Watts Simon; Dean JacquiSIMON WATTS (National—North Shore): Thank you very much Madam Speaker. I wish to stand on behalf of the National Party as a member of Parliament for North Shore to oppose the third reading of the Pae Ora (Healthy Futures) Bill. It is with some disappointment that I do that having spent nearly half a decade working within the public health system in New Zealand in a variety of roles and continuing to work as a volunteer with our ambulance service. It is very disappointing that we aren't in a position where we've got consensus in terms of how we progress and build and improve our health system going forward. Because importantly our health system is critical to the success of this country. Our health system is one of those pillars that will serve us all at periods of our lives and the reality of where we stand today is that we do not have agreement across this House in terms of how that will look in the future. That is a grave shame because this is not an area which we should look to change or continually move from one point to another. But we are here for reasons that have been articulated already before: we need a health system that is based and focused on health outcomes; a system that targets resources based on need. If you do those two elements you deal with the challenges that have been covered already in the House today. New Zealand is out of step in terms of the way in which we are progressing with these reforms. Nearly every other country embarking on large-scale health reform—of which there aren't many during a pandemic of global scale but those that are progressing are moving to a devolved system the complete opposite to the centralisation model that has been adopted by this Government. That is a challenge for a number of reasons. Not only is New Zealand out of step in terms of what we are doing we're actually looking to adopt models that have been tried and failed in the past. And so we are missing the opportunity to use this opportunity to improve and do what could and will bring significant value in the future. Our system has a number of challenges and we all agree that that needs to be improved in different areas. But the workforce element within the health system is probably the most critical and fundamental aspect that is broken today. The aspects around retention of the existing staff who work within our system were pretty much forgotten in regards to the last Budget process articulated by this Government. Yet those are the very individuals across our district health boards across our primary care sectors across our front-line ambulance providers across our allied health areas across our aged-care sector that need our support. Retention is the single biggest factor—in terms of investment—that will be able to retain people within the system. Once they're gone—and New Zealand's health system leaks like a sieve to other countries particularly Australia—it is very challenging and very expensive to get them back.We also need to overlay outcome measures and targeted resources and reduce the level of bureaucracy. Having worked within the public health system there is a significant element of bureaucracy within our system but that will not be enhanced by further centralisation and further bureaucracy for Wellington. We need to remove that bureaucracy. We need to remove that overhead and provide certainty to not only the front-line clinicians that are working very hard day in day out within our system but also to those many staff who work in the back offices supporting our front-line health providers.Ideological change by this Labour Government will not result in better outcomes. Centralisation will result in a loss of local voice. Bureaucracy will not deliver better outcomes. In 2023 a National-led Government will inherit a wasteland of failed reforms. Having worked in the system for many years the conversations that I hear from past colleagues are that there is no clarity in terms of what and how this reform will be implemented. There is significant fatigue and many of my past colleagues are looking at options to move offshore not because they don't care about the health system and want to do everything within their power to improve it but they are tired. This reform will simply make that situation worse. We need a health system that is sustainable—that is not only in regards to the fiscal elements in terms of how we fund it but also in terms of the people that operate within it. National opposes this bill.ASSISTANT SPEAKER (Hon Jacqui Dean): Debbie Ngarewa-Packer—five minutes.