COVID-19 update 24 September 2021

Kia ora koutou katoa welcome to Friday's media conference.

 I will hand direct we over to Doctor McElnay to update on the latest case numbers and I will make a few brief remarks before taking questions.

>> Thank you, Deputy Prime Minister. Kia ora koutou katoa.

 There are nine new community case is to report today, all in the Auckland region. That takes our total numbers associated with this outbreak to 1131.

Of those, 902 cases have recovered.

Additionally, there is one new case in a recent attorney in our managed isolation facility.

After day's nine new community cases, all are linked. Three are household contacts and six are contacts of known cases.

 For yesterday's 15 cases, only one remains unlinked and investigations into the case are underway to determine if there are any connections.

There are 13 people in hospital with three of those in ICU.

Testing numbers in Auckland dropped a little yesterday but 6928 swabs were still taken across Auckland. With 14,855 swabs processed across the country.

 At our new suburb of interest, Mount Wellington, there were 297 swabs taken yesterday. That is a great effort, so thanks to everyone who came forward to be tested.

 In Clover Park, a suburb of interest this week, 1725 swabs have been taken since Tuesday. Since 1 September 20.8% of that suburb's population have been tested, which is a great effort but we still want people to come forward for testing and that suburb.

Public health officials in Auckland continue to carry out surveillance testing at large essential workplaces and their focus next week will turn to construction and retail sectors. 

As Dr Bloomfield mentioned yesterday, there is a new testing requirement for people who need to travel across the alert level boundary for personal reasons. That requirement is for most people permitted to travel for personal reasons from the alert level III boundary into an alert level II area. For example, travelling from Auckland to Hamilton. These people now need to carry evidence of a negative test result taken 72 hours prior to their travel or proof a test was taken within seven days prior to their travel.

There are two exceptions to this testing requirement. No test is required for the following. For one-way travel for people travelling from an alert level to into alert level III and then remaining there. And for people attending a healthcare appointment including vaccinations who are travelling from their residence in alert level to into alert level III and then back into alert level II. -- two. They need evidence of their appointment and be able to show that if requested.

Details of the testing requirements can be found on the Unite Against COVID website. Just a reminder, it can take 24 to 48 hours to get results of your test. Sometimes longer depending on the demand for testing, so please plan ahead and factor that in to the time for your travel.

A reminder that people who cannot provide the required evidence will be turned around at the boundary by police at checkpoints and aviation security staff at Auckland airport.

Please note that the testing requirements for permitted workers crossing the alert level boundary are unchanged. That is proof of it has taken seven days prior to their travel. But Minister Robertson will talk further about the requirements for those travelling for business.

 Just some comments on the Upper Hauraki outbreak. All tests in that area have come back negative with the exception of members of the Whakatiwai household which have already been announced. I can also report there has been a good uptake of vaccinations in the Hauraki plains with 60.1% of residents having had their first dose and 23.9% their second.

And just turning to our vaccine rollout, there have been more than 4.91 million doses given. Of those, more than 3.19 million were first doses covering 70 covering 76 % of the eligible population and more than 1.72 million or 41% of the eligible population. That is the population aged over 12, 12 and over.

Yesterday more than 49,115 doses were administered. That is broken down into 20,983 first doses and 28,132 second doses, so the second those numbers are coming up. In Auckland yesterday, there were 16,258 vaccines given.

Over in Auckland more than 1.7 million doses have been administered. Of those, 1.16 million were first doses, covering 81% of the Auckland population and 626,103 second doses covering 44% of the population.

 The Ministry of health is also updating its advice about having routine vaccinations at the same time as the Pfizer COVID-19 vaccine. Our initial guidance was there should be a gap between two there should be a gap between 2 to 4 weeks.

We have received further advice from our technical advisory and we now advise that the majority of routine vaccinations can be either given before, after or at the same time as the COVID- 19 vaccine. There is an exception to that and that is the shingles vaccine where it does -- there does still need to be a gap between receiving it and receiving the Pfizer vaccine. We will update the information to health professionals about that today and on our website. What that means is that it will help ensure that our routine immunisation program such as MMR and HPB can continue without disruption while we are rolling out the COVID-19 vaccine.

 Finally today I would like to acknowledge pharmacists as it is Well Pharmacists They tomorrow. -- day.  they have stepped up and helped us and use the strong community links and relationships with people to make sure people can continue to get vaccinated. I would like to thank you very much for their hard work.

 Back to you, deputy promised.

>> A few brief comments before we take questions. Firstly, ministers have today agreed that the Upper Hauraki will move down to alert level II at 11:59 PM on Saturday. As Doctor McElnay has indicated we have had an incredible response from the Upper Hauraki community with people getting tested following the health advice and sticking to the alert level requirements. More than 1000 tests have been undertaken in the immediate area since Monday with the only positive results as you have heard being from the original household stop all the close contacts from the Mangatangi School event including staff and students have been tested with all tests returning negative. Widespread wastewater testing in many areas this week has produced no unexpected detections.

The public health assessment is it is now safe for Upper Hauraki to move to alert level II along with the rest of New Zealand except Auckland of course, which remains at a level III.

Today's numbers are encouraging and indicate the hard work is paying off but as you have heard us say before, the job is not yet done.

 As we head into this weekend, I once again asked the people in Auckland to remember it is still alert level III. We need you to stick to your bubble and to stick to the rules.

Thirdly, we continue to make good progress on vaccination. As the Director of Public Health has just told us, 76% of the eligible population now have a first dose.

Today I want to particularly (unknown term) to our Maori health providers to bring founding members forward in innovative ways so they are protected against the virus. In the Waikato area, there is a max fascination event from 10 AM to 3 PM to deliver vaccinations and can I encourage whanau across the Waikato to go to the sports ground to get vaccinated? I do here there prizes on offer including a trip. You just need a sharp. -- show up. No booking is necessary.

The government provide support to businesses. As of this morning 593,262 applications for the wage subsidy have been approved, totalling more than $2.5 billion in payments. The second round of the Resurgence Support Payment has now been open for a week and is paid out $256.8 million to 87,647 applicants. We are working closely with the Ministry of Social Development and Inland Revenue to clear any  backlogs in processing.

This includes outbound calling to those whose applications are still pending. As I have said a couple of times, one of the issues is the different details being held by Inland Revenue than what is on the application for the wage subsidy.

We do ask people to look carefully at this as they make their applications. With the move of Auckland into alert level III this week, we estimate about 280,000 more people will have been able to go back to work.

 I would just like to remind everyone of the rules for businesses at alert level III.

Firstly staff should continue to work from home if they can. If your business requires close physical contact, it cannot operate under alert level III. Your business must be contactless with the public. Your customers can pay online, over the phone or in a contactless way. Delivery or pickup must also be contactless. Staff should remain at least a metre apart and 2 m away from any other person. In terms of travel, as the Prime Minister indicated on Monday, permitted movement across the alert level III and two boundary is essentially the same as it was in Auckland was at alert level IV.

This is because we are dealing with the delta variant which, as we know, is far more transmissible.

The strong advice from our public health officials is we do need to continue to take a precautionary approach. In the case of businesses, you need the business travel document and you need to be tested, part of the testing regime. Key movement like freight and primary industries is allowed to ensure food and other supplies can move stop there is an obligation on employers to have systems and processes in place to minimise travel of workers between alert level areas and mitigate the risks of spreading COVID when workers are travelling.

 If you're not sure of the rules, please go to the Unite Against COVID 19 website to check them.

Having said all of this, we recognise that the longer the restrictions are in place, the more challenging it is for people to meet deadlines such as the settlement of house sales or starting jobs outside the region. Equally, those who have been in Auckland undertaking carer duties may have completed these but they are currently unable to leave.

There is an exemptions regimes for both personal and business travel that is ultimately managed by the director-general of health. We have agreed that ministers will work with the Ministry of health to look at the exemptions regime to facilitate some more one-way movement to relocate out of Auckland.

We anticipate that this will include testing requirements. Ministers will consider this advise on Monday and we will announce any changes as soon as possible given the pressure we know some people are under. 

Just before we go to questions, for those watching at home, this is to let you know there will be no 1 PM media conferences on Saturday or Sunday, just the statement from the Ministry of Health with the latest case numbers and finally, you would have seen earlier today myself and Minister Andrew Little released the first report of the implementation unit which looked at the 2019 mental health package.

 Minister little will be here at about 1:30 PM and we can take questions on that matter after we have finished with the COVID-related ones. 

>>We have heard that we are on top of this, but how much confidence should be have that we are on top of this outbreak.

>>We have heard from ministers that we do not believe that there is widespread transmission in Auckland. We feel comfortable to move down to level 3. What we do know is that there are still isolated cases but we do feel that we are getting on top of this outbreak. That is the reason why I said we have just got to stick at it and we have come so far here and this is why we need Aucklanders to make sure that they stick to the other level 3 levels so that we can get those cases down again.

>> Does that show that we are on track to elimination and zero cases?

>>That is alcohol and that has always been our goal to get to elimination of cases. That is why we have the measures we do. At other level 4 and a low level 3. We may see case numbers pop up again because bear in mind that each time a case is identified with and move into the contact tracing process and there are household contacts who may not have known that they had the virus. So it is possible that we will see case number still bounce up and down a little bit. But I think what the trend is showing is that the measures we have taken our working. If people stick to the rules we will continue to see the numbers going down.

>> Can you just clarify something you said...

>>Can you just clarify why Mount Wellington is now a suburb of interest? Are the other cases there or can you go into the detail of why that is the case?

>>That is advice that we have received from Auckland regional public health, so that is based on the analysis of cases and clusters and some of the movements and they have identified that. The other suburb that we have announced this week. As a particular suburb that we would like to encourage testing in.

>> Just to add onto that, particularly for Clyde Park and Clover Park in the details about that and Mount Wellington, we are encouraging everyone in the suburbs to go and get tested whether you are symptomatically asymptomatic. This is part of our surveillance testing just to give us that absolute assurance that there are no cases out there that we don't know about. As Dr McElnay says, we have some cases associated with that suburb, and this is a real opportunity for the people of Mount Wellington to get tested. I do just want to thank the Clover Park community for responding in such huge numbers over the last few days. Please do continue coming up and getting tested.

>>And just to clarify, that is Clover Park and Mount Wellington. Have we uncovered any new cases that you are talking about?

>>We have found cases as a result of that extra testing. That is exactly why we are doing the protesting. We want to uncover comically extra testing. We want to uncover any cases that may be there. It is really important that we get tested even if you are symptomatically or asymptomatic.

>>I think it is one case in Clover Park.

>>One case.

>> And how much of this long tail is due to people breaching their bubbles?

>>Well, overall the compliance has been good. We have asked that question every day. We ask that of the Auckland regional public health and the police and others. They are confident that people are keeping to the rules. Monetary examples have come through where perhaps we have seen and mingling between a couple of households. I wouldn't regard that as flagrant bubble breaching. I think it is just sometimes people, the way their lives are organised, but we do ask people to stick to the bubble. And one thing that I would also be advised of his that mind people have received a positive result we get very, very good compliance. We don't find many examples of breaches.

>>From the modelling yesterday 7000 deaths from 80%, let's assume the Pfizer vaccine is at the midpoint of what is a zero to 100 effectiveness scale, how effective is the vaccine?

>>I will turn to Dr McElnay for the technical side of that. I have not seen any change in efficacy of Pfizer, which is high. The nature of this is that you will always have to create a set of circumstances and it pops out a number at the other end. There are different modellers with different views on these matters. But we have no doubt that Pfizer has a high level of efficacy.

>>Very high levels, like 95% efficacy against death and severe disease. Where the vaccines have a lower level of effectiveness is mild disease and any infection and that ultimately transmission. And that is where we are still waiting for the latest updates, particularly for delta variant and the effectiveness of Pfizer for transmission. Still shows that it is still very, very effective for death and severe disease, and we are just waiting for the updated information about transmission.

>>Given that committee believe at all the 7000 devil's number? It seems alarmingly high.

>>I am not going to weigh in to the debate about modelling. One of the things that has been present throughout the pandemic is that there are different views and therefore different models that get created about the impact. I will just finish, Jason. The one thing I know for certain is that every modeller believes that every New Zealander should get vaccinated. The message people should take from modelling and people's response to the modelling is that every New Zealander should be vaccinated.

>> The differences yesterday in front of hundreds of thousands of people, the Prime Minister wheeled out this professional modelling and that essentially that it was announced to the nation. It had not been peer reviewed, and since and a lot of people have commented and said that this is essentially scaremongering. What do you make of that?

>> It most definitely is not. I would put the counterfactual to that if we had not of these at modelling you would be sitting here, not you, but one of your colleagues would be sitting here today asking why we had not. It is important for us that we put out the results of the modelling that has been done. It is professor Hendy's model and there are other people that have a different view about that. The important thing to note is that the more people that get vaccinated the better it will be for all New Zealanders in terms of being able to return to the levels of freedom that we want.

>> People so that you seek a range of use, but you only listen to people like Rodney Jones who have been providing advice.

>> We take advice from a vast array of people not only the modellers like professor Hendy or Rodney Jones but equally the groups that we have established with the likes of David skied and others. We have a group that advises a ministry on a local basis. This is modelling that was provided to government and it was put out there transparent. Of course it is contested and buried mind that also the outcome is determined by what we all do. It is determined to getting vaccinated and the other public health measures that we might take alongside that. This is an example of us being transparent about the information that we have, but no New Zealander should be left in any doubt whatsoever that if we can get our levels of vaccination up, that will give us options to return to some of the freedoms that we know.

>> Obviously you are pretty confident that we can drive down the cases. (Inaudible) not people have transmission but still creating cases. Can you guarantee that you won't let us out of Auckland by lowering a two level 2, keeping some sort of (inaudible) around at? Obviously there is no COVID elsewhere.

>>We will take the advice of our public health people as we have all along. I will not pre-empt a decision today about advice that we have not seen. We have seen a good number today and we want to see more days where that number goes down and we will get the advice about where the pockets of transition are -- transmission are and then we can take decisions on there. I know why you are asking what you are asking, but we have to take this one step at a time and there is a certain amount of time before Cabinet will be reassessing alert levels.

>> Do you need to make a choice between giving Aucklanders a freedoms versus the fact that we have to have some COVID. (Inaudible) all that covert get out?

>> We will continue to take a precautionary approach, that is your project we have taken all along. The prime minister has made clear that while Auckland is a bit elevated to level 3 level 4 and the rest of the country will stay at level 2. We have to analyse the outbreak and look closely at it and measure the risk. The other thing I would point out as well as the Prime Minister indicated yesterday that obviously we are doing more thinking about where we go from here. As vaccination rates increase. You will hear more about that in coming weeks.

>> Apologies for the other day

>> Auckland was allowed last time at level 3. Why has this changed and not been properly communicated, and will they be able changed to allow more people to move if they want to get it done?

>>That was a comment I made earlier on. We took a decision, which the Prime Minister to talk about on Monday, that with you delta variant we need to be incredibly cautious and careful. Our decision was made that movement would say essentially the same however, as I said, we note that the longer the outbreak goes on the more difficult it becomes for people in the circumstances you are in. You can only push the settlement date out so far. What you can do over the next couple of days is to sort out the exemptions regime to deal with people who are leaving Auckland so it is not about people that are coming and going, you have reasons such as that. We will set that advice over the next couple of days and have something to say early next week.

>> What do you make of Judith Collins describing (inaudible) as dodgy?

>>I totally reject that. The decisions that we have made around the COVID response and recovery fund have been taken in number of different times. One thing I would note is that a number of the New Zealand grant that some people have chosen to highlight were not even funded out of the COVID grant. Well we have provided support to our artefact it has been a recognition of the tremendous damage done and the ability for this to be put on. And so we have had this scheme open to artists in the country and we have an additional direct funding in the arts sector because it is part of our society.

>>Deputy Nestor, the level 3 restrictions (inaudible) on the applications, and he said that you are making it easier for people to leave who are buying houses or whatever. What other restrictions are you looking at easing a bit, because there are a lot of businesses that would like to get out but I been refused? And that be is a bit more human

>>Yes, so look, we will take advice that we get. We remain committed to a precautionary approach with delta, but who do recognise that longer restrictions are in place the more challenging it becomes. I have mentioned some of the personal areas today. In terms of business is ultimately those exemption decisions to end up pack with the Director- General of Health, and no doubt he will be in the same period that he is giving us his advice, taking a look at that. The problem is that we often talk about is one risk saying that - - one business anger they can need to move across the boundary, but if you do that for everyone, you need to do that carefully. What we do do is make sure that freight can move and we have seen increased volumes of freight moving over the last few days. So we will take a look at that but we will be guided by the advice that we receive.

>>The Wellington (inaudible) is about to take off on the third season. Obviously that is brought more of an operation, but what assurances can you give them that at some stage they will be able to (inaudible)?

>>I very much hope that that can happen, but obviously right now the decisions that they have to make a based on the current state of travel guidance and the fact that we don't have a trans-Tasman bubble at this time. As you know, from the Reconnecting New Zealand Plan does work we want to move to a situation where we can have more movement at the border. That is still our plan at the next year. We need to get people fascinated.

>> We want to get to a place where we have sports teams prioritise? To have the spoke arrangements with the board arrangements 60?

>>I will not pre-empt decisions that might come next year, but right now the settings aren't exactly the same. Have some group allocations and there is a process for teams to apply for this group allocations. For the Phoenix, we have the issue that they will be playing and they have a schedule to attend and fly backwards and forwards, which we would actually work out.

>> Two weeks in a row .

>>242.

>>Sorry, Zane.

>> The World Health Organization today is talking about a drug for COVID-19 patients. This is something that New Zealand is likely to approve?

>>Well, we always look at WHO advice in greater detail. And met a safe, our regulator, they are the part of the ministry that regulate medicine. Certainly anything like that I know that they will be considering.

>>And (inaudible).

>>One for you, minister.

>>Not from a regulators point of view.

>>We have continued to try to put as much support behind our response to COVID-19 as possible. If we find ways that we can support New Zealanders through it, we always seek to do that.

>> What about the antibody treatment for New Zealand?

>>I will have to come back to you on the specifics of that. There are some treatments available, but emotional where we are at from I'm not sure where we're at with the approval process.

>>Is looking at yesterday's modelling, doesn't some of the modelling highlight the need for a stand- alone agency to administer the government's response? (Inaudible).

>> I wouldn't say that two modellers disagreed that that highlights the need for it. We take a range of advice. This is science. It is not always absolute. One of the things in the case of COVID-19 is, as a government, we have had to make decisions with imperfect information from the very beginning. It is the nature of COVID. It is a rapidly evolving area. There are contested views and sites throughout it. Modellers will always differ from time to time. The government has the ability to listen and take that advice.

>> In terms of your comment earlier that had it been wheeled out the ways it was yesterday, he would have been accused of hiding it. -- way it was. What other bits of information are you receiving and has that been made public? It's not being made available in the same ways yesterday that what other modelling are you getting that be perhaps not seeing?

>> I don't think there are particular examples I can give of you not seeing. Professor Hendy is funded through his institution and so therefore he is one we listen to particularly but you have seen others release modelling from time to time including Rodney Jones who you have heard from on the scale we are talking about, there is nothing comparable to that.

>> Doesn't MB also found that research?

>> It is partly government funded.

>> What reports or feedback are you getting around, in particular, miss information but not just COVID and anti- vaccination type stuff but also in light of the terror attack and particular messages going out with people around that on social media and what sort of relationship is there between social media sites like Facebook and the police? Is there were going on to read -- get rid of those messages?

>> When the monastic comes up, he can wear one of his other portfolio hats to respond. Obviously coming out of the Christchurch terror attack there was an elevation of the role that we felt social media companies could play and there are protocols in place that I know are used from time to time between, for example, the police and those agencies but if you have something specific you are alluding to, feel free to say.

>> In light of that, with there was an uptake and whether the relationship between police and social media sites and if they are actually actively in light of that working more closely together to identify...

>> I cannot comment more specifically but since the Christchurch terror attacks there are more protocols in place that are better understood and are made use of from time to time.

>> One. The number that was highlighted is based on an underlying assumption of the efficacy of the vaccine which I know is not an assumption that the government has many governments. -- more. (Inaudible)

>> I cannot stand here and neither with any other minister second-guess modellers whose job it is to reduce this. There are as you alluding to a number of numbers in the modelling and obviously those numbers are highly sensitive to one very important thing people getting vaccinated. That is the message we want to send. There is an opportunity here for New Zealanders to lead the world in our vaccination rates. We are up to 76% today of the eligible population. 81% in Auckland stop we are making incredibly good progress, so yes, you could focus on that number or you could focus on other numbers in the report that C, as we move to 85 or 90 or 95% vaccination different numbers in terms of mortality rate or hospitalisations. From our perspective we do not do the modelling and again if we did not interfere in it, then there will be other criticisms made of us.

>> I guess there was a decision made and the way the modelling was publicised on the number chosen from all those numbers to publicise was one that was very high and that was based on an assumption about efficacy of the vaccine, which would make it much less effective than New Zealand believes it to be. (Inaudible)

>> I cannot comment specifically on the numbers in a press release. From a government point of view, we look at the whole suite of numbers in the modelling. We also look at other advice we get the message that is very clear here for New Zealanders is that what happens here is in our hands. It is in our hands to the extent we get vaccinated and in the hands of the government to the extent of the wider public health measures that we build around this. It is one model, it has people contesting it today. That is fine. That is science. From the point of view New Zealanders, the message should be loud and clear about being vaccinated.

>> Are you aware of a discrepancy between the number of tests taken for the border crossing and the number of tests protest -- process for those crossing the border?

>> I'm not aware of that. I would have to come back to you on that.

>> Do you view vaccination as an additional tool in the safety (inaudible) against COVID or an essential, critical tool?

>> It is very, very critical and I cannot emphasise that enough. She and so further to that, you kept saying test, test, test and get vaccinated so why are none of the staff in Auckland's borders needed -- needing to be tested or vaccinated?

>> It depends on who they are. If they are police staff we are making good progress on the numbers vaccinated and we continue to do that for all of our frontline staff.

>> Why not ensure that you have the officers, the police, why not ensure it is the ones who are vaccinated who are going to the order?

>> I think decision on who is deployed there will be made by the Commissioner of police and I don't sense there is any significant concern being raised with us about that.

>> Cannot confirm the decision around the location... Relocating made on Monday.

>> Will be, I said. Sorry, the original decision. That was, as we made the move to a level III, that was part of that and the Prime Minister did talk about that at this very podium.

>> What you say then to people who received emails from the Ministry of Health on, say, Tuesday saying quite the opposite?

>> If that has occurred, I'm sorry for that. The position was clear that we are continuing to adopt the level IV style settings. Where this really comes down to  is around exemptions, so it is not so much the settings themselves, it is the way in which exemptions get granted. That is the process we are now going to have another go.

>> Finally on that, the fact that Cabinet will review those settings in the decision-making processes on Monday, is this a backdown?

>> This is a recognition that as the outbreak goes on the circumstances people become more challenging and more difficult. This is not a major change to the settings, it is about whether the way we grant exemptions is appropriate to where we are now in terms of how long the restrictions have been in place. There are people and examples I've heard and seen people who are at the point where they can only push out the sentiment of sale need to get a job or have been caring for somebody for some time in that situation -- that situation has ended and those are examples where yes, that has gone on longer now, we can look at that, but the overall settings and precautionary approach remain because we have to make sure we get on top of Delta.

>> Debris promised, the decision to go from Level 3 to level II, could the internal border restrictions be kept at that level for level change the rest? In other words could you again decide to keep those very tough rules in any move from 3 to 2?

>> We have not considered that advice and it is a genuine response. I haven't heard anyone advocate that particularly, but of course we will continue to see where we track in terms of cases what we understand about the outbreak but I haven't seen a particular piece of advice on that.

>> You yourself and your predecessors have always been worried about the way restrictions and other macro tools, the Reserve Bank implements how that might affect first-time buyers or marginalised people. Making it harder for them to buy property and just yesterday the Reserve Bank confirmed that a smaller portion of bank lending can go to people with small deposits effectively. Are you comfortable with that decision? It means that someone is really going to struggle to get a mortgage book -- with a deposit of less than 170,000 for a median priced house.

>> I think I might let Doctor McElnay go if we have finished on that and invite minister Little to, and we will segue from housing to health. The issue we have here is the Reserve Bank does continue to operate independently. We have set the rules around the things we want them to consider and they are considering those. When it comes to loan to value ratios, they have made the judgement that this is important to the financial stability of New Zealand. We have still got discussions to have around debt to income ratios but for loan to value ratios they are already in place and this is a tweak of that system. The second point I would make is we have seen the proportion of investors reduce and that means we are now starting to see the balance tilt towards first homeowners and owner occupiers. That is good, an important stop it we will monitor the changes we have made.

>> (Inaudible) responsibility for the situation, though.  It is hands down pretty dire. The economic response has pumped up prices by about 30% and the Reserve Bank is closing the door on people at the margins and a lot of people are saying (inaudible) don't pose a financial stability risk, this is what the data indicates, so I guess (inaudible) accountability of the situation.

>> I would challenge the statement it is the economic response that has led to the annual house price inflation. , the increase. It may have contributed but it certainly goes on a trend that is a long-running trend in New Zealand. I would not accept that analysis. We have made a number of significant moves on both demand and supply that are designed to try and address these issues full stop we need to give them a chance to work as well. Bernard, I will take you and then we will do a bit of help stuff.

>> And housing, how does that decision contribute to improving housing affordability because now, what with three quarters of the high (inaudible) lending, they now have $5 billion less left for housing. How does this improve affordability?

>> It is all part of an overall package and it has to be about both improving the supply which we are making progress on and a range of demand measures, putting everything on one single measure you may well not measure up to the goals that you and I both might have in that area. But from our perspective, the Reserve Bank has the loan to value ratio tool in its toolkit and will use that and it is made its decisions independently to do safe -- so.

>> What do you say to first- time homebuyers that you are not pulling up the ladder (inaudible)?

>> I reject the suggestion we are not doing anything for first-time homebuyers and we have seen the balance shift to first-time homebuyers. We will move now to questions around the report of the implementation unit and the border mental health issue. -- broader. By way of introduction, this is the first of the reports from the implementation unit that we established. It is run out of the Department of Prime Minister and cabinet but reports to me as the Deputy Prime Minister. We undertook to do what was essentially a mid-term report on the mental health package that was announced in 2019 but it was therefore the approach was one 2019 but it was therefore the approach was 1 to do that fairly swiftly.  It did create for us some very interesting observations. The first of those being that actually a number of very good things have happened as a result of the mental health package and there has been an increase in services to a range of New Zealanders stop it also highlighted some areas where further work is needed and some of that has already happened and others, for example, in the area of health infrastructure, we need to do even more work on but minister Little, I will offer you a chance to share introductory thoughts.  Where I think there is room for improvement is where some reporting and oversight is needed and terms of health or mental health infrastructure, the report highlights some shortcomings but am confident that since the report has been produced, the ministry has taken a number of initiatives including officials qualified officials out of the ministry directly taking project management response ability for some projects being funded out of the 2019 budget package

>> Are you satisfied that you report (inaudible) focused on outcomes from your investment better to take into account any of the data that the Ministry of Health holes on the demand of how these outputs are affecting the actual (inaudible) of real people? it is easy to say this money  has been sent to (inaudible) and that is not included in the report. You get quite a narrow picture.

>> But quiet D picture. I understand exactly the point you are making. This was firstly done as a mid- term report on this funding and it was very targeted for that. There are a number of other ways in which we can assess the success or otherwise of the interventions the government makes. We are continuing to keep the mental health package on the implementation unit's work program so they can come back to it at other times but for the purposes we set it out here, it was to say we have got to on that $1.9 billion package and what did we need to change or improve? I think on those grounds it is done it's job but it is not the be all and end all of the way we monitor health performance.

>>This was the implementation unit and they reviewed this implementation which was their job. We decided on this package in 2019 and the ministry was responsible for 1.1 billion dollars in that package. How that would be implementation. In terms of mental health services, generally within New Zealand, obviously that is ongoing, but within the package one of the issues was the workforce development and it is noted that that is happening. It also notes that one of the biggest challenges we have got is the continued rollout of the program are those workforce issues, which is why the assurance group chaired by Mr McGregor will also look at that and she also happens to be the workforce combined group. She brings a lot of insight and experience from there. That will help us to keep focus on building a workforce.

>>Obviously there is quite a lot of frustration around how long it has taken to get done with the business cases. It has taken a long time. Is there, is that part of the (inaudible) over the years of investment? It seems to me that education is much better than investing in property. It just cannot. Hospitals and the Christchurch  hospital rebuild had a problem. It is a wider problem with the Ministry of Health?

>>That point I would make is that changes have been made in that regard, so the creation of the health infrastructure unit is a recognition that we want a greater focus on that. I can assure you that ministers share the frustration on some of the progress on some projects, that is highlighted in the report. If you take a step back, one of the questions you have asked is about business cases and I do recall when I first began the Minister of Finance discovering that in the years in which very little funding for health care was put in, DHB simply stop doing business casework so that when we arrived and restarted the funding for healthcare they then actually had to start doing the business case first. And so there is a process here. One of the things that the Treasury is doing is now working not only with the Ministry of Health and with other agencies on whether the business case process is fit for purpose. Oh sample, when you got quite a small healthcare project, doesn't really need to go through all of the stages of the business case can go to something like Dunedin Hospital where you have several billion dollars?

>>I think the other thing as well is that the health bills, the big ones, they are not public. They are complicated. There is work required from clinicians that have to work on this basis. They can be somewhat future proof to the best extent they can give that medical technology changes reasonably rapidly. Even at the smaller levels if you take some of the health facilities there is now an internationally recognised stance for therapeutically suitable environments and we want to build filler standards. We want to incorporate those with a local input. Sometimes we just have to identify the right place or facility to be and it does take a little bit longer than usual. That is it. The Director-General of Health Ashley Bloomfield to set up the infrastructure and the ministry precisely to put focused attention on this. But the nature of construction in the industry is that project managers, project leaders are in short supply and filling some of the roles has been a challenge as well. But I'm confident and the report has highlighted that the report and further work that is happening as we are in a better space with this.

>>What responsibility does he Ministry of Health me to take for not having a clear plan on how to deliver so many of these services and infrastructure?

>>I think they had a plan because we knew what we were going to do, but we built them and the challenge was getting the right skills and the right places. Reasonably recently it was DHB's that were responsible for projects that put in a bed and then we would do the approval. And then we had the business case once I was approved we then had that alternate the DHB level. The reality is that across the network with 20 DHB groups they struggle to get it. We are now having on some projects and one in particular that the ministry has taken that project and on three of the others the ministry has appointed a ministry person out of the health infrastructure unit to sit on the governance of those particular projects to make sure that that is being built.

>>And also this highlights in many ways one of the reasons for the health reforms as they, the DHB by DHB process means that things like capital infrastructure builds are somewhat reliant on individual DHB units and the ability for them to manage their staff and manage the process, dwelled by and large that has been working well, having the health New Zealand framework allows us to have significantly more oversight of that work from a central point.

>>As well as the ministers, don't you also have responsibility to ensure that those services were being delivered, that those expectations exist?

>>I can assure you that me, and Mr Little and his pre- assessor from a predecessor were. There are building projects taking place all the time. There are just one or two that have not gone the way that we wanted. As minister Little has indicated, that one is a good example where after a period of time is said that this needs to come back into the ministry.

>> How frustrating would that be for you as ministers to see that they have not gone as planned?

>>I'm just focused on making sure that we get them built. Yes of course our frustrations for us, but equally there is tremendous work going on as well. We take the good and the frustrating together.

>> Medicinal cannabis patients are extending the transition period for medicinal cannabis. They say they will (inaudible) if you don't. What is your response to them?

>>I will not extend the exemption. There are products that have been approved. There are more products that are about to be or will be approved before the before 30 September and in the end of the standard that was put in place and for an exemption that has been in place for 18 months or more was to ensure the product safety that are in the market in New Zealand meets the acceptable international safe standards and at some point we need to say you know what, they have had enough time to get the data from overseas and produce that and they can not be providing an exemption.

>>How could it be extended? Some product simply are not safe, and in terms of some that are set to come onto the market, I confident that that will cover all the gaps that have been left by those?

>>I'm confident that there will be a range of products on the market. There was a view that if there was only one provider who has got approval, then no competition and that might cause problems. There will be products on the market, multiple products. The other thing is that some products available do not meet their needs. They still have not assessed the patient regime, which needs the approval of the doctor who becomes important that they can get the products that have not been otherwise available in New Zealand. One of the points made was about --

>>Where the point was made about mental health and are too many GP clinics had too many on-site mental health support. It was a point that you made. Does it make up only 10% of the total GP clinics in the country? Is that true, and if so, how do you consider that a success?

>> It is not very good with numbers. It is not a proportion of practices, but enrolled patient population. It is roughly 1.4 million I think. We are halfway through the implementation, and that is roughly where we think we will be with the time of the completed rollout in 2023 or 2024. It will be about 3.7 million. So that is and actually at the bigger practices we have had the first kind of take up with these particular roles. Those of you that are at the this week will have seen the role that health coaches and practitioners play. I know that the correspondence that I'm getting from GPs and many practices and patients themselves and the impact that a have had has been fantastic.

>>Both of us have actually got another meeting that we are due at relatively short. Take three or four more. Table you have spoken a lot about workforce issues. Recruiters are having difficulty getting much-needed doctors into New Zealand. As a been anything done to speed that in up in the meantime? What are the impacts of that Ondo DHB units are waiting for medical staff?

>>Yes, I mean pretty much every health worker has an exemption in terms of coming across the border. Citizens and residents. If you look at those who have crossed the border to come to New Zealand to work here, 43% are healthcare workers. To the extent that there are problems with the places in MIQ, I know that we are waiting for a couple of DHB's and we are working with them to get spaces and they have got them. I did see a report from a senior clinician that went to a journalist to say the matter is urgent and so urgent that it is time they (inaudible). It might have been put to the minister first. There is a response to some of this. It is challenging right now. There is a broad shortage of a lot of specialist and we are continuing to work with DHB's and others to ensure that we get the workforce that we can as soon as we possibly can.

>>Are you concerned about the super fund holding and Chinese firms that are blacklisted in the US because of their connections to Uighurs? There is a report that has come out. What is the status of the work that you are doing around the responsible listing framework?

>> I do have high expectations of all of the Crown financial institutions for the fact that they would undertake ethical investment. The super fund has very well known process for how they deal with that as we discussed before. In terms of that framework we have been working on it and we will have something to say about that very, very soon.

>> Why do you still have no idea about the number of staff hired or trained for the mental health report? I see that there are issues in the workforce, but it is that they do not have the numbers on how many staff have actually been trained or hired.

>>I'm not quite sure what that is a reference to. We know that there are over 570 total appointments with the roles that we were talking about before, and we know that there is a number for existing health staff who have been trained for mental health work and that has been a specific program of work as well. I'm not quite sure what you are referring to.

>>And the delivery of addiction and suicide prevention services in particular were found to be lacking on delivery. Our concern is that for you?

>>Yes, it is. I can tell you that it is a key focus of work at the moment. There has been, and again a lot of it has been about getting clinicians in place in towns and cities in New Zealand where they need to put in recruiting before that. We remain focused on lifting and improving our addiction responses.

>>Will just take a couple of more. Bernadette then over here.

>>There is a lot of businesses that want to get access to rapid antigen testing so they can test workers. What is the status of that? Currently has been held up.

>>, Toilet they have been held up. It does have to go through the approval process for med SA.

>>I've heard Doctor Bloomfield talking about rapid antigen testing and making sure that it integrates overall testing program. We need to make sure that we get all of the rules around usage and the way in which it is deployed right, but there is an enthusiast and to use it. But clearly any testing that we do has to go through the approval process.

>>A question that was asked earlier about Grant Robertson, and I wondered whether you had any more specific information about social media and Facebook for example. Has there been any more sort of activity where that has been working greatly with Facebook and back?

>>I'm not entirely sure what they are looking out for, the threats and indicators for mobilisation to action. There are a lot of people that would say things with conspiracy theories and things. But I don't want to intervene on an unlawful basis. But I'm not aware of anything or concerned about anything that any of the agencies have received.

>> On the implementation unit, it is a shame (inaudible) government giving itself a pat on the back.

>> This is a useful report. The job is to make sure that critical programs underway are being delivered. We have put it out there. It is not all entirely positive. There were shortcomings and things that needed to be dealt with. It is a good and frank report and I'm not aware that the party ever expose themselves to such matters.

>> There has been criticism they are not trained psychologists. Did you have to train people who are not qualified psychologists but essentially coaches?

>> Some skill in this area.

>> The port was clear. It is not about having a bigger army of psychologists, it is about having people qualified in talk therapies which is what they are about and identifying the many people that their mental distress is a consequence of other things in their lives and it's about giving them guidance on how to deal with other things in their lives, might mean nutrition, housing, domestic violence and plugging them into agencies and for a lot of people that is what they need help with as opposed to deep, clinical psychology sort of responses.

>> You have lost quite a few senior people in the Ministry of Health on mental health (inaudible) caused a lot of trouble earlier this year. Has this influenced how you think this program is going? You losing senior people. Is that telling or anything? Does it need a refresh?

>> I think as the report makes clear, they have done very well with what they have got, they have let slip some of the disciplines and I think they will benefit from having external insurance group to provide with focus and a voice including the voice of lived experience, so some of the people on the group are those with lived experience and can add to the mix of people (inaudible) and that will add considerably to the ability to continue the roll-out successfully.

>> Thank you, everyone. Enjoy a press conference free weekend.