4. Question No. 4—Prime MinisterHon JUDITH COLLINS (Leader of the Opposition) to the Prime MinisterQuestion No. 4—Prime Minister4. Hon JUDITH COLLINS (Leader of the Opposition) to the Prime Minister: Does she stand by all her Government's statements and actions? Rt Hon JACINDA ARDERN (Prime Minister): Yes—in particular our recent announcement supporting our recovery from COVID-19 that pending final confirmation by New Zealand's Director-General of Health and the Cook Islands Secretary of Health two-way quarantine-free travel will commence between New Zealand and the Cook Islands on 17 May. In addition recent data from the Tertiary Education Commission shows that our investment in free apprenticeships has led to the number of apprentices increasing by 17.6 percent compared to 2019. It's particularly pleasing that the number of Māori and Pacific apprentices grew almost 30 percent last year. There was also a 19.7 percent jump in workers aged 25 to 39 taking the opportunity for a career change and more than 1500 additional apprentices aged over 40. Hon Judith Collins: Does she agree with her health Minister's proposal to Cabinet that the Māori Health Authority be given clear approval rights including an ability to exercise a veto in sign-off" over national health plans? Rt Hon JACINDA ARDERN: Here the intent of what has been designed is the idea of us seeing joint health plans developed between Health New Zealand and the Māori Health Authority. So that is intended to cover off areas where delivery is intended for the general population but we want to make sure that we've got input from the Māori Health Authority and say over whether or not that is going to adequately reach Māori communities. Of course what we want is that not to be consultation which is what we have now and what hasn't worked so we're seeking joint agreement. We will need to put in place mechanisms if there isn't agreement on how to resolve those disputes but this cannot be a situation of mere consultation—which is what we're designing. Hon Judith Collins: So which health services are currently not accessed by Māori? Rt Hon JACINDA ARDERN: Currently you can see in our data and our stats that anything from screening programmes for say bowel screening and unfortunately cervical screening is inadequate for Māori because we are not reaching as many. The number of Māori we are reaching with those screening programmes isn't the same as what we are reaching for the rest of the population. Now we have to ask ourselves the question: "What do we need to do differently?" Because ultimately it's resulting in Māori dying younger. Hon Judith Collins: So when national and regional plans have to first be approved by the Māori Health Authority how is that not a power of veto over all of the Government health policy and implementation? Rt Hon JACINDA ARDERN: Because that is the difference between partnership and consultation—you have to have that equal say—and this isn't something we should be afraid of. We have tried the process of having a consultation style of approach. It hasn't worked. For Māori they have worse outcomes for cancer in every cancer bar melanoma. I'd like to hear the member's proposal for how we are going to turn around those statistics. Hon Chris Hipkins: In making the decision to establish the Māori Health Authority did the Government consider article 23 of the declaration signed up to by the last National Government—[Interruption]SPEAKER: Order! Order! The member will resume his seat. Who made that comment? The member will withdraw and apologise. Hon Dr Nick Smith: I apologise. SPEAKER: Chris Hipkins—start again please. Hon CHRIS HIPKINS: Did the Government consider in making the commitment to establish the Māori Health Authority article 23 of the declaration signed up to by the last National Government: "indigenous peoples have the right to be actively involved in developing and determining health housing and other economic and social programmes affecting them and as far as possible to administer such programmes through their own institutions."? Rt Hon JACINDA ARDERN: You could ask any member of this Government what their rationale for the Māori Health—[Interruption]SPEAKER: Order! Order! Rt Hon JACINDA ARDERN: You can ask any member of this Government their rationale for why this change was important. For some it will be the preventable hospitalisations we see amongst our children but particularly our Māori and Pacific children. For others it will be the heavy prevalence of co-morbidities; others it will be the public health issues around for instance the prevalence of smoking amongst our younger rangatahi. Everyone will have a different reason but what we all agree is the system right now doesn't work. Surely as a House we can concur that we have to do things differently. That is what this Māori Health Authority is all about.Hon Judith Collins: So isn't that in fact a power of veto because the Māori Health Authority needs to co-sign or approve all national health strategies and what happens if it decides not to?Rt Hon JACINDA ARDERN: Again this is partnership. We have to form agreement on how we are going to roll out health policies that we want to make a tangible difference to the health of Māori communities—now if the member has another proposal on how to achieve that I'd very very much be interested in it but a lot of thought and work has gone into these proposals and our view is: ultimately it will make a difference to health and therefore it will make a difference to the way that we're able to allocate our health resources and ultimately save people's lives and save money.Hon Judith Collins: If this is actually based on need as the Prime Minister now seems to be indicating then why is she not contemplating say a Pasifika health authority with a power of veto like she's giving the Māori Health Authority?Rt Hon JACINDA ARDERN: I'm not actually going to go down the track of implying here—[Interruption]SPEAKER: Order! Order! I apologise to the Prime Minister. I know it's the first day back after the school holidays but I think members—especially on my left but earlier on my right—need to know that they're back at work now not just in a playground yelling.Rt Hon JACINDA ARDERN: The question that I would put to the member is on what basis did the National Government establish Whānau Ora? On what basis did the National Government seek to support kōhanga reo? An acknowledgment actually of not only the obligations that we have but that we should be offering services—be they health or education or social services—in partnership with Māori. I don't think that's a new concept. It certainly never used to be a new concept for National.Hon Judith Collins: So why is the Prime Minister so set on having this power of veto for a Māori Health Authority over every other provider and provision of health services in New Zealand?Rt Hon JACINDA ARDERN: I reject the premise of that question and I have already given an answer."