2. Question No. 2—Prime MinisterCHRISTOPHER LUXON (Leader of the Opposition) to the Prime MinisterQuestion No. 2—Prime Minister2. CHRISTOPHER LUXON (Leader of the Opposition) to the Prime Minister: Does she stand by all of her Government's statements and actions?Rt Hon JACINDA ARDERN (Prime Minister): Yes particularly the progress being made on this Government's plan to reconnect New Zealand to the world. From midnight last night travellers no longer need for example a COVID-19 pre-departure test to enter New Zealand and we know that that will be welcome news for many from our tourism sector. And at the end of this week I will travel to Europe to promote Aotearoa New Zealand's trade and tourism interests which will build on the progress we've made with the recent free-trade agreement with the United Kingdom. Our borders being open and the removal of pre-departure testing represent important milestones in our reconnecting strategy that creates real opportunities for our recovery. We're letting the world know that we are open for business study trade and travel.Christopher Luxon: Does she agree with her health Minister that the system is coping" and if so why are thousands of people waiting longer than six hours in the emergency department and elective surgeries are being cancelled?Rt Hon JACINDA ARDERN: What of course the Minister will be reflecting is that we often in New Zealand see over the winter periods pressure in our health system. But as we flagged at the beginning of the year we anticipated that this period would be worse than most because those things that exacerbate pressure in our system include for instance seasonal illnesses and influenza has not been present circulating in New Zealand for two years and is now circulating in Australia and New Zealand with a vengeance. Flu is outstripping for instance COVID-19 hospitalisations when it comes to respiratory illness in our Auckland hospitals. But we are encouraging and working alongside the health sector on innovative solutions such as those you've seen in Counties Manukau and of course an increase in the availability and subsidies around flu vaccines all in an effort to ease those pressures. Christopher Luxon: Why then did the Government exclude nurses from the fast-track straight-to-residency immigration pathway when we have a nursing shortage of more than 4000?Rt Hon JACINDA ARDERN: I've seen some of the Opposition's statements in this area which are completely misleading and wrong. The most important factor here is that New Zealand needs new nurses so for the first time we are fast-tracking them to residency on the basis that they are willing to be a nurse. Now if the member thinks that the best option is for us to remove the criteria that they continue to be a nurse I don't see how that helps our nursing shortage.Christopher Luxon: What message does it send to the overseas nurses we are trying to attract when Australia offers them immediate residency but this Government refuses to do so?Rt Hon JACINDA ARDERN: Again misleading. Our message is "Come to New Zealand and you will be fast tracked for residency." and our only ask is that you continue to be a nurse. So Mr Luxon if your proposal is that we don't ask people to be nurses when they come in it will hardly support our efforts.Hon Grant Robertson: Which approach does the Prime Minister think will help address issues in the health system: consistently increasing the funding for the health system or not funding it enough for population growth and demographic changes?Rt Hon JACINDA ARDERN: The member is correct. Of course one of the most significant issues that we have raised by our health workforce is the fact that we have had under-investment over a number of years in health and that includes of course at an operational level but it includes at a capital level as well. We have worked to rectify both. We've increased the number of nurses by thousands but we still carry vacancies and need to continue to recruit. We've funded the ability to do that and we are recruiting offshore and for the first time fast-tracking—not something I saw the National Government do because they didn't increase the number of nurses either.Christopher Luxon: Why despite all this spending have health outcomes like emergency department wait times and faster cancer treatment got worse under this Government?Rt Hon JACINDA ARDERN: Of course we've put hundreds of millions into the catch-up campaign following the global pandemic that is COVID-19. The appropriate point of comparison would not be New Zealand against itself but globally on the impact on the health systems because of the pandemic where prolonged lockdowns in other countries led to delays in planned care. Yes there has been an impact in New Zealand but relative to other countries not nearly what it would otherwise have been.Christopher Luxon: Why did her Government decide to scrap the national health targets including the target for emergency department wait times which University of Auckland research found had saved thousands of lives?Rt Hon JACINDA ARDERN: Because we saw that some of those measures caused distortionary behaviours in order to be seen to meet the targets. What our health system needed from the National Government of the day was investment; that is what it lacked.Christopher Luxon: Does she accept that if her health Minister spent less time focused on building the health bureaucracy in Wellington and more time focused on the front-line health workforce in our hospitals people wouldn't be waiting as much as 32 hours in the emergency department or having their surgeries cancelled?Rt Hon JACINDA ARDERN: The member has displayed his complete lack of understanding of what Health New Zealand is designed to do. One of the issues that we have is we essentially run 20 distinct health systems almost in New Zealand. We are not a country that can sustain that and we've seen the impact of that. What we need is the ability for our health network—particularly tertiary care—to work together. We've seen the signs of the benefits that can bring when those providers have worked together through COVID. We need the ability to move our health workforce around where the need is. We need the ability for different tertiary institutions to focus on the specialist care that they can provide nationally. We need to make sure that we are funding our community-based provision and ensuring that we have health resource in the places people access it when they need it and not a nine-to-five. These are failings we cannot overcome unless we move to a more national service. That is what Health NZ is. The member continues to call it a bureaucracy; he clearly doesn't understand the reforms."