Little AndrewHon ANDREW LITTLE (Minister of Health): Madam Speaker thank you. It's a great pleasure to make an address in response to the Prime Minister's statement. I'm just reflecting on Paul Goldsmith the member who just resumed his seat and his speech. It's not just classic conservative politics; it's classic New Zealand National Party politics where in their closing days in Government in 2017 they looked all around them and didn't see a single problem. It doesn't matter that there were thousands of people living in cars and homeless and with nowhere to go—there was no problem! It doesn't matter that we had huge inequities in our public systems particularly our public health system they looked around and saw no problem. They saw no problem with the housing crisis. They saw no problem with unemployment. They saw no problem with the infrastructure deficit that we had. They said No problem." That's of course why they were booted out of Government and still they do not get that there were major problems and challenges that this Government has had to step up to and deal with. I want to say that the health system in Aotearoa New Zealand has never been tested to the extent that it has in the last two years because it's not just been dealing with the COVID pandemic but it's been dealing with years of neglect and chronic underfunding under the previous Government. We know that when we make health policy decisions and health investment decisions there is a reasonably long lead time. From the time that you make the decision and make the investment it can be two three four or sometimes a few years longer before you see the thing that you've invested in the policy that you've made and the impact that it has on people. But the converse is also true that if you fail to fund the system properly and if you fail to invest in facilities then it takes a wee while for that to start to show and for that to have an impact and that's what we're dealing with right now. This Government inherited a health system that under the previous National Government saw funding not even keeping pace with a massive growth in population: 600000 people were added to the New Zealand population under the previous Government and not a single dollar per capita more was added to health. There were some cost pressures and there was some inflation adjustment but not to cope with the massive additional population that was drawing on our health services. There was chronic under-investment in buildings and IT systems. Buildings were literally falling down and with sewage running down their internal walls because the previous Government did not invest. Two years where no money was allocated in successive Budgets to capital spending for health and an IT system across the health system generally—I think I was told there were 120 different platforms across 20 DHBs and no DHB system was able to talk to the next one. Just crazy—just crazy. If you compare the investment from that Government to this Government in capital spending in health it was roughly $1 billion over nine years under the previous Government and so far in four years it's nearly $6.5 billion by this Government because that's what's needed to start get things back up to spec. There were mental health facilities and services that were just neglected—that were just neglected—and an emerging mental health crisis that was just completely ignored. That was what we've had to deal with. That's what we have had to step up and deal with in the health system. One thing that has become patently clear and will become more clear is that when it comes to the two major parties in this House the National Party does not care about public health. This party—the Labour Party—cares for a quality public health system and will invest in it every time that it is in Government as it is doing now. The background that I'm talking about too is that this Government is now undertaking the biggest rescue of the public health system in this country's history and that rescue is being carried out against the background of fighting the worst pandemic the world has seen in a hundred years. We are rebuilding the house at the same time as fighting the brush fires around it. That's the situation that we have been in for four years and are continuing to be in. But I look at our COVID response widely regarded now as world class and as world leading. We have one of the lowest case numbers in the world we have one of the lowest hospitalisation rates in the world we have one of the lowest fatality rates in the world we have one of the most highly vaccinated populations in the world and—for the benefit of those out the front—we have administered more than 10.1 million doses since we started the programme last year and nearly 2 million booster doses since we started the booster programme at the end of last year. That's 61 percent of the eligible population now boosted 216000 paediatric doses administered in the last few weeks and we have 95 percent of people aged 12 and over now with two doses of the vaccine. Since our friends out the front have been out the front in the last seven days 373000—nearly 374000—more doses have been administered in the time that they say they represent the rest of the country. Even first doses: over 400000 first doses are still being administered in the time that they've been out in the front and 15000-plus paediatric doses in that time. So this is a vaccination programme that has worked really well. But as I said we are rebuilding the system and fighting the brush fires as well and I want to acknowledge the incredible work of those in our system those doing the policy leadership in the ministry and those on the front lines: those leading our DHBs those working in our wards running the vaccination programmes running the testing programmes for the COVID pandemic—those doing an incredible job providing the healthcare that New Zealanders expect and still coming up trumps. Even when it is short-staffed even when so many nurses are working short-staffed shifts and even when doctors are working extra hours and knowing that they don't necessarily have all the colleagues because all the slots for their particular discipline aren't filled on their slate they are doing an incredible job. But one thing we will not do is we will not under-invest in our health system. That's why I want to come to why the plan that the Prime Minister outlined in her statement is so important. I want to acknowledge too of course that in all that time it has been really tough. The COVID pandemic response has been really tough on so many people: so many families who have had their family lives disrupted family connections disrupted celebrations of family events disrupted and the ability to grieve over loss and loved ones disrupted. That has been tough and that is real—it's real for people out on the forecourt and it's real for thousands and thousands of other New Zealanders—and that is regrettable. But it has been important that we respond to COVID in a way that protects and preserves as many lives as possible and protects our health system to be able to respond to all the demands placed on it and not just those placed on it by the pandemic. But I'm really proud to lead a Government and to lead a health reform that is going to make so much difference to everybody. We've already started a programme of investing to reboot our mental health system: more than 800 new front-line mental health roles added to our mental health workforce in the integrated primary care system that we've got; more people with access to talk therapies when they turn up to their GP; investment in new facilities with the construction about to start on as many of those as possible; and investment in our youth mental health as well particularly for Māori and Pacific services. We're doing all those things but now the next phase is under way. We've made commitments to reform the system through our health and disability system review. We've made the commitment to remove the 20 DHBs and put in place Health New Zealand with all of its ability to do much better localised planning and regional funding and to lead a nationwide system so that our clinicians and our people in this system can start thinking of themselves as part of a truly national system and draw on the best of the system wherever it is in the country. We start to address inequity too: the Māori Health Authority is a major advance and a major development that will make a huge difference to the inequities in our health system that have been around for so long. I look forward to Health New Zealand and the Māori Health Authority. Their interim bodies are in place already but the permanent bodies subject to the passage of the legislation will be in place by 1 July this year and that will make a significant difference. We have an opportunity with the reforms that we're putting in place to actually have a nationwide hospital network that will serve the needs of all New Zealanders where patients can move to where the best care is for them without a whole lot of form-filling without a whole lot of bureaucracy and without 20 different administrators having to make a variety of different decisions. We will have a revamped primary and community healthcare system. Primary healthcare will be a big winner out of the reforms. We'll see more funding going into primary care than we've ever seen before and we will have the Māori Health Authority. Labour has had as its historical mission the support of the creating of and the building of a truly quality public health system. That's what we did from 1935 in the Government that started then. We've picked up that mantle again and we will restore a public health system that is the pride and envy of New Zealand and the world."