Grigg NicolaNICOLA GRIGG (National—Selwyn): Thank you Mr Speaker. I rise for my first opportunity to take a call on the Pae Ora (Healthy Futures) Bill. And while I would commend as the National Party spokesperson for women the inclusion of a women's health strategy and acknowledging the Minister for Women in the Chamber this afternoon please please don't let this opportunity pass you by because I would say of the rest of the bill what a missed opportunity. What has been touted as a generational reform a once-in-20-years reform this bill is the Government's so-called answer to the recommendations made in Heather Simpson's report released a couple of years ago which sought to actually improve the delivery of healthcare across the country. Unfortunately what we see in this bill will most certainly not achieve that. All I can tell from this bill is that it is going to rip the guts out of community healthcare providers. It disestablishes district health boards; their services will instead be run by locality commissioners locality coordinators and up to 80 locality networks which will add layers and layers and layers of bureaucracy between patients providers and the Minister. In the entirety of this document a $500 million reform there is not one target for a single improved outcome. I would have thought half a billion dollars on a sector-wide reform would demand some improved outcomes at an absolute minimum.Labour seems to think that you can achieve better health outcomes by putting more power in the hands of bureaucrats. As a rural Cantabrian let me tell you this is not the case. If it is passed as it is written this bill will simply make the system less responsive to the health needs of Kiwis especially those who live rurally and that is where I'd like to focus my comments this afternoon. Heather Simpson's report mentioned rural" at least 30 times—I think 34 to be exact. This bill mentions it once—once. This is an extraordinary indictment of the Government's view on 750000 New Zealanders 15 percent of the population who contribute 50 percent of our national GDP. In a stroke of irony on the Primary Production Committee today we have had the Office of Rural Communities in front of us. Their role is to pass a rural lens over legislation like this which passes through the House.Chris Bishop: How's that going?NICOLA GRIGG: Now well that's the point Chris Bishop. How is it going? I asked them that. I said "What tangible outcomes what results what changes have you as an office been able to make on bills like Pae Ora like three waters like fresh water reform?" Answer: "We don't measure them. We haven't really had much impactful change." which says to me once again that a Government who thinks it can run everything from Wellington is a recipe for worse health outcomes in underserviced communities not better. I would love to hear this Government face up in Leeston to the Friends of Ellesmere Hospital. This is to be fair a 95-year-old building that's been running in this community all that time servicing the needs of aged care and those convalescing post-surgery. There are just 10 beds in it. It is the beating heart of this community. It was shut during the pandemic to try and centralise all services into Christchurch. Thirty minutes' drive away in Darfield at the other end of my electorate—talk to me about the trustees of the Darfield Hospital and all the time and effort they put in to service their local community; also shut. Now here's the clincher: when I go and speak to the DHB about whether or not there are plans to continue the provision of these services in these rural communities post-pandemic they all say—they throw their hands in the air they look at me and ask us and they all say "We don't know. We cease to exist from 30 July."I would also recommend that the Government take it from the experts that appeared during the select committee process. There were a number of rural health groups that highlighted their concern as well as those who are actually operating in the field in rural New Zealand. The Rural Health Alliance said that they were "very concerned with the lack of focus on rural communities" and that "it is well documented that rural communities have poorer health outcomes than urban communities." The Rural General Practice Network said that "rural New Zealanders need to be added to the list of priority populations. Health inequities will remain and might well worsen if focus shifts elsewhere." Both these organisations that have spoken at the Pae Ora Legislation Committee on this bill want to see rural communities added as a priority group in the legislation. This priority group would therefore mean a targeted rural health strategy and specific rural health outcome measurements. The report—the one written by Heather Simpson—said that "rural services should be specifically planned for recognising the unique challenges of [those that live rurally]".So to put it simply my challenge to the Government: it has one more opportunity—when this bill gets to the committee of the whole House stage it has one more opportunity—to prioritise rural people to enshrine their needs in the legislation so that there are targets there are outcomes. Fifteen percent of this population—750000 New Zealanders—should not be forgotten by this piece of legislation and by this Government. Please my plea to the Government do not forget these people. Take this opportunity to enshrine it in law otherwise this is a massive—massive—missed opportunity."