Intellectual Disability (Compulsory Care and rehabilitation) Bill — In Committee Third Reading 
Intellectual Disability (Compulsory Care and rehabilitation) Bill — In Committee Third Reading 
[Volume:612;Page:9583] 
Intellectual Disability (Compulsory Care and rehabilitation) Bill 
In Committee 
Debate resumed. 
Part 2 Principles and general duties ( 
continued 
)  
JOHN CARTER (National—Northland) 
: 
 I know that the members in the Chamber over lunch were worried that I would not take the extra 2 minutes and they have come down just to encourage me to do so. I am pleased to be able to share with them the fount of knowledge I have on this particular issue. What is really important is that I know that this Minister having listened and gained an understanding of the issue I was raising before dinner will have gone away and spoken with her officials and she will probably want to take the next call to answer the questions. I am sure; I myself am absolutely convinced as I think are members on this side—but I can see from the look on the faces that the others over there are not quite so convinced. 
Hon Ruth Dyson 
: The member is probably backing Bill English as well. 
JOHN CARTER 
: Absolutely! The whole of New Zealand is. That is the good thing. The whole of New Zealand is backing Bill English as the next Prime Minister. Let us get that very clear. Life is just getting better and better—but back to the bill before the Chairman brings me back to the bill. 
There is a point I want to make about clause 12 and I was asking the Minister before lunch whether we have the resources to carry out this sort of gathering—the discussions the family group conferences etc. If we will be relying on the Department of Child Youth and Family Services to provide the service then I say that we are in trouble. If the Minister has some other idea on how we are going to provide the service then that is fantastic and I hope she will assure the Committee of the system that she will provide. This is a very important part of this legislation. The families have a right to know what is going on. They have a right to be able to discuss amongst themselves the things that they want to see for the people we are dealing with. They have a right to be consulted and involved. Of course the individuals themselves also do. It is good that we are setting this system up having taken it from previous legislation but we want to make sure that it works. We want to be absolutely assured that some of the resources the taxpayer funding that the Government is putting aside will be spent on making sure that this service and this facility is not only just written here in the legislation but is real and meaningful. Otherwise quite honestly we have wasted our time in discussing and debating and passing this legislation. I hope the Minister will take the next call and can give the Committee the assurance that she has something in mind to allow us to have these services delivered. 
GEORGINA BEYER (Labour—Wairarapa) 
: 
 I move  
That the question be now put 
. 
A party vote was called for on the question  
That the question be now put. 
Ayes 69 
New Zealand Labour 52; Green Party 9; United Future 8. 
Noes 48 
New Zealand National 27; New Zealand First 13; ACT New Zealand 8. 
Motion agreed to. 
Part 2 agreed to. 
Part 3 Needs assessments and care and rehabilitation plans 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 Part 3 discusses needs assessment and care and rehabilitation plans assessment and care and rehabilitation needs care and rehabilitation plans and case conferences. The purpose of it is to ensure that when somebody with an intellectual disability ends up before the courts or has behaviour that looks like they may end up before the courts—they may engage in what is considered criminal behaviour breaking the laws of the land even though they do not understand the implications of that because of their intellectual disability—assessment care and rehabilitation needs can be met. The behaviour of a great many of those people can be managed if appropriate care and support is put around them. Often people get angry only when they cannot understand what is happening in their environment and they are frustrated. Appropriate management of behaviour can be achieved. 
In this bill originally there were two groups: those who had committed an offence and had broken the law and the non-offender group. It was felt that people like David Stephens were in the non-offender group initially and if a care plan had been able to be put around him then and if he could have been contained in a secure environment then he would not have gone on to the offender group. We had a lot of representation from disability groups on this issue. They stated that they did not feel we could put in that sort of obligation and take away the rights of somebody who has an intellectual disability just because we think they might have behaviour that will cause them to break the law. It was felt that that was unacceptable and that was taken out. But it has not stopped the needs assessment and care and rehabilitation plans being able to be implemented for people whom we think may develop in that way and not be able to be managed in a normal community environment. 
The purpose of a needs assessment has been that every person who is a care recipient under an order under the Criminal Justice Act because they have committed an offence will have a care plan decided by the people who will be caring for them. That involves talking to the caregivers and also to the families involved in the person’s care. A needs assessment looks at the behaviour a person has had what is driving that sort of behaviour and what one can do to provide a care and rehabilitation plan. We did have a debate before about whether “rehabilitation” is the right term because rehabilitation means to a lot of people the individual changing behaviour whereas actually rehabilitation plans are more about changing the behaviour of people around someone with an intellectual disability so that they do not get into a lose-lose situation and so that they do not get into a corner where their only out is to hit somebody. The reason we need specialised carers to be able to look after people who have an intellectual disability and also have committed an offence is that they need to know how to manage anger. They need to know how to manage someone who is frustrated who may not be able to communicate and who will act out if they are unhappy. There does need to be those people who are specifically trained to be able to manage this type of care. 
I am pleased to say that this bill was a National Government bill when we were in Government and it had money with it. Those 24-hour intensive care plans and the training of care professionals have all happened because of National. We put the money with this bill to make sure that we did not just lump a whole lot of compliance costs out there into the community for those that are already caring. We put in money to develop services. The one thing that has not developed fast enough—probably because it has taken 4 years for this bill to reach this point today—is inpatient care. We do not have the inpatient care facilities—the really secure facilities. I know there was one being built at Porirua Hospital to contain people who have an intellectual disability and severe behavioural abnormalities that bring them before the courts. I believe that the Mason unit in Auckland is also having one developed. It is important that we get on with those because although small in number there are those with an intellectual disability who do absolutely wreak havoc—as we see if we look at the Ryder case—in the community. 
SANDRA GOUDIE (National—Coromandel) 
: 
 Again I acknowledge the fine efforts of my colleague Dr Lynda Scott and I acknowledge Wyatt Creech who introduced this legislation in 1999. They made sure that funding was put aside for that purpose and it is absolutely critical that we do have people who are trained in this field. It is vitally important that diagnoses and needs assessments are done appropriately and specifically to the individual. That is hugely important to the parents and to the welfare guardians of people with intellectual disabilities who are being assessed within the ambit of this bill. Funding is absolutely critical in ensuring that we do have the trained personnel and the specialists necessary to make those assessments. One person has made a substantial submission in that regard and has some concern about the need to ensure that there is ongoing funding for people such as service providers and caregivers and to make sure that they are appropriately trained and can handle those difficult behaviours. 
Certainly there needs to be a secure environment for people like Barry Ryder who need to have an eye kept on them for 24 hours. The moment one takes one’s eye off someone like Barry Ryder he will reoffend. That was the opinion of the judge and that was the concern of many of the parents of victims who were so traumatised by him when he went out into the community. His assessment was done and unfortunately at that time there were not the provisions that this legislation will provide. It is absolutely imperative that we have the funding necessary to train people to do those appropriate needs assessments and this bill will certainly make sure that people like Barry Ryder will not be out in our communities and will not pose a danger either to themselves or more particularly in Barry Ryder’s case to others. 
Parents of 45-year-old persons who are like children and are 6 foot 2 and incredibly strong will also be comforted by knowing that their needs assessment of their children will be accurate and that they will have the care and attention that is needed. Although the families are required to be involved with all of the assessments etc. I did not see very clearly where welfare guardians are incorporated in the legislation except in clause 21 which states: “During the needs assessment process the co-ordinator must make all reasonable efforts ...” and I just wonder what that means. I would hope that they would go to the nth degree to make every single effort to ensure that welfare guardians are contacted and involved in the needs assessment process because they have a particular understanding and knowledge of the care recipient—the new term—and it is absolutely imperative that they be involved in that needs assessment process. They are particularly concerned about the ongoing care and protection of their charges if they are not their biological children. 
I also draw members’ attention to clause 23 “Cultural assessment”. Another member of the House Stephen Franks expressed some concern about cultural assessment and I think there could have been more appropriate wording. Clause 23(2) states: “If following the assessment under subsection (1) the co-ordinator considers that the care recipient is Maori …”— more appropriate wording would have been “considers that the care recipient is of particular ethnicity and the care recipient agrees with that assessment the co-ordinator must try to obtain the views of any suitable person”—rather than just any suitable Maori person—“or organisation concerned with or interested in the care of persons who have an intellectual disability from within that particular ethnicity.” It is important that we look at the range of ethnicity that exists. 
HEATHER ROY (ACT) 
: 
 Many parts of Part 3 I would like to support. I feel they will make a positive contribution to the care of the intellectually disabled particularly in relation to compulsory care. I refer in particular to clause 21 which states that when discussing the needs assessment the coordinator is to consult with persons concerned with the welfare of the care recipient. That is much needed. The families must be involved as some of my National Party colleagues have pointed out. Clause 21 also refers to the need to consult with the welfare guardians of the patient—I must say I still have a great deal of difficulty with the term “care recipient” which does not exactly roll off one’s tongue. But the intention of that clause is I think very good. 
But I would like to speak particularly to clause 23 and I thank Sandra Goudie for mentioning it now. In his second reading speech Stephen Franks talked at length about the cultural assessment aspects within this bill; and clause 23 brings out the point I want to make particularly. Sandra Goudie did read out subclause (1): “The co-ordinator must try to identify the care recipient’s culture ethnicity language and any religious or ethical beliefs.” It is very sad in this day and age that we have to legislate for things of this nature. Coordinators particularly clinicians have a lot of training now in cultural aspects of care and many—most in fact now—have incorporated those features into the assessments that they do on all patients not just the intellectually disabled ones. Certainly in the area of mental illness this is now common practice and I find it extremely sad to think that we need to specifically spell out that we must take into account factors that might be very important in people’s lives. 
I refer now to subclauses (2) and (3) of clause 23 and I ask the Minister whether she could tell us—I am not living in great hope because she seems to be studiously ignoring any other requests I have made for an explanation—why in fact Maori have been singled out in this clause. Subclause (1) mentions different cultures and ethnicities but in subclauses (2) and (3) only Maori are singled out. Is there something we are missing? Is it only Maori who actually have cultural expectations and important cultural aspects that should be considered? What about Samoans and other Pacific Islanders? What about Asians? Counties-Manukau now has patient advocates and interpreters for the Asian communities. Do Asians not count when it comes to intellectual disability? Are their needs not as great as anybody else’s? I would like to know why they have not been specified. 
Sandra Goudie made a very good point. She said that ethnicity should be referred to generally not by a specific ethnic group or breakdown. That is a very good point. As a result of that I just cannot accept this clause as it stands and I have put forward an amendment to have it omitted from the bill completely. If it were reworded the way Sandra Goudie explained it perhaps it should be included and maybe she would like to put forward an amendment. I would have found that much more acceptable but if this clause is to stand as it currently is then ACT New Zealand will not be supporting it—we will ask for it to be omitted—and we will not support this part if in fact it stays in the bill. I say that with sadness because I feel that other clauses in this part do deal with valid concerns. 
I ask all parties to think about legislation of all sorts that has been brought before the House of late. Cultural assessment of all sorts has become a trend with this Government. It is becoming a very big part of its bills and also we are seeing the specific singling out of Maori. We should in this country have one law for all people not race-based law. What we are seeing here is again a perpetuation of the push towards the promotion the singling out of separate ethnic groups within our society. What that does in effect is cause separatism not a united New Zealand. 
Dr PAUL HUTCHISON (National—Port Waikato) 
: 
 Part 3 “Needs assessment and care and rehabilitation plans” is certainly one of the very important parts of this bill which by and large I do support. The select committee put great emphasis on rehabilitation. That was explicitly stated in the commentary because members said during the hearing of submissions examples were brought to the attention of the committee of people with challenging behaviour which often reflected poor management and uncertain environment: “If the person is not receiving proper care they will possibly become a danger to themselves and/or other people.” Clearly this part of the bill is extremely important. The commentary goes on to state: “We believe there should be explicit recognition of the importance of rehabilitation where possible to ensure that people do not receive custodial care only.” 
Clause 15 “Needs assessments required for certain care recipients” is fairly prescriptively spelt out. There is always the great danger in this sort of legislation of being overly prescriptive and I want shortly to take up the point of the cultural assessment provisions because that is prescription gone berserk in this politically correct world. Once again this part has been infiltrated by the term “care recipient”. Most people throughout the world who look to the English language to contain relatively simple clear meaning are perplexed as to why we have to double up the verbiage and make it much more obscure but oh no the Labour Government insists on that sort of somewhat inane and totally unnecessary nomenclature. 
Nevertheless I absolutely agree with clause 19 “Maximum period for needs assessment and preparation of care and rehabilitation plan”. It is good to see a time limit put on that sort of thing which is so clearly important. 
Hon Rick Barker 
: What’s the time limit for Bill? 
Dr PAUL HUTCHISON 
: There was an interjection by the member for Tukituki over there. Is the member speaking specifically about the Intellectual Disability (Compulsory Care and Rehabilitation) Bill? I certainly hope he is. Clause 19(1) states: “The process of assessing the needs of a care recipient and preparing his or her care and rehabilitation plan must be completed as quickly as practicable.” Fortunately subclause (2) states: “The process referred to ... may not continue for longer than 30 days”. I wonder whether the Minister will take a call and say what will happen if it is not completed within 30 days. It is very important to have time limits explicitly put into legislation like this because in reality it is over that period of initial assessment and preparation of a plan that some disastrous and avoidable tragedies have occurred. 
Again one wonders why on a bill that has been talked about since 1997 and that came into the House in 1999 and is finally before the Committee under urgency at the end of 2003 the Labour Party has suddenly come to its senses and realised that time limits are important. If only it could have done so with regard to the bill itself. 
To go on to clause 23 “Cultural assessment” I cannot but agree wholeheartedly with the points that both Sandra Goudie and Heather Roy have made in terms of the extraordinary length to which the Labour Government is determined to try to legislate in such areas as culture ethnicity language and any religious or ethical beliefs. It seems to me that we live in a day and age— 
DAVID BENSON-POPE (Senior Whip—Labour) 
: 
 I move  
That the question be now put 
. 
Motion agreed to. 
The question was put that the amendments set out on Supplementary Order Paper 160 in the name of the Hon Ruth Dyson to Part 3 be agreed to. 
Amendments agreed to. 
The question was put that the following amendment in the name of Heather Roy to clause 23 be agreed to: 
to omit this clause. 
A party vote was called for on the question  
That the amendment be agreed to. 
Ayes 35 
New Zealand National 27; ACT New Zealand 8. 
Noes 82 
New Zealand Labour 52; New Zealand First 13; Green Party 9; United Future 8. 
Amendment not agreed to. 
A party vote was called for on the question  
That Part 3 as amended be agreed to. 
Ayes 109 
New Zealand Labour 52; New Zealand National 27; New Zealand First 13; Green Party 9; United Future 8. 
Noes 8 
ACT New Zealand 8. 
Part 3 as amended agreed to. 
Part 4 Compulsory care and rehabilitation of inmates and former special patients 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 Clause 29 provides for the assessment of inmates and former special patients. Subclause (1) states: “A superintendent of a prison may apply to the co-ordinator to have an inmate assessed under this subpart if the superintendent has reasonable grounds for believing that the inmate has an intellectual disability.” One of the problems in that is talking about people who have an intellectual disability people who have a mental illness and people who have committed offences. Those situations can all go together: just because somebody has an intellectual disability does not mean that that person cannot have a mental illness and vice versa. 
Sometimes that makes it very difficult to determine the level of care and where that person should most appropriately be placed. Some people end up in prison and it is not really recognised that they have an intellectual disability until they get into that strongly supervised environment. At that point the superintendent can ask for an appropriate assessment of those prisoners so that they can get the appropriate level of care. Until this bill is passed it is not possible to put someone from a prison into an intellectual-disability compulsory-care situation because we need the legislative framework to be able to do that. 
 There has also been concern for those who have been in the Kimberley Centre and Braemar Hospital which were psychopaedic hospitals where a lot of children have been placed who then grew into adults. Having those people placed in the community has been a very slow process because the hard end of the process has been reached—placing those who have very high complex needs and challenging behaviours. 
It is good to see this bill here today because the Health Committee reported it back in April 2001. It could be said that that is only 2½ years but it is a very long time to wait for legislation so that the services can be developed around it and facilities built to care for people with behavioural problems bad enough to land them before the courts or in prison. The Rt Hon Wyatt Creech who was Minister of Health at the time this bill was promoted and during the first stages of its passage through Parliament earmarked $20 million for its development. The Health Funding Authority—which to its detriment this Government merrily scrapped; instead setting up 21 district health boards which are all running over budget and developing 21 different levels of care throughout the country—initiated a service development process that included the development of best-practice indicators for the specialist support of people with high and complex behavioural needs. 
That is what needs to happen. There needs to be specialists who can arrange appropriate assessments for people who are considered to have an intellectual disability and if necessary ensure that the proposed care recipient stays within a facility. If a compulsory-care order is to be imposed there needs to be a determination when an assessment and examination is undertaken that the person has an intellectual disability. Under clause 32 on finishing the assessment of the proposed care recipient the specialist assessor or assessors sends a report of the results through to the courts. 
It is important that we understand the differences between those who actually do the assessments and who the most appropriate people are to do them. If the condition is a mental health one then it should be a psychiatrist because the appropriate level of care for people who have committed offences is an appropriate specialist. There was quite a bit of debate in the select committee about the most appropriate people to do assessments of intellectual disability and psychologists were considered. 
Dr PAUL HUTCHISON (National—Port Waikato) 
: 
 Clearly Part 4 is again getting into the machinery and teeth of this bill because it deals with the compulsory care and rehabilitation of inmates and former special patients. I note that clause 29 refers particularly to “Application for assessment of inmate and former special patients”. I am once again reminded of the work done by Dr Sandy Simpson one of New Zealand’s most eminent psychiatrists back in 1999. He really pointed out for the first time the enormity of the problem of psychiatric patients and those with intellectual disabilities—or a combination of both—within our penal system. Unfortunately it is a very real problem that neither the mental health facilities available in New Zealand nor its prison system have been able to cope with at any stage. It is a huge problem it does require focus and maybe the Minister will take a call and for a moment outline what she is planning to do to bring this issue forward because it is a very serious problem for New Zealand and certainly requires to be dealt with. 
However Part 4 does attempt to provide a mechanism whereby inmates or former special patients can apply for assessment. It is a fairly rigorous process and by its very nature it must be. In fact every application under clause 29 must be accompanied by a certificate from a person who is either a medical practitioner or a psychologist and who has examined the person to be assessed within 3 days immediately before the date of application. Again the time sequence is absolutely all-important. 
I am a little concerned in that I understood earlier on that the Royal Australasian College of Psychiatrists did advocate that there be either two psychiatrists or—in the case of an intellectually disabled individual—a psychologist making sure that the findings are appropriately peer-reviewed but I do not know whether this provision actually ensures that that happens. A lot of this assessment work can be extremely hard to be objective in and I think there is considerable use in having peer review and quality control mechanisms in place all the time to ensure that these assessments are carried out expertly and also within time. 
I refer to clause 34 where once again “Timing for and place of assessment” is emphasised. In fact the assessment of a proposed care recipient must take place within 7 days after the receipt of the application under section 29. In many respects it would be better to emphasise that the assessment should take place just as soon as possible and not necessarily within 7 days. As I mentioned earlier with the practical delays that inevitably occur from time to time preventable tragedies have often occurred. Rather than putting it the way it is—“within 7 days”—I think there would be some sense in having those time limits very much directed towards efficiency and expediency throughout. 
I note in clause 36 “The fact that an inmate who is charged with or convicted of an offence is also a proposed care recipient or a care recipient”—and my word there are those two terms again; four words for the price of two; they just seem to pop up all over the place with this politically correct Government—“does not—(a) prevent the inmate from being taken to—(i) the trial or hearing of that offence; or (ii) any sentencing for that offence;”. 
The question was put that the amendments set out on Supplementary Order Paper 160 in the name of the Hon Ruth Dyson to Part 4 be agreed to. 
Amendments agreed to and Part 4 as amended agreed to. 
Part 5 Status and rights of care recipients 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 Under Part 5 “Status and rights of care recipients” we are looking at the requirements to accept care. We are talking about taking away the rights of somebody who is being compulsorily cared for and entrusted to a care manager so it is important that care recipients are consumers under the Code of Health and Disability Services Consumers’ Rights. Just because those people are under a compulsory treatment order does not mean that they do not have the same rights as any other patient to be treated with care and respect and given an appropriate level of services. 
Many clients with high and complex behavioural support needs may be able to be managed in the community. The aim has always been to have the least restrictive environment for those patients. However we know that there are some who need to be in a restricted environment so it is a matter of getting the balance right—assessing when a care recipient needs to be under much tighter and more restrictive care and when he or she with support services can return to a community setting. 
We see that balance between the rights of individuals and their families and the rights of the community to be protected in the area of mental health as well. It is always a balancing act to try to get those rights in the right balance. Part 5 talks about the rights of care recipients but we must not forget the rights of the community to be protected. The Barry Ryder case of course was an extreme example in which young boys’ lives were tragically ruined by one person who needed to be in a restricted environment. That is why we need to see this bill progressing today and I will be pleased when we have the third reading and it becomes law. However people under compulsory-care orders have a right to medical treatment. 
We talked quite a bit in the Health Committee about how somebody could liaise with his or her family. The fact is that there will not be a huge number of those sorts of care facilities for people who need a restricted environment so people are likely to be cared for in a place away from their families. We talked about their rights to use the telephone to legal advice to company and to receive information from their families. Those people also have the right to communicate with others whether that is the Health and Disability Commissioner district inspectors their own lawyers their own doctors or specialist assessors from whom they have sought a second opinion about their condition. The care recipient will probably not be the person asking for that—it is much more likely to be his or her family. It is also important that the people caring for someone in a restricted environment have the ability to manage their care so this bill involves the rights of the carers as well as the rights of the individuals cared for. 
There are sizable specific powers over care recipients in this section. In very specific situations they can be put into isolation if their behaviour deteriorates out of control and they are a danger to themselves or others. A care manager may isolate care recipients if it is necessary to prevent those persons doing themselves or others harm. But there will be strict guidelines on how that can happen. Clause 61 talks about the restraint of a care recipient. Restraint must be used only on very rare occasions but sometimes it is needed and a care manager may restrain a care recipient if it is necessary to prevent that person endangering the health and safety of himself or herself seriously damaging property or seriously compromising the care and well-being of others. 
SANDRA GOUDIE (National—Coromandel) 
: 
 I turn to clauses 63 and 64 which refer to the placement of care recipients. As we have already covered Part 4 I remind members that care recipients can be placed within a mental facility if no other facility is available for them at the time. That needs to be recognised because if the Ministry of Health also accepts responsibility for removing people from safe care it must also admit responsibility for the outcome. So if there are no purpose-built or professionally staffed facilities other than mental health facilities those are the facilities that will have to accommodate care recipients. It is to be hoped that we will have an adequate number of facilities available for the purpose that this bill intends. 
I would now like to draw members’ attention to clause 65 which refers to when a care manager may grant leave. This is where it starts to get a little bit confusing in respect of the definitions for care recipient and special care recipient which are used quite a lot in the legislation. It would seem that the definitions are not too dissimilar. The care manager may grant leave for a 2-week period. They can go on holiday. I look at the case of Barry Ryder and I am thinking: are we going to send Barry Ryder on holiday? It would certainly have to be a supervised holiday because it would be absolutely atrocious to give people like Barry Ryder a 2-week holiday. I can see clause 65 being the area that could cause us some problems. There could be a failure in the system that could cause us problems and more of the sorts of things that happened with people like Barry Ryder. As we are aware and as I have mentioned previously on a number of occasions the judge said that Barry Ryder was likely to reoffend and clearly whenever he went out into the community without supervision for any period of time he went out to reoffend. He could not help himself. He was not a person who could be rehabilitated to any degree in order to provide the necessary level of safety and comfort for the community. So clause 65 “Care manager may grant leave” is a concern. It is to be hoped that before that leave is granted a substantial amount of consultation will take place with all parties including the welfare guardian. I am sure that there will be some concern about that. 
The Minister may also authorise leave for special care recipients. Again while I am sure all due care would be taken I see that as an area where there may be a substantial shortfall and where the real close care and security of not only the care recipient but also the public at large could be put severely at risk. We have seen that in the case of Barry Ryder. He was supposed to have been monitored and supervised but he was not monitored and supervised to the degree necessary and he offended to quite a horrific degree. So I think it is absolutely vital that in making any of those determinations about leave—where the care manager is going to grant leave for whatever purpose—cognisance is given to the absolute safety of all the persons involved be they the care recipient the service providers the caregivers or the public at large. That is absolutely vital. 
I would like to go back to the placement of care recipients. It is to be hoped that there will be sufficient accommodation for care recipients. We are closing down a lot of institutions—such places as the Kimberley Centre. We can see that Kimberley has deteriorated to quite a degree but I understand— 
Ron Mark 
: Deliberately. 
SANDRA GOUDIE 
: Yes deliberately. 
Ron Mark 
: Deferred maintenance. 
SANDRA GOUDIE 
: Absolutely! But when we look at Kimberley its grounds and its environment we see that it really is a community within itself. That I think is a vision and it could be a really good vision for a secure environment. 
Hon KEN SHIRLEY (Deputy Leader—ACT) 
: 
 I have a very specific concern with this part which I have just picked up. I was not on the Health Committee and I have not been in the debate until very recently. I refer members to clause 57(2) because I have some real concern with that provision. I think we have a problem that has been overlooked and I ask the Minister in the chair to consider it. Subclause (2) states: “If there are reasonable grounds for believing that the receipt by or the dispatch on behalf of a care recipient of any written communication or other item could be detrimental to the interests and care of the care recipient or of other persons the care manager may direct that the communication or item be checked; but a direction to check communications or items sent to the care recipient requires the approval of the co-ordinator.” 
 That is fair enough. I think that is a very appropriate measure. What really concerns me is subclause (3) because it states: “Subsection (2) does not apply to a written communication or other item sent by or on behalf of or addressed to any lawyer of the care recipient.” My point is that we understand what is intended here. It is very important that the patient or care recipient has the right to communicate with a lawyer but it could well be suspected that the care recipient wanted to cause the lawyer harm and under the way this is worded we could not check on the item. We could not do that search. I am sorry if this is— 
John Carter 
: The lawyer of the care recipient. 
Hon KEN SHIRLEY 
: No it says that— 
John Carter 
: Any lawyer of the care recipient. 
Hon KEN SHIRLEY 
: Yes that is right. It could well be that the care recipient had malicious intent to the lawyer. That is not an uncommon situation. It could well be that the institution suspected it yet under this bill the item could not be checked prior to dispatch. Perhaps the Minister could explain what is intended. Perhaps I am reading it wrong but at first glance to me there seems to be a loophole that is quite serious and needs reconsideration. That is the concern I have and the main reason I took this call was to make sure that we are not passing with all best intentions something that would be very unhelpful and inappropriate. 
The question was put that the amendments set out on Supplementary Order Paper 160 in the name of Hon Ruth Dyson to Part 5 be agreed to. 
Amendments agreed to. 
Part 5 as amended agreed to. 
JOHN CARTER (Senior Whip—National) 
: 
 I wonder now that we have dealt with the substantive part of the bill and the rest is more the machinery part whether the Committee might consider giving leave for us to consider the balance of the parts as one. I seek leave for that to happen and if members object then of course they can do so. 
The CHAIRPERSON (H V Ross Robertson) 
: Is there any objection to that course of action being taken regarding Parts 6 to 11? There is no objection. 
Parts 6 to 11 
Dr PAUL HUTCHISON (National—Port Waikato) 
: 
 In speaking to Parts 6 to 11 although the substantial part of the bill may have been dealt with these other parts of the bill are pretty important. They deal with reviews of conditions and the status of care recipients. Part 7 “Inspections and inquiries” is a hugely important part in terms of quality control and also deals with complaints about breaches of rights and inquiries by district inspectors. Then we go on to Part 8 “Authority to take and detain care recipients”. Subpart 2 “Inquiry by High Court Judge”— 
Hon Ruth Dyson 
: It is Subpart 2 in Part 7. 
Dr PAUL HUTCHISON 
: Absolutely that is quite right. I do not want to be too tedious in the way I go through this but I point out that Part 7 is in two parts—Subpart 1 “Inspections investigations and inquiries by district inspectors” and Subpart 2 as the Minister quite rightly pointed out deals with inquiries by a High Court judge. 
Part 8 is “Authority to take and detain care recipients” “Authority to detain under court orders” and “Authority to take care recipients who escape or disobey court orders”—I would like to make some comments about that in a moment. Part 9 has mainly procedural provisions such as which court to go to and it is about the jurisdiction of the Family Court which is all-important in many respects. Part 10 refers to “Relationships with other Acts” because this bill—along with the Criminal Justice Amendment Bill (No 7)—is integrally related to a variety of other Acts including orders under the Protection of Personal and Property Rights Act orders under the Children Young Persons and Their Families Act and certain orders under the Criminal Justice Act which prevail over orders under this Act. There are a lot of interrelated connections all inextricably linked up. 
Part 11 refers to “Administration”. One would hope that administration under this Labour Government would be efficient and have timelines with it but sadly as we have seen right throughout in the very way that this bill was brought to Parliament—it has “Legislative History 5 October 1999” on the back and here we are on 21 October 2003—the Labour Government has allowed this highly important very necessary legislation to wallow then suddenly under urgency it has finally brought it before the House. So there is some number of very important parts that we are taking as one. 
I want to comment on the “Authority to take and detain care recipients” in Part 8 and on what was required because there are some very important implications in clause 109 “Authority to admit and detain under orders”. It states: “A care manager has authority—(a) to admit a care recipient to a facility in accordance with the care recipient’s court order or a notice of designation given by the co-ordinator under section 63(2); and (b) to take all reasonable steps to detain that care recipient in the facility during the period the designation is in force.” 
Clearly care managers have to take all the reasonable and possible steps they can. From time to time there is the difficulty of the facilities not being able to contain people. Clause 110 deals with the “Meaning of a care recipient who has escaped”. That is a practical matter because from time to time they do escape no matter how hard the vigilance. That leads to some very difficult reciprocal actions. 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 It is good to put these last parts together because they really do cover the administration of the Act and the details of what happens when someone has been placed under a compulsory care order. Interesting terms were developed for the bill such as that of the “specialist assessor” and the “co-ordinator”. The coordinator has to send copies of certificates to certain persons and needs to notify everybody about what happens to a care recipient when a compulsory care order changes or expires when somebody goes on holiday or when there is a variation to the order. There will need to be variations to compulsory care orders because people who may have become out of control in their behaviour—due to environmental issues or to other things happening in their lives—may settle down with appropriate care and changes will then be sought to compulsory care orders. The coordinator and the court will have regard to a specialist assessor’s certificate so a specialist assessor will come and reassess somebody. 
Of course the person’s intellectual disability is not going to change. The situation is not like that of mental health where somebody becomes unwell and with appropriate care treatment and medication can become well again. In the situation of intellectual disability we are talking about challenging and complex behaviours. The issue is whether we can change behaviour and therefore improve a situation. 
I remember another patient whom I dealt with when I went to see his mum and dad. There seem to be quite a few cases where mothers and fathers have become elderly but have children they have looked after all their lives—children who because of their disabilities remain children intellectually and continue to be in need of care. I will never forget going into that house. The mother had developed Alzheimer’s dementia and the quite elderly father was having a great deal of difficulty coping. They had a son—who I think was about 52 at the time I met them because his parents were in their 80s—who had never been known to any support services at all. I walked into that situation thinking: “Oh my goodness!”. That man could just dress himself and tie his shoelaces but that was about it. The parents had never had any help and he used to follow his father around two steps behind. That is how the father coped. Everywhere that dad went he went. 
That was fine in that situation but then one of his parents went into care and the other parent died. That situation was very similar to the other I mentioned but different in respect of which parent died first. When that man was put into a care facility in the community people were incredibly intimidated because he would be two steps behind them. Of course the women in the home became very upset because he followed them around so closely and some of the carers became very upset. His behaviour had been conditioned by his parents as it was their way of coping but it was very difficult to manage him in an ordinary care facility. There was a need for specialised education support and caring in this case to make those around that man understand that he was not being intimidating or trying to upset them but just showing a conditioned behaviour. That is an example of some of the things we see. 
As a geriatrician I was asked to assess people in Ngawhatu Psychiatric Hospital. Those people who had intellectual disabilities had reached their 60s and 70s and the hospital wanted to place them in rest home care. But some of the behaviours that had been conditioned by their many years of institutional care in psychiatric institutions proved totally inappropriate for a rest home situation. I remember one gentleman who whenever he got really upset about anything just picked up a chair and biffed it across the room. That was his way of getting attention in that environment but it was certainly not very appropriate in any other environment—especially a rest home environment. 
People with intellectual disabilities need specific care facilities in order for their behaviour to be managed. If that gentleman had picked up the chair and hit someone with it he would have ended up before the courts and come under the provisions of this bill. In those situations the status of special-care recipients must be clearly identified. 
The question was put that the amendments set out on Supplementary Order Paper 160 in the name of the Hon Ruth Dyson to Parts 6 to 11 be agreed to. 
Amendments agreed to and Parts 6 to 11 as amended agreed to. 
Bill reported with amendment. 
Third Reading 
Hon RUTH DYSON (Minister for Disability Issues) 
: 
 I move  
That the Intellectual Disability (Compulsory Care and Rehabilitation) Bill be now read a third time 
. I thank members and past members for their contributions as the bill has passed through its various stages since first being introduced to the House in October 1999. In particular I thank the members of the Health Committee under the chairpersonship of Judy Keall for their considered examination of all the issues in the bill and for preparing the bill to be reported back to the House. I also acknowledge the Minister of the time the Rt Hon Wyatt Creech for introducing the bill. 
Until 1992 Part 7 of the Criminal Justice Act gave the courts the ability to consider offenders who have an intellectual disability under the Mental Health Act. Since 1992 the courts have not been able to do that because of the legislative gap between the mental health legislation and the Criminal Justice Act. Having been properly excluded from the definition of “mental disorder” people with intellectual disabilities were also excluded from the coverage of Part 7 of the Criminal Justice Act. That meant they are currently liable to be treated inappropriately by the courts when they appear on criminal charges. These inappropriate placements include being sent to prison being detained as special patients in mental health facilities or receiving a non-custodial sentence. 
The Criminal Procedure (Mentally Impaired Persons) Bill is linked to this bill as it provides the legal mechanism by which people with an intellectual disability who have been charged with or convicted of offences are diverted to the compulsory care system. With the passage of both bills the legislative gap that has existed since 1992 will be closed and the courts will be able to make appropriate dispositions that provide for the care and rehabilitation of people with intellectual disabilities who offend. 
For the purposes of the bill the definition of “intellectual disability” is primarily based on one developed by the American Association for Mental Retardation. The association’s definition has recently been updated and the Supplementary Order Paper agreed to by the Committee of the whole House brings the bill’s definition into line with that latest version. I would like particularly to commend the work of the Health Committee which gave appropriate and very helpful consideration to improving that definition. 
The bill sets out the process for assessing people assumed to have an intellectual disability with special assessors provisions for second opinions and the input of members of the person’s family and community. There are three ways in which a person can become subject to the bill: through the criminal courts through a prison manager or through the director of the area mental health service. The Family Court can impose compulsory care under the bill only after completion of a needs assessment and a care and rehabilitation plan. The bill further provides for regular reviews and reports on the appropriateness of continued care and people may be released from compulsory care in a number of ways depending on how they first entered the system. The bill provides for two levels of care either supervised or secure based on the person’s assessed risk. It contains a number of mechanisms to ensure that the rights of intellectually disabled people are protected and further contains a number of statutory powers of compulsion to require the person to comply with his or her care order. These include the requirement that the person accept properly given care and comply with every lawful direction given by his or her compulsory care coordinator or case manager. 
There are provisions for specified people to use reasonable force for restraint detention or transportation. There are also powers for seclusion and medication. Those powers are balanced by specific safeguards against their abuse. They include court reviews of the terms and conditions of compulsory care 6-monthly clinical reviews independent monitoring and the opportunity for intervention by a High Court judge. In addition to those Part 5 guarantees people several specific rights including but not limited to information relating to their assessment and care order; respect for the care recipient’s cultural identity; independent health and disability advice as well as independent legal advice; and company to receive visitors and to receive and send mail. 
The main changes recommended by the Health Committee pertain to the definition of “intellectual disability” the removal of non-offenders from the original legislation and the inclusion of “Rehabilitation” in the title of the Act. Again I would like to commend the work of the select committee and I support those changes. 
Considerable progress has been made in setting up the infrastructure for the compulsory care regime. Each of the four regions within the Ministry of Health has established a regional intellectual disability care agency and has appointed staff who will now be able to carry out the care coordinator’s role as established under the legislation. Hospital level secure services are still at an early stage of development. The bill will provide the courts with appropriate options for the referral of offenders with an intellectual disability into a care and rehabilitation regime and in doing so will close a legislative gap. 
In addition to thanking the select committee I also want to place on the record my thanks to officials and to parliamentary counsel for their considerable assistance with the passage of the bill. It has been a particular pleasure to have the consideration and support of nearly the entire Parliament on this important issue and I commend its further speedy progress. 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 It is with pleasure that I rise to support the bill. The Hon Ruth Dyson made the point that one of the major changes to the bill was that the Health Committee took away the non-offender group. There were two groups: those that offended and could come under this bill and receive compulsory treatment and care and the non-offender group. 
I just want to quote from the commentary on the bill which includes a quotation from the submission of Kathleen Taylor who wrote: “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’...”. That is why that section was taken out. We cannot incarcerate someone for compulsory care simply because they appear to pose a risk. 
When we look at individual cases before us such as those of David Stephens and Mr Ryder we can see that the behaviour of those people has been at the level of offending. But those offences have been understood because the person concerned does not have the intellectual capacity to understand the consequences of his or her actions. What will have to happen under this bill is that when a person does assault another person or behaves in a very antisocial way that breaks the law that person will have to come before the courts be found unfit to plead and come under the jurisdiction of the Intellectual Disability (Compulsory Care and Rehabilitation) Bill. If that happens a person can either be placed in a secure facility or be subject to 24-hour community wrap-around services. 
I have to thank the Rt Hon Wyatt Creech who was the principal driver in developing this bill when the National Government was in power and my select committee colleagues especially Paul Hutchison and Roger Sowry who worked well on this legislation to get it to the state where we have all agreed to support it in this House. 
The Hon Ruth Dyson mentioned that hospital level care facilities have been very slow in development and I would urge this Government to get on with it because the people who will now come under this bill need somewhere to go. Some of these people are still in mental institutions or forensic care. They may be at the Kimberly Centre or Braemar Hospital. They need to be placed in special facilities because they cannot be placed in community care—their behaviour has been such that they pose too much of a risk to themselves or to society. It is important that hospital level care facilities are developed. I know that one is being developed at Porirua and another at the forensic unit in Auckland. But that development has been too slow and I urge that it be speeded up. 
The definition of “intellectual disability” was another area the select committee worked very diligently on. It was essential that we manage to have a definition with a broad enough scope to allow for the capture of people who have a low IQ around 70 and who may have some skills in some areas but very poor skills in others which leads to their offending. If they do have very poor social skills or have been trained in inappropriate behaviour then they need to be captured by this bill so that they can go into a care programme to improve their behaviour and to protect themselves and the public. The meaning of “intellectual disability” was expanded to allow this to happen and I think we came to a good conclusion in the end—one that we hope will work in practice. 
The whole purpose of the bill is to ensure that those people who since 1992 have not been covered by the Mental Health Act do have an Act of Parliament that will protect them and the community. It is with pleasure that I support the passage of this bill. 
PITA PARAONE (NZ First) 
: 
Tena koe. I rise on behalf of New Zealand First to support this bill. But in so doing I want to express some concerns I have particularly with regard to the costs that are likely to be diverted away from the area of service delivery and the likelihood that they will be used in managing the service. It is important that I mention that concern particularly if we take some note of how the health service in this country has developed over recent years. Although I acknowledge that we need good management I feel that much of the budget that has been allocated for the delivery of services has been consumed by management. 
I also want to mention that the apparent emphasis on one ethnic group under clause 23 does not augur well for other ethnic groups particularly those with similar social structures. In that regard I refer to our Pacific Island brothers and sisters and say that the bill as it stands is silent in that respect. The bill gives some solace to the wider community in that it goes some way towards protecting it from those people for whom this bill aims to provide improved services. In that respect the Government ought to be congratulated on promoting this bill. Clearer direction is provided to the courts and to the health professionals who will have to administer this new legislation. I note that there seemed to be no difficulty in the latter stages of the debate in debating most of the parts of the bill as one. The fact that a decision was made to deal with the earlier part of the bill in single parts thus avoiding further opportunity to call this Government to account in the time that would normally be set for oral questions was some cause of disappointment to me and my colleagues in New Zealand First. In conclusion I reiterate my support and that of my colleagues in New Zealand First for this bill. 
HEATHER ROY (ACT) 
: 
 ACT New Zealand will be supporting this bill. It is necessary to address a legislative gap that has existed for the intellectually disabled in need of compulsory care since the Mental Health (Compulsory Assessment and Treatment) Act of 1992 was instituted. This gap has seen the inappropriate placement of some of those with an intellectual disability in mental health services discharged into the community when this is clearly inappropriate for both the person involved and the community but worst of all of course is their placement in prisons. Prison is no place for those who need compulsory care but have not committed a crime or have valid considerations when these are taken into consideration. 
This bill allows for the requirement of the intellectually disabled to accept care programmes when compulsory care is necessary. We heard quite a lot in the Committee stage about Barry Ryder. He is a very good example of exactly why this bill is necessary. Barry Ryder was sent to prison and was let out as the law stipulated he should be—only to reoffend again. That happened despite the fact that Neil Pugmire breached his position with regard to privacy issues by warning that Barry Ryder would reoffend again and that that course of action was completely inappropriate. Had this legislation been in place when Barry Ryder was first sentenced the consequences the lives that have been ruined as a result of his further reoffending may well not have come to fruition. So ACT New Zealand will be supporting this bill but I would like to state for the record the concerns we have about it and they are several. 
Our first concern relates to the insertion of the word “rehabilitation” into the title. We are not opposed to rehabilitation and certainly the intellectually disabled should have the same right and access to treatment that all other citizens in the country enjoy. However “rehabilitation” needs to be defined for the purposes of the bill and despite my repeated requests to the Minister for a definition this matter has not been addressed. I would have liked to see the Health Committee at least attempt to define “rehabilitation”. I suspect in this case that it really meant behaviour modification and it would have been good to have had that pointed out. The problem with talking about rehabilitation both within the bill and inserting the word “rehabilitation” into the title is that it raises the expectations particularly of the families or the caregivers or guardians of the intellectually disabled and sometimes of the patients themselves. It also places an added burden on the workforce—the health professionals who are responsible for these patients—and I think it is an unrealistic one. Rehabilitation in its broader sense means we are able to cure people but of course there is no cure for intellectual disability and that is something that should be remembered. It is very important that terms like these are defined when we are talking about very specific things in legislation. 
The second concern is the change in the Supplementary Order Paper of the definition “intellectual disability”. I was not on the Health Committee but we are told there was extensive debate about the definition. The select committee spent a lot of time and effort and listened to many opinions about what the definition of “intellectual disability” should be but despite that—and despite coming up with what I thought was a very flexible but realistic definition and one that certainly the medical profession seemed happy with—the Minister in her Supplementary Order Paper went back to the original very narrow definition. I think that will raise problems for clinicians. The third concern relates to the political correctness in this bill and in others. We are very disturbed that political correctness seems to be pervading legislation these days. The term “care recipient” was brought up by several members. They used to be called “patients” and there was nothing wrong with that term. 
Dr Paul Hutchison 
: Quite simple. Everybody understood. 
HEATHER ROY 
: Yes everybody knows what it is. When somebody was receiving care or treatment that person was a patient. That term was later changed to “client” but those people were still receiving treatment so they were still patients. The politically correct title “client” implied that someone was paying for services. Now we have moved on to “care recipient” which does not roll off the tongue. People have to stop and think: “Care recipient—what does that mean?” The word “recipient” is not even part of some people’s vocabulary. Anyway this political correctness is unnecessary and just confuses issues. The law should be simple and clear. In fact terms like “care recipient” do nothing to help in this regard. 
The fourth concern is the cultural references which I also spoke about in the Committee stage. I did attempt to have clause 23 omitted by way of an amendment but unfortunately it was not supported except by my colleagues in the National Party. My question was: why was reference made only to Maori? Perhaps this Government believes it is only Maori who suffer from intellectual disability. That is not the case of course. People from all cultures deserve the same access and same respect when being treated. So quite why Maori have to be constantly singled out is beyond me. 
Darren Hughes 
: Just listen to yourself! 
HEATHER ROY 
: I am listening to myself and if the member wants to take a call he should do so. Good clinical practice incorporates a sympathetic approach to cultural matters and it is a sad day when we put into our legislation clauses about cultural awareness. Such measures are unnecessary—they should happen as a matter of course. If we single out particular ethnic groups a mini-industry builds up around the legislation on those cultural considerations. We have seen this happen in many areas particularly in the health field but not isolated to it. When these things happen an industry builds up. There is a legal requirement on the part of the district health boards whatever areas we are talking about to institute these things and those staff members must be available even when there is not much work for them to do. 
The people working in this field are delighted that this legislation will be passed and that is why I am supporting it despite my very valid concerns. Many of those workers share those concerns with me particularly the cultural ones. It is not acceptable in this day and age to have the intellectually disabled housed in places like prisons and in some of our mental health facilities around the country. They do deserve treatment that is specific to them and caters for their needs. For that reason ACT New Zealand supports this bill. 
JUDY TURNER (United Future) 
: 
 It is great that this issue is finally being addressed when we consider that work on this started in 1995 when the Ministry of Health commissioned a discussion document. It is concerning however that an issue directly affecting the lives and future of some of the most vulnerable members of our adult population can languish for such a long time and perhaps that reflects our ability to ignore the issues of those with intellectual disabilities. 
The bill is positive in that it reflects society’s desire to protect and rehabilitate vulnerable members of society rather than punish them. It represents a further step in recognising that although society does not condone offending our response to offenders with intellectual disabilities needs to acknowledge the reality that in many cases prison is not an option. The bill is important because the public eye has tended to focus on the specific issues of people with mental illness and the needs and unique issues of those with intellectual disabilities have often gone unheralded. I congratulate the Minister Ruth Dyson on actioning this legislation. 
United Future is pleased that the definition of intellectual disability has been altered to align with international definitions. We are pleased that non-offenders have been removed from the scope of this bill as such a move would have created alarming possibilities for discrimination on the basis of disability. However United Future is concerned that adequate care is resourced for those with challenging behavioural issues so that the possibility of offending is minimised. We were also concerned that the Government should ring-fence funding for compulsory care especially in the initial stages of the development of sites for staffing and protocols. This has not been done. However the Government has assured us that the additional $50 million funding over 3 years is tagged and able to be differentiated from other service expenditure. It will also have the protection of having to be signed off. It is essential that compulsory care is adequately resourced. United Future’s central concern is that although this legislation provides an avenue for those who have an intellectual disability and are in need of compulsory care the needs of a much larger and vulnerable segment of the population still remain substantially unaddressed. It is expected that approximately 150 to 200 people will be covered by this proposed legislation. However there are an estimated 11500 to 15000 adults who need support due to disability. 
The National Health Committee’s recent report  
To Have an ‘Ordinary’ Life 
 released last month raised a number of very disturbing concerns relating to the importance we place on the needs of those with intellectual disabilities. The committee found that adults with intellectual disabilities are treated as second-rate citizens. Their lives are simply not consistent with the vision of the New Zealand disability strategy. Unlike ACT in this regard we support the new terminology of “care recipient” as opposed to “patient”. These people are tired of being thought of as sick rather than impaired. The current support services are overly custodial and restrictive and they can stifle the ability of those with intellectual disabilities to make their own choices. The report in its disturbing category of findings highlighted that there is systemic neglect of the developmental potential of this group of people and their families and whanau. There are also high levels of poverty a lack of basic health-care low educational opportunities as well as a lack of communication support a lack of culturally appropriate services and a lack of purposeful futures. With the move from deinstitutionalisation in favour of community care this group has been forgotten and the committee comments that although the bricks and mortar have been removed many adults remain disenfranchised. 
We commend the development initiatives for non-offenders but believe that we need to see improved outcomes in the areas of respite care vocational services and independent supported living services. It is our responsibility to ensure all measures are in place not only to support the human potential of this group of people but also to ensure that the number of people with intellectual disabilities who become subject to compulsory care is reduced in the future. United Future is pleased to support this bill. 
Dr PAUL HUTCHISON (National—Port Waikato) 
: 
 With a great deal of pleasure I do indeed say that I support the third reading of this bill particularly so because it has taken so long before it has finally got through the House. After all the genesis of this bill was in the 1980s and 1990s. At that time it took people like Law Commissioner Tim Brewer to urge that it was very important for this to come into being after some preventable tragedies had occurred in New Zealand. During that time more preventable tragedies have occurred. 
It seems quite extraordinary that even though the bill was introduced in October 1999 the Labour Government has chosen to look at other priorities such as introducing the Health and Disability Bill which has only perpetrated on New Zealand the most enormous conglomeration of unmitigated bureaucracy that our health system has ever known and instead it could have concentrated on bills such as this. 
However I must say that I enjoyed that early select committee and the cross-party collaboration and enthusiasm to see this bill progress. I must acknowledge my colleague Dr Lynda Scott for her very valuable work and of course Wyatt Creech the former Minister of Health. That Health Committee was indeed unique with the presence of the former chairperson Judy Keall. While I cannot say that I necessarily miss her unique articulations and iterations I can say that the House and the select committee are quite different without them. She was a woman of huge enthusiasm and I am always grateful to her for bringing my 97-year-old mother a bunch of flowers on her birthday when she was 91 or 92. However she did indeed have a lot of care that this bill should be well considered and that it should be brought through the House with due expediency and that has not happened. 
What makes me even more frustrated is the fact that here we see this Supplementary Order Paper that has redefined intellectual disability. I acknowledge that the Minister has explained the reason it has been redefined on a technical basis but there is a mistake. Clearly on one page we talk about a confidence limit of 95 percent but on the explanatory note we talk about a confidence level of not less than 75 percent. If the Hon Marian Hobbs had that sort of confidence level with her sweetcorn she would be getting into a hang of a lot more trouble than she is in already. I hope that this was merely a typo and that it will be corrected because it was fundamentally very very important. 
I am also concerned by the political correctness that has infiltrated itself into this bill. 
Hon Ruth Dyson 
: The member is better than this. 
Dr PAUL HUTCHISON 
: This is important because these terms unfortunately stick and they are unnecessary. The point is that the person in the street does not understand them. It is the same with this extraordinary need of the Labour Government to legislate for cultural correctness. We have this whole clause 23 “Cultural assessment” where not only is there the requirement to attempt to legislate culture ethnicity language or any religious or ethical beliefs but also the attention to Maori. 
We never really had the explanation as to why it is so necessary in this sort of bill. We are living in a truly multicultural society and while of course it is absolutely appropriate that families whanau and iwi are totally acknowledged and observed why does it have to be put specifically in legislation? I think that in 50 years’ time it will not be relevant. We have sort of gone through this little 20-year time warp where there has been this absolute subconscious knee-jerk reaction to have attention to something that will not endure on universal principles over a long period of time. 
I want to make just another couple of comments. One is to reiterate that one of the submitters who left me with a strong sense of concern about getting this bill correct—Kathleen Taylor—who had been through the situation of having an intellectually disabled child who had not offended was in absolute constant worry of that child offending but she could not find anyone to take responsibility when the going got tough. The plea that she made was instead of such a punitive bill she would like to see measures put in place to adequately support parents and caregivers to care for the disabled dependants in their own community. This would be a far less expensive option. With adequate levels of supervision dangerous incidents would be extremely rare. I think again of the forethought of Wyatt Creech and the National Government back in 1999 when they provided $50 million to ensure that some of those basic facilities would indeed be put in place. 
I note that the commentary states: “The following service development has occurred: Service specifications have been developed … The Clinical Training Agency has put out a Request for Proposal for the provision of a training course …”. Now that has not gone as well as it could but it was very important that it actually happened. “Negotiations are commencing with providers to build up capacity in preparation for services for offenders and Work is also proceeding on the planning for other community based services.” 
Now the sadness is that not all those things have come to reality. Phil Goff back in 1999 again said that the basis of this bill was providing realistic mental health services and facilities for those who were intellectually disabled and that has not happened. However I end by saying that I certainly do support this bill into the House. It is timely. It is overdue but it is certainly necessary. 
Bill read a third time.