Reti ShanePAE ORA (DISESTABLISHMENT OF MĀORI HEALTH AUTHORITY) AMENDMENT BILLFirst ReadingHon Dr SHANE RETI (Minister of Health): I present a legislative statement on the Pae Ora (Disestablishment of Māori Health Authority) Amendment Bill.ASSISTANT SPEAKER (Greg O'Connor): That legislative statement is published under the authority of the House and can be found on the Parliament website.Hon Dr SHANE RETI: I move That the Pae Ora (Disestablishment of Māori Health Authority) Amendment Bill be now read a first time.This is a narrow bill focused on the changes needed to disestablish the Māori Health Authority. Disestablishment was agreed to by all three governing parties in their coalition agreements and mandated by the results of the 2023 general election where it was canvassed at length on the campaign trail. Substantively this bill meets our 100-day commitment and delivers on our intent.I want to acknowledge those who embarked on the Māori Health Authority dream and say to you that this bill is in no way a reflection of you or your good work. It is a reflection of an approach that failed to put health needs for all at its forefront and a reflection of an implementation plan that faced significant challenges from the beginning. I acknowledge that some people have a different view and I respect that. However I want to reassure them that this Government will remain committed to improving Māori health outcomes.While the particular version of the dream that the Māori Health Authority laid out is coming to an end today I want to paint a different dream one that will be outcomes-driven providing greater devolved decision-making that will deliver care as close to the home and the hapū as possible. There is organisational expertise in the Māori Health Authority and I want to retain that. I say to Māori Health Authority staff to please join me guide me and help us together to row a different waka towards better health outcomes. This bill enables that.Structurally the intent of this bill is that the Māori Health Authority staff and functions will transfer mostly to Health New Zealand with a few to the Ministry of Health. Retaining the expertise needed to drive better health outcomes for Māori is important. We will do this transfer with dignity and respect for fellow health professionals. However this is not simply a rehoming of the Māori Health Authority within Health New Zealand and the Ministry of Health. There will be less funded positions transferred across from unfilled positions especially. These are being covered to date by expensive consultants. Across health we are reprioritising funds from the bureaucracy and into the front line.I want to speak to iwi-Māori partnership boards and the Hauora Māori Advisory Committee. iwi-Māori partnership boards and the Hauora Māori Advisory Committee will remain in place. Their voices may evolve as both will have a continuing role in the future of Māori health and they will be very important as we press into communities to deliver care to monitor care as close to the home and the hapū as possible. Localities will be paused under this bill while their place in the reforms is reconsidered.We have inherited a health system facing a significant number of challenges following major reform. The system continues to perform poorly across many metrics. Access to healthcare varies unacceptably. There are increasingly long wait times for treatment and substantial workforce shortages. Much of this is as a result of poor leadership and decision-making by the previous Government. Decision making has mostly been centralised in Wellington with family and whānau not having as much input into services delivered as is desirable. This needs to change.I want to paint a vision for Māori and all New Zealanders. My vision is that all New Zealanders will have timely access to quality healthcare. That is the mission statement. To achieve this I will be setting clear health targets. These will bring attention resources and the accountability that's needed to deliver quality care in a timely manner. The Hauora Māori Advisory Committee will help drive our health targets and will be informed by the work already done in Pae Tū and the Whakamaua action plan. iwi-Māori partnership boards will be encouraged to have more of a say in their local communities in a manner not permissioned in Pae Ora. This bill then is necessary not just to support an election mandate but to undo an ideology that was struggling to produce tangible results.Many will say that the Māori Health Authority was still in its infancy. I would refute that statement. After 18 months in transition under the guidance of a transition unit before enablement in July 2022 and then given a further 18 months after that this infant needed to be up on its feet and walking; despite the best efforts of staff it was not. It is not clear to me that the Māori Health Authority was ever actually supported properly by the previous Government who in my view were distracted by wider structural reforms to other parts of the health system. I believe the transition unit and previous Government has much to answer for in this failed implementation.Often in politics there is near universal agreement on the destination what needs to get better; it is often how we get there that varies. This bill signals the beginning of a different journey. We acknowledge inequities. We acknowledge long waiting lists. At a macro level this bill commences a journey that is different in three key ways from the previous Government's approach: (1) we believe in decentralisation and not a centralised Wellington knows best" approach to decision making and resourcing; (2) targets will be brought back and be at the forefront of our health policy unlike the previous Government which said targets would not be at the forefront of their health policies it will be at the forefront of our health policies; (3) health workforce shortages are the biggest hurdle facing our health system despite what the previous Government stated and put on record.To conclude what we are putting on the table today is a start to enabling the delivery of care as close to the home and the hapū as possible. I look forward to expanding further in other stages of this bill but at this point I commend it to the House.ASSISTANT SPEAKER (Greg O'Connor): The question is that the motion be agreed to."