Kerekere ElizabethDr ELIZABETH KEREKERE (Green): Tēnā koe. Fluoridation is a hotly debated topic in our party. We support the provision to improve oral health of particularly marginalised communities as long as people can opt out. We agree with having a national and consistent approach that reduces inequalities so we do support this bill and are pleased to see it specified that councils are required to provide access to non-fluoridated water. This bill has been stored since 2017 and of course a lot has changed in that time. In light of the proposed changes to the health and disability system it makes sense that with the eventual disestablishment of DHBs we are doing something more sensible and are shifting that decision making to the Director-General of Health. So on that basis we also support the Minister's Supplementary Order Paper (SOP) to select committee. We have some concerns which I would just like to quickly go through. The first one is about the scope of the director-general's decision-making powers. They're pretty broad-ranging and we're aware that without a recent national review of fluoridation and dental health with recommendations that actually clarify exactly where it would be better to add it or take it away or leave it as it is—we're really pleased to hear just now from the Minister that they're going to initiate that review now. We would like to see something that's been widely consulted on with the broader health sector and of course community and of course Māori because it's so often in our name that changes are made because of disparities that we have across health issues even if we don't particularly want those things to happen. So yes we hope that the director-general will use its very broad powers and also its lack of requirement to listen to particular information to follow recommendations that have been broadly supported. As has been stated about half of our population is supplied with fluoridated water. That covers mainly the cities of Dunedin and Hamilton and the regions of Wellington and Auckland. Christchurch is the notable exception which brings up our second concern which is that under the current bill the Director-General of Health could decide that Christchurch City Council would have to fluoridate its population. The director-general is exempted from having to consult with anyone: not the council itself which it can just direct let alone the people of Christchurch who I imagine would have a lot—plenty—to say about that. The council is not required—so it could—to consult itself but I don't think the bill as it stands gives them a lot of leeway for making many changes from what they've been directed. For our party appropriate decision-making is very important so that the people most affected should have a say in the issues that are affecting them. So we acknowledge the support of the dental and medical professions that the Minister mentioned but we would really want to see that communities have a say in this. So I'm looking forward to that selection process. Health versus economic benefit—this is stated quite early on—a big focus. It's not clear from what we've seen what are the actual measures what standards we're going to use to determine that this particular amount of health is worth this amount of money. What we do have a lot of in the SOP is this is what will happen to the council who does not do what it is told—a lot of information real detail—like $200000 for contravening or permitting to contravene an order and $10000 per day or part of a day for while an offence continues. I really wish that those penalties were in place for whenever councils did not comply with statutory requirements requiring them to consult with iwi on say the Resource Management Act or at the moment the significant natural areas. Part of the reason we want this to go to select committee is so we can properly understand how it relates to the Water Services Bill. This has been directed to go to councils but the nature of local authority drinking-water suppliers has not yet been fully resolved. Hon Member: That's right. Dr ELIZABETH KEREKERE: So as my National colleague noted my last point is: who's going to pay for this? Are councils going to be required to fully foot this bill for when they're being forced or required to do this for what is of course a national health issue? So in summary we support this bill and I look forward to working on it with the hard-working and diligent Health Committee. Kia ora.