Little AndrewHon ANDREW LITTLE (Minister of Health): Thank you Madam Chair. I'll respond to the more recent contributions but I particularly want to respond to the Hon Michael Woodhouse's point because I think it's an important point and he raises a very good point and I thought very carefully about this. It kind of cuts two ways. Obviously with the removal of the DHBs we need to make a change so that those with working visas who have a specific DHB mentioned as a condition of their visa we've got to have that changed to Health NZ. I thought very carefully do we provide for a further condition that they're still tied to their locality. I'm satisfied that just through normal human resource management that that issue can be managed and those on those visas will stick with the particular hospital that they're working at. That said there is a further proviso that I think is actually potentially helpful. One of the benefits of the whole of the public health workforce or at least the hospital workforce working for a single employer nationwide means that there is the potential for greater flexibility to deploy staff when needed whether on a temporary basis or even on a permanent basis to allow career progression. We saw this during the COVID pandemic and when the Auckland hospitals were at the peak of the pandemic particularly last year reached out to other DHBs to say Look we need some more nurses or we need some more SMOs. What can you do to help?" there was a real spirit of collaboration. Other DHBs did provide the opportunity for staff to go and there were obviously some negotiations about how that would happen. But they were able to draw staff from other parts of the country. It was all done; there were no secondments or anything. So they didn't make it technically difficult on that occasion because of the nature of the need. But it did illustrate actually with a single employer across the country how it would be easier to arrange those deployments including with people on a work visa. I'm confident that Health NZ will manage that very carefully. I think this is the issue that we were grappling with—if I could just diverge for a moment—with those particularly nurses employed in the private sector under a working visa and the immigration changes we've made that allows some categories of work including health work to immediately apply for residency we still stuck at least with nurses many categories of nurses to have a two-year working requirement before they get their residency for that very reason—that we didn't want a private employer who employs a nurse from overseas to then suddenly lose that person within the two-year period probably to a DHB or to somewhere else. But I think the member raises a good point and I assure the member that it has been carefully thought of and I also assure the member of my confidence in Health NZ to manage that particular issue appropriately.Can I go back to Nicola Griggs' point. I know she asked about targets. That tends to be a management issue as opposed to something you would legislate for and she went on to refer to particular facilities particularly maternal facilities. She will be aware of course that the bill now has provision for a women's health strategy. So that'll be an opportunity to deal with making sure that along with the maternity action plan that my colleague Dr Ayesha Verrall is responsible for we can work with communities where there is a gap to better provide for those sorts of services. In the end that'll be for the strategy to work out and it's not a matter that we would want to try to develop here in the committee stage of the whole House. The Hon Michael Woodhouse in addition to his immigration issue raised the issue of equity. Just for the benefit of all members of the committee I just point out that in clause 3 the purpose of the Act the opening lines of that clause states: "The purpose of this Act is to provide for the public funding and provision of services in order to—(a) protect promote and improve the health of all New Zealanders; and (b) achieve equity in health outcomes among New Zealand's population groups". That's the purpose. That is already there. So members who are concerned about whether we're taking equity seriously or whether we're providing for it whether it is about health need those are the opening words of the legislation.Finally to Dr Elizabeth Kerekere I know this is not strictly part of Part 1 but the Rainbow strategy we'll come to that when we deal with the list of strategies I'm sure. But in terms of what else can be done I think there is great scope including in the locality planning processes which is very much community driven. The locality planning process is very much drawing on health provider input from health providers in the community and community input to see what can be done particularly on issues like that."