Little AndrewPAE ORA (HEALTHY FUTURES) BILLThird ReadingHon ANDREW LITTLE (Minister of Health): I present a legislative statement on the Pae Ora (Healthy Futures) Bill. DEPUTY SPEAKER: That legislative statement is published under the authority of the House and can be found on the Parliament website. Hon ANDREW LITTLE: I move That the Pae Ora (Healthy Futures) Bill be now read a third time. Tēnei tātou katoa e whakarongo ana ki te pānuitanga tuatoru o tēnei pire he kaupapa whakahirahira mō te hauora o Aotearoa whānui.[Greetings to everyone who is listening to the third reading of this bill a very important matter for New Zealand - wide health care.]This is a very important day for the future of the New Zealand health system. The Pae Ora (Healthy Futures) Bill sets out now or charts a new course for the health system for Aotearoa New Zealand. It starts at the very beginning of the legislation with its fundamental purpose and that is it is to provide for the public funding and provision of services in order to protect promote and improve the health of all New Zealanders. That's the starting point of this legislation. This is a once-in-a-generation change for our health system and there are a number of people I want to thank who have contributed to getting us to this point today. I want to thank my predecessor but one the Hon Dr David Clark who started the process of reviewing our health system and he put in charge of that process Ms Heather Simpson who chaired the Health and Disability Review group and who reported to the Government once they had completed that review. I want to thank Ms Simpson for her work and the others who were on that review group. I also wanted to thank the review group's Māori expert advisory group. They actually put up a dissenting opinion when it came to the final report arguing for a conception of a Māori health authority that was different to what the review group itself had put forward. I can say that we were persuaded by the compelling arguments that the Māori expert advisory group put up and that is reflected in the structure of the system that this bill represents today. I want to thank the members of the special select committee who reviewed submissions and reviewed the bill and made some very sensible changes to it. In particular I want to thank the chair Dr Deborah Russell and also the deputy chair Tāmati Coffey. I think that group did a stunning job. They had hundreds and hundreds of submissions they heard hundreds of submissions and they worked tirelessly and produced I think an excellent bill when they reported back. I want to thank all those who submitted to the select committee as well and who told their stories not just those who have been through the system as consumers of our health services but also the various experts and medically qualified people who also spoke and brought their insights and expertise to the committee. I want to thank the tens of thousands of health workers who work in our public health system for the job they do every day—the job they've been doing for years in many cases—putting up with a system that has put a lot of pressure on them. It hasn't given them necessarily the best working environment but we've heard what they have to say. They want change. Everywhere I go everywhere I listen to people they tell me they want change and this is the change that people have been asking for. For all those New Zealanders outside the health system but users of it who have also said We need to change. What we've got now isn't working for us.": Māori Pacific disabled people women those in rural communities the rainbow community—everybody has said that we need to do things differently. If we want to allocate resources and we want to have a system that's consistent coherent and fair across the motu we need to make change and this is the change we've got. There's one other person I want to give a huge thanks to the person I have worked alongside in terms of these changes and that's my colleague the Hon Peeni Henare. I could not as Minister of Health have worked alone on this bill and I could not have achieved what we have achieved as a party in Government but also as a House without the cooperation and collaboration with the Hon Peeni Henare. I thank him very much for his insights his mahi and his incredible connections through his networks that has enabled us to get where we are today. So I say thank you to everybody. There are a number of changes represented in this legislation to the health system. The first and foremost is the principles now that will govern the system. That will govern the entities in the system that will govern the Minister and that will govern others in the system too—those six principles that are set out in the legislation. They set the foundations for the system. The first is that the health system should be equitable and that everybody should be treated consistently and fairly because we don't have that at the moment and if we want to overcome the postcode lottery this is the change we need to make. Every New Zealander deserves to be able to have access to the health services that they need when they need them where they need them. The second principle is that the health sector should engage with people to ensure that the services reflect their needs and aspirations and that will be delivered through the locality planning process that we do in a way that we haven't been able to do before. We will have much rich input from communities across the country into what they expect of our health services. The third principle requires the system to provide Māori with the opportunity to make decisions that are important to them. That's nothing less than the commitment that was made by the British Crown under Te Tiriti o Waitangi. It's nothing less than the obligation that the Crown owes to Māori under the Treaty and that's what this legislation will deliver. It will allow Māori to make their decisions to exercise their rangatiratanga on this very important matter of the health of their people and we saw it amply demonstrated in the COVID-19 vaccination campaign where we handed over leadership and responsibility to Māori. They took it and they made the difference in the health of their people. Let Māori lead when it comes to health and this legislation will allow them to do that. The fourth principle is that the health sector should provide a choice of quality health services to everybody and that means culturally safe services in our health services. It means a workforce that is representative of the community and services based on clinical leadership technology and lived experience. Those are all principles that are now woven into the way our health services will be led and managed and run. We will have health services operated in a way as far as communities see that works for them and it's about lifting the wellbeing of everybody. We need a health system that is connected with what is happening in housing with what's happening in employment and with what's happening in other spheres of people's lives because these are the determinants of health as well. So it must be well rounded and it must be enriched. The fifth principle is that the health sector should protect and promote wellbeing. It's not just about the person who fronts up to a doctor or a nurse practitioner or a health worker and says "I'm feeling crook." because we need to know if we're going to help that person what sits underneath that. Is it just the physical ailment or are there other things that need to be attended to? So principles alone won't change things but these principles this legislation and the structure that we've got backed by the investments that this Government has made most recently in the most recent Budget—that is what is going to make the difference. That has been the pathway for this Government as we sought to address a health system that has been under-resourced and underfunded for so long and has needed a Government prepared to lead. We saw it when we first took office and we knew there was a mental health crisis because the mental health system had been so badly neglected for nine years under the previous Government. We did a review and we made the decisions and we've made investment that has now added more than 900 new roles to the front line of our mental health services. We saw that Pharmac did not have the confidence of a lot of people so we reviewed Pharmac. We've now got that review back and we've now got the opportunity to make a set of changes that will bring in Pharmac as an integral part of our health administration our health system so that they can work in collaboration with all those other vital parts to make sure that their decisions are relevant decisions to improving the health needs of all New Zealanders. We've seen it in the record investment in health this Government has made not just in Budget 2022 but in pretty much every other Budget since. This is a Government that is backing the health system and it's a health system that continues to be under pressure but we've funded extra positions—thousands of extra roles—in our health system and we'll continue working with that sector and working with the health system to make the improvements to grow the workforce and to make sure that New Zealanders have access to the best possible health system that we can produce. In Budget 2022 we've corrected the historical funding shortfall in our system and we've put additional funding in on top of that: in addition to the funding shortfall another $1.3 billion alone this year and every year thereafter. Then from next year another $1.3 billion on top of that and every year thereafter and we've funded specific areas as well: more money into mental health more money into ambulances and more money into workforce development. This is what you do when you take health seriously. This is a Government that has gripped up a health system that was in desperate need of attention and support and care and we've given it. We've funded it and supported it and we've now got the structure that will make sense. That means that we can make good decisions and treat all our hospitals as part of one health system for a population of 5 million - plus people. We have one major piece of reform work to go and that is the Therapeutic Products Bill. That will take legislation that is more than 40 years old governing our pharmaceuticals and our medicines and all those sorts of things and we'll modernise that. This will be a Government that will go down in history as the health Government of the 21st century. I commend this bill to the House. DEPUTY SPEAKER: The question is that the motion be agreed to."