Wall LouisaLOUISA WALL (Labour—Manurewa): Kia ora. Thank you Madam Assistant Speaker. It is my pleasure to speak on the Newborn Enrolment with General Practice Bill as the chair of the Health Committee and to acknowledge in the first instance Dr Parmjeet Parmar. She engaged with the select committee in a very robust manner. She attended as many select committee meetings as she could. She heard from submitters. I think we engaged in a genuine process of trying to understand what her intention was but also what was already happening within the health system within the health sector to address the purpose of her bill and I will read out some of the Health Committee's report. The bill's purpose actually was to increase immunisation rates and to promote the early detection of any health or social problems" via being enrolled before immunisations are due at six weeks of age.So the intention of the legislation as my colleague Michael Woodhouse has already highlighted is very good and in fact I do want to acknowledge that we did support it at the first reading. Currently the Ministry of Health has a target which is that 95 percent of newborns will have had by the age of eight months the primary course of immunisations: the six-week immunisations the three-month immunisations and the five-month immunisations. So already built into our immunisation system and the immunisation targets is actually a three-month lag and so what we acknowledge is an issue within the system about the timeliness of immunisations and I do want to acknowledge that the best way to ensure that our babies are being immunised on time is for them to be captured within a system. So I acknowledge that. The select committee acknowledged that. The ministry acknowledged that. Everyone did. But I think it then becomes incumbent on us to look at what the system's actually currently doing.The two performance measures that the Ministry of Health committed to through the select committee process to fulfil some of the obligations we have to make sure our children are registered with a GP and do receive their immunisations in a timely fashion were related to the performance measures that the ministry currently oversees through the district health board (DHB) annual plans. Through those DHB annual plans there is engagement through primary health organisation (PHO) service agreements and they would ensure the reporting and monitoring via the National Enrolment Service for the system to actually work. So the commitment we got from the ministry was that we needed a more joined-up system where the ministry was clearer about what the objectives we're seeking were and they then directed the DHBs. The DHBs would then direct the PHOs and then the PHOs would actually have some of those conversations—which my colleague Michael Woodhouse just highlighted—about who the families are. We were aware through the National Enrolment Service and the coordination of the system who was in the system who wasn't in the system and what we could do about it.So the ministry did propose targets of 55 percent enrolment by six weeks and I just want to note that in 2010 the enrolment rate for six-week-olds was less than 1 percent and at that time the enrolment rate for three-month-olds was 50 percent. So that was the other part of the commitment from the ministry—that they would set a target of 80 percent enrolment by three months. I say this to highlight those systemic solutions because in fact the ministry has been working on this issue since 2012 under the previous Government. They actually implemented a preliminary enrolment policy and that policy actually enabled the pre-enrolment of babies after notification from the National Immunisation Register. So the issue of enrolling our babies early with a primary provider making sure they were in the system so that they could receive immunisations and actually enjoy being in a system where we're going to detect any health and social problems has been a focus of the ministry for a long time now.So I guess then we considered the proposition of this bill and actually legislating for health targets. We do have to wonder whether or not this is the best mechanism. Imagine if we have to do that for every health target: have a piece of legislation go through the process and actually find out what the ministry is already doing as opposed to working with the ministry and I guess holding them accountable—and we have committed through the Health Committee to actually hold the Ministry of Health accountable for the implementation of these objectives and this regime of PHO service agreements and DHB annual plans. We have committed as a select committee to asking for regular reports from the Ministry of Health so I think we're fully justified in not supporting the bill. But now that I can actually acknowledge Dr Parmar I would like to say that I commend her for her focus on children and for wanting to enhance the beginnings of life for our children.We know and I know actually through previous work on the Health Committee that the first 1000 days of a child's life are incredibly important. So what this bill was aiming to do which was to make sure that every single New Zealand child was enrolled and was receiving the care that they need was valuable and it's something that we're committed to but I think the mechanism of doing that—and particularly within an interesting context. We did have some discussions about the fact that at the end of the day parents can choose not to enrol their child. This bill in no way wanted to address that because if we really wanted to we could have made it a legal requirement for a parent to enrol their child at six weeks of age. It was discussed and it was something that the committee—and particularly the member in charge of the bill—didn't want to do because we didn't want to then have to enforce that and create a regime where potentially parents were going to be breaking the law because they didn't enrol their child.So we had some very interesting discussions at the select committee. We also had discussions about capacity and the fact that sometimes a notice had been sent to a particular provider about taking the child but because of capacity issues those providers couldn't take the child—and then whose responsibility was it to follow up? So I think we're reassured as a Government because of the commitment that the ministry has had in this area since 2012 and because of the commitments that they gave the select committee. I want to credit those to the member in charge of the bill because we wouldn't have got those commitments out of the ministry if this bill wasn't presented to the House.So I would like to say that the member in charge of this bill has created good change and that good change will see more children enrolled with a provider so that they can receive the care that they need. Fundamentally we disagree with health targets being legislated for but we 100 percent support the purpose the intention and the rationale of why our children need to be enrolled and cared for by our public health system. Kia ora."