Wall Louisa: Reports — Inquiry into Improving Child Health Outcomes and Preventing Child Abuse with a Focus from Preconception Until Three Years of Age (Volumes 1 and 2)Text is incorporated into the Bound VolumeWall Louisa: Reports — Inquiry into Improving Child Health Outcomes and Preventing Child Abuse with a Focus from Preconception Until Three Years of Age (Volumes 1 and 2)[Sitting date: 10 December 2013. Volume:695;Page:15467. Text is incorporated into the Bound Volume.]LOUISA WALL (Labour—Manurewa): Kia ora Mr Assistant Speaker. Thank you very much for the opportunity to contribute to this discussion about a Health Committee inquiry that will leave a huge legacy for our Parliament. I want toacknowledge the leadership of Dr Paul Hutchison in being the champion for children. I think that this inquiry report provides a template for whoever is the Government in the future to actually address what the heart of this inquiry was about. It was about improving child health outcomes and it was about preventing child abuse.What I want to highlight are some extracts from the report. One of the clear findings was that parents should be as healthy as possible prior to conception. I mean I think there is general agreement that in New Zealand we have a bit of a problem around conception. We have a bit of a problem about young people particularly engaging in sexual activity and not being in the right state to then be parents of the 64000 children who are born in our country every year. So one of the questions for me and for all of us was about who is giving birth to our children and where they are being born.I do also want to highlight that in parallel to our inquiry the Māori Affairs Committee has been doing an inquiry into the determinants of well-being for Māori children so I look forward to the recommendations in that report. To quote from the report: “Great effort must be made to ensure that Māori and Pasifika people have access to services and that those services are culturally centred.” I think actually that is one of the biggest challenges that we have.I would like to highlight two areas in particular. One is around sexual and reproductive health. The context I talked about earlier is really important because more than 40 percent of pregnancies in New Zealand are unplanned. So we do need a huge emphasis on sexual and reproductive health and well-being education for our children and it should be a priority. What this report does is say that we have to create young people who are aware and who are resilient. They go through biological processes that mean that they will engage in sexual activities. I think that it is in the best interests of all of us that our children and young people are doing that in a safe context where they have the tools to make decisions and also the tools to be able to grow up supported. So that is one of the areas I particularly wanted to highlight.The second area is around the national health target that says that for 90 percent of all pregnancies mothers should be booked in for antenatal assessment by 10 weeks’ gestation. I want to focus on where that recommendation came from because it was very specific. It came from an external review of maternity care from the Counties Manukau District Health Board led by Professor Ron Paterson. Why did the Counties Manukau District Health Board have this independent review? Well it had the independent review because between 2007 and 2010 2804 New Zealand babies died before reaching 28 days of age post-birth. In the Counties Manukau District Health Board that figure was 469 babies or 17 percent of the burden in that particular district health board.Why is it relevant? We have just under 9000 babies born in South Auckland every year and of those 50 percent are born to Māori and Pacific mothers. If we look at that 90 percent target what will that target actually achieve? It will mean that mothers have access to lead maternity carers and midwives so that we can assess mums we can help them prepare for baby and we can monitor their diet exercise and whatever else but firstly we will be able to help prevent these perinatal mortality statistics. Currently in the Counties Manukau District Health Board only 16 percent of mothers are receiving the treatment that they are entitled to.We need to ensure that we can identify the mothers who are at risk and that we can support them but overwhelmingly the biggest challenge that we have as a country is the distribution of our midwives. We may have 13.5 percent of the births but we have only 5.5 percent of the midwives. We are over 200 midwives short so I believe that this particular recommendation can make the biggest difference. Again I want to commend Dr Hutchison for his leadership. Thank you.