Healthy Futures (Pae Ora) Amendment Bill

I present a legislative statement on the Healthy Futures (Pae Ora) Amendment Bill.

SPEAKER: That legislative statement is published under the authority of the House and can be found on the Parliament website.

Hon SIMEON BROWN: I move, That the Healthy Futures (Pae Ora) Amendment Bill be now read a first time. I nominate the Health Committee to consider the bill. At the appropriate time, I intend to move that the bill be reported to the House by 24 November 2025.

This bill is about cutting through bureaucracy, restoring accountability, and, most importantly, putting patients first, because for too long we’ve had a health system where the focus has been on reports, strategies, committees, and union processes while patients sat waiting in pain. As we say on this side of the House: less Wellington waffle, more results. This bill will help clear some of the barnacles off the ship while we steer it in the right direction towards timely, quality healthcare for every New Zealander.

This Government is firmly focused on delivery. That’s why we’re legislating health targets—not just talking about outcomes but making them law—because what gets measured gets managed. Let’s be clear about what those targets are: shorter wait-times in emergency departments; faster access to elective surgeries like hips, knees, and cataracts; on-time immunisations for our children; faster access to cancer treatment; shorter delays for first specialist appointments. These are not abstract statistics; they are the difference between a grandfather regaining his ability to walk after a stroke or spending the rest of his life in a wheelchair, whether a young mum’s cancer is caught early or missed altogether, whether a teenager gets answers today or spends weeks in fear, waiting.

Let’s take a look at the numbers. In 2018, Labour removed the health targets. Emergency department wait-times fell from 90 percent of patients being seen within six hours in 2017 to just 61 percent by late 2023. The number of those waiting over four months for a first specialist assessment skyrocketed by 6,400 percent between 2017-18 and 2023-24, while the number of patients waiting over four months for elective treatment skyrocketed by 2,500 percent over that same time period. At the same time, childhood immunisation rates plummeted to a 10-year low. These are not just numbers; they represent real people: mums, dads, tradies, nurses, grandparents, children. That’s the legacy of Labour’s so-called reform. They promised transformation; what they delivered was longer waits and less care.

Now, they’ll claim it’s all because of their COVID-19 restrictions, but the reality is that performance fell off the cliff the moment they scrapped the National Government’s health targets. Speaking of COVID-19, in the middle of a pandemic, Labour decided that was the best time to restructure the entire health system. And the result? A public health system riddled with failures that should shock every single member of this House. Earlier this year, an independent report from Deloitte found that, under their reforms, Health New Zealand even lacked the basic financial oversights, with no clear accountability, poor performance-tracking, and inadequate systems to manage public funds. In fact, their entire financial system, which we inherited when we came into Government, was that they were running a financial system on an Excel spreadsheet—a multibillion-dollar organisation. That is what the last Government gave us.

There are also several examples across New Zealand where infrastructure projects identified and funded by the previous Government have suffered from poor management and significant delays. Take the Hutt Valley acute mental health unit, funded back in 2019, yet construction only just began under this Government; or the upgrades to Middlemore Hospital; also, the Kidz First work, which we announced on the weekend, also funded in 2019 but not due to begin construction until later this year—again, under this Government. It’s essential that our health infrastructure must be as good as it can be. It should also be commissioned and built as efficiently as possible, by people who are qualified to do it.

The purpose of our public health system should be to give patients timely, quality access to health services. We are fortunate that our health system is staffed by expert nurses, doctors, support staff, and others, who work hard every single day to provide the best care they can to our patients, but they’re let down by a system, and legislation the last Government passed, that has promoted a large and inefficient bureaucracy, a lack of accountability, and confusion about direction instead of a laser focus on delivering the best outcomes we can for patients. That’s why, for this Government, one of the first steps we took was to reinstate the health targets to ensure that there is transparency and accountability for patients. We have put patients back at the heart of our health system to ensure the system is delivering for them, and today this bill takes the next step.

I’m proud to present this bill to Parliament as a core component of this Government’s health delivery plan. The primary aim of this bill is to refocus our public health system, in particular Health New Zealand, and strengthen the arrangements that it has. These changes will ensure we can all be confident the health system gets back on track. This bill does four main things. First, it inserts a new purpose in the Pae Ora (Healthy Futures) Act, which will ensure that patients—patients—get timely access to quality health services. It’s hard to believe that this Act, which is so central to our country’s health system, does not have this purpose at its core—the word “patients”. This purpose will ensure the Government’s priorities are the core of this legislation and will form the basis for what Health New Zealand, in particular, is expected to achieve.

Secondly, it repeals the health sector principles and charter. Let’s be clear: we don’t need another 16-page charter that forgets to mention the word “patient” yet references “unions” 11 times. We need shorter wait-times, faster surgeries, more kids being immunised—that’s the job that we need done. The health sector principles, in particular, are a recipe of unfocused and diffused decision-making, and set no less than 21 different matters that every decision maker must be guided and informed by when making decisions. The principles will be replaced by mandated health targets, which must be included in the Government Policy Statement on Health. This will ensure that the health system has a laser focus on delivery in the core areas where the Government expects results.

Mandating the health targets in legislation provides clarity and certainty for the entire health sector going forward. All health entities, including Health New Zealand, will be required to give effect to the targets. The health strategy will also be required to give effect to them. We expect results against these targets. We expect the entire health system to be focused on them. We also expect transparency about whether they are being achieved, and that’s why we’re reporting on them every three months. The situation under the previous Government—where waiting times for emergency departments ballooned and childhood immunisation rates plummeted—cannot be allowed to repeat itself.

Thirdly, the bill will strengthen the governance arrangements for Health New Zealand and give the Crown entity a much-needed objective and function for Health New Zealand relating to infrastructure. The Government is already making steps to strengthen this area and will be putting in place a permanent Health Infrastructure Committee, whose members will be appointed by the Minister so we have stronger governance in this area. This bill will also clarify that a function of Health New Zealand is to work with private healthcare providers. When they get a hip operation, New Zealanders do not care which operating theatre they’re in; they just want it done, and that’s what this Government is focused on delivering.

Fourthly, the bill will complete the reform that began with the disestablishment of the Māori Health Authority by strengthening the role of the Hauora Māori Advisory Committee (HMAC) and providing greater focus for iwi-Māori partnership boards (IMPBs). HMAC includes some of the best-qualified people in New Zealand to advise on Māori health. Its role will be elevated so it provides advice both to the Minister and to the ministry and to the board of Health New Zealand. It will be given a clear statutory function, and the board will be required to take account of its advice. The role of IMPBs will be refocused to engage with their communities and provide advice to HMAC about local needs and priorities and advice to Health New Zealand and the Minister.

It is important also that this bill will ensure that Health New Zealand has a clear focus on public service delivery. We’ll be making sure that Health New Zealand staff must uphold the Public Service principle of political neutrality and follow the Public Service code of conduct.

This Government has put record funding in place for our health system—an additional $16.68 billion over three Budgets—and now we expect results. This bill is not complicated. It’s not ideological. It’s common sense. It puts targets in law, it reduces the bureaucracy, and it puts patients back at the centre of the health system, where they belong. At the end of the day, the job is simple: the Government sets the priorities in the Budget, Health New Zealand delivers care to the people, and we hold them to account for results. That’s what this legislation is about, and that’s why I commend it to the House. I look forward to the Health Committee’s consideration of the bill, and I invite the committee to particularly consider whether there are other further refinements that can be made to streamline our health system. I commend this bill to the House.

The question is that the motion be agreed to.

The claim that this bill is not ideological is really a bald one to make—one that directs the health system to engage more with the private sector is “not ideological”; one where the legislative statement says the name of the Act is changed so that the English one is first and the Māori is second is “not ideological”. Goodness me, I don’t know what that Minister means by “not ideological”.

I’ll tell you what this bill isn’t: it isn’t anything to fix anything in the health system. Of course, we recognise that the Government has a right to set targets, and it has done so through its Government policy statement. What is passing that into law going to change? It is not going to give the Government any more powers with respect to achieving its policy direction. So I would say this bill is both ideological and utterly political, and not actually directed at changing anything meaningful in the health system.

The Minister took quite a few liberties with talking about the past Government’s actions, and I intend to take the same liberties myself. Let us recall what this Government has done in its management of the health system. It came in and its first action was to institute a hiring freeze. They have avoided owning up to it, but doctors and nurses on the ground have told us again and again they cannot get gaps in their services filled. It is getting harder and more expensive to get the care you need under Christopher Luxon’s Government because of this Government’s actions.

They went about trying to claim that they had spent record amounts in the health system, and brought to select committee accounts that had over $200 million misrepresented in terms of which year they should have fallen in as expenses—a change that supported the Government’s narrative of there being a problem that they were fixing, but, in fact, the reverse was the truth. This Government did try to misrepresent the health system’s books so New Zealanders would expect that they were going to get less care. They went looking for savings in the health system and what did they do? Well, they found they could cut toast at Wellington Hospital. They took so many of these reforms behind closed doors.

I want to draw some attention to some of our concerns about this bill. Firstly, it has removed much of the power from and decision-making role of iwi-Māori partnership boards. Now, it was one of the few avenues for Māori to have their needs elevated in the health system that remained when the Government didn’t repeal this part of the Pae Ora (Healthy Futures) Act. But they’re further weakening the ability of iwi-Māori partnership boards to positively improve health at the local level. They’re no longer permitted to have a perspective on how the health system is performing. They’re losing their role in evaluating local Māori health needs. They are not able to expect accountability for services at the local level. Their job is now to report back to an advisory committee in Wellington. That’s a terrible loss of Māori voice, and our health system will be worse for it.

But I want to tell you something else: they’ve also removed all the local voice for patients altogether. They have delayed localities in their last amendment to this Act. They are going about gutting the consumer and whānau voice sections of the health system as we speak. It’s so ironic, because they campaigned against a centralised health system, and what have they done? Vested power in one man and created four giant regional bureaucracies and removed opportunities for locals to be involved. So I look forward to the members of the Health Committee, sitting opposite, learning that that is in fact what’s happened to their health system at select committee. We stand against this bill.

Tēnā koe, Mr Speaker. I stand on behalf of the Green Party to say kāhore. This is not Pae Ora anymore. This Government has turned its back on Te Tiriti o Waitangi and on the recommendations from Wai 2575 of the Waitangi Tribunal, which informed the Pae Ora (Healthy Futures) legislation. That’s what this Government’s done—they’re turning their back on te iwi Māori and those most vulnerable in our communities.

Now, let’s look at the way that these amendments have been rushed through with no evidence, based on vibes. There was no issue in the first place that this legislation is meant to be fixing. There has been no engagement with any of the public on this. There has been little to no kōrero between our Government departments and agencies, right down to the Ministry of Health and also Te Whatu Ora. There has been only a discussion with the Māori health advisory committee, and what did they say? There’s nothing reported as to what the feedback was that the Minister received. That’s a part of the issue—the speed of change that is coming is not evidence-based and is based on vibes.

Te Whatu Ora has an obligation through the existing Pae Ora to give effect to Te Tiriti o Waitangi. Now, these changes are the Regulatory Standards Bill hauora Māori. This is coming through by stealth. This is a tāhae and a kuhu. This is he mahi huna nā tēnei Kāwanatanga ki te iwi Māori, ki te hapori whānui [a deception by this Government on the Māori people and the wider community].

That’s what you’re doing—coming through quietly, like a thief in the night, to strip back the powers, our voice, of local whānau, community, and our workforce. If we look at the health charter, Te Mauri o Rongo, it was something that was built up through solid consultation with the workforce, with our unions, and with kaimahi. Te Mauri o Rongo is there for the entire health sector to be supported in the way that they can provide safety of care to patients, whānau, and communities within the health system. But no, no, no, this Government is taking away the health charter, Te Mauri o Rongo, which gave effect, again, to the Waitangi Tribunal, Wai 2575. It’s a huri kōaro once again.

This Government, through this legislation, is also stripping back anything population health - based. It’s like going back to the 1990s, I would say. If you’re anybody with any difference—whether you’re Māori, whether you’re takatāpui, whether you’re whaikaha, whether you’re migrant, refugee, anybody with difference, anyone who’s facing challenges in community—no, no, no; no strategy for you now. All of the strategies that are meant to be delivered on and developed so that we can see and feel ourselves within the health system are being stripped back, because it’s all going to the health strategy alone—one thing. We’re going to become a chapter. That’s what our people are going to become—a chapter. We won’t have the Hauora Māori strategy, we won’t have the Pacific health strategy, we won’t have the health and disability, and we won’t have women’s health, rural health, or mental health and wellbeing, because it’s all being stripped back.

Patients are the focus, forgetting the rest of the population, the whānau and community. That was the vision of Tā Mason Durie—the vision was healthy, thriving individuals, whānau, and community. This is not Pae Ora; this is “Pae Mate”. Let’s be clear. You tāhae our kupu Māori, and then you go and takahē on us and treat us like we’re tūtūā. Te iwi Māori ain’t no tūtūā. He iwi rangatira te iwi Māori. Kāhore mātou i te tūtūā, engari ngā mahi a tēnei Kāwanatanga e takahi ana i te Tiriti, e takahi ana i te iwi Māori, e takahi ana i ērā o ngā mātāpono, e ū tonu tō tātou iwi ināia tonu nei.

[The Māori people are a noble people. We are not dishonourable, but the actions of this Government are an abuse of the Treaty, they are an abuse of the Māori people, and they are an abuse of those particular principles that our people are resolute right now.]

Iwi-Māori partnership boards—what are they now? They’re only advisory, up to the Māori health advisory committee. Let’s talk about the Māori health advisory committee. They are a shoulder-tapped, ministry-appointed role in the system. They aren’t here through iwi mandate, iwi-Māori partnership boards. They were mandated through the people. The Hauora Māori Advisory Committee, which has been elevated to ngā rangi tūhāhā [the independent heavens], is through the Minister. They have no accountability back to te iwi Māori, and our iwi-Māori partnership boards are merely whānau voice. Meinga, meinga! Moumou te wā ki te mahi tahi a-iwi nei ki roto i te pūnaha hauora. Moumou te wā.

[Is that so! It is a waste of time to collaborate on an iwi basis within the health system. A waste of time.]

That’s what the Government is doing. It’s forgetting about inclusion and equity for all of us who face challenges within our communities. Those of us most vulnerable are not seeing ourselves in this bill moving forward. Kia ora.

Thank you, Mr Speaker. I rise on behalf of ACT to speak on the Healthy Futures (Pae Ora) Amendment Bill, and I want to thank the Minister for bringing this bill to the House. It makes some important changes to actually put the focus back on patients. I want to say it’s actually quite astounding to think that we have to insert a section into the purpose to say that patients should be getting timely access to quality health services, so that’s a really, really important change.

I also want to thank the Minister, because he’s picked up on some of the things that ACT campaigned on in making some changes. ACT supported and campaigned on some of these changes in healthcare, because we want to make sure that what we’re delivering in healthcare is based on need, not race. Every New Zealander deserves timely, quality healthcare, regardless of their ethnicity. The changes that are being made in this legislation stop embedding some of the race-based criteria into what was being done around appointments and service delivery. We think that is wrong and we think the focus needs to be on skills, experience, and outcome, not identity.

Repealing some of the provisions in here that require Health New Zealand to do specific report-backs to Māori, and maintaining some cultural frameworks, is actually about streamlining the processes our health system works under and ensuring that universal standards apply. We are certainly not saying that Māori health outcomes don’t matter, but what we’re saying is that the focus for the system needs to be designed for everyone equally, and we need to make sure everyone gets access to healthcare when they need it. So let’s get rid of these race-based obligations.

It’s also very encouraging to see that we’re adding targets into the Act and making sure we actually measure things that are going to make a difference in our health system. I also welcome the Minister clarifying that the health system needs to work with private providers. Really, it should go without saying, but having to introduce political neutrality sections into the bill is important, but we do expect our health system and our public servants to be politically neutral and actually be delivering for New Zealanders.

So I really do welcome this, and I do thank the Minister for also saying that the select committee can look at other refinements in the Act. We hope that that will be a fruitful discussion for this bill, and we look forward to supporting it in later readings.

Thank you, Mr Speaker. I’m pleased to stand on behalf of New Zealand First in support of the Healthy Futures (Pae Ora) Amendment Bill. Now, the purpose of this bill is a really good one. It’s to improve the effectiveness of health service delivery to all New Zealanders. Who can disagree with that?

The health system, during the COVID period, was in total disarray because the former Government, under the cloak of COVID, decided to basically pull apart the health system and then try to put it back together into one big entity. All whilst those in the health service, those workers, were dealing with a country under COVID conditions. It was exactly the wrong time in which to do major once-in-a-generation reform of the health sector.

Dr David Wilson: Madness.

JENNY MARCROFT: It was absolutely madness, as my colleague has just said. What we require, though, of this health system is to actually refocus and put patients first. We need better access to the care that they need, when they need it, in a timely manner.

The objective of the Healthy Futures (Pae Ora) Amendment Bill is to improve the effectiveness of the health services delivery for patients. It will refocus the purpose, objectives, and functions of Health New Zealand so that patients get the quality and timely access to health services they need. It will also add a new objective so that Health New Zealand will deliver effective and timely services. It will also have a focus on the infrastructure that’s often forgotten over the years—actually having a focus on infrastructure so that we don’t have these massive deficits moving forward. It also notes the targets and puts in place legislated targets to ensure there’s faster elective treatments, shorter delays for cancer treatments, faster specialist assessments, more childhood immunisations rolled out, and greater access to primary care.

It’s on primary care that I’d like to focus now, because primary care is the gatekeeper to the health system. It’s the first port of call when someone is ill, so we need a really strong primary care setting. Addressing need, real need, in the primary care setting will mean that people will have much better health outcomes, which is so important. As Dr Bryan Betty from General Practice NZ has said, “Quality, comprehensive, continuous access to primary care in general practice will reduce demand for hospital-level care.”

Having that primary care focus inside this legislation, I believe, is a really important way to focus the health system, to get patients seen to, and to put patients first. I commend this bill to the House.

First of all, we stand in absolute fierce opposition to this ridiculous bill. What we agree with, with the Minister, is that we should have a top-quality health system. We shouldn’t have the high wait-list we have, we shouldn’t have health staff under-resourced and underpaid, and we shouldn’t have the failings that we’ve seen through consecutive Governments coming through in our health. But we do, and that should be improved, but not at the cost of Māori equity.

That’s what this is about. The proposition being put to ordinary Kiwis—and I love that terminology, “ordinary Kiwis”—out there is that Māori are the reason why the health system has been failing Māori, and the fact that we had inequities is the reason why we’re removing Te Tiriti from the legislation. That is why we’re repealing the legislation. That is why we’re saying to iwi-Māori partnership boards, “You will no longer be in charge. You will no longer be co-designing what your districts want. You will no longer be sitting there having a strong Māori iwi voice. You’re relegated to being advisory only. You’re relegated down.”, because you know what? We have a Government that believes the only way to address this nation’s problems is to whitewash it. That’s what we have happening in this health system, and it happened when they destroyed Te Aka Whai Ora.

I want to be really clear: I’m not opposed just to this settler Government; I’m opposed to other settler Governments that put these kaupapa in place and didn’t follow through, because when it came to COVID, I’ll tell you who took the weight off the health system. I’ll tell you who helped their whole communities. I’ll tell you who went out there on the line and took the hits when the Government’s one-stop-shop solutions for the public health system failed Māori. It was iwi and Māori. It was iwi and Māori. When we weren’t recognised as needing vaccination support, it was iwi and Māori.

We have a long memory, and what we have here is a bill that is proposing to take away Māori health targets. We have a bill, whānau mā—I’ll be really clear: surprise, surprise, the Government is repealing Te Tiriti in this legislation. It is taking away any equity Māori targets. It is reducing, demoting, whitewashing the role of iwi-Māori partnership boards. Iwi mā, your economic dollars are wanted, your economic partnerships are wanted, but do not come and talk to them about your social aspirations. New Zealand First were in bed with Labour in 2017, so let’s stop having that argument. The reality is no one is going to back a Māori-led solution for Māori health other than Māori, and every expert across the motu—Māori and non-Māori—has talked about it.

I want to share some of their w’akaaro. We have the likes of Naida Glavish, who said that this is a direct attack—a direct attack—on Māori wellbeing. We have Professor Sue Crengle, who said that this bill is devastating—it’s devastating—to the aspirations of Māori and our ability to not want to be at the bottom of the queue, to not want to die seven to eight years earlier than everyone else, and to not want to have the worst statistics. We don’t want that to be our solution, and we don’t believe that we are the reason why the health system has to be revamped at the cost of Māori equity. What we have is also Dr Rawiri Keenan, who called it what it is: control over care.

It’s ethnocide. It’s ethnocide. That’s what this Government has done. It has continued to claw back the national Iwi Chairs Forum, the New Zealand Public Service Association Māori caucus, New Zealand Medical Students’ Association, Hāpai Te Hauora. All the Waitangi Tribunal claimants have called this out for what it is: it is clawing back, rolling back, our wellbeing, Māori wellbeing, for everyone else for the reason, the rationale, of equality—one law, one procedure, one policy, one legislation for all. It’s trying to deny the historical context of why Māori were historically disadvantaged in the first place. This bill is creating waves of distrust—and the fact that the Minister tried to stand up and say, “I am going to make your health system better by getting rid of all the equity roles and measurement, those iwi-Māori partnerships, those Māori targets, and all of those.”

Despite that, Māori mā, a COVID could come down tomorrow. We would all stand up and look after the wider community. This Government is cruel, and it does not value you in any way or form. I want to make sure that this bill, if it doesn’t fail, will be the first thing to be repealed when you’re no longer here. I can’t wait to get the opportunity in Government in 2026 to repeal this bill as fast as we can. Kia ora rā.

Thank you, Mr Speaker. I want to commend the Minister of Health for bringing this bill to the House. It’s a fantastic bill. It finally puts patients at the centre of our healthcare system. For too long, we’ve wandered off, looking at bureaucracy and a number of other things. It’s putting back health targets; it’s putting them in place so that we will hold the health system accountable for delivering it. It removes the clutter. There were a lot of unrelated items in there related to things that didn’t actually enhance patient outcomes. We’re focused on delivering for all New Zealanders.

That previous speech was one of the worst I’ve ever heard in the House. The Minister’s one, which was the first one, was spot on. I’m looking forward to looking at this in the Health Committee. I commend this bill to the House.

This bill is the epitome of arrogance. It is promoting an autocratic style for the health system. It erodes public system and public sector neutrality. But, most disturbingly, by taking away looking at equity, it really does make it about pae mate [sickness] rather than pae ora. It completely takes it away from prevention. By focusing on patients rather than on equity, it pretty much, in one fell swoop, wipes away any kind of public health initiatives or things that keep people healthy, and that is just the wrong approach.

It is so disingenuous of the health Minister to suddenly talk about how hard the healthcare sector workers work and how much time he has for them, when we know that they are burnt out, we know that they are going in droves to Australia. In fact, he accused nurses with the nurse union of politicising the patient ratio numbers, when all they were trying to do is get safe numbers so that people can safely be cared for.

It is so disingenuous for him to stand in this House now and say that he is on the side of the healthcare sector and then workers, when it is his Government’s reforms, his Government’s cuts, his Government’s autocratic style that has got them so burnt out and so concerned for the health system, and now the way of responding instead of actually doing something to rebuild the system and to fund it properly—the way that they respond is to try to put into the legislation things to send a message to healthcare workers that they cannot criticise this Government. There is no other reason to put the health neutrality statements into the legislation except to try to put fear into the hearts of the clinicians who have bravely stood up because of the oath that they have taken around making healthcare available to all people.

When I look at what is being repealed—I mean, it’s quite disturbing. There are principles about being equitable. There are principles about engaging with Māori population groups and others to reflect their needs and aspirations. I do not see either of those as clutter. That is about equity. There are principles that will be removed about providing choice of quality services to Māori and other population groups—other population groups, like rural groups, who we know don’t have the same access to healthcare. It also removes principles about protecting and promoting people’s health and wellbeing.

When we look at what is happening now, despite all the rhetoric coming from the Government, it is true that patient wait times are longer, that people are getting sicker, that they cannot get access to healthcare close to home at costs that they can afford. Those are the aspirations that our health system should have. But the numbers do not lie and neither do the clinicians who are making those statements—and many of them are.

When we look at the targets that the Government is so wedded to, are they measuring the right things? I don’t think so. We have, for example, targets that talk about getting cancer treatments, but we don’t have any targets about cancer screening—surely that is one of the most important targets, and in terms of equity, an incredibly important target if we want to keep people well for longer.

When I look at the changes that have come, first with the cut to the Māori Health Authority, and now the diminishment to the iwi-Māori advisory board, which is just placing it as something that has to respond and confer upwards rather than be able to have any kind of say over the health of its people—all of this is about centralisation. It’s about one-size-fits-all. It’s about putting fear into people who dare to speak out. These are absolutely contrary to the promises that Christopher Luxon made at the last election.

It is so disingenuous for people like the Minister of Health to stand up here now and say that this is all about creating a better healthcare system. It’s short-sighted. He clearly doesn’t place any value on preventative health, on understanding the health inequities which are demonstrated through the seven-year life expectancy of Māori and six-year life expectancy of Pacific people. It is a terrible bill, and I do not commend it.

I rise to support the Healthy Futures (Pae Ora) Amendment Bill in this first reading. This legislation is a critical step in strengthening and making our healthcare system more effective. Our healthcare system has been stymied by the previous reforms. The bureaucracy has overshadowed health outcomes, and we just need to look at the purpose of what we’re doing here today. We are adding a new purpose to this bill, one which ensures that patients get timely access to quality healthcare.

It is amazing that we actually have to put that in the purpose, that it’s not there already, because I think most New Zealanders want to have quality, timely healthcare. Crucially, health targets are now going to be enshrined in law. This provides clarity and certainty and ensures a laser focus on getting real results for patients. This is things like cancer care, it is immunisation, it’s emergency department times—it is about accountability. Therefore, I commend this bill to the House.

Thank you, Mr Speaker. I find it quite ironic that the Minister would say, and the contributors would say, in one breath that this bill seeks to improve the health system and then systematically go through and do so many things that do just the opposite. One thing that we do agree on is that everybody deserves the chance to stay healthy and, when they’re not, they deserve the opportunity to have access to healthcare—good quality healthcare—no matter where they live and where cost isn’t a barrier. Nothing in this bill actually does that, apart from pretty words that are written in a purpose statement, which are then completely contravened by the further parts to this bill.

The Minister made a bit of a hoo-ha about the fact that he was addressing some sort of ideological mishap, or some sort of ideological slant that he took exception to, and he has then gone along himself and planted heaps of ideological slants in this bill that don’t serve people’s purposes. Two things that disturb me, which haven’t been spoken about in great depth so far, are what I will perceive as a silencing of the health workforce. I think that the bill fundamentally misuses the Public Service neutrality aspect to do that. That is a chilling thing to do. Front-line health workers, who have a professional obligation, an ethical and a legal obligation, to call out things that they see in their professional practice—it is not political; it is professional, and they should not in any way, shape, or form have this hanging over them, this concept of the misuse of Public Service neutrality.

Speaking out is not a political move, as I said; it is absolutely professional, and there are those obligations. Those obligations are, in fact, embedded in their code of conduct—in the Medical Council, in the Nursing Council, and in other regulatory bodies—and it’s incredibly important. As a society and as consumers of the health system, we absolutely rely on those health workers to be able to speak out freely. I do think this has a chilling effect, and I do look forward to the fact that, when this goes to select committee, we will hear evidence from people who actually do know what they’re talking about, about what the potential unintended consequences of that could be.

The second thing that piqued my interest in this bill—that, as I said, has an opportunity to actually do what it says it wants to do, and that’s to improve the health system. For goodness’ sake, we know that things are getting worse and worse. Over the last 18 months, dozens and dozens of stories have permeated through the media about how hard it is out there and how the last thing we want is for it to be more expensive. Under this Government, it is certainly going backwards. The privatisation by stealth, the risk to that universal public healthcare, that is open in this bill is not the answer. The bill opens the door to making it a formal objective—a formal objective of Health New Zealand—to work with private health providers.

We’ve heard the Minister say trite statements like, “People don’t care where as long as they get their operation.” It’s not as simple as that. It’s the same health workforce. The provisions in this bill are not about using private care simply to fill urgent gaps. It’s actually about embedding what is a parallel system and moving money from the public system, increasingly flowing it into private interests. I think that is incredibly dangerous. Once private provisions become normalised—and we’ve heard this time and time again, and there are some real stalwart experts who have been working to make sure that this issue comes to the forefront—it’s incredibly hard to peel that back. We know that the service shifts to where there is profit, we know that providers can then cherry pick lower-risk and higher-paying patients, and we know that the long-term investment in the public system simply dries up.

I also think that it has been incredibly sad to listen to some of the rhetoric. Taking steps to overcome inequities isn’t inherently race-based at all, as has been projected on the other side of the House. It just so happens that New Zealand’s ethnicity, in New Zealand, is a genuine factor in those inequities, and there is nothing wrong with seeking to reverse that. I do not commend this bill to the House.

Thank you, Mr Speaker. It is a pleasure to speak on the Healthy Futures (Pae Ora) Amendment Bill. The previous Government’s changes to the health system were a complete omni-shambles, or to put it another way from the military, we would call it FUBAR—and I won’t spell out what that stands for. But the overall effect of the previous administration’s changes have been to disorientate the decision making and communication. No one has had either the authority or, frankly, the temerity to make any decisions, and the responsibility for the consequences of that have been opaque as well. This brings back direction to the health system. I commend the bill to the House.

The question is, That the Healthy Futures (Pae Ora) Amendment Bill be considered by the Health Committee.

Motion agreed to.

Bill referred to the Health Committee.

Instruction to Health Committee