Rurawhe Adrian; Ngarewa-Packer DebbieDEPUTY SPEAKER: Tēnā rā tātou katoa. The House is resumed. Members before the dinner break we were debating the Health (Fluoridation of Drinking Water) Amendment Bill. We're on call No. 9 which is a split call. I call Debbie Ngarewa-Packer.DEBBIE NGAREWA-PACKER (Co-Leader—Te Paati Māori): Tēnā koe e te Pīka. Tēnā tātou e te Whare. I rise on behalf of Te Paati Māori to speak to the second reading of the Health (Fluoridation of Drinking Water) Amendment Bill.We know we have a Māori oral health crisis in this country. Māori were more than 1½ times as likely as non-Māori to have teeth extracted due to decay abscesses or infection in the past 12 months. At school entry age Māori tamariki have had a much higher number of missing or filled teeth then non-Māori. We know Māori have the poorest oral health outcomes of any other population in Aotearoa. Māori dentists and experts in oral health are telling us just how critical it is for fluoride to be used in a consistent way across the country. The data and the science is absolutely clear: fluoridated water supplies significantly improve the oral health of our communities particularly for tamariki. Fluoride should only ever be one part of the response to this crisis. But it is an essential and immediate response. Therefore Te Paati Māori will be voting in support of this bill. Fluoride is a necessary part of the solution especially in the short term until such time as our people have free and open access to lifelong oral healthcare.However we want it noted we have significant concerns with the drafting of the legislation. The Government has announced that they will introduce a Supplementary Order Paper to amend the bill so that rather than DHBs the Director-General of Health would make the sole decisions on fluoride. This reflects the Government's decision to disband the DHB system and the agenda to centralise decision-making power. Debates about the fluoridation of drinking water have plagued local councils for years. This has resulted in inconsistencies across the motu and for many communities a failure to achieve fluoridated water.We agree that local councils aren't necessarily best placed to make these decisions and we of course recognise the health reforms which also preclude DHBs. However what we must maintain is the ability of tangata whenua local communities to engage with these decisions. Placing policy decisions in the hands of one Government bureaucrat runs completely against Te Tiriti o Waitangi and our decision-making rights as tangata whenua. Under the current proposals there will be no Treaty framework for fluoride decisions and there'll be no opportunity for public consultation let alone dedicated mana whenua engagement. Tangata whenua and indeed all communities have the right to decide what chemicals our wai supplies are treated with.This bill fails to uphold our mana motuhake. That is why we'll be seeking to further amend the bill as it progresses through the House so that it requires the Māori Health Authority to agree before any fluoride decisions can be made. It must also require opportunities for the public including local communities of whānau hapū and iwi Māori to submit on fluoride decisions. For these reasons we are loath to vote in support of this bill in its current form. But we feel compelled to as we recognise the immediacy the absolute urgency of dealing with the Māori oral health crisis affecting our tamariki and whānau.The reality of the matter is that we shouldn't be in this position where fluoride is so essential. The crisis of Māori oral health is a result of decades of systemic racism in the health system and under-investment in oral and primary healthcare. The data is clear that even for Māori who are accessing fluoridated water supplies their oral health outcomes are still much worse than the general population. What is really needed is free dental care and free primary healthcare across the board. Far too many whānau can't even afford to attend the dentist more less access it. We won't have a truly free and accessible health service until we have a Government with the courage to invest at the scale that is needed. We look forward to working with MPs across the House to improve this legislation and to continue to find solutions to deal with the oral health crisis in Aotearoa. Nō reira tēnā tātou katoa.