Doocey MattMATT DOOCEY (National—Waimakariri): Thank you very much Madam Speaker. I rise on behalf of the National Party in opposition to the first reading of the Pae Ora (Healthy Futures) Bill. I am speaking on behalf of our health spokesperson Dr Shane Reti a good friend and colleague who's up at the moment in the Far North vaccinating his people and we wish him well.I want to start off with two questions for Government MPs and this is what I want to hear in their contributions today: which Labour MP went to their constituency in the election last year and said to their constituents I'm standing to disestablish your DHB." Which MP went to their constituency and said that? Oh good two! OK well I'm interested to hear what the others did. Only about 10 percent said they did—what did the other 90 percent do? I don't think they knew or I don't think they told their constituents. [Laughter.]The second question—and they're laughing because laughing is a good way of hiding fear. The second question is: what health outcome will be increased in the first year of this restructure? Every Labour MP I want you to answer that question: name one health outcome metric that will be increased in the first year. Because I'll tell you what the health Minister Andrew Little still hasn't answered that question and questioning for months. Because what's interesting today is we had the Hon Nanaia Mahuta with her steamroller going over the top of local authorities. And now we have Andrew Little on his wrecking ball wreaking through DHBs. And they will tell the public it is because of the findings of the Health and Disability System Review. Let's be very clear the Heather Simpson review recommended reducing DHBs from five to 12 leaving five to 12 DHBs. It never found that they should take a wrecking ball to our DHBs.Let's be honest who would believe this lot can deliver? Their track record—all I need to say is KiwiBuild light rail the Auckland Harbour Bridge mental health. These guys do not have a track record. Now they're saying to the public "Let's take a wrecking ball to the DHB system in the middle of a pandemic." They're saying to the public "Trust us we know what I'm doing." And I'll tell you what the irony was not lost on the New Zealand public last Friday when they announced the new COVID traffic light system premised on each DHB getting 90 percent vaccination coverage. The irony. I had several people reach out to me and say "Here they are with a straight face talking about DHB jurisdictions when the following week they're taking a wrecking ball to it."Because what we need to be—let's be very clear here this is ideological. This is centralised. This is socialist central planning. These guys fundamentally believe the country should be run out of Wellington. Running the country out of Wellington running roughshod over local people's views. Labour takes "local" out of "local people's views". Because what National believes in is strong communities. What we know about strong communities our strong communities they are our local economies. They employ our family our neighbours and our friends. Strong communities are the heart of local democracy and strong communities deliver local public services to our loved ones. These guys are taking a wrecking ball to the DHBs and to our local communities.I want to share a story that some people might say actually validates the restructure it is a story about the postcode lottery. I had a constituent reach out to me a solo mother who was having a tumour taken out of her jaw. The Canterbury District Health Board (CDHB) declined her jaw reconstruction. She was going to be left having to eat out of a straw and drooling. I made a representation to the CDHB because if she'd lived in other jurisdictions she would have had it covered. The CDHB took that representation from their local MP and reversed their decision. That is what DHBs provide: local decision making. Labour is ripping that away.Every New Zealander—rural provincial metropolitan—deserves the best world-class health services on their doorsteps. And you know what's going to happen when they strip away the DHBs to a centralised national health service that localised control that localised needs won't be there. And how do I know? I actually worked for the British National Health Service (NHS) for 15 years. If you want to see an inefficient health system go to the UK. And what's interesting about the UK model is actually they're moving away from a centralised model they're actually moving to foundation trust. I'll quote what they say the UK moving from a centralised National Health Service to NHS foundation trust "The reform of NHS Trust is an important part of the United Kingdom Government's programme to create a patient-led NHS with an internal market." The stated purpose—and this is moving away from centralised to devolved into foundation trusts—is to devolve decision making from a centralised NHS to local communities in an effort to be more responsive to their needs and wishes. So here you have the UK with a centralised healthcare system moving away from that because they know it doesn't provide a responsive health service.Yet we are going the way the other way and you can see that in the language. Look at the regulatory impact system "Government intervention is necessary to address these long standing issues"—and indeed "only Government"—it says "only Government can take the steps needed to reform the structure and operating model of the publicly-funded health system." "Only Government." And that's where we differ on this side of the House because it's not only Government it's the people that we represent—the local and strong communities and partnerships making those decisions. That's what this reform will strip away. And what's really concerning if you look at the cost-benefit analysis it's basically bureaucrats before nurses. What they're planning to do is reduce acute unplanned admissions; reduce readmissions; and reduce length of stay—so in a nutshell stop people coming into hospital and kick them out quicker.Now in some ways you know we can understand that assumption. It is expensive to have people in hospitals. But for all the cost of the reforms hundreds of millions of dollars in a time of a pandemic when we could be putting that money into ICU beds into ICU staff—Middlemore is sending people home at the moment who have got COVID because they've got no room—and here we are embarking on the biggest health restructure probably in a generation. Timing. What's interesting—when you look at the hundreds of millions of dollars they're going to focus on this restructure in the middle of a pandemic—the benefits are evaluated at 1 percent of Vote Health. Even that they're not sure they'll get there they said probably "low to medium certainty." Low to medium certainty of the biggest restructure taking a wrecking ball to DHBs. Local people are going to lose local representation purely out of ideology. And what we're finding out is that potentially down the track we might get a 1 percent return.The Māori Health Authority. Māori having a lower life expectancy in New Zealand is a blight on New Zealand. We should hang our heads in shame. But I would point out what about people with mental health illness? Their life expectancy is 20 years shorter than the average New Zealander's life expectancy. Where is the "Mental Health Authority"?We've clearly outlined this restructure is not for New Zealanders. Thank you."