2. Question No. 2—Prime MinisterHon SIMON BRIDGES (Leader of the Opposition) to the Prime MinisterQuestion No. 2—Prime Minister2. Hon SIMON BRIDGES (Leader of the Opposition) to the Prime Minister: Does she stand by all her Government's statements policies and actions?Rt Hon JACINDA ARDERN (Prime Minister): Yes. In particular I note the policies the Government has confirmed in just the last two weeks including the beginning of the roll-out of primary mental health services across the country; a cancer action plan which sees increased investment in Pharmac the creation of a cancer control agency and more prevention and screening work; the launch of consultation on our plans to clean up our waterways; a child and youth wellbeing strategy which includes a food in schools programme that will roll out food in schools to children beginning 2021; new initiatives to help more New Zealanders into homeownership; and I will add to the list continuing the work on the Christchurch Call. Hon Simon Bridges: What is the number of confirmed cases of measles notified across New Zealand? SPEAKER: Order! Order! The question is quite a direct one: the Government's statements policies and actions. That does not relate to any of those. The member may rephrase the question so that it fits the primary. Hon Simon Bridges: What are her policies in relation to the number of confirmed cases of measles notified across New Zealand and is she aware of how many cases there are? SPEAKER: The member may answer one of those or must answer one of those. Rt Hon JACINDA ARDERN: I am. The latest report I received has indicated that we have—Hon Simon Bridges: Someone's under pressure. Rt Hon JACINDA ARDERN: —1149 cases. Hon Simon Bridges: No no no. We know what that's about. Rt Hon JACINDA ARDERN: That's up 15 in Auckland and an additional three nationally since the last report I received. Hon Grant Robertson: I raise a point of order Mr Speaker. In an interjection that the Leader of the Opposition just made he made a direct reflection on the ruling that you just made around whether or not that question was asked appropriately. It was a direct reflection that you were protecting someone. SPEAKER: And I'm used to the direct reflections. I know that the Leader of the Opposition has both publicly privately and in this House reflected on me. I know that he wants to be thrown out and I'm not going to. Hon Simon Bridges: Isn't it the case that between June 2009 and June 2017 vaccination rates increased from 80 percent to 93 percent and only began decreasing after that—under her Government? Rt Hon JACINDA ARDERN: Actually the advice I've received from the Ministry of Health is that we've had declining rates in this area since 2014. I know the last Government had—as we share of course—a desire to get to the World Health Organization level of immunisation that means we have herd immunity. That's 95 percent. The last Government managed to get it to 91.2 percent and that in the previous quarter was 91.7 percent. So this is an area where the last Government didn't reach its own goals either.Hon Simon Bridges: Will she table that advice?Rt Hon JACINDA ARDERN: It's actually data on the health targets that the last National Government set.Hon Simon Bridges: I raise a point of order Mr Speaker. I asked if she'd table it.SPEAKER: Well I heard the member ask the question. If the member had sought to have it tabled by way of point of order and it was official advice then the Prime Minister could have considered tabling it. I understand that those things were published on a website but if the member really wants it—seeing as he is the Leader of the Opposition—well I'll ask the Prime Minister if she is prepared to table it notwithstanding the fact that it's come from a website.Rt Hon JACINDA ARDERN: Mr Speaker my understanding is it has come from a website. It's references to the national target of 95 percent for immunisation. I was just simply reading the quarterly results from what I believe is a public website. There's no problem then with that being tabled.SPEAKER: It will be tabled.Document laid on the Table of the House.Hon Simon Bridges: What does she say to Tauranga mother Jessica Barnes who has been turned away from GPs more than eight times from getting measles immunisations for her child last week?Rt Hon JACINDA ARDERN: I had a conversation with the director-general about the issue of rolling out a national immunisation catch-up campaign. I believe this is something that for some time the Ministry of Health has been interested in—well before this outbreak; a number of years I would say to the last Government. This is something clearly that's needed. We should have everyone who wants to be immunised and needs to be immunised able to be immunised. However I'm also advised by the Ministry of Health that there is not a shortage of vaccinations. They are ensuring however at this point that vaccinations are focused on the outbreak areas whilst also ensuring that they order in additional vaccinations on top of the 50000 we expect coming in this week.Hon Simon Bridges: If there isn't a shortage is it remotely good enough that across the western Bay of Plenty 650 measles mumps and rubella vaccinations are needed across the 15 practices but there are only 100 in stock?Rt Hon JACINDA ARDERN: I was advised yesterday by the Director-General of Health that there isn't a shortage of vaccines. However they put a pause on orders yesterday while they made sure that they were prioritising those areas where there are outbreaks.Hon Simon Bridges: Does she agree with Willie Jackson who is tired of anti-vax parents being labelled nutters and maniacs"?Rt Hon JACINDA ARDERN: There were statements made particularly last week that I don't think correctly reflected the fact that we have a percentage of New Zealanders who will have what's called "vaccine hesitancy". It's not enough access and not enough information and advice. We need to overcome that to get that immunity up to 95 percent so that we can protect New Zealanders. A 300-percent increase in measles cases worldwide—this is a global programme that we have to tackle in New Zealand as well.Hon Simon Bridges: Isn't it true that the number of confirmed measles cases in the United States with a population of 327 million people is 1241 compared to New Zealand's 1149?Rt Hon JACINDA ARDERN: My understanding is the United States and I believe the UK have lost their measles-free status through the cases that they've experienced. We too obviously have an outbreak in Counties Manukau and we previously had one in Canterbury. Canterbury was brought under control and we must do the same with Counties Manukau. That is the absolute focus of the ministry.Hon Simon Bridges: Isn't it true that the measles epidemic faced in New Zealand right now is worse per capita than anywhere in the world—the developed world certainly?Rt Hon JACINDA ARDERN: The outbreak in Counties Manukau is something that the ministry is putting every effort into making sure that we vaccinate particularly 15 to 29s that we ensure that those at 12 months are also prioritised and that we get that outbreak under control. It's exactly why I've been in direct conversations with both Ministers and the Director-General of Health. It is a priority.Hon Dr David Clark: Is the Prime Minister aware that there are outbreaks in Hong Kong the Philippines in Europe in Australia and also in the United States and that around the world there has been a 300-percent increase in measles cases and that countries around the world are grappling with the challenge of—SPEAKER: That's a very good question and a very long question and none of it is the Prime Minister's responsibility.David Seymour: Is the Prime Minister concerned that her Minister of Health appears to be finding the world's worst examples to follow?Rt Hon JACINDA ARDERN: Actually what the Minister of Health is pointing out is that the large majority of cases that have come into New Zealand have been traced to overseas. Of course now with the outbreak in Auckland containment—of course the spread is within the population. That's obviously what an outbreak is and that's what the Ministry of Health must get under control.David Seymour: Can the Prime Minister promise that New Zealand will not lose its measles-free status as she recently referred to the US and UK having lost their status?Rt Hon JACINDA ARDERN: Obviously with a 300-percent increase globally we are seeing countries that have previously been declared measles free losing that status. Our focus has to be getting this outbreak under control and getting people vaccinated. Of course we want to retain that status but we also actually want to take care of people's health and wellbeing.Hon Simon Bridges: Does she accept that a significant part of the reason for the increase in measles is her Government doing away with any health targets and accountabilities upon becoming Government?Rt Hon JACINDA ARDERN: Again as I said in my earlier answer the last member set a target that the last member did not reach. We've actually had an issue for a number of years with immunisations. We know that we have to get that rate up to 95 percent. This has been experienced in the 1990s before and we have managed to turn those numbers around. Right now we have to use this as the beginning of a national catch-up campaign for those people who are unsure of their status or who aren't fully immunised to make sure they do so.Hon Simon Bridges: Having done away with health targets and an immunisation target will her Government come up with new ones; and if so when?Rt Hon JACINDA ARDERN: Again I want to reflect on the fact that that last member set a target which they then consistently did not achieve. It has to be about more than setting a target. We need to make sure that we have better access; that we have more nurses for instance in our schools able to issue these immunisations to the target groups; that we make sure if there is any perception of access or any hesitancy over education issues around the benefit of immunisation that we address that. We have not had decent immunisation rates in New Zealand for a number of years and we have to turn it around.Hon Simon Bridges: Is her position still as it was as Prime Minister not so long ago that "What gets measured gets done."; and isn't it therefore an incredibly significant problem that there are no immunisation targets?Rt Hon JACINDA ARDERN: I'm going to read out: quarter three 2017 immunisation rate 91.7 percent; quarter four 91.2 percent; quarter one when we came in 91.4 percent. The member's goal was 95; he didn't hit it. You've got to do more than set a target; you have to be proactive. That is what we are doing. I ask the member that there should not be politics in immunisation. We all need to send these clear messages."