Clark DavidNEW ZEALAND PUBLIC HEALTH AND DISABILITY (WAIKATO DHB) ELECTIONS BILLThird ReadingHon Dr DAVID CLARK (Minister of Health): I move That the New Zealand Public Health and Disability (Waikato DHB) Elections Bill be now read a third time. I want to start by thanking the House for the speed with which it has considered this bill. I would also like to thank the parties that have supported this bill across the House and also the Health Committee for the fine work that it has done in reporting back on the bill so efficiently. Suspending democracy is a big step and that is what this bill does and I know that in considering that the parties in this House that have supported it across the House and the parties of the coalition Government have weighed those concerns carefully and all reached agreement that indeed the appropriate thing to do here is to make sure that sound stable governance is in place as the district health board (DHB) ensures it is well positioned into the future for both clinical and financial reasons. I want to also thank Dr Karen Poutasi as the commissioner of Waikato DHB and her deputy commissioners—Andrew Connolly who is a well-respected surgeon and former chair of the Medical Council; Chad Paraone an experienced senior health executive with deep data expertise; and Professor Margaret Wilson a former Speaker of this House someone with clear legal expertise and experience in the health sector—for the job that they are already doing to improve the quality and services for people in the Waikato district.The effect of the bill is to allow for the term of the Waikato DHB commissioner to be extended until the triennial elections scheduled for 2022. The wider picture is that that extension effectively provides the commissioner sufficient time to develop oversee and implement a financially sustainable plan for the people of Waikato improve service performance and develop stable governance. Without legislative change the commissioner would have had less than seven months to improve the Waikato DHB's position—and indeed in appointing a commissioner which is a serious step things have to be in a serious position. That would be taking probably a short number of years hopefully to resolve rather than being possible to do within a few months.So in May this year—to remind the House—I dismissed the board of the Waikato DHB following my serious dissatisfaction with the performance of the board. In particular there were ongoing clinical performance concerns poor financial performance and those things together had caused me to lose confidence in its ability to deliver on its strategy for the region into the future. In so saying I do also want to acknowledge and thank the board—as I as Minister consulted them as I am required to do by law before dismissing them—for their honest feedback about some of the achievements of the board and also some of the serious challenges that they accepted they had been unable to deal with.I also want to pay respect to Sally Webb who was chair of the board for her professionalism and integrity in drawing to my attention the concerns she had over a period of time and for her frank assessment of things and willingness to support my decision to dismiss her and her board. That was a courageous thing to do and I do want to commend her for that. I also want to acknowledge Derek Wright who was the interim chief executive for the role he played in ensuring continuity after a very difficult period for the DHB during the tenure of a CEO who was subsequently investigated by the Serious Fraud Office. The period 2014 to 2017 was not a happy one at the Waikato DHB. These problems did not arise overnight and I think no one expects they will be solved overnight but they do need to be solved.The commissioner has already succeeded in appointing a permanent CEO in her short tenure and I have every confidence that she will continue to tackle the other issues currently facing the DHB. Certainly one of the big ones that was facing them as a board that wasn't able to provide the leadership required was that they were struggling to appoint a permanent CEO and service performance issues were resulting from that.In the debates during the first and second reading some members raised concerns about the impact on local democratic rights. I do note that members certainly in the committee stage sought reassurance that the normal electoral processes would return in 2022. I'm happy to give that assurance. Certainly the law that we're passing makes that clear—that the normal process resumes in 2022 but we do need those years to get the DHB back on a sustainable clinical and financial setting.Some also raised concerns in select committee submissions regarding Māori representation in Waikato health governance; I certainly want to acknowledge those concerns. The Waikato DHB should not in my view lose any Māori representations due to the lack of a board. As stated in the Government's renewed commitment to Māori-Crown relations all DHB functions will continue to foster the development of Māori capacity for participating in the health and disability sector and for providing for the needs of Māori—and indeed as health Minister I have set a very clear equity agenda for the sector and it is my very clear expectation that that is followed up on.I know that Dr Poutasi has already been working with local iwi and Māori groups to ensure there are clear lines of communication and I believe that to be very important and indeed the right thing that she is doing. Although there is no board in place until 2022 as I've said it's been made very clear by me to the commissioner and her team that I have that expectation on achieving equity for them and of course for the whole health system. As members have also mentioned during the previous readings of this bill the commissioner is a highly respected and accomplished health service manager. Dr Poutasi is a former Director-General of Health with a tenure that spanned two previous Governments and she has had other senior leadership roles across the public sector. I am personally delighted that she was willing to take on this role. I believe that her mana and experience will be important for leading the change that's required at the DHB for ensuring that relationships with primary health organisations are optimised for ensuring that the three Ts—the other hospitals in the region the smaller ones outside of Hamilton City—are appropriately resourced and the relationships are well managed and that they also deliver the high-quality healthcare that is expected and deserved in the Waikato region. This bill will give her and her team the time to accomplish critical and sustainable change at Waikato DHB to improve health services for the people of the Waikato. I would like to reiterate as we close that I do not take these measures lightly. This Government though has shown that where performance is of concern we are willing to act. I have put Crown monitors firstly into Counties Manukau then also into Waikato and more recently in order to clarify the situation in the Canterbury region we put a Crown monitor in there as well. Where the Crown monitor raises concerns and where further concerns are discovered as in the case of Waikato we have been clear that we will take the steps to put in a commissioner if required. I want to thank members of DHBs across the country who stand for election. There are more elections coming up in October and we need good people to put themselves forward. Governing a DHB is a public service role. I want to thank those people that do that across the country mindful of the big challenges that DHBs face from a long period of underfunding. The workforces have been stretched and strained for a long time in the DHBs and across our health services and in some places they have been able to manage this better than others. In the Waikato they now have a commissioner in place and have the confidence that is necessary to deliver better health outcomes and sustainable health services to the people of the Waikato. I commend this bill to the House.