Today, on Newshub Nation ` is Minister David Clark the right man to rebuild our health system? Golriz Ghahraman on what Black Lives Matter means in New Zealand. And can we trust Oranga Tamariki? Children's Commissioner Andrew Becroft on his damning report. www.able.co.nz Copyright Able 2020 Kia ora, good morning. I'm Tova O'Brien. Welcome to Newshub Nation. The government's announced major exemptions to New Zealand's border controls, allowing hundreds of America's Cup team and family members from the UK and US to enter the country. Some families will also be reunited. But the change doesn't fix the problems for most of those on temporary visas who are stranded overseas. Black Lives Matter protests continued globally this week, with monuments celebrating slave traders toppled in Australia and the United Kingdom. In the United States, President Donald Trump has seen the most significant drop in his polling since taking office, with an approval rating of 39%. And a stocktake of our health system has revealed $14 billion will be required over a decade to shore up sagging hospitals. Budget 2018 committed $750 million to help infrastructure ` a fraction of what's apparently required. And a major review of our health system will also be out next week. And the man holding on to that mega-report is David Clark, Health Minister in the era of COVID-19. Staying safe. We want people in their homes doing the right thing. So simple for the Health Minister, though, who drove his tell-tale van to a mountain bike park for a wee blat in the hills during lockdown. I don't see that there's any excuse for my behaviour. That's why I offered my resignation. Under normal circumstances, I would sack the minister. What he did was wrong, and there are no excuses. It was bloody obvious to me at that point. I felt like a complete dick, if I'm honest. $500m for health, but still just one twentieth of the total spend announced today. Is health getting enough? Health, as I say, we've made the record investment in the last two budgets. Grant Robertson said, hand-on-heart, that by 2020, the government would deliver on all of its promises. Holes in the wall, asbestos and cramped operating theatres are just some of the problems laid bare in a report on the state of our hospitals. Those who work in the buildings say the run-down nature of them comes as no surprise. So, what will be in the report? Does the Health Minister have the mana to implement it? Health Minister David Clark joins me live now from Christchurch. Welcome to the programme, Minister. Thank you for joining us. You've had that report from Heather Simpson, that mega-review, for a couple of months now. We're expecting it to be released this week. Can you commit to adopting all the recommendations in that report? Morning, Tova. I've had the report now for a couple of weeks. It was put on hold during COVID and it was right that we focused entirely on COVID as a government. We are committed to building a strong and sustainable public health system. COVID has highlighted the importance of having a strong health system. We want to make it better. The report will be released very soon, and it will lay out a plan for doing just that. And you're committed to adopting all the recommendations in that report? Look, I'm not going to get ahead of that announcement today. What I will say is that the report is very thorough, very detailed, very long. It warrants good consideration. I've been talking with colleagues about it and I'll have more to say on it soon. Are you going to have to adapt your response to the report in the wake of COVID-19? I think when people see the report, they will see that the recommendations in it and the content of the report is very much in a direction that COVID-19 supports. We've learnt a lot through the COVID-19 period about just how important a strong public health system is. We've seen our doctors and nurses and allied health professionals step up and deliver. And we want to make sure they're supported to do that even better in the future. Is there a risk that if you don't commit to adopting all the recommendations in that report that this ends up becoming a $9.5 million waste of time and taxpayers' money? Look, it is a thorough report, as I say, and warrants thorough consideration. The challenges that we've inherited as a government are long-term challenges. We've already committed 3.5 billion in capital spending in our first three budgets, which is a huge amount ` unprecedented. We know that it's going to take a while to rebuild the system, but we are absolutely committed to doing that. Heather Simpson's interim report asks whether we should have fewer District Health Boards and on this programme you even kind of posed the question about whether we should have any District Health Boards at all. Is that still your view? Are you still questioning their use? I think that is something that needs to be closely looked at. The DHBs already share services. That's something that's happened organically over time. We see Canterbury and the West Coast collaborating on administrative functions. We also see Hutt Valley and Capital & Coast working together. The Auckland DHBs do their capital planning together. It's happening almost despite the settings in the system. So I've long said I can see room for more sharing of backroom functions, but in terms of the report, I'll wait until we release that. Getting rid of some of those DHBs as well, Minister? I'll wait till the report comes out before I'll say more on that. Because the criticisms are that the duplication of functions; the conflict of interest, because they act as both funder and provider; and also they're expensive, because you've got 20 CEOs of these DHBs all being paid about 500k a pop. Are those concerns valid, and will you address them? Can you give a commitment to addressing them? I think the concerns are rightly highlighted. We want to build a stronger system overall, and that means looking to where we can make the gains. But, I mean, that's in the context, the report will say, of a system that is one that compares well internationally. We know our system's really good; but I'm yet to meet someone in the health system who doesn't know things we could be doing better, so we need to strengthen our health system to make sure it's sustainable for the future. And also make sure it's delivering equitably for all of our citizens. Yeah, on that ` do you believe that there's institutional racism in the health system? I certainly believe that there is a long, long history of difficulty with intergenerational poverty, and the system does seem to have a way of perpetuating that. It is being confronted through our system, and I'm now requiring DHBs to be very explicit about how they are improving outcomes over time. That's now part of their standard reporting. It hasn't been in the past. Is there institutional racism in the health system? I think we can see historic evidence of that. I think we need to make sure that we` Currently` Is there a hangover is there institutional racism currently in the health system? I think there is. I think there is, and I think that it's very difficult to point to specific examples. That's the nature of institutional arrangements, but we are, as a government, absolutely committed to making sure that we improve things into the future, and I am seeing that change happening. You know, I've appointed four Maori chairs. We didn't have any in our health system before ` at all, across the 20 DHBs. A large number of my appointments have been Maori. And those people are making a huge contribution to the way the health system thinks about meeting equity, and as are all of the people who are working across our health system. That is part of my requirement on them. Heather Simpson's interim review says, quote, that, 'Maori experience of hospital services 'includes poorer access, poorer treatment, poorer outcomes and institutional racism.' Given those inequities, do you think that Maori and Pasifika should be prioritised on surgical waitlists? Look, I think the real opportunity, Tova` I think, when it comes to waitlists ` those are clinical decisions, and I think the real opportunity actually for addressing equity` You as Minister- Sorry to interrupt, as Minister, you define the direction of the health system. You say you want to address those inequities, so should Maori and Pasifika patients be prioritised on surgical waitlists to address those inequities? Well, this is where I want to make the point that the actual opportunity to address the inequities comes far earlier in the system. We know it's at the primary care level ` access to services at an iwi provider or primary care level is where we'll make the big differences. Prevention, screening programmes ` those things are the things that will make the big difference in terms of equity. Absolutely, but we've got to look more holistically, right? Some DHBs are already doing this off their own bats. So why don't you put out some kind of directive ` ministerial directive ` that they should all be prioritising Maori and Pasifika patients in that way? But those are tweaks at the end of the system, and they have to be supported by clinical judgement. I am not convinced that that's where the big gains are to be made. OK. This week you announced $211 million for hospital facilities in South Auckland to improve them. That's great, but access is still a real problem for low-income families. What about Labour's election promise of cheaper doctor visits for everyone? Why not reinvigorate that election promise? Well, what we have seen is that there was need across the system, and actually we've decided to focus our energy on where the greatest need was, in the Community Service Card holders. Over half a million Kiwi families have benefited from doctors' visits that are actually now $20 to $30 cheaper for them on average. That's a huge change, and has meant that we've seen a big reduction in need. 57,000 people in the first year of that programme fewer have reported that cost was a barrier to accessing the support they need at primary care level. So, that programme has focused on where the greatest need is. That's what the evidence suggested to us in government. That's why we focused there first. So you won't be reinvigorating that broken promise. You also promised free breast screening for 70- to 74-year-olds. Where's that at? Look, the intention of the government is to look at that in the future. It is true that` It was a coalition promise that you made. It's in the coalition agreement, Minister, so it should have been achieved in this first term. Well... Why haven't you done that? What I would say is that COVID has changed things. It has meant we have needed to re-prioritise. You could have done it pre-COVID. You could do it now. It is something that was being looked at and, right now, with COVID we have had to focus our health system differently. We've put in a record investment of $3.9 billion across our DHBs in this most recent budget. Completely unprecedented. We're investing heavily, but our priorities have had to change with COVID. We've had to make a big investment in our public health capabilities. More generally, Minister, fewer people are getting faster cancer treatment under your watch. 14 of the 20 DHBs have actually gone backwards under that measure under Labour. Why? Certainly the COVID period has had an effect on some of those cancer services. This was happening pre-COVID. Well, the most recent data I've seen is that earlier this year our cancer detection rates were up, and actually our treatment through the COVID period has been challenged a little, but we've put more money into a significant catch-up campaign. And we've announced several hundred million to go into that for the coming period. The interim Simpson report also talks about the importance of data being at the centre of decision making within the health system. But you scrapped the public reporting of national health targets, you haven't replaced them with anything better yet. And in all-bar-one of those measures, things are getting worse. So, that's cancer treatments, increased immunisations, shorter stays in emergency departments and smoking. All worse under your watch. Why? I challenge you on that. For example, the immunisation rates are actually up, perhaps unsurprisingly, given the focus over this period on them. Not according to those health targets, which you're still reporting on the Ministry of Health website. Certainly the most recent data I've seen. But that might be what you'd expect in the current circumstance. Look, across our health system there was a focus on narrow targets ` on things like making sure our surgical procedures were done in the most expensive setting to meet those political targets previously. Avastin injections and skin lesion removals that could often better have been done at outpatient settings` But it's still all we've got, because you didn't replace` More convenient for the patient and better outcomes. It's still all we've got, because you didn't replace those targets with anything better. Let's move on to mental health and Budget 2019, the 'Mental Health Budget'. Key to that ` $455 million for frontline mental health workers in doctors' clinics. How much of that $455 million have you spent so far? Well, in year one there was an expectation that we'd spend a lot less than that. Obviously it's a five-year programme that ramps up over time. It was slightly interrupted by COVID. But we've already had significant roll-out and by mid-next year, 1.5 million New Zealanders will be able to access free mental health services. How much have you spent so far? No one expects` I mean, this is one of the long-term challenges we've inherited. We've spent about 40 million so far. Minister, sorry to interrupt. 40 million? OK, because you committed to spending 48 million in that first year. That's right. It has been interrupted by COVID, so by the end of this financial period, we'll be around the 40 million mark. And we've also announced a number of programmes through the COVID period that were not planned previously. So I really think we're making some good progress in that area. You cannot expect, when we've inherited the size of this challenge, that this long-term challenge would be solved overnight. We're creating whole new workforces here. We're training health coaches and health practitioners to do a job that simply wasn't being done before ` providing support for free for people with mild to moderate mental health needs. This is the first government that has taken mental health seriously. We don't pretend we'll solve that overnight. But we are working very hard on it and we are seeing the progress. Minister, there is clearly so much to do in health that I'm going to put to you that you don't have the mana or the credibility or the respect to do that job. Well, I certainly am energised to do the job. Through the COVID period, we've seen our doctors and nurses and allied health workers respond in an incredible way. We've put a whole lot more investment to support them, to back them in their efforts. This is a problem with you, I'm talking about. Because the Prime Minister said she would have sacked you if she could have. She stripped you of that authority. She basically left you as a lame duck minister ` a fate worse than sacking, arguably. So, do you expect to be the Health Minister if Labour is re-elected in September? Oh, look, I'm certainly very keen to get on with this. The Health and Disability Sector Review, which I commissioned, is about to report back. I am very keen to do the job, but obviously this is a decision for the prime minister. Ultimately, the choice of which ministers are in which portfolios rests with the Prime Minister. So, you still want the job, but I'm just going to put it to you as well that the country doesn't actually want you to have the job. In our latest Newshub Reid Research poll from last month, off the back of you breaking lockdown rules twice, we asked voters ` should you still be Health Minister? A clear majority, 56.8%, say no. Just 35.7% say yes, you should be minister. And Labour voters don't want you either. 47.5% of Labour voters say no versus 43% yes. You're a liability to the Labour Party. Tova, I mean, my response to that is that I'm working hard to regain the trust of New Zealanders. That report is obviously from a month ago. But ultimately, this decision rests with the Prime Minister. I will be working very hard in my portfolio, because I believe that it's possible to make a real difference in our health system. I've been very focused on addressing equity, rebuilding our public health services, addressing primary care and mental health, and I will continue to do that for as long I have that responsibility. How does that sit with you that voters do not want you in that role? And will you defy them and push forward to try and hold on to the health portfolio if you're given the chance after September 19th? Well, I think the thing is, Tova, that I admitted that I got things wrong. I offered my resignation to the Prime Minister; that was during the period that you were surveying. And my job now is to get on with things... It was after it. ...to do the job that I'm entrusted with for as long as I have that responsibility. I take that responsibility incredibly seriously, and I'm very proud of the way the health system has responded during this crisis. I think the results there speak for themselves. OK, well, 10 points for tenacity. Thank you very much, Minister. Health Minister David Clark, thank you for your time. If you've got something to say about what you see on our show, let us know ` we're on Twitter, Facebook and Instagram ` NewshubNationNZ. Or you can email us at nation@mediaworks.co.nz. Still to come ` we dissect the week's political news with our panel. Plus Golriz Ghahraman joins us live ahead of her book launch on Tuesday. Welcome back. Green MP Golriz Ghahraman will launch her first book on Tuesday ` an autobiography titled Know Your Place. While it's well known that she made history in 2017 as New Zealand's first former refugee MP, there are a few surprises in here too. And Golriz joins me now. Golriz, thank you very much for your time. Let's start at the very beginning. The title, Know Your Place ` why did you call it that? Well, I think, as women, we're really familiar with that play on words. But I've kind of learnt online, at least, that I get told that a lot as someone who is a former refugee, and it's that thing of owning it, you know? We know our place as women is at the very top of government, in media, and so I kind of wanted to take that back for us. And I want to talk a bit more about some of that vitriol that you've faced online in a bit. But there's a particularly poignant chapter in the book as the Christchurch terrorist attacks unfolded, and you talk about how you began to interact with the bureaucracy of government and Parliament that day, and you realised, quote, 'that establishment institutions are not only ignorant of minority issues; they're actively resistant to engaging with them.' What happened? Well, I learnt that day, as things started to unfold, that to a certain community, this was horrifying, immediately, and that they saw me as a representative, you know? And I went to work immediately, trying to get statements out, trying to get information, and I realised that not everyone was as touched immediately. Who was that within the bureaucracy? That's just, sort of, back in the office, people going, 'You don't speak about every crime. Why would`?' Within the Green Party? Well, not the Green Party, because it's parliamentary staff. And I think, once the prime minister came out as strongly as she did, it felt like, 'OK, no, we're all in this together.' But it did make me think back to us as women, as minorities, getting in, and that that isn't quite enough. We need everyone in those institutions ` whether it's the health system, whether it's Parliament, whether it's media ` to have us mainstreamed. We need to be behind the camera as well as in front of the camera. And so I hope that those institutions become more diverse and more inclusive at every level. And you also accuse both National and Labour of espousing anti-immigrant rhetoric. How much racism is there in Parliament? I don't think that it's so much that it's racism in Parliament, but I think there is that insensitivity to the way that what we say as leaders affects other communities, minority communities ` whether it's that we're blaming them for the housing crisis; whether it's we're blaming them for road congestion; whether it's talking about refugees as being the leftovers from terrorist nations, which is a former prime minister who said that. We feel that out on the street. It emboldens a certain type of very real racism against us that hurts, and on March 15th last year, it... it killed. And you called former prime minister Bill English an 'island nation xenophobe'. Why? Well, I think it was Newshub that broke the story. He had on his website, even at the last election, this essay that he'd written about how refugees are the leftovers from terrorist nations, how we do need a red light at the border. It sounded like Trump with his wall. And to have a mainstream politician say that does really validate the kind of prejudice that those communities feel. And what are some specific examples of Labour's anti-immigrant rhetoric that you're talking to? Well, you know` And I think we kind of all know the line for the housing crisis at the last election was from Phil Twyford, saying that people with Chinese-sounding names were buying up the houses in his electorate. That turned out not to necessarily be true` They were Kiwis. They were literally Kiwis. That's exactly right. And so to define who we want to be in homes in New Zealand based on the sound of their name... isn't quite right. And this paragraph stuck out to me too. You're talking about Parliament being the most adversarial context that you've ever worked in. 'Rather than consensus-building or true debate, we're expected to hold our party lines 'and either ignore the opposing view or fight, almost with actual hatred, what our opponents stand for.' Has the Green Party put that expectation on you? Well, the Green Party's a little bit different in the sense that as you come up in the Green Party, you agree to the policies, or you actually publically say that you don't. So as candidates, we tell the party what policies we don't agree with, very openly. So then you can stay your line in that way. I'm not sure that that happens in other political parties. But the debates seem weird to me, as someone who's come from a courtroom, where you actually have debates, and they're adjudicated, and you have a role in that way. This isn't a debate in Parliament. We're just saying words and sitting down. Often we're not listening. And you touched on it before as well ` some of that online abuse. You have received unprecedented amounts of horrific abuse and threats online ` people criticising your role, your race, your gender, the way you look, your age, your experience. And that fear that you talk about for your physical safety and for your family ` you talk about having to carry a panic button. And for all of your experience, you say that the only time you've felt so scared, like a child walking into a darkened basement, was when you're leaving Parliament house at night. Has there come a time where you've just thought, 'It's too... 'I don't want this any more. It's not worth it'? It is a thought` And you and I have spoken about this before, and I've spoken to other journalists, female journalists, because you guys get it too, and there are moments when we go ` and on a heavy day when we've been getting it, you know, 'Why am I doing this?' But then you remember the void that would be left if we all retreated and succumbed to the hate. What I'm hoping is that by my presence there, by minorities being included and represented, that there'll be more of us. And once we're normalised, I think that will subside. And you also talk in the book about fighting back online, and there's a paragraph that really stuck out to me as well about James Shaw, your co-leader, pulling you aside and telling you that your responses online were perhaps getting a bit angry. The book focuses a lot on empowerment ` so how was it, then, to have a Pakeha man telling you that your responses to these threats were getting a bit angry? Well, the way that James approached it was to say` be really upfront about that and go, 'I don't know what it's like for you, because I am a Pakeha man. 'I totally accept that. But I know you well, and it's starting to not sound like you,' you know? And so I don't want to become that person either. But that's also an attack line that you talk about, how people talk about you're a radical, angry woman, and that's an attack line that they use. So was your co-leader guilty of doing that, on a spectrum? I think that, as a friend who knows you well and wants to` wants to give you the support but also to point out, 'Is something changing? Do you want to be this new person?' it was a good wake-up call, I think. Because you are seen as being more aligned to the Marama Davidson wing of the party, and you can definitely feel that aroha for her in the book. Is that how you see it? We certainly` It's very strange, in one way, the way that we get treated, because we come from very different backgrounds to our work. So, you know, me having come through the legal world and advocating for these issues in that way, and Marama having come through a different line. And she is a protester; we both do that. But the way that we're seen as being the same is interesting to me, because I think, to some extent, it comes from us just being women of colour. It's bound us together. I think it's also because the Green Party is quite factionalised in that way. I think you can unite, often, across that void, but it is quite factionalised, just talking to other Green MPs, what it's like behind the scenes. I think, internally, the party itself is quite united, but it's the kind of party where you do speak out if you don't agree. And I've come out through the party. I've been in there for 10 years or so, so I've seen the rise and fall of those voices. And you've been vocal on the Black Lives Matter protests, even when protesters broke COVID rules. Why was it important for you to show that solidarity? Well, because I think representation matters, and I talk a lot in the book about seeing people like Keith Locke. As a teenager, I saw an actual MP come to protests for the rights of refugees, and that meant so much to me. So I know that it means something to see somebody who's in a position that we're in to raise the voices of those who feel really downtrodden and really hurt. And just finally ` do you think that we should be tearing down statues that memorialise our colonial past? Well, I think if they were memorialising our colonial past, maybe it would be a different conversation. But they're glorifying people who've done certain things that have been hurtful, and we are seeing the impacts of that still. So tear them down rather than just add some context? I think remove them. They're a glorification of something that we, as a country, don't stand for. Golriz Ghahraman, Green MP, thank you very much for your time. Up next ` the news and politics of the week with our panel. Plus ` National's Nicola Willis tries to convince us she'd make a better housing minister than Megan Woods. Welcome back. I'm joined now by our panel ` Lance Norman, head of equity and Maori health at ProCare, and Thomas Pryor, former parliamentary staffer, now at Sherson Willis PR. Kia ora korua. Thank you very much for joining me. Kia ora. Can we just start by talking about COVID-19 and health inequities? Has COVID thrown up, in stark relief, the inequities in our health system? Lance, I'll start with you. It definitely has. Like, when you think of the things that worked over COVID, if you were the closest to the community, that really worked. So if you were working in residential aged care, you were looking after whanau, that worked. If you were an NGO or Maori or iwi provider, and you were activating and delivering kai to families, that worked. If you were a general practice, and you stayed open, and you were able to keep people out of hospital, that worked. There was a bunch of things that didn't work. PPE ` everyone knows what PPE stands for ` that didn't work. We had enough in the country; it was just in the wrong locations. The flu vaccinations ` we actually ran out in general practice. Once again, there was enough in the country, but it was in the wrong locations. And then getting our payment systems right to keep the system running ` that was a little bit delayed. So those kind of tripped us out. And they talked a big game, this government, on transformational change, but should Labour, Thomas, have achieved more on health so far? Yeah, I mean, I don't think they've achieved much at all. They sort of got in and said everything that was wrong with previous governments, got rid of targets, as you talked about with the minister, then he hasn't replaced them with anything. So, they've put money into it` And, I mean, health's just a black hole, so it will keep on sucking up money. You need to put discipline in there. You need to put targets to actually get results. And if you don't, you end up where we are now where it's kind of three years and they haven't moved things on. Minister keeps on talking about COVID. I'm not really sure that's an excuse for the, you know, two and a half years preceding COVID. And if anything, the pandemic... We've dodged a bullet, actually, cos it kind of showed up how poor our health system was, how low our number of ICU beds were, things like that. So, no, I think it's been a pretty sub-standard performance. It feels like they've shifted the line from nine years of neglect, nine years of neglect, to, 'It's COVID's fault. Everything's COVID's fault.' You work, Lance, as head of equity, Maori equity for New Zealand's biggest doctors' network. Has the minister failed, in your view, to address inequality? I think every minister has failed to address inequality, and that's probably right across every spectrum of our government. We've talked about Oranga Tamariki, the prison system, the healthcare system, the education system; there is constant failure for our people, and it needs to be at a policy-driven level, and it needs to be backed by resource change. So he was kind of right on that, wasn't he? He's saying, 'You can't just do this one thing ` the ambulance at the bottom of the cliff.' But there needs to be a holistic approach. But do you also think that Maori and Pasifika people should be prioritised on waitlists, because that makes a difference? Yeah, well, you asked a good question, and you also asked him a question about institutional racism, and he got there eventually, and the answer was yes. Always takes him a while. Did take a while. So that's helpful. But COVID gave us the opportunity to recalibrate and say, 'Well, actually, there's a whole bunch of things in our healthcare system 'that weren't working. Let's not bring those back post-COVID.' There were some good things that were working over COVID. Let's accelerate those. But prioritising waiting lists is a good one. Bringing back those health targets, as you know... We've gone backwards on every target bar one. That's not good for equity. COVID will have a negative impact on Maori and Pacific families who are closed out of the hospital care system, which will then be replaced by people who miss out on care. And so they'll be pushed out even further. So the equity gap will actually be bigger in New Zealand if we don't accelerate some of these positive opportunities that we've seen over COVID. And if Heather Simpson's review next week recommends scrapping the DHBs or consolidating the DHBs or getting rid of some of them, do you think we should do that? Scrap the DHBs? I think we do. Yeah, we should, from a policy perspective. I think, politically, it's really difficult, cos the moment you do that, every local MP starts getting lobbied by their DHB board and the people involved in the DHB who want their little fiefdom maintained. I mean, it is ridiculous that we have such a decentralised health system in New Zealand. And again, actually, I think that was shown up in the pandemic, where you had every DHB with a different policy around how to distribute PPE or different criteria for testing. And in a country of five million people the size of New Zealand, it's just ridiculous. So, yes, it's the right thing to do ` politically, really hard. And I think unless this government goes out and gets re-elected on a mandate of significant consolidation, you'd be a brave minister to do it. And do you think that there is` Both of you can perhaps touch on this. Do you think there's a genuine desire to reform health, or will the government use COVID, as we've talked about, as an excuse to perhaps water down its response to the Simpson review? Well, I think what worked over COVID was public health messaging was very good. We focused on coughing and sneezing in your elbow, social distancing. If you were having troubles with your mental health and wellness, ringing the 0800 number or 1737. So, those public health messages were good, so they need to be enhanced post-COVID. Primary care needed to be invested more in, and our NGO and our Maori and Pacific providers who are face-to-face with communities, that worked really well. So I'm expecting in the health review that that focuses on giving more resource to those areas that need it the most. I think DHBs... They should be consolidated. You still need them, but as you say, you don't need 20 DHBs, CEOs on $500,000 when you could have three or four across the region. And they should just focus on getting hospitals better and running them more efficient. Don't worry about everything else; let everyone else who's really good at doing their job do that, and just get the hospital system better. And the health minister ` he made some significant missteps during the lockdown. Is he bouncing back from that, do you think, or has he lost the credibility to do the job? Yeah, well, I think after your interview with him, he definitely isn't bouncing back. I almost felt sorry for him. But no. And, I mean, I think that's the problem; he... he sort of has that 'dead man walking' look about him. And I think, you know, he'll probably last until the election, because frankly, it's not like there's a huge amount of talent behind him to replace him with. But beyond that, if the government gets returned, it'll be a different minister of health. And that means that reform process needs to start over again. But just finally, on the Simpson report ` I think that's very hurriedly being rewritten, as we speak, by people in the Beehive to moderate it or to soften it or to turn it into something that is politically more palatable. Yeah, and he definitely wouldn't commit to adopting any of those recommendations. The first report ` 300 pages. Probably expecting the same again. Very expensive, heavy doorstop if they don't adopt those recommendations. Let's talk about the Golriz Ghahraman interview. Based on that interview, are you guys tempted to read the book, and why? (CHUCKLES) Oh, most definitely. You know, we pride ourselves on being a nation of multicultural people. We pride ourselves on putting women up first to vote ` three prime ministers who are women. And it's actually saddening and disappointing that an ethnic woman is feeling that way in our country, and that's actually a reflection of some of the institutional racism stuff that sits there. We don't like to talk about it, but it is there. And Thomas, based on what you heard from Golriz, are you tempted to read the book? I'm a bit of a political geek, so I read most politicians' books. So, yeah, it'll certainly probably be above Chris Penk's book in my reading pile this Christmas. Alongside Judith Collins. Alongside Judith Collins, yeah. And what did you think of the view, Lance, that 'establishment institutions are not only ignorant of minority issues; 'they're actually actively resistant to engaging', talking about the Parliament and the government? Well, they are. I mean, we actually have very good healthcare systems relative to the rest of the world. We have very good financial systems. Our housing system's actually good relative to the rest of the world. But we have a bunch of people in our communities who can't get access to any of these systems, because they're set up to fail for our people. So, it's inherent. So what we need to do is reflect that through policy change, have more active... activist voices around the table to say, 'Well, actually, that's not acceptable.' There are solutions there. New Zealanders know the solutions. We just need to implement those for our communities. And Thomas, was it fair to call Bill English an 'island nation xenophobe'? Yeah, I thought... It was unfortunate singling him out, actually, cos I think Bill, as far as recent leaders of the National Party have gone, has actually been one of the more thoughtful, more progressive, more reform-minded prime ministers and leaders who has actually put quite significant effort into areas around, for instance, Treaty settlements and Crown-Maori relations. So I thought it was unusual for her to single out Bill, and actually, it's not fair towards him. But I think... More generally, actually, I think what Golriz does within Parliament is really important, actually. She's quite a distinctive and unique voice, and it's a really important voice to be represented in Parliament. And it's interesting that it generates so much hate and anger from, generally, I must say, white, middle-aged men, which often is completely unjustified` almost always unjustified, and it just shows that I think what she's doing is really important, standing up and providing that perspective. Absolutely. A fear from those white men, I think, as well, oftentimes. Yeah. Thomas Pryor and Lance Norman, thank you both so much for joining me. Coming up ` Children's Commissioner Judge Andrew Becroft on the latest blowout at Oranga Tamariki. Plus ` she's tipped as future leadership material. Can National's Nicola Willis sell you on her policies? Welcome back. A new report by the Children's Commissioner describes racism against mothers and babies within our child protection agency Oranga Tamariki. Maori mums have shared their real and traumatic experiences with Oranga Tamariki, or Child, Youth and Family. WOMAN: She told me that if I was ever to have any other children, that they'd be taken straight away, and I would never be a mum again. The report said that some unprofessional social work by Oranga Tamariki is causing harm, that Maori babies and their families are experiencing racism, and that the state care system needs to treat mums and their babies with humanity. NEWS PRESENTER: A human barricade at the doors of Waitakere Hospital has stopped two newborn babies being taken from their mothers. It comes just days after the Children's Commissioner highlighted deep systemic issues in the state care and protection system. It's been very stressful. I've had hardly any sleep all week since the birth. Professional support is what I've been needing and wanting. And Children's Commissioner Judge Andrew Becroft, who wrote the report, joins me now. Thank you for being here, Commissioner. Your report outlines a litany of awful, shocking allegations against Oranga Tamariki ` women and babies subjected to racism. One mother told halfway through labour that her baby would be taken, and another told that she couldn't see her baby after giving birth. You've spent months on this report. Based on that, how would you categorise the state of Oranga Tamariki? I think there are some deep-seated and fundamental issues facing the organisation, from the perspective of Maori children in particular. You're right, this report shows a deep-seated and profound mistrust and alienation, but we need to say this isn't new. It's utterly consistent with Oranga Tamariki's own report about the Hastings case, with the Whanau Ora report, and it's decades long. So it's not as if this mistrust has suddenly developed. It's a long term issue, and it's a challenge. Absolutely, and we'll talk more about that. I'm very interested to talk more about that in a minute, but you also said in the green room to one of our producers that this was the most harrowing report that you've read. It would draw tears from stone. I mean, to hear of babies being removed right at the moment of birth, and the mother finding out about her pending removal of her baby during labour. Horrific as a removal must be, in those circumstances, yes, I guess it stopped me in my tracks. And your report was based on the personal accounts of 13 families. There are 6100 children in Oranga Tamariki care. Are the experiences of those 13 families truly representative? We undertook qualitative research. We wanted to dig deep, understand the lived experience of what was going on. From those interviews, we hoped we could surface, and we have, some issues for further investigation. But again, it's totally consistent with what happened in Hastings, the own inquiry from Oranga Tamariki, from Whanau Ora. So a small group ` a deep dive as it were ` into their life, and they were very realistic and very honest about it, but it's quite consistent with the wider picture. We've spoken to some social workers doing an extremely challenging job who feel defeated and misrepresented by your findings. What do you say to them? The last thing I want to do is to put the knife into social workers. We want the best system possible. We do know the delivery of social work services is very patchy. It's variable. We know areas where it's terrific. We all know outstanding social workers, and it's their job. My challenge is ` I hope they take this up ` is to lift the standard across the organization. But it's undeniable that Oranga Tamariki inherited some very patchy and substandard practices. A spotlight's been shone on it. Now, I think it's healthy that we do that. It's healthy to exemplify where things are going wrong. I mean, how else can we do the job? How else can we make progress unless we own how bad it can be in some situations? Of course we know there's good social work, but I'm not` I just don't think it's constructive to sweep it under the carpet. But at the same time, it's a challenging frontline job. Social workers need our support and encouragement, but we need to hold them to the highest possible standards. Because they're saying that there's a lack of time, a lack of support, resources. One said, quote, 'The pressure, the risk we carry, the anxiety, the stress, the crisis, 'the need to intervene immediately to prevent a death or injury, 'and the fact that our decisions are made within a blaming, low-trust culture.' How do we address those concerns? As our own report said, as the voices said, we're in much earlier, we're working with good assessments, we aren't pre-judging. We're not relying on historical data. We're realizing families can change, and we know that with good support and assistance, as has often been recently been demonstrated particularly for Maori families with Maori organisations and iwi, when that is done there is much less need for urgent, last minute, without notice applications to the Family Court ` bang. I mean, there's got to be a paradigm shift. And in a way, the voices ` they point towards that. Yes, there were no recommendations in our report. We wanted the voices to speak for themselves, but implicit in those voices are areas for change. What about caseloads? Because best practice internationally is 14 cases per social worker. We've been hearing about some social workers who have caseloads of up to 50, or more. Does the government need to set a maximum cap on caseloads for Oranga Tamariki workers? Those caseloads are unacceptable. Several previous attempts have been made to cap caseloads. At one stage, there was a commitment of 18. This is not a new issue. The expert advisory report from the National government made clear ` things had to change. I'm disappointed that we're still fiddling with this issue. Still having the same conversations. And Dame Tariana Turia said that off the back of your report, heads should roll at Oranga Tamariki. Should they? My job is to monitor systems and organisations, not personalities. Given the deep-seated concern, the challenge for leadership of Oranga Tamariki, and I know they know this, is to build the trust. Now, part of that is going to be what I call ` and it's not just glib ` revolution by devolution. That is genuinely and equitably sharing resources. Partnering, delegating functions and responsibility so there is a real devolution. Almost the by Maori, for Maori. Now when that happens, and it can happen, and the legislation now directs it ` when we get to that point, there is trust and there is a way forward. Oranga Tamariki know the challenges. They know what the law requires. I'm cautiously optimistic, but yet deeply concerned at the same time. I want to pick you up on the 'for Maori, by Maori' approach because Maori leaders want their own child protection service. You said on this programme last year, quote, 'The time has come for us to seriously consider that.' Is that still your view? Do we need a separate Maori Children's Ministry? I've just been talking about revolution by devolution, equitable sharing of resources. That idea's on the table, yes. Maori have been calling for it for decades, but as I say, the prescription for that is now in the legislation. Some people say, 'you are far too trusting. 'You're a lawyer and a judge and you believe in the power of the law to change.' Well, I do, and if good leadership` if Oranga Tamariki grabs that opportunity, it can be done. Have you had any conversations off the back of your report with Oranga Tamariki CEO Grainne Moss, or with the Children's Minister Tracey Martin? Yes. Before the report was released, we were pretty clear as to what it was saying. They were hard messages. I think there was a feeling that were we able to say too that there were positive things going on. I guess I'm talking about the ought, where we want to be big picture. I can see there've been developments. There are four relationship agreements with Oranga Tamariki and iwi. There's a change of landscape. A good example ` Ngati Porou in Gisborne, and now saying our vision is by 2025, no child in state care. If resources are given to us, if we're helped to build our own capacity, we can do it. I mean, that's the model. So, I want to be balanced in what I'm saying, but let's not shrink from the challenge. This isn't the time for fiddling around the edges for minor changes. It really is something revolutionary that is required. We've talked and talked and talked about it. The expert advisory panel talked about it. We've got to deliver, and I won't shrink from doing that. It's my job. I've got to push that for all I'm worth. Because Oranga Tamariki, as you say, it's received so much scrutiny in the last year, hasn't it? Five reports into its practices. Have you seen` you've talked about some of those examples ` the iwi consultation, but has there been real, meaningful change in the right direction to address the concerns that have been raised in every single report into the agency? There's been real and meaningful discussions. There's been real and meaningful agreement, but we haven't yet seen the real and meaningful delivery. And you're right, that's where the rubber meets the road. And just finally, Commissioner, this isn't unique to Oranga Tamariki though, is it? Because every report into prisons, the justice sector, into education, into housing, employment. We always see that Maori families are disproportionately disadvantaged. So, is there hope? It's probably the biggest challenge facing our country. I don't think we argue now whether there's systemic and institutional racism. I saw it in the justice system for 16 years. I see it in Oranga Tamariki, health and education. Is there hope? The question is we have to do it. It's no longer optional. This isn't a matter of, sort of, academic discussion from our armchairs. There is hope because we acknowledge it, and there is hope because we're committed to change, and there is hope because we want to bring about a difference. And as long as I have breath in this job, that's what I'm committed to. Thank you so much for your time, Children's Commissioner Andrew Becroft. Stay with us. We're back after the break. Welcome back to The Pitch where we give an MP just five minutes to sell you their ideas. National MP Nicola Willis has leapt up the party rankings and snagged a prized portfolio after backing Todd Muller's leadership coup. So, this week we asked the new Opposition housing spokesperson her plan for fixing the housing crisis. I'm going to put Kiwibuild out of its misery. It was eventually a hoax. The government promised 100,000 houses. They've only built 395. Let's get rid of Kiwibuild, and let's focus on building houses properly. OK. Are you going to salvage anything from its carcass? Oh, look, if there are contracts that need to be honoured, National has always believed in honouring contracts, so we would do that. But we'd want to do that in a way that doesn't put any more taxpayer money at risk, and doesn't put first-home buyers at risk. So how many houses are you gonna build, and how quickly? Well, this government has committed to 8000 more state houses over the next few years, and National thinks that that's about right. We need to keep building more houses. But let's remember that that's only a tiny proportion of the overall houses that New Zealand needs. It's only about 10% of what gets built. So, we want to charge up private sector building by making it easier for private developers to get houses built. So how are you going to make it easier to get houses built? Judith wanted to scrap the RMA Repeal and Replace. Are you committing to do that as well? Judith's absolutely right. The RMA is a beast. It's an 800 page monster. It's had 80 amendments, 18 different acts have gone through to fix it. OK, but what does the new thing look like? Well, I'd like to see it split into two different pieces of legislation ` one that is focused on protecting our environment with environmental bottom lines, and one that's focused on giving certainty about planning, so that when I'm a developer and I'm wanting to build new houses, I'm wanting to do a new development, I can be clear about whether I'll get a consent, where I can do that building, how long it's gonna take me, and what the costs are. So, the government has already moved to cut out some of the red tape from the RMA. You're broadly supportive of that, but how much more needs to go? Oh, this government's done its absolute classic ` it started a working group, and the working group is yet to report back, and I'd be very surprised if the working group does report back before the election. Would you keep the housing portfolio split between three, or would you just tackle it yourself? I'm always a team player, my friend. I like to have other people alongside me. We've got such talent in our caucus, and people with such a broad range of experiences that the reality is in a cabinet, we would want to be working collaboratively, and we'd be wanting to get insights from different communities because the challenges for housing in rural areas versus urban areas can be quite different, and we need to have` So, to be clear, the portfolio would be split into three, still? That's not my call. That's a call for the leader. I'll work with whoever wants to work alongside me to get more houses, to make them more affordable, and to make it easier for first-home buyers. So, National's been previously quite reluctant to refer to the housing situation as a crisis. Are you open to acknowledging that we have a housing crisis? Well, if you're a first-home buyer in Auckland, and you're looking down the barrel of a median house price of $925,000, you betcha it's a crisis. If you're one of the 16,000 New Zealanders currently on the state house waiting list, you betcha it's a crisis. Is it a human rights crisis? Well, I believe that the ability to live in your own home and to have security, and to have an affordable, good place to live is something that we should absolutely aspire to as a bottom line. So, yes, it's a human rights crisis. (STAMMERS) Whether it's a human rights crisis or an actual crisis of how many houses there are, I think that it really matters to people's rights. Well` so, that's a yes, then. The United Nations sure thinks it's a human rights crisis. Having a home to live in that's warm and affordable is a right. OK. Well, this is all really focusing on the supply side. How are you going to ramp up demand? How are you going to make it easier for people to get into those homes? Yes, absolutely, and government` National did make sure that people could access their KiwiSaver savings to get into a first home, and we'd want to continue that approach. We also started first-home buyer schemes that meant that people would get grants to help them into their first home. I've been talking with community housing providers who believe that there is more that we can do to innovate in the space. So, things like shared equity, rent-to-buy schemes ` what can we do to get alongside people who want to work hard, who want to save hard, who really want that aspiration of their own home` This is all stuff that's already being discussed. The thing with Labour is it's great at discussion. It's not good at delivery. OK, just a couple of quick ones then. What's the median house price in Wellington? Ah, here in Wellington it's 730,000. That's bang on. How many households currently in public housing? Ah, there's about 70,000. Yeah, 69,499, but very close. I rounded up. What percentage of Kiwis spend more than 30% of their income on housing? More than 30% of their income on housing? I'd say that you'd be looking at a significant proportion of Kiwis. Maybe... Put a percentage on it. Let's say half. Not quite half, it's 31%. Now, final question ` you were part of the team that took down Simon Bridges. Do you want the leadership spot for yourself? I want Todd Muller to be the next prime minister of New Zealand because he is the leader who will ensure we get the economic recovery we need. Will you rule out putting your hand up for leader? I will rule out putting my hand up for leader because I want Todd Muller to be our prime minister, and that's what this election is about. Now, and in the future. I'm not interested in the leadership of the National party, I'm interested in a National-led government with Todd Muller as our prime minister. That was Nicola Willis there. We're back with our panel ` Lance Norman and Thomas Pryor. Thank you both, again, for joining me. The Children's Commissioner report into Oranga Tamariki ` harrowing reading. Did that surprise you, Thomas? Sadly it didn't. I mean, we've just seen so many of these reports over Oranga Tamariki and some of those practises, which are just` they're just horrific. And yet, despite us hearing more and more and Judge Becroft doing an amazing job highlighting what's going on there, it appears the government just isn't acting. And it's an oddly head-in-the-sand approach. I mean, even if it's just` Clearly there might be some systemic issues that need to be addressed, but at the very least, surely it's a resourcing issue, cos we heard about some of the great work that individual social workers are doing, but they're hampered by resourcing issues, which mean you end up with some of these terrible situations, which he talked about. And Lance, what do you think of this idea of a specific Maori children's protection agency? I'd go a step further. I'd say hand the whole Oranga Tamariki model over to Maori, because what's good for Maori is actually good for all. And you could change the entire organisation, rather than having two separate organisations running two different models of care. Just change the whole system. Is there political appetite, do you think, for that? Would it ever actually happen? Well, I mean, you know, the previous government did Whanau Ora, which in a way took a similar model of actually saying to iwi organisations, 'Actually, you know best how to deal with your people.' There's a bizarre trust of the state in this government and in fact in successive governments, so, perhaps if the Maori Party returned to Parliament next time round, if they're supporting whoever's in government, they may push for this sort of greater devolution, cos ultimately all the experience shows the closer you can get to the end-user, if you like, the better the service is going to be, and Wellington doesn't always know best. And, Lance, Oranga Tamariki was launched in 2017 from CYFS, but it seems to still be dogged with those same old problems. Why do you think that is? It's` So, it's still CYFS. You've changed the name and you've spent a lot of money changing the name, but it's still the same behaviour, attitudes and the same negativity towards Maori. I'm getting a little bit over people saying, 'Oh, it's the responsibility of the last government.' So, if you go back, this has been around for decades, so if you're in government for the last 20 years, you are responsible for this issue, and you're responsible for not solving this issue. And, indeed, there was a report back in 1988 into our child welfare agency, which highlighted all of the same problems, so when we put this question to Judge Becroft, is there hope, is there real hope for change? (SIGHS) I mean, I'm pessimistic on this. I don't think so. I think for governments, it's an easy thing to shove away. You know, the odd report pops up, but actually they seem reluctant to put the money and the reform into it that is needed. And it is challenging, right? I mean, some of the reform needed will challenge a lot of the preconceptions and presumptions we have or Wellington have about how best to govern. And so that's always a little bit uncomfortable, a little bit unsettling, and 'mainstream New Zealand', if you like, might get worried about that. But, actually, there is a radical shift needed, otherwise we're just gonna have more and more of these reports and more and more of these horrible stories. And, Lance, are you optimistic that we might see that radical shift? Well, the irony is people say there's no money there. Oranga Tamariki gets billions of dollars now, it just needs to be recalibrated to be more focused on the communities that they look after. So there's a significant amount of money they have ` just recalibrate it and make better use of the existing money. Of course we want to add money to it, but if you just handed over a $3-$4 billion organisation, over time, to people that could run it way better, you're gonna get much improved outcomes. Really appreciate your insights, both. Thank you very much for joining us. Lance Norman and Thomas Pryor. That's all from us for now. Thanks for watching. Ka kite. See you again next weekend. Captions by Joshua Tait, Alex Walker and Lillie Balfour Captions were made with the support of NZ On Air. www.able.co.nz Copyright Able 2020