4. Question No. 4—HealthDr SHANE RETI (National—Whangarei) to the Minister of HealthQuestion No. 4—Health4. Dr SHANE RETI (National—Whangarei) to the Minister of Health: Does he stand by all his actions and policies around the Northland meningococcal outbreak and all Government-funded immunisations?Hon Dr DAVID CLARK (Minister of Health): Yes and in particular the swift response to the declaration on 8 November of a community outbreak of meningococcal W in Northland.Matt King: When was the Minister first made aware of the meningitis outbreak in Northland?Hon Dr DAVID CLARK: I have been made aware over time of concern around meningococcal W. The outbreak itself was first confirmed on 8 November of this year. I had the response brought to my attention last week. The fact that they had moved very very quickly and secured what are very hard-to-get vaccinations very quickly for New Zealand and will have the needles in the arms of children within weeks—I congratulate the district health board (DHB) Pharmac and the Ministry of Health for moving so quickly.Dr Shane Reti: When did the ministry first receive requests for a meningitis vaccination programme from Northland DHB in light of the internal memo from the CEO on Monday saying We have been strongly encouraging the Ministry of Health for some months to approve this"?Hon Dr DAVID CLARK: As the Minister who answered on my behalf said yesterday there is a test for what constitutes a community outbreak. That was recognised on 8 November. But in answer to the member's question the Government has acted swiftly on that expert advice. The conversations between Northland and the ministry have been ongoing for some time as concerns were raised about isolated incidents of meningococcal W and it is appropriate that they have been discussing these matters for some time.Dr Shane Reti: Why has the ministry missed a meningitis outbreak when their own nationwide public health surveillance data for meningitis shows four cases in January 10 cases in February more than 20 cases in March nearly 30 cases in April and nearly 40 cases in May which by that time was already nearly double 2017?Hon Dr DAVID CLARK: I reject the assertion at the beginning of the member's question.Dr Shane Reti: When officials say selected schools will receive the meningitis vaccination who will decide which students will have a chance of protection and which students will miss out?Hon Dr DAVID CLARK: The programme is targeted at those aged from nine months to four years because they are the ones most at risk—inclusive. Also a focus will be on students aged 13 to 19 because teenagers are those who carry and spread the disease. That's been identified as the best way to target and arrest the spread of meningococcal W and that's the basis upon which the programme is based.Dr Shane Reti: How will the Minister and his officials reach senior students particularly the 13- to 19-year-olds in the target group which he's just mentioned who have already left school for the year?Hon Dr DAVID CLARK: Members of the community will certainly be encouraged to participate. These are the problems that have presented in previous meningococcal and other vaccination campaigns and fortunately in Northland they are experienced in dealing with these things. I congratulate the staff for acting quickly and I know they have the expertise to handle this in the best way possible.Dr Shane Reti: Was the Minister made aware of the increasing monthly cases of meningitis in his own ministry's monthly notifiable disease surveillance reports?Hon Dr DAVID CLARK: If the member wants to ask specific questions about when I was notified and on which particular outbreaks around the country—he will know there's many; he's a clinician—I would be happy to have those questions written down and I will answer them."