Pae Ora (Healthy Futures) (3 Day Postnatal Stay) Amendment Bill

Committee of the whole House

I seek leave to have all clauses heard as one.

CHAIRPERSON (Tom Rutherford): Leave is sought. Is there any objection? There is objection.

I just thought it might be useful to open this discussion to put some context around the background of the bill and what’s occurred here. As you know, this bill was a member’s bill in the name of Catherine Wedd MP, and the Government adopted that bill. As a result of the Government adopting that bill, there is a significant Amendment Paper 647, which is relatively standard for a bill that has gone from a member’s bill to a Government bill. So a lot of the components that we’ll be talking about will also be addressed through the Amendment Paper, just for the committee’s information.

Committee of the whole House

Thank you, Mr Chair. It’s a pleasure to have this bill back. Of course, we’re seeing this bill now after the Budget, which included some provisions for the implementation of this bill and, also, after Budget documents have been released. So I guess the interesting thing about this bill is that it’s creating a new entitlement for women who have delivered babies to have a three-day stay. I have to say, most of the debate that we have previously had about this bill relates to the issue of whether or not the provisions in it can actually be implemented. The main issue here is the real challenges with resourcing that exist in maternity wards across the country.

The Government sought to address that with some funding for increased beds in the Budget, but since then we’ve seen Treasury documents released that show considerable concern from officials about whether or not this actually can be achieved. For that reason, I think my question to the Minister is: what confidence does she have that this three-day stay can be delivered for women in the time line that the Government’s set out for implementation? What advice has she had on the feasibility of this implementation pathway? What steps need to be gone through to achieve the number of beds needed to realise this? Where will the places in the country where this can be achieved quickly be? Where are there places where it will take some time to achieve this new entitlement?

We’ve discussed this bill many times by the time it reached committee stage, so it’s no surprise that everyone is in support of it, but the issue really is about what work the Government has done, while this has been part of the Government programme for some time now, to make sure that it can be achieved. It would be very troubling if some of the concerns that the Treasury noted in its advice to the Government before the Budget were still held and, therefore, we’d like to know—especially with there being an important election coming up shortly—that everything is tickety-boo with the implementation.

Committee of the whole House

Thank you, Mr Chair. I believe we’re on clause 1, which is the title—looking at you, Mr Chair?

CHAIRPERSON (Tom Rutherford): Yes.

Yes. Just given my colleague the Hon Dr Ayesha Verrall’s comment there about the Budget and the beds, my question related to that—and I won’t repeat what she said—is just if the three days should still be in the title. That links to the questions that she was making, so that’s my question.

Committee of the whole House

Thank you, Mr Chair. I’d just like to thank the Associate Minister of Health for drawing our attention to Amendment Paper 647. Although we have been in this House and through the Health Committee with this bill—this very well-intentioned bill, which we do support in its intentionality. It’s news to us to see the Amendment Paper, and I’d like to flag that there are going to be questions about why the entitlement and the information that patients are given about their entitlement to the three-day stay seem to be the subject of such a large Amendment Paper which has just been dropped on to us outside of the select committee process.

That does bring me to clause 1, the title, because we’re talking about the “Healthy Futures (Pae Ora) (3-Day Postnatal Stay) Amendment Act”. I’m seeing that the name of that suggests that there is a right, and we have been told consistently in the Health Committee, through the process, that this is about enabling new, I’d say birthing parents—and that’s another question we’re going to come to about the nomenclature of who has given birth, because there will be political differences, but there are also medical and clinical differences about who gives birth. But the title really captures this right to give the birthing parent this three-day postnatal stay. Given that we now have an Amendment Paper that is questioning whether people are entitled to know about their right—because that is the Amendment Paper—I’m wondering if the title needs to perhaps better reflect something that says “unless they don’t know about that right” or some other kind of words that capture the fact that birthing parents will be assumed to have knowledge about this if they want to be able to assert this right.

It is a small technical question. It’s not one I had anticipated to ask, and I can see the chair of the Health Committee, Sam Uffindell, looking quite amused about this, but it’s not amusing to have an Amendment Paper dropped on to the Table after the select committee process and after the many submissions from people that suddenly limits what we thought was going to be something that was universal. As my colleague the Hon Dr Ayesha Verrall has mentioned, we are supportive of the intention. What we are sceptical about is the resourcing. If we draw those threads together, there is a cynical element to the Amendment Paper that might perhaps be a cost-cutting measure that if women are not told or birthing parents are not told about their right, then perhaps that is going to save some expense.

We will be having questions about the modelling that has been done. We will have questions about the fiscals. We will have questions about the ability of this Government to deliver on something that is aspirational that we support in intention. But we don’t want to make promises that we can’t keep. My question to the Minister is whether she believes the title still accurately reflects the name of the bill, given the new Amendment Paper that changes people’s knowledge and assumed knowledge of what their rights are.

CHAIRPERSON (Tom Rutherford): Thank you. Just before I take a call, I would note the Minister’s Amendment Paper was tabled on 25 August, so was not tabled in just the days up to today—a significant period of time in advance. Members did have time in advance of today’s committee stage to consider the bill for this evening.

💬 Hon Dr Duncan Webb: Point of order. I’m sure the Minister could make that point, but it’s hardly the point of a Chair to debate whether or not an Amendment Paper—

CHAIRPERSON (Tom Rutherford): Thank you, Mr Webb. I wasn’t making a debating point; I was simply stating the facts.

Committee of the whole House

Thank you, Mr Chair. Just in response, although we haven’t got to that clause yet. In terms of the confidence and the implementation, in the first two years, Health New Zealand will use existing capacity where it can be, acknowledging that there was approximately $34 million from the Budget allocated to achieve this where it can be—so in the first two years, Health New Zealand will use existing capacity where it can be safely supported, including through community partnership models where targeted workforce support can be helped to utilise the capacity. Health New Zealand’s modelling indicates that some districts such as Whanganui, Nelson, Gisborne, and Whakatāne have relatively more existing capacity, while larger urban areas are more constrained and will require additional commissioned capacity. In parallel, Health New Zealand will look to commission additional capacity from the provider mix that best meets the needs of each community. I’m very confident in the delivery.

In terms of the questions in relation to the title: yes, the title is accurate, and reflecting the three-day stay is important because that is the guarantee—that the three-day stay in maternity care will be delivered.

Committee of the whole House

Thank you, for the Associate Minister of Health’s fulsome answers. I’m wondering if the Minister can please let the committee know why three days specifically was given for the purposes of this bill? Was that a clinical decision? Was it based around resourcing? What was the rationale where three days was considered to be the optimal amount of time for birthing parents to be able to have this entitlement?

Committee of the whole House

Just to clarify, are we just on—

CHAIRPERSON (Tom Rutherford): We are just on the title.

Clause 1, title. Sorry, my question’s about clause 2.

CHAIRPERSON (Tom Rutherford): The question is that the Minister’s amendment to clause 1 set out on Amendment Paper 647 be agreed to.

Amendment agreed to.

Clause 1 as amended agreed to.

Committee of the whole House

Clause 2 Commencement

CHAIRPERSON (Tom Rutherford): Members, we now come to clause 2. This is the debate on commencement. The question is that clause 2 stand part.