Intellectual Disability (Compulsory Care) Bill — Consideration of Report of Health Committee 
Intellectual Disability (Compulsory Care) Bill — Consideration of Report of Health Committee 
[Volume:612;Page:9558] 
Intellectual Disability (Compulsory Care) Bill 
Consideration of Report of Health Committee 
Hon DAMIEN O'CONNOR (Associate Minister of Health) 
 
 on behalf of the  
Minister of Health 
: I move  
That the House take note of the report of the Health Committee on the Intellectual Disability (Compulsory Care) Bill. 
 This bill provides for the assessment and care of people with an intellectual disability who are charged with or convicted of an imprisonable offence. It bridges a legislative gap that has existed since 1992.  
People with an intellectual disability are included in the definition of mental disorder in the Mental Health Act which was later linked to the Criminal Justice Act in 1985. However the Mental Health (Compulsory Assessment and Treatment) Act in 1992 deliberately excluded people with an intellectual disability unless they also had a mental disorder. 
This exclusion created a legislative gap between the two Acts for people with an intellectual disability who offended resulting in inappropriate placement in prison in forensic mental health services or in discharge into the community. As a result of this gap there are limited options available to the courts for dealing with people with an intellectual disability who are in need of compulsory care. For some this has resulted in inappropriate placement in prison in mental health services or as I said in discharge into the community. 
This bill links with the Criminal Procedure (Mentally Impaired Persons) Bill to enable the criminal court to impose appropriate orders for defendants with an intellectual disability. The purposes of the bill as reported back are: firstly to provide courts with appropriate compulsory care and rehabilitation options for people who have an intellectual disability and who are charged with or convicted of an imprisonable offence; secondly to recognise and safeguard the special rights of people subject to this bill; and thirdly to provide for the appropriate use of different levels of care. 
It is estimated that about 50 to 100 people will be affected by this bill. The bill was introduced into the House in 1999 and the main changes that were recommended by the process through the Health Committee were firstly to change the name to the Intellectual Disability (Compulsory Care and Rehabilitation) Bill as stated. This reflects the focus on rehabilitation as well as compulsory care. Secondly the committee recommended that the bill apply only to offenders with an intellectual disability because the bill as introduced applied also to non-offenders. Thirdly the committee changed the definition of “intellectual disability”. I commend the bill to the House. 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 I thank the House for the opportunity to speak on one of the first bills I worked on when I became a member of Parliament in 1999. It was a pleasure to be able to come to Parliament because then it had no members who were medical doctors. I had the slogan: “Put a doctor in the House.” and it was good to be able to be part of the Health Committee and work on a bill in an area on which I had quite bit of knowledge and experience in my past life as a nurse and a doctor. 
In 1992 changes were made to the Mental Health Act as we have heard. Those changes meant that people with an intellectual disability were no longer covered by the Mental Health Act. My very first job was working as a nurse-aide at Porirua Hospital. In those days in the 1970s psychiatric hospitals were very large institutions that had within them a large number of people with intellectual disabilities. As those hospitals closed down those with an intellectual disability were placed in the community. It was recognised that there is quite a difference between someone with an illness due to a mental health problem and someone with an intellectual disability. The cause may have been congenital—people may have been born with an intellectual disability. Excluded from this bill are those who acquire brain injury either by accident or by stroke. The bill does not cover those people. Those types of situations where there is challenging behaviour are still not covered. However the bill did fill both a legislative gap and a service gap in the community. 
The bill was introduced in 1999 by the Rt Hon Wyatt Creech. At that time it had two sections to it; one was for offender groups and the other was for non-offender groups. The aim of the bill was to determine that intellectually disabled persons who had committed a criminal offence and who could not be held responsible for their actions could be placed in permanent care and have a secure environment. 
It is always interesting that specific cases often drive a need for legislative change because they demonstrate so clearly where the gaps are. One of those cases was that of David Stephens. His parents were having a very hard time trying to cope with David’s care. David had an intellectual disability. He was a very big lad and as he grew older his behaviour deteriorated. When he was able to be cared for under the Mental Health Act he spent time at Tokanui. Mr and Mrs Stephens described this time as being probably the best time because he was managed. However when he was released from Tokanui they could not cope with him and there was nowhere else appropriate for him. 
The Stephens were the very first submitters to the select committee and they appeared before it in person. They said they supported the intent of the bill that provided protection of a legal status for someone with an intellectual handicap who has offended or who is in danger of offending. We heard from intellectual disability groups from around New Zealand from the Human Rights Commission and from civil liberties groups that those who have not offended but who have an intellectual disability are entitled to the same rights as any other person. I had to agree with that. I had to agree that just because a person may have an intellectual disability and behave in a way that is strange to those viewing that person perhaps in the street it does not mean that that person is likely to commit an offence. Luckily in today’s society people with an intellectual disability are living within our communities and people have a lot more understanding than they used to. 
However the select committee decided that it would be only those who had committed an offence who would come under the jurisdiction of this bill. At that time the National Government put in a large bucket of money—to the tune of $20 million—to go with this bill to develop services. I am pleased that although it has taken this Government such a long time to get this bill before us—and we are pleased to have it here today at long last—the fact is that that money has been spent to develop services for people with an intellectual disability who commit an offence. 
Because the non-offender group was taken out of this bill there also needs to be good wrap-around services for people whose behaviour is deteriorating. That can happen for a lot of reasons but generally it is because of the stresses and changes in a person’s life. I remember a case of an intellectually handicapped young man in my own hometown. His mother had a stroke and his father died. They had cared for this young man their son who was in his 40s by the time I got to meet him. When his whole support structure collapsed and the scaffolding in his life fell apart his behaviour deteriorated markedly and he ended up in the criminal justice system. That was totally inappropriate for someone with an IQ of probably around 70. 
I have been reading the Supplementary Order Paper introduced by Ruth Dyson. She has changed the definition of “intellectual disability” and I am very disappointed about that. The Health Committee spent a lot of time looking at the definition of “intellectual disability”. We did not want it to be a rigid IQ of 70 or below because many other factors can come into it when looking at someone with an intellectual disability. A person may have a slightly higher IQ but have very very poor social skills. If the definition of “intellectual disability” is tightened up as in the Supplementary Order Paper then one excludes people from being able to be cared for under this bill and I have some concerns about that. If members look at the bill they will see that the first 90 pages have all been struck out. So through the select committee process we did make major substantive changes to the way the bill works. 
The submission from the Stephens pointed out their distress and the trauma was relieved when their son was admitted to the Kimberley Centre. But he would assault staff and leave to go off down the road. There was no law by which they could put him in a secure facility and take away his right to be free to walk wherever he chose. David assaulted somebody in the street and in the end they used I think the Protection of Personal and Property and Rights Act to contain him in a secure environment. As I have said the millions of dollars that were put up by the National Government to back this bill have been used to expand services within the community markedly during the last 4 years while we have waited and waited for this bill to come to this House. 
The changes we made to the legislation by excluding the non-offender group were supported by the Society for the Intellectually Handicapped. I talked to Barbara Rocco the other day a former chair of the society and told her that this bill was in the urgency motion. She could not believe it. She said: “I will hold my breath and just wait because I have been waiting for so long for this bill to be passed trough Parliament.” So she will be very pleased that we are debating it today. Hopefully we will see it through its Committee stage and third reading because the National Party will be supporting it. 
DIANNE YATES (Labour—Hamilton East) 
: 
 I wish to thank the previous speaker for supporting the bill. It is a bill that many of my constituents will be pleased to see passed. I also want to thank Judy Keall the previous member for Otaki for the work she did on this legislation as former chair of the Health Committee. 
PITA PARAONE (NZ First) 
: 
 I welcome the opportunity to participate in the debate on this bill. New Zealand First is supportive of it. The rights of those in our community with an intellectual disability need to be enshrined in law since current mental health legislation does not apply to them thus resulting in a limited range of options available for dealing with those in need of compulsory care. The events of recent times involving loss of life call for such legislation. Furthermore how often have we heard criticism of the judiciary as to the inadequacy or even the inappropriateness of their order when dealing with matters that come before it? I believe that this bill provides a much clearer indication for the judiciary to deal with those issues. 
Admittedly the bill has been substantially rewritten since its original introduction on to the legislative agenda. In the last Parliament the House and the Health Committee—on which New Zealand First did not have a member—limited its scope to those with an intellectual disability who had been charged with an imprisonable offence and found guilty or unfit to stand trial or those who had been detained but had completed their sentences. This is to ensure that people who are deemed to be a danger to themselves and/or to others are not locked away because they might offend. The way people with intellectual disabilities are regarded and treated in our society has changed and deinstitutionalisation and mainstreaming now underline the approach taken thanks to earlier Labour and National Governments—the decision that we are now seeing the adverse consequences of. 
This is all fine and well as long as the resources are there to cope with the demands of this and the burden of care is not placed on the families or the nebulous community. We must accept that some people in our society are not able to participate in a normal way because of the dangers they pose to themselves and others. Secure care or constant supervisory care is necessary for those people and I do not mean locking them up in prison with criminal offenders. This bill is an attempt to ensure the correct balance between proper care for the people who are affected and the rights and the safety of the community. 
This is where my reservations lie because all too often it takes a tragedy to occur before it is realised that the skills training and particularly the resources that are required to manage the daily care of those people that this bill applies to are totally inadequate. 
I watched with great sadness the Television New Zealand  
Documentary New Zealand  
programme 
last Monday which told the stories of three families who had lost family members under violent and heart-breaking circumstances because of severe lapses in the care and supervision of mental health patients. I will never forget the words of the man whose wife lost her life at the hands of their schizophrenic son. He said that his son had been released into community care but it was in effect he said community neglect. That is a sad commentary on the state of this country’s present attitude towards the care of those of our society who are identified as intellectually disabled. He was a young man with a serious mental illness who was left to his own devices. He had severe negative and psychotic feelings towards members of his own family. We know the outcome of that episode. This young man who had been cared for under the Mental Health (Compulsory Assessment and Treatment) Act 1992 was allowed to fall through the gaps with disastrous results. Now he and his family must live with the results of that just as people with intellectual disabilities and their families must live with the reality of their situations. For them the reality is that they will never recover or grow out of their disability. They will always need special care. 
It is imperative then that we provide the best care available and ensure that the quality of staff is of the highest calibre and above all suitably trained. This means we must fund the best training for the best people who are capable of working effectively with people who have intellectual disabilities. This means realistic remuneration ensuring a full complement of staff at all times and providing the best facilities available. 
Notwithstanding the report on progress in 2001-2002 towards implementing the blueprint for mental health services in New Zealand I would like to know whether the ministry has developed this disability strategy and if so how this problem of resources including staff attraction and retention is being addressed. I would like to be assured that they are well-resourced well-staffed and with well-funded facilities for those people who require the sort of care we are talking about. 
A further issue was raised with regard to children or young people under 17 years old with an intellectual disability and who are assessed as being a danger to themselves or others. The record shows that the Family Court Judge Mahoney submitted to the select committee that adequate services and facilities for these young people are not available and that they are often detained in secure facilities with young offenders. I understand that the select committee has sought assurance from officials in the ministry that strategies are being developed to address this issue. I would like to know whether this assurance has been given; if not when it will be; and if so what progress has been made. 
In summary New Zealand First is happy to support this bill and wants to make sure that it is properly implemented so that everyone who is affected by it can live with dignity and without fear that inadequate resources and lack of funding will turn this stream of care into a nightmare. 
STEPHEN FRANKS (ACT) 
: 
 I rise as the ACT spokesman on justice to address the second reading of the Intellectual Disability (Compulsory Care) Bill. I see that it is now to be called Intellectual Disability (Compulsory Care and Rehabilitation) Bill. That change in heading says quite a lot about this bill. The bill started out to try to draw a distinction regarding people who by reason of intellectual deficiency—low IQ defined in the bill—were permanently to be in care and would always need the community to look after them and also to look out for them. This is the bill that explains how people will deal with those who are so subnormal that they will be a threat to others and have committed crime. 
As I understand it although no ACT member at the moment was on the committee that considered this the difference or the distinction drawn here between people who are mentally ill and people who are just incapable of being left uncared for and out of custody in effect is supposed to be quite significant. But this bill is so nauseatingly horribly politically correct that it has now stuck right into the title the term “rehabilitation” which undermines the whole basis of the distinction. It seems to assume that these folk are simply people who have lapsed from a normal state of full competence and they are to be rehabilitated into that normal state of full competence. I hope to find out during the Committee stage whether my fears are in fact justified about this bill being likely to be counter-productive and utterly ineffective because of the nauseating approach that infuses it. 
I have looked carefully to see whether this bill deals with the primary problem in the boundary between the criminal justice system and the mental disability system. The real problem is that the criminal justice system takes measures to protect the rest of society the innocent. The health professional’s duty is clearly to the patient. That transcends all other factors. When we have people who have committed crimes or people who threaten or harm others the community needs to know that those who then have the custody and power of control of those folk have a duty to the rest of the community a duty to protect the innocent that transcends the duty to the patient. 
I am afraid I cannot find it in this bill. It may be there. It may be that this bill does resolve that fundamental conflict; if so it should be in plain terms. It should say that when patients come under the Act while they still have the expectations of patients with their carers there is one very very important qualification: that the carer has a primary and first-ranking duty to the community to make sure that they cannot harm others again. I fear that in all the disgusting verbiage of this bill that does not appear anywhere. 
I have used strong language. Let me just look at a few of the measures in this bill: for instance the statement of principles. When I look into Clause 12(d) of the principles governing children and young persons I start to get anxious: “consideration should be given to the wishes of the child or young person”—of course—“that is appropriate in the circumstances having regard to the age maturity and culture of the child or young person:”. In other words we are to draw race distinctions to govern whether we consider the wishes of a child. So having decided that someone’s culture is generally not very respectful of the wishes of a child the rest of New Zealand which holds that to be of high value will subordinate its judgment to the culture that has decided that it does not respect the wishes of a child. 
I then go to clause 13. All the powers of the Act have to be “exercised with proper respect for cultural identity and personal beliefs” including “proper respect for the care recipient’s”—that is a nauseating term is it not; what about patient— the patient’s “cultural and ethnic identity language and religious or ethical beliefs;”. I have no problem with religious or ethical belief. The rest are just synonyms or euphemisms for “race”. 
That in itself is not exceptional but I go a little further. We find when we look at clause 23 that every care recipient is to have a culture assessment. In other words one of the primary matters is to find out the race of the people in care. If the caregivers decide that the care recipient is a Maori and the care recipient agrees that he or she is a Maori the coordinator must then try to involve any suitable Maori organisation. This does not require the patient to agree that he or she wants a Maori organisation involved. All that that person has to agree is that he or she is Maori and the machinery of the State grinds in to draw it to make race discrimination. What does this have to do with the care and rehabilitation—as this proposes—or even the safe custody and humane treatment of mentally subnormal people who are a danger to their community? Nothing! It is politically correct garbage. 
The care and rehabilitation plan under clause 24 must identify the care recipient’s needs and take into account the cultural assessment. The whole thing is infused with race prejudice. The whole thing assumes not that these people are first people individuals—poor children many of them young persons who have been born with the worst cards in the pack. Instead it says to identify their race and start from there. Worse it does not say to the caregivers—another nauseating term—“Remember that once they have come into the criminal justice system the primary responsibility must be to the innocent to those who might be harmed in future.” It says no the primary responsibility is—first on the list clause 25(1)(a)—“the social cultural and spiritual needs” of the patient. That is before even their medical psychological or physical needs. The very first needs that have to be considered are the cultural needs. 
None of this augurs well for the detail in this bill. It says that the Health Committee soaked as it is in race consciousness has gone about looking at the needs of these people. Clause 50 is another one which I will not have time to go into in detail. Clause 50 carries it on. It states: “Every care recipient is entitled to be dealt with in a manner that accords with the spirit and intent of section 13.”—which is the one that sets up the race criteria. That is just in case we forgot halfway through the bill. The Government goes back to remind us that it has set this up as a primary duty. 
Then a little bit of lunacy that just caps it: all the provisions of the Health and Disability Commissioner’s Code of Health and Disability Consumers Rights regulation code are to apply to these folk who are in protective custody—that is protecting themselves and protecting the rest of us. Right No. 2 says that every consumer has the right to be free from discrimination coercion harassment and sexual financial or other exploitation. Free from discrimination! Yet the law tells the caregivers they have to start discriminating. And then the code says they are to be free from discrimination and free from coercion. The whole purpose of this bill is that they are subject to coercion they are in protective custody. This bill does not have the intellectual honesty to even make an exception for the irrelevant parts of this code that is to apply. 
This is a typical piece of politically correct nonsense from a Government that has waited 4 years since it was first introduced and then lands it on the House in urgency probably hoping no one will read it too carefully. 
SUE BRADFORD (Green) 
: 
 The Green Party welcomes the return of this bill to the House today. As most members will be aware it has been around for an awfully long time. While it is odd that we are dealing with such neglected legislation under urgency I am glad for the sake of the people affected that it will be finally passed into law. 
The need for this bill and for its accompanying Criminal Justice Amendment Bill (No 7) was created in part by changes to criminal and mental health legislation in 1992. The Green Party totally supports the intent of those changes which are to separate out legally offenders who are suffering from mental illness from those who have an intellectual impairment. Unlike some other speakers in this House over the last 24 hours Green Party members do not think that mental illness and an intellectual disability are the same thing. It was and is entirely appropriate that criminal offenders in those categories should be treated quite separately and distinctly under law. 
A problem occurred however when the legislative gap created by those changes meant that too few options in the intervening years were left to the courts for dealing with people with intellectual impairment in need of compulsory care. While their numbers are not large at any given time it does not mean that we as a society should simply dump those people into inappropriate places like prisons or mental health units. Over the last 20 years or so there has been a lot in the media and elsewhere about the problems associated with that unacceptable situation. 
For example the incidence of physical and mental abuse of intellectually disabled offenders in prisons is well documented and lurks like an unspeakable shadow within the greater conspiracy of silence about real life in New Zealand prisons. It is also reported that such prisoners are often abused and even exploited by other inmates are even less able to cope with the harsh environment and are far more likely to regress rather than progress towards any form at all of rehabilitation. Prison is a tough place even for those in sound physical and mental health and without any physical or intellectual disability. For people with major intellectual impairment it is horrendous that prisons have and continue to be the sentence of last resort. I hope that the passage of this bill really will mark the beginning of the end of that situation. 
The major concern the Green Party has with the legislation is not with its intent but with its implementation as the previous speaker also pointed out. We are suspicious that the number of secure placements needed for offenders covered by the bill’s provisions will not be enough—either now or in the future. We know that the Government has allocated more money and has started setting up hospital-level secure services facilities but progress does not appear to be happening quickly enough. I hope that the new regional intellectual disability care agencies will move as quickly as is practicable towards establishing the full range of services possible and that the Government will continue to commit sufficient funding as the agencies go along to make sure that that happens. 
I also note that the Green Party very much supports changes from the original drafting of the bill which mean adults and young people who are not criminal offenders will be excluded from the scope of this legislation. It was totally unacceptable from a human rights and a civil liberties point of view that the National Government even considered subjecting non-offenders to the provision of compulsory care under this bill. I am glad that the select committee had the sense to take that provision out as soon as it could. For example in a submission to the Health Committee on the original bill People First New Zealand a self-advocacy group for people with an intellectual disability and others expressed their fear that even people who had committed no crime at all could be locked up and that that provision would apply not just to adults but also to children and young people. Such a discriminatory approach has no place in the 21st century and I can assure people that the Green Party would never have supported this bill had those provisions remained in place. 
We welcome changes on the Supplementary Order Paper to the definition of intellectual disability so that it is now in line with the most up to date international standards. It is good to see that the select committee has made it clear that people cannot be defined as intellectually disabled solely because they have a mental disorder personality disorder or a brain injury. We are also pleased that there is now a greater focus on rehabilitation than was originally intended. 
The Green Party looks forward to the passage of this bill into law later today. I hope that the Government will put the necessary resources behind it so that it can fulfil its functions satisfactorily and well. 
JUDY TURNER (United Future) 
: 
 I rise on behalf of United Future in support of this bill which was introduced in 1999. It sets limits on the freedoms of a small but identifiable group of people with an intellectual disability who are in need of compulsory care. 
Intellectual disability is defined as a learning disability that limits day-to-day functioning and skills. Unlike mental illness it cannot be treated. Intellectually disabled folks are permanently impaired with significant deficits in two or more of the following—I list these because even today in the debate it seems that in some members’ minds there is confusion between mental health and intellectual disability—communication; self-care; home living; social skills; use of community services; self-direction; health and safety; reading writing and basic numeracy; leisure; and work. 
The legislation covers two similar groups. The first group is of those who enter compulsory care from the criminal court and who due to impairment require specialised care and attention. The second group is of individuals who are no longer subject to the criminal justice system but who still require compulsory care of some kind. United Future supports the Health Committee’s recommendation to deal separately with individuals who have an intellectual disability but no history with the criminal justice system. 
The new strategy for deinstitutionalising the care of individuals who are intellectually and mentally impaired has meant a difficult time for everybody involved in the transition. Many clients have been successfully reintegrated into the community and now enjoy a quality of life that is vastly improved. However it is also true that a number of recipients have not been able to make that jump and will always need some form of institutional care. It is interesting that on 12 July last year the  
Dominion Post 
 noted the opening of a secure unit at Porirua Hospital. That 10-bed unit is for offenders who have an intellectual disability and it is the first unit to separate intellectually disabled offenders from mentally ill offenders. 
In 1977 when those provisions were mooted it was estimated that nationwide between 50 to 100 people would be subject to the provisions of the proposed legislation. Current figures are unclear but I draw to the attention of the House a speech I gave last week in the general debate regarding the increasingly large numbers of children born with brain damage due to foetal alcohol - related causes. There is growing and convincing evidence that our prisons are full of people with intellectual impairment directly related to foetal alcohol conditions. Even this week I have had contact with the Foetal Alcohol Support Trust which was very worried about the imminent release of a recently diagnosed foetal alcohol syndrome prisoner in relation to where he could be safely housed. That man’s mother was terrified of what could happen. 
That case highlights the need for increasing resources for the diagnosis of these more subtle intellectual impairments and for better resourcing of appropriate care facilities. It is not about turning back the clock but about recognising that the numbers needing compulsory care may be larger than we realise. However United Future welcomes the change in thinking this legislation represents. No longer can people be conveniently managed; instead they are to be viewed as people with rights to quality of life and opportunity to reach potential like everybody else. We are very happy to support this bill. 
DARREN HUGHES (Labour—Otaki) 
: 
 I rise to take a very brief call in support of the Intellectual Disability (Compulsory Care) Bill. I pay a special tribute to Judy Keall my predecessor as member for Otaki who chaired the Health Committee very ably through the process. I am very pleased to see the bill back on the floor of the House. I know that Ruth Dyson will take it through its final passage—and very ably too. 
SANDRA GOUDIE (National—Coromandel) 
: 
 I am very pleased to speak to this bill. I recognise the incredible time effort and dedication of my colleague Dr Lynda Scott and I acknowledge the significant contribution made by a former MP Wyatt Creech who introduced this bill in 1999. My only disappointment is that this bill has languished for some 4 years or so and that the parents who have been concerned for their children who are not covered and protected in the manner they would like to see have seen it languish. 
 They will now be pleased to see that it has come to the forefront. I reiterate my acknowledgement of Dr Lynda Scott and all her fine efforts. 
I also would like to bring up the point that they did recognise the need for resourcing. That is very evident in the fact that we have only a limited number of services available to accommodate the provisions of this bill and those people who will come into its ambit. A lot more funding will be required. We have a shortage of specialists and caregivers. They are underfunded and a lot more training and services will be required to give them the ability to meet the needs and standards required by this bill. 
One of the reasons that this bill was brought into being is because of one Barry Ryder. Looking at some of the press releases regarding what happened to Barry Ryder one of the first things I saw was the statement: “Yesterday the court heard Ryder was institutionalised unable to cope out in the community and had borderline mental retardation. He was committed to Lake Alice Hospital in 1985 after he tried to rape and strangle two boys aged 6 and 7 near Timaru. It was also recognised and acknowledged that he could not be rehabilitated.” People like Barry Ryder would come into the ambit of this bill and have the security and care of the protected environment they need. This bill will provide that. Barry Ryder will then not do what he was doing which was molesting innocent young boys. Every time he was out in the community unsupervised he would offend. 
The judge said the prognosis for Ryder given that he had already received 12 months of treatment was not good. His assessment was that he presented an extremely high risk of reoffending yet not much could be done to make sure he was in a secure environment and not able to reoffend. The existing services that were supposed to provide that protection for the public failed in his regard and this bill will help to fill that gap and address that failure. It provides for the compulsory care of those with intellectual disabilities who because of their lack of understanding anti-social or violent behaviour need compulsory care. 
We have already heard the story of one young man. When he is around 45 and becomes frustrated he will become violent and angry. When people see an angry and violent 45-year-old man they do not necessarily realise that he has the intellect and capabilities of a 5-year-old. How do we deal with someone who is 45 and 6 foot 2? How do we control somebody like that and manage the situation in such a way that that person is not a threat to the public? How do we make sure that those people do not do themselves or anybody else harm? 
Barry Ryder’s family were most concerned about their ability to make sure that their son was provided for as they grew older. He is 45 and they themselves are aging. They know that there will come a time when they are not around and they are concerned about his future care in a secure environment. They are absolutely pleased that the Intellectual Disability (Compulsory Care) Bill is now passing through the House and feel somewhat comforted that their son will be looked after in the future. They believe it looks promising and so are looking forward to having some comfort in their declining years when they will no longer be able to ensure the safety and protection of their son. 
There are other cases including that of a young woman who was confined to police cells in Palmerston North. The judge actually apologised to her family stating that it was clearly unsatisfactory that a young woman in her situation mentally immature at 33 years of age was put into a prison cell. Under this bill that person will be able to be put into a secure and safe environment with support which is the sort of environment that she needs rather than being put into jail. It is not on that people with an intellectual disability come into the ambit of being declared criminals and put into jail. 
In the case of the young man previously mentioned the family were appreciative of the police’s understanding in that regard but that might not always be the case. In the young woman’s case it was late at night she had wandered away from the family property was eventually located by rescue helicopter and transferred to a psychiatric unit but was not admitted. The unit did not take her because she was not declared or considered to be a mental patient. She was a person with an intellectual disability. When she at 33 years of age threw a tantrum—because her capabilities were not the capabilities of a 33-year-old but those of a 5-year-old—the staff could not control her so they called in the police. How do people deal with those sorts of rages? They can deal with them in a more secure and supportive environment and that is what this bill provides. 
I know that a number of families out there will be so thankful knowing that their children—at whatever age—will be in a safe and secure environment when they can no longer look after them. That is what this bill does. It provides them with some comfort and measure of hope that that will happen for their children and that the public including our children will be protected from the likes of Barry Ryder who preyed on young boys at schools. 
I am very pleased to see that National had the foresight to ensure that funding was put aside for this bill. It is an excellent plus and we can only hope that it is still there and ongoing. I thank my colleague Dr Lynda Scott for all her efforts—it has been fantastic—and I acknowledge the efforts of Wyatt Creech in introducing this legislation in 1999. I am disappointed that it has languished for so long. 
DAVID BENSON-POPE (Labour—Dunedin South) 
: 
 I am pleased to rise in support of the Intellectual Disability (Compulsory Care) Bill. I add my congratulations to the members of the current Health Committee and to their predecessors and to Judy Keall in particular. I congratulate those members of the House who discussed this matter in a sensitive and professional way and resisted the political temptation to make cheap gains at the cost of other people’s grief. 
Dr PAUL HUTCHISON (National—Port Waikato) 
: 
 Thank you for the opportunity to speak on this very important Intellectual Disability (Compulsory Care) Bill which is be renamed the Intellectual Disability (Compulsory Care and Rehabilitation) Bill. The very existence of Supplementary Order Paper 160 is an indictment on the increasing arrogance and carelessness of the Labour Government in the way that it has handled what is indeed a very sensitive and important issue. 
In saying that I note that the Supplementary Order Paper appears to have some changes in it that are important and were stressed by the Health Committee back in 1999 and 2001 as being important: for instance the change in the definition of “intellectual disability”. I certainly hope that the Minister the Hon Ruth Dyson will take a call to explain why that particular definition has changed because the select committee went to considerable trouble to ensure that it was reasonably and tightly confined. I believe members wished for a margin of error of about five whereas now it is expressed in a different way. An intelligence quotient is expressed as 70 or less with a confidence level of not less than 75 percent. 
 This is the sort of thing that Mr Benson-Pope must also take seriously. A Supplementary Order Paper has been brought in under urgency without the collaboration and communication that was the spirit of this bill when it was first reported to the select committee and there are some changes. I think it is hugely important that the Minister take a call to clearly explain that sort of change. 
I too would like to pay tribute to the enthusiasm of Judy Keall as chair of the Health Committee. I have mentioned that she has a unique and distinctive way of articulating herself but she was particularly sincere in ensuring that this bill was progressed. Once again there is a huge worry that that was back in 1999 to 2000. I want to refer to a press release of January this year: “Sex offenders bill gathers dust”. The fact of the matter is that once again the Labour Government has not put a priority on a hugely important bill. It has brought it in under urgency with a Supplementary Order Paper that has some significant changes which hopefully the Minister will explain. 
I note that the Intellectual Disability (Compulsory Care) Bill was introduced by National in 1999 in response to concerns that Barry Ryder who has a 17-year history of sexual offending would be released back into the community. It is one of the problems of this very sensitive and difficult area of the mentally and intellectually disabled that the press latches on to the highly spectacular cases but does not concentrate on the detail and the importance of the majority of individuals who are caught up in this legislation. There is also the anguish of the parents of children who are non-offenders but who know that they are a time-bomb in terms of their potential for offending yet there is a lack of adequate facilities to look after them. Again one of the very important and thoughtful contributions made by Wyatt Creech and the National Government was to put aside $50 million to ensure that as this legislation finally came into being there would hopefully be provision to cater for it. 
In terms of the background commentary the importance of the bill is encapsulated by the fact that as introduced it sets out the limits that can be imposed on the freedoms of people who have an intellectual disability and are in need of compulsory care. Prior to 1992 people with an intellectual disability were included in the definition of “mental disorder” under the Mental Health Act of 1969. It was absolutely obvious that there had to be a dramatic catch-up in this legislation which was clearly inappropriate. This bill certainly does that but the huge indictment on the Labour Government is the fact that it has languished for so long. 
I note that the commentary points out that the specific exclusion of people with an intellectual disability does create a legislative gap resulting in limited options being available to the courts for dealing with people with such a disability. For some that has resulted in inappropriate placement in prison mental health services or discharge into the community. Once again I go back to the Simpson report on psychiatric illness within the prison system in New Zealand. It points out just how substantial and serious untreated mental illness is within our prison system and how serious is it that this Labour Government—despite all its rhetoric from the 1990s—has not moved seriously to correct the findings of that extremely important report from Dr Sandy Simpson back in 1999. 
I think it is also important once again to point out the pleas from parents who were submitters to this bill. For instance Andrew and Kathleen Taylor wrote of the problem of lack of adequate resources: “For several years now we as parents of a child with special needs have been encouraged to believe that the care of our children should happen in the communities in which they live. We have been encouraged to embrace ‘mainstreaming’ and ‘inclusion’ in education and leisure. We were promised adequate levels of support. Institutions were a thing of the past. Now it appears that our children can be incarcerated if authorities feel that they ‘appear to pose a risk …’ without them having committed any offence.” They go on to state: “Instead of such a punitive bill we would like to see measures put in place to adequately support parents/caregivers to care for their disabled dependents safely in their own communities. This would be a far less expensive option. With adequate levels of supervision ‘dangerous’ incidents would be extremely rare.” 
I want to end by saying that it was the Hon Phil Goff who 4 years ago said that the nub of this legislation was in providing adequate facilities. That has not happened under this Labour Government and it is high time that this bill has finally appeared before the House. 
The debate having concluded the motion lapsed. 
Amendments recommended by the Health Committee by majority agreed to. 
Bill to proceed. 
Name changed to the Intellectual Disability (Compulsory Care and Rehabilitation) Bill.