Katene Rahui: New Zealand Public Health and Disability Amendment Bill — First Reading 
Katene Rahui: New Zealand Public Health and Disability Amendment Bill — First Reading 
[Volume:663;Page:11028] 
RAHUI KATENE (Maori Party—Te Tai Tonga) 
: 
 Today is a very good day to speak to the New Zealand Public Health and Disability Amendment Bill and to share the good news for Te Tai Tonga health. The district health board results for the third quarter which were released today show that in four of the Government’s six health targets district health boards in the Te Tai Tonga rohe featured in the top four results of performance. That is great news. It is fantastic. In fact there were some exceptional results for the Southland District Health Board which has improved access to elective surgery by 110 percent and for the Canterbury District Health Board which has improved access to elective surgery by 109 percent. In the area of increased immunisation Otago Southland and South Canterbury district health boards took up first second and fourth places in improving the targets for 2-year-olds to be fully immunised. 
There is a bit of bad news though I am sorry. The results were not as good in comparison with other district health boards in respect of the target of providing better help for smokers to quit. As members know that is an area of considerable interest to the Maori Party and I for one will be keeping a good eye on that one over this next quarter. Hopefully those district health boards will pick up their performance in those measures. 
But with this bill such accountability and transparency will become par for the course. The Maori Party welcomes the initiatives in this bill to respond to the challenge of providing high-quality health care and disability support services. I want to establish from the outset the context in which we read this bill. We read it in the context of the emphasis on Maori health and the principles of the Treaty of Waitangi expressed in the primary bill. Importantly we see many of the initiatives specified within the bill as being closely aligned to Whanau Ora. 
Much of the thrust of the bill is about increasing efficiency by removing duplication between corporate and administration functions. In this way it is a clear expression of a policy commitment we campaigned on which was to review the duplication of corporate and administration functions between hospitals primary health organisations and district health boards to see whether any savings would be available if these duplications were removed. As the Minister of Health would say it is about working better smarter and sooner. 
It is also about a system in which public services have to be monitored by reports against targets. The bill amends the objectives and functions of district health boards to ensure that they work together for the most effective and efficient delivery of health services to meet national regional and local needs. In these three key points—streamlining bureaucracy monitoring against targets or more appropriately outcomes and provider collaboration—there is a tight synergy with Whanau Ora. We absolutely believe that district health boards should work together for the more effective and efficient delivery of health services. 
But I want to make it quite clear that although the changes are positive we do not believe that it is necessary to legislate for such change. Collaboration to work more effectively and efficiently should be done naturally without people being forced into it. As members will know my colleague Minister Tariana Turia has been zooming around the rohe to Whanau Ora hui and she has been sharing with us the amazing response that has accompanied the hui throughout— 
Hon Tony Ryall 
: 3500 people already. 
RAHUI KATENE 
: That is amazing. There is so much interest in the Whanau Ora approach; it is fantastic an amazing response. One of the most exciting aspects of those hui has been the willingness of providers to consider collaboration in the interests of a cohesive and comprehensive approach to whanau well-being. 
Another aspect of this bill is the structural changes to enhance quality improvement activity including the establishment of a new Crown agent the Health Quality and Safety Commission. The Maori Party health policy includes the notion that the community must receive accurate information about the performance of hospitals primary health organisations and district health boards including the public reporting of adverse results. Although we welcome the emphasis on quality improvement we have some questions about the structural change and we would like to know the impact that setting up the commission may have on the Public Service. How many jobs will be cut as a result? 
While talking about personnel another initiative in this bill is to enable the appointment of elected district health board members to the boards of other district health boards. In Te Tai Tonga for example Tahu Potiki is a member of both the Southland and Otago district health boards so in many respects this bill reflects current practice. This is a positive development and will certainly assist in reducing duplication. Our only question around extending this approach to the nation is that we must ensure that we elect the right people to the board in the first place. 
Finally there is just one question that we would like to raise and that is the concern about whether this legislation will give the Minister of Health a lot more power over district health boards; if so what controls are in place to ensure that power is used wisely and not abused? 
There is a great deal of change activity currently occurring within the health sector and in most respects this legislation reflects the direction by investing in a system where outcomes matter where whanau matter—a system in which Whanau Ora becomes the norm. On that note we are very pleased to note that at one of the hui the former Minister of Health Annette King was present with her husband and was showing interest in the Whanau Ora approach. We support this bill at its first reading.