Reti ShaneDr SHANE RETI (Deputy Leader—National): Thank you Mr Speaker. It's a pleasure to speak to this bill and National will be supporting this bill. Before I get into some of the details just to respond to some of the Labour Party manifesto on dental healthcare which I've just heard: where are the 20 mobile dental clinics that were promised in Budget 2021? If we're so enamoured and convinced that dental health is important where are they? The failed campaign promise.Anyway let's talk to this bill. I do support—and we do support—fluoride. We believe in the science that supports fluoride. I think if we look across the health spectrum if we look on a cost per people touched for benefit sort of ratio it's almost hard to go past fluoridation. There might be things that you could do in other parts of the food chain per se but I've always found and always believed that fluoridation is one of those really effective mechanisms that can touch the most number of people in a good way. I can understand why district councils for many years have said that they were a poor fit to be injecting fluoride into the water. As has been said they were sort of thinking This is a health response. We aren't the specialists in health and yet we're going to bear the responsibilities for things that might go wrong in areas that we don't have domain expertise." and for a large number of councils this was the reason why they didn't fluoridate. So in 2016 we said "Yes look we agree. Why don't we shift that decision making to DHBs where we've got that combination of elected people offering a community voice and appointed people bringing Government policy?" Sort of looking for that blend of both understanding the sensitivities of fluoridation and fluoride in the water in communities. We thought that was a sensible place to put it.Fluoride and fluoridation is important to Northland we have one of the worst areas for dental decay. There's been no fluoride in Northland over 20 years apart from two years: 2007 to 2009 in Kaikohe and Kaitāia. I have a role to play in that story so I'll share it with the House. I was appointed to the Northland DHB and at that point there were 12 health needs that we were required to address and report to—that we had to go out and do a health needs assessment. I looked across all those responsibilities and said "Well I can't do all of them. What would you choose?" and so I chose Māori health to be good at I chose the financial health of health systems and I chose dental health as well. Of course at this point in time Northland has no fluoridation. So I arranged to meet at a council meeting with Far North District Council and proposed to them in the meeting that it was time to do a citizen's referendum on fluoridation in their region.The council chair heard me out—this is in a full council meeting—and says to me "OK Shane. We understand what you're saying but our reality is we're not a wealthy council. We couldn't afford to do a citizen's referendum." So what I then did was take out my personal cheque book signed it and put the cheque on the table and said "Now what's the hurdle?" They said "Let me just understand this. Are you saying that you'll underwrite it?" And I said "Yes I will." They said "Do you know that's going to be tens of thousands of dollars?" I said "No I don't but it is what it is." They said "OK let's just be clear here. What would happen is you would need to go out and get a balanced opinion from those for fluoride and those against. You need to present that evidence and then if you did that what we'd do is we'd put that in with the next rate demand. You'd need to organise the barcoding so when it came back the analysis could—you'd need to do all of that." I said "Yeah OK. I'm up for that."So I learnt more about barcoding that year than I really care to know. But that was what I needed to do. It went out to citizen's referendum and the people of Kaikohe and Kaitāia said "Yes." Not by much by a margin of about 56 57 percent as I recall. But it was statistically significant. So Far North District Council said "We're going to inject the fluoride in Kaikohe between October 2007 and September 2009 at the Taraire Hills and Monument Hill injection sites and at the Kaitāia supply 2007 to 2009 as well. I was particularly proud to have maybe just made a small difference there. I tried the same with the Whangārei District Council and maybe got a bit too cute because I made my proposal to the council a binding proposal as it went before council. It was looking really good up to 30 minutes before the council meeting and then Mayor Craig Brown realised that if they sign that off they're in deep trouble. They were going to be committed to what I was trying to sign them through to and so he stood it down and Whangārei council decided not to proceed. So it was the Far North for two years where I had a little bit of involvement to inject fluoride into their water.I understand the sensitivities for communities that for some this is something that they don't believe in and that doesn't work and they feel aggrieved that it's placed into their water supply. So this was part of our thinking to pass it to DHBs where there was community representation. This bill removes that and places that with the director-general and I understand the imperative for that the imperative to more effectively implement across DHBs. The reality is that if it had have been just at a DHB level there was probably some DHBs who would have said no actually. That's the indications we had. If we really believe this is an effective public health mechanism it needs to be widely deployed so I can understand the imperative that places it with the director-general. I would still reflect—and this was the intent of the Supplementary Order Paper in my name—that we should still take the community view into account as best as we can. While I understand that the director-general does need to take into account the oral health of the population the feasibility the readiness to start and the cost at the end of the day that Supplementary Order Paper was looking for a bit more than that from whatever becomes DHBs or replaces them whatever that community contribution would be. I still think the community should have a say a bit more than what I'm seeing in this bill and I hope that can be figured out. I hope that the director-general has got a bit more discretion to reach out further than what I'm interpreting the legislation as saying.At the end of the day I believe this will improve the implementation of fluoride across New Zealand. I believe in science. I think it will benefit people and I think we can improve oral health statistics by taking measures of this type. That's the sort of thing that here in the National Party we want to be a part of and so we are supporting this bill. Thank you Mr Speaker."