Utikere TangiTANGI UTIKERE (Labour—Palmerston North): Thank you Mr Speaker. I rise to make a contribution to this urgent debate this afternoon. Following on from colleagues can I firstly acknowledge the whānau the loved ones of the person whose experience at Middlemore was far from ideal and certainly meant that they are no longer with us. Anyone in this House I think would reflect on opportunities and occasions like that and it's appropriate to acknowledge the loss of life that's been sustained on this occasion.I want to also follow in the footsteps of colleagues in acknowledging the workers; certainly the workers at Middlemore Hospital in Auckland but also those within our healthcare system generally for the outstanding work the outstanding service that they provide on a daily basis 24/7—individuals who I'm sure we all have in our own families members of our community who we know who have over the last few years shown enormous strength when they get up in the morning or in the evening depending on shift work and make their way to work in order to serve and help others within the health system.Earlier my colleague Minister Little talked about context and I want to spend a little bit of time on that this afternoon because context is important in any situation. And in the context of this incident in June at 1 in the morning it's clear that we all expect that when we front up to a hospital—certainly to an emergency department (ED)—there will be policies in place; that there will be support that is given. It is the role of a reviewer—in the words of the Minister the independent reviewer which I agree with—to make some decisions to form some judgments to have fulsome access to evidence and information whether they be policies or other forms of record to inform the report that they may write.I agree that there is a basic expectation in this country—and indeed in our community—that people should be able to access healthcare on a 24/7 basis and particularly when it is of an urgent nature that the individual or their family thinks that they need to go to the ED to hospital or whatever service is provided in local communities whether they be urban provincial or rural to get the support that they need. But it's also worth noting that isolated events do occur from time to time and so with that backdrop of context that's particularly important. For the folk at Middlemore and elsewhere around the country I don't think we need to look too far to see or to understand that we have experienced for quite some time a global pandemic; that we are in spring but for many it still feels like winter and there are staff members in any workplace who are away sick. If we reflect on our own workplaces in our own communities or here at Parliament we know the toll that COVID that winter illnesses do take. And the sense of protection that people have in a workplace as well is also something that is quite important.But in terms of a hospital I think there are often—and I reflect on my own hospital in Palmerston North and the fantastic work that the folk there do—additional layers of protection particularly in circumstances where health is a significant issue where there is additional resource at the front door where there are limitations on the numbers of people that perhaps can be accompanying someone who is fronting up to a hospital. All of these things all of these factors do point and paint a picture of context that I think is really really important.After many years of underfunding—and Minister Little touched on this much to the chagrin of those opposite—for the first time in decades there has been a significant increase and uplift in the funding that Government have put within the health sector. I can tell members of this House and I will tell others who wish to listen or ask that that also filters down into my own community of Palmerston North. When I think about the investment in Palmerston North Hospital when I think about the medical assessment and planning unit suite that's been invested in—those that drive down Ruahine Street on a regular basis will see the work that is being undertaken; the first bit of kit and infrastructure that has been delivered in Palmerston North Hospital for many many years. I'm proud to be part of a Labour Government that is investing in health investing in infrastructure investing in making a difference for people for whom it really makes a huge difference in their lives.I want to acknowledge the COVID workforce the individuals who tirelessly over many years have got up and gone about supporting our community. They don't ask for much actually because they want to support their loved ones their own communities whether it's in the face of COVID through vaccination of workforces and loved ones—and I think of the efforts of those who either have retrained in order to deliver that service in our community or are wanting to start out in that particular space. I think of those community organisations—our Māori and Pacific community organisations who are connected on the ground; also with new migrants certainly in Palmerston North and other places as well who are connected to be able to deliver those services. They have worked extremely hard in terms of painting a picture of context in Aotearoa New Zealand over the last 2½ to three years.We have made no secret around the fact that these changes are good and great but they are not going to deliver wholesale changes overnight. Anyone who thought that come 1 July and the clock ticked over and suddenly it was no longer June and we were 1 July that suddenly healthcare in New Zealand would be much much better is dreaming. We are on a journey. We are on a pathway to deliver an increase in improved healthcare for New Zealanders and that is something that I am extremely proud of.Just last week I know many of us were out on recess and had an opportunity to spend some time with St John Ambulance and this to me indicated the pressures that our healthcare system has been under for quite some time. I was thankful that they were able to show me around their particular site and in the process of that the pager went off and the first responder and the emergency paramedic or technician were dispatched to a job and then about three minutes later a loud audible siren started and then the emergency care paramedic jumped in his vehicle and off he went and then about two minutes later another siren went off and a visiting paramedic who I think was actually from the Horowhenua from Ōtaki was visiting and they were dispatched. Then I said to the person who was showing me around What happens next?" He said "Well next it will be me and after that it's the manager." I said to the manager "Well what sort of training do you have?" and he said to me "I've got a basic level of medical training that will allow me basically to hold the fort until the paramedics arrive."So it's clear to me that even in Palmerston North—a provincial city that is in desperate need of the increased funding that this Government has delivered to meet the needs of my community—even in my city there are pressures that are apparent. They tell me that a lot of the calls are from people because they can't access a GP service and I know that is something that has been an issue for quite some time. But context is so important—context is so important. Minister Little touched on the immigration changes that have been made and yes the 381 nurses that have been ready since July and the changes in terms of the specialised unit that will effectively have a real focus on the way in which those applications are processed and considered will no doubt make a difference. But when Minister Little talks about the month of June here in New Zealand and over 100000 people turning up to an ED here in New Zealand that indicates a huge level of pressure. Actually 80000 just in a general month on its own indicates a huge sense of pressure as well.So these wholesale changes are coming but they're also a result of professionals within the sector who are working extremely hard to support patients to support whānau to support others in their time of need. I agree with Brooke van Velden when she says that we pay taxes for a public healthcare system and it's about the best use of resource. Well I reflect again on the largest investment of a Government in recent times and it's come from a Labour Government because we have acknowledged that the system is broke and it needs to be fixed. Now that's not going to be a small comfort for the woman and her experience at Middlemore but it is some comfort for others. Thank you Madam Speaker."