Reti ShaneDr SHANE RETI (National): Thank you Mr Speaker. History will look back and record 2022 as the time the Ardern Labour Government finally broke health in this country and the damage they do here will last for years. The 36000 New Zealanders waiting more than four months to see a specialist do not see their hips knees and cataracts being done any time soon. They only see an ideological health reform in the middle of a pandemic and at a time when New Zealanders are still dying from COVID every single day. The timing is terrible. The 36000 New Zealanders on waiting lists see ward closures at Auckland Christchurch and Dunedin hospitals. They see people with typhoid fever being told to sleep in a car at Middlemore Hospital and they see their appointments being pushed further and further away. The timing is terrible. The 50000 women backlogged for breast cancer mammography do not see their appointments any time soon. They don't see the $15 million required to fix that backlog or the backlog for cervical smears. All they see is Andrew Little letting $25 million of vaccines expire last month—enough to fund the backlog for both mammograms and smears. The health reforms have distracted this Government from cancer management and there is a price to pay. While I'm talking about cancer I will send a warning straight up the middle of this Labour Government right here right now. Many of us saw the section in the Government response to the Pharmac report last week that suggested changes to free cancer care for children. It read Pharmac is currently reviewing suitability of the child cancer treatment pathways". If this Labour Government removes free cancer care for children the 8lb. exception I will fight you the National Party will fight you New Zealanders will fight you—and you will lose. Under these health reforms the regions and the provinces do not have locally elected voices at the table. Elected voices are removed and all the regions see is a socialist Labour Government goose-stepping to the cadence of "Wellington knows best comrades". This could have been all different. If Andrew Little had resourced ICU beds we might not have had to protect the health system by cancelling so many operations. Maybe lockdowns could have been shorter and the economic impact less damaging if he had built ICU beds instead of doing a premature COVID victory lap. This Labour Government voted down my Supplementary Order Paper (SOP) demanding a health workforce strategy. The workforce is exhausted and we are not a welcoming international environment. If Andrew Little had kept his promise to fully implement the safer nursing accord if he hadn't instituted a pay freeze for nurses and if he had kept his pay negotiation promises maybe we would have had more than just three critical care nurses employed to April in his much vaunted and then delayed Kiwi Health Jobs campaign—a sure reflection of our international perception. The tsunami of mental health has had no trickle-down benefits from the $1.9 billion for mental health. There is no trickle in mental health—just a river of tears from blighted promises and outcomes that the mental health commission says do not meet the promises. This health reform loses its moral imperative by removing health need as the sole arbiter and sole utility in the health system. In its place are inequities and Treaty responses. Neither are the same as health need. An unfair distribution of resources which defines an inequity does not necessarily describe the area of greatest need.There are two ways to reduce inequities: the rising tide lifting the lows or pushing down the peaks. Both seek to level the playing field. The belief is that maybe in the middle is where services might actually end up but myself and others do not believe this Labour Government has any chance of delivering that middle. The Government does not have a track record of delivering in health and even less of raising the base. What they do have is taxpayer money and as we have seen the way they use it in health is more money more bureaucrats for worse outcomes. This Labour Government's ideological attempts to reduce inequities in health will simply drive services and outcomes to the lowest common denominator. That is where all will be equal—at the bottom. This Labour Government voted down my SOP demanding an older people's health strategy. This Labour Government cancelled a $300 million promise for free GP visits. This Labour Government decided their poorly targeted cost of living sham was not necessary for those on a pension. For these reasons older people will vote this Government out. Where is the place for general practice in these reforms? Not a word in the Minister's speech. It burns his mouth to say general practice. General practice is the safety net that picked up the pieces when COVID couldn't be managed any more in managed isolation and quarantine the safety net that daily picks up the pieces when hospital beds are full the safety net that daily sees patients when the emergency department is full. Where is the value acknowledgment for the role of general practice that these reforms hold out as solutions and yet fail to value and fail to fund? There were signals of Labour's arrogant posturing towards general practice well before they offered 3 percent in recent cost pressure negotiations when they knew that 12 percent is the real cost of their bungled management of the economy and inflation. A further signal of general practice being dismissed was in the recent request to primary care the week before that they stop work and help this Government design the health system and to take time off and to do so without being recompensed. There were even earlier signs. The very first signal of general practice being taken for granted by this Government was the appointment of the interim Health New Zealand board without primary care representation. That was the first signal a signal on a pathway that I believe seeks to break general practice and eventually nationalise GPs like the NHS—something Helen Clark tried to do and probably still is. General practice needs to be urgently supported and funded to be the cornerstone that it is. To Māori I reiterate that you are being thrown under the bus with these health reforms. If inequities and Treaty responses—anything other than health need—are the foundation to these reforms then tomorrow it will be the depth of your pocket and the next day it will be your value to society and Māori will do poorly. It is the principle of health need that arbitrates fairness and anything else condemns to the politics of the day. We support a strong Māori health directorate not a standalone third system Māori Health Authority. To Māori look at these health reforms and ask yourself this. Where has the much vaunted Māori health veto gone? Why were iwi-Māori partnership boards deleted from Schedule 3? And why is the only redaction in all of the Government's key health reform documents the section on the Māori Health Authority titled "Financials underpinning the bid"? This aligns with the $40 million for the Māori Health Authority in last month's Budget that has been derided by many commentators as being insufficient. National will talk the language of health outcomes for Māori. We will focus on function not form. We will start with the two big inequities: cancer and cardiovascular disease. We will set targets and hold ourselves accountable. For Māori health under National we will get things done. National will talk the language of health outcomes for all New Zealanders. There is much in these reforms that we would not do but there is some we would. The formation of a public health agency for example has merit and there are some things like a semantic terminology that simply have to be owned by a central Ministry of Health. These reforms have no plan. Everyone is saying "What is the plan?" There is none. The buzzwords evangelising primary care as the saviour for health are empty and hollow and cold. The buzzwords "looking for excess fat in the system" are fanciful in their naiveté. National has a plan and over the next year as New Zealanders see that plan they will see that we understand health that we are pragmatic and that we get things done. For health National has a plan. Follow us. Thank you Madam Speaker."