Henare PeeniHon PEENI HENARE (Associate Minister of Health (Māori Health)): Thank you Madam Speaker for the opportunity to contribute in the second reading of this bill.I've got a number of notes here but I do want to address a number of the matters that the previous speaker Dr Shane Reti has just presented to this House. It was drawn a parallel that commissioning would fail. Actually commissioning was established under that Government the National-led Government. It was established through Whānau Ora and the same model for commissioning that is being implemented here through the Pae Ora legislation in enabling the Māori Health Authority to be able to deliver is the same commission model that was established and supported by the National-led Government. Now I'm really excited about that also as the Minister for Whānau Ora because we've seen the results that can be achieved through commissioning for outcomes a very different way of doing things. We know that when we commission for outcomes what we're allowing is actually a certain kind of outcome that allows flexibility for providers to be able to cater for the needs of whānau. Now that's exciting because why? Whānau Ora actually was born with a health lens. It was born out of health. However the National-led Government established Whānau Ora as we know it today and the commissioning that will be enabled through the Pae Ora legislation.So I'm really quite proud of that particular fact. It was something that was asked for by Māori to the tribunal in the health claim to the tribunal in the hauora claim the hauora report. It's something that we were quite clear on actually. The member gets it wrong. He says that this party the Labour Party didn't—what do you call it—campaign on a Māori health authority. We were quite clear. We were campaigning on a Māori health authority no ifs or buts about it. What we were quite clear on though was that we needed to work through what would be a once-in-a-lifetime change in the health sector. That's something that we've afforded the committee to do this House to do and I'm proud now to stand here in this House in support of this bill in its second reading. In supporting my colleague the Hon Andrew Little I do want to acknowledge the Pae Ora Legislation Committee for the work that they did. We know that it was a huge piece of work. Minister Little has already outlined the large number of submissions on the bill. They sat through extended sittings and hearings to make sure that they could work through as many of those submissions as possible. No mean feat. I want to acknowledge them.Of course I also want to acknowledge the leadership of the Hon Andrew Little on this particular bill. What he has said is true. When we've been around the country to promote the Pae Ora legislation and to talk about the health reforms it has been overwhelmingly positive. If one wants to listen to the speech from Dr Reti they would think it's all doom and gloom. But I can tell you that actually the optimism and the positivity from the health sector I have never ever seen it before. This is in the face of a pandemic in the face of a health sector pivoting to respond to that pandemic. There is still huge optimism for what we are going to achieve in the Pae Ora legislation.Of course the Pae Ora (Healthy Futures) Bill provides for the essential foundations for that reform. I want to touch on a number of those as have speakers before me. The Māori Health Authority will work with iwi-Māori partnership boards Māori health providers professionals iwi hapū and Māori communities to understand and deliver Māori health needs and aspirations across New Zealand. Now just reading that one sentence there when I heard the previous speaker who said Health in Wellington is different to health in Hokianga." Well guess what! There are iwi hapū whānau and health providers in Hokianga which this legislation enables their voice to be heard. It enables their voice to be heard so that we can make sure they receive the support that they need to meet the health aspirations in those regions.Also this will help build a stronger Māori workforce support the growth and capability and capacity of hauora Māori healthcare providers and encourage more innovation and services that deliver better outcomes for Māori. That innovation we speak of we saw it at the forefront of our COVID pandemic response from our Māori health providers. What better way to acknowledge and reward them for the work that they did in the pandemic than enabling them to make sure that this continues into a reimagined health future for our country? The reform presents us with as I've already mentioned that once-in-a-lifetime opportunity to reset our thinking and in particular the challenges with Te Tiriti o Waitangi.Dr Reti names luminaries and leaders in the health sector and the Māori health sector in particular over centuries. The same Māori doctors and Māori health providers presented to the Waitangi Tribunal on the hauora claim—a very clear voice. That voice said that change needed to come and this legislation does it. They went on further to make sure that as we match the clinical expertise of those doctors with actual public health services on the ground that they were in a match that would suit that particular region. I want to acknowledge that because the tribunal was quite clear and continues to guide much of the work that we're doing in the reform work now.The other part that's been much spoken about basically since the start of this reform work is the iwi-Māori partnership boards. The iwi-Māori partnership boards through this legislation are an important part. Now it was quite clear through the submissions that the iwi-Māori partnership boards needed to be put into legislation to make sure that it has form and function. It also has the powers to make sure that the aspirations that are led through those particular iwi-Māori partnership boards are met.I want to go back to what Mr Reti said when he said "What happens in Wellington is different to Hokianga." The iwi-Māori Partnership boards will allow those voices to come to the fore for health aspirations at a local level and even another local level because guess what! Hokianga is part of Tai Tokerau. When the Tai Tokerau finds its voice on these reforms which is what this legislation does so too will Hokianga through the iwi-Māori partnership boards. Because the same thing is true actually—what's right for Ngāpuhi isn't necessarily the aspirations and health for Te Arawa. Now what the iwi-Māori partnership board does is it enables that voice and it enables that aspiration to come to the fore in all of what we're trying to achieve here.It also looks towards engaging with more Māori. Sir Mason Durie a luminary in Māori health who created the Whare Tapawhā model which I know many in this House are familiar with made it very clear that through the engagement the accountability structures needed to be in place so that it wasn't simply an accountability structure in Health back to the centre—in other words to central government—but also from the provider to the whānau. We're quite clear in our work with iwi-Māori partnership boards that that is an expectation that we have that accountability structures between whānau and health providers are also measured and also accounted for in this reform work.We also want to through these iwi-Māori Partnership boards assess the current state of hauora Māori and determine those priorities with them not for them. Monitoring the performance is of course the duty of the Crown as we move forward. But as I said the accountability structures must be throughout the entire system and not simply to the centre. The engagement with the Māori Health Authority and the support from the Māori Health Authority is crucial to make sure the iwi-Māori partnership boards are a success. My recent meetings with the Māori Health Authority board and its management and leadership is quite clear that they too are excited. They are fully engaged with the iwi-Māori partnership boards that have already come to the fore in recent times. Ngāti Toa and Te Āti Awa here in Wellington have come together to create an iwi-Māori partnership board which is hugely exciting and they are already engaged in the health aspirations from their local perspective with the Māori Health Authority.What it'll also do is agree local priorities and locality plans with Health New Zealand and the Māori Health Authority. Well we hear from the other side of the House this loss of democracy. Actually it's the opposite. What this bill does is it strengthens local voices. It strengthens local delivery to make sure that we can—Matt Doocey: Define what a locality is. What's a locality?Hon PEENI HENARE: If Mr Doocey was listening he might ask his colleague where Hokianga is. That is a locality Mr Doocey. Hapū and iwi through iwi-Māori partnership boards and a locality plan are quite clear that we can deliver localised outcomes to meet the health aspirations of our people. So I dispute the assertions from the other side that it is a failure in democracy. In fact I think it is a strengthening of democracy. We see it in our health work. We see it in our three waters reform. We see it in all of the work that we're doing in the regions and I'm proud to be on this side of the House to support that.The Minister has already spoken about the Hauora Māori Advisory Committee. Once again another local voice adding to central decision-making and being a part of what will meet Māori health aspirations. The Minister made it clear the people who are appointed to that board come from the regions. And guess what! Those are rural regions too Mr Reti.Finally I support this in the second reading of this bill. I'm proud of the progress we have made. These reforms present a once-in-a-lifetime opportunity to make significant changes to our health sector and I commend this bill to the House."