Roy Heather: Health (Screening Programmes) Amendment Bill — Second Reading 
Roy Heather: Health (Screening Programmes) Amendment Bill — Second Reading 
[Volume:613;Page:9913] 
HEATHER ROY (ACT) 
: 
 The aim of this bill the Government says is to assist the operation and evaluation of the national cervical-screening programme. Indeed as we have heard the committee did work very constructively together and was united in its will to get this legislation right. We have heard various concerns tonight and in fact ACT New Zealand still does have some concerns about the bill although they are slightly different in nature regarding informed consent from those of the previous speaker. 
It is important that this bill is robust so that we do have a robust national cervical-screening programme. Dr EuphemiaMcGoogan’s recommendations of course are very instructive and the bill has stemmed from many of those recommendations. In fact I think that at select committee level we have managed to address many of those but there are still some I do have concerns with and for that reason ACT will be reserving its position on this. We are very keen to hear the amendments the Minister has spoken about and until we hear what those are and the specifics that relate to them we will still be reserving our position. 
I do agree with the National speaker Paul Hutchison who said that there are still problems and I have similar concerns which I will go on to outline. But first when I was researching for this debate I looked back on my first reading speech and in fact some of the concerns I had then still do exist. I said that the current programme was set up because of a need to be seen doing something about cervical cancer. But international guidelines were ignored experts within New Zealand were not consulted and most important there was no adequate system of quality control. My concern is that the bill still does not address these concerns adequately. 
These failings were brought to attention with the report from the Gisborne cervical-screening inquiry and the most recent inquiry. The current bill is a response to the Gisborne inquiry but it risks creating another political response to a medical problem and again I say that that is still a valid worry. My first problem with this bill is that the ministry is still given the wide range of powers that it has at the moment with the national cervical-screening programme. The national cervical-screening programme provided by the ministry is going to be setting up the programme. It is going to be administering the programme and it is still going to be responsible for auditing and evaluating the programme. 
There is a conflict of interest when one body does all those things. I said in my first reading speech that there are other well-qualified bodies around the country that could participate in this programme and some that spring to mind are some of the university departments. We were very fortunate to have Professor David Skegg as our adviser. He in fact was brought to the committee at my suggestion and he gave us what I felt was very good advice. 
The second major concern I have is that one cannot take almost 1 million women directly from an opt-on programme on to an opt-off programme without their informed consent. [ 
Interruption 
] I know it has. One cannot take those women though from the programme we have at the moment change the rules and still expect them to go directly on to the new regime without their express consent. That is another reason we will be reserving our position on this. [ 
Interruption 
] If the Minister would like a call perhaps she should take another one. 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: I refer members on my right to Speaker’s ruling 51/5(3) which states that running commentaries are out of order. If members wish to take a call they can do so next time. 
HEATHER ROY 
: I refer to the issues of informed consent that we have had. I do not share personally the same concerns that some of the other speakers have about access to primary-care records. I was involved with medical research for 10 years. Auditing and evaluating are done in a very robust way. In fact the auditors and evaluators have a very specific job to do. They are not there to scour through people’s primary records looking for every little embarrassing situation that may have arisen in somebody’s life. They do not have the time for example. [ 
Interruption 
] I agree with the people on the Labour side so it would be wise for them to be quiet with the sarcastic comments or else I might change my mind. 
Hon Annette King 
: They are good comments based on evidence. 
HEATHER ROY 
: That is right and I do believe in scientifically based evidence. The evaluators are not there to look for every little problem that exists so that is not my major concern. My major concern is that women are being changed to a different type of programme without their informed consent. Women need to have confidence in this bill and confidence in the cervical-screening programme. My concern is that the bill as it exists at the moment does not provide women with this confidence. My major concern is whether the Ministry of Health which I do not have confidence in to run and administer and evaluate this programme is the right body to be doing this. 
As I say it is very important to have this confidence from women to participate. We know that in public health circles it is imperative to have the majority of women participating in this programme for it to be truly effective. Part of the reason that the death rate from cervical cancer has decreased over the past decade is probably due to the fact that we have had a national cervical-screening programme. I would like it to be more effective than it has proven to be with the Gisborne inquiry findings. I feel that the best way of achieving this is for there to be more transparency within the programme. By that I mean that the Ministry of Health must not be involved at every step; or at the very least it must be a contestable process so that other bodies that we know exist within New Zealand and are well qualified to participate in a cervical-screening programme should be given the opportunity to do so. ACT New Zealand certainly would not have difficulty with this concept. In fact we would encourage it. 
I come back to the fact that women must have confidence in this bill. I look forward to hearing the amendments that the Minister is putting forward. Certainly I would like to be able to be in a position to support this bill but unless some of the concerns that I have and that the National Party has expressed—and in fact some of the informed consent concerns that the Green Party has expressed with New Zealand First’s support too—can be addressed I am afraid we will not be able to support the bill. 
Having said that the expressions of support given at the select committee still stand. Certainly I would like to see for the good of New Zealand women support from the whole House. I must say that if the amendments can address the concerns that we have then ACT New Zealand will be in a position to support the bill but at the moment that is not our position.