Rurawhe Adrian; Verrall AyeshaDEPUTY SPEAKER: Members the House is resumed. Before the dinner break we were in an urgent debate and we're up to a Labour Party call—five minutes.Hon Dr AYESHA VERRALL (Associate Minister of Health): I want to share my condolences with the families of the two men whose deaths were investigated as part of the report that we are currently debating tonight. If I reflect upon the families of patients who have passed away who I have worked with I think about the universal sense that I picked up from those families: that they want to see lessons learnt to understand what went wrong if anything for their family members so that systems can improve. For that reason I thank those families for being forthcoming with the investigations that were undertaken in relation to those two deaths so that we can find out how to better improve our systems and in case these deaths could have been prevented.It's important to note that the review that we have seen published relates to a moment in time—a specific moment in time—when the community self-isolation and quarantine model was being rapidly scaled. As the results of the review say many of the findings of it have already been implemented. I want to talk about a few areas—those relating to process equity and information technology. It is clear that there were areas where either the processes were not followed or those processes were not suitable and there are areas of gaps in communication—communication that should have occurred and didn't. These certainly contributed to the care of both men and may have contributed to their outcomes. It's worth noting that there are a variety of systems improvements under way. Notably all patients being cared for in the model will be clinically assessed within 24 hours of their being diagnosed. There are scheduled health and welfare checks and clear information to be provided to patients. Underpinning all of this are clinical protocols including assessments and escalation pathways. I was surprised by the comments of Dr Reti the last speaker in this debate. He described this system as ICU-lite". That's surprising to me having cared for people with infections in this country for a long time because we know that the vast majority of influenza is treated in the community. The vast majority of pneumonias are treated in the community. Of course the COVID response involves standing up appropriate clinical care in the community. That is the only feasible way to really care for COVID at any scale. So I am surprised that Mr Reti seems to have a different view on this and that the idea that high quality care should be provided in the community isn't a goal he shares. We need to think carefully about equity in the roll-out of these plans. The reason why equity matters is that most of our patients that we are caring for will be people who are unvaccinated. Increasingly by definition people who are unvaccinated have some type of barrier in accessing care—whether that is their socio-economic status cultural or language barriers prior bad experiences in the health system or lack of trust in the Government even. Our challenge for our health services is that those who need us most now will be those that we have traditionally struggled to serve. That's why there are important improvements under way including the involvement of Māori and Pacific providers to provide that manaaki—that early wraparound support—in the patient journey.Finally the reports document the decades of under-investment that have led to information technology problems that are widespread. I think anyone who works in our health system will not be surprised that things like primary care data are not available to specialist or other services. I'm proud that this Government has worked to remediate those things through historic investments in our health information technology systems. We honour those who have died from COVID-19 by learning from their deaths. I am pleased for the opportunity to debate this report. I thank the member from ACT for initiating this debate so that we can have the opportunity to cast light on these findings. The lessons are at the heart of the community-care model that Minister Little has now implemented. It is with these lessons in mind that we go forward and make sure that New Zealanders can have confidence that we can care for them should they have COVID in the future."