Reti ShaneDr SHANE RETI (National—Whangarei): Thank you Mr Speaker. It's a pleasure to speak today on the Budget. As part of that I'll traverse several portfolios. I want to talk to the health portfolio first of all. I'll cover a number of points in the Budget. I'll then also move to the tertiary portfolio and cover a number of things there as well. I think talking to health I want to say there are some things in health that I'm pleased with some that I have a neutral view on and some I'm looking at saying Gosh I don't know if that's in the right place or not. I would do something different." and I'll traverse some of that. But I think generally every health system in the world needs more funding as does ours. It's a vacuum and every health system struggles and so it's good to be getting more money in health. It's a point of contention of course as to whether it's enough and where it's going to but it is a good thing to have more in health.Why I think particularly it's a good thing is around a point that I brought out last week because more money is going to be needed at the health interface with the Customs Service. I'll tell you why that is: because when we open up our borders—and I may speak to it when we talk to international students and I make the point that I think safely we should consider opening the borders to international students in a safe way. When we do that the first point of screening—because we're going to need to screen for coronavirus for a long long time—is the arrivals card that they receive when they come into New Zealand. About six weeks ago now on 16 March a new arrivals card was proudly waved here in the House by the Minister of Customs. The concern I've had with this is that one of the key questions on the arrivals card asks "What symptoms do you have?" And the symptoms that it asks are "Do you have a cough fever or difficulty in breathing?" Now again remember this is the first contact people have the first screening for coronavirus when they come into New Zealand. The problem I've got with that and why I'm proposing that a part of this Budget is going to need to completely redo the arrivals card is because the three main symptoms for coronavirus in New Zealand are actually—ASSISTANT SPEAKER (Adrian Rurawhe): Order! Sorry to interrupt the member. There's about half a dozen conversations going on just in this area and it's really difficult for me to hear what Dr Reti is saying. I'd really like a few conversations to tone it down.Dr SHANE RETI: Thank you Mr Speaker. So the concern I have is that some of this Budget will need to be expended to completely renew the arrivals card. Why? Because it's asking the wrong questions. Our prime screening tool at the border is simply asking the wrong questions and indeed it has been since 3 a.m. on 20 March. That is what the Minister tells me is when this new arrival card—and I recall her in the House waving it around and saying "This is what we're doing here now."The principle is good. It's a health declaration card which actually sits outside the flu pandemic response. It sits in another document from 2016 around protecting international ports and borders. It's a good document. It's a good tool but we've got to ask the right questions. The wrong questions to reiterate are "cough fever and difficulty in breathing". It's the difficulty in breathing part that's the wrong question and we know that because when I queried the Institute of Environmental Science and Research (ESR) and said "What are the main set of symptoms that New Zealanders had?" they said "Cough fever and a sore throat." Were there only a few people with a sore throat? No. In fact nearly 50 percent of people with coronavirus have had a sore throat and when I talk with people who have gone to the testing stations and asked them "Well what symptoms did you have?" the vast majority have actually complained about a sore throat. So it's a really key symptom and our arrivals card—our prime screening tool—doesn't cover it. When this was raised with Professor Des Gorman he pointed out that it was a grave omission and a grave mistake and so I would strongly commend the Minister that with this Budget she look at very quickly redoing that arrival card. Go on an evidence base. Base it on science. Who knows or who cares where "difficulty in breathing" came from—that's a late symptom long after the sore throat. Use the evidence that other ministries and our own ESR is bringing forward. Use that to redo the arrivals cards. So that's one of the things I'd like to see in this Budget—that in the health interface with Customs some of the money is used there.I then want to talk to funding for the Ministry of Health for their administrative arm and I'm a big fan of more people at the bedside rather than managing the bedside. But clearly administration and management at the Ministry of Health is going to need funding and I see they have received that. Why I think that's important is because it can fill in some of the holes and I want to highlight one of those holes. It's one of the holes that came up through the Epidemic Response Committee where the chairperson the Hon Simon Bridges took the Director-General of Health to task for being late with information back to the committee. In fact he was questioning whether he was controlling the information to the committee. Then on the 7th—Hon Member: Completely incorrect. Dr SHANE RETI: It's not correct and I'll tell you why it's not correct. I'll prove why it's not correct.On 7 May the director-general then put up on the website his response saying that it's not correct. I'll tell you why that's correct: because at the meeting on 22 April questions were put to the Minister and the ministry. They were sent by the clerk on 23 April. Nearly 10 days later—that is at least a week if not two weeks late—they arrived back at the committee. Those questions to that select committee were late. The Hon Simon Bridges was absolutely correct. What's even worse was that on 1 May and 4 May the clerk actually followed up with the director-general's office. "Where are the questions?" "Oh they'll be here tomorrow." "Where are the questions?" "They'll be here." No they weren't. What's even worse than that is on 29 and 30 April the clerk followed up with the Minister's office—in fact his personal SPPS.So the response the answers to questions from the select committee definitely were late just from that one committee. In fact 50 percent of the committee questions in May were late. I know that because 94 percent of them were mine so I was watching them and tracking and waiting for them to come back so that we could do a better job. So just this one committee questions were returned two weeks late and four times the clerk went to the Minister's office. The clerk went to the director-general's office and got no response so much so that unanimously the whole Epidemic Response Committee passed a motion to send a letter of complaint to the director-general. Those are the facts. That's what's on the record. Furthermore if we really want to get into further details at least 50 percent of all of the questions that were asked by the select committee in the month of April were late being returned. Simon Bridges was absolutely correct. Ask the clerk; it's a matter of record.So where I get to with this is saying clearly the Ministry of Health is going to need some of the administrative funds that are positioned there in the Budget because we can see here just from this very recent episode there are holes there that need fixing. But I wanted to set that record straight because the chairperson was absolutely correct. Ask the clerk; he's got all the details—really simple. Ask about all the other ones by the way. The late questions from 14 April due on the 17th didn't arrive until the 21st. On 29 April due on 4 May received on the 6th—a whole litany of late replies to that committee. Absolutely evidence-based—need to correct that record.I then want to talk to the funding that's put aside for vaccinations and just make the comment that last year was the year of vaccine hell for New Zealanders. If we started the year and talk about the meningitis vaccine we've prosecuted that already in Northland. There is still more to come from them. I'm still unhappy that children weren't able to be vaccinated.We then move to the running out of flu vaccines in May-June last year if we recall. But remember: that's only a distribution issue! I don't think so. And when I said to the Minister here in the House and asked her questions—Minister Genter this was—around responsibility for the flu vaccine last year she said "No no. I didn't have a responsibility for that." Yes you did. The delegation from David Clark was on 22 or 23 July. Every vaccine from then onwards you are responsible for. You are responsible for that. In fact David Clark passed you that delegation—it was a suicide pass you didn't see coming—because it was very soon almost 24 hours after the select committee had prosecuted him for his management of the meningitis outbreak. He saw the trouble coming passed it to Julie Anne Genter and she took it up.So vaccines and then of course we had the measles issue last year. We had the measles outbreak. My question has to be: what did we learn over the year about logistics and supply that are focused on this Budget that improve it that make it better? It's not clear to me that there was any organisational knowledge retained or any things that could be done better by the time we came around again this time and are running out of flu vaccines a year later. It's not clear to me we learnt anything. As the coronavirus infection hit us did we learn that the backpacker in Mount Maunganui who developed measles and hopped on an Air New Zealand and then Cathay Pacific flight to get home to Germany and infected people on the way—did we learn that you need to ask the airlines? Because in that instance they didn't even ask the airlines. Cathay Pacific or Air New Zealand let that infected backpacker make their way back through New Zealand and home. Why didn't we learn about contact tracing way back last year with the measles response?So these are some of the things that I'm looking for in this Budget to make sure that we do a better job. It's a hard job—I get that—but it seems to me we haven't learnt anything from last year. This Budget needs to help fix that. Thank you Mr Speaker."