Reti ShaneDr SHANE RETI (National): Thank you Mr Chair. Supplementary Order Paper (SOP) 157 in my name and on behalf of the National Party recognises the importance of the health care of older people by requiring this to be a specific strategy in the Pae Ora (Healthy Futures) Bill. I'm becoming increasingly concerned about the aged residential care sector as a sector that is very close to breaking. At an overview level the long-term importance of the magnitude of the approach and quantum of care required for older people was evident in the 2021 Treasury document He Tirohanga Mokopuna. This described a long-term fiscal position over a 40-year horizon. The care of older people was highlighted specifically in the statement: The most significant spending pressures come from a combination of healthcare and [New Zealand] Superannuation which we project will increase by 6.4% of GDP from 2021 to 2061." Those are the two long-term fiscal concerns of Treasury: superannuation and care of older people. You'd think with that that we might want to include it as a strategy in the Pae Ora bill. The care of older people is an approach a reality and a privilege. Living arrangements range from independent living aged residential care support and care. My concern is for the caregivers and the aged residential care workforce and the shortage we have right now of a thousand registered nurses and we know that there's a significant shortage of healthcare assistants—the two big groups in the aged residential care category. We know that when fully staffed there are 5000 registered nurses working in aged residential care. Nearly 50 percent of these are actually on a visa. I come back to a previous discussion the Minister had and ask him to clarify the current settings for nurses who are not available for the shortened residency pathway. If they are on the two-year pathway are they required to stay with one employer because Megan Woods and Kris Faafoi said something different. That's part of the concern of the sector initially that a nurse would be able to come in work with aged residential care and then move to a DHB. The Minister has said here "No that is not correct." I need some clarity on that because I don't quite understand how we can have a difference of views. At the moment there's a shortage of roughly a thousand registered aged residential care nurses. We've got that perfect storm approaching and amongst us we've got COVID we've got immigration settings vaccine mandates work conditions increasing acuity in the sector sector funding and pay parity. There's a combination of forces coming together here and I've mentioned the recently announced immigration settings which are not friendly to nurses wanting to work not just in older people settings but in healthcare overall.What will happen here if we don't figure out a strategy for the care of older people? Particularly in aged residential care facilities the facility owners only have a couple of levers they can pull. They can increase prices and that's really not tenable or they can just start peeling back their high-resourced expensive residential beds. Those are dementia care and you can't just build a granny flat for someone with dementia if they're kicked out of their aged residential care facility. So I'm very very concerned about this sector—concerns that Age Concern are expressing to us. They're worried Grey Power are worried social workers are worried New Zealanders with older parents are worried and Treasury are worried. I would submit we require this Labour Government to include an older people's strategy as described in my SOP to deliver genuine care to older people. Thank you."