McLellan Tracey; Little AndrewDr TRACEY McLELLAN (Labour—Banks Peninsula): Thank you Madam Chair. We heard from the Minister of Health about—as my colleague Liz Craig said—the appropriations that weren't related to COVID-19. The most significant I think we would all agree was the reform of the health sector. In April 2021 in April of this year the Government announced significant reforms to the health sector in response to the Health and Disability System Review. Now its proposed changes include disestablishing the 20 DHBs as we've heard from July 2022 and establishing two new health entities both Health New Zealand and the Māori Health Authority. So when we think of Budget 2021—as my colleague across the House Shane Reti said—it included around about $486 million over four years to implement the health sector reforms. So I'm wondering whether the Minister can talk a little bit more or provide some more detail about how performance of that appropriation will be assessed; and specifically what are some of the kind of key milestones in the implementation plan that's been agreed by Cabinet. And I suppose more grassroots-wise specifically bringing it home what can ordinary New Zealanders everyday New Zealanders expect to see over the remainder of this term in relation to those appropriations?Hon ANDREW LITTLE (Minister of Health): I thank the member for her questions. I think in addition to the $486 million to implement the health reforms which includes funding for the transition unit and also for the Māori Health Agency and Health New Zealand—when those organisations are set up on an interim basis the member might also be aware in addition to that amount of money there was also $380-odd million appropriated for a significant IT upgrade of the health system. In fact there has been further funding of about $116 million for another part of the IT system that processes the 90 million payments that get made out of our health system at the moment. So what we've also discovered is that in addition to rundown hospital buildings a workforce that is stretched and a workforce that is short of what it is needed we've also discovered IT systems that are simply not up to the mark. So we have to fix all of that. When we came to the reform process—as a consequence of the Health and Disability System Review report that we published at the end of last year that followed a very thorough analysis of the system; extensive consultation with communities around New Zealand; and a very close considered study of our health system—it's very clear that change was warranted. Change is needed. We're not getting the benefits that we need in our health system when it is disaggregated across 20 different legal entities. And it is no criticism of anybody in that system at the leadership level or otherwise. In the end people respond to the structure they're in and the environment that they are in but the reality is technology has changed; the population is changing. Our health performance is revealing that we are simply not keeping up with health demand. And where people get health is changing as well. So we have to change the way we make health decisions. That's what the purpose of this is.We have the opportunity now to get the best across the various 20 hospital systems that we've got. And for that matter to ditch the worst. We have the benefit of scale and that is going to be a real help when it comes to building the workforce and planning long term for the workforce. We will have all that.In terms of implementation of those reforms as I've said before considerable work is being done. The next major milestone will be the announcement of the governing boards. That will happen in the next couple of months. Those interim boards—they'll be interim organisations set up—their first task is to appoint a chief executive an interim chief executive whose job then is to start building the team that is needed to provide the leadership for those organisations. There will be engagement with the sector later this year and in the early part of next year as those interim bodies start to lay out what they're doing what their plans are. There'll be an intensity of work I think from the beginning of next year in terms of systems in terms of personnel in terms of preparing for the cutover.We'll be working very closely with existing workforces across the DHBs at all levels to make sure that they are kept clearly informed about what is happening but also what is expected. Where there are opportunities—because they will arise before the cutover date of 1 July—for people to pick up roles and provide that leadership that will happen also. Then we're looking at 1 July as effectively the cutover date to the establishment of a permanent Health New Zealand and Māori Health Authority. Of course in the meantime there'll be legislation to pass. I expect that to be introduced to the House again in the next couple of months or so. That will go through the usual process and my expectation is that will be passed by the end of April next year. Then we will have a very clear path to the commencement on 1 July next year for the two organisations and the revamped Ministry of Health.Of course that's not the end of it because the reality is this is a significant shift for the entire public sector health workforce. So it'll be two three four years of bedding in processes procedures workplace culture—which is going to be very important in establishing the leadership of those organisations. I have to say everywhere I get around every visit I make to hospitals and healthcare workers everybody sees—in spite of the pressures that the system is under at the moment they are truly excited about the opportunity that the reforms offer and they are looking forward to seizing those opportunities and making an even greater difference than they do at the moment.