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

I move, That the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill be now read a second time.

I just want to take this moment to speak a little bit out of what I was expecting to, to acknowledge, firstly, Suicide Prevention Day yesterday, and also Mark Cameron’s son Brody and Mark’s speech earlier today in the House, which I think was timely and poignant and very much related to this bill.

Look, forgive me, all, for the start of this speech being quite dry. I think it’s necessary at a time when we’re responding to the report from the select committee. Of course, to all those listening avidly at home, I just wanted to share that this bill, obviously, amends the Pae Ora (Healthy Futures) Act 2022 to better enable the long-term planning and delivery that is required to improve mental health and addiction outcomes. Currently, this Act doesn’t adequately provide for a mental health and wellbeing approach. This bill strengthens the commitment to mental health and wellbeing by requiring the Minister of Health to consult with the Mental Health and Wellbeing Commission in the preparation of strategic documents, including health strategies, the New Zealand Health Plan, and the Government policy statement, and to prepare and determine a mental health and wellbeing strategy.

I’ve been really proud to be the member in charge of this bill since the beginning of this term. I want to again thank Minister Matt Doocey, the now Minister for Mental Health, for introducing this amendment bill to the House. It was done because the previous Government didn’t feel it necessary to have a statutory strategic plan to better address improving mental health outcomes. We are lucky to now have a mental health Minister—the first of its kind. I know that the Minister has already done great work to address the mental health crisis, and I hope that this amendment bill, when passed, serves to support him in his work.

I want to thank the Health Committee, chaired by Sam Uffindell, for their careful consideration of this amendment bill. I appreciate the detailed report from the committee, and I’m grateful to the organisations that submitted their thoughtful feedback, as well as to the ministry officials who provided advice. It’s buoying to read that the submissions were largely in favour of this amendment bill.

I just want to address the recommendations of the committee. Regarding the proposal to amend clause 8 to insert a new Part 3 into Schedule 1 of the principal Act, the committee’s amendment would state that section 46A, pertaining to the making of the Mental Health and Wellbeing Strategy, would not take effect until 12 months after the date on which the bill came into force. I feel strongly that the quality of the strategy is the most important aspect, and if a delayed commencement date is what is required, then I am supportive of that—and I appreciate the advice that was given on this.

Regarding the treatment of the Mental Health and Wellbeing Commission as a health entity and the committee’s recommendation that that not be the case, I agree. The intention of the bill was for the Mental Health and Wellbeing Commission to be consulted as an independent body, and I feel that it’s important to maintain this. If it were implied in the bill’s drafting that the commission should be a health entity, it was an error, and that wasn’t the intention.

Regarding the advice from the Mental Health and Wellbeing Commission, the committee agrees that the commission has a role to play in providing advice in this area when it thinks fit but that it shouldn’t be required to participate in the usual Government consultation processes. It considers that the Minister should be required to have regard to any advice from the commission when preparing the Mental Health and Wellbeing Strategy. Accordingly, it recommends inserting a new section 46A(1A) to prescribe this. Because of the proposed change, the committee has recommended removing clause 6 of the bill, which would have required the Minister to consult on the commission in the preparation of the Government policy statement. It then proposes a new section that would include a broader requirement for the Minister to consider advice provided by the commission. My view is that if the Mental Health and Wellbeing Commission can contribute and their advice can be considered, then we are ensuring that its experienced voice is heard.

Regarding the title of the strategy, the committee has reported that some submitters observed a discrepancy between the focus on addiction outcomes in the provisions relating to the purpose and requirements of the strategy, and the title “Mental Health and Wellbeing Strategy”. It considered whether the name of the strategy should be amended, but were advised that the term “wellbeing” is typically used to refer to the holistic concept of wellness and the factors that affect mental health, and is well understood across the health sector. I support the committee’s consideration that the name for the strategy as set out in the bill as introduced should be retained.

Regarding the committee’s recommendation of making some amendments to clause 7 for greater consistency, it has recommended amending new section 46A to replace the reference to “addiction” with “wellbeing”, and it also recommends amendments to new section 46A(3) to include a reference to wellbeing outcomes, rather than addiction outcomes. I appreciate that it doesn’t wish to preclude a focus on addiction and, as a result, it has also recommended specifying in new section 46A(2) that a minimisation of harm from addiction is included in the long-term improvements in mental health and wellbeing outcomes. I appreciate the committee’s recommendation here, and it’s very important that addiction is given weighting in this strategy, as mental health and addiction and the treatment of them go hand in hand. I am confident of this recommendation, if it doesn’t diminish the inclusion of addiction in the strategy.

The committee has also raised that the principal Act sets out requirements for further health strategies, including provisions requiring a focus on workforce development. It has recommended amending new section 46A(3)(c) to bring the Mental Health and Wellbeing Strategy in line with the other strategies. Its amendment would require that the strategy sets out priorities for mental health and addiction services, and health sector improvements as they relate to mental health and wellbeing, including workforce development. I’m supportive of this recommendation for the reason of having consistency with the rest of the Act, as well as reinforcing the importance of workforce in achieving the outcomes of a strategy.

I want to give thanks to the Mental Health and Wellbeing Commission for their ongoing advocacy and support. When the Pae Ora (Healthy Futures) Bill was introduced by the previous Government, the commission advocated for the inclusion of a mental health and addiction strategy. As they so rightly pointed out, the purpose of the strategy is to provide a framework to guide health entities for the long-term improvement of mental health and addiction outcomes. I talked about this in my speech in the first reading of this bill. We must have a strategy to inform the decisions we make around directions, funding targets, and, of course, workforce development. While there might be strategies in place by choice, when they aren’t a statutory requirement they don’t hold the same weight when it comes to funding bids, policy development, and—most of all—the work of related agencies that are further removed from the central health system.

Finally, I want to take a moment to acknowledge some important work closer to home. Making a difference in mental health is what this is all about, not just cycling around the same reactive approach. An organisation that is doing something different is Mates4Life. They created a suicide prevention programme in Hawke’s Bay to work with workplaces and organisations to provide free mental health first-aid training for their staff. It’s innovative approaches like this that will make a difference in preventing the demand on the health and emergency system.

Hawke’s Bay has had a wild four years with COVID and Cyclone Gabrielle. In the case of Cyclone Gabrielle, the impact on mental health has been immediate and ongoing. I want to acknowledge those we have lost in the months and years after 14 February 2023, and particularly Rob Poulton from Pātoka, a farmer, volunteer rural firefighter, husband, and dad.

My hope is that the Mental Health and Wellbeing Strategy will see our health system put as much focus on preventing addiction as we have on preventing type 2 diabetes. I hope that this strategy sees mental health conditions treated more like physical health conditions. While stigma is one of the biggest barriers to treatment of mental health issues and addiction, access, capacity, and capability are also factors. I am excited to see a health system in five to 10 years’ time that, because of a good strategy, will have addressed these barriers and will see less Kiwis taking their own lives and more Kiwis living with good mental health and wellbeing.

I have cried too often over lives unnecessarily lost or attempted to be taken to do nothing. My friends, my friends’ families, and my friends’ neighbours—good people who needed help with an invisible condition. I am pleased that in the first reading of this bill it was supported unanimously, and I hope that this continues to be the case.

In closing, as I commend the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill, I want to touch on the different te reo Māori definitions of “ora”: “ora” is to be alive, well, safe, healthy, fit, and healed; “ora” is also to survive or escape; “ora” is also to be satisfied or satiated; “ora” is also to recover or revive; and “ora” is also life, health, and vitality. I hope that the future for those suffering with poor mental health or addiction is all of the above.

The question is that the motion be agreed to.

Thank you, Mr Speaker. I too wish to acknowledge Suicide Prevention Day yesterday as the granddaughter of somebody who committed suicide in my family, but also to acknowledge my very good friend Louise Gizzi, who was a great Labour supporter from the trans community, who took her own life earlier this year and is in the group that represents the highest number of people who commit suicide in this country—between five or six times that of the general population, depending on which research you read.

We are going to support this legislation but with a challenge, really, to the Government members, because everything I’ve heard opposite makes sense; that sounds great. To have a strategy is good news, but without a workforce plan, without funding, without transparent procurement, without localised solutions to mental health, the strategy is at risk of sitting on the shelf gathering dust as we continue to experience this really shameful crisis in our country that is the mental health crisis, particularly of our youth.

We are supportive, but we are also sceptical because we are now, what, nearly nine, 10 months into the electoral term and we know that the biggest challenge facing our mental health sector is workforce. Yet I have yet to see a workforce plan. Where is the workforce plan and where are the workers that are going to bring about the changes that the strategy will, hopefully, bring to the front line? We haven’t seen that. We know that we are desperately short of workers across the board. We know that despite assurances from the Government that there is no front-line freeze, there are hiring freezes, certainly in my electorate in Taieri, in Southland, where advertisements for mental health nurses have disappeared, where pregnant women who are in the mental health sector—nurses that I door-knocked on the other day—said they could not, as a fulltime-equivalent, get somebody to take over part of their shift because there is an effective hiring freeze. These are the nuts and bolts, or the devil in the detail, of a strategy that will make the difference.

It’s good to have a strategy, and I’d just like to clarify that the reason the Labour Government didn’t include one—originally—is because the other population strategies are around population groups, and the landscape of mental health provision is at risk of becoming cluttered if every single group has a strategy. On this side of the House, we believe that mental health is cross-cutting. It impacts on every part of ora, as the previous speaker Katie Nimon has said. There was no need to carve out a specific strategy, but we have listened to the submitters; we agree that a focus on mental health and a strategy is a good idea. What we are waiting for now is the workforce strategy and the funding to support it and funding to the front line so that the community groups that are so desperately waiting for funding so they can continue the work they’ve been doing at the coalface for the last several decades can continue rather than them fold.

My challenge is to the Government members: thank you for your words, thank you for what sounds good; when are you going to back it up with action? When are we going to see funding? When are we going to see a workforce plan, and when are we going to see an end to the mental health crisis that so many of our rangatahi in particular are calling for? I commend it to the House.

Thank you, Mr Speaker. I rise to take a call on this bill. Just wanting to acknowledge the previous speakers and also acknowledge the Minister and congratulate him for getting his bill drawn. I also acknowledge—as Ingrid Leary has already said—that it’s really great to work together on issues like this in a cross-partisan way if we’re able to. I think one of the most special moments that I’ve had in the admittedly brief period of time that I’ve been in this House for was yesterday with the tributes to King Tuheitia and how we all came together as a House and all came together to sing the waiata. After, I think I literally had tears in my ears.

I’m going to talk a little bit about what this bill does, and then I’m going to talk about what actually makes up components of good mental health, because I think it’s really fantastic that we’re moving towards a strategy that this bill amends the Pae Ora (Healthy Futures) Act to better enable the long-term planning and delivery. That’s important to mental health and addiction outcomes. It’s really important to take the long view when you’re dealing with issues—particularly with mental health issues. There are things that you might invest in that will take a long time to bear fruit. Sometimes you might want to invest in things that won’t obviously bear fruit for another couple of political cycles, and it would be a terrible thing, I’m sure we would all agree, for long-term investments to get attacked on the basis that they’re not delivering immediate outcomes. I think when it comes to thinking about issues like this, we need to make sure that we are thinking of the long game.

This bill does strengthen the commitment to mental health and wellbeing by requiring the Minister of Health to consult with the Mental Health and Wellbeing Commission in the preparation of strategic documents, including health strategies, the New Zealand Health Plan, and the Government policy statement. It’s really important that when the Government and the Minister of Health is actually preparing plans that they consult with the wider sector and that they consult with the Mental Health and Wellbeing Commission, particularly when it comes to preparing those strategic long-term documents, because it’s really important to get that kind of grassroots perspective.

There’s a lot of work on this that’s actually being done on the ground by volunteers or community groups that aren’t necessarily resourced to do so. I just want to acknowledge all the great mahi that goes on in this space, particularly from members of the community to prepare and determine a mental health and wellbeing strategy. I think that one of the things that will make a really big and substantial difference is actually having a strategy—having a sense of direction about where you might want to go in the future—because if you don’t have a strategy, if you’re not planning for things, if you’re not trying to plan in a kind of cross-partisan way, you’re kind of setting up the process to be disjointed. You’re setting up the process so that there’s no coordination between all the kind of different arms of Government, and you’re setting it up so that it can get chopped and changed across the different political cycles—so that’s fantastic. The Green Party has supported this to select committee and there were no significant issues identified at select committee. So we’re going to continue supporting this bill.

I want to talk about what makes up good mental health now, because I want to acknowledge Ingrid Leary’s contribution to this. I do think we definitely need to have a good workforce plan. We definitely need to ensure that the kind of pipeline issues are being resolved. But I think—and I know the Minister will be thinking about this—a lot of strategies just fail at the strategy phase because there’s no implementation plan behind it. So we definitely—

Hon Matt Doocey: Yes—dead right. That’s exactly it.

FRANCISCO HERNANDEZ: Exactly, Minister. And we definitely want to see resourcing behind it. We want to see an acknowledgment of the kind of holistic things that make up health, including secure housing, including making sure that we’ve got a well-resourced public health system that can deal with people and pick up people when they’re down. We want to make sure that there are jobs for young people and, well, jobs for everyone, really—that everyone can end up in secure, well-paid, well-remunerated employment where they’re supported by strong unions and employers that recognise and value the contribution that they make.

I think one of the things that is most important is that we need to have a future worth belonging to so that our mental health can be in a kind of safe and stable way, because there’s a lot of things out in the world that are alarming young people—well, alarming everyone across the board. There’s the genocide that’s ongoing in Gaza, there’s the climate crisis that’s ongoing, and we need to be actually working to resolve those issues, because, otherwise, it’s just band-aid solutions after band-aid solutions.

Thank you so much for acknowledging my call and thank you so much for all the previous speakers in the House. The Greens are looking forward to working with this Government and continuing to work with a cross-party group on mental health to continue advancing mental health solutions in a cross-partisan way. Thank you.

Thank you, Mr Speaker. I’m proud to rise on behalf of the ACT Party for the second reading of the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill, in the name of Katie Nimon. Well done to you, Katie, on having your bill read in the House, but also to you, Minister Doocey—fantastic work on introducing this piece of work to the House.

I am on the Health Committee and I was hearing submissions on this bill and what it will mean in mental health and wellbeing, and healthcare more broadly, and the impacts that people were concerned about and the impacts that people welcomed. I think it’s great to hear the member in charge of the bill referring back to what the select committee came to when talking about health entities. It was obviously something that’s been taken into account.

The Mental Health and Wellbeing Commission should really maintain its independence—that was a core concern of many submitters. It has been addressed by the member—I’m glad to see that. This independence led on to discussions that many submitters had about who’s out there supporting mental health in New Zealand. What’s the rallying cry? Where can we actually look to, to be guided in the way we address mental health in this country? So, again, I commend you—adding a mental health and wellbeing strategy to the list of health strategies already in the Pae Ora legislation is clearly a good outcome.

Look, earlier in the House, we heard from my colleague Mark Cameron about mental health in the farming industry, the rural industry, contractors and alike. Now, I can speak to that as a farmer for years in a beautiful place in the country called Galatea, Kuhawaea Plain. Now, we’re an isolated place with not a lot of amenities. It’s very important that we have things like mental health and wellbeing strategies to make sure we can address what is faced by many people in rural communities who feel isolated, not just physically and geographically but also very often from broader society. Making sure that we speak about people in a way that is uplifting and not tearing them down on any kind of characteristic, be it rural or urban alike, is very important. Having a strategy that will start addressing these things, I hope, is also going to be a huge contributor.

I’m also from the building industry. Now, that’s another industry that has got more than its fair share of problems with mental health. Earlier this week, I attended the MATES in Construction launch of their research in Auckland. We had a great presentation from Minister Doocey on the big screen talking about the importance of people talking about—and mates; talking to mates on construction sites, making sure that you’re actually checking in. This is something that’s come ground up. It’s been brought in from ideas overseas. This is a great thing to bring into the industry.

It’s also going to be incredibly helpful to have a mental health and wellbeing strategy that will help collate and organise these ideas across a broader sector, and a building and construction industry which is open to the plagues of the business cycle. No matter how much certain entities in New Zealand try to mitigate that, they never seem to time it right, so we end up with things that compound upon us in the building industry. In the same way, you’ve got scarcity of work; very often, surplus of work, which actually creates its own stresses—when you mistime things and start pumping activity into an industry, and people feel like they can’t cope, they stop spending time with their family. They just work as much as they can to get it done while it’s there because they know that this mistime is going to mean that there’s going to be a low point that probably didn’t need to happen. The building industry is a prime place that is not really addressed. Mental health and wellbeing hasn’t been addressed in the other strategies; the building industry, farming—I guess you could say the rural health strategy addresses it—but having that mental health and wellbeing approach that can go across industries and across sectors is going to be a huge benefit.

I’d like to finish this up and just say I appreciate, Mr Speaker, you giving me this opportunity to expand on something that isn’t talked about. You know, we’re bringing farming forward in this House, and I think it’s time that the building industry and the challenges it faces are also addressed. Thank you, Mr Speaker, I commend this bill to the House.

Thank you, Mr Speaker. It is a privilege and an honour to speak to the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill, and I’d like to begin my contribution this evening by acknowledging the member Katie Nimon. Well done; congratulations. I look forward to the progress of this bill through the House, acknowledging also Minister Doocey for writing up this bill in the first place, previously. He gets to speak on your bill as well, so congratulations to you.

As part of the Health Committee, we heard a number of submissions on this bill, and I’d just note also that the member Katie Nimon has spoken to the number of amendments that were recommended by the committee. I’d like to, following hard on the heels of fellow Health Committee member Cameron Luxton, talk about FirstMate. FirstMate is in the seafood sector, and this is a charitable organisation for those in the fishing industry—the seafood sector. There are a lot of challenges being out at sea, and this organisation supports people by providing free counselling sessions for those that are facing mental health challenges in the seafood sector.

I do rise to voice New Zealand First’s support for this bill. This addresses an issue of critical importance to New Zealand: mental health. The rationale behind this bill’s introduction is admirable. We are, in New Zealand First, committed to improving mental health outcomes in this country and are very proud to have been part of greater funding being secured for the I Am Hope Foundation, for Gumboot Friday. We’ve heard a range of useful submissions on this bill through the committee and agree with the recommendation to remove the classification of the commission as a health entity. This recommendation allows for the commission to maintain its independence, which is critical for it, and, therefore, the effectiveness of its oversight role.

Mental health is an issue that every New Zealander must deal with, whether for themselves or maybe someone close to them, a colleague, or even someone in the community that they’re part of. Mental health is at the core of every person. We have a nervous system and a brain and a capacity for decision making that’s guided by really powerful internal forces that are part and parcel of biological life. There are fears and desires that unconsciously guide us—the neurochemicals that power through our brain, which cause pleasure or pain or boredom or despair. The design of our internal motivating systems are essential features of our human nature and, without it, our species would not survive. But, whether we like it or not, we’re all subject to the feelings that we experience, and there are only a few ways to escape from them.

People who do try to escape from their unwanted feelings often get stuck either in drugs, alcohol, or risky behaviour of some kind to dull their pain or, worse, in attempting to end their lives. We do have too many acutely and chronically unhappy citizens and too few with the skills and understanding to care for them. The challenges to mental health come at us from every direction. Everything can become a mental health issue, especially when we have depleted our reserves and are at the limit of our capacity to continue. It’s in our own interest to reexamine our thinking about how best to care for and restore people to functional mental health.

It was a privilege, in the 52nd Parliament, to be part of the initial cross-party mental health and wellbeing group, and it was really there, through that group that we established cross-party, that we were really able to raise the issue of, in particular, suicide. I just would like to note our member of Parliament colleague who spoke in this House today about his own son’s passing—very moving, and aroha to him and his whānau.

When this bill was first drawn, the Mental Health Foundation made a couple of statements which I think are really important for us to note. They said—and I quote—“We simply cannot help one person at a time through services. We need population mental health and wellbeing approaches to help all New Zealanders to be well and to stay well, and without a mandated strategy decisionmakers could simply revert back to using outdated but deep-rooted deficit models around mental health and addiction and focus on solely expanding services, an approach that can’t and hasn’t solved our wellbeing crisis.”

We heard from around 57 interested groups and individuals through the submissions process, and hearing those submitters—19 oral evidence hearings that we held in Wellington. There was a number of recommendations that were put forward. I won’t traverse those, but just a couple of the submissions I’d like to mention: one was from Women’s Refuge, and their feedback—obviously, Women’s Refuge has specific data, research, and evidence as well as decades of experience of our senior practitioners in supporting women and children who experience family violence, because family violence is a hidden cause of poor mental health and health outcomes. Half of all women patients accessing mental health care are victims of current or recent family violence. Childhood exposure to family violence is implicated in one-fifth of youth suicides. One in nine women victims sustains a brain injury related to domestic violence, which then doubles the likelihood of developing mood disorders and exponentially increases the risk of suicide.

Federated Farmers—and we have been talking about our rural partners here and poor mental health—submitted as well in great support of this bill, along with the recommendation that geographical considerations form a requirement of the mental health strategy’s preparation, so as to ensure that rural communities’ outcomes are considered distinctly from those of urban populations, and I think we have heard that message very clearly today.

Save The Children also spoke about Government being obligated to uphold the rights of children under the Convention on the Rights of the Child, and the development of a new health and wellbeing strategy presents an important opportunity to fulfil this commitment. They believe that the most important issue affecting young people is mental health, and they really support a holistic approach to mental wellbeing. These are just a couple of the submissions we heard from and read through the process.

So, really, in conclusion, there are a number of ways that we can support people, whether it’s developing more workforce, whether it’s developing a new strategy, but I think it’s something we all in this House agree is important work for all of us to consider, and that we are able to work in a way that is bipartisan to make sure that the wellbeing of all the people in our communities is at the forefront. Therefore, I’m pleased to commend this bill to the House. It lays a strong foundation for a comprehensive and effective mental health and wellbeing strategy. Thank you, Mr Speaker.

The next call is a split call.

Tēnā koe e te Pīka. First of all, I stand for Te Pāti Māori to support the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill. What I have to offer to the discussion is as an electorate MP for Te Tai Hauāuru, which spans from Tokoroa all the way down to Porirua, around about a 9½ hour drive straight, if you don’t stop for chips. One of the things that we’re continuously being contacted about by constituents is the mental health system—how frustrating it is to navigate, how there is no system, how our w’anau are struggling for support, how they’re struggling to be diagnosed, how they’re struggling to have any advocacy. And if there’s anything that I would absolutely stand 150 percent in support of, it is a Government that can get this right.

For four years now, I have had to stand and talk to different parts and different Ministers well intending on the mental health system and the changes and, indeed, the improvements that they want to make. But the reality is, for many of our w’anau, including in my own, you have to have some of the biggest navigational skills to actually get your w’anau member seen to. In fact, you end up with not just one family member who is unwell and needing support, but the whole w’anau, and then it becomes the whole community. And I see the Minister wearing the 1757 badge. I was a director in that entity for the sole purpose of hoping that I could make a difference and a change for rangatahi, who are shamelessly, on us as a nation, experiencing some of the worst suicide rates, and I reflect back home to some of our w’anau that are all in grief as w’anau pani, for the loss of many of our rangatahi tāne.

The circuit breaker for us as a community regionally hasn’t, in Te Tai Hauāuru, from anyone who I can speak to, been realised. And w’anau are struggling, not just struggling because they can’t access or even see anyone on the front line, more or less a back line—there are a whole lot of other social factors that are exacerbating the desperation of our w’anau on a day-to-day basis. I’ve heard some of it mentioned over here—the poverty, the w’anau struggling to pay bills; the uncertainty in sectors; the housing; the abuse; the trauma; the addictions. But the reality is, we all have an obligation.

There are many solutions that we’ve seen on the ground but there’s not enough of them. For some, Whānau Ora, Māori health providers, iwi, hapū, and marae are starting some of their own initiatives. I’m in real awe of what’s happening with our farmers and the surfing initiatives that are happening, because these are things we were actually addressing and connecting our w’anau to our environment, because it is an environmental issue, a physical issue, as much as it is a mental issue. I think what’s really, really frightening is we’ve had some amazing kaupapa like He Arotake and Te Akai Whai Ora and the suicide prevention, and I think the six recommendations—they are all really good initiatives—but the reality is, as much as we resource and target, we also, within ourselves, have a role and responsibility.

I heard earlier the kōrero of ora. Currently, our w’anau aren’t feeling ora coming out of any of us and particularly this House. There’s a whole lot of attacking going on, which isn’t helping the grassroots situation. I guess what we all need to be thinking about is what our role in this is, and it’s not just the Minister and the legislation. The reality is that we are contending with an environment that is affecting our people, whether it be an anti-Tiriti, an anti-environment, a fast this or a removal of that. We are all responsible for the wellbeing of each other and our communities. While it’s important that we get this right and we resource everyone right and we find services that are able to be accessible, we also have to remember we’re responsible for the wellbeing of each other’s ora, and how we behave and what it is we do outside of just this amendment impacts on our communities.

I cannot think of a better message to use right now: we all deserve to live well and we have the ability to influence that and use our sphere in a responsible way. Nō reira, tihei mauri ora! Kia ora rā.

Thank you, Mr Speaker. I’d like to acknowledge the kotahitanga in the House today, the unity and the support for each other, and the people we know in our communities and our own whānau that suffer from mental health and their families that suffer with them, and the difficulties that workplaces and schools have when one or more members suffer from bad mental health. Mental health is not something we can vaccinate against. Mental health is not something that is always biological or genetic or predetermined. Mental health is also something that is a bigger social society issue.

I’m really pleased that we’re talking about men’s mental health. Whether it’s professions of farmer, builder, fishing—yes, those—it’s great that that’s able to be recognised and talked about, though I still think that individuals in those areas have great difficulty realising that it’s not just them, that they are able to ask for help whether it’s from their whānau or from the professional support.

I’d like to acknowledge the mention of family and sexual violence as a causal factor in people’s mental health. Often poor mental health is a natural response to pressures, and I’d like this House to consider to what extent we are adding to those pressures from time to time. And, yes, that is a thing across the House—how we behave to each other—but I’m more meaning in terms of the legislation that we produce and the way we talk about groups of people. One of the most vulnerable groups to poor mental health is people who are non-binary, not just when they are adolescents finding their identity but also as adults. Nominally, they’re much more accepted, but if you look at the statistics, they often feel oppressed and not part of mainstream society. I think we need to think about when we’re producing legislation that discriminates, what are we actually doing for mental health. Mental health is much bigger than just the professionals and the funding in the health sector.

While I acknowledge, and I’d like to acknowledge, Minister Doocey and his work in clearly setting out some of the issues in mental health, let’s not forget some of the more traditional issues of mental health that may be temporary but may lead to permanent tragedy: postnatal depression, menopausal changes, and, of course, the effects of dementia and ageing. There are a huge number of issues and I think it’s going to be very interesting to see how this strategy can possibly prioritise across them. That’s not to say it shouldn’t be done; I just think it’s going to be extremely difficult.

My colleague Francisco Hernandez did also mention some of the issues that press upon, again, particularly young people, which is what kind of a future they’re going to have—are they going to have a future? Some people might think of it in terms of can they buy a house, but I think there is some more existential issues at play in whether they actually feel they have hope. I think that that is not necessarily a criticism of other parties. When our party paints a dark picture of something like climate change, we also need to talk about how people can actually have agency and hope as well. There’s some pretty wide ramifications to mental health.

I look forward to better access to diagnosis, appropriate medicines, support at school and, later on, and—above all—a less divisive and more inclusive society. Thank you, Mr Speaker.

Thank you very much, Mr Speaker. It’s a real pleasure and a privilege to rise on behalf of the Government in support of the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill in its second reading.

Look, it feels a long time ago that I sat on that side of the House, watching the then Labour Government putting together their big flagship reforms of the Pae Ora health reforms, and going and listening through their strategies and understanding that there was going to be no mental health strategy. It was interesting at the time; the Mental Health and Wellbeing Commission and the Mental Health Foundation came out and said that mental health was invisible in those reforms. It felt the right thing to do at the time, to put in a Supplementary Order Paper, which the then Labour Government voted down, which made me more determined to put forward as a member’s bill what we’re getting back today from the select committee.

I probably did the easier part of putting an idea in a biscuit tin, but I just wanted to acknowledge the fantastic work of Katie Nimon in sponsoring this bill through the stage of the select committee. I want to acknowledge her speech in leading off the debate tonight—the tone of the speech, how parliamentary it was, talking to the issues that we are debating tonight. I want to thank her for her sponsorship, which, I think, has made this bill clearly turn up in a better shape than it first probably started when I wrote it. There were a few drafting errors, so I’ll hold my hands up to that, but that’s the reality of why we go through a select committee process. What I do know from reading the departmental report: there were 56 submissions. There was an ability for people to have their say, to come and have their oral submissions, and to be heard.

One clear theme that came through the submissions is those with lived experience who wanted their voice to be heard, because, of course, when there was no mental health strategy in the original bill, people did not feel heard, they did not feel listened to, and they did not feel valued. We can come up with all the apologist excuses we want of “Oh, it was supposed to be around population groups.”, but, sadly, when you look at the life expectancy of people with lifelong and enduring mental illness, it’s one of the greatest reductions we have out of any grouping of people. Quite rightly, it’s fair that we prioritise them today with this mental health strategy.

It was important to hear those with lived experience being able to give their view through the select committee process. That’s why one of the first things this Government did when it came in was to announce a new peer-support and lived-experience service based out of emergency departments. We know that is an under-utilised workforce that can connect with people in a time of crisis and allow that person to be listened to and heard by someone who’s been there themselves. It was great to hear that lived-experience voice come through the select committee as well.

I do want to acknowledge some of the other speakers tonight. Debbie Ngarewa-Packer spoke about the inability to navigate through the services, which is exactly the issue we have. Our services are fragmented. They need to be joined up, and, quite often, people under mental distress or mental illness don’t have the literacy to engage in services that maybe others just expect people to have. It is important—and I hope through the strategy—that we do look at how we join up our services, because I’m actually one of optimism that I’m in a privileged position to see, as I travel around the country, that we have a great range of services out there. The problem is they’re very disconnected, very fragmented, and people don’t know how to navigate their way through them.

Also, Francisco Hernandez from the Green Party—a new member of Parliament to this House, but I think he nailed it very quickly. The last thing we want is another strategy. We got that after the last Government’s mental health inquiry—58 or so recommendations that sit on someone’s shelf somewhere. It isn’t about a strategy. What Francisco Hernandez says is that it’s about an implementation plan. That’s why I value the amendment that’s come back around the commencement date of 12 months, which gives time to understand and put together that implementation plan, because when you look at the current mental health strategy, Kia Manawanui, you read it and you don’t disagree with any of it. It all makes sense, but the problem is it can’t tell you what’s going to happen by what date. That’s what the sector is calling for as well—a clear plan, how we’re going to join up the services, and how we will implement and deploy them as well.

I just want to acknowledge Jenny Marcroft from New Zealand First, who talked about the conception of the cross-party mental health group. It’s brilliant to hear some of that coming through in the debate today as, fairly, most speakers are coming together in support, because that’s where the genesis of this happened.

I acknowledge the Health Committee chair, Sammy Uffindell, for the great work he was doing. It was Jenny Marcroft, Louisa Wall, Chlöe Swarbrick, and myself on that Health Committee. When we started working more collaboratively together and getting together to talk about the issues, then we started saying, “Hey, there’s something here. Shall we go off and look at joining our first cross-party mental health and addiction group?” It’s great to see that that group has continued under the chair of Chlöe Swarbrick as well. That’s why this is important, because I think the public expects us to take cross-party support.

What I do hope for this bill, once it’s passed, is for the fruits of it to be an implementation plan. Quite clearly, what we need to do is increase access to timely mental health and addiction support in New Zealand. We need to grow the mental health and addiction workforce. The biggest barrier to timely care in mental health and addiction services at the moment, in my view, is the workforce vacancy rates that have ballooned over successive years. The Labour Opposition can crow that we don’t have a workforce plan, but the reality is the Auditor-General, who I wrote to in Opposition to investigate mental health after the failings that come out of the Mental Health Commission’s report—that actually turned up at the start of this year, saying we did not have a workforce plan. It beggars belief that in the six years of the last Government, we had no plan. So, fair challenge in our first nine months, where is the plan? But have some reflection of why you didn’t have one in the six years when you had a chance to make a difference.

Of course, we need to strengthen the focus on prevention and early intervention and improve the effectiveness of our services. One thing—and the Prime Minister sets this from the top—is that this Government will hold itself to account. We will be accountable, and we will quite rightly be accountable to the New Zealand public over this term. I’m very aware as New Zealand’s first mental health Minister—and let’s be very clear—that nothing has changed, because someone has a job title. But, hopefully, with what we use this role for, there will be a high level of expectation where I will be accountable.

That’s why there’s nothing more accountable than setting very clear targets, and that’s what this Government’s done—the first time ever in this country for mental health: 80 percent of people to access primary mental health and addiction support within one week; 80 percent to access specialist mental health and addiction support within three weeks. The Scottish target is 18 weeks. We’ve just set a target of three weeks, and we’re not going to settle for the national average. It might say we’re reaching 80 percent, but I guarantee if you scratch the surface and go into an area like Northland, it won’t be. We’ll have to go in and raise Northland to 80 percent. We’ll have to go in and raise Māori to that target of three weeks as well, to young people and other population groups and distinct groups. Think of rurality. That is holding ourselves accountable. We’re going to set very clear targets around one-week access to primary support, three-week specialist, six hours wait time in the emergency department. We’re going to train 500 new mental health professionals every year, and we’re going to ring-fence 25 percent of the mental health and addiction workforce budget on prevention and early intervention.

We’ll hold ourselves accountable, the performance reporting will be for New Zealanders to see, and they will make their decisions on whether we drove mental health forward in this country over this term. Thank you, Mr Speaker.

Thank you, Mr Speaker. It’s a pleasure to rise on the second reading of the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill. Can I, like others, also join in congratulating member Katie Nimon on bringing this bill, and I want to thank you, Ms Nimon, for the way in which you engaged with the Health Committee. I felt that all of our questions, no matter which side of the committee chair we sat on—or committee table—were heard openly and considered fairly in your consideration of your bill. There was no self-indulgent engagement in chipping around some of the history of this issue, so congratulations to you.

I want to focus my remarks on some of what, I guess, we might see in the future as this bill progresses to a strategy. Firstly, it’s to remind colleagues of the structure in the Pae Ora (Health Futures) Act, that surrounds strategy. Strategies don’t exist in isolation. The statutory strategies are required to be consulted on, as is this one, and I was lucky to be able to see the results of the consultation of the original strategies, and really heartened by the interest that members of the community took in sharing their views with officials, that were then presented to me on how they want their health and health services to be. That opportunity is really precious. I learnt a lot about how people see our health system through that process, and, no doubt, we’ll see the same when we do that engagement again.

The purpose of the strategy is then to inform the Government policy statement (GPS). The Government policy statement has already been released by this Government; that’s the first one that’s existed because the pae ora legislation is new. That sets out what the Government wants done, based on those strategies in the health system. That GPS—it’s then the responsibility of Health New Zealand—Te Whatu Ora to use those expectations set by the Government to write a health plan, and that health plan lasts for a three-year term. It’s funded through the three-year Budget that was also set out by the last Government—and good to see continued by this one, though at an insufficient level of funding.

The result of that is that this strategy should have really strong connection to the decisions about service provision in our health system. That is the underlying function of the pae ora Act. It means our health system stops going from one-year initiatives to the next; one Budget, one single-year Budget, to the next. It means we’re finally able to plan and get on top of some of the long-term health system challenges. So this is a positive step to have a strategy. But how will the strategy impact the GPS if it’s already been published? That is a question of mine from select committee that has not been answered. Will the GPS be rewritten in light of this strategy, and, if not, what is the point of the public coming forward and giving their perspective on the strategy?

Will the health plan, which is delayed—it has not been published on time by Health New Zealand—is that plan awaiting this strategy? That would mean it would be very delayed, or will it be amended in light of the strategy? That’s an important consideration, and Te Whatu Ora’s budget-setting—will that be altered in light of the strategy; if not, why are people putting all their effort into submitting on a strategy where the fiscals won’t change around it? So those are important questions and, no doubt, we’ll pursue them in the committee of the whole House stage for this Budget.

Colleagues in the House tonight have already mentioned the importance all New Zealanders place on being able to access services, and I’m very proud of the progress we made in Government, in the Labour Party, of being able to roll out the first primary mental health access and choice system, which, by the time I was Minister, had addressed its issues with understaffing and had already reached 1,000 visits. Now it has over 600 and perhaps over 700 sites nationwide. It’s available in primary care services, particularly for Māori, Pacific, and youth, as well as in general practice. It’s a real treasure and something special that was achieved in a short period of time and during a pandemic.

I’ve heard others talk about healthy environments of all kinds and how much that matters to mental health. That came through really strongly in the submissions we received as a committee. This means environments of all sorts: the housing environment—people’s housing security impacts mental health—their employment rights impact mental health; their experience of social inclusion, as has been discussed by others tonight in relation to the rainbow community, also, experience of racism. Those things impact mental health, experience of addiction, adverse child experiences. I frequently was given cause to think about that when I read the findings of abuse in State care and realised how much of a scar that left on the mental health of our nation.

Those are some of the themes that came through in submissions and I hope, despite the relatively narrow focus of the Government’s GPS, that we are able to have the inclusion of these very important influences on mental health included in the strategy.

Another thing that came through in the public submissions in the last set of statutory strategies was what I might call “health and human rights”. You could call it patient rights, but I think health and human rights is perhaps a more inclusive term. The human rights of people that they enjoy in our health system matters deeply to them. Nowhere is that more true than in mental health. Some of that is governed by the mental health Act, but some of it is also governed in how we operationalise the delivery of services. The pae ora framework, prior to this amendment, already requires health entities to report annually on how they are giving effect to the code on consumer engagement, and I am hoping to see that continues to flourish as we see more and more consumer voice and whānau voice in our health system.

By way of conclusion, I want to reflect on some of my recent experiences. It is humbling to grasp the enormity of some people’s suffering when they struggle with mental health conditions. In my life as a family member, friend, and as a doctor, I have had cause to feel that my efforts to comfort and alleviate that suffering are inadequate. It’s heartening that we can agree on this bill. Let’s go forward on these matters with honesty and sincerity and let’s make sure that our actions in relation to this truly have meaning.

Before I speak on this bill, I would like to acknowledge my parliamentary colleague ACT Party MP Mark Cameron for sharing his personal pain with us earlier today. Mark, as a father, my heart goes out to you. The loss of your son to suicide earlier this year serves as a reminder to everyone who sits in this House that mental health is a serious issue and there is so much more we need to do. As Mark mentioned before, mental health should always come before politics. Thank you for being so brave, sharing your story to help others. I would like to take a moment of silence to acknowledge both your son and your courage. [Moment of silence]

I stand in this House to support the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill. I would like to acknowledge my colleagues the MP for Napier, Katie Nimon, and the Minister for Mental Health, the Hon Matt Doocey, for all their hard work to bring this bill to the House. This bill amends the Pae Ora (Healthy Futures) Act 2022 to better enable the long-term planning and delivery that is required to improve mental health and addiction outcomes.

The pae ora Act 2022 currently does not adequately provide for a mental health and wellbeing approach. When the bill was first introduced by the previous Government in October 2021, we advocated for the inclusion of a mental health and addiction strategy under the legislation. The purpose of the mental health and wellbeing strategy is to provide a framework to guide health entities for the long-term improvement of mental health and addiction outcomes. These strategies can provide clear direction and a framework for the development of a holistic and transformative approach.

Whilst the other strategies were specific, mental health and addiction was not included. It is good that this omission will now be rectified. This bill strengthens the commitment to mental health and wellbeing by requiring the Minister of Health to consult with the Mental Health and Wellbeing Commission in preparation of strategic documents including health strategies and the New Zealand Health Plan and the Government policy statement, and to prepare and determine a mental health and wellbeing strategy. This means the Act will be amended to better enable the long-term planning and delivery that is required to improve mental health and addiction outcomes. Because we believe that our people deserve better and we must do better.

Mr Speaker, let me remind you why this bill is so important: because over half of the people living in New Zealand have experience with mental illness and addiction challenges at some point in their life. Nationally, one in five people have experienced some kind of mental illness in the last year, and 3 percent experienced a serious mental illness. Half of those who developed a mental health disorder have problems evidenced by the age of 15 years old. People diagnosed with a mental disorder have a reduction of life expectancy of approximately 15 years, raising to 20 for those diagnosed with a substance use disorder. Earlier this week, Tuesday marked World Suicide Prevention Day. Here in New Zealand, 565 New Zealanders took their life by suicide in 2022 and 2023. However, the true impact is so much more than the 565 people: each and every one of them is someone’s son or daughter, brother or sister, friends or colleagues, taken too soon in devastating circumstances.

I genuinely believe this bill is a step in the right direction towards ensuring mental health outcomes improve in New Zealand. This is why this Government employed New Zealand’s first Minister for Mental Health. I need to acknowledge the work that Minister the Hon Matt Doocey is doing to fix a broken system, often trying to help broken people.

Earlier this year, Minister Matt Doocey announced five key targets for mental health. They are, first, faster access to specialist mental health and addiction services; second, faster access to primary mental health and addiction services; third, to shorten mental health and addiction - related stays in emergency departments; fourth, to increase mental health and addiction workforce development; last but not least, strengthening the focus on prevention and early intervention. We try to target 25 percent of mental health and addiction investment to be allocated towards prevention and early intervention. I believe the Minister, for setting such an ambitious target, will make a real difference to New Zealanders who need help.

Also, I would like to acknowledge the work Minister Matt Doocey is doing with our Minister of Police, Mark Mitchell, to transition to a stronger mental health response for people who need crisis mental health support. I agree with the Ministers: for too long, those seeking crisis support have often been met by a uniformed officer, which can cause further distress. People in mental distress are not criminals. Those seeking assistance deserve a mental health response rather than a criminal justice response. This is why it’s extremely disappointing the mental health call response service was cancelled by the Labour Government. The previous National Government had announced $8 million to trial sending mental health workers on crisis call-outs, but, unfortunately, under Labour that funding was cut. We are prioritising mental health, and this is clear in the action being taken now alongside works under way to implement a five-year transition plan to a multi-agency 111 response.

Before I conclude my speech, I would like to draw everyone’s attention to this upcoming New Zealand Mental Health Awareness Week. It will be held from Monday, 23 to Sunday, 29 September. This year, the theme is “Community is ... what we create together.” We need to raise awareness. I encourage every one of you to start the conversation, because every conversation contributes to a supportive and understanding society and creates a better culture of support.

Finally, to all New Zealanders, but especially my constituents in Mt Roskill: this bill will pave the way to a brighter future and ensure more New Zealanders have access to mental health care when they need it. This bill, along with other measures this Government is undertaking, will save lives. I commend this bill to the House.

The next call is a split call.

Thank you, Mr Speaker. It is a pleasure to take a call on the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill. And can I also join with colleagues in the House tonight on congratulating the member in charge of the bill, Katie Nimon, on guiding the bill through this process.

Other members have also just acknowledged our colleague Mark Cameron today and just recognising the loss that he and his family have had with the loss of their son. I don’t think there’d be a single member in this House who hasn’t been touched by mental health in some way, whether that be someone who has suffered in their family, a friend of a colleague, or has lost a person. I was 18 years old when I first lost someone to suicide—one of my closest friends—and sad to say not the first person and probably won’t be the last. I think it’s a shared experience that all of us have in this House and why these matters are ones where we do take real care in the comments that we make and do our best, I would hope, as a Parliament, to work together to ensure that the strategies and services offered by Governments are those that all New Zealanders can benefit from. I thank members for what has been a considered debate tonight.

I wanted to touch on a couple of things around, I guess, the impact of the bill. The bill specifically looks at ensuring we have strategies around mental health. But, as my colleague Ayesha Verrall touched on earlier, what is also important is that those strategies lead to policies and outcomes for people. While the Minister is in the House, I did want to take the opportunity just to share a couple of recent reflections that have been raised with me from members of the sector around services that are being developed where I think there’s feedback that probably needs to be shared. I do this, I hope, in a constructive way.

I hold the arts portfolio for the Labour Party. A couple of weeks ago I had the benefit of attending the Arts Access Aotearoa conference and met with a large number of providers who provide art support to people with disabilities and, actually, a large number of people with mental health. We have one service provider in Nelson called Magenta, who are an amazing service provider that provide art and mental health support to people with mental health and disabilities.

One of the concerns raised was around the recent mental health innovation fund—and a good fund; it’s a good programme. One of the concerns raised was that the requirement to have matching funding sitting in bank accounts was actually prohibitive, particularly for rural, regional community-based organisations that actually do exactly that—they innovate. We see people who go and are able to express themselves through art, and, actually, it significantly helps their mental health. I wanted to take the opportunity, just in the short contribution I have, to raise that we need to ensure, as Mark Cameron said earlier today, that the services we are providing in these areas do actually reach into rural and regional and provincial areas that often have different and unique needs to how we may deliver services in the major centres.

I had the opportunity on Friday to visit our mental health unit at the hospital, Wāhi Oranga, and meet with some of the staff there. What was really good to see was a refurbishment that’s happening at the unit where we have new rooms and the whole design of the unit has been changed to actually assist with where people arrive and how they’re treated when they first arrive. I’d love the Minister to actually go and view that. I think it would be a good change for him to go and see in Nelson at the hospital there. I was also really pleased to see and to hear that the use of seclusion, which had been very high in this unit, has dropped, and, actually, the number of assaults on staff has dropped—two things that had been raised with me.

I also just want to acknowledge that Nelson was actually one of the first centres to introduce peer support at the emergency department a few years ago, and we also rolled it out to young people as well. The next step that we took a couple of years ago was to roll it out to young people. I think it would be great for the Minister to come and see some of the amazing innovations we’re doing in Nelson that I know have been rolled out around the rest of the country. Congratulations again to the member, and I commend this bill to the House. Thank you.

Thank you, Mr Speaker. I’d just like to join with the rest of my colleagues in acknowledging colleague Mark Cameron in his loss and the profound sense of, just, bewilderment and the tragedy that it is.

I’m very much in support of this amendment bill. It was an interesting position being the deputy chair of the Medical Association when the pae ora bill was first going through, and we recommended in our submission that if you’re going to do a whole lot of different strategies, you need to include all of them. Maybe we just needed a health strategy instead of all of these different ones, because, otherwise, everybody wants to have their own strategy. Anyway, here we are.

Other colleagues across the House have acknowledged the wide contributions and the very complex nature of the causes of mental illness. I think that the more we understand, the more we see that there is no such thing as any difference between a physical condition and a mental condition; they are all interwoven and are all connected.

I’d like to acknowledge my friend and colleague Katie Nimon for shepherding this bill through the House, and congratulate her on this great work—and also Minister Matt Doocey, the first Minister for Mental Health. Yes, one person doesn’t change everything, and it’s very important that we acknowledge that. I’d also like to acknowledge the wider Health Committee for their progressing this through, and all of the people who made submissions throughout the process.

The Minister really nailed it when he said it’s about implementation, so, for all that, it’s really important to have the strategy and to outline things. The really fundamental thing that people care about is how we deliver that, how we implement, and then, also, how we hold ourselves to account—how we use the information that we have to be able to show that the investment that we’ve made has been worthwhile.

I highly recommend members read the Mental Health and Wellbeing Commission’s recent report into how the $1.2 billion was spent—

Katie Nimon: $1.9 billion.

Dr VANESSA WEENINK: Sorry, $1.9 billion. Thank you for your correction. That is really useful information. But part of the challenge is that it doesn’t address—it can say where the money was spent but it doesn’t say the impact that it had. For example, one of the key things that needed to be addressed was access to specialist mental health services, and one of the ways that we can address that is to look at the workforce and the number of fulltime-equivalents (FTEs), and so forth. What this report was able to show was where the spending had occurred, but it wasn’t able to tell us how many more FTEs we’d had for that availability. In some areas, we were able to say how many people had been seen and how many appointments people have progressed through, for example, the Access and Choice programme, but there’s little explanation of what impact that has on reducing people’s anxiety or depression symptoms. I think that we’ve got a long way to go.

Strategies and targets are really important, and the Minister has outlined a very, very ambitious target of access to specialist mental health services within three weeks, which will be a massive change from the current situation—and also to have that be similar across the country, because, at the moment, we have huge geographical disparities in access. For example, in Canterbury, the wait time for some of the children’s mental health services can be anywhere between eight and 18 months, depending on the underlying conditions.

Really, this strategy, for me, is going to be about how it helps the people who are served by this, but also the people who are working in the sector. I just want to do a quick shout-out to all of my colleagues in general practice who are doing the bulk of the work of diagnosing and treating psychiatric illness in this country; my very under-the-pump psychiatrist colleagues as well, who are very challenged; and all of the Allied and nursing workforce that also support them. I commend this bill to the House.

Thank you, Mr Speaker. I’m very pleased to rise and take a call on this bill, the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill.

I first want to acknowledge, like many of our colleagues across the House, the sponsor of the bill. I also want to acknowledge our colleague on the other side, Mr Mark Cameron, for him and his whānau and aiga’s loss quite recently; it is a very tragic matter when one loses a valued member of your family.

I’d like to acknowledge and take the time to also acknowledge the Health Committee, and in particular the submitters and the opportunities that submitters have to bring forth their circumstance or their experience. I’d also like to acknowledge—just very quickly—Ingrid Leary, who is the spokesperson for Labour and continues to remind us, on this side of the House, of our many citizens across the country that deal with mental health.

Labour supports this bill with caution, and I have questions for the House that I’d like to bring from a more local perspective. I’ve heard colleagues right across the House tonight raise a number of those who are vulnerable in our communities, and I want to focus my comments particularly on my local community in Māngere, particularly the youth. I’ve spent the last 4½ months speaking with vulnerable youth who are facing mental health issues that the current Government may not have a good understanding of, or officials.

It is important that the wellbeing strategy that is being talked about and that is being offered are the mental health and addiction services. They’ve got to get it right, particularly for Māori, Pasifika, and ethnic youth who—in my community, poverty is an example where sometimes those young people are the very ones that the system or strategies or papers comment on. But, for the real-life factors in our local communities, the mental health issues are really important. They have a lot of questions, our young people. Māngere has a very high population of young people in our community, and one of the things that many of our young people face is the vulnerability of suicide, because when they cannot get answers for questions from the adults that they rely on, they turn to each other, and they sometimes just do not have those resources.

I want to raise that when systems or strategies do not adequately provide or understand the language of our young people who come from vulnerable backgrounds, then we, as a society—or we as a Parliament in this House—have got to get this right and we’ve got to work together. Labour did a lot of work, and I’ve already heard some criticisms, however, in Government—and that’s that side over there. It is important that we, as members of Parliament who have the privilege to speak in this House, continue to raise those issues on behalf of our community.

In the talanoa that I’ve had in the last—that’s kōrero; that’s meeting with young people and also those from the disability sector. They are very alarmed that the people in Wellington or those in different ministries like the health ministry do not understand some of those issues on the ground. They look to their local representatives to come into our offices to voice what they find in terms of the vulnerability—whether it’s poverty, whether it’s housing, whether there’s just not enough pūtea in their kete week to week. This bill focuses on that in terms of the long-term planning and the delivery.

I’ve heard colleagues on this side of the House talk about the workforce. I want to stress that the workforce has to have the ability to understand our young people from different parts of society and different parts of the community. At the youth talanoa in Māngere, what they’ve said is there’s three issues that are really important to them. Less than 100 young people from different parts of the community in Māngere—they talked about three issues that they are contending with. The first issue is mental health; that’s right up the top of their list in terms of trying to cope as a young person here in Aotearoa. Mental health is not just for them as an individual, but mental health—there are issues in their whānau, in their aiga, and just not being able to reach adequate services or talk to a qualified social worker around those issues—the issues that they face in terms of poverty and not having enough, or just their housing, their wellbeing. I wanted to raise those things on their behalf.

It is important for the workforce to be trained, and, in particular, I just want to say to you, the Minister, that is really important in terms of getting that strategy right, because those citizens in my local community have the lived, day-to-day experience of the things, and the early intervention for the young people in my community is really important.

I just wanted to finish my comments on the solutions that are offered to the young people: that we need to have a really good workforce who are able to connect, who are able to listen, and who are able to offer really good solutions because they understand our communities really well. Thank you.

Thank you very much, Mr Speaker. It gives me great pleasure to rise as the final speaker on this bill. I am speaking in support of the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill. This legislation represents a really critical step forward in prioritising mental health and wellbeing for all New Zealanders, and the core purpose of the bill is relatively straightforward yet quite profound: to amend the Act to require the Minister of Health to determine a mental health and wellbeing strategy. This may seem like a relatively small change, but its implications are far-reaching and vitally important for the future of healthcare in our nation.

For too long, mental health has been treated as secondary to physical health in our policy frameworks and healthcare systems. This bill seeks to correct that imbalance by enshrining mental health and wellbeing as a key priority at the highest levels of our health strategy. The need for this focus could not be more urgent. According to the New Zealand Health Survey, in just the six years leading up to 2023, there was a staggering 92 percent increase in Kiwis reporting unmet mental health needs. This is a health crisis, and this is a crisis that demands our immediate and sustained attention. This bill builds on the groundwork laid by the report of the Government inquiry into mental health and addition and Kia Manawanui Aotearoa, our long-term pathway to mental wellbeing. It provides the legislative framework to turn these aspirations into concrete action.

I also want to acknowledge the broad support this bill has received from mental health advocates and organisations across New Zealand. The Mental Health Foundation, Emerge Aotearoa, and the Mental Health Advocacy and Peer Support trust have all emphasised the critical importance of explicitly prioritising mental health in our health legislation. The Mental Health and Wellbeing Commission in particular has noted that mental health was “almost invisible” in the original Act. This amendment corrects that oversight, ensuring that mental health and wellbeing are given the prominence they deserve in our health strategy. It’s also worth noting that this bill represents a bipartisan commitment to improving mental health outcomes. When the Act was first going through Parliament, in 2022, the National Party, through Minister Matt Doocey, proposed a similar amendment. While it wasn’t accepted at that time, I’m pleased to see that we now have cross-party recognition of the importance of this issue.

Let me outline some of the key provisions and changes recommended by the Health Committee. Firstly, the committee has recommended that the mental health and wellbeing strategy provisions come into force 12 months after the bill receives Royal assent. This gives the Ministry of Health and other relevant bodies time to prepare for implementation. Secondly, the committee has wisely recommended removing the provision that would have designated the Mental Health and Wellbeing Commission as a health entity under the Act. This change preserves the commission’s crucial independence, allowing it to continue in its vital role of monitoring and holding the system accountable.

Thirdly, the bill now requires the Minister to have regard to any advice from the Mental Health and Wellbeing Commission when preparing the mental health and wellbeing strategy. This ensures that the expertise and insights of the commission are formally incorporated into the strategy development process. Fourthly, the committee has recommended expanding the scope of the strategy to include wellbeing, not just mental health and addiction. This holistic approach aligns with a modern understanding of mental health as part of overall wellbeing. Finally, this bill includes workforce development as part of the strategy. This is crucial, as we know that a skilled and supported mental health workforce is essential to delivering better outcomes for New Zealanders.

I want to address the importance of the consultation that was undertaken by the Health Committee and the inclusion they took in developing this strategy. The Health Committee received 57 submissions on this bill, demonstrating the public interest and engagement on the issue. One submission that particularly stood out to me was from Save The Children New Zealand. They emphasised the need to meaningfully consult with children and young people in developing mental health strategies. Given that mental health is consistently identified as a top concern for our youth, their voices must be heard in this process. This bill now requires consultation with key stakeholders, including Māori and other population groups, in developing the strategy. This inclusive approach will help ensure that the strategy addresses the diverse mental health needs of all New Zealanders.

This bill is not just about creating another Government strategy; it’s about sending a clear message that mental health is a priority, that mental health is on equal footing with physical health, and that mental health is part of our commitment to long-term, systematic improvements to mental health outcomes. By requiring a comprehensive mental health and wellbeing strategy, we’re creating a framework for accountability. Future Governments will need to report on progress against this strategy, ensuring that mental health remains a focus regardless of changes in political leadership, regardless of who sits on the Government benches and who sits on the other side of the House.

In conclusion, the Pae Ora (Healthy Futures) (Improving Mental Health Outcomes) Amendment Bill represents a significant step forward for mental health in New Zealand. It addresses a glaring omission in our health legislation, provides a framework for long-term planning and improvement, and sends a powerful message about the importance of mental health and wellbeing. Our fellow New Zealanders struggling with mental health challenges deserve nothing less than our full commitment to improving the system and outcomes for all. Thank you, Mr Speaker. I commend the bill to the House.

Motion agreed to.

Bill read a second time.