Verrall AyeshaHon Dr AYESHA VERRALL (Minister of Health): It's a privilege to rise in this debate on the Prime Minister's statement. In particular I want to take this opportunity to acknowledge all of the people who have been hit firstly by the extreme weather event that we first saw affecting the Coromandel Northland Auckland and parts of the Waikato; and then Cyclone Gabrielle. It is unbelievable the force of nature that has been unleased that has caused the loss of life of 11 people and others to be unaccounted for. But believe it we must because we need to get on with both responding to this disaster and ensuring that we continue to take bold action on climate change to make sure that we prevent the harm of these sorts of events becoming more and more common in the future.I want to focus my remarks on the incredible work of our healthcare system first in response to Cyclone Gabrielle. In the past week I've been briefed multiple times a day and the resounding message that I've heard about the response particularly in the Hawke's Bay and in Tai Rāwhiti has been about the fortitude of those healthcare workers on the front line. The Prime Minister reflected in his remarks on a nurse he met in the Esk Valley but I know that that story reflects one of many healthcare workers who has been out serving their community while they themselves have faced very difficult situations at home having their home impacted by flooding or their family disrupted as well.For this reason we are determined to make sure that we can sustain the commitment of those healthcare workers in affected regions to their communities. That means making sure that they get a break. For that reason using our new nationally coordinated health system we're able to send in a team of nurses and other healthcare workers to areas where they are most needed in order to give the people who've been doing it tough for the last week a break so that they can come back to work refreshed.The reports have been—and I'm sure members of this House will be pleased—that the hospitals have remained open and able to take care of people and their acute needs. The health system has also made sure that primary care and aged residential care has been able to manage in what has been difficult circumstances. I want to take this opportunity to thank all the healthcare workers in affected areas for their work. It is valued by all of us particularly your communities.It's an honour to be health Minister under Prime Minister Chris Hipkins. This Government has already done so much to tackle the long-running issues in our health system and I am proud to continue that work. I want to take a proactive approach to health leadership in order to make sure New Zealanders get the services and access they need and deserve. I know there are challenges in our health system and of course we will traverse them in this House—at length I'm sure. But I'm also optimistic: we have the chance the opportunity to address some of the long-run issues which as a worker in the health system I thought we'd never get around to. Having worked for almost 20 years in the health sector I know the workers and the patients well. I know that there is a lot that we can do to make things better for our workforce and the people we serve. It won't happen in an instant but I want everyone to know we have a plan and that work is well under way.In the first few weeks of this job I've been out talking to healthcare workers around the country. They've been pretty open with me about the pressure that they've been under. I know it and I recognise it. I've visited the emergency department I trained in and seen that it is much busier now than it ever would have been in a February. I want to reassure New Zealanders that the healthcare that they need is available to them and many healthcare workers are going above and beyond to make sure that that remains the case.I think the three most pressing issues our health system faces right now is its workforce waitlists and winter. So I want to see us deliver a long-term workforce strategy that addresses training and recruitment and other factors that make staff feel safe and supported in their workplace. We need to reduce the planned care waiting list backlog. We need to plan for the coming winter to ease pressure on emergency departments and the rest of the system.The Government's health reforms were initiated to make sure our healthcare system delivers what people need. There's a lot of discussion on the details in this House over the last several years. I will never lose sight of the purpose of those health reforms: to take care of New Zealanders and their family and ensure that healthcare is equitable and everyone has the opportunity to have better outcomes.We've removed district health boards and the debt that they carry that impaired their ability to help local communities. We're making sure that we're having avenues for local engagement through localities and Iwi-Māori partnership boards. We're giving Te Whatu Ora long-term sustainable funding meaning they can plan for services in a way we've never been able to in the health system before. We've established Te Whatu Ora to make sure that Māori always have a voice at the table in the health system and that they can directly commission services for themselves. I'm really proud of what we've achieved so far and it's a really important part of improving the health outcomes for all New Zealanders.A key part of the reforms was Pae Ora—wellbeing. Our health reforms have done so much to help us focus on an area I'm really passionate about which is prevention of illness to tackle the public health issues that stop people from getting ill in the first place. Our response to COVID showed what we could achieve when the health system worked together to focus on prevention. It's important as we've been reminded earlier in this House that we focus outcomes. I want to remind everyone of the very important outcome the COVID-19 response achieved of saving 20000 lives. I wonder if some in their remarks in this House today might have forgotten that was the outcome.It's also provided an opportunity for us to establish new systems that we are using to address and fight public health threats. Remember how we had a cluster of cases of monkeypox late last year that didn't blow out into outbreak like it did in just about every other Western country? That's due to the improvement of our contact tracing. We've responded rapidly to a measles case just recently. The contact tracing there has performed exceptionally well—102 out of 104 contacts have been quarantined identified and appropriately managed. The legacy of COVID is that we have a stronger public health system. We've also made sure that we're coordinating on some of the big issues: HIV elimination and hepatitis C.We're taking care to achieve great health outcomes by focusing on some of our biggest health threats. That includes the world-leading legislation on tobacco that this House passed last year. We're using the systems that we developed through COVID to make sure we continue to focus on prevention. For example the digital tools that we've developed will now be expanded. We'll be making those available to do things like make sure people are recalled for their cervical smears as we move to the new HPV screening later on in the middle of this year. We'll use data and digital in the way we did in the COVID outbreak to enable many of the changes that we're seeking through the reforms. People should have control of their own data so they can be empowered to make decisions about their healthcare.We also have long-running priorities and one of the key amongst them for this Government has been the improvement of mental health services in New Zealand. There are multiple points in which you can see that we've gone from sweeping mental health under the carpet under the last Government to making sure that we have an integrated system of care now in New Zealand; 2.6 million people are covered by a primary care mental health service. That's half the country. If you can imagine any other primary care system being invented from scratch in that time well you're welcome to have a go about it but that is a phenomenal achievement. We've delivered over 670000 sessions. We're seeing nearly 30000 people a month. We have funded counsellors in 164 schools. We have other services like Piki that has delivered 51000 services this year. And we're rolling out Mana Ake a school-based programme to multiple regions.So I want to go back to where I started about Cyclone Gabrielle. We have a system of integrated mental health care in New Zealand and those supports exist for people. I've received multiple questions from colleagues about this and we will be making sure that there are clear ways forward for people to reach into services if they need them. But the most important thing we can do after a disaster is recognise that the majority of people have stress and anxiety about the traumatic things that they have seen and been through and just need the opportunity to talk it over with someone. I encourage all members of this House and all members of our community to reach out to friends around the country to help them do that if they've been impacted.