Reti ShaneDr SHANE RETI (National—Whangarei): Thank you Madam Chair. It's a pleasure to speak at this annual review and it's particularly useful to be able to look back through the annual reviews and ask the question: what do we know now? Why we can do that is because when the annual review questions went in which as I recall may have been around November last year we asked a whole sequence of questions around infectious diseases. We asked a whole sequence of questions around meningitis measles and influenza. In fact we asked 19 questions around that which leads rather nicely into the discussion which we can have today basing it off what we learnt last year. What did we know last year—were we ready for what we have today? And we can answer that question by some of the information we got back from the annual reviews. In fact it lets us talk about several parts. It lets us talk about infectious disease supply chain. It lets us talk about infectious disease contact tracing. It lets us talk about general practice robustness because we asked all of those questions in the annual review some of which I will read.I want to start with the supply chain. Remember the question I'm posing to the Minister here today is: were we ready? Did we learn from our exposure and experience to infectious diseases last year? Were we ready? If not why not? So what we know about the supply chain—to start with that first of all. We had the situation with the measles vaccine and indeed with the flu vaccine last year where we were told there was not a supply problem; it was a distribution problem. Boy we've heard that again with coronavirus. We heard it in the issue of personal protective equipment (PPE) primarily: not a supply issue; a distribution issue. This was the wisdom from the Minister and from those that we were posing those questions to.We asked exactly that question to every single DHB. We posed it in the frames of the measles vaccine: During the current measles outbreak from January 1 2019"—and this is from West Coast DHB by way of example—"has the DHB ever had a shortage of supply or supply issues for the measles vaccines and if so on what dates?" West Coast replied "The West Coast has experienced a shortage of supply of measles vaccines since early September 2019. The National Health Coordination Centre put a hold on measles vaccines orders between the 5th and 8th of September while a stocktake was undertaken." So just like we've been told here supply is not an issue—that was what we were told last year. Yet clearly it was for at least one DHB. In fact about five DHBs replied in a similar tone as did—I think this is—Whanganui. We asked the same sort of question: "Did you have a shortage of measles supply?" "Yes." dated 12 September 2019.We were sort of interested in drawing together like we've done here with coronavirus other health professionals who could help us with the emergency that was in front of us. So we asked questions around "Have you ever authorised pharmacists to give the measles vaccines?" Whanganui: "No due to lack of vaccine supply." I won't make my way through the Whanganui example—although it talks about influenza in the same sort of breath I would add—but consistently we were told last year there is no shortage of vaccines and yet there clearly were. We've been told here now there is no shortage of PPE and I contend there were.So what did we learn about supply chains from last year around measles vaccines and influenza vaccines? Were we ready? Had we figured out that no matter that it may be in central stores; it's not getting out to regional areas? Now I know there have been some changes made and I think they're actually correct—that is to take PPE out of the hands of regional DHBs and centralise them. We maybe could have learnt that or maybe we were doing that and it wasn't effective—I don't know. The Minister can address that but maybe we should've brought those smarts to the table a heck of a lot earlier than we did. So I think this was a learning that we clearly had out of infectious disease last year that DHBs were telling us that we should have been ready to do. We should have had the supply chain of PPE. If we ever get a vaccine please goodness let us have a supply chain that makes sense and can deal to that. I've put that question on the table: supply chain and were we ready; did we learn from infectious diseases last year?I have two other questions: infectious disease contact tracing and general practice robustness—again coming out of annual review but in the context of what we're wanting to do here I'll stop here now."