King AnnetteHon ANNETTE KING (Deputy Leader—Labour): I enjoyed that contribution from Scott Simpson albeit brief. He did make a very important point when he began his contribution on this bill in that it was a challenging and confronting piece of legislation because we know that any legislation that compulsorily requires treatment cannot be entered into lightly and cannot be done without due consideration. That is exactly what the Health Committee did. We did give this legislation due consideration. We raised a lot of issues at the select committee. We asked a lot of questions. We looked at how we could give as many safeguards as possible in a piece of legislation that is going to replace outdated legislation which goes back to as Jacinda Ardern said 1966—the outdated Alcoholism and Drug Addiction Act. We are putting in place a more modern approach to compulsory treatment. I am sure the purpose of this bill has been canvassed but I think it is worthwhile repeating for people why we need to have this new piece of legislation. First of all the old legislation is outdated and overdue to be updated. But most of all this new legislation has got some key things that it sets about to do. The first is to protect people from harm. When we are talking about compulsory treatment we are talking about people for whom there is a very very high threshold for treatment. It is a situation where the person is considered to have severe substance addiction and does not have the capacity to consent to treatment. So that is a very high threshold—that they have reached a point in their life where they do not have the capacity to consent to treatment. The first purpose of this bill is to protect them from harm. In the Health Committee we did hear from family members who told us of the harm to their loved one who was addicted but also about the family members themselves and of the many efforts that they made over and over again to try to help that loved one only to have failed. The second purpose is to facilitate a comprehensive assessment of their addiction. That means that you have got to really look into what has caused it and what has happened—a proper assessment. They are no longer a once-over-lightly. They need a proper assessment of what their addiction is. Then there is of course the stabilisation of their health throughout the application of medical treatment including medically managed withdrawal. We were not just talking about medically managed withdrawal; we were also talking about the fact that many people who are severely addicted have other health issues. So it is not just one issue that they are dealing with. They often have many other health issues that they have collected along the way perhaps related to their substance abuse but maybe not always. They could have many co-morbidities. So there is stabilising their health—whether they have got diabetes or whether they have got a heart condition whatever those issues are. Many of those issues have been neglected over the years as well. They rarely have been to their regular check-ups with their GP so you need to stabilise their health as well. It is also about protecting and enhancing their mana and dignity and restoring their capacity to make informed decisions about future treatment. So it is to get them into a position where actually they can take back their lives and start to make some decisions about themselves. Part of the purpose is also to facilitate planning for their treatment and care to be continued on a voluntary basis. You do not wish to have someone in a mandatory state for the rest of their lives; you would want to bring them to a point where they can then be part of what happens to them and it is done on a willing and voluntary basis. It also gives them the opportunity to engage in voluntary treatment. So that is the purpose and they are very laudable goals. I do want to raise some of the issues that did worry us—it was not just the Opposition; the Government worried about these as well. We have to ensure that if you bring in a new process that you actually are able to fund it to provide it. I think it was important that we did hear from some of our experts in the field who told us that this will not work if we do not have the funding to go alongside it. One who comes to mind was the clinical head of addiction at Capital and Coast District Health Board Tom Flewett who said the Government already substantially underfunds addiction services—this is in just this region but you will hear it in other submissions. He said that when the new compulsory treatment law comes into force existing resources may well have to be redeployed and that would compromise patient care in other areas. He said: I know from experience that if you put a new Act in place and there is no new resource then we have to reconfigure existing resource. That is a given for working in this country." He does support the bill but this issue of making sure that we resource it was raised by many of the submitters. We could not get from the Ministry of Health at that point what additional resource would be put in. We are told that it will be phased in so that they will presumably putting resourcing along with the phasing but we are unsure as to exactly what that requires. We are told that there could be up to 200 New Zealanders a year who will receive compulsory treatment and that could cost up to $750000 annually. That is the assessment; we are not sure whether there are going to be 200 or more. I think one of the most telling submissions that we received at the select committee was actually from the Salvation Army. Think of the Salvation Army as being probably the foremost provider of residential services for addiction in this country. For many many years it has been sterling in its efforts to try to help people who have addictions. It made I thought probably one of the best submissions to our select committee. The Salvation Army supports the bill in principle. It said: "It is a milestone for the addiction sector following 30 years' of advocating for change …". It said it "agrees with the Law Commission that in the case of a small group of people who are severely dependent on alcohol or drugs there is an important public interest that is served by intervening …" on their behalf. However it said the current Act "administers this intervention in a way that is at times unworkable does not enhance the dignity and rights of the person [concerned] …" so it supports that and the change in that. It does have "reservations and questions relating to specific resourcing the need for more support of the whanau of those under the proposed regime and multiple comments on specific clauses …" which it sets out a little further on. It believes there needs to be more support for this bill. It said that it also agrees that the number could be between 200 a year—this is an increase from the 70 to 80 that we currently have now. It also has concerns that the legislation will place more challenges on people who are providing these services. I just want in the short time I have got left to mention an area that was raised and that is around what those who are going to be "approved providers". The issue was raised of whether we will have enough approved providers at the time that this legislation is implemented and assurances were wanted that we would not only have the funding but we would have the people who would become approved providers under the Act trained and ready and available throughout New Zealand to be able to provide this service to those who need compulsory treatment. So overall it is a good bill but we will be watching it. In fact the select committee has said that it wishes to watch and monitor it to ensure that the guarantees that were given by the Ministry of Health that there will be appropriate funding and we will have the approved providers—we will be looking to make sure that happens because the worst thing that could happen would be if this legislation was to fail after all the work that has gone into it and if we do not make progress at all. So we will be voting in support of this bill."