van Velden BrookeBROOKE VAN VELDEN (Deputy Leader—ACT): Thank you Madam Speaker. I rise today on behalf of the ACT Party to oppose the third reading of the Pae Ora (Healthy Futures) Bill. That is because of a very basic point: that this bill has nothing to do with better healthcare it is all to do with co-governance. This bill is an exercise in co-governance rather than putting healthcare at the centre of the healthcare system.This bill reforms our healthcare sector by taking away 20 district health boards. It replaces them with Health New Zealand and the Māori Health Authority and it then carves up New Zealand into localities with separate locality plans. There are up to 80 localities but as of today we still have no idea from the Minister whether it will be closer to eight or 80 localities. It also then puts in place the iwi-Māori partnership boards who will be consulted on and who will set in place these localities. But as of today we don't know who the iwi-Māori partnership boards will be because that's up to the whim of the Māori Health Authority and we don't know where the localities will be.So in essence we are taking away 20 district health boards adding up to maybe 80 separate localities—maybe more who would know?—under two separate systems that separately commission health services based on people's race. We fundamentally believe that if we're going to reform the healthcare sector we should be reforming to simplify the system and not make it more bureaucratic and make it more complicated because that won't go any way to addressing having better outcomes for New Zealanders; it will simply focus on co-governance and administration rather than on healthcare and people.The real problem here is that the Minister has focused his attention on co-governance and administration and not on patients and not on New Zealanders. This reform has been completely flawed from the start. We should keep people and patients at the centre of our healthcare sector. And the Minister at the introduction of this bill said that this bill was about meeting our Treaty obligations. It wasn't about better healthcare it wasn't about all the discrepancies about access through New Zealand; it was about meeting our Treaty obligations. What the Minister is really saying by that is that this is the Treaty-at-the-heart-of-everything approach that the Government has taken across the board in governance in this term in Parliament.Hon Meka Whaitiri: That's a good thing.BROOKE VAN VELDEN: It's got nothing to do—oh and we have a Minister saying That's a good thing." The Treaty at the heart of everything co-governance at the heart of everything—well the ACT Party believes that we should put New Zealanders at the heart of everything not co-governance. We should put outcomes in the centre of our healthcare sector.The Minister throughout this entire debate has never addressed the question: how will this reform get better treatments to more New Zealanders faster? That has been missing from this entire debate. And I have spoken to doctors who have simply laughed when I've asked: how will this reform help you in your job? They said it won't—it won't. It won't lead to faster access to treatments for everybody. Patients won't see better quicker access to more modern medicines—they won't. Rural doctors have no idea how this will make access to rural patients easier. It's all been about co-governance of administration and the people have been forgotten. And we've forgotten about the outcomes.Now I put up three amendments to this reform during the committee of the whole House stage to say that we needed to make this bill better if it was to pass. And that was to put in place a rural health strategy to put in place a medicines health strategy and to remove the Māori Health Authority.I want to pick up firstly on the rural health strategy. We wanted to create a rural health strategy because for 750 New Zealanders who live rurally or remotely there is inadequacy of access to care in our rural areas. And this Government often forgets about rural New Zealand. I'm proud of the role that ACT has taken in this Parliament to remind the Government of those discrepancies for the people who work hard up and down New Zealand in our rural and remote areas who do have worse health outcomes because they live in rural areas. We put up the amendment and thankfully the Minister finally listened and adopted the ACT Party's recommendation that we put in place a rural health strategy. I'm proud of the role that ACT has done by listening to New Zealanders and putting their voices in this House in Parliament. We have changed this law to make sure that rural New Zealand is not being forgotten and that has made access—I hope—in the future better for rural New Zealand.It was with this change to the bill—this last minute change to actually acknowledge rural health—that we hoped that the Minister would also adopt two of our other recommendations. That was firstly for the medicines strategy and the Māori Health Authority. Now Pharmac last week—at the time we were debating—they had their Pharmac final report come back from the Pharmac Review. In that review they talked about a lack of transparency they talked about the problems with medicines access for all New Zealanders and they said that a medicines strategy was needed—they called it a crucial omission that a medicines strategy was not part of this health reform.Well I think it's a shame that the Minister had an amendment ready to go under the ACT Party for a medicines strategy that was called for because you have to think of medicines access if you're trying to reform the healthcare sector. The Pharmac review said it was essential and the Minister shot it down. So he did not think about patients; he did not think about their wellbeing; he did not think about how do we get better modern medicines to New Zealanders faster—he forgot about the patients and all he cared about was the co-governance. We should have had a medicines strategy in this bill. He focused too hard on the Māori Health Authority believing that the Treaty at the heart of everything will solve New Zealanders' problems—and it won't. It will make our society more divided—and divided on the basis of race. Our healthcare sector should focus on the needs of people—not on their race. And that is fundamentally why we cannot support this bill.We want to have a healthcare sector that has better health outcomes for all New Zealanders. We need to acknowledge that we live in a multi-ethnic society—over 260 different ethnicities in New Zealand. We are no longer white and Māori. We are a diverse society and our laws should reflect that. It should not be one separate system for Māori and one system for everybody else. We should acknowledge the needs of all of our diverse New Zealand populations and I think it's a shame the way that this bill has been written to divide New Zealanders based on their race.So in conclusion this has been a messy process from start to finish. We at first had this not being seen in the Health Committee as it should have been. It was a separate organisation that was set up a select committee that had both Māori Affairs Committee and healthcare members of Parliament—I think that was a shame. And it points to the whole reason why we're here in the first place: that this Minister believes that he can set up institutions based on people's race and their identity groups rather than their needs and on the analysis and debate of good ideas. Everything this Government touches is divisive and it makes for a worse New Zealand. ACT stands for a better New Zealand that is inclusive of all New Zealanders and that actually puts patients at the heart of the healthcare system.We don't want to get roped into exercises of politics and exercises of co-governance and forgetting about the people and health. We want to strengthen the healthcare system not divide it. Thank you Madam Speaker"