Clark DavidDr DAVID CLARK (Labour—Dunedin North): I want to acknowledge the previous speaker Nathan Guy and express condolences for his situation.I got into politics because I was concerned about a growing gap between the ultra-wealthy and the rest of New Zealand. It is something that I want to see come to an end. But we have seen in this current Budget another change from the Government where a set of tax cuts ensure that those who are at the wealthiest end of the spectrum are the ones who get the biggest cheque in their pockets. It just does not seem to care about those who are struggling most in New Zealand.I want to talk a little bit about health and particularly about mental health in New Zealand. This Government has underfunded the health system and independent research by Infometrics looking at Treasury data estimates that over the past 6 years the Government would have needed to put $1.7 billion more into the health system just to stand still.There are consequences when that investment does not take place and most New Zealanders know that our health system is struggling right now. It is stretched. There was a recent survey on unmet need that found that for primary care in New Zealand one in four adults now struggle to afford to get basic primary care. Nearly a million adult New Zealanders are not able to get the care they need at the GP or at the dentist or are not able to afford their scripts or get to their local practice because they do not have transport or similar reasons. One in four—nearly a million—adult New Zealanders are not able to get the basic care they need in the New Zealand health system. I find that truly shocking. It is unacceptable.Yesterday's Auditor-General's report found that the impact is spreading. It was released and it was a bombshell. It looked at a very narrow scope which was those who are at the hardest end of the mental health system—those with really acute need who have been admitted to hospital—and the follow-up that happens once they are released from hospital and go back into the community. That report found a number of things and made a number of recommendations to the Government and one of those was that inpatient units have high occupancy rates—sometimes beyond their capacities—and in some places there is little availability of community services such as suitable accommodation to discharge people to. In these circumstances discharge planning can be late or incomplete and may not involve everyone who needs to be included for it to be effective."The Auditor-General then went on to explain that nearly a third of people are not followed up on within the recommended 1 week. They are discharged into the community some of them to caravan parks and they are not followed up on. They are also being discharged on the basis of being least needy—i.e. they have not finished their treatment but they are least unwell as somebody with even greater need is coming into the system. There is no bed available and they are kicked out on to the street without a plan often in place for their care. This is an appalling thing to be happening in a First World country. It should not be happening in New Zealand.In fact some district health boards had a 100 percent readmission rate within 28 days. That means that every patient they discharged came back into the hospital within a month—every single patient. They were not in a state where they should have been released back into the community. That is simply not acceptable and the Auditor-General finds improvement is urgently urgently needed.We have had several such reports recently highlighting issues in our mental health system that urgently need addressing. Notably the People's Mental Health Report was brought to Parliament. It contained the stories of 500 New Zealanders who had experience with the New Zealand mental health system and it suggested some very sensible steps the Government could take. The first was a review of the current situation regarding mental health in New Zealand—a very reasonable request. The second was that funding should be allocated appropriately after the findings of that review to make sure that mental health was adequately resourced in New Zealand—a very reasonable request. The third was that more education is needed. We know there were successful education programmes—the likes of John Kirwan putting himself out there explaining to New Zealanders that it is OK to admit that you need help—but that has dried up. The report's final request was for independent oversight of the mental health sector so that the public can have confidence that Governments are spending money on mental health care wisely and that the right interventions are taking place. All of those were reasonable requests.The Minister of Health unfortunately described that review as a review from anti-Government left-wing activists. I think that was a very sad response and an indictment on a Government that is out of touch with the needs of New Zealanders. We do need a fresh approach to these issues and I think that was highlighted in that Minister's response.Another petition has been brought to Parliament recently by the Life Matters Suicide Prevention Trust and it too has requested a review of services. Mike King was on the draft suicide prevention strategy group. He has resigned in despair at the failure of the Government to set real targets to reduce suicide in New Zealand. We have horrific statistics for suicide and the Government seems to have no plan to deal with them. It is 9 years on—9 years of this Government—and things are getting worse.Just today I drew attention in this Parliament to the fact that nearly half of the children under 12 in New Zealand with a mental health issue are not seen within the Government's target 3-week period. That means a child under 12 with a mental health issue is not being seen in 3 weeks—one in two New Zealand children identified as having a mental health issue. That is simply unacceptable and the Minister across the House Nicky Wagner had no answer. She could not answer the question as to whether that was acceptable or not and I think that speaks volumes.We desperately need a Government that takes a fresh approach on these issues one that is willing to say that things have not been done as well as they could have been in the past—a Government that is prepared to do things differently to bring a new set of eyes to the issue and adopt fresh policies to address the growing mental health crisis. For a long time those in the mental health sector at the coalface have said: "What we need actually is care at the mild-to-moderate end. We need to intervene early."Labour has already announced a policy to put funding into primary health organisations so that people can go and see their GP and if they are diagnosed with a mental health issue—maybe anxiety or depression—they can get care for free right there at their local GP. They can be referred on to somebody in that same practice who has time to see them who will follow up to make sure their scripts are being picked up and see what is going on for them and who will be there alongside them. That is the kind of thing we need to have happen. Jacinda Ardern has announced a schools-based health system that would put a nurse into every State secondary school in New Zealand to make sure that there are people available to talk to children who need help with mental health—depression anxiety and other issues that are becoming more prevalent amongst young people.These are the kinds of fresh ideas we need. Instead we have a Government that can announce nothing new unfortunately in the Budget and that has announced a contingency as a political knee-jerk reaction just before the Budget was delivered. The press release from the Minister and the Budget documents say he will take a paper to Cabinet. That is the best the Government can offer after 9 years and I think most New Zealanders would say that is unacceptable. When children under 12 cannot be seen when they have been suspected of having a significant mental health issue—it is simply not acceptable.Then the Budget overall for health was far short of what was needed. We know that just a standstill health system needed $650 million; the Government put in $439 million—over $200 million short of what was required to deliver just the level of service now in the health system. I do not think there are many people in this House who would say that our health system is all that it could be for a First World country. We can do so much better.I think back to when the Hon Annette King was health Minister. She would not have put up with this. We would have seen health growing becoming more adequate and a better system for New Zealanders but instead under the watch of Jonathan Coleman and Tony Ryall before him we have seen the system's funding dry up in real terms. Core Crown health expenditure as a proportion of the economy has dropped under that Government. It is spending less money on the healthcare of New Zealanders even though it says our economy is growing. It is inadequate. We need a fresh approach. We need to tackle mental health. Nearly everybody I meet and speak to has someone in their family who has been affected by a mental health issue—and if not in their family then certainly in their circle of friends. This is a serious issue for New Zealand. We need to get serious to tackle it. We need a fresh approach and we need to get on with it.Hon Judith Collins: Mr Speaker?Brett Hudson: Now this will be good."