Leary IngridINGRID LEARY (Labour—Taieri): Thank you Madam Speaker. I'm letting members opposite know that we will support this amendment bill. It is important but we're interested to see what kind of impact this Government will be able to do to deliver on this strategic inclusion into the Pae Ora legislation. As the previous speaker Katie Nimon has said there are many people in New Zealand who have experienced mental distress or illness in their life. In fact half of New Zealanders will do so.It is my great privilege to be the Opposition spokesperson on mental health which is a passion I share with the new Minister and I really want to tautoko to him on his role. I know that he shares that passion from a personal level and is very engaged in it as I am personally through the experiences of my own family but also as a fellow of the Rosalynn Carter Mental Health Foundation. Rosalynn was the wife of Jimmy Carter and did a lot globally around the destigmatisation of mental health.So I know that we have a really committed Minister. My question is: by putting this into the Pae Ora (Healthy Futures) Act will this have an influence will it have an impact or is it just a tick-box exercise? And I do note that the previous speaker hasn't actually mentioned the lead strategy on this—I'll speak to that in a moment—but also there is nothing on mental health committed by this Government in its hundred-day plan. There's been a big talk around this and we on this side are really keen to know what the Minister is going to deliver. Will he have the funding to deliver? Does he have influence in his Government?I'm reminding this House and also anyone viewing that actually this inclusion is being built on the previous Government's investment into mental health. It was the biggest ever investment to lay a whole new foundation for the mental health system and what this bill will do is ostensibly enable the long-term planning and delivery that's required to improve mental health and addiction outcomes. The proof will be in the pudding. Again I query how that's going to happen in an environment where the Government is requiring Public Service cuts of between 6.5 and 7.5 percent. I also wonder how Māori will be able to deliver on this given that there will be the disestablishment of the Māori Health Authority.So we will support this. It's a good start to add to the other strategies which the Labour Government introduced around the Māori strategy Pacific health women's strategy and rural strategy. What we hope it will do is cement in law the mandate for change as envisaged in the Mental Health Foundation report Kia Manawanui Aotearoa which as I mentioned the previous speaker has not alluded to once in her speech.We agree that without leadership mental wellbeing promotion will be deprioritised. Leadership has to come straight from the top and today in the Health Committee it was really good to hear a clear confirmation that the Ministry of Health is accountable for the operational delivery of that leadership around mental health. The strategy though we fear will reflect the inherent status quo bias towards an illness-orientated medical approach and service development approach if it doesn't have the associated wellbeing promotion element to it.And I note that the Minister himself has said that mental health promotion is one of the key pillars. He said that in his election document—it came after prioritising delivery of more services and enabling tino rangatiratanga around keeping mental resiliency. It was a reference to growing mental wellbeing at the grassroots level. The reason I'm slightly sceptical is because when we look at the wording it first of all talks about a mental health and wellbeing strategy and it talks about in new section 46A(2)—inserted by clause 7—being a framework to guide health entities for the long-term improvement of mental health and addiction outcomes." I query whether that is broad enough. I query whether other agencies should be involved and I'll come to that later in terms of how we promote wellbeing rather than a medicalised response. I note that the word "addiction" is not in the heading to new section 46A which talks about the mental health and wellbeing strategy. When I look at the numbers around what the National Party had said they were going to commit to addiction it was a four-year promise of $63 million for methamphetamine addiction treatment out of a total commitment—or promise—of $179 million. So it's a significant portion of the money and yet the word "addiction" is not in the nomenclature of the new section 46A mental health and wellbeing strategy provision.So I have a few questions around that. Where is wellbeing?—obviously. Where is addiction? Where are the voices of lived experience? Where is the requirement in the legislation to include the voices of lived experience which we know from so many reports is essential to the delivery of this? There must be proactive investment in health promotion. It needs to be community based. And who is accountable for the delivery? Obviously the Minister will be. How is he going to deal with that?The Mental Health Commission has already identified in several reports that there is a narrow sort of deficit model to mental health and wellbeing promotion. And what I didn't hear in the Health Committee today—and I did ask about this—was any accountability from the Public Health Agency for mental health promotion. So what we need is for the new Minister to let us know how the strategy is going to be developed. Where is it going to be developed? Is it going to be a desktop exercise? Who will be involved in the consultation? Where is the voice of Māori? Where is the voice of lived experience? What is the element of addiction in it given that it is not actually included in the provision in the bill? Those are my main questions.The other element to this if I talk about how I would like to see it broadened is a meeting that I've had with FinCap an NGO that supports 200 free financial mentoring services. Now they have shown a strong research database showing the relationship between debt resilience and mental health. That doesn't seem to be included in this. There is no reference to social determinants. There are no references to how this could enable people like for example former prisoners to be able to access bank accounts which will support their mental wellbeing support them into work and therefore also reduce crime rates. I don't see the whole-of-Government support for the provision. I support it but it does feel a little bit like sloganeering.The other questions I have are around funding because as a previous speaker said funding doesn't work if there's no strategy. Well strategy doesn't work if there's no funding. I know the Minister wants to see more funding. He said so to the Southland Rural Support Trust in January this year when he met with farmers and spoke about mental health. Will the Minister commit to getting that funding that is needed? Will he commit to getting the workforce that is so desperately needed? And again in the select committee today we asked about workforce. We were told by the ministry that there are gaps not only in the workforce big significant gaps particularly in my part of the world down in in Taieri in the deep South but also in the knowledge in the data baseline of what we know about where the gaps are. So that work has yet to be done. So I do think it's really ambitious for the Minister to say he's going to deliver on all of that when we don't have workforce strategy to do so.My final point is around the fact that I do support this because it's explicit but I would also note that anybody who's read the health strategies from the other sectors will see a really strong focus on mental health. In the rural strategy for example there is almost a dominant focus on access to mental health services and provision of wellbeing. So there could be an argument to ask why this is suddenly needed to be inserted. It makes me suspicious that this could be a little bit more of the sloganeering that we've come to see from this Government—great on slogans; how are they going to deliver?I have more faith in the Minister than that. As I've said the Minister is really invested in this. He wants to make a contribution. I hope he can make a contribution. The questions I have are not really around his commitment to this but around his Government which hasn't committed to anything around mental health in the hundred-day plan. Will he have the influence and the support of his caucus colleagues? Will he have the support of his Minister of Finance who is currently trying to make a 6.5 to 7.5 percent cut in the public health sector? How is he going to manage all of that and deliver on this great ambition and what is the strategy going to look like? I'm looking forward to seeing that work from the Minister. I want to support him. I think it's great that we have a Minister of Health and I'm looking forward to hearing the further contributions in the House on this today."