McKelvie Ian; Little AndrewCHAIRPERSON (Ian McKelvie): Members before the dinner break we were debating Part 2 of the Pae Ora (Healthy Futures) Bill.Hon ANDREW LITTLE (Minister of Health): Thank you Mr Chairman. I just thought I would take the opportunity to respond to some of the contributions just before the dinner break.Dr Shane Reti had referred us to his Supplementary Order Paper (SOP) 157 and the call for an older person's strategy. And I just draw his attention in that respect to clause 43C(1)(a) of the bill which requires the Government's policy statement on health to include the Government's priorities and objectives for the publicly funded health sector:" So that would also include parts of the health sector that receive public funding as well as what we would currently call the district health boards (DHBs). So it is a requirement when we set out our Government policy statement that we also clearly refer to all parts of the health sectors that are in receipt of public funding. And that makes sense. It would make sense for the Government if we're going to fund activities regardless of who's providing it that we do so in the context of a strategy and a plan a set of values and a set of principles. And that's what this bill will do.I note what the member says about the challenge with particularly the nursing workforce because of the large number of vacancies. Something in addition to the vacancies: one of the challenges we have that's exacerbating things is the fact that we have a high incidence of absence for sickness because as you would expect the health workforce is exposed to more sickness and not only them but their families and whānau as well. And we're seeing an elevated level of absenteeism for that reason. But we need them to be absent because when people are unwell or associated with people who are unwell we need to make sure that they're not putting other patients at risk.The member expresses concern about facility owners and the member can be assured I hear from the facility owners on a reasonably regular basis and hear their concerns. We will continue the ministry and I expect Health New Zealand and the Māori Health Authority when it is there. They have the authority to do so. We'll continue to engage with those aged residential care services to make sure to the best extent we can particularly in these straitened times we offer them the support and the help that we can. That's what we have continued to do. I think too just more generally I recognise the point the member is making is that actually that sector to the extent that it provides important levels of care—hospital care and dementia care—it's actually a very important part of our total health services our total health offering. And so we do need to make sure that as we make strategies as we make plans as we set policies we're properly incorporating them and their interests.To Brooke van Velden who raised the issue of the iwi-Māori partnership boards just a couple of things. First of all iwi-Māori partnership boards are in existence at the moment have been for some years. They haven't had statutory recognition but they have evolved under the current DHB model as DHBs were required to find a basis on which they could engage with local Māori through iwi. So these boards have been set up. They have worked to varying degrees across the country but we undertook as we've set up these reforms to actually (a) recognise them and (b) ensure that they are supported to be established to do the job that iwi want them to do and urban Māori want them to do and in a sense sort of charging them up with a little more energy than perhaps they've had previously.Now the way that these things are it is Māori that will decide how they wish to organise their representation. That is the right thing to do. The Māori Health Authority has a role to assist them in that to support them in that and they will do that. It will emerge over time how many there will be. Currently as I understand it there are about 14. That may be the limit of it. There may be one or two more. There may even be one or two less. Some may consolidate over time. But they will work out the way they will organise that and then how they will interact with Health NZ both at a regional and a national level and then feed into the various work that has to be done. So I am quite confident that they will work that out.Likewise they will work out their relationship to the locality planning process. They are an integral part of that. We need their voice in locality planning and they will work that out because there will be the kaupapa Māori health providers and there will be plenty of other health providers providing services to Māori where iwi and urban Māori organisations will want to and should properly have a say on what happens there. So no further changes are required and so we won't be supporting the member's SOP on that. We think that what is in place in the bill at the moment will do the job."