Post-Cabinet Press Conference: Monday, 3 July 2023

Good afternoon, everybody. It’s good to be back. Last week, I was in China supporting Kiwi exports, tourism, education, and other commercial opportunities between our two countries. My message was that New Zealand is open for business, and it was heard loud and clear. There are positive signs that China’s recovery will also assist our economic recovery, a good example being the four extra flights that China Southern will add to New Zealand each week, boosting capacity by 7,000 seats a month, which is great news for our tourism recovery. The 29-strong business delegation rated the mission highly, and it’s the exact thing that we need to be doing to help nurture business and political ties.

Since I became the Prime Minister, I have made trade and export growth a key focus of all of my overseas travel. I intend to continue to do that. It’s my intention to lead at least two international trade delegations every year that I am Prime Minister. Export growth is good for our economy; it’s good for Kiwi families; it will help to grow incomes, generate jobs, and raise the living standards of all New Zealanders.

This week, the Government’s focus is on our health system, and we’ve got a series of announcements coming over the next week. Since taking office, the Government has increased the per capita investment in our health system by 66 percent. A big of chunk of that extra investment has been increasing the pay of our health workforce to ensure that it is fair and competitive.

You will have seen this morning that the NZNO and the PSA leadership have reached an historic in-principle agreement with Te Whatu Ora on pay equity. More than 30,000 nurses employed by Te Whatu Ora will soon vote on a pay equity rate and a back-pay offer. It’s an historic pay equity settlement and will be the largest in New Zealand history. I’m incredibly proud of the $4 billion commitment we’ve made to address pay inequity in this largely female workforce who have campaigned for years to have these issues addressed. The proposed settlement sees a 6.5 percent increase to the rates for senior nurses and a 4.5 percent increase for graduate nurses. In addition, nurses will receive lump-sum payments totalling $15,000 to address their back-pay issues.

That comes on top of the interim pay equity adjustment that was paid in April this year—14 percent—and the previous lump-sum payment of $10,000. When you add those things together, alongside the collective bargaining increases that nurses have received since we became the Government, a new graduate nurse’s starting salary has gone up by 40.7 percent, and the salary for registered nurses at the top of their scale has risen by 49.2 percent. That’s a very proud track record and one that I’m happy to stand on. But our work is not yet finished.

Yesterday, we also announced further action to grow the nursing workforce by adding 830 additional clinical placements for nursing students; 130 students will be able to commence their nursing studies in the second half of this year, and a further 700 will be able to do so next year, increasing the number of nurses we train each year by around 10 percent. We know that we need more nurses, and this initiative responds to the Nurses Organisation’s Maranga Mai! campaign, which calls for more people to train to be nurses, and it sits alongside the immigration green list settings that are helping to bring more nurses into the country.

After taking a bit of time to gear up, our health reforms are now really helping to bring about the sorts of changes that we need to see. A nationally consistent approach to training and hiring nurses will assist with shortages and with improved pay. But one area where a nationally consistent approach can really pay dividends is when it comes to wait-lists. The old system saw variations that created a postcode lottery when accessing services, and it led to a lack of collaboration to speed up the time it takes for someone to get the treatment that they need. Since becoming the Minister of Health, Dr Verrall has made reducing wait-lists and removing that postcode lottery a key priority. I’m now going to hand over to her to provide details of our plan to give around 3,500 more New Zealanders access to cataract surgery.

Thank you, Prime Minister. Kia ora tātou katoa and good afternoon everyone. When I became Minister of Health at the beginning of this year, I said the three areas I’d be prioritising would be winter, workforce, and wait-lists. The announcement today marks important action on wait-lists.

For decades, former DHBs had threshold scores for eligibility for cataract surgery that ranged widely from 45 to 61. A score of 46 represents mildly reduced vision. A score of 61 represents poor vision and means a person can no longer legally drive. In Auckland and Waitematā, for example, you become eligible for a cataract operation at a score of 46, but in Canterbury and the Southern District you need a score of 61. Districts will now be working towards a maximum score of 46, which means patients with mildly reduced vision due to cataracts will be able to access surgery.

The Government is committed to eliminating the inconsistency patients experience when they need surgical treatment—across New Zealand—because of the postcode lottery for care. The health reforms have allowed us to end this postcode lottery in healthcare when some people got surgery with mild disease, whereas others had to wait until they were legally blind. This work is enabled by the investment in Budget ‘23. Te Whatu Ora prioritised $118 million to address wait-list issues and standardised healthcare and this initiative responds to calls from ophthalmologists across the country for a consistent national threshold. Te Whatu Ora’s hospital and specialist teams will work with those who refer to surgical services to identify who will be eligible for surgery under the new scores, as they are progressively rolled out, and will ensure they have timely access to the procedure.

Today’s announcement is the first in what we can expect to see across elective surgeries from now on: a joined-up health system working towards timely, consistent access for healthcare regardless of where you live. We will now be able to use and build on this revised cataract surgery threshold as a model to improve other wait-lists in the future.

Today, I also announced that a historic pay equity offer has been made to nurses which, if accepted, will see nurses employed by Te Whatu Ora receive additional increases to pay rates and a $15,000 lump-sum payment to address back-pay issues. The total value of the pay equity settlement on the table is now $4 billion. And yesterday, I announced a significant step the Government has made in growing the nursing workforce by adding 830 additional clinical placements for nursing students.

1 July marked one year of operation of our new health entities—an important milestone in our journey to build a more equitable, accessible, cohesive, and people-centred health system. It’s early days and we know there is more to do but there’s already signs the reforms are making a difference, making care more accessible. Under the old system, we would not have been able to add those 830 clinical places for nurses or standardise access to cataract surgery. I’m happy to take your questions.

Right, we’ll do questions on health first, and then we’ll move on to other topics.

Firstly, even without this change, Te Whatu Ora’s leading measures to drive down the wait-lists, starting with those that have had the longest waits and also making sure that those with clinically urgent need are addressed. Secondly, we anticipate that as we make these changes and roll them in progressively, and in some places it will take 18 months to roll that in—in those areas you will have to do a catch-up of those people who are newly eligible. We think that is approximately 3,500 people and we’ll be using capacity in the private sector as well as the best use of our public capacity to meet that extra demand, and then, from there on, we think demand will stabilise.

The main thing we will do is prioritise additional funding to those areas where that catch-up is required. That can be used for one of two things; firstly, outsourcing to the private sector where there’s capacity there; and, secondly, an approach called “in-sourcing”, which is where we might pay our public staff to do extra operating lists, if they’re willing, on a Saturday, to get through that sort of hump of work that we have to do at the very beginning when the threshold criteria changes.

So, currently, there are 7,884 people waiting for procedures; 67 percent of them have been waiting for less than four months, and the work to get the long tail of people on the wait-list treated is well under way—4,052 of them in the Northern region; 1,278 in Te Manawa Taki; 1,317 in Central, and 1,237 in Te Waipounamu.

I know that the ophthalmologists have been pointing out that this is such a visible and important area to act on first, and they were ready to do that. We actually have a number of engagements with other clinical groups to see if we can make similar changes in other areas, but it’s a matter of getting the logistics of all of those right.

You’ll recall we had the Planned Care Taskforce report last year. There is a lot we can do to use our systems more efficiently. There’s a lot of work under way to make sure our theatre efficiency is improved, for instance, to get what value we do have—get maximum value out of our facilities and make sure we continue to move the lists. We are making progress, particularly where this has been a focus for a long time. In the Northern region, we’re seeing them really get down to reduce those number of people waiting more than 12 months substantially.

Sorry, we’ll have to get back to you on that.

Well, of course, we train, I believe it’s 7,000 nurses at any one time already, and what we announced yesterday was approximately a 10 percent increase in those placements. The Te Whatu Ora team have assured me they have that capacity. We will need to be working with education providers to make sure that we’re identifying the eligible students to come through and growing our demand of students who want to come into careers in health to make that happen.

Yeah, I’m aware that health officials have been working for some time with the tertiary education organisations and TEC.

It is incredibly important to be able to make this offer to nurses. It represents a significant step to ending gender-based pay discrimination in the health system and finally paying nurses what they are worth. That is the primary reason why the Government brought in the legislation to do that and why we’re making this offer today. I’m also pleased that it should have positive impacts on our workforce recruitment and retention.

Tomorrow, Minister Henare and I will be talking a lot about our wider plans for the workforce, including specific initiatives for Māori and Pasifika nurses— workforce.

Not off the top of my head, but I am also pleased to be saying that Te Whatu Ora will be starting up its regular reporting of its data very shortly as well.

Yeah, Te Whatu Ora will be presenting its terms of reference for that this week.

They’re also convening the panel to that and making sure that they’ve got the approach to this right. It’s a very important matter.

No. It’s important that this is done well in a way that has integrity; that’s why we’re making sure the terms of reference are right.

I believe every wait-list has a scoring system that is assessing the clinical severity of the person’s condition and, therefore, it’s a clinical prioritisation tool.

Absolutely, and that was part of the justification for why we went down the route of a single national system for the reforms. I mean, in effect, the DHBs used to be bulk-funded, with only Government setting high-level expectations of what they did but not able to manage the granular level of how they resourced each wait-list over the other—and so we had the postcode lottery.

That is the direction that we’re going in, if we—yes, and it’s an important reason for why we did the reforms.

Yeah. Officials are working on advice on what we can do next, and, in general, it would depend on the logistics of that. So the number of operations we would need to do, what the picture is across the country. And in order to make this decision today, we also had to make an estimate of the people we didn’t know about who aren’t on our waiting list because they’re currently not eligible. That sort of process just takes some time to make sure that we can get through—once committing to do it, get through it.

Essentially, we have to step through it. That’s why the reduced threshold is being phased in. And in some places, that will take up to 18 months to phase that in.

Just remember the equity adjuster was not about clinical prioritisation or eligibility for care; it was about prioritisation of, essentially, the tail of the wait-list. So people who were eligible, the ordering of their surgery. And, as I mentioned earlier, that is being the subject of study by Te Whatu Ora.

That’s right.

I guess, no.

I can understand that when wait-lists are the way they are, people are very sensitive about access to surgery. And so I think it’s important that, alongside that evaluation of the equity adjuster, that Te Whatu Ora does everything in its power to reduce the wait-list, because that is the fundamental issue that is causing the problem for people in the community.

All right. Thank you, Dr Verrall. We might move on to other topics.

Yeah, we’ve had a brief phone conversation earlier today.

I’ve indicated to Kiri that we’ll have a catch-up when I get back from Europe, which will be in a couple of weeks’ time. I’ve suggested to her that she take a couple of weeks off, and she’s going to be doing that.

I don’t relay the conversations that I have with Ministers about other Ministers, but I can provide a reassurance that if anyone raises any serious issues about ministerial conduct, that is something that I will take very seriously. I have been very clear with Ministers, in the time that I’ve been Prime Minister, that my expectation is that all Ministers will treat their departmental officials, the staff working in their office, with respect and with basic courtesy. That is something that I would expect of everyone. I don’t expect Ministers to be absolutely perfect human beings; everybody will have a bad day from time to time, particularly when they’re under pressure. The question is: what do you then do about that? So if you exchanged words with someone—this happens in workplaces every day—what do you then about that? And I expect Ministers, again, to make sure that they’re treating people with respect.

As I indicated last week when I was asked about this, the feedback that I have had from the senior levels of the Public Service is that they—the chief executives; the relevant chief executives—are satisfied that any issues that were raised informally were resolved at the time. None of these issues were raised formally, and so, where issues are raised informally and the people who have dealt with them have said that they felt that they have been dealt with satisfactorily, I don’t see the need for there to be a separate layer of inquiry over the top of that.

What was that?

Well, these are the issues that were canvassed publicly last week.

Sorry?

Well, like I said, none were formally raised with me. So the chief executives concerned have not raised any specific concerns with me. They have said that any issues that were discussed internally within their organisations were resolved, so those are staffing matters that are matters for the chief executive. If they don’t feel that they have any issues that need to be elevated to me because they are staffing matters, then I will leave that with them. That’s the appropriate course of action.

I haven’t asked them for details of employment matters concerning the people who report to them, because they ultimately are their employees. The Public Sector Act is pretty clear about that.

Kiri had a rough couple of weeks, and I think it would be good for her to take some time off. She’s indicated that she would like to take some time off. It’s school holidays and a lot of people will take a bit of a break during this time and I think that will be a good thing.

Generally speaking, when any Minister has been the subject of intense scrutiny, as Kiri has been in the last few weeks, I would encourage them to take a bit of a breath. That’s what I’m doing here.

Kiri indicated that she would appreciate some time off. I think that that would be good.

Ultimately, not that I’m going to share publicly and Kiri’s indicated that she would like a bit more time off. I completely accept that and I’m happy for her to have it.

Look, as I’ve said, we’re going to catch up and have a good chat about where everything’s at when I get back from Europe—

—which will be Friday next week. And I’ll have a conversation with her about that then.

I think people are getting ahead of themselves. When someone says that they want a bit of time off and then we’ll have a chat about everything that’s happened over the last few weeks, generally I will leave the conversation about that until they get back.

Kiri is an exceptionally talented Minister who has contributed an awful lot to our Government.

I think what it does point to is that there has been a change in culture around this place in the last couple of years, which, in my mind, is a good thing. Things that previously weren’t talked about now do get talked about. As a former Opposition member, I can tell you that allegations of this nature flew around the place all of the time in the whole nine years I was in Opposition, and none of them really made it into the public domain—I’m talking about Ministers in the previous Government. I think it’s good that there is more openness and willingness to talk about that. Parliament as a workplace did need to change, and the fact the threshold is now higher is a good thing.

No, I don’t think that’s a fair characterisation of anything that I have just said.

As I’ve indicated, since I got back from China over the weekend I haven’t had the opportunity to sit down and have a chat with her. I will do so and then I will comment on those matters, but I’m not going to do that until I’ve had the opportunity to sit down and talk to her about it.

I haven’t had an opportunity to have a conversation with her.

So there is also a basic concept called natural justice, which is when someone has any suggestions of anything of this nature levelled against them, they have an opportunity to respond to those, and I’ve not yet had the opportunity to sit down and talk to her about that. Clearly, I’m not going to get that over the next week, and then I’m away next week. So we will have a conversation when I return.

I wouldn’t necessarily say that. I’m saying that we haven’t had the chance to have a conversation—so, therefore, making judgments is premature.

By being human.

What I understand is that there was a case of miscommunication and she thought she was going to a meeting organised by the Electoral Commission to encourage people to enrol to vote. Turns out that that’s not the case.

It would appear so, but, anyway, I certainly accept that that’s how she ended up being there. That’s what she said about how she ends up being there, and I accept it.

Certainly not—40,000-odd charges have been laid against gang members as part of the police’s crackdown on gangs; 400 firearms have been seized. This Government has changed the law to give police more powers to crack down on gangs. I don’t think that gangs play a useful role within our society. I certainly don’t endorse any of their activities, and they can expect the full weight of the law to be applied against them when they break it.

Not particularly, no.

My understanding was that the advice or whatever—the invitation was that went to her, indicated that she was going to meeting that was organised by the Electoral Commission around voter enrolment. That’s the sort of thing that members of Parliament attend regularly all the time, and I encourage them to do so. Clearly, that was not the nature of the meeting.

I have no idea. I haven’t spoken to her directly about it.

All I can share is the information I was given which is that she has said that she thought she was going to a meeting about voter enrolment.

What’s that?

That’s probably a question for her. I don’t have all the details.

I completely accept her explanation. If you’ve got further questions about that explanation they’re best addressed to her.

Look, I can comment about MPs and Ministers that are part of my team. I don’t think it would be appropriate for me to comment on other elected officials in other capacities. That’s ultimately a matter for them.

I’m not going to go into the conversations I have with people individually. Kiri’s indicated that she wants to take a bit more time off. I think that’s a good idea, and I’m happy to leave my comments at that.

I’ve got nothing further to add on that.

A formal complaint does not need to be a written complaint. So it could be that someone goes to their manager or their chief executive or whomever the relevant person is and said, “This has happened. I didn’t like it. I’m concerned about it. I want something to be done about it.”

No, not to my understanding.

You can expect to see something in the next few weeks. There’s obviously been a change in the Minister of Transport. The new Minister of Transport is taking a little bit of time to make sure he’s on top of the details of that and comfortable with it. But I expect that there will be progress within the next few weeks.

Not at the time that he stood down from the role.

So she’s taking a bit of time out. Ministers take time out over the recess. That doesn’t mean that all of their work disappears and so on. And so if there is a need at any point for someone else to pick up any extra workload to help her out, then I’m happy to facilitate that, but at this point I don’t think that’s needed.

Alcohol—there’s been a lot of work done around alcohol reform across the entire time that I’ve been a member of Parliament. It’s a pretty broad topic. If you’ve got something more specific I could give you a more specific answer on that. But, you know, there are bits of that that I’ve supported and bits of it that I haven’t. So, you know, happy to answer more specifics.

So one of the conversations that I was having with police as Minister of Police— and I know that this has now been followed through by the new Minister of Police, Ginny Andersen—is just the work that they’re doing around traffic enforcement and that includes regular breath testing, because the police weren’t hitting all of their performance targets there in terms of the regularity of breath testing and so on. So I know that that’s been an area of focus for the commissioner to make sure that they’re lifting their game there, because I think that will make a difference in terms of the level of drunk drivers on the road who then go on to have accidents. So that’s primarily been the area of focus. It’s been around enforcement of the existing rules. There’s nothing wrong with the existing rules. We need to make sure that the police are properly enforcing them.

No, I’m not comfortable with what happened in the youth justice facilities. I have got the Minister for Children having a look at what our additional options are to prevent these sorts of things happening again in the future. Obviously, in terms of the process of getting them down off the roof, there were police involved in that process. I’m not necessarily going to comment on the specifics of that; those are operational decisions taken. But I don’t find it acceptable that they ended up on the roof in the first place.

Look, ultimately, the operational decisions, given that the police were involved in that—I don’t comment on police operational decisions; there’s a longstanding practice of that. I don’t think it was acceptable that they ended up on the roof in the first place.

As I’ve indicated, longstanding convention says that I don’t comment on the operational decisions taken by police.

Yeah, I don’t recall having seen any update either. I wouldn’t necessarily expect to be the immediate recipient of that. It would typically go to the Speaker and to the Parliamentary Service Commission, which I’m no longer a member of, so I’m happy to follow up and find out what’s happened to it. But the Speaker’s office is probably the first port of call for that question.

Look, I have not said it’s mental health leave. I’ve said that she’s taking some time off.

Well, as I’ve indicated, the conversation I had with her earlier today was that she was going to have a couple of weeks off.

I think it’s a work in progress. I think—you know, positive steps have been taken. I think a bunch of new systems and processes have been put in place that mean that this sort of thing isn’t swept under the carpet any more, and I think that that is a good thing. But it’s something that requires ongoing work.

Well, there’s bad behaviour in almost every workplace, and it requires ongoing vigilance to create a work culture where it’s not tolerated and it’s not accepted. Actually, I don’t want to defame all workplaces, but large workplaces you’ll often find examples of bad behaviour and I think we need to work hard to create a culture where that’s not OK.

It depends on the context and on the circumstances. Setting clear expectations is perfectly OK. Expressing dissatisfaction when those expectations aren’t met is also perfectly OK.

Being robust in your conversations is also OK.

No, there is a difference between robust conversation and bad behaviour. Now, strongly disagreeing with someone will often result in robust conversation. That is the nature of a democratic system of Government. People are going to disagree with each other. If you look at the disagreements that happen in the parliamentary debating chamber, some of them are very robust. That is the nature of a democratic system of Government, and I don’t think we should change that, but you can still treat people with respect whilst disagreeing with them robustly.

As I’ve indicated, it depends on the context. If you’re participating in a parliamentary debate, people shout during those things all the time. Shouting at someone in a one-on-one context is not OK.

She’s taking some time off.

She’s taking some time off.

Yes.

Well, no, because there’s a general election, but my expectation from this point onwards would be to do two a year.

I’m sure that there will be future trade delegations to China given the size of it and its importance, but I would envisage that we’ll be looking to further our trading opportunities in other areas. One of the things that we do in shaping up trade delegations is talk to our export industries around where there are emerging market opportunities that a prime ministerial - or ministerial-led delegation might be able to help unlock.

It’s our largest export economy, or our largest trading partner.

We need to continue to diversify, of course. Next week, I’m going to the European Union where there’ll be further progress on our European Union free-trade agreement. My first significant, I guess, steps into this space were in Australia, where we were looking at further exploring the closer economic relationship, partnership, and the UK, where we got entry into force of the UK free-trade agreement. So I don’t accept that the Government’s only focused on China. It’s a very important trading partner for New Zealand.

Like I’ve said, I hope that the Minister will be bringing some proposals forward in the next couple of weeks.

No, it wasn’t discussed today.

Oh hello; welcome back.

Not directly, but through my office and through the leadership of the Public Service, which is how this would normally happen. I would not routinely, as Prime Minister, speak to the chief executives of individual departments. Where an issue arose, it might be raised by the chief of staff in my office, the chief executive of the Department of Prime Minister and Cabinet or the Public Service Commissioner, depending on the nature of the issue in question.

I stand by all of the answers that I just gave earlier on about the fact that they were issues that the chief executives indicated they thought had been resolved.

Clearly, there are some people raising concerns publicly that they’re not raising internally within those organisations.

Of course.

It’s difficult to form a judgment on that without knowing why they’re not raising those issues internally.

In terms of what?

Well, I can’t speak to your level of confusion, I’m afraid.

Yes.

It’s a situation that I’m monitoring closely and have been receiving irregular updates on. In keeping with all of my previous comments, I’m generally not commenting on it publicly because it’s likely to compromise the efforts that are under way there.

Yeah, we’re going to have a conversation when we have the opportunity to do that in a couple of weeks.

Well, in the first instance, I’ll have a conversation with Kiri.

Ultimately, there’s interests of fair process at play here, and that’s what I’ll do.

Like I say, I’ll follow a fair process.

Well, the first step in that fair process, as I’ve indicated, is to sit down with the Minister and have a conversation.

Well, it depends on the nature of that conversation.

No.

No. OK, thanks everybody.