Little AndrewHon ANDREW LITTLE (Minister of Health): Thank you Madam Speaker. I acknowledge the member who has just resumed her seat Barbara Kuriger. I just want to correct one small matter that she raised. She said that on the announcement of the Mt Messenger project in 2016 I had ecstasy. Now in light of the drug-checking bill that we've just passed this week I just do want to correct for the record for the sake of the House that I would describe myself as very happy on that announcement; I will leave ecstasy to the festival goers of the nation.I want to say how privileged I am to be part of a newly re-elected Labour Government and a Government that commands the majority of the House and therefore gives some certainty about the direction that we can take. We enjoyed very good relations with our coalition partner and confidence and supply partner in the last Parliament but this election has produced a different result. That result is also a vote of confidence in the leadership of the Prime Minister Jacinda Ardern and also in the policy direction represented by Labour. It is gratifying but that is all and we also understand that with that result comes responsibility to go in carefully but to make change and to make progress in the areas where we have been woefully lacking for a long time.I want to also at this point welcome all new members to the House because it's been a phenomenal intake of new members new MPs in this House and I'm looking at those on our side. I see Helen White there. I see Tracey McLellan behind me. I see Naisi Chen behind me. I have to say from Labour's point of view I have never known such a phenomenally talented group of new MPs to come into the House at one time. But also I look around the House at other parties and I also look at the refresh and new talent. I see Christopher Luxon over there who comes with a significant and successful corporate leadership background. I see people like Ricardo Menéndez March over there from the Green Party and other new Green MPs. In the ACT Party a phenomenal new suite of talent only two of them in the House at the moment—I'm not meant to talk about those who aren't in the House—and Te Paati Māori too bringing their skills and talents. I've known both of those members through my professional engagements over the years. This House is so well served by the new talent maybe the rest of us should take the next three years off. But no; we've got work to do and we will get on with that.In terms of my opening remarks—I've taken some time—I want to congratulate the presiding officers for their election or re-election. I think this House is well set up now for what has the potential to be a phenomenal three-year term ahead of us.This Government has a number of challenges as we know and they are in—if you think about the major social challenges we've got now housing has got to be foremost amongst them and housing affordability. Just the number of people who want to get access to a warm dry home whether they are renting or buying. We've got to get on top of the housing challenge because far too many people are missing out. I'm going to make some comments as Minister of Health very soon about the sorts of things that affect health that are the source of health problems and housing is foremost amongst them. If people don't have a stable warm dry home to live in that has huge implications for their health and for the health of their family.Child poverty is another. We took some steps in the last Parliament by legislating the child poverty reduction legislation and started to take that seriously starting to actually shine a light on what is happening with child poverty in New Zealand. I'm confident with the leadership of the Prime Minister and also the Minister for Children the Hon Kelvin Davis that we will see some really significant change this term because we have to. We have to make gains and improve the situation of those living in deprivation and poverty. Children don't ask and don't choose to live in poverty; it's a circumstance put upon them and we need to support them their whānau their families their parents to make a difference for them.Finally the global challenge of climate change. I know that the member who has just resumed her seat Barbara Kuriger talked about what's happening in other parts of the world. Actually there is no step that is too small to take and there is no country that is too small that it cannot make its contribution to the worldwide challenge of reducing carbon emissions and saving this planet because it is nothing less than that; it is about saving this planet. And I'm very honoured and pleased to be part of a Government that is taking that seriously and taking those steps. We declared the climate emergency yesterday. There are some tangible initiatives now being taken now being set up and that will be the start of making a real difference. We have to do that. These are also not just about addressing those specific issues but about laying the foundations for a better future. This is our opportunity to do it. There's no question that the COVID-19 pandemic has really shaken this country and every country in the world. There have been pandemics in the past and in world history. We've talked about it. Many countries have prepared for it. But until it happens you just don't know. And COVID-19 has tested every nation has tested every nation's leadership and New Zealand I think we can say humbly has done reasonably well. We've kept our people safe and we continue to keep our people safe but we have to remain vigilant. But that said with the insights that we've developed now the reflections that we've been able to have this is an opportunity now to build on some of the new things that have emerged because of COVID-19 and really build better for the future of New Zealand. So one of the challenges is we continue our role in managing the response to COVID-19.In the area of health policy as I said before there are a number of factors that really determine the status of people's health. Housing clearly is critically amongst them; whether or not you're living in poverty is another. They are areas which I've said we have made very solid commitments on we've made very solid starts on but we have to accelerate our work on these. We have to accelerate what we're doing and really start to make real progress in lifting incomes lifting people out of poverty doing it through not just the financial transfers but the investment in training and opportunities the support we give to business and to investors to make investments that generate jobs not just sort of inflate property prices and allow some to live off the wealth that is created by that. So we have a lot to do. In the health system itself we've taken the opportunity in the last term to conduct two major reviews. One was into mental health and addiction. We got that report. We've started the investment in making a change in mental health and addiction. That is a huge problem. It still remains a huge challenge for us in terms of getting the right support and the right help and the right assistance in place right around New Zealand including for the more acute end of it as well. But actually for the kind of more moderate incidences of mental health problems that people have getting the talking therapies in place getting access to mental health support through primary healthcare—that's where the future lies and really making a difference in that area. We're starting to do that.But we've also got the structural issues—what we do with the Ministry of Health and its role in providing stewardship for the $20 billion - odd a year that we put into health in New Zealand. So the proposal out of the second big report that was done which was the health and disability system review with a group chaired by Heather Simpson one of the proposals it says is let's have a focused Health NZ body that is about driving the performance not only of our hospitals and that sort of expensive end of healthcare but actually making sure that our primary healthcare is being delivered in ways that are relevant to communities around New Zealand. We have to do that as well—also a health authority that really means we are fulfilling our obligations under Te Tiriti o Waitangi in terms of tino rangatiratanga. Give the Māori health authority the power not only to advise and make change and make a difference but to work with Māori health providers and all health providers to make a difference for Māori health outcomes. We have to do that. That remains an important challenge too.The answer or the future or the real gains in health are going to be made in what we do in primary healthcare. It's not just what happens at the GP's clinic; it's what happens in community centres. And the range of health practitioners—we have not just GPs as I say but nurses nurse practitioners kaiawhina; all those who are involved in providing care and support to those who need healthcare. If we get that right we can make a huge difference for New Zealanders for their enjoyment of life for their ability to do the best for their whānau and for themselves as well. That's where the change must happen. All of that has to be in the context also of supporting our initiatives and addressing climate change because that too is also a health determinant—what we do to keep people safe from the effects of climate change is as much a health initiative too.