4. Question No. 4—Prime MinisterCHRISTOPHER LUXON (Leader of the Opposition) to the Prime MinisterQuestion No. 4—Prime Minister4. 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): May I begin by congratulating the member on his new role. Yes; in particular I stand by this Government's ongoing successful response to the COVID-19 pandemic that for the past two years has seen New Zealand have the lowest cumulative number of cases hospitalisations and deaths per capita in the OECD and now we can add extraordinarily high vaccination rates as well. At the same time our economy has continued to perform with record levels of unemployment high economic growth and some of the longest stretches without restrictions of any comparable country. Over the past two years this Government and New Zealand have provided a strong response to a global pandemic that continues. It of course hasn't been easy but the results tell the country's story. That is why I proudly stand by this Government's statements and actions.Christopher Luxon: Why did her Government spend more than $50 billion from its COVID fund before announcing any funding for extra ICU beds?Rt Hon JACINDA ARDERN: Well I reject that question. What we know: one of the most important things that need to be provided are not just the beds but the staffing of the beds. Five nurses are required for every ICU—[Interruption]SPEAKER: Order!Rt Hon JACINDA ARDERN: Five ICU nurses are required per bed so not only have we got 300 ICU or high dependency unit beds and the ability to surge to 500 we put aside funding in the Budget to ensure that we could train the staff required for the additional beds that we have.Christopher Luxon: Does she agree with—sorry. At any—sorry. Why did her Government choose to prioritise things like eradicating wallabies including a pandemic over increasing the number of fully staffed ICU beds?Rt Hon JACINDA ARDERN: Again I reject the premise of the member's question. So not only did we increase the amount of money that went into training our ICU staff because that is the critical piece of the puzzle we also have of course put in capital expenditure for ICU physical space as well: $10 million into the expansion of Tauranga's ICU space; a new ICU facility at Waitakere; 12 additional beds in Canterbury; and in addition to the training that we've provided for ICU nurses $544 million for the operational spending of staffing for those new beds. But the one thing I would say: our focus has been ensuring people don't end up in ICU in the first place. We want to save lives not have a situation where people are critically unwell.David Seymour: If the problem with staffing more ICU beds was getting the nurses why did it take until 20 October for the Government to set aside managed isolation and quarantine (MIQ) space for nurses coming to look after those Kiwis she cares so much about?Rt Hon JACINDA ARDERN: That is not true first of all. Second of all as I said the funding for the additional staff was right at the beginning of the pandemic. Second point: if you only rely on surge capacity—that is what happened in the UK. When you have ICU staff who come in to support a surge—an overwhelming of a health workforce—the death rate in ICU increases. Our goal has always been to stop that from occurring. If you are overwhelmed in a pandemic people die no matter how many staff you have.David Seymour: I raise a point of order Mr Speaker. My question was very specific about MIQ not about funding and not about the nature of staff whether they were organised as surge staff but about MIQ capacity and when it was announced. She did not address that at all.SPEAKER: Order! Order! The member started his question that way. Unfortunately it had a tail which opened it up for the answer.Christopher Luxon: So why did Wellington ICU specialist Dr Paul Young say recently I challenge you to visit any ICU in the country and find one clinician—just one—who can show you their newly staffed ICU beds."?Rt Hon JACINDA ARDERN: As I've said we have increased the support and funding for ICU staff. We've put an extra $100 million into capital funding for ICU beds. But ultimately our goal has been not to put pressure on that part of the system. At the peak of this outbreak my recollection is that we've had 11 people in ICU. We have had capacity throughout the pandemic in our ICUs. We've had surge capacity of an additional 200 beds. But if the member's goal is to simply have capacity open up and flood the ICU we have a very different view of pandemic management.Christopher Luxon: At any point in the first 12 months of the pandemic did she actually pick up the phone and instruct her health Minister to increase the number of fully staffed ICU beds; if so when?Rt Hon JACINDA ARDERN: I've said multiple times now that part of our pandemic response of course has been about enabling not just physical beds but the capability and capacity to properly staff them. You can convert a ward but you need the qualified staff in order to operate it in a way that people do not die. We have funded that. Again though I come back to the point that throughout this pandemic our issue has not been pressure on our ICU; our focus has been on making sure we don't have outbreaks that overwhelm our ICUs. If we at any point got to that level it would mean contact tracing would have fallen over it would have meant our public health units would be overwhelmed it would have meant that we would have been like many other countries and we have not been.Christopher Luxon: Why did it take her 21 months to announce additional funding for ICU beds when during the same time New South Wales was able to double their ICU capacity?Rt Hon JACINDA ARDERN: If the member wishes to compare us to a state that had 75000 cases and when the state of Victoria was setting up infrastructure in its car parks that is the member's prerogative. I think what it demonstrates is that no matter what your surge capacity or your ICU beds is if you are overwhelmed you are overwhelmed. No country in the world had capacity that allowed themselves to save people's lives if their ICUs were overwhelmed. That has never been our goal. We had a different strategy.Christopher Luxon: What does she say to the Viaduct business owners I spoke with last week who are utterly confused by her traffic light framework which suggests that they should already be at green; and when will she finally tell them what actually is the criteria for a colour change?SPEAKER: Before that happens I've asked this side; it's same for the other side. Can you just leave it while questions are being asked?Rt Hon JACINDA ARDERN: Firstly I'd say I'm very pleased that we can see them open now. And what I'm also pleased about is that people can go out with confidence knowing we have an outbreak that is contained and that they can enjoy hospitality services again. I would also say that we very carefully designed the new framework so that it protects people's health but gives them certainty that at every level they can stay open. And finally what I would say is what I have said all the way through: this transition point is different. We are easing in at a point where we already have an active outbreak; that's different from the rest of the times we've managed a framework before and that's why we will be cautious about it.Christopher Luxon: So again what is the criteria to go to orange?Rt Hon JACINDA ARDERN: As I have said in this House many times before and on the podium many times before of course vaccination is only one issue; outbreak is another. Auckland is the epicentre of an outbreak in New Zealand that the rest of the country continues to be concerned about. On the one hand we of course have Auckland businesses that are pleased to be open; in other parts of country we have concern about the spread of COVID. We have to manage all of those interests.Christopher Luxon: Does she agree the failure to increase ICU beds during a pandemic is quite simply another illustration of her Government's ongoing failure to deliver and to actually get things done?Rt Hon JACINDA ARDERN: My view of delivery—[Interruption]SPEAKER: Order! Order—both sides!Rt Hon JACINDA ARDERN: —is the lowest case numbers in the OECD the lowest level of hospitalisation the lowest death rate record low unemployment growth in our economy and debt rates relative to other countries in the OECD that are still far lower. I measure our success in the wellbeing of our people and through joint efforts we have helped to keep them alive.Debbie Ngarewa-Packer: What does the Prime Minister say to a nation whose tangata w'enua now make up the highest hospitalised doubling in the last month?Rt Hon JACINDA ARDERN: That we have a duty of care for everyone; that we do need to make sure that we're extending the protections that are available to us particularly through vaccinations to everyone; and that we need to work alongside iwi and hauora providers to make sure we're reaching those who currently don't have that level of protection. And what I would also say is that despite the urging of the Opposition to open our international borders to remove the protections of the COVID protection framework which they don't believe in we will not do that because we know it is protecting our people.Debbie Ngarewa-Packer: What does the Prime Minister say even against the warnings of Māori health experts to the nation on why Māori are now making up more than 50 percent of the Delta cases?Rt Hon JACINDA ARDERN: There I would say that I am heartened by the rates of vaccination in the area that has been most affected by the outbreak. So in Tāmaki-makau-rau we now have first-dose rates at 90 percent and we're up to 84 percent first-dose rates across the country. The job is not done. So long as there is anyone that is unprotected by being unvaccinated we have a job to do. We will not just rely on vaccines though. Those countries who have had to quickly reimpose lockdowns and restrictions and that's why we have the protection framework.SPEAKER: Before I call the next question I'm going to just remind new members to the front bench who are very close to my microphone that when you—yes the two of you—interject it comes through my microphone and is—[Interruption] No—earlier it was I think. Not just recently but through the question time. And therefore when you are sitting where you are now—and I sat there for far too long in my political career; it took me a while to learn the lessons—can you just try and turn your volume down a little bit. Thank you.Chris Penk: We'll try.SPEAKER: You'll try?"