New Zealand Public Health and Disability (Waikato DHB) Elections Bill

I move, That the New Zealand Public Health and Disability (Waikato DHB) Elections Bill be now read a second time.

This bill will allow for the term of the Waikato District Health Board (DHB) commissioner to be extended from December 2019 until the triennial election scheduled for 2022. It provides the commissioner sufficient time to develop, oversee, and implement a financially sustainable plan for Waikato DHB and to improve clinical service performance. Without legislative change, the commissioner would have less than seven months to improve the Waikato DHB’s position.

In May 2019, I dismissed the board of the Waikato DHB and appointed a commissioner for the DHB, following my serious dissatisfaction with the performance of the board. In particular, ongoing clinical service performance and poor financial performance had caused me to lose confidence in its ability to deliver on its strategy for the region. Financial deficits have been a feature of Waikato DHB’s performance for some years. The DHB recorded a deficit of approximately $37.2 million for 2017/18, which was unfavourable to budget by $27.2 million. I’ve not approved the DHB’s 2018/19 annual plan, given the scale of the deficit and the clinical service issues.

I thank the Health Committee for its consideration of the bill, appreciating the short time available due to the upcoming local body elections later this year. The Health Committee examined the bill and recommended it be passed without amendment. Two issues which were considered by the committee were the impact of the bill on the democratic process in the Waikato and how Māori representation and participation could be provided for. The committee considered that the ability for the people of Waikato to vote for representation on their health board is fairly balanced against the need for a commissioner to address the serious financial, service, and governance issues that the DHB is facing.

With regard to Māori representation and participation on the Waikato District Health Board, I have emphasised the importance of achieving equity for Māori, in the terms and conditions of the commissioner’s appointment. The objective in the Act for the DHB to reduce health disparities by improving health outcomes for Māori and other population groups remains in place. To assist with this objective, the commissioner has appointed a deputy commissioner with significant experience in Māori health, and is engaging with the Waikato Iwi Māori Council and Waikato-Tainui.

I do not propose the cancellation of a local DHB election lightly. The bill therefore impacts only one election at Waikato DHB and will help ensure that the next board to be appointed as part of the 2022 local body elections will begin its term on a more secure financial footing, with more stable governance in place. I have appointed a commissioner in an attempt to resolve the DHB’s financial service and governance challenges for the people of the Waikato district. It is important that the commissioner is given a sufficient period of time to achieve the significant changes.

This Government is tackling the long-term problems facing our country. We’re tackling the challenges created by years of under-funding in our health system. We’re fixing problems that have accumulated over many years and were ignored by the last Government, down to kids growing up in cars, down to rundown schools and hospitals, down to stretched workforces, and dirty rivers. We know that everything cannot be fixed overnight, but we are getting started.

In respect of this particular bill, I do, however, want to acknowledge that the Opposition have also supported it through its progress. That, I think, is due recognition that there are significant issues to be addressed in the Waikato that have taken some time to build and that will indeed take some time to fix. I do thank the members opposite for the mature and supportive way in which they have approached this process, recognising the need to put the local population’s interests first. So it is that I commend this bill to the House. I look forward to hearing from the Opposition in support of this bill.

Thank you, Mr Speaker. As the Minister said, the National Party did support this bill at first reading, and it will continue to do so through its remaining stages. I firstly want to acknowledge the Government in its reasonable adjustment to the report-back date for the Health Committee. This was a bill that was introduced at first reading, and while I wasn’t present for the first reading debate, I am aware that the shadow Leader of the House asked for an extra week in order that there be a very speedy—but at least something of a more thorough process—and the Government benches agreed to that. So that did enable the Health Committee to do its job, I think, very well.

There were only a small number of submissions, and the Minister has articulated the two main concerns as reported back by the Health Committee: that is, the obvious loss of the democratic process, and that’s not one that I think anybody in this House would take lightly. We have some precedent for that, and certainly the previous Government needed to take steps of a similar nature at the Southern District Health Board. I would suggest that the response from the Dunedin-based Opposition spokesperson for health at that time will be identical to the response from the Dunedin-based Opposition spokesperson at this time, and that is: we understand the circumstances that lead to what is a loss of the democratic process and the people’s right to choose its representatives on the district health board, but there are some occasions when that is necessary and appropriate, and I think the Waikato situation has reached the threshold for such action being taken.

Karen Poutasi—Dr Poutasi—is a very experienced both clinician and health service manager, and it will be for her and the commissioner’s team to drill into the circumstances that led to the difficulties that are facing the Waikato District Health Board both from a clinical and a financial perspective. I would make the opposition that a threshold for intervention has now been reached and met, and the Minister has taken action. It is of serious concern that that is a threshold that is being met and exceeded by a number of the district health boards around the country, and so it will be a challenge for the Minister and his Government to be consistent in their approach to the circumstances that would give rise to some kind of intervention.

It will also be an important task, I think, for the commissioner to lift the bonnet on the issues and find out where, indeed, things are going wrong, because one of the things that I think is a feature of the district health board process—and let’s bear in mind that the governance of these organisations is a very difficult thing, requiring a high level of skill not only from the election process but from the ministerial appointments to augment that process. There has been quite a bit of reflection on whether or not these very complex, sometimes billion-dollar - plus organisations actually have the right level of governance. But when things go awry, when clinical and financial milestones aren’t met, it can be extremely difficult for Ministers, for the ministry, and even for the board to understand exactly what’s going on. I think it’s a feature of our district health boards that may well be within the terms of reference, the scope, of the review that the Minister has embarked on through Heather Simpson.

I also note in passing that the Canterbury District Health Board now has a Crown monitor, and, indeed, one could argue that the threshold for the appointment of a commissioner there has been comfortably exceeded, except that the circumstances are different; the governance in place is different. But it will also be, I think, not only necessary but crucial to understand why things are changing so rapidly there, and I’ll resist the temptation to go toe-to-toe with the Minister as I have for the last weeks and months about why that might be the case and who’s to blame. What I would say is that the appointment there of Dr Lester Levy is an excellent appointment. Dr Levy is someone who’s been known to me for the 25 years that I’ve been involved in the health sector, and I find him to be an excellent health service manager. If anybody can provide detailed intelligence to the Minister, I think it’s him, but he will have his hands full.

Now, that said, I would encourage the Minister, on behalf of the people of the Waikato, to require the commission to be even more upfront than would otherwise be the case. They have had to watch from the sidelines while an escalating issue has unfolded for reasons which I won’t go over again here. But one of the things we owe to the public of the Waikato is a clear and transparent understanding of what is going to happen, what has happened, and what will happen in the future. I’m sure that, given the right direction from the Minister, Dr Poutasi will do that. When we take away a democratic process, we need to replace it with something that that region can have confidence in. So I would encourage the Minister to continue and to improve the transparent nature of the reporting not only back to him but also to the people of the Waikato. But with those words, we will be supporting this bill.

Tēnā koe e Te Māngai o Te Whare. It gives me great pleasure to speak on the second reading of the New Zealand Public Health and Disability (Waikato DHB) Elections Bill. I wasn’t at the Health Committee for the hearings of the three submissions, but I want to highlight that the focus of these changes—and I want to acknowledge our Health Minister David Clark—is, actually, access to high-quality services for the people of the Waikato. Essentially, what this piece of legislation does is cancel the October 2019 elections, and it does so because the Minister has appointed Dr Karen Poutasi to be the commissioner for the Waikato District Health Board. She’s a former Director-General of Health with 11 years’ experience.

The reason that had to happen, after a two-week process—and I want to highlight that the Minister engaged with the 11 board members of Waikato District Health Board (DHB)—was that, at the end of the day, they had a dysfunctional team and they weren’t working together, which was required. Nine of those 11 board members offered their resignation, and it was because of the instability at that governance level and the fact that they couldn’t recruit a permanent chief executive, that in fact Dr Poutasi was elected, or asked, to be the commissioner for Waikato DHB.

What has she done in that role? She’s actually appointed three deputy commissioners, and so I want to acknowledge Dr Andrew Connolly, Chad Paraone, and also Professor Margaret Wilson. The reason that she did that—and I will quote from Dr Poutasi—was that it will “take a team to turn the health board around”, and that, actually, is the essence of these changes. You need teams to run these big organisations which are providing services to populations. So from the perspective of the Minister, that wasn’t happening. I want to say in the time that she’s been the commissioner, we now have a chief executive for Waikato DHB; it is Dr Kevin Snee, who, from 2009, was the CEO for Hawke’s Bay DHB. So already, the DHB’s on firm footing.

The only other thing I wanted to highlight, particularly from the submissions, was a focus not only on the fact that there wouldn’t be democratic elections, and the community wasn’t represented, but a very specific focus on the fact they didn’t have Māori representation. That also came from the departmental disclosure statement, and hence the appointment of Chad Paraone. But one thing I do want to highlight, as the Minister did, is that there is actually a memorandum of understanding between the DHB and iwi. Those iwi are Ngāti Maniapoto, Hauraki, Waikato-Tainui, Raukawa, Ngāti Tuwharetoa, and Whanganui, and, in addition to that, Te Rūnanga O Kirikiriroa and their kaunihera kaumātua is actually listed within that MOU. I want to acknowledge Te Pora Thompson-Evans, who’s the chair of the Iwi Māori Council who also sits on many other Waikato DHB statutory committees.

So I want to reassure the people of the Waikato that they will have a Māori voice continue to be expressed within the context of the new governance arrangements, and I commend this bill to the House. Kia ora.

Thank you, Mr Speaker. It’s a pleasure to speak to this bill—a bill that we’ve supported at the first reading, second reading, and we’ll support now in the third reading. As has been commented on, we had three submissions at the Health Committee, and a number of points raised by the submitters. One of the common themes was around the loss of democracy with the postponement or failure to vote the district health board in in the 2020 elections. The comment there was, well, certainly we understand that, but, really, if we were to put in a democratically elected board in 2020 with these sort of challenges, we’d be setting them up to fail. That just wouldn’t be correct when there’s obviously challenges that we all agree with. It wouldn’t be right, nor would they have time to affect their functions and meet our expectations.

There were also comments from Māori that they’d like to be engaged in the appointment of the commissioner. That’s actually not part of the approval process, but their views were taken on board, and, more particularly, it was the Iwi Māori Council and Waikato Tainui who were saying that “this is important; we’d like to be involved”. Interestingly, the question was raised to us around the cost of the commissioner versus the cost of the existing board—is there any substantial difference there? Very late in the piece, we received some information back saying that the fee to the commissioner is $1,800 a day capped at $230,000 an annum, and the expectation is the commissioner may need to be involved two to three days per week. It was also commented that the deputy commissioner’s fees were $1,000 a day, with an expectation of 30 days per annum. When all of that was added up, it turned out to be around about $320,000 for the commissioner and the deputy commissioner, which was roughly the same as the stipend paid to board members. So net-net, there was no substantial change in placing a commissioner and deputy commissioner in, as compared to the existing board members.

I’d like to talk to the appointments—Karen Poutasi, an excellent public servant, previous Director-General of Health. She actually sat on my Harkness appointment committee, and I have high praise for Karen. I’m sure she’ll do a great job. The Hon Mike Woodhouse mentioned the chair Lester Levy, and how he’d known Lester for 25 years. I’ve actually known Lester for 40, because in a previous life he was actually a pathologist, and where Karen assessed me for appointment to Harkness, Lester actually assessed me as a pathologist at fifth-year medical finals. He was a very tough assessor, I’m sure he’ll bring those same qualities to this role, and he has our support.

I think really the only other thing we have obvious support across the House for is to raise the question that when we placed a commissioner into the Southern District Health Board, there was vehement resistance from the Greens at that time. They could not possibly get over the affront to democracy, and the affront to their morals and principles. I’ll be very interested to see their vote here tonight, to see if they’ve been subjugated or what they’ve sold them for or if they’ll vote against this as well. I look forward to that. We are supporting this bill. Thank you.

Thank you, Mr Speaker. I’m not really sure how much more New Zealand First can add to the debate this evening on the New Zealand Public Health and Disability (Waikato DHB) Elections Bill. The main points that we noted, and our caucus considered were—and I have to thank the Health Committee for the work that they have done, the report that they have provided. But clearly, what the Minister is faced with here, from our perspective, is an under-performing, under-resourced health board that has been digging itself deeper and deeper into a deficit hole. I do note from one of the Minister’s answers to a question this afternoon in question time, when he was asked how much longer it is going to take to turn things around, that he did say that it’s not possible to turn around nine years of previous governance in a short space of 18 months.

I thank the Opposition for their support for the Government in passing this legislation. I note that this is just another example of some of the challenges that the Minister is facing. That the board in 2017-18 should be reporting a deficit of $37.2 million, forecasting $56.1 million for the 2018-19 fiscal year, with increasing deficit forecasts in future years, was clearly a matter of concern. Ongoing performance issues with clinical services was clearly a matter of grave concern, and their inability to recruit a permanent chief executive, I think, would probably have been a bit of a final nail in the coffin, from the Minister’s perspective.

Having served on three district health boards (DHBs) myself, appointed by the Hon Tony Ryall as a Government appointee, I know the challenges and the difficulties. I know, from first-hand experience, sometimes there are complications that are injected into the governance structure through people who are elected but who do not necessarily bring with them the commensurate skills necessary to operate at such a level. I think this is a challenge, and when we discuss—and New Zealand First has in the past expressed its concerns about the removal of boards, and the appointment of commissioners. We have, like those submitters who submitted to the committee, expressed our concerns around the loss of democracy. I think sometimes the reality is that at some times, boards simply display an inability to do effectively that which they are charged to do.

At that point in time, in the interests of public safety, in the interests of public health, and in the interests of being able to deliver good health services in a sustainable way within the budget levels that are set by the Government, we have to take steps such as this. It is regretful. It is not something that we want to do or that we do without a considerable amount of thought. Removing the democratic right of a community to elect its health board is something that New Zealand First believes in, but when that board gets itself into strife and continually demonstrates that it’s unable to extricate itself from that, then the Crown cannot sit by and let those matters go unchecked.

So it’s with regret that we accept it is necessary to pass this legislation and to support our Minister of Health as he seeks to place Commissioner Dr Karen Poutasi, a previous Director-General of Health, in the position, in the hope that she will turn the DHB around. We note that this is a three-year suspension and that the intention is that there will be elections in 2022. We are hopeful and, indeed, confident that Dr Karen Poutasi will be able to achieve those targets and those goals.

I do note—from listening to Dr Reti’s submission—with some satisfaction that this will be a fiscally neutral transaction in terms of standing the board down and paying the commissioner and deputy commissioner to do the work. If it turns out to be fiscally neutral, that’s a good thing.

Like I said, it’s regretful and it is a sad turn of events, and in the normal course of events, New Zealand First would be uncomfortable. But this has to be done, and we accept that. On that basis, New Zealand First supports this bill.

Thank you, Madam Speaker. I rise to speak in support of the New Zealand Public Health and Disability (Waikato DHB) Elections Amendment Bill. As other speakers have indicated, this is a bill that enjoys support throughout the House.

The chair of the select committee, Louisa Wall, when it came before the Health Committee, managed that process well. We were all very clear that there’s a big deficit. If we don’t move quickly, the $56 million forecast deficit could balloon out to $500 million by the end of the year. That is the kind of thing that needs to be acted on very quickly and very decisively. It is entirely appropriate, then, that we look ahead and try and prevent bad things from happening. I think this is a very sensible intervention, as does National generally, which is why we’re supporting it.

Taking on board the points of the previous speaker, Ron Mark, who’s just resumed his seat, the skill set around the district health board (DHB) table is the key. These are multimillion-dollar organisations with big decisions to make, and sometimes—not necessarily in this case; I’m not commenting on individuals—on some occasions, local interests and people’s set interests can overtake good outcomes and be very expensive for all concerned. I think that nobody wants to see a DHB fail, and when you see something happening that is going to be as greatly disastrous as this, we would be derelict in our duty if we didn’t do something quickly.

I think the former Director-General of Health Karen Poutasi, as others have indicated, is an excellent choice to sail the good ship Waikato DHB through the choppy waters it’s found itself in. She did a stellar job over a long period of time in the Ministry of Health. I worked with her when I was on the National Health Committee back in 1996, I think it was—a while ago now. But when you have someone with a breadth of experience, as Dr Poutasi has, I think that the DHB is in very safe hands, and even at $1,800 a day—the figures that Dr Shane Reti quoted before—I think it’s about $320,000 for the commissioner and the deputy commissioner to have this role for the next couple of years, which would be cheaper than running in the elections.

We needed to do this quickly because the deadline is looming—9 December is sort of the cut-off point, and it was very clear that there wasn’t going to be a significant change or development before that time. So I think acting quickly is a good idea. It’s time-limited and it needs to be, and I think the next election—the triennial general election of 2022—will be the time when the DHB has enough time to get itself back on its feet and have a proper governance plan to ensure that it can run itself in a way that isn’t going to spiral into debt. So this is a very sensible, pragmatic thing, which is why National supports this bill and commends it to the House.

I rise to offer the Green Party’s support for the Public Health and Disability (Waikato DHB) Elections Bill. As was previously signalled by a member of the National Party who spoke previously, this is not an easy decision for the Green Party on one level. We hold local decision-making dear to our hearts. It’s part of our charter that informs all of our policy making. We have in the past, on one other occasion, supported legislation in the public interest that overrode the public elections of councillors in the interests of public safety, and we have been convinced that this piece of legislation has the same purpose. We have had very strong assurances from the Minister of Health that there will be more mechanisms put in place to enable local input and ensure there is a new vehicle for democratic participation while Waikato waits for the next election in 2022.

The reasons that the Minister has had to propose this legislation are significant. The financial forecasted blowout in terms of the Budget has a consequence for the entire country when we look at the difficult trade-offs that are made for Governments around spending. A massive blowout in one area because a district health board (DHB) is not able to manage their costs has a consequence for everyone, as well as that community, and there was a history of instability in terms of governance at executive management levels. Most concerning for me, when considering this proposal, was the increasing number of clinical concerns that we were hearing, and I don’t think anybody can responsibly sit in this House and ignore clinical concerns coming through from the community that they could address through measures like this.

We also had seen the issues around improper spending by the former chief executive (CE) and the board’s inability to appoint a permanent CE to be able to address the issues that had been identified. There were examples of the board’s decisions reportedly reaching the media while the board was still meeting—just showing a real breakdown in relationships on that board that was not serving the community—and senior doctors being concerned about the decisions being made, and some GPs as well as other hospitals in the area were also starting to raise concerns. So those are issues that would, I suspect, concern everyone in that community, and they would want to see us taking that seriously. If we didn’t have the ability to get a good CE in there to address those issues, then we believed, and we were convinced, that the appointment of a commissioner really was the only option in this situation.

So there’s no way that we’ve taken this lightly, but with regard to our concerns around ensuring that local decision-making, we’ve been given that strong commitment from the Minister that there will be clear expectations about community engagement, replicating what was used for the Southern District Health Board. We’ve had the feedback from people down South that, on the whole, that’s actually been a really positive process for them.

In the South, where there was a commissioner, the Southern DHB has continued to operate a range of local engagement mechanisms and public advisory committees, including an iwi governance committee, a hospital advisory committee, a disability support advisory committee, and a community and public health advisory committee. These committee meetings usually also involve public forums that open up this process to the public in a way that, actually, it would be lovely to see more of our DHBs, as normal business, pick up mechanisms to increase that public engagement.

We would also note, recognising that one of the submitters to the select committee raised some concerns around Māori representation, that alongside the very well-respected Commissioner Dr Poutasi, is Chad Paraone, a senior health executive from Te Aupōuri, who is of Ngāi Tahu descent, who has been appointed, and that there is an existing iwi Māori council and consumer council within the Waikato through whom that relationship can be strengthened. We expect to see that strengthened through this process, to ensure that the inequitable health outcomes for Māori can be addressed in this process.

So it was with a lot of consideration but, really, coming down on the side of public interest and safety and wellbeing that the Greens are supporting this, with the confidence and the assurance from the Minister that there will be many ways for the people of Waikato to engage and be part of this and have a sense of creating a DHB that serves their community.

Thank you, Madam Speaker, along with everyone who has taken a call to this point in the second reading debate. I express my support, cautiously, for this particular bill. It is always unfortunate when the House finds itself in a position where such a measure is necessary, but I think the reasons why this particular step has been taken have been well articulated by previous speakers, and I want to thank everyone for the thoughtful contributions they’ve made.

I would, however, just wish to take issue with Ms Logie, who spoke on behalf of the Green Party on one matter, and that is that she referred a couple of times to clinical concerns. I just wish to put on record that it’s certainly not my view that there are clinical concerns in this matter. On the contrary—and it’s good to have my colleagues the member for Waikato and the member for Hamilton East here, because I’m sure that they will endorse what I’m about to say—the clinical care that is provided at Waikato Hospital and throughout the region in which the Waikato District Health Board (DHB) operates is second to none, and we are very proud and grateful to all of those who provide that clinical care. We have extremely dedicated, compassionate, and competent clinicians, and they are well supported by all the secondary staff, the administrative staff, and others. I’m sure Ms Logie didn’t mean to cast aspersions on their work, but I just wished to put on record that this is not, in any way, a matter that has arisen because of clinical concerns within the Waikato DHB.

It is, of course, as I said, not a welcome development, but as the MP for Hamilton West, the Waikato Hospital is located in my electorate, and the Waikato DHB operates out of boardrooms and offices adjacent to the hospital. So I have met most of the board members and many of the staff many times. I know a number of them well, and therefore I’m sure that I can say, with some knowledge, that they and my constituents are welcoming the fact that even though this step has been taken, we have received an assurance from the Minister that he will be seeking the restoration of local democracy in the elections of the DHB within a three-year period, and that all should—we hope—be back to normal by 2022.

I also want to echo the comment that I think was made by Louisa Wall earlier, that it should be noted that all but two of the outgoing board members actually offered their resignations. So by no stretch of the imagination has the board been sacked. I think it’s important to put that on record, because they are people who have given their time and talents—in some cases, over many years—and they deserve to be acknowledged for that.

As I say, I want to acknowledge all of the staff. In particular, I want to acknowledge the outgoing acting chief executive, Derek Wright, who has been a very fine leader. He’s a man of great integrity, and after the very unfortunate and sudden exit of his predecessor for the reasons that have been well explained and which are inexcusable—no doubt of that—he has brought competence and integrity and calm leadership to his role. I think many were hoping that he might’ve stayed on, but I understand his desire to move towards retirement, and I just put on record my thanks to him and all his senior staff and others who have worked so well to calm things down. As I say, I also want to thank all of the clinical and administrative staff who work within the DHB.

Could I briefly, in closing, say the very best of good luck and support to Dr Karen Poutasi, who is, as others have noted, both an experienced and highly respected practitioner commissioner. I’m sure she is going to continue doing a very good job. She is to be congratulated on the fact that she’s already managed to secure the appointment of the new chief executive, which is one of the problems that the outgoing board was struggling with. I think it’s understandable why they were having difficulty finding a replacement, but Dr Poutasi has done very well, and I welcome the announcement that Dr Kevin Snee, who is currently the chief executive of the Hawke’s Bay District Health Board, and I know that members in this House will be familiar with him—I can’t bring the Speaker into the debate, so I won’t—I hear he is very well regarded. I look forward to meeting him at an early opportunity, and I certainly wish him well.

I think that is probably all that I need to say. We are pleased to know that this is a short-term measure. I think that people in the greater Waikato region understand the reasons for it, and we look forward to seeing things return to normal at the earliest opportunity.

This is a split call.

Madam Speaker, thank you for the opportunity to take a brief call on the New Zealand Public Health and Disability (Waikato DHB) Elections Bill. Now, the purpose of this bill has been very eloquently outlined by a number of speakers. I would just like to continue with the particular local focus on this bill.

The outgoing board members—many of them are known to me personally. I’d like to acknowledge the former chair, Sally Webb, and the deputy chair, Margaret Wilson. Now, many of the members in this House will know the Hon Margaret Wilson for the wonderful work she’s done across many, many fields.

The board recognised that they were facing quite challenging circumstances, and as we’ve heard, nine of them offered to resign. They felt that it was the best course of action.

I’d like to acknowledge the leadership of the Minister of Health, the Hon David Clark. Certainly, this action was not taken lightly, but the action needed to happen, and that’s been acknowledged both here in the House and across the community of Hamilton and the Waikato region.

The Waikato District Health Board (DHB) serves 420,000 people. It’s important that the leadership is strong, stable, and that that leadership is able to provide that sense of stability so that the services—the excellent services—continue to take place. I commend this bill to the House.

Thank you, Madam Speaker. I also rise to take a call on this bill, with some trepidation, but, at the same time, we are supporting it, of course. I say “trepidation”, because in any normal circumstance, we would be encouraging, of course, the democratic process to continue as expected. The district health boards (DHBs), the election of those members who choose to stand for election and subsequently represent a district health board and the region, are an important part of the process.

Now, obviously, in this particular instance, we’ve heard already tonight, but I understand some of the challenges that have led to this decision by the health Minister to appoint a commissioner. Obviously, the well-canvassed situation of the previous CEO, in terms of that scenario, was probably the most highlighted aspect of concern. I certainly want to echo my colleague the Hon Tim Macindoe, with his comments that there are no concerns, from our perspective, around the clinical performance at the Waikato DHB, but rather a series of other concerns that have led to this appointment.

Actually, just most recently, it’s been highlighted—just in the last week or so—that a number of the hospital buildings actually do not currently have warrants of fitness, due to non-compliance with fire issues. So that’s a concern as well, and it just adds to the challenges that the commissioner will have to deal with, supported by the deputy commissioner, and, of course, now the newly appointed CEO. And I’d also like to welcome Kevin Snee to the role of CEO and wish him all the best in what will be a challenging period of transition to make significant improvements at the Waikato DHB. And I wish him well for those endeavours and look forward to meeting him in due course.

Now, this is an area—of course Waikato is the best region in the country. Any DHB role is very important. And so it is with some caution that we look to appoint a commissioner, because, of course, as I mentioned, democratic process is absolutely critical. But in this instance, it would be unfair and challenging to let the normal process that will happen for other DHBs roll out later this year at the elections, because of the challenges that have been canvassed already. And so the appointment of a commissioner, I think, will provide a coherent focus on dealing with some of those issues and setting the Waikato DHB up to then be able to resume normal democratic processes at the subsequent election. So, on that basis, I commend this bill to the House.

Thank you, Madam Chair. It’s a real pleasure to rise and take a brief call on the New Zealand Public Health and Disability (Waikato DHB) Elections Bill. First of all, I want to stand in support of the Minister the Hon Dr David Clark for his actions in appointing a commissioner. We have traversed in this House quite thoroughly the difficulties, or the poor financial performance, of the district health board (DHB), and some governance issues. I also want to acknowledge the way that we in the Health Committee have worked. We knew that this was quite a time-pressured situation, and we worked together very, very well under the chairmanship of Louisa Wall.

Waikato Hospital has a special place in my heart. Waikato Hospital is where my daughter was born some 26 years ago, and I lived in Hamilton for 18 years and know the city well. I do believe that the DHB is an incredibly, incredibly important large employer, groaning under the previous regime’s financial issues, but by and large it works very well. Recently, unfortunately, I was there for the death of my grandmother, who was under palliative care, and she died in the hospital. The work and the care that they gave my grandmother were amazing. So, yes, life and death comes to us all.

The bill essentially works to solve one simple matter, and that was that with the appointment of a commissioner, as we know, the elections that were going to happen in October this year essentially couldn’t happen. We needed to act quickly; there was a gazetted notice and we had to beat that time frame in order to change the law, so that the process didn’t occur and the election didn’t take place.

Now, we heard from three submitters. These submitters were, as we’ve heard, concerned about democracy and the opportunity to be represented. And we addressed that absolutely by balancing out the needs of both the community but also the needs of the community to have a well-managed DHB. So on the balance of that, we came clearly on the side of needing to put in place a commissioner. Secondly, there were concerns, absolutely, about Māori representation, and that has been traversed in this House and covered well.

It is important to acknowledge, absolutely, that this is a good bill that’s fixing a small problem but a problem that was important, nevertheless. I commend this bill to the House.

Thank you, Madam Speaker. I think everybody has really approached this bill with the right attitude this afternoon, and we’ve heard a lot of thanks to the staff at the Waikato District Health Board (DHB), and I think that’s very much appropriate. They have endured public—you could say, nearly—condemnation of the way that the organisation has been run, when they have done a sterling job through all that time in providing the services that they do, day in, day out, as doctors, as nurses, as staff that assist in looking after people, cooking meals, and cleaning, and everything that’s there. I think they’ve done a wonderful job in very difficult circumstances, so I’d like to also pay my thanks to the staff of the DHB.

As the Hon Tim Macindoe said, you know, many board members had recognised there was a problem there and were willing to seek change. And I think the Minister has done the right thing in this case. And I’d like to thank him for the way that he has kept us informed and also approached the DHB as well. I think he’s done a good job there. And we had Derek Wright there, as Tim Macindoe mentioned before, that had done a very good job, and it would have been lovely to see him continue in that role, but not to be. We wish the new leadership team of Karen and Ken all the best as they move their DHB forward.

But I think it does raise an issue that we need to really focus our minds on as communities and not just parliamentarians, and that is that, you know, we all accept that being an MP is a great honour and a great privilege, and if you’re a councillor and a local council, it’s similarly a great honour and a great privilege. But sometimes we don’t put enough value on the board positions of some of those really big community organisations like DHBs. And if the reforms that we’re going to see from the Government around education come to fruition, we’re going to see exactly the same thing there with large-scale education organisations as well.

We need people in our communities to step up to those governance roles. You know, at the end of the day, we can do these bills every five years and find some DHB that fails to meet its requirements and that, but it’s actually a symptom of the fact that, you know, we’ve got great people in the Waikato that manage significant businesses, and some manage significant community organisations, and some are very active in their local iwi and other cultural activities, and we have people that lead large migrant populations. And do we get these people standing up for our board positions in education and health? No, we don’t. Often, we get ex-politicians that have got name recognition, that can basically do well in the voting system that’s based on the most popular name that’s on the list, or the most recognised. There needs to be a better way of doing that so we encourage people, first of all, to take out that leadership position because it is a community responsibility.

And, secondly, we need to inform the voters of who is standing and what their credibility is and what they have to offer to that organisation. And so that is a challenge that this Minister, like previous Ministers of Health, have all experienced. And I would encourage the Ministers to look at that—you know, there’s the perennial question of should we have DHB reforms, and that’s always something that’s raised. And that may be not what we need to do here today. But, certainly, I think the governance capacity on our DHBs needs looking at. Whether we have a group of people that have been shown to be experienced and have skills that can then be considered as appropriate for going into elections, and have some kind of mandate, or have some kind of certification showing that they’ve passed a director’s course or they’ve shown themselves to be worthy in that—maybe there’s something like that that we need to do locally or nationally.

But there is an opportunity, I think, for us to really encourage those people out there that do have good governance and do want to make a difference, to, actually, step up and go for things in our health and education system, because we need those New Zealanders to take on those roles. I know it’s a hard choice because you put yourself in the public light.

Many people have been successful in their private endeavours, but we need those people to also be community-orientated and help others by being able to take those roles on. So if there’s any way we can encourage that in the future, I think, then we’re actually doing a good service for our local communities, and not just going from one district health board to the next as we go through this process as we have done in the past. So thank you, Madam Speaker.

Often, when we read the titles of some of these bills, they’re a little bit obtuse, a little bit vague. Once we start reading through them, we get the gist of what it’s about, but this is not one of those bills. This is one of those bills that when you look at it—the New Zealand Public Health and Disability (Waikato DHB) Elections Bill; I think anyone at home or anyone who hears that will say “Oh, that’ll be that district health board (DHB) that’s in the news all the time, that appears to be in trouble every week”—it’ll be hardly surprising that, finally, we’re sorting it out. Well, good on this Minister.

I am not going to stand here and go through the litany—I could probably fill a 25 minute slot here, going through the things that we have all heard about the Waikato District Health Board—of course, Dr Nigel Murray, I think, probably started that and that list, there forth. But, no, sometimes you just need some decisive action; sometimes you need a Minister who’s prepared to step in and do what needs to be done. Clearly, that has happened on this occasion; I congratulate the Minister for doing it. We now have the New Zealand Public Health and Disability (Waikato DHB) Elections Bill, which is going to allow a situation that could not be allowed to continue to be re-diverted, and, hopefully, will get back on track. So I have no hesitation in commending this bill to the House.