Doocey MattMATT DOOCEY (National—Waimakariri): Thank you very much Mr Chair—a very good call. This is the first time we've had an appropriation debate with the new Health Committee so I want to wish my colleagues on both sides of the House all the best for the coming term. I'd like to take note of our new chair Louisa Wall who I think is doing a fantastic job and our deputy chair Shane Reti. I'd also like to acknowledge the new Minister of Health and wish him all the best for what's ahead of him.I must say I was interested to read the national portrait on David Clark the new health Minister where he said I'd decided that I didn't want to do medicine because it involved a lot of biology and chemistry which I should have known." Funny that! He possibly should have known that by the time you get into a medical career that possibly you'd be studying biology and chemistry. I'm a bit concerned that will be a theme that will run through his tenure as health Minister—that he'll get into the job and say "I should have known." So I think what we're talking about here is possibly the accidental health Minister and that's something that this Parliament is going to have to support over the coming term.I think what we do have is a very good health system. I've been fortunate enough to have worked across two health systems the British National Health Service and the New Zealand health system. When I came back from England to New Zealand they were having efficiency savings of 5 percent a year. Basically in the mental health field where you don't have a lot of consumables or technology a reduction is basically a reduction in staff numbers. Now we've never had to face that in New Zealand. In fact when you look at two key health components being efficiency and equity you'd say that the New Zealand health system weighs up pretty well with both of them. We've got young people accessing GP care for free. We are doing more and more elective surgeries. So overall there is always room for improvement. But what I do want to say is to acknowledge the very hard-working staff both clinical and non-clinical who work every day at the front line supporting the well-being of New Zealanders. I just want to applaud them. That pretty much came out as a theme of our annual reviews—the great work that district health boards (DHBs) are doing.Now I wanted to pick up in my call the subject of mental health. We spoke to a lot of the DHBs around mental health and it was quite rewarding to hear about some of the great work that's happening in the mental health space within our DHBs. When we spoke to the Auckland DHB they talked about the last three years they'd spent co-designing services. Basically what they were doing was shifting services not necessarily specifically looking at mental illness but at mental well-being as well. When we look at it if we look at a graph—traditionally I think Governments haven't always got it right because if you look at neurodevelopment it declines over age but the Government appropriations into mental health increase over age. So it's in the inverse. Basically what that is is DHBs traditionally fund the acute and severe mental health services but now the acknowledgment is we have to do a lot more around mild and moderate and we have to do a lot more prevention. Because mental health is not just the absence of mental illness; it is in fact building psychological and emotional resilience in our communities. So it's great to see these DHBs adapting that they're not only looking at focusing on their clinical pathways around mental illness but also around mental well-being as well.We heard from Counties Manukau DHB who were looking at piloting a place-based approach to services. Basically in the mental health field we've got a recovery model which basically puts the person at the centre of their care. With a place-based approach they'll have navigators that will help them navigate through the services. You're looking at peer-to-peer services where other people have had lived experience of mental health services and shared care as well. Because when you look at some of the budget spends Waikato DHB spends 40 percent of their mental health funding and this is what they told us in the review on the NGO sector. What that is about is—[Bell rung] Mr Chair?CHAIRPERSON (Adrian Rurawhe): I call Matt Doocey.MATT DOOCEY: Thank you very much—good choice Mr Chair. The 40 percent on the NGO sector—because when we go around doing our sector visits and engaging the mental health community actually NGOs are saying they're ready they're primed they can actually do a lot more and they can actually be more productive than our traditional DHB services. So I think one thing looking forward for either Government is to understand how we understand the funder/ provider model better for DHB services and how we can use some of that money to fund the NGO sector that will pick up community services for well-being as well.There was a word of caution by one of the DHBs the Bay of Plenty that actually they were reluctant to continue or progress their work stream around mental health because of the upcoming Government inquiry. I think we should be well aware of this—that many DHBs will be waiting for the outcome of the inquiry. So there is a lot of pressure now on this Government to make sure the inquiry delivers at the level it says.We already have a lot of mental health advocates not happy that out of a year-long inquiry the actual time for oral submissions is only eight weeks and we now have the chair of the inquiry saying that it's just a policy advisory inquiry. We need to make sure that if DHBs are putting their work stream for mental health on hold this inquiry will deliver what they need and not just kick for touch mental health for another year another year and a half for the 2019 Budget because the concern is there will be no extra funding in the Budget that's to be announced soon.Another entity we had an annual review of was the Health Quality and Safety Commission. It was a very good discussion about our suicide rate in New Zealand—one of New Zealand's biggest social problems. I think quite rightly they pointed to some of the issue around suicide is that we're looking at a small window of the three-year political term. I think for an issue like that and the wider issues of mental health we actually need to be looking longer than three years.We can always look at other jurisdictions for learning. In Scotland their devolved Parliament has a cross-party select committee very similar to what we have in the New Zealand Parliament called globe for climate change that looks at a pilot policy direction over five eight 10 15 years. I do hope that all the parties in this House will consider how maybe we might come together and depoliticise mental health somewhat. We would still want to have the adversarial approach in the House to hold each other to account but ultimately if we could agree a policy direction like we currently are doing around climate change in the New Zealand Parliament for a longer period of time I think the New Zealand public would welcome that and reward that as well.Just in conclusion one thing that also came out from the MidCentral DHB was looking at how we can deliver cross-Government services better. Now they highlighted they're partnering with St John's. St John's and even the Fire Service and the police would say they get a lot of callouts that are mental health - related. And in fact they mightn't be the best emergency response service to go out in the first instance. So it's great that they are developing new ways of working and looking at partnering with mental health professionals to go out with St John's and the police.So overall I've highlighted a range of good work in the mental health space. It's very clear there's a huge demand; a lot of that's to do with population growth changing dynamics in the way we live and also the breaking down of barriers and stigma and more people are asking for help. Thank you very much Mr Chair."