Doocey Matt; Little AndrewMATT DOOCEY (National—Waimakariri): Thank you very much Madam Chair and if I could just thank the Minister for his time today in Estimates. We are looking at the amount allocated in Vote Health. I want to look specifically into mental health. It's fair to say that we don't have many opportunities to drill down into the numbers and to understand the plan for them. In fact successive attempts that I've tried in the Health Committee I was blocked by Labour MPs for calling in the Mental Health and Wellbeing Commission to do a briefing on their first report. In fact that is the context for Vote Health and the Estimates for this year. The backdrop is that report from the Mental Health and Wellbeing Commission which was very interesting because the Government spent a lot of time and energy setting up that commission with legislation in the House yet its first report they blocked. At the Health Committee I was joined by ACT the Greens and the Māori Party supporting that briefing because what we wanted to drill down was to understand that yes you can just throw about numbers but how did we get in a position where the numbers are not shifting the dial? Because that report did say there'd be no material improvements. But also when you dig down into that report it says there was leadership needed and a well-managed plan to execute change. I think why this is important is because not only did we have that report we also had the report from the Auditor-General who said quite clearly that there were no performance measures in place to whether the public is receiving value for money for mental health. I think we've got to look at that report from the Auditor-General about the evaluated framework the report from the Mental Health and Wellbeing Commission that said there was no plan and of course what we also know is that it wasn't that long ago that Official Information Act documents revealed Ministry of Health officials running a risk lens over mental health statistics as to not embarrass the Government.So my question to the Minister taking in the context of those quite damning reports and statements is: what has changed? What will give this House confidence that the money that was announced in 2019—because of course that is some of the Estimates for this year—plus the new money as well. What has changed? How will we know in the House here that that money will actually make a difference that there's actually leadership a clear plan and ultimately that will execute change? And also for the Auditor-General what has changed around performance measures so that the public knows that they will get value for money in the money that we are talking about today?Hon ANDREW LITTLE (Minister of Health): Thank you Madam Chair. I thank the member for his questions and perhaps slightly more rhetorical than I think some of the data. I think the member takes some of the comments in some reports out of context. The Mental Health and Wellbeing Commission made comments about acute services earlier this year and was concerned that not a lot had changed. But the Mental Health and Wellbeing Commission was very complimentary about the Access and Choice programme—that's the programme that was funded out of the 2019 Budget and the roll-out of which is continuing. I think the Mental Health and Wellbeing Commission has been very supportive of that. I mean ironically the member refers to comments about leadership being needed. It was this Government that re-established the Mental Health and Wellbeing Commission because the previous Mental Health Commission had been abolished by the previous Government in 2012 because apparently they didn't like being called out on what was a mental health system that was not meeting needs there. That might explain why the country went for years without the emerging mental health crisis not actually being attended to at all. So we did a number of things: we put in place the Mental Health and Wellbeing Commission we made the $1.9 billion investment—this all followed the review that was conducted in 2018. That was the act of leadership. The act of leadership was with my predecessor but one Dr David Clark accepting the advice that actually the big gap—the big gap—in front-line mental health services was for those with mild to moderate mental health needs. That informed the integrated primary mental health care programme that is now seeing 1000 fulltime-equivalent roles funded right across GP practices community health services kaupapa Māori health services and youth one-stop shops and we haven't finished yet; we've still got more to go. As I get around and meet the people in those roles but most importantly meet the people using those services they are highly complimentary about what is being done; the difference that it is making to people's lives.I think what is interesting is to see that the demand in the number of referrals to acute mental health services has been somewhat static over the last couple of years even when we've had COVID-19 and lockdowns and disruption to people's lives and their social lives and we know an increased impact particularly on younger people on their sense of mental wellbeing and their mental health—we haven't seen a huge increase in referrals to acute mental health services. It's conjecture at this stage because we're still waiting to see evaluations. But the sense is that even at 1000 fulltime-equivalent contracted roles of which about 850 are filled that is absorbing impact that would otherwise have been sent off to those acute services.So I'm confident that the leadership that is needed that the member referred to is there and has been there and continues to be there. I'm very pleased with the continued roll-out of the integrated primary mental health care programme. That has been the subject of review not only by the Mental Health and Wellbeing Commission but also by the Implementation Unit run out of the Department of Prime Minister and Cabinet which said at least in that respect—and they were more critical about the infrastructure needs of mental health and I am too—when it came to the integrated primary mental health care programme that was being implemented on track and as expected. We will continue that. There will be struggles. We're trying to draw from a workforce that we're struggling to draw from across other mental health needs as well. But we are getting there.The member notes—and I take from the fact that he notes that he's critical of—a comment about officials running a risk lens over the release of data. I agree with the member—I agree with the member—and I agreed with him at the time: officials do not need to be and should not be running risk lens about the disclosure of statistical material about data. We all need to know that data. That's what helps us improve systems and allows members opposite to provide the scrutiny that they ought to be providing. I can assure the member that I am satisfied that in the disclosure of data in the release of data that is now happening as that member would expect and as I expect to ensure transparency of what is happening. In all those respects I am satisfied with what is happening. I would finally refer the member to the Kia Manawanui long-term mental health programme. One of the things that came out of the 2018 review was the need for a longer-term horizon a 10-year horizon. We've done that with that programme and aspects of what was laid out in that 10-year programme are being implemented as we speak.