Wagner NickyHon NICKY WAGNER (National): Thank you very much Madam Chair. I too would like to pay my respects to the Canterbury District Health Board. On March 15 I happened to be at the hospital and I have to say it acted like a well-oiled machine. Obviously it was a huge challenge but they rose to that challenge and I think we need to be very proud of them.The health budget for 2017-18 involved $13 billion of funding for DHBs and another $3 billion for health services from DHBs and organisations that don't directly report to Parliament. But I'm concerned that during our annual reviews we heard that some of the essential services that our families are desperate for despite all that money are deteriorating rapidly. The key here is that because the health targets have been dropped—they're gone—there's no ongoing accountability and healthcare outcomes are sliding backwards.So I'm particularly interested in two areas. One is the immunisation rate—and we've heard people talk about that this evening—and also better help for smokers to quit. Now both of these were health targets under National. Both areas had been increasing in effectiveness and had improved health outcomes which have now either stagnated or slipped dramatically over the past year or so. Without the health targets the only way that we can monitor these failings is through increased numbers of people with disease or through deaths and we've seen that.So let's start with immunisation. Back in 2008 76 percent of two-year-olds were immunised but because of the health targets by 2017 92 percent of them were immunised. There was a very high percentage for both Māori and Pasifika. Now that was a huge step forward because immunisation is one of the easiest and most effective ways to protect our children. When I was the Minister for Disability Issues I used to meet with groups and individuals who lived with disabilities. I remember very well going to a meeting in Christchurch in 2017 for those who still suffer the effects of polio. It was a support group that consisted only of older New Zealanders—only of older New Zealanders—because now our children are immune to this crippling illness. But they're only immune if we continue to immunise. We do not want another generation joining these older citizens with the effects of polio. This is only possible if we immunise and people immunise all children across the board.But during the recent reviews of our district health boards they consistently told us that their immunisation rates were dropping and that there were alarming trends of people actually being against vaccination. The result: recently we've had recorded deaths from meningococcal disease in Northland and there's been a large number of measles cases right across the country—and that's totally unacceptable. People actually die of measles. We've forgotten that. So as we head into 2019-20 I hope that the Government will act to help address these alarming impacts that the anti-vaccination movements are having on public health. We must have more funding to support immunisation and to manage the outbreak of these diseases so that that can be prevented by immunisation. If anyone has any doubts about that they just need to talk to the older generations who are still suffering from the effects of polio.Another loss for health targets has been better help for smokers and that's been a retrograde step. Thousands of smokers die of smoke-related diseases every year. Research tells us that although most of them would like to quit they can't. I'd just like to put in a plug for vaping. It's been a game changer internationally and this Government really needs to recognise the value that vaping has for people who want to quit. They must encourage people to vape rather than smoke. The previous Government sought to pass legislation to clarify the position on vaping and to promote it as an alternative to smoking. It is 95 percent less harmful and it's a far better option.