3. Question No. 3—HealthBROOKE VAN VELDEN (Deputy Leader—ACT) to the Minister of HealthQuestion No. 3—HealthBROOKE VAN VELDEN (Deputy Leader—ACT): Thank you Mr Speaker. My question is to the Minister of Health and reads as follows. What clinical criteria if any are being used to determine whether a person who is COVID-positive and self-isolating in the community should be given a pulse oximeter and does he believe that the home isolation model—SPEAKER: Order! Order! The member's question—Brooke van Velden: I'm just reading from the yellow sheet.SPEAKER: I apologise. The member will continue. The adjustments that had been made to the question appear not to have been given through to the proper people. I apologise.BROOKE VAN VELDEN (Deputy Leader—ACT): All right. I can start again?SPEAKER: Yes. Start again.BROOKE VAN VELDEN: OK. Thank you. What clinical criteria if any are being used to determine whether a person who is COVID-positive and self-isolating in the community should be given a pulse oximeter and does he believe that the home isolation model is ready for the traffic light system?Hon ANDREW LITTLE (Minister of Health): Mr Speaker a point of order. I have prepared my answer on the basis of amendments to the question that were notified to my office late in the morning so just so you're aware—SPEAKER: I hear what the member is saying. What I'm going to do is leave it to the member who is asking the question to decide which of the two questions is to be asked. I think to be fair to both members before I intervened to bring the question into what I thought was order the Minister's office had been given the original question. So given the fact that through an error—although it was given to the member—it didn't make it on to the yellow sheet I think we'll leave it to Brooke van Velden to choose which of the two versions she goes with. She knows that if she goes with the original one she is likely to have a less prepared answer but that's something I take responsibility for. Brooke van Velden—whichever way you want to go.BROOKE VAN VELDEN (Deputy Leader—ACT): Speaking to the point of order I'm happy to do the question that we had submitted post—that is not on the yellow sheet.Hon ANDREW LITTLE (Minister of Health): I will do my best to please the member. Pulse oximetry has a critical role to play—Brooke van Velden: Point of order Mr Speaker. If we're going with a different question should I at least read the question?SPEAKER: Sorry. I think what we're going to do is we're going to get the member to ask the question that she wants again. I'm sorry I was momentarily distracted but I think that may have been obvious to all members and that again is my responsibility. I'm not having a good afternoon—that was my responsibility.3. BROOKE VAN VELDEN (Deputy Leader—ACT) to the Minister of Health: What clinical criteria if any are being used to determine whether a person who is COVID-positive and self-isolating in the community should be given a pulse oximeter and does he have confidence in the home isolation system?Hon ANDREW LITTLE (Minister of Health): Pulse oximetry has a critical role in monitoring the clinical status of some people with COVID-19 but most people will not require a pulse oximeter to safely monitor their health. People who would benefit from having one are identified during their clinical assessment which includes assessing against clinical criteria such as their vaccination status and any medical risk factors such as other diseases age ethnicity and complex and dynamic circumstances such as their housing. These criteria reflect a scale highlighting that often for example young fit people do not have the same level of care needs compared to those who may be older with comorbidities or other factors increasing their risk. However our model enables clinicians and COVID-positive individuals to continue to assess their care needs and deliver the appropriate level needed. In response to the second part of the member's question yes. As our vaccination levels have increased this has given us options as to how people can recover and more people can recover at home. I'm confident that work that the Ministry of Health and the DHBs have been leading in partnership with the primary care sector means that as we move to the COVID-19 Protection Framework we will have a care in the community model that enables more people to be cared for as appropriate to their need including by isolating at home.Brooke van Velden: How is the clinical assessment or judgment being made—for example over-the-phone conversation or face-to-face conversation or from looking at health records—and would it not be simpler to give a pulse oximeter to everyone when we know there are thousands available? Hon ANDREW LITTLE: Well a pulse oximeter cannot give a full clinical assessment of a person who has just been notified that they've tested positive for COVID. It's important that somebody who's just got a positive test gets as quickly as possible a clinical assessment to assess whether it is safe for them to recover at home. So the way the model is set up is that they will get that clinical assessment in most cases from their GP but if not from their GP then another competent clinician who will go through the factors that they know. If it is the person's GP then that GP will have access to that person's health records. If it is not the person's GP it will be for the clinician through questioning and assessing that person by and large over the phone to work out what is in the best interests of that person. Brooke van Velden: Is the Director-General of Health correct when he says that the metrics to help measure whether the system is working well won't be ready for a couple of weeks and if so when will the metrics be ready? Hon ANDREW LITTLE: Well it might depend on when the Director-General of Health said that because this is a programme that has been put together over the last few weeks. But we do have metrics about the time that we want people to get that first clinical assessment and the social assessment and any public health assessment and to make sure that depending on the health profile of that person and the nature of their health at the time they test positive they're getting the right clinical oversight for the time that they are recovering at home. Brooke van Velden: How many COVID-positive people have been home isolating to date and how many have been given a pulse oximeter? Hon ANDREW LITTLE: As I recall the figures roughly: 1700 COVID-positive patients have been recovering at home; roughly 900 pulse oximeters have been issued to households with a COVID-positive patient. Brooke van Velden: Has he asked for projections of how many people will be home isolating in the community at Christmas and if so what are the minimum and maximum projections? Hon ANDREW LITTLE: The problem with trying to get modelling on these things is that there are a whole range of factors that come into play and we don't know where the vaccination levels for example will end up in the next couple of weeks before we're going to cut over to the system and there are a range of other mitigations that are in place. But we are preparing for an increase in the number of COVID-positive patients. That's why we have roughly now nearly 27000 pulse oximeters available throughout New Zealand to be deployed as and when needed. I'm not sure that we're going to need all of those but with that measure and also the work that the DHBs have been doing with the Ministry of Health I am confident that New Zealand will be prepared for once the COVID protection framework is put in place the restrictions on people's movements around the country are reduced and people will start to move throughout the country as will COVID.