Pugh MaureenMAUREEN PUGH (National): Thank you Mr Chair. Thank you. I've been trying to get a call on this bill all afternoon. Thank you. I'm speaking to the Pae Ora (Healthy Futures) Bill Part 2 and I want to focus on Subpart 2 which is Health New Zealand" Minister. Some of the activities that are listed in the bill about the functions of Health New Zealand are seen to omit the focus that some of the Health New Zealand responsibilities and in particular the ownership of district health board (DHB) practices—and I'm not sure if the Minister is aware but at last count and I do stand to be corrected 10 of the 12 clinics and practices on the West Coast were actually DHB-owned. So I wonder if the Minister could explain: what is the future for these practices and then how is the current relationship with the primary health organisation (PHO) going to work in terms of the funding arrangements? Because as you will be aware the funding comes via the Ministry of Health through contracts with the DHB and is then on-funded through capitation and contracts and programmes into the practices and also undertaken by the PHO. So there are some things that the PHOs are doing now with their GP practices and some of those are becoming quite challenging. As we know the workforce issues which have been spoken about today is a big part of that. So in terms of the Minister's responsibility that it talks about in here as part of Subpart 1 is around developing those strategies and we learn today that there is going to be a rural health strategy. Can the Minister tell us and the communities how long it will take to develop that strategy and then after that how long it will take to implement that strategy and inside of that what will the measures be for success and how long will the Minister anticipate it will take to recognise the success in that particular strategy and will the Government agree if that rural health strategy does not measure and deliver success to unwind this legislation?And one of the things that I am concerned about with the DHB-owned practices is the workforce but also some of the other contracts that are funded to deliver services into the very outreach areas. And one of the issues that was raised with me was midwifery services and the struggle that it is for midwives to service areas for the likes of Haast. So a midwife may have to travel 3½ hours to visit one woman and 3½ hours to come back. So basically that's a whole day and the payment for that is recognised at the end of that service when the delivery happens—literally. So will the rural health strategy actually recognise the time constraints involved with delivering services in rural areas and compensate those practitioners adequately for the service that they provide in those areas?When I was discussing this with some colleagues I thought "Well the best thing for me to do is to actually contact my PHO and ask them how the new structure is going to impact on them come 1 July when the changeover is likely to happen." And to my surprise the manager told me that she had absolutely no idea—no idea what was going to happen to her team and to all of the service providers. And I thought that was quite telling in terms of the contact that obviously has happened—or lack of contact that has happened—with those front-line workers. Now she was quietly confident because they are the only act in town—they have the workforce teams—but actually they didn't know what their role was going to look like when this new system was put into place. And I just think Minister perhaps there needs to be a bit more liaison with the people on the coalface as this is rolled out. Thank you."