Dean Jacqui; van Velden BrookeASSISTANT SPEAKER (Hon Jacqui Dean): The House is resumed. Members when the House broke for dinner we were considering the first reading of the Pae Ora (Healthy Futures) Bill and I call Brooke van Velden.BROOKE VAN VELDEN (Deputy Leader—ACT): Thank you Madam Speaker It's my pleasure to rise tonight on behalf of the ACT Party in opposition to the Pae Ora (Healthy Futures) Bill. I want to take some time to acknowledge the health workers who have been working as our essential workers under the COVID crisis. You know we have had so many months of nurses and doctors GPs people working in our hospitals and in our community care who have worn full personal protective equipment who have sometimes left their families aside and who have been wearing masks that have started to cut into their faces so that we can have healthcare and that we can have the essential services that we need under COVID. But I also want to take some time to acknowledge the hard work of people who weren't considered our essential workers under COVID—and there are many people who are in our health workforce who aren't considered essential workers. I think that's wrong and I'm glad that the Government under alert level 3 has changed some of the rules so people can have their osteos and their physios for example. We have a huge workforce of healthcare workers in New Zealand and I want to acknowledge all the hard work that they do.But I want to come back to the Pae Ora (Healthy Futures) Bill and the reason why we're having this discussion—and it's because the Government has decided that we need a health reform. That's coming after the health and disability review which said that the system was fragmented and complex. We have unclear roles and misalignment of strategy and it's what we quite often refer to as the postcode lottery. You know I constantly hear examples of people who are living in Southland who can't get access to midwives who travel for hours to try and get to the hospital and who are giving birth on the sides of roads because they don't have the facilities that they need in their areas for healthcare. We hear of farmers who can't get mental health care in the areas that they live. We do have a very fragmented approach to healthcare in our country.So the ACT Party also believes that the status quo isn't acceptable. We have hospitals that are very run down. We have essentially Third World conditions quite frankly in some of our hospitals and people are languishing on waiting lists just for elective surgeries. It's hard now under COVID but it was terrible even before that. We need a modern healthcare system that empowers people to get the healthcare that they truly need and deserve and we can do that by reducing bureaucracy and having a stronger focus on patient outcomes but it needs to be a greater collaboration between the public healthcare system and private provision. We would be happy if the Government adopted some of the ACT Party's policies and ideas that I truly believe would help the healthcare system. We have publicly subsidised common elective surgeries—that's a good idea. A national fully integrated IT system across public healthcare for patient management—that's another very good system. We need better security if you see what's happened under the Waikato data breach. We also need new hospitals. We need to allow for building arrangements for construction of new facilities under public-private partnerships. We also need a new mental health and addiction agency that is a centralised agency for all mental health and addiction across New Zealand.The ACT Party opposes the Pae Ora (Healthy Futures) Bill because it doesn't actually address any of those issues. We are the party of reform and of ideas and I've stated the issues that I believe would actually create good reform and good ideas. So this bill in particular speaks to wanting to reduce the number of DHBs from 20 down to one. Now the ACT Party's position was always that we should reduce from 20 to six and it's because we believe that we do need to reduce bureaucracy. We do want to have a streamlined healthcare system and that's a positive step forward but we cannot support this bill in good faith and that's for two main reasons. One is it's divisive—unnecessarily so for a healthcare system—and two is when it's happening. So not only do we have set up under one entity Health New Zealand there is a separate entity that is being set up called the Māori Health Authority.I want to acknowledge that New Zealand has a very complex arrangement with families. You know there are a whole range of different structures and ethnicities and cultures and there are over 260 different cultures and ethnicities within New Zealand. It shouldn't be that we are dividing people based on their race; we should be giving people the healthcare they need based on their needs. I want to raise one particularly salient example and that's that of my colleague Karen Chhour. I am talking about this with her permission of course. You know Karen is Māori. Her husband is Cambodian. She has four wonderful Cambodian/Māori/New Zealand children. Why should it be that her children are put in a position where they are pitting their different racial heritages against each other and having to pick which one of their heritages they place more weight on? We should be basing those children's needs on their needs not based on which race they particularly want to identify with.There are inequities in our healthcare system that have to be addressed but there are vulnerabilities that exist in all communities. You can cut and slice and dice New Zealand in so many different ways but I do not believe it is helpful to try and slice and dice it based on our race. Whether you are Māori whether you are a Pākehā New Zealander Pasifika Indian - New Zealand Chinese - New Zealand—any form of New Zealand—everybody deserves good healthcare. But a racially-based and separate parallel Māori Health Authority is not the right way forward.I acknowledge that when this announcement was made the ACT Party said We have more than two races in New Zealand. What about the separate authority for Chinese New Zealanders? What about the separate one for Indian New Zealanders? What about the separate one for Pasifika New Zealanders?" And I was very happy to see that the Minister for Pacific Peoples Aupito William Sio very quickly pointed out: where was any indication of Pasifika in the Government's announcement? So you know he's echoed our concerns too. We oppose co-governance. It is divisive. It represents a serious departure from the idea that all New Zealanders have equal rights.But the second reason that we oppose this bill is because we're currently in a COVID crisis. Our DHBs have just been tasked with dealing with the pandemic and we see the weight that the Government places on them because the new traffic light system specifically talks about the need for each DHB to get to 90 percent. We do not need more uncertainty at this time and we certainly don't need more uncertainty in our healthcare system. That is the whole reason why we had lockdowns in the first place. We cannot in good faith agree with disestablishing the healthcare system in the middle of a pandemic. We're talking about a weary and tired workforce telling them that we're going to disestablish their roles but we're going to then replace them into new roles at a time when we're asking them to be stable certain and show leadership in the community. I don't think it's right to give them that form of uncertainty at this time.But this is also a little bit about implementation. When COVID came along the Government forgot about community care. When Health New Zealand was started up with the interim board the Government didn't even put anybody from community care on it. It completely forgot it existed. I hope that these reforms go well because we do need a good functioning healthcare system going forward in New Zealand but I certainly did not see that in the Government's implementation of COVID response and I hope that this is not what happens to the Health NZ and Māori Health Authority. Thank you Madam Speaker."