Grigg Nicola; Rurawhe AdrianNICOLA GRIGG (National—Selwyn): Thank you Mr Speaker. I rise to join my colleagues in our very strong opposition to the Pae Ora (Healthy Futures) Bill. This is a piece of legislation that's been shaped time and time again by polls and by public pressure and certainly not by policy. It is a piece of legislation that started out as Labour's answer to a once-in-a-lifetime or generational opportunity to reform the health sector but it's finishing up as nothing but the shifting of the deck chairs on the Titanic. I think every New Zealander would agree that we have an exceptional health workforce. Our doctors and our nurses and our health practitioners across the spectrum have gone beyond the call of duty over the last couple of years particularly. But they are working in a system that is creaking and groaning and all but sinking and as much as Andrew Little has been warned by the sector he is still ploughing ahead—full steam ahead—paying no heed to the warnings or the danger signs. What Government in its right mind would force a sector through reforms like this during one of the most deadly pandemics this world has seen in a century at a time when doctors and nurses are sick; they're suffering extreme exhaustion burnout; they're working from home; they are following complex home isolation rules; they're managing the health of their own children and families; the borders are closed and there is no migrant workforce on standby to step in and breach the gap. This bill purported to fix the system but as most would rightly predict we on this side of the House say it is going to fail and fail miserably. But there was no need for it to be a failure. In fact if the Government had listened to their very own person Heather Simpson and her recommendations it might not have. This bill is the so-called answer to the recommendations made by Heather Simpson in her 2020 report which actually sought to improve healthcare across the country. It proposed to disestablish some health boards. Now we on this side of the House would agree that not all district health boards (DHBS) have performed to expectation and there is certainly a case to reduce by potentially merging some. But instead of streamlining the system the Government in its infinite wisdom has chosen instead to bloat it—to inflate it. We would say that DHBs should be reformed but to keep that locality of them. We would say that the Government's answer of bloating the system with layers of bureaucracy between we the patients we the public and Ministers is unacceptable. Labour though seems to think that you can resolve all issues that you can achieve better health outcomes by putting more power in the hands of bureaucrats. But we say it is better in the hands of locals—in the hands of those at the grassroots. I think it would be fair to observe that any public policy that is informed by poll results is a recipe for disaster. It should be informed by stakeholders and user groups. For example this bill started out life without a dedicated women's health strategy. And as the National Party spokesperson for women I was very very pleased to see the response of huge pressure from organisations like the Gender Justice Collective so women now have at least been identified as a priority population. But it is just another strategy. There are no health plans. There is no wellbeing plan. There are no targets. There is no money tagged to these targets. There are no outcomes. We say the Government needs to immediately respond to the 50000 women who've missed a mammogram the 50000 women who have missed a cervical smear test the year 13 girls who've missed out on their HPV vaccines and the 130000 women and girls who spent almost nine years waiting for an endometriosis diagnosis. Where is the urgent response in this bill to addressing those backlogs? Where is the advocacy for more maternal beds for more midwifery training for longer post-natal stays? And while we're on the topic of public pressure how about that eleventh-hour inclusion of a rural health strategy? It is equally as laudable as it is laughable. Thank goodness for the relentless pressure from this side of the House and our colleagues in ACT and thank goodness for the relentless pressure from organisations like the Rural Health Alliance and the Rural General Practice Network. At least they have recognised the specific needs of 750000 Kiwis who live rurally or remotely. Both of these organisations have pushed to see rural communities included as a priority group in the legislation. This will mean targeted rural health strategies and specific rural health outcome measures. My message to the Government is: do not squander this opportunity; make it count. It should also mean parts of New Zealand's health system will be held accountable for ensuring outcomes and the equity that has been promised. But I return to the Heather Simpson report which is the driving force behind this bill. The report said that rural services should be specifically planned for recognising the unique challenges of living rurally—and there are multiple challenges to living rurally. I wouldn't mind betting that the rural people of New Zealand who have the misfortune of being landed with a Labour MP have been hammering on the doors of those MPs and making their views known. And wasn't it a stroke of irony when Andrew Little said to this House during the committee of the whole House last week that he was responding to his rural MPs—and yet he did not respond to the rural health practitioners. Unfortunately though he's still ignoring the mental health advocates the aged-care advocates—and let's wait to see how their health outcomes fare under this new regime. He's also ignored Dr Shane Reti's excellent Supplementary Order Paper that would have bedded in workforce planning and equally Erica Stanford's tireless advocacy for overseas health workers. And as we know this workforce is burnt out. GPs are ageing and retiring in droves. There is no structure in place to continue this workforce and the workers who are dealing literally with life and death every single day. It is such a crying shame for a small country that used to punch well above its weight on every social metric just about in society that this Labour Government has reduced our health sector to what some might call just about Third World and that is not good enough. New Zealanders deserve better. We deserve First World standards and services no matter who we are no matter where we live and no matter how much we earn. The National Party opposes this bill in its entirety.DEPUTY SPEAKER: I understand this is a split call. I call Tangi Utikere—five minutes.