Henare PeeniHon PEENI HENARE (Associate Minister of Health (Māori Health)): I'm sure my childhood family doctor would be bitterly disappointed with that representation in the House. Dr Reti was a good family doctor but I can tell you that what I've just heard today would be a poor representation of what's actually happening in the health system and what needs to change.I stand in support of the Pae Ora (Healthy Futures) Bill. I stand in support of the actions taken by the Hon Andrew Little to make systemic changes to make sure that the health system delivers equity to our country to make sure that the poor statistics that are impacting upon our people—when I say our people" yes Māori people; yes Pacific people; yes disabled peoples; yes people in rural communities. They need to change and the action being taken by this Government hasn't started today; in fact it started a long time ago. Minister Little already talked about the Simpson review and the huge consultation that went on around the country. It became clear and evidenced in all of the submissions that the system needed to change and that's what we're proposing to do here today.I'm excited. I'm excited because despite the assertions from that side of the House and the tip-toeing around Te Tiriti o Waitangi that this bill actually delivers something that Māori communities and that Te Tiriti o Waitangi partner can look to with hope and aspiration. I find it interesting that on the other side of the House the National Party crow about their record for Treaty settlements but aren't prepared to deal with the fact that Te Tiriti o Waitangi has not been met and the obligations within it and that's why we have the poor health outcomes for Māori people today.This bill looks to address that. This bill looks to make sure that not only is equity in the system but accountability is too. It's no good just being accountable to each other here in this House. It is important that the system that serves our communities is accountable to the communities. So the mere notion from that side of the House that we are taking away that local representation I can tell you is not true. In fact the iwi Māori partnership boards that are being proposed in this bill look to strengthen the way that we deliver those health outcomes and meet the health aspirations for our people locally is all in this bill. What it also does too is it makes sure that not only are those organisations accountable to Wellington and to the leaders in the health sector they're accountable ultimately to whānau. That's ultimately what this is all about. It is about whānau and it is about wellbeing.What we also saw is in Wai 2575 the evidence became clear that in order for us to make the changes in health it had to be a fundamental shift and a systemic change and that's what this is offering us here today. But let me be clear that this is only the first reading of the bill. Under the process that was proposed by Minister Little it is going to go through more debate more rigour. We're going to get our whānau and our community speaking up on this bill and that's important. We need to hear their voice. We want them to be engaged in this process so that the bill at the end of the process is the strongest bill it can be.To answer the member's question from the other side of the House I stood on the election platform and said to those DHBs and to my health community and Māori health community in Tāmaki Makaurau: this has to change; it's no longer good enough. That's what we're doing here and I'm excited that one year after the election this bill is being introduced into the House and real change is under way.We've already heard about the statistics that impact on Māori and we can all I'm sure tell a story of a whānau member who has suffered those inequities through the health system whether it was early testing for identification or whether or not it was falling through the cracks on the pathway to treatment or simply by the way they were treated by their health providers or by the health system. I won't go into any of those stories but I will encourage anyone who doubts that what's happening in this bill and the proposed changes in this bill will make change and important change and positive change for our people to read the submissions to the Wai 2575 claim. In those submissions there are harrowing stories of inequity and the bad treatment of communities and people right across Aotearoa.I've already spoken about Te Tiriti o Waitangi and strengthening Te Tiriti o Waitangi. I'm positive that we can find more equitable outcomes as it will hold not only Health New Zealand but also the Māori Health Authority to account and that's important. Our people have asked for this. And what I find interesting from the other side of the House is the health sector despite all the pressures—and I want to thank them for the work that they do every day—even they're calling for this change. The nurses the kaimahi the doctors the GP clinics all of them the Māori health providers are calling for these changes. They acknowledge they're working hard and they're doing the mahi with respect to the COVID-19 response and the roll-out of our vaccination plan. But even they are hugely optimistic about this particular bill and the work that's being done to restructure our health system.I want to come to the Māori Health Authority. What was clear from our discussions with the community around the country on the Māori Health Authority was it couldn't be an ivory tower in Wellington. They were quite clear with us on that. So too is the interim board that we've actually announced for the Māori Health Authority. So in order for us to make sure that the Māori Health Authority can continue to have its strong influence into our communities the iwi Māori partnership boards are the way to do that. And I'll tell you why. Because on a number of occasions in this House I've stood up and if there's one thing I can say about iwi Māori is they're all different. Every iwi will say Ngāpuhi is different to us here in Te Arawa or they'll say Ngāti Kuri do things differently to Te Aupōuri even though they're neighbours. And what we're hoping to do here with the iwi Māori partnership boards is to make sure that those local nuances are driven locally.But in order to give them the most impactful plan in moving forward to meet Māori health aspirations we must make sure that the Māori Health Authority can use all its levers and powers to make sure that the entire health system is delivering for our people. Because it's no good just doing it there in the community or it's no good just doing it at GP clinics. It's no good just doing it here in Wellington. What we also need is a Māori Health Authority to influence and engage with the systems that our people are engaging with.It's interesting that approximately 84 percent of the Māori population when they are unwell they go straight to the hospital. They don't go to their primary GP they don't go to their primary health organisation. What they do is they go directly to the hospital. Therefore we require a Māori Health Authority and iwi Māori partnership boards to have the most influence they can over that hospital to deliver the service for our people to make sure it is equitable to make sure that the service they receive when they go into that hospital is one that will see them get well and get better sooner rather than later.Just in the last couple of minutes that I have I want to encourage everybody who has already contributed to the passage for health reform to date and for those who choose to or might choose to in the coming weeks and months—to make sure that your voice is heard there are more engagement hui to be held right across the country. Minister Andrew Little is already on the road talking to our communities to make sure that they can continue to keep up to date and find their voice in this important process. I will be doing the same and in order to do that to have a kanohi ki te kanohi discussion it's important that colleagues in particular my Government colleagues do that in their communities so that their voices are heard.Just finally I find it interesting when Mr Doocey talked about DHBs and then going towards the traffic light system and I'll tell you why. Because what we're saying is if they cared that much then why haven't the DHBs put their hand up to be held to account? They are publicly elected many of them and I want to encourage Mr Bridges to go back to the Bay of Plenty and ask them why their vaccination rates aren't high enough. That's just a clear example that the DHBs in this particular instance have tried their best—some of them haven't tried their best. But ultimately the vaccination rates are a sign that what needs to change is the health system fundamentally and I'm proud that this particular bill will do that. I look forward to its passage and I look forward to rigorous debate throughout its passage here in the House and I commend this bill to the House."