Henare PeeniHon PEENI HENARE (Associate Minister of Health (Māori Health)): E aku apa whatukura e te ika huirua kua riro atu ki te pō kia tāpai ake ki tini kua riro atu i tēnei tāima o te urutā kia tangihia wā tātou mate ki te tāhuhu kōrero o tō tātou Whare e tū nei. Ki a koutou katoa kua riro atu ki te pō haere mai haere.Ka whakahokia mai ngā rārangi kōrero ki a tātou e te Māngai o te Whare tēnā koe kia ora tātou katoa.[To my many spiritual ancestors and to the two victims who have recently passed away adding to the many who have passed during the time of this epidemic let us lament our dead as they pass into the history of this House. To all those who have passed away may you rest in peace.Bringing the discussions back to ourselves Madam Speaker greetings to you and greetings to all.]As I have done on many occasions I stand first to lament the loss of these two gentlemen. Of course we send them and farewell them with all of those whom we've farewelled during this tricky time and challenging time of COVID-19 whether they've passed because of the disease of COVID-19 or whether they've passed during the time of lockdown. We know that these particular challenges on our whānau have been heightened in the Māori community heightened in the Pacific community but I will say this: heightened across all communities of Aotearoa. And I want to take the opportunity to farewell them and farewell them appropriately here in the House.The Minister of Health has already explained that we accept the recommendations from this report. We know that as COVID-19 has been in our community in particular over the last four months we have required a system that must be agile and nimble during what is a particularly tricky time and if I can echo the sentiments of our colleague Dr Kerekere in thanking a hard-working health sector—and I mean hard-working. I've travelled the country to meet with Māori health providers primary health organisations (PHOs) pharmacies health leadership and I acknowledge the role that they've played in adapting to these tricky COVID times and making sure they can continue to serve their community and not in a one-size-fits-all approach. And I'll come to that a little bit later in my contribution as we look towards what the report recommends and how we might continue to make sure that we've got a better system that will continue to serve our people as we look towards the new protection framework and of course the 15 December date that has been offered to allow the people in Tāmaki-makau-rau more freedoms across the country and the ability to travel. What we know in the conversations in the community is that while we count down to 15 December communities right across the country are looking towards the right model that suits them for care in the community. And I can say that if we get the framework right the leadership right the most important part will be how we connect it to the execution on the ground—the way that we implement it amongst our people—and that's going to be key.If we look towards these two gentlemen and acknowledge their Māori whakapapa—and Dr Kerekere is right in saying that we can't simply look towards a clinical assessment. While we acknowledge in the report that that was lacking we acknowledge too that that must be one of the first priorities as we find whānau members and community members who contract COVID to have a clear clinical assessment early. From there we must look towards the entire system to cater for them and their whānau. And I want to give an example: what we know in recent times is a particular person in a whānau has contracted COVID-19 and what's happened is that the health response was strong—actually a strong clinical assessment a strong connection with the whānau—and then sadly what happened was the social connection wasn't there. In a remote area how was that whānau supposed to be able to go and get the needs of their tamariki their mokopuna who all live in the same house? And who stepped into the breach? Māori health providers—Māori health providers. And we've heard it right across the country. I suspect members right across the country have heard the same line: trusted members of the community—not just anybody but a trusted member and a skilled member and the right person in that community to continue to work with that family.So we accept these recommendations and as the report already outlines we've already gone some way to making sure that we can fulfil those recommendations to make sure we can adjust the system to be able to respond. And I want to come back to a previous point I've made: it is important that we have a good structure and good leadership here but the system must be able to respond according to its environment and we know that these particular cases are in Tāmaki-makau-rau where despite the challenges on the health sector there is a health infrastructure there that you will not find in either Kaitāia Te Tai Rāwhiti and more remote rural area across Aotearoa. So we need to make sure the settings are right to allow the ability for our providers in our community to lead the isolation at home. And I want to come to that very shortly.I want to address a couple of the points that have already been made by members from the other side of the House. One of them is: OK what has the Government done to be able to prepare ourselves for COVID-19?"—and in particular the Delta strain. I have been travelling the length of this country since March to promote the most effective tool to protect our whānau during these times whether it was before Delta or even after Delta and that is the vaccine. I can tell you that certain members on the other side of the House have proven a roadblock or challenged the push for equity in this space as we've looked to support Māori communities to vaccinate to make sure that our people have the number one tool that will help them in the onset of COVID-19 in their community. Those efforts continue today and I want to be clear to the Māori community in particular but also to our Pacific community our ethnic communities and our tangata whaikaha communities: we will not give up on you. We will continue to push the vaccine to make sure it's readily available to you to help give you the best protection as we move forward.The other part I want to touch on is of course—right we accept the recommendations of the review of the report—where to from here? And I'm actually quite proud to stand here and say that about a month and a half ago we announced a significant investment of funds to be able to make sure that amongst iwi and in particular in Māori communities we can support them now to do the planning for care in community. And I'll tell you what makes that special: not only do we have the health expertise to be able to do that led by Māori health providers PHOs and regions but we also have the more fulsome tapa whā model that Dr Kerekere refers to that are led by iwi led by hapū led by Māori communities. And I want to really emphasise that point because I'll tell you why: in recent days a member from the ACT Party has likened the actions of iwi to protect their community to thuggery calling them thugs. Now what we know is that for this model to be successful we need iwi on board. In fact I've seen multiple iwi plans for care in community which are fantastic—iwi-led community-led. For example Ngāti Tūwharetoa showed me their plan which would look toward isolating the case of COVID. They'd wrap around support in the whānau and instead of putting the positive case into the marae what they'll do is take in the whānau those who test negative and put them on to the marae where we would normally care for and cater for our whānau while wrapping the health services around the positive case isolating at home. Now that's how you do Māori care in community and the support that we are giving iwi to plan this to lead this amongst our own people in our own communities is really important. Now that planning isn't just done in Tāmaki-makau-rau where a large percentage of our Māori population are. In fact 74 percent of Ngāpuhi live in Tāmaki-makau-rau. What it also does is support our more rural isolated communities and that's going to be the key so that we don't repeat the mistakes that have been identified in this report.So we've got a job to do to continue to support those efforts and I acknowledge that as we look towards care in the community as we look towards making sure that Māori actually can play a lead role in this space we need to continue to drive home some very key messages to our community: (1) vaccination. Our rates are climbing for Māori and I'm proud of that. In fact if we look towards all the vaccination programmes ever run in this country we have now well exceeded the best that Māori communities have ever done in the past on a vaccination programme. Long may that continue. The next one is to allow the space and to resource Māori communities to do this. And I'm proud to say that on this side of the House we are doing that now and we will continue to do that. Ultimately though as we look towards the way that we care in community and the 15 December date that I've already mentioned who's going to lead this? It is going to be our community. It'll get there with strong health leadership from the centre from this Government from health infrastructure across the country and I'm confident that as we move forward into the coming weeks and months we will manage this well during summer."