Reti Shane; O'Connor GregThird ReadingHon Dr SHANE RETI (Minister of Health): I move That the Pae Ora (Disestablishment of Māori Health Authority) Amendment Bill be now read a third time. This is a simple piece of legislation and I will conclude with a few simple closing remarks recognising all the work that the House has put into it over this past 24 hours. This bill lays the foundation for a future health system that is focused on health need. I want to reiterate that I believe we all have the same dream for the health system: we all want to address health inequities we all want to shorten waiting lists and we all want a workforce that isn't overstretched and that has the right skills to respond effectively to all our diverse populations. I said in the first reading debate that even though this particular version of the dream with the Māori Health Authority is coming to an end I wanted to paint a new one one that is outcomes-focused driven by need and with decisions made closer to the home and hapū. This Government is totally focused on outcomes. The question we ask about any policy is: will it improve outcomes? Will it mean people get better care? Will it mean people get faster care? Will it mean people will get the care that suits their circumstances including cultural competency? We will be setting clear health targets to drive improved outcomes but I want to be very clear that we will be setting ambitious targets that will take some time and resources to meet.The Hauora Māori Advisory Committee will be retained and supported to do even more including further monitoring Māori health outcomes. The outcomes we are focused on are those that respond to health need. Throughout the debates on this bill members have repeatedly highlighted disparities in Māori health outcomes. I acknowledge these disparities and the need to improve them. As I've said before when we focus on need we very quickly find that it is Māori who have the greatest need in most areas of health. My dream for the health system isn't about bureaucratic structures and endless plans and reports; it's about identifying need and responding to it. This bill retains the iwi-Māori partnership boards. They will work with their communities with hapū and iwi to identify those needs. There is a positive obligation on Health New Zealand to work with the boards in developing priorities for improving hauora Māori. We seek to empower iwi-Māori partnership boards but for those who are needy and have capacity beyond what Pae Ora allowed. One of the fundamental differences in approach is enabled by this legislation: this Government believes that decisions should be made closer to the home and hapū. Local circumstances require local solutions rather than national bureaucracies. The iwi-Māori partnership boards will have a role in the planning and delivery of healthcare in their communities. Local input into health services especially primary and community services is good for everyone and a priority for this Government. There will be more to say and more thinking to be done. This bill allows us to pause work on localities while we work out how to ensure genuine local influence on local service design and delivery. We need to have ways of working that identify and support local solutions to local health challenges. That means using data measuring progress and working with people who know their communities best. Primary and community healthcare is most people's gateway to the health system. When we get this right we'll be supporting New Zealanders to stay in good health for longer wherever they are whoever they are and whatever their health needs are.I want to reiterate some of the key changes in this narrow bill: (1) Māori Health Authority staff are to transfer to Health New Zealand and the Ministry of Health—this will retain a focus on Māori health and retain organisational knowledge including any gains that have been achieved—(2) uplifting of the Māori Health Advisory Committee into advisory and monitoring roles; (3) uplifting of iwi-Māori partnership boards enhancing their relationship with local communities; and (4) pausing of the schedule for localities while we reconsider their place.Finally I want to once again acknowledge the many staff of the authority who have worked so hard. Your expertise is essential to achieving this new dream. I know you will be welcomed into Health New Zealand or the Ministry of Health.We can choose form or function; I choose function. We can choose activism or actions; I choose actions. We can choose outrage or outcomes; I choose outcomes. I commend this bill to the House.ASSISTANT SPEAKER (Greg O'Connor): The question is that the motion be agreed to.