Craig LizDr LIZ CRAIG (Labour): Thank you Madam Speaker. It's a real pleasure to rise and speak in support of this bill because what this bill will do is establish a new Mental Health and Wellbeing Commission for our country. And what that Mental Health and Wellbeing Commission will do is hold the current Government but also future Governments to account for what they're doing to improve mental health and wellbeing. And what I want to do tonight is just focus on why we need a Mental Health and Wellbeing Commission because I think if we look back to the Government inquiry into mental health and addiction I think what it does is it shows a very very clear picture of what happens if we don't take mental health seriously. And it also provides a very clear picture of the situation that we inherited when we came into Government. And so what I'd like to do is just look through a few of the quotes coming out of that report.What the inquiry said is We heard of services stretched to breaking point a lack of timely responsive and culturally appropriate access few options and a lack of 24/7 services disjointed care and limited wellbeing and [preventive] interventions and initiatives." Scattered throughout the inquiry's report they actually included some quotes from service users from whānau family members and also from staff in mental health services. And I would just like to read out a couple of those quotes because I think they reflect some of the situation in terms of what the inquiry heard. So one service user noted "People have to fight and beg their way into services and wait far too long. In the meantime everything gets worse and permanent damage is done … Most people find it incredibly hard to reach out for help. So why are we forced to prove that we're worthy?" And I think that basically sums up how some people were feeling about their access to services. Another quote from a staff member working in some of the mental health services says "We are under-staffed burning out told to just get on with it and suck it up. No breaks are allowed [in the] afternoon shift as they pay us for this time. Abuse towards staff is on the rise … We are always over 100 percent capacity. We are asked to do double shifts every day and we feel under-valued and paid."I think just reflecting on you know: how did we get in to that situation—and so the inquiry also talks about the common perception that came up when they were talking to people about a lack of clear leadership and national direction in terms of mental health and addiction. And they also reflected on the diminished role of the mental health commissioner because we did have a former Mental Health Commission but what they highlighted is that it was really great back when it was established in 1996 and at that time they felt it performed a really powerful role in terms of independent oversight. What it was doing was providing oversight in terms of the implementation of the national mental health strategy and also looking at the performance of the Ministry of Health and regional health authorities which were the precursors to the district health boards. But what they noticed is that then over time the resourcing got less and less and then in 2012 the Mental Health Commission was disestablished by the previous Government and its roles were folded into the mental health and disability commission. Basically they were sort of reflecting on where the leadership had gone in that area. What they noted is—they basically said—the role of an independent oversight of the whole system by a powerful commission is an important and missing piece in this puzzle. That's why they were recommending that we do exactly what we're doing today and reinstate and create a Mental Health and Wellbeing Commission.Just looking at some of the things that this Mental Health and Wellbeing Commission will do: basically it's an independent Crown entity and the aim is to hold current and future Governments to account for improving mental health and wellbeing. What we've got at the moment is the current Government is taking mental health incredibly seriously. We've seen the $1.9 billion investment in our Wellbeing Budget this year into mental health services and facilities. But what we need to make sure is that that oversight that strategic direction and that prioritisation continues on with successive Governments. I think the question is: how do we do that? I think one of the most important things is visibility—make sure that mental health and wellbeing needs remain in the public eye public vision as we move forward.What the bill does is it talks about some of the functions of the commission. I'll just go through them briefly. The first one is to assess and report publicly on the mental health and wellbeing of people in New Zealand. I think you can't underestimate the power of having access to good information. Certainly in my previous role in terms of monitoring child and youth health what we found is that if we had data for things like hospital admissions for children for respiratory infections then the funding and planning people that were looking at health needs took notice because the information was right there in front of them. What we really struggled with was finding decent information on those with mental health issues or disabilities.Often what we were concerned about is the fact that the needs of those children and young people often slip below the radar because we just didn't have the data available. So one of the functions of the commission is to assess and report publicly on the mental health and wellbeing of people in New Zealand and that will basically keep those needs in the public view—and also then basically having that prioritisation in terms of funding and planning decisions.One of the other things that the bill's going to be doing is—basically the commission assesses and reports publicly on factors that affect people's mental health and wellbeing. This is thinking about those underlying determinants of mental health and of wellbeing.Again in my previous role monitoring child and youth health but also women's health what became apparent is that things like household crowding and really bad housing and having to move house numerous times—start schools and move into different communities—were incredibly incredibly detrimental to families' wellbeing. So the role decent housing and stable tenure has is incredibly important. Also things like family income—because often what you found is that as the family income went down the stress and interpersonal conflict actually went up. So making sure that people have got adequate incomes adequate access to health services to social security and to justice—all the basic services that we as a country need to provide; making sure that we have got oversight of those as well. And so when it's looking at one of the roles of the Mental Health and Wellbeing Commission it's to basically assess and report publicly on some of these underlying determinants.One of the other things in terms of its function is to assess and report publicly on the effectiveness efficiency and adequacy of approaches to mental health and wellbeing. This is actually an umbrella that looks at the adequacy of mental health services because what we've had at the moment is—I mean you do wonder whether if we had this function in and had continued on over the last decade we would have ended up quite in the same situation that we ended up in when we listen to the stories coming out of the inquiry into mental health and addiction. So again making sure that this commission is having a look at those on a regular basis and making sure that we're holding decision makers to account on the delivery of those services.And then basically advocating for the collective interests of people who experience mental distress and addictions and also their whānau/family. I think this is a situation when you're talking to those that have actually experienced mental health and wellbeing issues where what you find is that their ability to simultaneously go out and advocate is actually—it's often very difficult to do that. And so having the commission looking across and thinking about how they can advocate collectively is incredibly important.So there's a whole range of functions that are outlined in the bill. One of the other roles of the commission is to actually collect information. That's basically the power to obtain information that is also talked about in the bill. And basically the ability to request specific entities you know ministries—the Ministry of Health the Ministry of Justice the Ministry of Social Development—to provide the information that that commission needs is incredibly important.I do note though that it does restrict that so that the commission isn't going to be collecting personal information as defined in the Privacy Act. I think what that does is suggests that what the role of the commission is is that collective advocacy rather than focusing on individual cases and drilling into those. So basically it's that broader advocacy role in that respect.There's been a number of comments made in terms of timeliness tonight in the House. While the bill doesn't come into force until February 2021 what we've already had signalled is that an interim commission has already been announced which was in September and we're having those commissioners in place because what we need to do is start that urgent work. There's a whole range of tasks that need to be done and so basically we need to get under way much sooner than that and we are.But also just reflecting on that huge contribution—the $1.9 billion investment in terms of the mental health package in this year's Budget—what that's doing is providing that resourcing to put front-line mental health services in primary care and also looking at things like telephone counselling services internet-based services and also looking at suicide prevention in much more detail. So while this is one of those recommendations that the current Government is very happy to implement in terms of setting up the commission we're also getting on and doing much much more. So it's a real pleasure to commend this bill to the House.Bill read a first time. Bill referred to the Health Committee."