Coleman Jonathan: New Zealand Public Health and Disability (Southern DHB) Elections Bill — Third ReadingText is incorporated into the Bound VolumeColeman Jonathan: New Zealand Public Health and Disability (Southern DHB) Elections Bill — Third Reading[Sitting date: 12 May 2016. Volume:713;Page:11082. Text is incorporated into the Bound Volume.]Hon Dr JONATHAN COLEMAN (Minister of Health): I move That the New Zealand Public Health and Disability (Southern DHB) Elections Bill be now read a third time. I thank the House and the Health Committee for the speed with which it has considered this bill and I would also like to thank the parties including the Labour Party that supported this legislation. I would also like to acknowledge the officials at the Ministry of Health for their dedicated work in preparing the legislation. But most of all I would like to thank commissioner Kathy Grant and her team for the work they have done so far in the southern region.This is an important bill. The effect of it is to allow for the term of the Southern District Health Board commissioner to be extended from December 2016 until the triennial election scheduled for 2019. That provides the commissioner with sufficient time to develop oversee and implement a financially sustainable plan for quality health services for the people of Otago and Southland. Without this legislative change the commissioner would have had less than 18 months to improve the Southern District Health Board’s position.Back in June 2015 I dismissed the board of the Southern District Health Board because of my dissatisfaction with its performance and in particular with its management of the finances. I had lost confidence in its ability to deliver on its strategy for the region including delivering much needed capital redevelopments at Dunedin Hospital. The Government needs to be able to invest with confidence in the health infrastructure of the southern region.The commissioner has developed a work plan that has begun to address the financial and service challenges which she has been consulting on with the district health board staff and Southern District Health Board communities. At the same time the Dunedin Hospital redevelopment is being quickly progressed through the new Southern Partnership Group. I note the district health board is currently performing better than budget for the 2015-16 year. These are the first steps in achieving the sustained financial performance improvements and I look forward to the continuation of such improvement over the commissioner’s extended term.In parallel with the work undertaken by the commissioner on the district health board’s financial and clinical sustainability the Government is working with the district health boards on two streams of capital development. This includes $22.5 million for urgent hospital maintenance as well as facilities upgrades in gastroenterology audiology and the intensive care unit. These projects will ensure the immediate demands around delivery of services continue to be met while the planning for the major redevelopment of Dunedin Hospital progresses.The Health Committee examined the bill and recommended it be passed without amendment. From public submissions the committee raised a concern that Ngāi Tahu felt their access to decision making was diminished under the new governance arrangements. The committee strongly urged the commissioner to engage with Ngāi Tahu to ensure Māori can contribute to district health board decision-making and the principles of the Treaty of Waitangi are upheld. This concern was also raised by some members in the debate in the second reading of this bill.I understand that the commissioner is currently in consultation with the chair of the district health board’s iwi governance committee regarding the provision of nominations for Māori representation on the district health board’s statutory advisory committees. The commissioner has previously affirmed the status of the district health board’s Treaty relationship agreement with local iwi groups. Through this relationship agreement and other established communication mechanisms the principles of the Treaty will continue to be recognised and applied.The committee also encouraged the commissioner to consider how the district health board’s work can be made more transparent and recommended the commissioner sets goals and targets and reports on these to the public at the end of each year. Public meetings of the district health board’s statutory advisory committee meetings have now been advertised by the commissioner and the first of those meetings will be held later this month.Although welcomed public meetings are not the only contribution to transparency. The 2016-17 district health board annual planning process is currently under way. Initial goals from the commissioner’s plan which was published back in December 2015 are expected to be included in this document. This is the key district health board accountability document and a statement of intent that forms part of it is publicly reported at the end of the financial year. The district health board’s annual plan is also available on its website. The annual report which is also publicly available provides information on key aspects of the district health board’s performance.At its second reading some members raised concerns that the bill would affect local democratic rights to elect the board of a district health board. The select committee considered whether a requirement to consult with the community should be added to the bill to overcome the perceived reduction of democracy. I understand the concerns about democracy but I do not propose the cancellation of a local district health board election lightly. This is a serious case where correcting the financial situation is important to allow for quality health services to be delivered in a more sustainable way to the local population. That needs to happen sooner rather than later. The bill therefore impacts on only one election at the Southern District Health Board and will help to ensure the next board to be appointed as part of the 2019 local body elections will begin its term on a more secure financial footing.I agree there is a need for the commissioner to work closely with local communities. When appointing the commissioner I asked her to ensure that she was working closely with all stakeholders in the district. This expectation continues during this extended term. I know that since her appointment the commissioner has held meetings and forums with a wide range of stakeholders and she regularly updates the public on district health boards through updates in local newspapers on television via the radio and via the Southern District Health Board website. I note that the committee considered that there were appropriate mechanisms for public consultation and that no change to the bill would be required. The introduction of public advisory committee meetings provides additional opportunity for the public to better understand how decisions in their local district are being made.Continued work by the commissioner offers an opportunity to resolve the district health board’s financial challenges and helps secure more sustainable health services and health facilities for the people of the southern district. The commissioner has already begun to address the deficit challenge and it is important that she is given time to complete this important work. I want to thank Kathy Grant for that work. I also want to thank Richard Thomson Graham Crombie and Angela Pitchford—the other commissioners—for the role they are playing. I think we have got a very well-balanced team. I especially want to thank actually the people who work at the Southern District Health Board—that is the doctors the nurses the non-clinical people and the administrators. It has obviously been a time of stress and change there and they have been very supportive and welcoming of the installation of a commissioner.As I say it was not something that we did lightly; it was a step that was taken once all other options had been exhausted. We had had the district health board under intensive monitoring. We had had a Crown appointee on the board. In the end it had got to the point where everyone across the district regardless of political affiliation decided this was the right step. So I want to thank my National Party colleagues in the region for the support they are giving the commissioner. I also want to thank actually local MPs David Clark and Clare Curran for the support they are also bringing to bear down there. We may not agree on everything but we are very keen across this Parliament to see long-term sustainable health services restored for the people of the southern district. I commend this bill to the House.