7. Question No. 7—HealthHon MICHAEL WOODHOUSE (National) to the Minister of HealthQuestion No. 7—Health7. Hon MICHAEL WOODHOUSE (National) to the Minister of Health: Will he accept all the recommendations of the Health and Disability System Review; if not which recommendations will he be rejecting? Hon Dr DAVID CLARK (Minister of Health): The Health and Disability System Review is a thorough and thoughtful piece of work and I want to take this opportunity to put on record my deep and sincere thanks to the panel and the Māori Expert Advisory Group for their mahi and insight. Cabinet has accepted the case for reform and the direction of travel outlined in the review—specifically changes that will reduce fragmentation strengthen leadership and accountability and improve equity and access and outcomes for all New Zealanders. That means we are committing to an ongoing programme of reform to build a stronger health and disability system. As the member will understand change of this scale will require legislation which will be subject to the usual processes. Decisions on individual recommendations will be taken to Cabinet over coming months and into the next term of Parliament. Hon Michael Woodhouse: Does he believe the public has a right to know prior to 19 September which of the substantive recommendations the Government would implement if it was in a position to do so after that date? Hon Dr DAVID CLARK: Cabinet has accepted the direction of travel in the report and therefore the recommendations contained in the report will be worked on and worked up for legislation but it will be the privilege of the next Government to put into place the recommendations that it agrees with and the member knows how that process works. Hon Michael Woodhouse: Would it have been in a position to do so—to put those recommendations to the public—had the Minister not refused to accept the report in March because his singular focus was on the health response to COVID-19"? Hon Dr DAVID CLARK: I think it was appropriate that the Government was focused on COVID-19 during the period and the results of that singular focus have meant that we have been very successful in our response to COVID to date. However now that we are at alert level 1 I have received the report and turned it around in a little over three weeks which for a report of this size and substance is a very quick turnaround for Cabinet to agree to the direction of it. Now the public can access this report read it for themselves—so can the political parties—and if the member wishes to have a briefing from the lead author I can arrange that for him. Hon Michael Woodhouse: Does that singular focus indicate that he is incapable of doing more than one thing at a time? Hon Dr DAVID CLARK: I won't reflect on whether that is the case for the member himself that leads to that question. Obviously we have priorities and as a Government we have prioritised responding to the COVID situation. The results there speak for themselves. Now that we're at alert level 1 we have agreed that it's a good time to receive this substantial report which indeed does indicate years of neglect have had a deleterious effect on our health system—nine long years of neglect by that Government. Now we have a report that maps out a way forward and it's up to every party in this Parliament to take a view on it and if that member objects to some of the findings in here about greater accountability better outcomes for New Zealanders then he's free to say so. Hon Michael Woodhouse: Will he commit to no increase in health bureaucracy as a consequence of any changes? Hon Dr DAVID CLARK: This report is focused on producing better outcomes for New Zealanders. As a Government we have grown the health sector. We have now 1700 more nurses in the sector than when we took office and 900 more doctors in the sector. We have 600 more allied health workers. We want to make sure that it's a system that delivers for New Zealanders. We will have fewer DHBs as a result of this report which recommends that we move to that situation where we plan for our regions and then over time work out how we have fewer of those structures in place. Hon Michael Woodhouse: Is his comment in the previous answer "We will have fewer DHBs" an indication that the Government has already committed to that recommendation in the Simpson report? Hon Dr DAVID CLARK: The Government has as I've outlined previously agreed to the direction in the report. If the former Minister believes that we should have more DHBs I believe he'd be on his own with that one. Rt Hon Winston Peters: As a matter of precedent how many DHBs were to be reduced under the previous policy that he inherited from his predecessor in his portfolio? Hon Dr DAVID CLARK: Well when I inherited the DHB sector from the former Government it was very much a status quo situation. There seemed to be no indication that they wanted to reform it. All they wanted to do was starve it of funding and reduce the services available to New Zealanders. We had an independent report done that showed that New Zealanders had higher barriers to care because of the underfunding of that previous Government."