McLellan Tracey; Dean JacquiDr TRACEY McLELLAN (Labour—Banks Peninsula): Thank you Madam Speaker. It's a great pleasure and a really good opportunity tonight to take a call and to stand to speak in support of Pae Ora (Healthy Futures) Bill tonight. I say this for a number of reasons and I'm going to work my way through a couple of salient ones and hopefully make a couple of good points.I think at the moment health is at the forefront of everybody's mind. You know everybody can understand that that's rightly so. It's something that's particularly topical. We've just been through a series of events over the last 18 months which make that quite salient. The COVID-19 pandemic has highlighted I think just how critical public health is and this bill in particular gives it the attention and the resources that it needs. A robust public health system is essential to the wellbeing of all New Zealanders and a robust public health system is one which I think we can or should or would all agree is one that leaves no one behind.Health outcomes have for far too long been an accident of birth and geography a so-called postcode lottery that I've heard several members refer to. I think it's really important that while we coin phrases like that we make sure that we don't trivialise or that we don't gloss over what that actually means. It's a postcode lottery: it means quite simply that for some individuals depending on where they're born and depending on who they are they can have quite drastically different outcomes. And that's not good enough.So this Government is dedicated to creating a fair and equitable system and a fair and equitable system that reflects and respects Aotearoa's diversity. This bill will go a long way to ensuring that we have a health system that is fit for purpose in today's expectations. Earlier on we heard some prior contributions talk about the cyclical nature of reform as if that was a bad thing or something that was there for derision. It's just a matter of fact that the world changes and things do change and sometimes we need to revisit and sometimes the right time for reform is now.So this bill will go a long way to ensuring that we have a health system that is fit for purpose for today's expectations and one that achieves equity by raising standards for all. I think it's particularly important to note that it's raising standards for all particularly those who have been disadvantaged in the past. To address the inequality in our health system it was essential that we scrutinised existing arrangements. And as has been spoken on several occasions tonight we have 20 district health boards (DHBs) each one with a highly skilled—and I really want to emphasise this—highly dedicated workforce.Over the years I've had the pleasure and the opportunity I suppose to work with various kinds of groups within our very dedicated and very skilled health workforce—most recently our amazing nurses not only within the DHB system but within other aspects of our health sector. I greatly admire what they do. I've also had the opportunity to work with other groups within our health system like our doctors both clinical research medical scientists our healthcare assistants and our auxiliary workforce and our clerical and various other people that support our amazing health system.So I want to be really clear when I say that it's the structural realities and the duplications inherent in our system that cause the impediments not our highly skilled workforce. Due to that we see a situation now where it's just simply not resulted in a cohesive and consistent healthcare. And cohesion and consistency comes through unity which is why the DHBs need to be replaced with Health New Zealand a centralised authority that will take control and responsibility for our health system. This of course is entirely congruent with the key recommendations of the Simpson report released last year.One thing I want to make very clear also because of previous comments is that communities will remain at the heart of the system. This is something that this side of the House knows only too well. We understand communities. Most of us come from a grassroots organising activist base. We understand what that means and what it actually means in reality. With the additions of locality networks which the Minister of Health has described earlier on each of which will be within the health sectors for regional divisions that's the means by which to ensure local voices are effectively heard. If anybody thinks that having a triennial election—and I think as a member on the other side of the House mentioned earlier on with the misfortunes of an STV system and all of the name recognition sort of criteria that almost certainly guarantees election—if that accounts for local representation then we're not doing things correctly.Another key pillar of reform proposed by this bill that we're discussing tonight is the establishment of a Māori Health Authority which will ensure we give a strong voice and provide a vehicle for change for those many New Zealanders that are disadvantaged by the current arrangements. And despite earlier contributions which I think tended to trivialise lived experience and tended to trivialise all of the planning the governance and the strategy—all of the work that goes into making sure that when a member any particular member rocks up to their GP and may not care who that GP is—it's not indicative of all of the reality that goes into making sure a system is fair and equitable.Who better to commission Māori health services who better to monitor Māori health outcomes and who better to develop Māori health policy than Māori? Detractors will of course say that we're creating some sort of two-tier system and favouring one group of people over another but that's trivial it's silly and it's simply not true. In fact the opposite is true. The Māori Health Authority is a distinct entity but it is one that will work in partnership with the other relevant entities as we take a much needed more robust holistic approach to health. Equality in health achieved by raising healthcare standards and accessibility to all New Zealanders is the intended outcome and it's the intended outcome of this bill. Indeed it will be how this aspect of the bill will ultimately be judged.This bill has significant ramifications for the Ministry of Health as well as it now will focus and pivot towards more policy and performance monitoring. The ministry I'm glad to see and feel very reassured by the Minister will be appropriately resourced and strengthened to facilitate the implementation of these changes and you know as other people have talked about there were various other additions to the public health agencies and to make sure that we boosted those resources as well.Even from my very brief outline this is a significant piece of legislation with wide-reaching impacts on society. It has accordingly been prepared with a great deal of care incorporating extremely valuable contributions from a wealth of experts including Heather Simpson as we've discussed previously and the rest of her team; including the Waitangi Tribunal and a raft of primary- and community-based services and medical specialists. The Labour Party manifesto recognised that over the last three years we have made record investment in health playing catch-up after years of neglect. This bill also supports to build us back better as we learn from our strong COVID-19 response and inculcate all of those lessons into the design of this new national health system; something to be really proud of.I'd like to acknowledge the work of Minister Little Minister Henare Minister Verrall on this particularly really exciting piece of legislation. They've obviously consulted widely they've listened to the key stakeholders and they've considered a variety of viewpoints in the preparation of this bill and it's really evident in the quality of this bill. I said on numerous occasions—in response to a question earlier on in the night—I said on numerous occasions during the election campaign that we can't keep doing health the same way as we have done and keep hoping for better outcomes. Something needs to change. So I will follow with great interest the progress of this bill through the House and through the select committee process. I have no hesitation at all and am in fact quite excited to commend this bill to the House.ASSISTANT SPEAKER (Hon Jacqui Dean): Penny Simmonds—five minutes.