Collins Judith: Health (National Cervical Screening Programme) Amendment Bill — Third Reading 
Collins Judith: Health (National Cervical Screening Programme) Amendment Bill — Third Reading 
[Volume:615;Page:11447] 
JUDITH COLLINS (National—Clevedon) 
: 
 It has been very interesting listening to the reasoned debate in the Chamber and I must reiterate some of the comments made by other members of the House that there was a great deal of cooperation through the select committee on this bill and post the select committee to get the bill agreed to by our various caucuses. It has been a very good bill to be involved with. 
I will address some of the issues that were raised by the Green member Sue Kedgley. Having worked with Ms Kedgley on the bill I know that she is genuinely concerned and has raised those points regarding privacy. This is an issue that we all take very dearly. None of us particularly want our medical records known to all and sundry although some of us probably have less to worry about than others. But basically nobody wants to have his or her private medical information trotted around the place. 
I have a few issues that I want to take up. One of the points made by Ms Kedgley was in relation to the fact that the evaluators or auditors have access to the primary health records of people. Actually lots of people have access to primary health records including receptionists in doctors’ surgeries anyone who may work there anyone who wants to break in Accident Compensation evaluators and all sorts of people. The fact is that the health system cannot work if medical people cannot have access to people’s records. I am sure that when most of us ring our general practitioner to make an appointment to see him or her we would say what our name is and the receptionist will get our medical records out and have them ready for the doctor to look out. The receptionist might even open them up. The fact is that that can happen even now. However should that person take that information and use it in a way contrary to its purpose that person would be in breach of the law as he or she would be and will be under this bill when it becomes an Act. The misuse of the private information will be just as bad and just as unlawful as it is now. The point we need to get through is that no matter what system we put in place if somebody wishes to break the law get that private medical information and misuse it then they jolly well will. They will do it. Our only recourse will be to the law as it is now. 
I came to the conclusion that we should support this bill—having first been very concerned about the privacy issues. This bill will mean that the women of New Zealand who are on the National Cervical Screening Programme can be assured that they will have auditors and evaluators who will be checking their records against the facts. They will be checking that when women are told their cervical screen has come out with a negative—which is a good result—they will be able to rely on it. What can be worse than a cervical cancer screening programme that women endure—I say that from experience—and are told there is a negative result therefore they all breathe easy and think: “Goodness for how many years can I put it off again?” only to find out that the results they have been given are wrong? That is what has happened in Gisborne. That is why we have to do something to help to stop this. 
The women of New Zealand deserve to know as do the men of New Zealand that when they are told their medical results are X that they are in fact X and not Y. Otherwise we will have no faith in the system and women will not even want to be bothered having their cervical screens. They will say they cannot see the point because they think they will be given the wrong result. That is what has happened for some women. 
Ms Kedgley has brought up another issue that I would like to deal with. That is the issue of opting off the programme. It is very important to make it clear that when a woman says she wants to opt off the programme—that she does not want to be part of the National Cervical Screening Programme—that does not mean she will not be able to have cervical smear tests. She will still be able to have the tests; she will still get her results. What will happen is that she will not have those tests evaluated against other people’s tests and she will have to work with her own general practitioner or gynaecologist over those issues. For instance her general practitioner her gynaecologist or herself will decide when there needs to be another smear test. There will not be a letter from the programme organisers the Ministry of Health. 
The opting-off has nothing to do with saying that women will not therefore be able to have their smear tests. It is simply that they will not be part of the national call-up programme and they will not be part of the national auditing programme. We need to get it very very clear that we do not want women to opt off but those who do wish to opt off—I absolutely respect their right to do so and every woman should have that right—need to know that they therefore have to take more responsibility for their own health. That has to be understood. I think some of the concerns that Ms Kedgley raised are certainly valid but she may have possibly overstated the case just a bit. 
One of the other areas I want to talk about again is education. I would like to thank the previous speaker Judy Turner for her kind comments on this issue. It really is true that the air of secrecy and lack of information that absolutely envelops this whole area is because of the fact that sexually transmitted disease is one of the primary causes—and certainly according to some submissions that we heard—the main cause of cervical cancer. That is not to say this is a judgment on women who get cervical cancer. It is incredibly easy to get. It is something men need to know about too because of their being carriers. That is what happens. It is very important. 
I would love to see a bit of effort put in by the Government—I would certainly be very supportive of it—into educating people. I think back to the tremendous amount of effort that was put into education on the smoke-free environments legislation on our television screens all night every night. I think it would be great to see a bit of education around this area—whether or not there is a television programme or whatever; people who want to do some documentaries on it. That would be great. The fact is that it is not a subject that everyone wants to know about or think about; they would rather just not think about it But it does not go away just because we do not want to know what causes it and what can be done. 
That brings me to the kaitiaki regulations. These are a travesty for Maori women. The kaitiaki regulations are there supposedly for the benefit of Maori women but this is a dreadful trap that somehow we have allowed to happen. We have allowed Maori women not to have the same benefits I believe as others. It is just not fair when records regarding Maori cervical cancer health are kept secret and are not allowed to be told. Maori women need to know the facts as much as anyone else—particularly when we were assured or rather frightened in the select committee by the fact that Maori women are up to four to five times more likely to have cervical cancer than non-Maori women. It is something we need to look at and I would really like the Government to look at it. I would certainly be very supportive of that.