Clark DavidDr DAVID CLARK (Labour—Dunedin North): Can I say from the outset just to be clear that Labour will be supporting this bill to select committee. The idea within the bill is one that is hard to dispute really and I congratulate the member on bringing a sensible bill to the House that deals with a problem that is real. I do have some criticisms of it in its current form and I will lay those out—well concerns really—because hopefully we will be able to address these things at the select committee and I do look forward to that experience. The Health Committee is generally a productive select committee and a well-led select committee I have to say looking across the House at Simon O'Connor the chair of the Health Committee. It is a select committee that works well together and is ably led. So it will be good to sit down and have a look through this piece of legislation. It is actually pretty short—the member who drafted it will notice that I am holding it up for anybody who is following this at home. I mean the active clauses really are less than one page and it is kind of a list of instructions as to how a GP will—Hon Simon Bridges: No they just turned the TV off—your mum and dad just turned the TV off. Dr DAVID CLARK: —follow through to carry out the required process. The member Simon Bridges has got his earpiece in there. I think his folks have just tuned in he is telling me—good on him. That will double the audience tonight I am sure. The thing that this bill does though is something that we would hope will be happening anyway. The concern I have—and I suspect many on this side of the House will share my concern—is that part of the problem here is that GPs are incredibly stretched and they are underfunded. This year alone they have been significantly short-funded by tens of millions of dollars. The GPs themselves estimated it was about $45 million they needed to meet existing cost pressures but in the Budget they got only $9 million and that means of course that they are having to cut their levels of services and we know that there are underserved communities in South Auckland in our rural communities and so on that are unable to get GPs. So talking about what those GPs do—the niceties of when they have got to refer a child on for a specific treatment when they have got to have an enrolment completed and so on—is kind of important but in the bigger picture where nearly half of the GP workforce is expected to retire in the next 10 years it is really playing at the margins. If this was obviously the Government's main priority it could pop it through in a moment as a piece of Government legislation. But instead we have it here as a member's bill and in its current form I have to say it is a toothless bill. That is one of the things that I hope we will look at at the select committee though I would be keen to see the initiative that is described in this particular bill properly funded and I am not sure that is something that is on the Government's agenda. But we may hear more of that as the debate progresses. The bill is toothless because it describes what has to happen if the GP cannot enrol somebody. The GP is required to consult with family members to consider the appropriate general practice provider supply a list of general practices in a newborn's area of residence if so requested or if the general practice provider is full and help them find another place where they might take their child if a particular practice is full. These are requirements placed on the GP who is already stretched and there are no penalties whatsoever for a GP who does not carry these things out. In the bill there is no response if somebody says Look I can't do it. I'm too busy." and there are no penalties for patients who do not do their part in this process on time. The bill is completely toothless. It reads like a wish list of how GPs ought to best enrol newborns in their practices and of course the GPs already know that. The GPs are not stupid. They are smart they are medically trained they know what best practice looks like and really this bill amounts to little more than a best-practice guideline in its current form. So I would say that while the idea is good what it needs is financial support and it needs incentives and if it was properly funded then you could put sanctions in place for those who are not compliant. But in its current form it has little more merit than Nuk Korako's lost luggage bill. Here we are debating a bill in the House that has no teeth and that is simply a wish list of things that the member would like GPs to do and there is no funding following it there is no incentive to do this and there is no sanction for those who do not do it so there is no penalty for not doing it. To take legislative time in the House for this bill—Hon Simon Bridges: Is a really good idea. Dr DAVID CLARK: —seems a very strange thing to do. The Leader of the House says it is a really good idea. He is trying to fill up the legislative schedule to make it look like his Government is busy and has got good ideas. But it has been here 9 years and if this really is the best idea that it has then I think that is pretty concerning. In good faith—as I said at the outset—we will be supporting it because we think it could have teeth added. It could have funding that comes in behind it. We could actually make this into a good thing. But in its current form if this is the best thinking the Government has had after 9 years and the Leader of the House says this is a good thing for the House to be debating then I think that sends a signal to New Zealanders that this is a Government out of ideas and out of time. What we really need is a fresh approach. We need a fresh approach to these issues one that actually says: "Let's fund this adequately. Let's make sure that general practice has enough GPs to carry these things out in South Auckland. Let's make sure that we have a plan for retaining our rural GP workforce or for building it over time." There is no plan laid out for that—there is no plan—because these GPs are the people who are supposed to deliver this bill and if half of them are retiring in the next 10 years they will not be able to do that. That is the ridiculousness of what we are being asked to look at here in the House today. Of course it sounds fine. It sounds sensible. You know if there is no room in the practice find another practice and give a list of other practices in the area to the person coming in and seeking to enrol their child. That is not very practical though if you are in a small town in the middle of nowhere and there is no GP for hundreds of kilometres. That is the situation that could be brought up in the situation described in this bill if there is no GP there to carry that out. And there is no penalty. As I said earlier on there is no penalty for the GP who does not carry out these things. Hon Simon Bridges: You should suggest that at select committee. Dr DAVID CLARK: The Leader of the House is suggesting that we bring this in at select committee. I think the Leader of the House knows that this bill has got a few wee holes in it as it stands. I think he senses that it is not a great tome. It is a light bill and it expresses an idea and in those few short paragraphs we can see that there is the seed perhaps of an idea. But it does need to be fully funded and I think that is the point I would like to emphasise in this first reading speech. If the health system is not fully funded we cannot expect these GPs—who are actually not even there in great numbers—to continue doing more with less when there is no workforce to deliver it. We are using the House's time to argue something that really really is a little bit trivial. I am sure others will have something to add to this as well so I shall not talk too much longer other than to say I do look forward to having the debate in the Health Committee. It is a very productive committee and the member Simon O'Connor at the back chairs it well. We will I am sure have a lively debate about this and I hope the Government can be persuaded to put a little bit of money behind this. The health system is being underfunded by $2.3 billion by our count and—Mr DEPUTY SPEAKER: I think this is about the fourth time you have repeated that point. Dr DAVID CLARK: Not the $2.3 billion Mr Deputy Speaker. That—Mr DEPUTY SPEAKER: If you are done you can take your seat. Dr DAVID CLARK: That is a serious amount of money and if money does not go into the system we cannot expect it to continue to deliver on these things."