the really big stuff. It\u2019s there for the rebuild of Dunedin Hospital, Whang\u0101rei Hospital, probably Hutt soon, and other major capital expenditure. It\u2019s not really there for the lower-level asset management that goes on in each district health board (DHB) every week. I think there\u2019s probably a task to understand the level of delegation of a lower level of asset management and replacement. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000497\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EThat kind of segues into the question that I have on this, which was: the Minister referred to cost centres. Now, in accounting parlance, there\u2019s a difference between a cost centre and a profit centre, and I just want to know whether the\u2014we\u2019ll call them the localities, using the new nomenclature. Will those localities actually be\u2014I don\u2019t want to call them \u201Cprofit centres\u201D, because profit\u2019s the wrong word, but will they be allocated funding within which they need to stay, and so will they have the responsibility for managing within, effectively, an appropriation, if you like, from Health New Zealand to a locality, whether it\u2019s a former DHB or something else? And what would happen, and how quickly will there be an intervention, if one of those localities then fails in its endeavour under clause 16 to live within its means?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00220855e8f1cd354aeeb81c414ada603e14\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000498\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00220855e8f1cd354aeeb81c414ada603e14\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E I think it\u2019s appropriate to just dispose of that question now. I, again, thank the member for it. I think the member\u2019s right. I mean, one thing we don\u2019t want Parliament to do is to start setting up the financial management regime for Health New Zealand. But I think he can be assured that there will be appropriate delegations throughout the health system, the Health New Zealand organisation, and there will be a level of capital expenditure that will be left to local management. It will be whatever the name is given to whoever heads up an individual hospital.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000499\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EAnd, indeed, what I would expect to see\u2014which, I think, again, when I look at some district health boards (DHBs), they have struggled with this\u2014is managers at different levels having appropriate delegations. And I am aware of one reasonably large DHB where reasonably senior managers, responsible for reasonably significant operations, had no budget delegations given to them. They just spent as they thought was appropriate to do their job, without any budget within which to operate. So it\u2019s that kind of discipline, if it hasn\u2019t been there before, we need to get quickly back into those organisations.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000500\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EIn terms of costings, I can say to the member that the localities won\u2019t be a cost centre. The locality planning process will be kind of coordinated at the regional level within Health NZ, and is really a basis on which to evaluate health need and informs the basis of the, for want of a better phrase, funding to third parties. So funding to your primary care or your primary health organisations, if they\u2019re there, or your aged residential care, or all those others who get public funding to provide particular services. The locality planning process is kind of an information-gathering and a planning process for which the regional division of Health NZ will then follow with funding and commissioning decisions. Obviously, the way Health NZ will operate is to make sure that the funding of services across New Zealand has a consistency in terms of formula but is about addressing need. And so they will have to kind of weigh that balance out.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000501\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo to the extent the member thought there was cost centres around localities, there won\u2019t be. The locality planning process is a planning process from which funding decisions will subsequently be made.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u002240703246f8b74a2e834b3fea7051ce7c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000502\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002240703246f8b74a2e834b3fea7051ce7c\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Mr Chair. I was just hoping that the Minister might be able to provide a little bit of clarity on the structure of the healthcare system as it pertains to Health New Zealand.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000503\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EWhen I\u2019m looking through Subpart 2 and it talks about the establishment of Health New Zealand, the objectives, the functions, how it all works with the Iwi M\u0101ori Partnership Boards and the M\u0101ori Health Authority, there\u2019s an element that I\u2019m not sure is missing or is just intentionally not part of the legislation. And that is, when you go on to the Future of health website, it talks about there being four new regional divisions within Health New Zealand, and I wondered whether these four divisions within Health New Zealand that are regional should be prescribed in the legislation and if there is a reason why they\u2019re not prescribed in the legislation at all.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000504\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EHas there been a decision made that these four regional divisions no longer exist or do they still fit within the M\u0101ori Health Authority and Health New Zealand, then the regional divisions, and then the localities? And if they do exist as four regional divisions, where are they and who is in charge of them? How do they fit within Health New Zealand?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022 data-id=\u002278aaa08d5c404d90ac658e675c372c92\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000505\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002278aaa08d5c404d90ac658e675c372c92\u0022\u003EPENNY SIMMONDS (National\u2014Invercargill):\u003C/span\u003E Thank you very much, Mr Chair. I would like to return to Supplementary Order Paper 157, which is perhaps a subject dear to your and my hearts, the older persons\u2019 health strategy\u2014no offence intended, of course\u2014and, Mr Chair, this is a matter that I spoke on earlier today. So my questions to the Minister are around this. Given the crisis that we are seeing in our aged-care sector at the moment, surely a reform process such as this and the Pae Ora (Healthy Futures) Bill would want to have included in it a provision that would prevent the sort of dislocation between the aged-care sector and the district health board (DHB) delivery as it is at the moment. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000506\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003EAt the moment we are seeing a very, very big sector\u201436,000 beds in the aged-care sector\u2014that is at crisis point because of something that has happened in the DHB sector. So we all agree that the hard-working nurses deserved their pay increase, but what it has done is create this differential of around $15,000 per annum between a registered nurse in the aged-care sector and a registered nurse in the DHB sector. With the pay equity increases that have now been settled and will come into play, that differential will almost double, and so we have got an aged-care sector in crisis because of what has occurred in the DHB sector. Surely, a bill that is looking at healthy futures would want to hold a strategy for older people that would prevent this ever happening again.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000507\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003ENow, I understand that an older people\u2019s health strategy would be much broader than the aged-care sector, but given the situation that we are currently in, where 700 beds in the aged-care sector have closed in the last few months and the sector is forecasting that it may increase to around 5 percent of the beds in the aged-care sector closing, the impact on the DHBs, on the hospitals, will be enormous if that occurs. That could be up to 1,800 beds closing in the aged-care sector and those residents being placed into hospital care, and the associated issues that would occur with that: the operations that would be cancelled and the procedures that would be delayed because of that sort of bed blocking that could occur. So, surely, a bill that is looking at healthy futures would want to have provision in there to ensure that this dislocation never occurred again and this sort of crisis in the aged-care sector never occurred again.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000508\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003ESo I would like an explanation from the Minister, if there isn\u2019t an older people\u2019s healthcare strategy as has been put forward by this Supplementary Order Paper from Dr Shane Reti, as to how it will be managed that we don\u2019t get something like this occurring again in the future. I appreciate that the Minister says he\u2019s aware of the situation and he has made a commitment to pay parity with the nurses, but those of us that recently had a Zoom meeting with aged-care providers saw the absolutely raw emotion and concern on the faces of those providers. They can\u2019t wait weeks or months or years for a Government to go about their possibility of creating relief to this pay equity solution. They are in crisis here and now. They are closing beds, and the welfare of our elderly citizens is being put at risk from this. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000509\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d2995873-613f-4202-a773-5ea2d57cc953\u0022\u003ESo I\u2019d like the Minister to give some assurances to us that somehow this bill, this reformation, will not allow something like this to happen again, and what mechanisms will prevent that? Thank you, Mr Chair. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022a89fcc3836c44d2eb069078ad2aa0e7a\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000510\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022a89fcc3836c44d2eb069078ad2aa0e7a\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Mr Chairman. I thank the members for their contribution. To Brooke van Velden, who asks about the structure of Health New Zealand in reference to the regions: the interim Health New Zealand, as it is currently established as a ministerial committee, has made it clear that it does intend to operate with a regional level. It has talked about coordinating networks of hospitals in particular regions. That\u2019s one level at which it will operate. Each of those regions will have at least one tertiary hospital as well as the others in it. So they will operate at that regional level and I think they also expect that certainly, when it comes to primary care, those commissioning decisions will be made at a regional level, and that will make sense for the locality planning authority also to be coordinated at that kind of regional level. In the end, you would expect an organisation, a single organisation, must be able to determine its structure and its organisation, and it will do that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000511\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Penny Simmonds, with all due respect, I think what Penny Simmonds is asking for is to legislate for perfection into the future, and of course that\u2019s not going to happen. I think what I would say by way of reassurance is that we are in a transition. I would hate to think that Ms Simmonds and her party are arguing for us to slash the wages and incomes of nurses in the district health board (DHB) sector to avoid the problem that the aged residential care are talking about. There\u2019s always been a differential between nurses in the DHB sector and nurses in the funded sector: aged residential care and primary care. That differential has got a little bigger because we are desperately trying to catch up and make sure nurses in the DHB sector are properly paid, because their pay went backwards in real terms under the previous Government, and we\u2019ve negotiated a pay equity deal and eventually that will come to fruition as well as we\u2019ve been negotiating other pay equity agreements. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000512\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWe\u2019ve made the commitment to then work with the funded sector to bring their rates up to speed as well. There needs to be a process for that, and there is. They need to collaborate in that as well. I think what\u2019s important is that everybody, all players in the sector, focus on what is needed, focus on what the goal is, and that is to ensure that we, to the best extent, can avoid any undue disruption and any undue fracture of the labour market in that particular sector. That\u2019s important. That\u2019s what we\u2019re committed to. That\u2019s why officials and others have been engaging with the sector to make sure that that\u2019s what we are able to achieve. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000513\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EBut we know that for the sake of retention and for the future workforce, we have to substantially lift incomes. We do that through the pay equity process. For one thing, we shouldn\u2019t have large chunks of the health workforce paid on rates of pay that are historically discriminatory, and that\u2019s what we are taking the historic step of starting to turn back. We will go through a transition where there will be a little bit of unevenness, but this is about lifting incomes in the health sector for those who for so long have been discriminated against and have been underpaid and undervalued for the work that they do.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002218f9e3ea-81c5-4414-af48-d6bb843a9227\u0022 data-id=\u002244a8c26d63de44f698f5b062545fac54\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000514\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002218f9e3ea-81c5-4414-af48-d6bb843a9227\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002244a8c26d63de44f698f5b062545fac54\u0022\u003EMELISSA LEE (National):\u003C/span\u003E Thank you, Mr Chair. I\u2019d like to ask the Minister a couple of questions in relation to the ethnic communities. As someone who hasn\u2019t actually participated in this debate from the beginning, I was just sitting in my chair listening to the contribution that other members have actually been making and I thought, \u201CWhere are the questions about the ethnic communities?\u201D I know that there are provisions actually made for M\u0101ori and Pasifika communities, but there\u2019s nothing in there about ethnic communities, particularly the Asian communities, because I come from that sector. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000515\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002218f9e3ea-81c5-4414-af48-d6bb843a9227\u0022\u003EIf you look at the Auckland region, for example, the Asian population in Auckland is about 30 percent, and it is actually a very fast-growing population. And for many of them, one of the biggest problems that they have when they\u2019re engaging with the health system, is that, one, they have language issues, and, two, they feel that the New Zealand health system doesn\u2019t actually understand their needs. They have medical professionals\u2014whether it\u2019s doctors or nurses or midwives or whatever\u2014who actually do not understand. They have different terminologies, for example, in Korean. If you have pain in certain areas\u2014I mean, the elderly people talk about the wind or the sourness in their bones and, you know, they say that like that in their own language. And often the translation services are actually not effective enough, I don\u2019t think. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000516\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002218f9e3ea-81c5-4414-af48-d6bb843a9227\u0022\u003EI\u2019m trying to find out if the Minister has put specific provisions for this new entity to provide for the needs of the ethnic communities in New Zealand, and what kind of provision he has actually made, particularly\u2014different ethnic communities have different health needs. They have specific\u2014what would you call it\u2014susceptibility to certain diseases, and I\u2019m wondering what the Minister\u2019s projection is in terms of what the attendance rate will be to these health entities by the ethnic communities, preventing them from going back home to their home countries to get services because they feel that those countries actually provide better healthcare than New Zealand currently does.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022868f3a11-6a23-474f-a25e-6bc1d4c6e93f\u0022 data-id=\u00223340a6c2c75d4c5eb3efeed057b615bc\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000517\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022868f3a11-6a23-474f-a25e-6bc1d4c6e93f\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00223340a6c2c75d4c5eb3efeed057b615bc\u0022\u003EHARETE HIPANGO (National):\u003C/span\u003E Thank you, Mr Chair. Minister Little, this evening I too have sat and listened, and rise to take this call in my spokesperson role for children. When I turn to the title of this bill, Pae Ora (Healthy Futures) Bill, of course my mind and my heart turn to: where\u2019s the children\u2019s interest in this bill? And, interestingly, Minister, this morning on the Social Services and Community Committee there was scrutiny of the oversight of the Oranga Tamariki systems bill, the Oranga Tamariki Amendment Bill. At a cursory glance at the bill, I am concerned that there is no reference to or mention of the future of our country, Aotearoa New Zealand: our children. We have a ministry in Oranga Tamariki. This \u201Cpae ora\u201D bill is about the healthy futures. So, Minister, I invite due consideration, particularly in relation to clause 10, which is the overview of the Minister\u2019s role; particularly Subpart 5 of Part 2, which is under debate this evening, \u201CKey health documents\u201D, from clause 29; and then, particularly, \u201CHealth strategies\u201D, from clause 37 onwards\u2014detecting, denoting, Minister, with the Supplementary Order Paper that was filed under your name this evening, the inclusion of the rural communities and also of women with a women\u2019s health strategy. And then there has been discussion more recently this evening in terms of aged care, our older generation.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000518\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022868f3a11-6a23-474f-a25e-6bc1d4c6e93f\u0022\u003ESo, Minister, in my spokesperson role for children, I am concerned, and particularly note, Minister, you did make mention, in reference of the collaborative approach that has been taken with other Ministers\u2014the Minister for M\u0101ori Development; seated beside you is the Associate Minister of Health (M\u0101ori Health), also the Minister for Wh\u0101nau Ora; and also one is expectant that there may well have been a discussion with your colleague the Minister for Children. They are our future, and it is important that there is a healthy future, and this bill is named that\u2014Pae Ora (Healthy Futures) Bill. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000519\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022868f3a11-6a23-474f-a25e-6bc1d4c6e93f\u0022\u003EMinister, also, may I just allude to the importance of, across the public sector, the strategy that this Government has engaged and implored and required in terms of a child-centric approach to the formulation of policy\u2014Government policy\u2014but also legislation. So I turn to child impact assessments. The Minister for Children has indicated, in terms of child-centric legislation\u2014the oversight of Oranga Tamariki systems bill that is under scrutiny at the moment\u2014the importance to use the child impact assessment tool when developing policy and legislation that impacts children. So, Minister, I am concerned, and I do invite you, in your position of responsibility in the ministry, to turn one\u2019s mind, in the formulation of a new health system, in the formulation of new health legislation, to ensuring that there is an element of child-centric approach to that with a strategy. It\u2019s been particularly identified, the relevance and significance of women\u2019s health; and, again, Minister, I invite and reiterate and emphasise the importance of children\u2019s health.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000520\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022868f3a11-6a23-474f-a25e-6bc1d4c6e93f\u0022\u003EJust concluding my k\u014Drero thus far, I just happened to turn to a whakatauk\u012B which is relevant in terms of the old net being cast aside\u2014which is what\u2019s being done in terms of the design of the health system, primary and secondary healthcare\u2014and the new net being cast. And the k\u014Drero whakatauk\u012B is ka p\u016B te ruha ka hao te rangatahi [And the proverb states the old fishing net is cast aside and the new net goes fishing.]\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000521\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022868f3a11-6a23-474f-a25e-6bc1d4c6e93f\u0022\u003ESo, Minister, I implore the importance of a child-centric approach with a strategy of health to encompass, to embrace, our children, our youth, our tamariki, our rangatahi. Kia ora.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00221a0d3cea5fba496382b8912b0a195fdb\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000522\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221a0d3cea5fba496382b8912b0a195fdb\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Mr Chair, and I thank members Melissa Lee and Harete Hipango for their contributions, and, hopefully, I can respond as quickly as I possibly can.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000523\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Melissa Lee\u2019s concerns about provisions for ethnic communities, I refer the member to a number of provisions in the bill. Clause 14(1)(h) provides for\u2014it says, \u201C(1) The functions of Health New Zealand are to\u2014 \u2026 (h) improve service delivery and outcomes for all people at all levels within the publicly funded health sector;\u201D. And I refer also to clause 7 of the bill, which sets out the health sector principles, and one of those principles, under clause 7(1)(d), is that \u201Cthe health sector should provide choice of quality services to M\u0101ori and other population groups, including by\u2014 \u2026 (ii) providing services that are culturally safe and culturally responsive to people\u2019s needs; and (iia) developing and maintaining a health workforce that is representative of the community it serves;\u201D. So I think there\u2019s a statutory requirement, as Health NZ and the M\u0101ori Health Authority, to develop health services to make sure that both the health services are culturally appropriate and safe and that we have a workforce that meets those particular population needs.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000524\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI might also add that the Government policy statement is about ensuring that the health services provided for and the Government policy statement itself meet the objectives of the Act, which of course, is set out in clause 3 of the legislation. Clause 3, in terms of the purpose of the Act, expressly states: \u201CThe purpose of the Act is to provide for the public funding and provision of services in order to\u2014(a) protect, promote, and improve the health of all New Zealanders;\u201D. So everybody is catered for in that respect. I\u2019m not aware of any Supplementary Order Paper that is calling for a specific ethnic community\u2019s strategy or a strategy for any particular ethnic community.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000525\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWhen I look in practise, I look at, for example, the Waitemat\u0101 District Health Board (DHB), who at the moment have an Asian directorate, effectively, and a specific focus on meeting the needs of their Asian population. One of the challenges we\u2019ve had with the system as it currently is configured is that good innovations like that are very, very difficult to migrate across the system as a whole. So, certainly, my expectation is that I want, when Health NZ and the M\u0101ori Health Authority are properly set up, that they have an opportunity to pluck the really good stuff out of each form of DHB and actually make that a practice across the organisation as a whole where there are concentrations of ethnic communities\u2014to replicate what the Waitemat\u0101 District Health Board has done in relation to their Asian people strategy.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000526\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Harete Hipango, about children, I acknowledge the comments she has made. I think there\u2019s a range of legislation that places an obligation on the State, where it is engaging with children in a whole variety of different contexts, to put children first, and so there\u2019s no question about that. And when it comes to health services, again, for the reasons I\u2019ve pointed out in relation to Melissa Lee\u2019s comments, there will be an obligation on Health NZ and the M\u0101ori Health Authority in the delivery of services to make sure that they are safe and appropriate and relevant to the patient population that they are delivering their services to. So I\u2019m confident that the needs of children will be well catered for. I think that, when it comes to the planning processes, the Government policy statement, the New Zealand health plan, and the various strategies that come out of the Government policy statement, the needs of children will be well catered for.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002218f9e3ea-81c5-4414-af48-d6bb843a9227\u0022 data-id=\u0022c2bb32b5301744958950176e1a54ff6d\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000527\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002218f9e3ea-81c5-4414-af48-d6bb843a9227\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c2bb32b5301744958950176e1a54ff6d\u0022\u003EMELISSA LEE (National):\u003C/span\u003E Thank you, and my apologies to my colleague behind me, Simon Watts. As somebody who doesn\u2019t, actually, normally sit on the Pae Ora Legislation Committee or speak on this and is actually getting some attention, I\u2019m sure your turn will come, Mr Simon Watts. Very quick question to the Minister in response to the answer he\u2019s actually given me. I\u2019ll try and make it very succinct and short. When the Minister actually says that the commitment is actually there to make sure that the new entity will provide for all communities, that doesn\u2019t actually tell me that there has been work done by your officials or yourself to actually project and be ready when this entity is actually launched and that the services will be available for those communities. I\u2019m trying to find out if, in fact, there was work done to project to the future as soon as the new entity is actually ready: what kind of services will there be, what percentage of the population may potentially use it, and what kind of language services are required for those services? To tell me that there are current, new, and good examples in the Waitemata District Health Board and that you can\u2019t necessarily transplant it into a new one. Yes, I probably agree with him, but the thing is that that doesn\u2019t actually mean that there\u2019s been some thought put into a population that is really, really massively growing and growing really, really fast, and I\u2019m concerned that their needs\u2014the ethnic communities\u2019 needs\u2014are not going to be met by this new entity.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00221ebd1031-ea10-4c3d-bb56-2cd99528ae91\u0022 data-id=\u00220e0fd6f818224720a994c0fd419ab4e3\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000528\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00221ebd1031-ea10-4c3d-bb56-2cd99528ae91\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00220e0fd6f818224720a994c0fd419ab4e3\u0022\u003EWILLOW-JEAN PRIME (Assistant Whip\u2014Labour):\u003C/span\u003E I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022 data-id=\u0022f3e5ff326d214f30bcfde06da53e782b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000529\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f3e5ff326d214f30bcfde06da53e782b\u0022\u003ESIMON WATTS (National\u2014North Shore):\u003C/span\u003E Thank you very much, Mr Chair. I\u2019m just wanting to ask three questions in regards to Part 2, clause 16(1)(c), which relates to financials in regards to the DHB, and then come on to clause 16(1)(d)(i), which is around capacity and capability.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000530\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EFirstly, in regards to the fiscal aspect, my question for the Minister is in regards to how the centralisation and the forming of Health New Zealand is going to create a significantly bigger entity than the individual district health boards (DHBs) themselves. The challenge, potentially\u2014I\u2019m interested in his perspective around that\u2014is: how will the threshold for materiality change in regards to that entity? Why I ask that is that, and it\u2019s getting into a little bit of detail, is that one of the significant drivers of DHB deficits has been holiday pay. The other element there around holiday pay is the other contingent liabilities that relate, and the fact that, actually, there is an element of that holiday pay that hasn\u2019t been necessarily quantified and the role in which the Ministry of Business, Innovation and Employment play in order to, in effect, provide opinions and decisions to DHBs around the quantum or how they should respond to an issue around a contingent liability, such as holiday pay, and, therefore, the burden of that liability falls on the DHBs. In the current model, because the 20 DHBs look at that in terms of their scale, which is smaller, they pay a lot of attention to it. But the challenge and the concern I\u2019ve got around a large centralised entity is that those numbers will become, while significant, less material in the context of a single organisation.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000531\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003ETherefore, how do we ensure, in terms of clause 16(1)(c) around financial sustainability, that aspects around contingent liability won\u2019t actually get lost? Don\u2019t forget that those are the liabilities that aren\u2019t actually expensed, they\u2019re not ones that are included within the deficit; they sit outside of that, but sometimes they can be a ticking time bomb in terms of the fiscal impact that will either be inherited by a future Government or a Government will need to make some decisions around how they treat for that. So that\u2019s the first part.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000532\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe second part is around the point that was raised before around novation of assets, and I think my colleague Michael Woodhouse referenced this. I\u2019ll give you an example, it\u2019s the Auckland Regional Dental Service\u2014ARDS\u2014which provides dental services to school-based children in Auckland. It is a combination of three DHBs: Auckland DHB, Counties Manukau DHB, and Waitemat\u0101 DHB. The ownership of those assets that provide those services is a mixed model, some of which are owned by different DHBs; some of it is land leased from different schools in Auckland. There is a very complex arrangement of asset ownership. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000533\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EMy question for the Minister is in regards to the transition costs of novation of those assets to the single-entity model and the time it takes to actually unwind that, and, actually, the reality that, in most cases, the outcomes don\u2019t necessarily change but there\u2019s a cost burden to transition. How has that been considered in regards to, again, the financial sustainability around clause 16(1)(c)?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000534\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe last element is in regards to clause 16(1)(d)(i), which states that the health entity will need to have \u201Cthe capacity and capability\u201D to deliver it. We had a question before around the fact that we couldn\u2019t quantify\u2014I think Dr Reti mentioned\u2014around health need. But how are you going to be able to measure the fact that the health entities\u2014and I quote\u2014\u201Chas the capacity and capability to perform its functions\u201D\u201416(1)(d)(i)? That is a huge statement in the context of delivery of healthcare services in this country. Therefore, what is the monitoring, the measurement around that? We\u2019ve got significant deficit around service provisions in parts of our country, which I\u2019m sure we\u2019ll get into soon. But how are we actually going to affect that clause, in reality? It\u2019s quite aspirational to say that, one, you\u2019ll have the capacity, and we know that operating theatres around the country are closed because they\u2019ve got no staff; but, secondly, to have the capability, which then gets into workforce, which, again, as you\u2019ve just articulated earlier, we\u2019ve got significant gaps in that space. So can you give us a little bit of clarity around how that clause within Part 2 is actually going to be effective? I\u2019ll have a few more questions.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022275e356b4b42412dbed47a1b3895d65e\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000535\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022275e356b4b42412dbed47a1b3895d65e\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Mr Chair. Just responding to Melissa Lee\u2019s second contribution and also to Simon Watts\u2019 second contribution. To Melissa Lee, I don\u2019t wish to be repeating myself, as she has done, but the provisions are very clear in the bill about what is expected. All population groups must be taken account of and services must be available in a way that is culturally appropriate and safe. That will include, where needed, language services. I don\u2019t think the member was being dismissive of what Waitemat\u0101 District Health Board (DHB) is doing. It\u2019s actually a very good service and I would like to see more of that in other places where that is an appropriate model to adopt that. But I think there is provision in the bill that both signals it and will allow it to happen. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000536\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Simon Watts\u2019 three points, I think, that he makes: first of all, on the holiday pay issue and the liability that creates\u2014and he will be aware of it, because he probably was involved in trying to counter it at some point\u2014that work has considerably progressed. I think one of the challenges, and he may well know, that we had is that different DHBs had different interpretations of the provisions in their respective collective agreements and how that was to apply. That\u2019s part of the problem. With a single employer, we then have the recipe for a single consistent interpretation of contractual obligations. So the risk of that problem replicating is very low. And even if with a single organisation they did get the interpretation wrong and somebody went to the Employment Relations Authority or the Employment Court and got an interpretation that was different, everybody will have suffered the same kind of misinterpretation by the employer and that can be rectified across the board as opposed to having to rectify 20 different approaches that have been taken with that. So I\u2019m confident that actually we won\u2019t see a failure to address contingent liabilities that we know are there and upon which work is being done. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000537\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI think the member also asked a question about the materiality threshold for those liabilities. Again, I don\u2019t think it\u2019s for Parliament to start planning the financial systems for Health New Zealand. They will take appropriate professional advice including from chartered accountants, who will give them advice on how to set those appropriate thresholds and delegations. I don\u2019t think the contingent liabilities will be lost. I don\u2019t think the Audit Office would allow it to happen. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000538\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EIn terms of the example the member gives of the Auckland Regional Dental Service\u2014mixed ownership of assets, different DHBs, land owned by the schools\u2014the legislation makes clear about the transfer of assets, including real assets, so that will happen. There may be some conveyancing to be carried out, but there\u2019s no question about who the owner will be or who the owner will transfer into where there needs to be a registration of that ownership interest. But otherwise contracts will transfer legislatively, so the cost for that is minimal. I don\u2019t see a major challenge with that. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000539\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EFinally, in terms of capability and capacity, the member raises an interesting point. But I think it is important. You know, this is the challenge that we\u2019ve had. The boards have got to make sure their job is running health services and that we maintain health services in a way that means that they\u2019ve got the capability and capacity to deliver those services. There\u2019s always going to be variability in the margins, and there\u2019ll be times where there might be a larger number of vacancies than is desirable. You\u2019d want as stable a workforce as possible. But it is for the board with management to make sure that challenges are met, to make sure that the capacity is there to deliver, and as that changes and as they forecast the future, they\u2019re planning for that change. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000540\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI think that\u2019s one of the shortcomings with the current system. We\u2019ve relied on 20 different operators of health services to do that and they simply haven\u2019t done it, been able to do it, and we haven\u2019t had a ministry be able to drive them to do it. Health New Zealand, with a single entity, gives us a much better chance of getting on top of that in a much better way.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u0022247411dc18134b4b98939f69d6be5894\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000541\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022247411dc18134b4b98939f69d6be5894\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Mr Chair. I\u2019d just like to pick up on a few comments that have been made around the Chamber, in particular, talking to Melissa Lee\u2019s point about ethnic communities.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000542\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EI think it is really important that in New Zealand we are not just M\u0101ori and everything else. Everything else isn\u2019t just white. We aren\u2019t the 1950s any more. We have actually moved on, and we are a society of about 260 different ethnicities. I do have a point to be made there, that the Minister says, \u201CWell there is relevant ability for different ethnicities to be considered in parts of the legislation because they are New Zealanders and different parts of the health strategy refer to different population groups and the needs of different New Zealanders.\u201D\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000543\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EWell, if it\u2019s all right for Asian members of our society, why is it different for the Pasifika and the M\u0101ori people that have been singled out in this legislation?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00229c069cdb-968c-4f11-b126-92f9c655148b\u0022 data-id=\u0022fec3c65e6ebb4b6d9f0289645a58fc23\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000544\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00229c069cdb-968c-4f11-b126-92f9c655148b\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022fec3c65e6ebb4b6d9f0289645a58fc23\u0022\u003ESHANAN HALBERT (Labour\u2014Northcote):\u003C/span\u003E I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00229526a3aa36c345cd8a794c0196c24bf7\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the question be now put.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EMotion agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022a07048aa943b4df9987f7c19a5e08b2c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000545\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022a07048aa943b4df9987f7c19a5e08b2c\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: The question is that the Minister\u2019s amendments to Part 2 set out on Supplementary Order Paper 169 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000546\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003EAmendments agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u00220398b86e39ac48958e1d6236f52caf7b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000547\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00220398b86e39ac48958e1d6236f52caf7b\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: The question is that Dr Elizabeth Kerekere\u2019s amendments to Part 2 set out on Supplementary Order Paper 164 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00223826a63c4dfc448a86a8346fff214c7a\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 12\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EGreen Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 107\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; New Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u00225b70495857004170a99d50491b4ee143\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000548\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00225b70495857004170a99d50491b4ee143\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: Debbie Ngarewa-Packer\u2019s amendment to clause 43B set out on Supplementary Order Paper 172 is ruled out of order as being inconsistent with the previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000549\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003EThe question is that Debbie Ngarewa-Packer\u2019s remaining amendments to Part 2 relating to the M\u0101ori Health Authority set out on Supplementary Order Paper 172 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u002280f87b3b7a12474b84dc30d15695edaa\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 12\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EGreen Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 107\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; New Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022ea860b68ab4c461481cde11c27122929\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000550\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022ea860b68ab4c461481cde11c27122929\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: Brooke van Velden\u2019s amendments to Part 2 set out on Supplementary Order Paper 153 are ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000551\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003EThe question is that Debbie Ngarewa-Packer\u2019s amendment to Part 2 inserting a new subpart (3B) relating to a M\u0101ori Director-General set out on Supplementary Order Paper 167 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022935f4cf8a7f54974acb9892e6a0aeb21\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendment be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 12\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EGreen Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 107\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; New Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendment not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022c3bf26498b784fdc85f10f5c22d475ce\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000552\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c3bf26498b784fdc85f10f5c22d475ce\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: The question is that Dr Elizabeth Kerekere\u2019s amendments to Part 2 requiring the Minister consult with relevant Ministers on health strategies set out on Supplementary Order Paper 165 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022a990532012284843b147d7249c7292e9\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 12\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EGreen Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 107\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; New Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022a92b0c05f0f2478ab2659f50ed3e60ce\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000553\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022a92b0c05f0f2478ab2659f50ed3e60ce\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: Brooke van Velden\u2019s amendments to Part 2 relating to a rural health strategy set out on Supplementary Order Paper 151 are ruled out of order as being the same in substance as a previous amendment.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000554\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003EThe question is that Brooke van Velden\u2019s amendments to Part 2 relating to a medicines strategy set out on Supplementary Order Paper 152 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022edddf55fce174a6c8b313a7e2f703bd1\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022bd9c34aa726c4dcf94f2f5da2d91171b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000555\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022bd9c34aa726c4dcf94f2f5da2d91171b\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: The question is that Dr Elizabeth Kerekere\u2019s amendments to Part 2 relating to a rainbow health strategy set out on Supplementary Order Paper 154 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022ba354f35ab5c40f39540e0500f8f37d9\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 44\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 75\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u00227d4040a705ed4d70a3df996e9e5a57f7\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000556\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227d4040a705ed4d70a3df996e9e5a57f7\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: The question is that Dr Shane Reti\u2019s amendments to Part 2 relating to an older people\u2019s health strategy set out on Supplementary Order Paper 157 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00228d64b0863783433c9896dd72c84b3311\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u00222f84099bf0474fcea3071e515765b06a\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000557\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00222f84099bf0474fcea3071e515765b06a\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: The question is that Dr Shane Reti\u2019s amendments to Part 2 relating to a health workforce development strategy set out on Supplementary Order Paper 158 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022e048929956834bc38d340d1484402955\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 54\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; ACT New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 65\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022cc580a4cb6e64babae974d74b9146c40\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000558\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022cc580a4cb6e64babae974d74b9146c40\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: The question is that Matt Doocey\u2019s amendments to Part 2 relating to a mental health and wellbeing strategy set out on Supplementary Order Paper 170 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00228176d3190ab049f6a5d9f3b035ef25b1\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 54\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; ACT New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 65\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022c04eb77b16d64916824ebd928f314b88\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000559\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c04eb77b16d64916824ebd928f314b88\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: Matt Doocey\u2019s amendment to clause 43B set out on Supplementary Order Paper 171 is ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000560\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003EThe question is that Matt Doocey\u2019s remaining amendment to Part 2 relating to consultation with the Mental Health and Wellbeing Commission set out on Supplementary Order Paper 171 be agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022c935c46c2caf4850bd41fed48e5855de\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the amendments be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 54\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; Green Party of Aotearoa New Zealand 10; ACT New Zealand 10; Te Paati M\u0101ori 2.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 65\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAmendments not agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u002273ad362094784020aa014fc42bd3720a\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Part 2 as amended be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EPart 2 as amended agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022bd524b87a1c24ecfbd953537616c4617\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000561\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022bd524b87a1c24ecfbd953537616c4617\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E I raise a point of order, Mr Chairperson. I seek leave to correct a statement I made earlier this evening, as we\u2019ve been discussing this bill.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000562\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022d50e4f73075f44f2bcf9235d1ab224d3\u0022\u003EHon Michael Woodhouse\u003C/span\u003E: Was that in the committee?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000563\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u002229974588a6b44628973583243f53a17a\u0022\u003EHon ANDREW LITTLE\u003C/span\u003E: In committee. Earlier this evening, Michael Woodhouse made a contribution in relation to the provision in the bill relating to amending the immigration provisions, in particular a condition attached to visas for those who are working in the health system. My response was to the effect that I thought that any problem with a health worker on a working visa, employed by Health New Zealand, who might want to go to other parts of the country with Health New Zealand\u2014that would be managed as an HR matter. I said, tangentially, that under the new arrangements with the new work visas, a health worker employed or at least under a working visa on the two-year pathway to residency, as now provided for, would, as a condition of the visa, be required to stick with their employer. I have been advised tonight that that is not correct and that a health worker, working here under a two-year visa on a pathway to residency, once they are here is free to work in the role in which they are employed, regardless of who that employer is. I just wanted to be very clear about that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000564\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u0022916470c61401449cb6324a56f514356f\u0022\u003EPart 3  Other roles\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000565\u0022\u003E\u003Cbr\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022 data-id=\u0022a4c5ebc5e2dc461798bde24805e2991d\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000566\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a6c42c44-3622-4c9c-98b8-793fb5ec15cc\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022a4c5ebc5e2dc461798bde24805e2991d\u0022\u003ECHAIRPERSON (Ian McKelvie)\u003C/span\u003E: Members, we now come to Part 3. This is the debate on clauses 60 to 86, \u201COther roles\u201D, as well as Schedule 1A relating to organisations for the purposes of sections 84A(1) and 84B(1), and Schedule 4, which has provisions applying to mortality review committees. The question is that Part 3 stand part.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00228e5fd6dff2ee40bca47706de5248d0de\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000567\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00228e5fd6dff2ee40bca47706de5248d0de\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Just by way of some just general remarks in relation to this provision, members will recognise some of the entities referred to here. This simply recognises the continuation of these particular entities. But it\u2019s in this area too that we also have some other particular provisions\u2014and I\u2019m just looking specifically\u2014in relation to the new public health agency and, specifically, the expert advisory committee on public health that is provided for.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000568\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EPart of the reforms is to beef up our public health offering and to make sure that we have good\u2014which is not a criticism of any leadership we\u2019ve had in our public health services to date. But this makes it clear as part of the structure that we will have a discrete public health agency with an external advisory committee who will be advising in that particular service. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000569\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EAlso in this regard\u2014or, in fact, not in that regard at all. But, yeah, I do want to draw particular attention to that. Otherwise, the other organisations here: Pharmac, Health Quality and Safety Commission, New Zealand Blood and Organ Service\u2014they\u2019re all provided for here. They all must continue. They are service providers and, therefore, they are health entities for the purposes of the legislation. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u0022e734208760cd4cffbff77c93f310c1c1\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000570\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022e734208760cd4cffbff77c93f310c1c1\u0022\u003EDr SHANE RETI (National):\u003C/span\u003E Thank you, Mr Chair. I rise to speak to Part 3, starting at clause 60, and I particularly want to focus my contribution around Pharmac. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000571\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThis has relevance for the Pharmac report that came out today, which tells us several things\u2014the \u201Cwhat\u201D, if you like, is the problem with Pharmac. First of all, one, poor performance across the whole organisation is what the report tells us. Secondly, the cost savings are not what we\u2019ve been told by Pharmac. Thirdly, it\u2019s highly likely that Pharmac has contributed to inequalities in the health system. That\u2019s the identification of the problems. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000572\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThe \u201Cwhy\u201D part to that\u2014well, that\u2019s probably multi-factorial, we know from the interim report, where Pharmac was described as having a fortress mentality. It\u2019s not prepared to share information and, in fact, it wasn\u2019t even prepared to share with the review panel. It\u2019s a problem, which, again, is highlighted in today\u2019s Pharmac report. Secondly, it\u2019s pointed out today that they don\u2019t well incorporate the consumer voice, so much so that their clinical advisory committees, which includes the Pharmacology and Therapeutics Advisory Committee, are being reconfigured, and, instead of being internal assignments, are actually going to be ministerially appointed.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000573\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EI think, myself, personally, one of the problems with Pharmac is they\u2019ve been allowed to be isolated and too far from ministry and ministerial oversight. The example I have with this\u2014and I know I\u2019ll need to get over it some time. But the 20,000 meningitis vaccines that were hidden, that Pharmac hid from the director-general, and, I believe, the Minister as well in the 2018-19 Northland meningitis outbreak\u2014that\u2019s a good example of Pharmac being way too isolated, its own little fiefdom, which I think has contributed to the report today.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000574\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EAs we look to some of the solutions that are proposed, particularly in the Government response, a large number of them say that this will be taken up by what we\u2019re talking about here: the Pae Ora (Healthy Futures) Bill. Well, that\u2019s kind of rich considering, going into select committee, Pharmac was excluded from the Pae Ora (Healthy Futures) Bill, and now it\u2019s the solution to a substantial number of problems that are raised in the report? That\u2019s really rich.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000575\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EI think what we then need the Minister to assure us around is several things. First of all, I want to express concerns for delays in upgrading the national medicines strategy, which expired in 2020, and, indeed, we\u2019re in support of our colleague with ACT and their Supplementary Order Paper around this today. The report describes it as a priority and states in as many words that its omission will be a significant failure for the health reforms going forward. So those words should be taken into account by the Minister as he reads that report.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000576\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EBut I think fundamentally what I really would like some reassurance around is whether the bill as it is here tonight adequately takes into account all the concerns that have been raised in this report, bearing in mind the Minister had it around about 28 February. Substantial parts of this bill would have been progressed by then. How do we know that the report today, retrospectively, is adequately taken into account by this bill? That\u2019s the sort of assurance I\u2019m looking for from the Minister. Thank you.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022 data-id=\u0022ce5f944ada634d909dbf55d3d20f32de\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000577\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022ce5f944ada634d909dbf55d3d20f32de\u0022\u003EHon MICHAEL WOODHOUSE (National):\u003C/span\u003E Thank you, Madam Chair. I want to continue that discussion about Pharmac because today is an important day in terms of that organisation.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000578\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EI also want to put on record that I think Pharmac, as a model, is a very effective one, but we\u2019ve known for years that three things Pharmac needed: it needed more money, it needed to make decisions in a more timely manner, and it needed to be more transparent about those decisions. Dr Reti and I have made these points very clear to the chair of the Pharmac Board in annual reviews over the last few years\u2014the Hon Steve Maharey\u2014and we got those assurances back. But today\u2019s report, I think, makes it very clear that there is a great deal of work to do.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000579\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EWe are a little bit on the road regarding funding with Budget 2022, although I want to point out\u2014and this is one of the opportunities I think Health New Zealand really has. I\u2019ll use this as an example: a couple of years ago, there was a very strong push for devices to be purchased for type 1 diabetics to, effectively, keep them out of hospital. It was turned down and it was turned down because it was very, very narrow grounds for cost benefit, and yet the real benefit was going to be on the DHBs. This is the one thing I think that\u2019s good about this bill, because I don\u2019t think we\u2019re heading down the right road in terms of the restructure, but, actually, if Pharmac takes more cognisance of a broader range of benefits than just its own cost benefit, I think that\u2019d be a good thing.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000580\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EWhen the Minister responded to the report this morning, he said, \u201CWell, we\u2019ve got this health reform and it\u2019s going to be in place in a month, and so that\u2019ll give us a good chance to\u201D\u2014I think he used the word \u201Creassess\u201D. We\u2019ve got a unique opportunity right now to build in a statutory framework to make Pharmac more responsive, more transparent, and more broad in its approach to cost benefit.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000581\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022c83012b4-3939-4753-80fc-1956a3e2bd1e\u0022\u003EMy question to the Minister is in the time he\u2019s had available\u2014because he\u2019s had the report for a lot longer than we have\u2014what thought did he put into making amendments to Part 3 that will actually make those recommendations a statutory requirement in the law? We\u2019ve got time because they\u2019re pretty straightforward, I think. Has he given that thought, and, if not, why not? If he decided not to make any changes right now, are we missing an opportunity? \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u002245cd8046e2a64684a05408c88d247f24\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000582\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002245cd8046e2a64684a05408c88d247f24\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair, and I thank Dr Shane Reti and the Hon Michael Woodhouse for their contributions. There\u2019s a lot of what Dr Reti said I actually agree with in relation to Pharmac, and I think the concerns about Pharmac\u2019s sort of isolation have been around for a while, let\u2019s be brutally honest. I\u2019m not going to blame politics here. It was because of the crescendo of concerns around it. That\u2019s what prompted us to think seriously about a review. Promises were made on the campaign trail in the last election from both sides of the House, and so we committed to the review. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000583\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWhat I took from the report was that, rather than Pharmac being solely responsible for everything to do with medicines and pharmaceuticals, actually you did need a broader framework within which to consider that. It is properly the province of the ministry, as the overarching sort of steward of the system and the centre of policy and intellectual capacity for the health system, to actually be leading that work, and the review report said that specifically in relation to vaccinations, but, actually, it needs to be for medicines as well. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000584\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo part of what we\u2019ve agreed to in relation to the independent review is that Pharmac will be required to work closely with others\u2014in particular, the ministry\u2014and I\u2019m confident that we will now see that. So the member asks does the bill take account of the concerns in the report, and I\u2019m confident that it does. I mean, bearing in mind that at the time I had the report, the bill was fully in the possession of the select committee, so it wasn\u2019t a question of fiddling around with the bill before we introduced it to the House. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000585\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EPharmac very early on\u2014in fairness to them\u2014said they didn\u2019t understand why they were excluded in the first draft of the bill from being regarded as a health entity for the purposes of the bill and, therefore, subject to the health sector principles. They now are. They\u2019re defined as a \u201Chealth entity\u201D and they are now subject to those health sector principles. So I think it does\u2014those health sector principles will make a significant difference to the way that board and its management will have to conduct themselves in Pharmac. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000586\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ETo Michael Woodhouse: again, Woodhouse raises some important questions about that and, again, he asks whether I had given thought to any further changes in Part 3. I\u2019m confident that no further changes were required. The critical thing is that Pharmac is treated under this bill\u2014the piece of legislation for the health system\u2014as part of the health system, and even though they are under the Public Health and Disability Act 2000 at the moment, like most things in that Act, their isolation is almost confirmed. They cannot possibly be isolated given the way this bill is drafted and the structure that we\u2019re setting up, and in any event, it will be partly this statute but partly also the political process will drive them to have to integrate properly with the rest of the health administration in order for them to do their job properly, because I don\u2019t think they\u2019re going to be able to avoid it. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000587\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWith the M\u0101ori Health Authority, because it will have some intellectual capacity as well as its developing policy and strategy for greater equity performance and improvement, they will have a critical role to play in their engagements with Pharmac to see that Pharmac lifts their equity performance as well. So my point would be that it is covered off in the legislation as it is.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022 data-id=\u0022496788f638d04b6092eb797ded22d04b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000588\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022496788f638d04b6092eb797ded22d04b\u0022\u003ESIMON WATTS (National\u2014North Shore):\u003C/span\u003E Thank you very much, Madam Chair, and thank you to the Minister for those contributions. I want to dig a little bit deeper into Part 3, clause 62(1)(c) in regards to operational budget, and I guess the broader theme here is in regards to\u2014I think we\u2019d all acknowledge one of the challenges with Pharmac and the way in which it operates. What I\u2019m wanting in my question for the Minister is why haven\u2019t we gone further in regards to this aspect. Is it that when benefits are calculated in regards to the benefit payback from the introduction of a pharmaceutical drug, the benefits generally are only those related to the health sphere related to that drug but do not go broader to other benefits? What I mean by that is the provision of pharmaceutical medication may, in effect, allow someone to go back into the workforce, and so the benefits in terms of the economic benefit of someone working or not is not necessarily going to be felt within the healthcare system, but it may be felt within, potentially, the welfare system, because that person would transition from welfare into a paid job. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000589\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe other aspect is in regards to pharmaceutical provision for mental health conditions, or even those in regards to paediatrics and children, and which allow them to have better outcomes in terms of their learning ability at school, or the fact that a mental health condition may restrict their ability either to work or to contribute in terms of society. Again, the way in which Pharmac assesses the benefit case for the investment regarding that pharmaceutical drug is solely restrained and constricted to the health sphere. In effect, when you stand back and look at it, you go, \u201CWell, that doesn\u2019t feel right.\u201D That doesn\u2019t meet that litmus test around the fact that benefits don\u2019t just derive within a single bucket; they actually fall across other aspects of our system, and I think the Government have shown through the justice cluster that they\u2019ve brought in in Budget 2022 a bit of an insight in terms of acknowledging that there are shared benefits across multiple sectors. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000590\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EI guess my question for the Minister is: can we expect to see something, even within acknowledging health is a challenging area, but with the Pharmac aspect in terms of a cluster, because I think the reality of cost-benefit payback and benefit not just being financial but other aspects, of course\u2014around social, particularly\u2014is significant in the pharmaceutical space. When you weigh it up in terms of dollar for dollar for, say, road safety versus pharmaceutical and the benefit derived, pharmaceuticals will trump most other elements nine times out of 10. So that\u2019s the first aspect.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000591\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe second aspect is in regards to clause 64(1)(b) which relates to consumer advisory committees. The Minister will be aware that, actually, the legislative requirement around having a consumer panel has existed and is in place at the moment. The reality is, though, that Pharmac has just simply not taken that as far as it could have done, and, actually, the reality of having the clinical committee has really trumped, and the Consumer Advisory Committee, while it has been there, has really been not of any significant substance. But the challenge, going back to point made by the Hon Michael Woodhouse around consumer input and being part of the Health Committee\u2014I see Dr Liz Craig down the back, a fellow member on the Health Committee last year with me\u2014is that of the petitions that you would receive on that, 90 percent of petitions coming through that relate to Pharmac and Pharmac-related drugs. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000592\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003ESo the element around consumer advice or the lack of that consumer input is a known significant gap in regards to the policy consideration but also, I think, the funding prioritisation of pharmaceutical drugs. My question for the Minister is: how are you going to actually measure or ensure that this actually occurs, because that\u2019s the case today, and it\u2019s not happening. So what confidence can we and consumers out there get in terms of, whether we\u2019re talking about rare disorders, or we\u2019re talking about type 1 diabetics looking for the provision of funding for continuous glucose monitoring systems, which is the next phase above insulin pumps\u2014what is the ability for those consumers to be able to have a voice as part of that process, and what will change as a result of this legislation, in particular, in clause 64(1)(b), that, actually, will make that a reality? Those are the two points I wish to ask.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u0022bf93ee1312104017ba79c3dc98e0bbad\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000593\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022bf93ee1312104017ba79c3dc98e0bbad\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Madam Chair. I also wanted to touch on Pharmac today, given that, obviously, we\u2019ve had the final review finally released by the Minister of Health, after he\u2019d sat on it for over four months, much to the disappointment of many patients in New Zealand. But I wanted to raise the issue of the fact that Pharmac is not very transparent\u2014we know it\u2019s not. We know that they have been having terrible processes, like the Pharmac review pointed to, such as that the decision that was made around whether new drugs should or should not be funded was made by staff members and not by people who are experts in the field of medicine. There are a lot of processes going on within Pharmac that many New Zealanders would have issue with, and I have been advocating strongly for a medicines strategy to be put into the health legislation here. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000594\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EBut when it comes to Pharmac itself, one aspect that I\u2019d like to get a little bit more clarity on is his previous comments that he\u2019s considered the Pharmac review and deems that there\u2019s no need for any change, and I just wonder how much insight the Minister really has, and has he actually considered the report at all? I wrote a question to the Minister back in February, asking, \u201CHow will the recommendations in the Pharmac review panel\u2019s final report, if any, be captured in this bill as it goes through Parliament?\u201D The Minister said at the time, \u201CIn view of the interim report, I\u2019m satisfied that the issues identified in that report will be adequately addressed.\u201D, and I just wonder whether at any point since the interim report and the final report any more consideration has actually happened, or is it simply the case that the Minister never really wanted to do this review? The Government were put into the situation where they needed to do it, because the ACT Party asked for it on the campaign trail because of patients. He\u2019s hidden the report. He hasn\u2019t really actually read it in any great detail and, therefore, we have no changes in the legislation.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000595\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EBut based on that, I\u2019d also like to raise an issue just on how Pharmac will operate with Health New Zealand and the M\u0101ori Health Authority, because under the current system the district health boards and Pharmac have a memorandum of understanding, and there are issues and areas that they overlap on. I\u2019m just curious whether there has been any acknowledgment of how Pharmac will operate with Health New Zealand and the M\u0101ori Health Authority, bearing in mind that the Pharmac review said that for the proper integration of Pharmac or closer integration into the new health system, it was incredibly important that there was a medicines strategy that guided how Pharmac operates under Health New Zealand and the M\u0101ori Health Authority.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000596\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003ESo given that there is no medicines strategy, the Minister doesn\u2019t want to put one in here, and there appear to be not really any changes to Pharmac at all, is the Minister aware of how Pharmac will operate with the M\u0101ori Health Authority and Health New Zealand to be more transparent and to have a better process for how we fund and allocate resources for new modern medicines, because I think the people of New Zealand will be very interested in knowing how any of this and any new medicines strategy will work. Will we actually have a better process in place for new medicines access than we have in the current system, or is it the case that, actually, things will really be just exactly the same as they are?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u002200ec2b94d17247718517d0497f4d667b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000597\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002200ec2b94d17247718517d0497f4d667b\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair. I thank again Simon Watts and Brooke van Velden for their questions. Simon Watts covers three points. He asked whether, such as we have seen in the justice sector, we will see something like a cluster around Pharmac. I think this will be a common theme in my answers for this next section, but both this bill and the effect of the sort of integration of Pharmac within all the entities that make up the public health system means that they will have to operate in a way that engages actively with each, so the bill will drive them to be part of the health cluster. The health cluster is, effectively, defined in the clause dealing with definitions under the term \u201Chealth entity\u201D. So I\u2019m confident that they will.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000598\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESecondly, Mr Watts notes and shares his observations about the Consumer Advisory Committee and whether or not it is really being allowed a voice to be provided by consumers to Pharmac. I think the review report makes it pretty clear that, actually, Pharmac, in its decision making, has really\u2014to be charitable\u2014struggled to incorporate the input of the Consumer Advisory Committee and, indeed, other groups that they\u2019ve set up like the rare disorders committee that they set up. That met infrequently, it didn\u2019t have somebody with lived experience on it\u2014those sorts of things. So I think that\u2019s out now and that\u2019s recorded in the review. I think that\u2019s an area that does need to change, and we made it clear as a Government in our response that we needed to see change in that. Again, I\u2019m confident that the way the health sector principles will apply to Pharmac will ensure that that will happen too. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000599\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo those were the two points that Mr Watts raised, and then turning now to Ms van Velden, she\u2019s made an assertion that nothing really has changed. Actually, a lot has changed. That might be her cursory reading of things, but the reality is that following the interim report, which really highlighted Pharmac\u2019s inability to perform well when it comes to equity, it was at that point that, given the health sector principles, and the legislation was in the House by that time, it was pretty clear that we could actually address that by bringing Pharmac into the rubric of health entities, which the select committee subsequently did, and I was very supportive of that. So that happened. That will make a significant difference\u2014just requiring Pharmac to satisfy those health sector principles will make a significant difference. So I\u2019m sure that it will.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000600\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe member asked how Pharmac will operate with Health New Zealand and the M\u0101ori Health Authority. Well, they won\u2019t have a choice, but they will have to, and they will be dealing with formidable organisations. Health New Zealand is a significant organisation. They will have to have a relationship; it\u2019s a working relationship and a constructive one. The M\u0101ori Health Authority with its roles as a sort of intellectual policy grunt shop as well as a commissioner of services\u2014it will bring extraordinary insights, and Pharmac will need to incorporate those and actively listen to those as the M\u0101ori Health Authority brings their wisdom to bear upon decisions about pharmaceuticals and medicines.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000601\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe review makes it very clear that Pharmac should not be solely responsible for strategies for medicines or for rare disorders. That is the role of the ministry, and the ministry will pick that up and it will actively involve Pharmac in that because they will remain the procurement agency. They are a very good procurement agency. They\u2019ve got great capability. It was interesting being at the World Health Assembly last week, with the number of countries that said, \u201CGee, we wish we had something like a Pharmac.\u201D So there is a lot to be pleased about and proud of with Pharmac, but improvements need to be made, as the review says, and we will ensure that those changes are made.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00225b6b1d74-9e5e-42ba-a922-85b0ea7f5ab6\u0022 data-id=\u0022c27f105d53c74a6aba65ecef33351c56\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000602\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00225b6b1d74-9e5e-42ba-a922-85b0ea7f5ab6\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022c27f105d53c74a6aba65ecef33351c56\u0022\u003ESIMON O\u2019CONNOR (National\u2014T\u0101maki):\u003C/span\u003E I\u2019d like to thank the Minister for his contribution. Can he or his officials give me one example of a country in the world, over 25 years, which has replicated the Pharmac model? \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00229c069cdb-968c-4f11-b126-92f9c655148b\u0022 data-id=\u0022cdeb3e66f0d44dc48ef5043e7d66f683\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000603\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00229c069cdb-968c-4f11-b126-92f9c655148b\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022cdeb3e66f0d44dc48ef5043e7d66f683\u0022\u003ESHANAN HALBERT (Labour\u2014Northcote):\u003C/span\u003E I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00225b6b1d74-9e5e-42ba-a922-85b0ea7f5ab6\u0022 data-id=\u00227a747c94f56744dfb75ca0e53c3748d1\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000604\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00225b6b1d74-9e5e-42ba-a922-85b0ea7f5ab6\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227a747c94f56744dfb75ca0e53c3748d1\u0022\u003ESIMON O\u2019CONNOR (National\u2014T\u0101maki):\u003C/span\u003E Sorry to leap back to my feet. It is actually quite a genuine question. I think Pharmac is amazing, but having chaired the Health Committee, one of the things that has struck me over that time, and particularly\u2014actually it\u2019s probably over 27 years or so now. Pharmac does many, many things well, but it\u2019s become somewhat of a sacred cow in this country, and I am, I hope, rightly and genuinely asking, Minister, what other country in the world has replicated the Pharmac model?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00222ad83ac8db2648998e467d2f31c7956e\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000605\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00222ad83ac8db2648998e467d2f31c7956e\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Just beginning with Mr O\u2019Connor\u2019s point: probably no one, but then no other country is quite like New Zealand, and there\u2019s a multiplicity of different systems. There are countries operating on a State basis and provincial basis, and at a State basis and provincial basis, there are some procurement agencies that operate on that basis where the health system is very much kind of subnational based, but the other thing is that other countries have complex arrangements when it comes to public and private insurance. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000606\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003ESo we know that many European countries rely heavily on private insurance or mandated private insurance to meet the cost in whole or in part of pharmaceuticals. When Pharmac agrees to fund a drug, they agree to fund it 100 percent. The cost to the consumer is the prescription charge of $5 each time, up to an annual value of $100. But that\u2019s what sets New Zealand apart from pretty much every other country\u2014that when we agree to fund a pharmaceutical, then we agree to fund it 100 percent. In most other countries it\u2019s at best a partial funding.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000607\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI just want to mention one other point too, and that was in relation to consumer engagement\u2014really addressing the point that Mr Watts made. There is a specific requirement in terms of clause 53 where there needs to be a code of consumer and wh\u0101nau engagement in the health sector. So there is a statutory impetus to make sure that there is consumer engagement.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002212d74f81-b1f7-4b51-9fb4-8f9481477192\u0022 data-id=\u002256b5cab5fcee4fff8a1320b9688f1299\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000608\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002212d74f81-b1f7-4b51-9fb4-8f9481477192\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002256b5cab5fcee4fff8a1320b9688f1299\u0022\u003EDr DEBORAH RUSSELL (Labour\u2014New Lynn):\u003C/span\u003E I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u002241b2d249121945948172fdab9d0cfd06\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000609\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002241b2d249121945948172fdab9d0cfd06\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Madam Chair. I just had a query on an area that nobody seems to have picked up on before, and that is about the Hauora M\u0101ori Advisory Committee under clause 84. I just had queries about how this operates in practice when it talks in new clause 84A about the Hauora M\u0101ori Advisory Committee comprises eight members appointed either \u201Cby the Minister on the nomination of all the iwi-M\u0101ori partnership boards; or \u2026 by the Minister if, and to the extent that, a nomination is not made;\u201D. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000610\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003ESo I can understand how you\u2019d end up in a situation where you would want to have the ability as the Minister to self-select because you don\u2019t want positions not to be filled, but, at the same time, the requirement that a nomination is made to be a member of the Hauora M\u0101ori Advisory Committee by all of the iwi-M\u0101ori partnership boards seems like quite a high threshold. So I\u2019m just curious as to why it\u2019s so specific that it needs all of the iwi-M\u0101ori partnership boards to be favourable to a particular person rather than some, or maybe a selection process based on people nominating names in general. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000611\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EAlso: how that kind of works when it comes to the fact that the Hauora M\u0101ori Advisory Committee does quite a few things, but, in particular, it can advise the Minister when it comes to maybe deselecting somebody to be on the M\u0101ori Health Authority. One area that I\u2019m interested in is maybe a potential conflict of interest where you have the iwi- M\u0101ori partnership boards needing to work with the M\u0101ori Health Authority to come together to create locality plans, but the people that are on the M\u0101ori Health Authority could in some way be deselected by the iwi-M\u0101ori partnership boards telling the Minister that maybe they should be advised to replace the person on the M\u0101ori Health Authority. I just wondered if I have that correct in my reading, and whether the threshold for the nominations is too high, given that it needs all of the iwi-M\u0101ori partnership boards to agree. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022fe5db15d44b443cfb55ef86ec7d1c8e1\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000612\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022fe5db15d44b443cfb55ef86ec7d1c8e1\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E The reason this provision is drafted this way is to make sure that the members of the Hauora M\u0101ori Advisory Committee represent iwi M\u0101ori. Now, we\u2019re not going to have a representative of each iwi on it\u2014it\u2019s going to be a workable number\u2014but in the way that we set up an interim group or a working group in the way my Associate Minister the Hon Peeni Henare and I did when we had T\u0101 Mason Durie advising us, he pulled together a group that advised us on the initial appointments to the interim M\u0101ori Health Authority. They sought a mandate from most iwi\u2014not all iwi\u2014but that was a model that largely appeared to work, and the engagement that Peeni Henare had with the M\u0101ori community was that that\u2019s what they would like to see in the future.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000613\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EWe need the Hauora M\u0101ori Advisory Committee to have the confidence of M\u0101ori\u2014iwi M\u0101ori and urban M\u0101ori\u2014and that\u2019s why that is structured in that way. They know there are six places for iwi M\u0101ori. I\u2019m confident that iwi M\u0101ori are capable of working it out amongst themselves who the make-up of that group will be and, likewise, the urban M\u0101ori organisations that are required to appoint, too.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000614\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe role of the Hauora M\u0101ori Advisory Committee is to advise me in exercising the powers I have in relation to the M\u0101ori Health Authority. That\u2019s a further kind of assurance to Te Ao M\u0101ori but also consistent with the Crown\u2019s obligations under the Treaty, and our commitment to partnership is that we work to ensure that the M\u0101ori Health Authority\u2014which has such a critical role to play in the health reforms\u2014maintains the confidence of M\u0101ori, and these systems, structured this way, are designed to achieve just that.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022 data-id=\u002206894ee83f3345b18a48f1f61ac98538\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000615\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002206894ee83f3345b18a48f1f61ac98538\u0022\u003ESIMON WATTS (National\u2014North Shore):\u003C/span\u003E Thank you very much, Madam Chair. I appreciate the Minister\u2019s contribution on the last point. I refer to clause 86(3A). It goes into some detail in terms of \u201CWhen determining appointments to the committee, the Minister must be satisfied \u2026 collectively\u201D around the capability and competence and the experience and knowledge and expertise of those on that committee. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000616\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EMy question actually relates somewhat to the point I\u2019ve made previously around Pharmac in terms of the cost-benefit model and the fact that the investment may be made within a health appropriation, but yet the benefit crystallises or is derived or is realised\u2014three words meaning the same thing\u2014outside of the health sphere. When I\u2019m looking through the skill sets of the people within that advisory committee, there is no requirement for anyone with any health economics, financial sustainability, fiscal health, fiscal experience, or any such aspect. Noting that one of the most significant challenges that we have within the healthcare system globally is how to meet the fact that, in effect, demand for healthcare services is infinite and yet funding is finite\u2014quite simply, that lens is important in terms of having that perspective around the table. You know, it can all sound nice in terms of blue-sky thinking of where we should be in terms of outcomes, but the reality is that we can\u2019t achieve everything within that finite health budget.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000617\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EWe saw that come through\u2014and I was fortunate to be part of the Health Committee\u2014when we went through COVID and saw the impacts of COVID on our health system. One of the, I think, learnings which will no doubt be picked up when we review our response\u2014and, of course, we did very well in aspects. But one aspect that I think we could have done better on was in regards to that operationalisation of the policy and clinical policy decisions that were being made such as the aspects around procurement of services, the speed of that procurement, and the fiscal considerations around how we did that. I think that would probably be acknowledged as an area that we could have improved. So this composition here is missing that aspect, and my question to the Minister, quite simply, is why, and what are the reasons for that?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u00227516f3635d4141609230c8a4122f8cd7\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000618\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227516f3635d4141609230c8a4122f8cd7\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E I\u2019m happy to respond, as best I can, to Mr Watts\u2019 question. I think the role of that expert advisory committee on public health is really to deal principally with epidemiological issues and to look at the technical and clinical information coming locally but, more often, from overseas to understand what is happening with our population-based health issues that we need to be addressing, what are the non-communicable diseases that we all struggle to deal with, and the various community interests that go to influence decisions on that. That\u2019s what that committee is really set up for. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000619\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI would expect as an ongoing thing that the ministry, which has the broader policy responsibility for health generally and health systems\u2014and bearing in mind that the Public Health Agency will be a discrete body within the ministry\u2014that it\u2019s the ministry that will have economists and other disciplines to bring to bear on this, and, indeed, I expect that Treasury will continue to have health economists as part of the make-up of their workforce, as we expect them to do for their long-term planning around health and the sustainability of health funding. So the broader agencies will have that capability, and we expect the Public Health Agency to be focused on the challenging epidemiological issues of the age.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00229c069cdb-968c-4f11-b126-92f9c655148b\u0022 data-id=\u002275398676206d419b9fc55f9aa343a698\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000620\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00229c069cdb-968c-4f11-b126-92f9c655148b\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002275398676206d419b9fc55f9aa343a698\u0022\u003ESHANAN HALBERT (Labour\u2014Northcote):\u003C/span\u003E I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022167227181f494fd08b5fa284248bf084\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the question be now put.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EMotion agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022a0a64ffafa7845659a1f8004a6b748ce\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000621\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022a0a64ffafa7845659a1f8004a6b748ce\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Brooke van Velden\u2019s amendment to Part 3 set out on Supplementary Order Paper 153 is ruled out of order as being inconsistent with a previous decision of the committee. Debbie Ngarewa-Packer\u2019s amendment to clause 64 set out on Supplementary Order Paper 167 is ruled out of order as being inconsistent with a previous decision of the committee. \u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00226219038cb1504000ba9fa9ad74b13975\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Part 3 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10, Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EPart 3 agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000622\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u002225cbab779b4d4b4494d9f30d7c190810\u0022\u003EPart 4  General\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000623\u0022\u003E\u003Cbr\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u002205c11b54b3b64c3aa17a83799a8ab197\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000624\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002205c11b54b3b64c3aa17a83799a8ab197\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Members, we come now to Part 4. Part 4 is the debate on clauses 90 to 99, the general provisions, as well as Schedule 2, \u201CConsequential amendments to enactments\u201D, Schedule 5, \u201CProvisions relating to imposition and payment of Ministry levies\u201D, and Schedule 6, \u201CClasses of alcohol and rates of each class\u201D. The question is that Part 4 stand part. \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022 data-id=\u0022950983033a72449bb23ebfebe56afe66\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000625\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022950983033a72449bb23ebfebe56afe66\u0022\u003ESIMON WATTS (National\u2014North Shore):\u003C/span\u003E Thank you, Madam Chair\u2014sorry, Mr Reti, I didn\u2019t see you coming. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000626\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u00226abac0ee72554c1c85d61e331070f91f\u0022\u003EDr Shane Reti\u003C/span\u003E: You\u2019re good. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000627\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003E\u003Cspan class=\u0022HpsBy\u0022 id=\u0022918561228769470eb7e128b1567ab3bc\u0022\u003ESIMON WATTS\u003C/span\u003E: Well, let\u2019s get started on Part 4, and I do just want to refer to clause 95, actually, in regards to the Minister\u2019s approval being required for health entities dealing with land. I\u2019m specifically interested around clause 95(2). As we all know\u2014well, most will know\u2014the reality of health assets, and particularly buildings that DHBs currently lease, is that these are long-term assets. One of the challenges in the current system is the bureaucracy of having to seek ministerial approval to get decisions made for what is routinely operational-type aspects, and I note in this clause that it remains the case that a health entity must not grant a lease or a licence over land for a term of no more than five years without the Minister\u2019s prior written approval. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000628\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EI guess my question for the Minister in regards to that is what assessment has been done in terms of acknowledging these entities. There\u2019s going to be a huge number of leases\u2014I mean, I can think of within one DHB that I have a reasonable familiarity with, there are hundreds of leases within that one entity alone, and we talked about the Auckland Regional Dental Service, which has dental clinics and other aspects. You know, this is a significant area, so my question to the Minister is what consideration was put around where these thresholds were set, and the cost benefit, I guess, quite simply, in terms of bureaucratic burden placed over the fact that ministerial approval was still going to be required for what here in this case seems to be a relatively routine decision.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000629\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022713ccc5b-7ff0-4fa5-ab58-4780620184fe\u0022\u003EThe other aspect is in regards to clause 95(1), in regards to the phrase \u201Csell, exchange, mortgage, or charge of land\u201D. I guess in this regard this is also relevant, because a number of health boards across the country own assets and land and buildings that are no longer required for the provision of health services, and a lot of that has a historical legacy aspect. But, again, I can only assume that the role of the Minister of Health is a busy one, and the fact that, again, ministerial approval in writing is going to be required every time that these type of transactions are required, again, just simply looks to me like a bureaucratic burden which could have been avoided with at least, I guess, a little bit of devolved consideration around that. So those are the questions I\u2019ve got in regards to clause 95.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u00225bdf51c5cdfe4e9bb56286beca726689\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000630\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00225bdf51c5cdfe4e9bb56286beca726689\u0022\u003EDr SHANE RETI (National):\u003C/span\u003E Thank you, Madam Chair. In Part 4, I have just one small question around clause 97(1)(h), around entitlement cards. As I think about it, the only entitlement cards I can think of are primarily pharmaceutical entitlement cards: the prescription card\u2014up to 20 items\u2014the community services card, maybe, and possibly the super card. So my question is quite short: are there any other entitlement cards that this legislation or that the Minister envisages? Thank you.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u0022407cdcde7ba248babfb9a4893b0d08a5\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000631\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022407cdcde7ba248babfb9a4893b0d08a5\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Madam Chair. I just wanted to quickly pick up on an area where I feel like the Minister may be able to be enlightening towards New Zealanders and, in particular, younger New Zealanders, who might be finding that once they turn 18, they\u2019re able to go off to the liquor store and purchase alcohol.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000632\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EIn Part 4, under Subpart 3, \u201CSecondary legislation\u201D, at clause 96, it talks about levies for alcohol-related purposes, so that the ministry is able to recover some of the costs it incurs in the health system by people drinking. Now, I know a lot of New Zealanders do enjoy a good drink on a Friday night or a Saturday night, but the Schedules 5 and 6 apply here, and it actually goes into a little bit of detail on how much levy on every drink that a New Zealander might consume is actually taken in for the purposes of taking up some of the costs that\u2019s incurred on the health sector.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000633\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003ESo I just wondered whether the Minister is able to be informative for some of the people who may not realise that when they\u2019re buying something, there\u2019s a levy taken, but also maybe just give a little bit of an example of what sort of alcoholic beverages fall between the maybe 1.15 percent to 2.5 percent versus the 6 percent to the 9 percent, or between 9 percent or 14 percent. Thank you.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022da456ec2884e4f528d44438209551f9d\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000634\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022da456ec2884e4f528d44438209551f9d\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair. Just responding to Ms van Velden\u2019s latest question, I\u2019m not going to go through an account of everybody\u2019s liquor stores to try and gauge exactly what levy might apply. I just simply make the point that the levy provisions in the bill are, in fact, a direct copy of the existing alcohol levy provisions in the current legislation. They are to raise funds for appropriate health promotion because of the harm that the misuse of alcohol causes\u2014and there is a misuse of alcohol consumption, and we have to be able to address it as a major public health issue. I say no more than that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000635\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI\u2019ll do this in reverse order, now that I\u2019ve started with the most recent question asked, and respond to Dr Shane Reti, who asked, in relation to clause 97(1)(h), about the regulations that can be made and specifically in relation to an entitlement card. Again, this is an existing provision that has just been carried over from legislation and put into this bill. I would say that this is simply futureproofing the health system in case we want to introduce a method of recording information for people, that we can record that information that way, and that information is stored on a card as the basis for people to get access to whatever it is\u2014a service, or medications, or what have you. So it\u2019s just being sure that there is statutory authority to be able to use that technology and use information and store it in that particular way.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000636\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThen turning to Mr Watts\u2019 questions about clause 95(2) and (1)\u2014in that order. I get the member\u2019s point that given the amount of land that hospitals occupy\u2014and their use is going to change over time. I get that. But I think the important thing is he is probably right that this is sort of a historical throwback. It\u2019s never really been amended to change from an organisation with a turnover of anywhere between $400 million and maybe $1 billion, to an organisation that will have a turnover of closer to $18 billion to $20 billion and a workforce of about 82,000. It\u2019s well worth considering in the five-year review that is provided for in the legislation here. But I think the underlying premise was that land that is held by the Crown for health services and used for health services\u2014you want to make sure that it continues to be available for that purpose, even if for a period of time it might be used for some slightly different purpose and to raise some revenue as an alternative.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000637\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI should add, as I understand it, the Minister\u2019s powers in this regard can be delegated\u2014most likely delegated to the director-general, who would then further delegate it to an appropriate senior official. It\u2019s possibly even capable of being delegated to Health New Zealand. But it\u2019s an old-fashioned protection\u2014if I could use that term in that way\u2014that, perhaps, when the legislation comes up for review in five years, this is something that could be looked at then.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00229c069cdb-968c-4f11-b126-92f9c655148b\u0022 data-id=\u00220459be8726ca4fc3881b0c2a828da17e\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000638\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00229c069cdb-968c-4f11-b126-92f9c655148b\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00220459be8726ca4fc3881b0c2a828da17e\u0022\u003ESHANAN HALBERT (Labour\u2014Northcote):\u003C/span\u003E I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022f96cdca1-b63c-4602-b2b3-276f58ebb518\u0022 data-id=\u002292537f751534488bb01f53e12a7fed80\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000639\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f96cdca1-b63c-4602-b2b3-276f58ebb518\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002292537f751534488bb01f53e12a7fed80\u0022\u003ECHRIS PENK (National\u2014Kaipara ki Mahurangi):\u003C/span\u003E Thank you very much, Madam Chair. I\u2019ve been watching the debate remotely, so to speak, and can I just say it seems to me an excellent discussion in the committee, so I\u2019m grateful to everyone who\u2019s contributed. My own contribution will be obviously limited to Part 4, because this is where we are now, and reasonably narrow and won\u2019t be unduly lengthy, actually. But I do just want to engage with the Minister, at least briefly, on some of the regulation-making powers within the bill. I acknowledge that the Minister has a legal background, as well as the fact that he holds a particular portfolio in the health space that relates to the substance of the bill.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000640\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f96cdca1-b63c-4602-b2b3-276f58ebb518\u0022\u003EBut from a legal perspective and, I suppose, wearing my hat as the enthusiastic chair of the Regulations Review Committee, notwithstanding that committee hasn\u2019t yet considered this matter, just in terms of the way that the regulation-making powers are provided in clause 97, I suppose I might characterise my contribution as an encouragement to the Minister to provide as much detail as possible. We may be beyond the point of no return in terms of what\u2019s actually in the legislation at this point, but any guidance he can give, or thoughts, will be helpful for the record.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000641\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f96cdca1-b63c-4602-b2b3-276f58ebb518\u0022\u003ESo, for example, the Governor-General may by Order in Council\u2014in other words, the executive government, essentially\u2014make regulations to do with regional arrangements. I think it might be helpful, in the making of the regulations, if not in the regulation-making power within the bill, for a bit of a rationale to be provided. So the regional arrangements through which Health New Zealand and the M\u0101ori Health Authority must provide and arrange services, I think it would be helpful if those regulations specified that their purpose is, for example, to avoid a postcode lottery approach to health. More eloquent language, no doubt, would be used for that, but no doubt those listening will know what\u2019s intended by that. I expect every member of the House would be anxious that we have a health system that doesn\u2019t make a lottery of a person\u2019s place of residence within New Zealand. So, I think, at that high level, we\u2019re all on the same page here. So can I encourage the Minister and his officials, when they\u2019re making those regulations, to be quite clear about the reason that those are going to need to be made, because that will be the yardstick against which their effectiveness is able to be measured.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000642\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f96cdca1-b63c-4602-b2b3-276f58ebb518\u0022\u003ESimilarly, in relation to the next subheading\u2014in italics, for those who are fortunate enough for them to have the bill in front of them\u2014\u201CInformation to be supplied by health entities\u201D. So the information to be specified and to be provided to the director-general would include the manner in which it\u2019s to be provided. A bit more detail there might be helpful\u2014for example, the frequency of such information being provided, the requirement of it being released maybe proactively on a publicly accessible Government website, and so forth. If I could just give an example, actually, where I think there is a bit of helpful detail later on, under the heading of New Zealand Health plan, we\u2019ve got the imposition of procedural requirements, including engagement requirements for consultation. So I think that\u2019s an example, actually, where there is a helpful level of detail in the legislation under that.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000643\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f96cdca1-b63c-4602-b2b3-276f58ebb518\u0022\u003EAnd then, finally, in the remaining time within this slot\u2014I should highlight that I don\u2019t expect the Minister to engage in detail on each one of these, but just to give a general flavour of my thoughts around the fact that more detail, rather than less, would be helpful\u2014under the heading of \u201CDispute Resolution\u201D, clause 97(1)(p), \u201Cfor the purpose of section 28 [elsewhere in the bill], prescribing procedural matters and requirements\u201D. So I think some examples there, and certainly it would be helpful to have those dispute resolution mechanisms\u2014for example, it might be that the system should prioritise the timely resolution of such disputes. Of course, generally the dictates of justice require timeliness, and, I can only imagine, in the context of contested healthcare provision, it would be particularly important for the mental health, if nothing else, of those involved to have these issues dealt with more rapidly than is, for example, in the judicial branch of Government more generally.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000644\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022f96cdca1-b63c-4602-b2b3-276f58ebb518\u0022\u003ESo those are my thoughts and comments. Any response that the Minister can provide would be gratefully received. Otherwise, please take it as read that we will look carefully and with interest at the regulations that eventually flow from this primary legislation.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022bbfb36f9380c47af983e0d5f9d27afc5\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000645\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022bbfb36f9380c47af983e0d5f9d27afc5\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Thank you, Madam Chair, and I thank Chris Penk. For a minute there, I thought he was going to say that they were going to vote for the bill, but that\u2019s too much to hope for. I want to correct the member, too. I know he refers to the Regulations Review Committee. It is known around are here as \u201Cthe all-powerful Regulations Review Committee\u201D, because we all bow to it. It\u2019s very important, a very authoritative committee, and one that I thoroughly enjoyed serving on for a period of time. No, it is important, and it\u2019s important that it\u2019s chaired by somebody with considerable capability, as indeed, that member reflects, as he sits in his chair\u2014it must be late at night! \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000646\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe member has invited a general response as opposed to a detailed response, although I\u2019m tempted to give a detailed response. I think that the member makes good points, as usual, and he makes the point about the extent that regional arrangements are provided for. And that reflects, I think, an expectation that Health New Zealand and, in fact, the M\u0101ori Health Authority, because they\u2019ve now said this, have a regional element to their structure. And the regional division, if you like, will be quite important. They\u2019re going to make commissioning decisions, and so it would be appropriate, for the sake of transparency and accountability, that there is some clear regulation about that, so the member can expect to see something in that respect in due course.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000647\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EAlthough there will be a regional level of organisation, the member is right. The whole purpose of the legislation is to try to get rid of the postcode lottery that we\u2019ve got\u2014I suppose what I would say is the unnecessary and unjustified variation in terms of health services. But, of course, the other part, and locality planning will drive this, is we do want some tailoring of services as communities ask for it and want it and need it. So there will be some variation, but that will be variation that is justified and warranted. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000648\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI accept the member\u2019s point about when it comes to information being provided, it is to be as specific as possible about that. Again, that\u2019s in the interests of transparency. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000649\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EThe dispute resolution provision there relates to disputes between Health New Zealand and the M\u0101ori Health Authority to the extent that dispute resolution will need to be regulated. Again, that\u2019s for the sake of various parties so they know what the rules of engagement are in the event that there is a dispute that can\u2019t be resolved in a more informal sort of way, but my expectation is that that will be possible. But I thank the member for his contribution.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u00226dd9c7b946454cb180df2b539f959116\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000650\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00226dd9c7b946454cb180df2b539f959116\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Madam Chair. I had a question that related to Part 4, clause 93, and it\u2019s about the director-general requiring information from health entities. It says that \u201C(1) For the purpose of monitoring the performance of any health entity or the health sector in general, the Director-General may, in writing,\u2014(a) request from a health entity, information in relation to any matter; and (b) specify a time frame by which the health entity must comply with the request.\u201D It also says that \u201C(3) The Director-General must not request under this section any personal health information of any identifiable person.\u201D \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000651\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EI think that\u2019s important, but I also wanted to give the Minister a chance to explain to people or provide a bit more context, because I know a lot of New Zealanders do worry about the privacy of their information. They worry about their names, their details, and their health records being put on registers, and somehow this information not necessarily being leaked but being deposited in an area that it was never expected to. We do note that with the Waikato DHB is an example where there was a privacy breach, but I also think of a range of other different registers, and I know that a lot of New Zealanders do have an issue with Governments holding their own data and whether or not they feel like that data should be shared. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000652\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003ESo is there in any other part of the health sector, or in any processes or requirements in place within the entities themselves, the ability to hold and store this information or processes to help with the transfer of information to the Director-General of Health where that information about that person won\u2019t be personally identifiable, because I know that this is an issue that has cropped up time and time again with people who don\u2019t trust Government departments\u2014people who do have vulnerable health conditions not wanting that to be public in any way. So if the Minister could shed a little light on how this process would actually work in effect. Thank you.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u002249a0f23550fc4220bbbd5642be79bff6\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000653\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002249a0f23550fc4220bbbd5642be79bff6\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E Madam Chair, thank you, and I thank the member for raising that question. That is a very big question that not just public health entities deal with but private as well. I think the single biggest compromise of health data we had was actually a private health provider. It was a primary health organisation where the health records of a million patients were potentially compromised through an encroachment by a bad actor. Upon investigation, it was found more likely than not that information wasn\u2019t exfiltrated, but certainly the person who compromised the system had the opportunity to do so over a considerable period of time. And then you\u2019ve got the situations like the Waikato District Health Board, where a ransomware attack happens and data is exfiltrated and is placed on the dark web. So those are real things that have happened. That really highlights the need for high-quality IT systems, and that\u2019s why we\u2019ve invested nearly half a billion dollars in upgrading and renewing health IT systems, but also the need for high-quality data security and cyber-security.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000654\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EI think to the extent that clause 93 signals anything, it is that we do respect the need for a high degree of confidentiality and respect for the confidentiality of personal health information. It is important for the Director-General\u2014as the head of the ministry, which is the steward of the system and needs good information to understand what\u2019s going on\u2014to get information, but not in a way that identifies individuals, so that individual patients can be sure that their personal health details are not being placed in data storage or data systems somewhere that people unknown to the patient could get access to them.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000655\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EOne of the challenges we\u2019ve got and we\u2019re working with\u2014and I think most members of the House would agree\u2014is that of health information. We want patient health information to be available to health practitioners who are authorised to have access to it\u2014authorised by patients\u2014at a time when it makes sense to. So we want to build a system where if a patient agrees, then whichever health practitioner they\u2019re turning up to\u2014whether it\u2019s somebody in a hospital, somebody in their GP practice, or, if they\u2019re out of town, an after-hours practice somewhere\u2014that health practitioner can get that person\u2019s health information to fully understand the health profile of that person.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000656\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EA system that can do that has been sought for a long time. That is the system that we\u2019re trying to create. It\u2019s what the health sector says will make such a big difference in terms of health service provision and preventing the need for patients to tell their story multiple times, particularly if they are a patient seeking treatment, for example, for a traumatic injury or a traumatic violent injury or an injury incurred as a result of a violent act. Patients in that situation seldom want to repeatedly tell their story, because just telling it can be traumatising. So the more that we can do to ensure that the trusted health practitioner in front of a patient can get the right information so that health practitioner can give the best possible advice and treatment\u2014that is where we want to get to, but it has to be done in a way that is respectful of the patient\u2019s privacy rights. That\u2019s the system that we\u2019re trying to build.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002286ae9a20-33bd-4912-8dc1-5b4eb670be44\u0022 data-id=\u00227c0a5c6017b4428c919e9a2d4e3f48b1\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000657\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002286ae9a20-33bd-4912-8dc1-5b4eb670be44\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227c0a5c6017b4428c919e9a2d4e3f48b1\u0022\u003EKAREN CHHOUR (ACT) (remote):\u003C/span\u003E Thank you, Madam Chair. Just a quick question around privacy with information: as we\u2019ve seen, this has been an issue in the past when it came to vaccinations with M\u0101ori and M\u0101ori information being wanted when it comes to finding out who needed to be vaccinated. I\u2019m just wondering how will people\u2019s health information be held under these two authorities, and will there be a choice of where M\u0101ori hold their information, or will that just be shared automatically?\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022 data-id=\u0022d4a63e51a197408eb44e3d35bbe444a8\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000658\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022d4a63e51a197408eb44e3d35bbe444a8\u0022\u003EHon ANDREW LITTLE (Minister of Health):\u003C/span\u003E I thank Ms Chhour for her question. I think she can expect that patient information will be held by health organisations who gather that information from the patient, because that clearly will have been imparted by the patient and the patient would expect that health provider to hold it.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000659\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022106966ef-8cc3-434a-9dbe-dd76b708c2a1\u0022\u003EInformation will not be passed on to any other health provider unless that has been consented to by the patient. So if there is a referral, ordinarily a patient would be asked to and required to give their consent to pass that on. That said, we know that from every patient transaction there is relevant data that is useful in the aggregate as we think about health planning and the incidence of infections and non-communicable diseases and all the rest of it. So we do need a system that can gather data on an anonymous basis, so that anonymised aggregate data can be provided to appropriate agencies as they do the health planning and the long-term planning for the sort of health services that might be needed, and the long-term aggregate data, too, that will assist in locality planning and more localised service provision. To the extent that the member is seeking reassurance about the safety and security of personal information, information will be held only by health providers that have been authorised by the patient to hold it.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002261725fea-7d5e-4d1f-8fd3-e5779bb7a14d\u0022 data-id=\u00221a886e32fa764db791bc76a847ff923a\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000660\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002261725fea-7d5e-4d1f-8fd3-e5779bb7a14d\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221a886e32fa764db791bc76a847ff923a\u0022\u003EBARBARA EDMONDS (Associate Whip\u2014Labour):\u003C/span\u003E I move, That the question be now put.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00224ba31bbcf8f34ae9920bd4949a8dfd44\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the question be now put.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EMotion agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022d82dd5c62ae34c09a0dd2ce8d1aa51d8\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000661\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022d82dd5c62ae34c09a0dd2ce8d1aa51d8\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that the Minister\u2019s amendment to Part 4 set out on Supplementary Order Paper 169 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000662\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EAmendment agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022ba40f052becb470884fed73c144f106d\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000663\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022ba40f052becb470884fed73c144f106d\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Debbie Ngarewa-Packer\u2019s amendments to Part 4 set out on Supplementary Order Paper 167 are ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000664\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EBrooke van Velden\u2019s amendments to Part 4 set out on Supplementary Order Paper 153 are ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022130328cda6cf42eb9147d15e292f34bd\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Part 4 as amended be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EPart 4 as amended agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000665\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u0022401abf52157f42fdb03205313d695790\u0022\u003ESchedule 1\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00220b3c394a583c4e888e7605a8ac819817\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000666\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00220b3c394a583c4e888e7605a8ac819817\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that the Minister\u2019s amendments to Schedule 1 set out on Supplementary Order Paper 169 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000667\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EAmendments agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00227331a912aec64feb9cf375def23e8fc3\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000668\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227331a912aec64feb9cf375def23e8fc3\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Brooke van Velden\u2019s amendments to Schedule 1 set out on Supplementary Order Paper 153 are ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000669\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EBrooke van Velden\u2019s amendment to Schedule 1 relating to a rural health strategy set out on Supplementary Order Paper 151 is ruled out of order as being the same in substance as a previous amendment. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000670\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EBrooke van Velden\u2019s amendment to Schedule 1 set out on Supplementary Order Paper 152 is ruled out of order as being inconsistent with a previous decision of the committee. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000671\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EDr Elizabeth Kerekere\u2019s amendment to Schedule 1 set out on Supplementary Order Paper 154 is ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000672\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EDr Shane Reti\u2019s amendment to Schedule 1 set out on Supplementary Order Paper 157 is ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000673\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EDr Shane Reti\u2019s amendment to Schedule 1 set out on Supplementary Order Paper 158 is ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000674\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EMatt Doocey\u2019s amendment to Schedule 1 set out on Supplementary Order Paper 170 is ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000675\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EDebbie Ngarewa-Packer\u2019s amendment to Schedule 1 set out on Supplementary Order Paper 167 is ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00220d0c94c931f24682a4c3f4257012f2b3\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Schedule 1 as amended be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ESchedule 1 as amended agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000676\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u002227206d2477e54ff09535ed876862f49f\u0022\u003ESchedule 1A\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u002250f903632ae04d31a2f104a3f06d06ce\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Schedule 1A be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ESchedule 1A agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000677\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u00228dd31f8b99074c73a694bcaff4ba1dbc\u0022\u003ESchedule 2\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00223e0a70c281dc420b94884f5d8a701187\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000678\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00223e0a70c281dc420b94884f5d8a701187\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that the Minister\u2019s amendments to Schedule 2 set out on Supplementary Order Paper 169 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000679\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EAmendments agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u002256971053741d40439051a7eaff5b388b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000680\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002256971053741d40439051a7eaff5b388b\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Brooke van Velden\u2019s amendments to Schedule 2 set out on Supplementary Order Paper 153 are ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000681\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EDebbie Ngarewa-Packer\u2019s amendments to Schedule 2 set out on Supplementary Order Paper 167 are ruled out of order as being inconsistent with a previous decision of the committee.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00222285c0023e26402daf70827fe8b0daee\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Schedule 2 as amended be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ESchedule 2 as amended agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000682\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u0022ba06c43f1dc74768bf13b053d9a3538c\u0022\u003ESchedule 3\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022f454024153904bc19196101628281336\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Schedule 3 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ESchedule 3 agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000683\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u002261a349527bfc4e5ca274930fabb89a33\u0022\u003ESchedule 4\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022bd8016f237114e089d6762784cbdff7a\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Schedule 4 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ESchedule 4 agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000684\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u00221b7f2ab884d6423eb104c7e2fbf97dc9\u0022\u003ESchedule 5\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00221ea2247f537240958e704c28fcb116c9\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000685\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00221ea2247f537240958e704c28fcb116c9\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: The question is that the Minister\u2019s amendments to Schedule 5 set out on Supplementary Order Paper 169 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000686\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EAmendments agreed to.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022f344d793e227472db4ab2737bbeba965\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Schedule 5 as amended be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ESchedule 5 as amended agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000687\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u0022e9250d163d194c22b2ecbbb2f5501a23\u0022\u003ESchedule 6\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u0022f69acfa70f4649d9b77b531dd5f8ba76\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That Schedule 6 be agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ESchedule 6 agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000688\u0022\u003E\u003Cspan class=\u0022HpsSubproceedingHeading\u0022 id=\u0022a8dd24be90f44618ab1d972bc4eec741\u0022\u003EClauses 1 and 2 \u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00227e8d24a773754430b579a9137f42cbbc\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000689\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227e8d24a773754430b579a9137f42cbbc\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Members, we come now to our final debate. This is the debate on clauses 1 and 2, the title and commencement debate. The question is that clauses 1 and 2 stand part.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022 data-id=\u0022fa02412636014ba0ab84feb57a7296c0\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000690\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022fa02412636014ba0ab84feb57a7296c0\u0022\u003EDr SHANE RETI (National):\u003C/span\u003E Thank you, Madam Chair. I rise to speak to Supplementary Order Paper 161, in my name, and on behalf of the National Party. This Supplementary Order Paper seeks to change the title of the bill to describe what it functionally does, which, by its own description, is to centralise healthcare.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000691\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EI now want to talk about centralising healthcare in this manner. We have significant concerns with centralising healthcare, as this bill and these reforms do. Quite simply, it is command and control by a socialist, Labour Government not happy with centralising polytechnics and ruining that sector, and not happy with centralising three waters and ruining local government; now, they want to centralise healthcare and will ruin that\u2014all underpinned by a theme of \u201CWellington knows best.\u201D Well, guess what! They don\u2019t know best. Local people know what is best for them. \u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000692\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EAsk yourself this: do these reforms increase or decrease elected democracy? By removing elected district health board (DHB) members these reforms, and this Government, arrogantly dismisses the rule of democracy and the voice of elected people. By removing elected officials and saying they never really made a contribution disrespects what the Parliamentary Library tells me are the nearly 1,001 people over 20 years who have been voted in by communities. I want to thank all of those elected people who put themselves forward and made a contribution; it was valued.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000693\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EIn 2001, the British Medical Journal described the reforms that brought about DHBs, and the Labour Government that did it, as working to achieve the goals of \u201Ca system promoted as allowing greater community voice in health sector decision-making\u201D and \u201Cputting the public back into the public health system\u201D. What these reforms do is put bureaucracy back into the health system. What these reforms do is take the public out of the public health system. Decentralisation of healthcare by this bill will put layers and layers of bureaucracy between patients and the Minister: a national commissioner, four regional commissioners, four to five district locality commissioners, 80 localities, and then providers, and then patients\u2014more money, more bureaucracy, and worse outcomes. Centralising healthcare in the middle of a pandemic, when New Zealanders are dying every single day, is a reform that will fail, that deserves to fail, and will see this Government out of office.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000694\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022861a1798-a396-4a6c-b9e2-7d2f15d4a001\u0022\u003EThe question I\u2019d then pose: how does the Minister explain the removal of the democratically elected local people, and is democracy enhanced or diminished by this bill? Thank you.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022 data-id=\u0022f309955decd647ccbe9e007e405ad6f6\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000695\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f309955decd647ccbe9e007e405ad6f6\u0022\u003EMATT DOOCEY (National\u2014Waimakariri):\u003C/span\u003E Thank you very much, Madam Chair. Look, I must admit I did take a bit of time out of the debate. So I just wanted to check back in and see if the Government had backtracked on any other parts of the bill, since they told us they weren\u2019t going to have a rural strategy. But we heard from the Minister tonight that, a few weeks after the select committee, where the Labour MPs sat on their hands and didn\u2019t say anything, he spoke to one of his Labour rural MPs and they said, \u201CHey, have you thought about putting a rural health strategy in?\u201D And the Minister said, \u201CGreat idea! I haven\u2019t heard of that.\u2014even though I\u2019ve been in the media saying we\u2019re not going to do that.\u201D It might have been the morning after a poll, I think\u2014the morning after.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000696\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EBut well done to rural New Zealanders for standing up and having a voice, because rural New Zealanders know that, under this bill, their voice will be taken away because bureaucrats in Wellington will be deciding healthcare in rural and regional New Zealand. And do you know why the Government backtracked on the rural health strategy? It\u2019s because the rural Labour MPs squealed; they felt the pressure of their constituents. And we got told in the House it was Labour that stood up for rural New Zealand. In fact, it was actually the Opposition that got this win over the line tonight.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000697\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EThis is emblematic of this failed socialist experiment that wants to centralise time and time again\u2014polytech mergers, three waters, now we\u2019ve got healthcare, and they think that if you just get the title and you just put the word \u201Chealthy\u201D in it, that will make a difference. Because, if you say, \u201Chealthy\u201D, it must be healthy! A bit like fair pay. If you say \u201Cfair pay\u201D, it must be fair pay! And then they think, \u201CWell, if you say \u2018healthy\u2019 and just throw money at it\u201D\u2014billions of dollars. But here they were; they invested $1.9 billion\u2014or they announced $1.9 billion; I\u2019m not sure they actually put it in. They announced $1.9 billion and the report came back, the scorecard, and said, \u201CNo material improvement, for $1.9 billion.\u201D Now they\u2019re saying, \u201CLet\u2019s put more money into health, and trust us. We will make a difference.\u201D The Minister could never state, through this whole process, one health outcome that would be improved in the first 12 months. So how do we have \u201Chealthy\u201D in the title when you can\u2019t name one health outcome that will be improved in the first 12 months?\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000698\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EAnd what is the real kick in the guts by this bill, in the final debate tonight? I think this Government needs to apologise to the thousands of vulnerable Kiwis that turned up to their mental health inquiry, told their traumatic and often personal stories; and yet they turn up and we\u2019ve got a once-in-a-generation health restructure and they wouldn\u2019t put a mental health, addictions, and wellbeing strategy in. But the submitters called for it. The Mental Health and Wellbeing Commission said mental health was invisible in this bill. The Mental Health Foundation said not having mental health in it demonstrated the Government\u2019s lack of commitment to transforming the mental health system. Every mental health submitter turned up and said, \u201CIf this bill is about health, if this bill is about equity, then it\u2019s equity when it suits them. What about the population group that has one of the most serious health inequalities: mental health?\u201D People with mental health die 20 years shorter than the average Kiwi. Do we hear of a mental health and wellbeing strategy in this bill? No, because Labour knows best!\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000699\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022ee649aea-c6fa-4610-9fcf-5c4bb2d3cd33\u0022\u003EThey will centralise the health system. They know best! Their bureaucrats know best! And that\u2019s why people in regional and rural New Zealand know exactly what is going to happen, because bureaucrats in Wellington don\u2019t know what\u2019s best for regional and rural New Zealand. And well done them for sticking up tonight and making sure their voices were heard, because what it was tonight was electoral pressure; electoral pressure on this Government that\u2019s waking up that people are realising they are not doing what they want. And well done to the Opposition for sticking up for regional and rural New Zealanders.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022 data-id=\u00229f899bed338141b0bce0c48b23776bf5\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000700\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00229f899bed338141b0bce0c48b23776bf5\u0022\u003EBROOKE VAN VELDEN (Deputy Leader\u2014ACT):\u003C/span\u003E Thank you, Madam Chair. It\u2019s a pleasure to take a call on behalf of the ACT Party on the title and commencement clauses. This bill should not be called the Pae Ora (Healthy Futures) Bill. I\u2019ve got two options for what this bill should be called.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000701\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003ENumber one, we should rename this bill to be called the \u201CCo-governance Bill\u201D, because that\u2019s what it is. This health reform is not a health reform; it is an exercise in co-governance rather than in health needs and better health outcomes for New Zealanders. The second amendment that I would make to this is to call it the \u201CDemocracy is Different in New Zealand Bill\u201D, because that is what the Ministers in this Chamber have said. They\u2019ve said publicly that democracy is different in New Zealand. I think that\u2019s a disgrace, and it should be front and centre. Rather than being called the Pae Ora (Healthy Futures) Bill, it actually should say what it is: that this Government doesn\u2019t believe that healthcare should be put at the centre of our health reform; co-governance should be put at the centre of our health reform. This bill should have asked the question: how do we get better access to more treatments, to more New Zealanders, faster? This bill is adding bureaucracy to our healthcare system. It will make it harder for New Zealanders to get access to healthcare, because it\u2019s focusing on the wrong problem. It\u2019s focused on co-governance and changing the definition of democracy in New Zealand rather than on focusing on patients.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000702\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003ENow, the ACT Party put forward three amendments to this legislation, and we\u2019re happy to see that the Government has taken up one of them, and that was an amendment in my name for a rural health strategy. I want to congratulate the Minister for recognising, at the last minute, that he had forgotten about rural New Zealand and forgotten about the rural population\u2019s health needs. I think it\u2019s important that the rural health strategy was put in this bill, and I hope it goes some way to acknowledging the difficulties that rural New Zealanders face getting adequate health outcomes and adequate health access.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000703\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EOne aspect that I think has been missed over is the need for a medicines strategy. That was another amendment that we put forward tonight. The Pharmac final review came back and said that for Pharmac to be truly integrated into the new health system, there was a desperate need for a medicines strategy to underpin it. Now, we had this amendment ready to go, the Minister could have taken it up, and it\u2019s a shame he didn\u2019t. I think he didn\u2019t take it up, because, like he forgot about rural New Zealand, he forgot about patients and forgot about medicines access. You cannot reform the healthcare sector if you don\u2019t talk about medicines access. It\u2019s shameful in New Zealand. We have hundreds of people who don\u2019t get adequate care and don\u2019t get the funding for the drugs that they need to live long, productive, and healthy lives. We can, and we should, do better, and that\u2019s why I think it\u2019s important that we should have had a medicines strategy.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000704\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u002266f06e7e-afa8-457f-a105-048b86a13282\u0022\u003EWe also had an amendment to remove the M\u0101ori Health Authority, and that goes back to why I think this bill should be called the \u201CCo-governance Bill\u201D or the \u201CDemocracy is Different in New Zealand Bill\u201D, because we are going down a divisive path of going through the three waters reforms, the healthcare reforms, and putting in place divisive policies that base people in New Zealand on their race rather than on their needs, and rather than on good structures, and I think that\u2019s shameful. So I hope anybody would support me in saying that this bill shouldn\u2019t be called the Pae Ora (Healthy Futures) Bill; it\u2019s should be called the \u201CCo-governance Bill\u201D or the \u201CDemocracy is Different in New Zealand Bill\u201D. We need more transparency about what this Government is actually doing. We need to put patients back at the heart of the healthcare sector. We need better medicines access, for more people, faster. We need better treatments, for more New Zealanders, faster. We need to look out for those rural New Zealanders, who are so often overlooked by this Government, and I am proud that the ACT Party forced the Government into putting the rural health strategy at the heart of this legislation.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u0022f84942bc95064adeabd2372723c8527e\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000705\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022f84942bc95064adeabd2372723c8527e\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: I call on Joseph Mooney, although I warn you that this will be a very short call because I have to report progress at five to 10.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u00222170b5bd-171f-4d9f-bfa6-cab72178f108\u0022 data-id=\u002268349fee02864264b16f3cb552b225a6\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000706\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u00222170b5bd-171f-4d9f-bfa6-cab72178f108\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u002268349fee02864264b16f3cb552b225a6\u0022\u003EJOSEPH MOONEY (National\u2014Southland):\u003C/span\u003E Thank you, Madam Chair. I just wanted to speak to the name of this bill, the Pae Ora (Healthy Futures) Bill. I wanted to ask the Minister whose futures his Government was thinking about. The biggest population group after Auckland and Christchurch in New Zealand is rural New Zealand, and yet only tonight has the Minister thought of a rural health strategy. I mean, this is shocking and it speaks to rural New Zealand who feels his Government has left them behind and forgotten about them. It\u2019s actually incredible\u2014\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00228b88b6ff934d486482405f7d007bd14c\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000707\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00228b88b6ff934d486482405f7d007bd14c\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Apologies to the member. I have to report progress now.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000708\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EProgress to be reported.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000709\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003EHouse resumed.\u003C/span\u003E\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022 data-id=\u00227d954121bd264422b85317a674806c6b\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000710\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022d14b1afe-2069-41e4-96fa-c8dc81a991a4\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u00227d954121bd264422b85317a674806c6b\u0022\u003ECHAIRPERSON (Hon Jenny Salesa)\u003C/span\u003E: Mr Speaker, the committee has considered the Pae Ora (Healthy Futures) Bill and reports progress. I move, That the report be adopted.\u003C/span\u003E\u003C/p\u003E\u003Ca id=\u00222684e9d2bce34c8db480bed3371373c6\u0022 name=\u0022division\u0022\u003E\u003C/a\u003E\u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EA party vote was called for on the question, That the report be adopted.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EAyes 77\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand Labour 65; Green Party of Aotearoa New Zealand 10; Te Paati M\u0101ori\u00A02.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENoes 42\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003ENew Zealand National 32; ACT New Zealand 10.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp class=\u0022HpsDivision\u0022\u003E\u003Cspan class=\u0022HpsItem\u0022\u003EMotion agreed to.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000711\u0022\u003EReport adopted.\u003C/p\u003E\u003Ca name=\u0022member\u0022 data-type=\u0022article\u0022 data-memberid=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022 data-id=\u0022879b34cbad064463ac9beb2832d92f74\u0022\u003E\u003C/a\u003E\u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000712\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003E\u003Cspan class=\u0022HpsByToc\u0022 id=\u0022879b34cbad064463ac9beb2832d92f74\u0022\u003EDEPUTY SPEAKER\u003C/span\u003E: Members, this bill is set down for further consideration in committee next sitting day. The House stand adjourned until tomorrow at 2 p.m. Tofa soifua. Manuia le po.\u003C/span\u003E\u003C/p\u003E\n      \u003Cp id=\u0022id20220601eebf669a235c4744ac4dfa81959e1445000713\u0022\u003E\u003Cspan class=\u0022HpsNormal\u0022 id=\u0022a434482b-7ac1-4862-9ce7-13e63289dee3\u0022\u003EThe House adjourned at 9.56 p.m.\u003C/span\u003E\u003C/p\u003E\n    \u003C/div\u003E\n  \u003C/body\u003E\n\u003C/html\u003E"