Hutchison Paul: Mental Health (Compulsory Assessment and Treatment) Amendment Bill — First Reading 
Hutchison Paul: Mental Health (Compulsory Assessment and Treatment) Amendment Bill — First Reading 
[Volume:661;Page:9587] 
Dr PAUL HUTCHISON (National—Hunua) 
: 
 Thank you very much for the opportunity to speak on what I consider is a very very important member’s bill the Mental Health (Compulsory Assessment and Treatment) Amendment Bill. I also thank the Hon Luamanuvao Winnie Laban for introducing this bill and I acknowledge the extensive work and effort she has put into it. I say from the depths of my heart that I admire enormously the contribution that Winnie Laban has made to this Parliament her sincerity her intelligence and the vast experience she has in this field through a long history of practising as a family counsellor. 
Although I absolutely agree with the sentiment behind this amendment bill and the Government fully supports the underlying principle of it—to strengthen family and whanau involvement and provide support when a family member is assessed or treated—we will not be supporting the bill because we believe that the current legislation is actually quite sufficient. I will go into detail about why that is and I hope members will listen. Firstly I have personally thought a lot about this bill and have done my best to consult widely and discuss it with others including a current mental health commissioner. Secondly we consider that the existing Mental Health (Compulsory Assessment and Treatment) Act 1992 and in particular section 130 as amended by the Mental Health (Compulsory Assessment and Treatment) Amendment Act 1999 provide the appropriate framework and fulfil the requirements of this bill. 
The amendment Act of 1999 was one of the first that I was personally involved in when I came into Parliament. I know that a huge amount of work was put into that and in my view it was one of the very worthwhile pieces of work that the Labour Government did ably assisted by Her Majesty’s most loyal Opposition at the time. Section 7A of the Mental Health (Compulsory Assessment and Treatment) Act which was inserted in 2000 by the 1999 amendment Act provides that the medical practitioner or responsible clinician “must consult the family or whanau of the proposed patient or patient.” unless “consultation—is not reasonably practicable; or is not in the best interest of the proposed patient or patient.” I must say that a huge amount of effort has been put into the work related to what is not reasonably practicable or in the best interest of the patient. Secondly the practitioner “must consult with the patient or proposed patient” with regard to the best interests issue. Paramount and fundamental to that legislation are the concerns well-being and safety of the patient. Inherently there has to be a balance between best clinical practice patients’ and relatives’ rights and ultimate patient well-being. 
It is fundamental to point out that section 130 of the 1992 Act allows the Director-General to promulgate standards from time to time. They include “Guidelines for the purposes of this Act; and standards of care and treatment of patients.” The guidelines and standards have had a huge amount of consultation and work and that should not be underestimated. The problems I see with this current amendment is that if anything on balance it is not necessary and it could erode patients’ rights where they have already been extremely well protected. Closely aligned to the original Act is the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers’ Rights. Both have had enormous consultation and have been worked up over a period of time. 
When the amendment that inserted section 7A was put into place submitters included the Privacy Commissioner the family law section of the New Zealand Law Society the Principal Family Court Judge the Mental Health Foundation the Mental Health Commission the Royal Australian and New Zealand College of Psychiatrists and many many others. Further to that the Health and disability services (general) Standards and various core standards that give effect to the general standards were promulgated by the Director-General of Health as recently as 2008. Those revised standards were the culmination of extensive collaboration with many groups—consumers providers Government and non-government agencies and the ministry—that took place over a 3-year period. They were extremely well-thought-out. In my view these existing standards satisfactorily accommodate the amendments that occur in this current bill. There already is an existing right to a second opinion that is clearly expressed in the Act as amended in 2000. I sincerely believe that the current legislative framework is appropriate and that the bill does not add anything practical to what is already in law. 
What is fundamentally important however is the way in which the current law is put into practice. Again in my view that depends on the proactive vigilance of clinicians to practise up to the standards and guidelines that are already there. Clinical reality requires that each patient their family and their whanau are treated according to their unique circumstances and it is impossible to accommodate that entirely by further legislation. Sometimes emergency situations will not allow a second opinion before a patient’s life is put into danger. Clearly sometimes it is totally appropriate that family and whanau are not directly involved—for example in cases of incest or violent abuse within a family that is repeated and where direct harm could occur to the patient. 
I once again sincerely thank the Hon Luamanuvao Winnie Laban for introducing this bill but I personally sincerely believe that the current legislation provides very well-thought-out and balanced protections and it would be inappropriate to introduce these further amendments. If anything what really is needed is constant revision of the best-practice guidelines between the Royal Australian and New Zealand College of Psychiatrists families whanau consumers and the Mental Health Commission. In my view that would be the most useful approach.