Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill

It’s a great pleasure to rise in support of my colleague Katie Nimon member’s bill, the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill. I was ready and rearing to go to have a lengthy, full-on debate about the title of the bill, clause by clause, but it looks like we’re going to have to start with a broader, wider, encompassing overview of the bill as a whole, as happens when we take all these clauses as one question. Can I start by congratulating the member in charge of the bill both for her good fortune and also for her stewardship and dogged determination in bringing this bill through the House. It is quite cheeky that a member in their first term gets to have a bill not only pulled from the ballot but progress its way through the House too, and, hopefully, into law in no time. Congratulations to Ms Nimon on her success. May it be the first of many, many bills to come.

This is, of course, a bill aimed at improving the healthy futures of our nation and of Kiwis in New Zealand by improving mental health outcomes. Of course, one of the first steps that this Government took to improve mental health outcomes was to appoint the country’s very first mental health Minister. It’s no coincidence that the very first mental health Minister, Minister Matt Doocey, was in fact the author of this bill. It may come as a surprise or as a shock to many in this House that the now Minister of Mental Health was, in fact, the author of this bill and, in fact, had this bill in the ballot in the previous Parliament, before it was drawn and handed over to Ms Nimon. I wanted to start just by giving that wider context, too. This is a Government which is dedicated and committed to improving the mental health outcomes of all New Zealanders, starting right at the top, with the country’s very first dedicated Minister for Mental Health.

With that, I wanted to start by asking the member in charge of the bill—and I’m aware that she doesn’t actually have any officials with her, so it may take some time and some process to get through the questions, because, of course, she’s doing this under her own steam and doesn’t have an army of thousands of officials behind her. I’ll start with some very broad, helpful, welcoming—easy, maybe—questions to ease our way into this very robust and long debate tonight. The first one was: just generally, what is the genesis of the bill? Why is this bill important to New Zealanders? We’re talking about the entire bill. If you can give us a very, very good, in-depth run through in your mind of why the bill is needed. What difference is it going to make to those New Zealanders who are faced every day with mental health challenges, as they get up, hopefully on their way to work, trying to graft and make a living but are faced with some of the most serious mental health concerns that we may face?

In fact, I think we are still, as a country, not quite at the point where we treat mental health the same as physical health, so I’m glad that we are here today having this debate and, in fact, recognising that part of this is to insert a mental health and wellbeing strategy and to try to lift the profile of mental health so that it is treated the same as physical health, so that if you are having a bad day at work, people are willing to talk about it as though you have sprained an ankle or you have perhaps dislocated a knee or a patella—that people are willing to talk about that and are willing to encourage their colleagues to be open about their mental health. I’d thought I’d start with that question to the member in charge. What is the genesis of the bill? Why is it important for the committee to support it? Why is it important to go through, as I believe your intention is, without any further change? Why should we be supporting it tonight? And I look forward to your answer on that one.

I call Dr Ayesha Verrall.

Thank you. It’s always a pleasure to have one of my titles announced in the House! Congratulations to the member on bringing this bill. I’m sure it will do a lot of good. I have one question, which is the question I raised at select committee and also mentioned in my second reading speech—so I’ll ask it again—which is: is there any intention from the Government to modify the Government policy statement (GPS) during this term of Government? Understanding the answer to that question helps us know what the likely impact of this bill would be. The GPS lasts for three years. Once a strategy is written, nothing happens to it unless it is reflected in the GPS. That is the marching orders the Minister gives to health services. So, unless there’s a modification to the Government policy statement based on the consultation and contents of the strategy, it won’t help people in the community unless that happens. My only question about this bill—which, in all other respects, I believe is a very good bill—is: will it have an effect on the health services in New Zealand through a modification to the GPS?

Thank you, Mr Chair. Firstly, I’d just like to congratulate Ms Nimon on getting this bill through, and it looks like we’re going to have support around the House, which is certainly where I hoped we would get to.

I’d also like to thank the members of the Health Committee. We’ve got Dr Cheung here, Dr Campbell, Dr Verrall, Ingrid Leary, Cam Luxton, and other members from the Greens and the Māori Party. It’s been a fairly good and agreeable process the whole way through, and, look, we did take this bill into the select committee and we recommended several changes, which have already been somewhat touched upon.

I think one of the important ones was the removal of the Mental Health and Wellbeing Commission as a “health entity” under the Act. I’d like to get a sense from the member as to how important she believes it is to preserve the independence of the commission. It was definitely something that we wanted to uphold, and I think that was called out pretty early in the proceedings by Ingrid Leary, if I’m not mistaken—a good pick-up there from you, Ingrid.

We also made a change around removing clause 6 of the bill, where the Minister would have been required to consult with the Mental Health and Wellbeing Commission in preparing the Government policy statement. We did propose a new section where the Minister could consider advice provided by the commission, and I’d be interested to know whether the member is agreeable to that suggested amendment.

There are some other parts in there. The committee recommends making the mental health and wellbeing strategy provisions come into force after 12 months. I’m wondering whether the member has had any discussions there with the Minister, or whether the member is agreeable to that, as well.

The reality is—and I think we’ve talked about it in select committee as well—that this is a relatively straightforward bill. Yes, there have been a few alterations, but, look, we’re trying to get to a place in New Zealand where—and I think we are getting there under this Government. It would be a falsity to say that we have ever achieved or are in the process of achieving great success in that space, because the mental health need out there in New Zealand is such that it requires everyone across this House, no matter who is in Government, to keep working very hard on it.

I’m very proud that we have this bill before the House and that we have a mental health Minister—the first Minister to have that role in New Zealand—who was actually the original author of this bill, and Ms Nimon is now the owner of it, but we have huge strides to make, and this bill is a good place to start in setting the general direction.

We did take a bit more of a holistic approach on this. We wanted it to include that wellbeing piece. It does have the mental health and addiction part of it too, which is very important, and I think we wanted to call that out there—the exact wording of that will be in here—but there are several questions there that I would want to put forward to the member, and I will leave that for her to consider and reply when she is ready. Thank you.

Thank you, Mr Chair. Look, thanks for everybody that’s asked questions so far. I will try and take them in a bit of a storytelling order, if I may. Thank you to James Meager for asking about the genesis of the bill because it leads quite nicely into some of the other questions.

Of course, in 2022 mental health was not included as a strategy in the Pae Ora (Healthy Futures) Act 2022, so, of course, we are on the back foot with our mental health strategy and how we progress that. That is a great consideration for me in terms of the commencement—and I take all of the feedback from the select committee and really appreciate that. Everything that we do, I believe, really has to have a strategic intention to provide the foundation for what decisions we make, whether it’s funding or otherwise.

To address one of the questions from the Hon Dr Ayesha Verrall—if I can find where it says about the intention to modify the Government policy statement (GPS) during this term of Government. I can’t speak to the exact timing, of course—I’m not the Minister, nor am I in the Minister’s office—but one thing I guess I’d ask is: did the other strategies impact the GPS? Of course, this is rhetorical because the questions are being asked of me, but I have no doubt that the intention of the strategies in general as part of Pae Ora (Healthy Futures) were to influence and be introduced or included in the GPS.

That is the very intention of this amendment. This amendment wouldn’t be being made if it was going to go nowhere. Just to acknowledge, obviously, my predecessor in shepherding this through: the honourable Minister Matt Doocey, who’s now the mental health Minister, that was his hope when this was drafted. That is also my hope. But, of course, GPS—they all take their time, they all go through a process, and this amendment is not necessarily intended to be a quick tomorrow fix; this is about implementing change for long term.

When the GPS is amended to include the forthcoming, I hope, mental health and wellbeing strategy, I really look forward to that. The timing will be as a result of this bill first being passed; secondly, being passed based on the timing of what is indicated in the amendments in this bill, and then, of course, it being worked through, implemented, and so on. That also is similar to a question that Ingrid Leary raised, which is: how does it fit into the GPS? Obviously, as I said before, it’s an ongoing thing, I hope, to be many and all GPS in the future as they go through their three-yearly process. I really look forward to that.

Just to speak to another item, I think, that has been raised a couple of times, which is the independence of the Mental Health and Wellbeing Commission. I actually think I front-footed it when I presented to the select committee by saying, you know, “Sorry, folks, it was a drafting error. It was never intended for it to be identified—the Mental Health and Wellbeing Commission—as a health entity.” It is interesting that, almost accidentally, it has really highlighted the importance of the independence of the Mental Health and Wellbeing Commission.

I think, if it hadn’t been a drafting error, would we have had this discussion? Would the Mental Health and Wellbeing Commission have been so open about how important their independence is and to maintain that? I’m almost glad that that drafting error was in there. I went in and front-footed to the select committee, saying, “Hey, drafting error; not intended. Happy for the independence to be maintained.”, but I feel like I have had to explain myself at every single point in the process since then. I’m happy to keep saying that.

To the point also made by Sam Uffindell—and thank you, to acknowledge you as the chair of the Health Committee and your contribution to the process—on how important I think it is to maintain the independence. Look, I think that is exactly the message that we got from the Mental Health and Wellbeing Commission. You know, actually an independent body that’s involved in this process really does help add gravity to the message that we’re getting through, and actually that what is being proposed in the strategy that the Minister of Health—or, by delegation, the Minister for Mental Health—will be writing, that it’s substantiated by people that are really seeing it through all the research and all the work that’s being done.

Just while I have the chance—five seconds—Sam, there was a third question that you asked that I missed, if you wouldn’t mind repeating that if you have that on record. I did write down two of those three.

All right. The committee is suspended and will resume at 7.30 p.m. Thank you.

Sitting suspended from 5.56 p.m. to 7.30 p.m.

Members, the committee is resumed. Before the dinner break, we were debating the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill. The question is, again, that clauses 1 to 8 and the Schedule stand part.

Thank you, Madam Chair. First of all, I want to acknowledge our member Katie Nimon for bringing this bill to the House. This bill is very important, but I also want to highlight her performance in front of the select committee earlier in the year. As a new member of the Parliament, she came to our select committee well prepared and organised, and she was able to answer some of our concern as well. For that, well done, Katie. Also, I would like to acknowledge the Health Committee as well for the hard work and their passion in this topic as well, across the House. We’ve got a chair, Sam Uffindell; we’ve got a deputy chair; we’ve got Hamish Campbell and me; and we’ve got, of course, members from across the House as well.

Going back to the bill now, because, as I say, this bill is very important because over half of the people living in New Zealand actually experience mental illness and addiction challenges at some point in their lives. Nationally, one in five people experienced some kind of mental illness in the last year, and 3 percent of the people experienced serious mental issues.

My question is: if this is a very serious issue, why did you set a commencement date for 12 months? This is actually referred to in new section 46A, which is related to the making of the mental health and wellbeing strategy. It will not take effect until 12 months after the date on which the Pae Ora amendment bill comes into force. It’s more like: why 12 months; why not six months or earlier if it’s a very important issue? Can you give us a little bit of detail on this and just a little bit of clarification as well. As I say, this is a very important issue for New Zealand that actually affects a lot of people. Thank you.

I move, That debate on this question now close.

Thank you, Madam Chair. I think this is a very important bill, and I’m glad for the member who has brought it to the House. I appreciate we have already heard that the Hon Matt Doocey originally worked on this—I think that’s really important—and we’ve touched on various aspects of this bill. The previous speaker, Dr Carlos Cheung, has talked about the 12 months and about the development of the strategy.

I suppose I would like to ask the member—and it probably, really, touches on the importance of mental health. In our life, 50 to 80 percent of us probably will be affected by some periods of mental distress, and I think it’s really important that we have services that deliver well. Touching on some of the things that we heard in the Health Committee, I think there were about 57 interested groups and individuals who actually spoke to various different parts of this bill. We heard from 19 oral submitters. One of the important things is, I think, probably when it talks about “The Minister must prepare and determine a Mental Health and Wellbeing Strategy.” I suppose my question is: how is this strategy going to fit in with the other ones, and what is the role of the Minister in this strategy?

Of course, we heard in the select committee that there is a whole range of people wanting to have a say. We also heard from different ethnic groups—also those from the Asian community, who are very interested in a mental health and wellbeing strategy. My question to the member would be around how this is going to be implemented and what it means going forward, given the fact that we heard from Asian groups, we heard from different sectors of society, and since so many of us are probably going to have periods of mental distress at some stage in our life—how that’s going to go forward.

I would just echo the words of my colleague around the 12-month time period. I think it would be interesting to hear the member’s view on what that means and, overall, the Minister’s role going forward.

You get used to sitting in the chair and actually being able to take the call when I want to answer something! Look, I just want to address a couple of things that I didn’t get the chance to before the dinner break.

Firstly, I think I’ll address the question about the commencement date of 12 months, because it’s clause 2 that it’s recommended by the select committee to delay the requirement to have the strategy by 12 months, to allow time for necessary engagement and development. I think my answer to that—and I did say in the second reading—is that I’m supportive of that. Obviously, that came as a result of hearing from people who submitted, and from officials as well. I don’t want to set anybody up to fail. I want this to be a robust strategy that makes a difference. As I said at the time, if 12 months is what is required to get that up and running—obviously, the original bill was passed in 2022 and, obviously, those strategies that were originally included had some time to be established and inform the work that they were doing. I think that’s important. I’d rather not rush the work that the Minister has to do to get this ready, because, of course, acknowledging that this is a member’s bill, it’s not something that is necessarily being done at the Government level, and so I want to be as supportive as I possibly can. I think that’s my answer to that question.

Going back to one of the questions from Sam Uffindell—to consider advice from the mental health and wellbeing strategy—again, I think, given that that is the advice that was received from submitters, that was supported by officials, I think that’s the best course of action. My answer to that, as well, is: whatever is going to make this most effective, that’s what I want to see. This is not my own personal agenda; this is for the outcomes of mental health in New Zealand. Whatever it is that we can do to make sure that’s most effective, then brilliant. If the mental health and wellbeing strategy said, look, they’d rather that their advice is considered, rather than they had to be consulted at every level, then that is wonderful.

Actually, going to a point that Ingrid Leary raised—and I’m surprised she’s trying to shut the debate down, because I actually haven’t answered her questions in full yet—one of the questions she asked was: how do we enable the workforce? What I’m putting in in this member’s bill is to have a mental health strategy, and, inevitably, that will call for either a stronger workforce, a more targeted workforce, or a greater workforce in some cases, I have no doubt. Of course, I won’t be writing the strategy. Here what I am asking is for there to be a statutory requirement for there to be a strategy. I have no doubt that part of that strategy will be informing what workforce is required, how we enable that, how we support workforce development, and in the right areas as well. Recently, I visited with a group of primary school principals, in fact, with the Minister of Education, and they spoke about counselling in schools and having that support available for the students and enabling that work at a level there as well. We’ve got to look at where is the support going to be most effective and most impactful. I have no doubt that that will all come through in the strategy.

While I have my time, I will also get to the point—actually, thank you very much to, I think, Hamish and, perhaps, Carlos; I’m going to conflate both questions together. One of the questions was about the strategy and how it fits in with the other strategies. I think that’s a really good point that I actually was thinking about earlier in the evening. Obviously, as was mentioned, the original Pae Ora (Healthy Futures) Act had strategies for women, for various ethnicities, and for rural communities. I think rural communities are a great example to make where it lies with mental health, in particular. I’ve seen some really poor examples in strengthening mental health and support in the rural communities. The Rural Support Trust do a fantastic job. There is obviously access to general services through the health system, but we know that there is a greater issue in rural communities. I have no doubt that these strategies will integrate in the same way that strategies for women and rural and ethnic would already work together. I expect that these would also be the case.

Not that it’s typical practice, I suppose, to respond to questions asked from the—[Time expired]

CHAIRPERSON (Barbara Kuriger): Katie Nimon.

KATIE NIMON: Thank you. Not that it is—[Interruption]

CHAIRPERSON (Barbara Kuriger): Katie Nimon’s still on her feet—I’ve given her another call.

KATIE NIMON: Thank you, Chair. Not that it’s typical, I suppose, to take questions when the member’s sitting down but also trying to close proceedings, but Ingrid Leary did mention the—

Hon Scott Simpson: They don’t like talking about it over there.

KATIE NIMON: —yeah; ha, ha!—Government policy statement (GPS). I did actually already answer that question and how it fits into the GPS, much like, I imagine, the intention of Pae Ora (Healthy Futures) Act 2022. When those strategies were in place, I have no doubt they were intended to be integrated and considered when the GPS was being created, much like this will when it is next reviewed and redeveloped. I really look forward to that. I really look forward to a well-informed GPS with a strong mental health strategy. I think that that is a really important one for us.

I also look forward to Sam Uffindell’s third question—that I’m still burning to answer—that I did miss that first time you were on your feet. All right.

Thank you, Madam Chair. Just going through the mental health and wellbeing strategy by clauses, now, it might seem very obvious to some, but I’d just like the member Katie Nimon to draw out a little bit more why we changed the reference to addiction with “wellbeing”.

The reason I ask is that it’s one of things, in health, where health is really this global, holistic concept of, you know, physical, biological, social, and spiritual wellbeing, so to me it’s kind of repeating the same thing, to use the term “wellbeing”. Actually, addiction is a very important part of the mental health complaints and conditions that people suffer from. Are we in any way deprioritising addiction through reducing that and not having that at the forefront. I certainly know, in my experience in general practice, that addiction is a very huge problem in the community. It doesn’t just relate to alcohol addiction; we have drug addiction, there’s gambling addiction—there’s plenty—there’s other substances, inhaled substances; even addiction to pornography. All of these things can really affect people’s mental health. They globally can contribute to other conditions as well. People who have addiction problems with gambling, for example, often have financial stress, and that then impacts on their mental health just through their general stress in their life.

I’m just wondering if you could explain a little bit more about that terminology—whether or not this is any way deprioritising addiction. Is there a complete focus change on that? In new section 46A, inserted by new clause 7, it does mention minimising harm from addiction—that is included—but I’m just thinking, with the overall title of the bill, if, somehow, changing and removing addiction has deprioritised that in any way.

Look, I wasn’t going to take a call on this bill, but I feel compelled to, to out-compete my colleagues this evening! But, no, seriously, this is a serious topic, and I think we’ve got our own stories of mental health challenges in our own families and settings. I’m very, very encouraged by this bill.

There is one question that I have lingering from this bill, and it relates to an organisation that I’m about to run a half-marathon for in a week and a half. It’s the Mental Health Foundation, and I’m really curious to understand where organisations like the Mental Health Foundation fit in this mental health strategy. There are some great, fantastic, high-impact organisations out there doing great work—far better work, in my opinion, than most Government agencies—to make an impact in the mental health space. Great initiatives in Northcote—a shout-out to Hearts and Minds.

My question to the fantastic member—and I’d like to just acknowledge Katie Nimon for her work in bringing this bill to the House. My genuine question to her—because I haven’t caught up with her for a while, so I thought I’d just do this in a formal setting like this—is to ask her how she sees the role of community organisations in the mental health space and how she sees them fitting into, particularly, new section 46A, in clause 7, in the preparation of the mental health strategy. I think that there are a lot of organisations out there in New Zealand that would be really keen to understand that, and I’d appreciate any reflections from the member on this fantastic evening in the Chamber. Thank you.

Thank you very much, Madam Chair. To answer the question on addiction rather than wellbeing, I’m really glad the member asked that question, because that was something that took me a little bit longer to kind of come around to in the changes recommended from the Health Committee. Obviously, I don’t have to take them all and, you know, I can maintain my own personal view, but of course I really respect the process. Like I said earlier, it’s not my own personal agenda. I want to see there be a mental health strategy; I think that’s really important.

I think we have got a lot of work to do, as members earlier talked about, around breaking down the stigma and treating mental health issues—whether they are short term or long term—like we do a dislocated knee; a nod to the member Carl Bates. For me, I think that’s really important. The terminology, I think, sometimes can be a little bit just about what fits into the system, and I think that was the recommendation. I do take it on board that the term “mental health and wellbeing” is more widely recognised and acknowledged within the health system as sort of the typical terminology, and I think addiction comes within that.

If we start to define it, we’ll probably get into a position where, when people want to add more amendments, they’ll say the “mental health and addiction and suicide prevention and recovery”, for example, and I don’t really want to open that can of worms. If we can be broader and refer to it as “mental health and wellbeing”, knowing that addiction does usually tie in or is typically considered part of—obviously, if you’re dealing with addiction and recovering well, it’s all about your wellbeing, but obviously it is a mental illness.

Look, I am confident with that, and I think, again, with the advice from officials in having that, and then supported by the committee, I am confident. Of course, we don’t necessarily want “addiction outcomes”; we want people to have good mental health and good wellbeing, and having people free from addiction is one of those outcomes. If we get into defining what each and every one of those mental health outcomes is, I think we’re probably sliding down a sort of slippery slope.

Again, I’m really happy to be guided. I thought the process that the Health Committee went through was really good. Lots of good people did submit to it, great organisations, and just to acknowledge them—which I think is a lovely segue into the point that member Dan Bidois raised about how this fits into organisations. Credit to you for running a half-marathon; it’s not something I could do, but we all do different things for mental health, and I think that is something that’s got to be considered in this strategy. Like I say, I’m not the one writing it; I’d sure love to contribute some thoughts—absolutely—but we can’t do this on our own as a system, and it’s an impossible task if we think that the New Zealand public health system is going to do all of this.

A strategy sets the tone, it sets the direction, it sets the intention, and then a lot of people jump on board with this. I did acknowledge in my speech, probably second reading, about an organisation called Mates4Life, doing this absolutely out of the love of their own hearts and receiving funding from all sorts of places that’s not public at this stage. I think, again, for them, they’re working off what we said is our intention and our goal, and that’s driving them, but it’s not necessarily their funding.

I think, to that point, the strategy or the strategic intention, our strategic objectives, what we’re wanting to achieve, is what gives the signal to these organisations to get involved, to get on board and to match up. Hey, look, if some of them think, “I’m going to go out here and do this because this lines up with what you’re saying and perhaps I might get funding for it.”, look, that happens all the time, and we do see that, but we’d rather be lined up with a system-wide approach and how that’s going to work and, you know, get those results, because at the end of the day, everything that these organisations do is to get results. If they can add into what it is that the system’s doing, we’re going to get a far better outcome for New Zealanders. This is the very intention of what we’re doing.

I obviously feel very strongly about this and I’m really pleased to have support from the whole House because what we’ve really got to do is have a joined-up approach that gets us results, that is future focused, that leads where the funding goes, and that connects in every sector of our health system, not just in rural communities or ethnic communities where we know those statistics feature higher on suicide rates and mental health cases.

At the moment, in Hawke’s Bay, obviously we’ve got considerable issues. We’ve got considerable issues in Hawke’s Bay after Cyclone Gabrielle, and when identifying a targeted response after an event, whether it’s the Christchurch earthquake, which I know people are still dealing with—and I have a friend that has a traumatic response every time a truck goes past her house because of the Christchurch earthquakes, and I know that she’s not alone in that—there have to be ways that we target those events. It doesn’t mean that we have to have a new response every time that event, or an event, happens, that we have a post-disaster approach; you can only really achieve that through a strategy that is statutory.

I go back to the earlier point that I made in reference to how this fits in with the Government policy statement. This should be an ongoing process for every Government policy statement that is designed for ever, every three years—that the mental health and wellbeing strategy is considered as a fundamental aspect of that in every single decision that we make. All that we can do otherwise is make estimated guesses, fling money into the atmosphere and hope it lands somewhere, and that’s not what’s going to get us the results. Especially, learning from what we did last time, redefining that, and then targeting it better in the future—I’m really excited; that is fundamentally what this is setting out to achieve, and why I keep saying I don’t have my own personal agenda of what’s going to be in this strategy. I couldn’t possibly comment, but I really hope that what we achieve is a far better target to where we’re going to go in the future. I’m really, really excited about that.

That sort of broadly answers the organisation. If we set the tone right, organisations will fall into line and do a fantastic job, as some of them already are, but I tell you, I get the feedback that they are struggling to find—in previous years, have been struggling to find—a sense of direction about where they fit into the grander scheme of things. I think that’s the way that I would address that question. Thank you.

I move, That debate on this question now close.

Thank you, Madam Chair, and thank you to the member Katie Nimon, there, for that quite succinct and detailed answer that she gave. I did ask a number of questions in my earlier opportunity to speak with her, and there were another couple of questions that I will get to for the member. Look, during this process, we did have a number of submissions come through, right? Obviously, there’s been a significant surge of mental health instances, and COVID has exacerbated that—or it certainly did. I think you’d probably see that mental health of youth, in particular, has trended in a negative direction for about the past 12 to 15 years. That’s really come to the forefront, and COVID really pushed that out and exacerbated that a lot.

We did hear a number of submissions, and we did hear them from youth groups. We did hear them from Māori—young Māori. We heard them from individuals. I think some of the really touching ones that we heard were from family members of individuals—especially family members or parents of young people who were suffering mental health episodes, mental health illnesses. We heard from mental health and clinical organisations. We heard from healthcare specialists and workforce representative bodies. One of the overriding things that we heard throughout all of that is that they wanted their voice to be heard. They wanted to have a say in that. I was curious then—if the member has an opportunity to answer some time this evening—around whether she heard any of the submissions there and whether there were any that really stuck with her. I’d also be quite interested to know whether the member thought, through this bill—or where committee amended it to at the committee stage—whether it has taken account of that ongoing request from submitters for their voices to be heard.

We heard from youths about how they feel that often their voice isn’t considered and that they want to be part of that decision making. Look, we recognise—and I have mentioned it before—the acute increase in mental health concerns among our youth, and we want to make sure that we do incorporate those voices. There’s no point us designing stuff that—I think the member over there was about to get to their feet, or no? Just rearranging, adjusting your legs? But, look, where I was going with that? Sorry, I was going to give you the opportunity if you wanted to say something. Where I was going with that is that we want to make sure that we are incorporating those voices. I’d like the member’s feedback on whether she feels that we have done enough with the adjustments we’ve made at the committee stage or whether she believes there are opportunities for us to go further in that response.

We also had Te Hiringa Mahara, who supported the introduction of the mental health and wellbeing strategy that will fall under the existing Pae Ora (Healthy Futures) Act. This being a new strategy, I’m curious as well whether the member had looked at that piece, and, if she had, what her thoughts were around that. I guess my overriding point here, Ms Nimon, is that there were a number of submitters, and I’m just curious around how much of that you followed and what the key points that you took out of that were, and whether you also think that the amendments the committee made at select committee stage reflected the will of the submitters, obviously keeping in mind that we have a direction that we want this bill to go in. Thank you.

Thank you, Madam Chair. It is a privilege to stand today and ask some questions of the member Katie Nimon—and congratulations—now at the committee stage of her member’s bill, the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill.

I’d just like to acknowledge in the committee tonight those members of the Health Committee who worked on this bill that have posed questions of the member. We did—as the chair of the committee, Sam Uffindell, has outlined—consider a number of submissions, and we heard oral evidence from 19 of those submitters. They did traverse a number of issues, and I think it was really important in particular that we heard about the value and the importance of the patient voice. I’d also like to note that, on the Mental Health and Wellbeing Commission, they also value the importance of patient voice inside the organisation of that commission. I’d be keen to hear from the member how she also values the patient voice and how that came through in terms of the submissions we heard.

I do have another couple of questions, because we do recognise that it was the Mental Health Foundation who we heard from—also, as the bill was drawn in your name; originally, I think, in your predecessor’s name—and I want to quote them. They said, “Without a mandated strategy”—because this bill is about implementing a strategy—“Decision-makers can simply revert [back] to using outdated—but deep-rooted—deficit models around mental health and addiction and focus on solely expanding services”. We know that, as we increase services, it doesn’t necessarily pave the right pathway for the direction of travel that we want our mental health and wellbeing strategy to take. Just expanding those services is, they say, “an approach that can’t—and hasn’t—solved Aotearoa’s wellbeing crisis.”—just reflecting on the vital importance of having a strategy.

Some of the submitters we heard from supported the strategy’s broad focus on mental health and wellbeing, and I think we have heard already tonight about the emphasis, actually—that it should focus on addictions in that strategy. We also heard there was debate on whether developing a new strategy might overshadow existing initiatives, like Kia Manawanui Aotearoa. I would be interested to hear your thoughts on that.

My final question to you is: in the bill, it talks about the amendment Act being able to better enable long-term planning. Could you just give your vision of what that long-term planning looks like—what your expectation of that long-term planning and then delivery of that planning would look like? Thank you very much.

Thank you very much to the members. Firstly, to Sam—and thank you for coming back to your third question. I’m really pleased about it, because I do recall now when you said that. Look, I appreciate that, because, obviously, my take on the submissions was that they were really in favour of this, and obviously some of them—largely the same submitters—during the 2022 Act, where the mental health strategy was omitted, were really pleased to see it come back again, but, again, want to make sure that they get it right.

Then, just to speak to a few of the clauses that haven’t been talked about: one was, obviously, clause 4(1)(vi)—that wasn’t really so much raised; clause 7, keeping the name as originally drafted, with the broader health and wellbeing approach; and then, of course, we’ll obviously—and without disregarding clause 2 and clause 4. You know, I think the significant things were maintaining the Mental Health and Wellbeing Commission’s independence; making sure that we don’t get too focused on the word “addiction” and that it’s a broader issue; and, really, just the approach and what it entails. I think, inevitably, submitters get quite excited, potentially, about what the strategy might include, and so then we’ve got to consider—and I’m really pleased that the Health Committee did consider—how, then, this piece of legislation can enable that. All of those things that the submissions covered—are we having and do we have a piece of legislation that enables all of those concerns and hopes and aspirations? I think—and with huge respect to the select committee and the drafting of the current Minister, the former member—they do pay good heed to those points.

Then, of course, the one that I think is the most significant is the delay of strategy provisions by 12 months to allow time for preparation. I think that kind of comes down to hearing from organisations that there just needed to be time to do this right. I take great comfort from the fact that action can be taken in response to those submissions—that this is going to be something that we do and do well. Then I think, to take from the points raised by Jenny Marcroft—and thank you to the member for those three questions—talking about long-term planning, talking about having a strategy, and does it overshadow existing functions and initiatives, and then, of course, how do we get the patient voice and include that?

I just want to acknowledge something that the Minister for Mental Health has already done, which is the Suicide Prevention Action Plan, and how much emphasis was put on getting those with lived experience’s voice and getting their views and making sure that that was informed. I think that that is really a signal for how this is going to go, and I’m really pleased about that—taking really good care of not only how we develop it but then, once it’s developed, how it is put out into the universe, so to speak, and then getting those voices involved.

You asked what my vision was for the long-term planning of that. I’d like, as any good MP would, to see a real focus on data and what works and what we need to address—and, like I did signal before, the issues in rural communities, breaking down stigma, helping people to be more comfortable talking about issues, and getting quick support, really, rather than people having to go through so many hoops to get the support that they do get, and especially having to feel like they’ve passed some severity bar. Often, we don’t want to wait until it’s—actually, in any case, and in so many cases I’ve seen, people feel like they have to do something really bad to get the support that they need. These are all the things that we need to consider.

I did say earlier—and not in this context, but to add it to this context—what I’d really like to see from a long-term planning point of view is workplaces, individuals, friends, and whānau seeing mental health, or mental illness in this particular respect, being the same as physical. I think a lot of people have a really hard time acknowledging invisible things. You can liken it to back pain: back pain is one of those things that’s really hard to prove or to show to anyone, but it’s debilitating, and because you don’t have a cast, it’s not necessarily something that people see or take seriously at all times. I do give that lens to it as a helpful metaphor. I’d really like to see that be the case.

Then, finally, to the point of overshadowing existing initiatives and what the strategy would do, I would like to see that, where those initiatives are right and doing what they need to be doing and achieving outcomes, they won’t be overshadowed; they will be absolutely learnt from, brought into this strategy, and go to do amazing things. In that particular case, if we’ve got functions or groups out there doing stuff—I keep mentioning Mates4Life; I can’t help myself, they’re fantastic—then I would say that those will be learnt from, developed in how we can have this in a workplace environment. This is something where companies are getting involved, training their staff like first aiders but with mental health, and the onflow effect of that is huge, and it is a direct removal of cost burden on the emergency system because we know how to triage it.

These are the things that I think, if we’re doing them right—we’re doing them right, right now—nothing will get overshadowed, but there will inevitably be things that we’ll highlight that aren’t working. And I think that that’s necessary, because that means the strategy is working. Like I’ve said a couple of times, I don’t get to write the strategy but I really look forward to seeing how this goes and, again, am very pleased we have had whole of the House support this. I look forward, I suppose, to debating it on the third reading. Thank you very much.

Clauses 1 to 8 and the Schedule agreed to.

House resumed.

Mr Speaker, the committee has considered the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill and reports it without amendment. I move, That the report be adopted.

Motion agreed to.

Report adopted.