Mark RonORGAN DONORS AND RELATED MATTERS BILLSecond ReadingHon RON MARK (Minister of Defence) on behalf of the Associate Minister of Health (Māori Health): I move That the Organ Donors and Related Matters Bill be now read a second time. This bill is in two parts. Part 1 of the bill amends the Compensation for Live Organ Donors Act 2016 in relation to earnings compensation to be paid to live organ donors while they recuperate from donor surgery. The bill provides for those who are not currently eligible for compensation under the Act but who clearly fall within its purposes.Part 2 of the bill amends the New Zealand Public Health and Disability Act 2000 to enable the New Zealand Blood Service to take on a national role within the organ donation and organ transplantation systems. The overarching purpose of the bill is to encourage and support live and deceased organ donations and organ transplantation. In New Zealand there are many more people waiting for an organ transplant than there are organs available. Organ transplantation saves lives for people in organ failure. Donation is a very special gift that makes a difference. It offers a valuable second chance and dramatically changes lives.I'd like to take this opportunity to acknowledge all the good work that has been done in the organ donation and transplantation sector. There have also been many individuals who have taken on a stewardship role over many years. Alongside this there is much work being done by many to help improve donation rates in particular by Organ Donation New Zealand. We want to build on this work and keep improving donation rates. We want to take a closer look at both live and deceased organ donation from a Māori perspective a Pasifika perspective and from other cultures. In future we want to make it easier for New Zealanders to make their deceased organ donation wishes known to family and whānau and to help those involved to make decisions with the best possible support and confidence—this bill is a step towards this.Contributions via submitters: I'd like to thank the Health Committee for its thorough consideration of the bill and I would like to thank everyone who made submissions. The committee received and considered 16 submissions and heard oral evidence from five submitters. Submitters engaged in a wide range of matters connected to organ donation and organ transplantation and have made valuable contributions to the development of the bill. Almost all submitters supported the bill's direction. Some raised concerns within Part 2 of the bill; others made practical suggestions to improve the bill and I acknowledge the committee for considering those contributions and for recommending several amendments that will add clarity and practicality to the bill's provisions.I'd now like to highlight some of the key changes that the committee has recommended in response to the submissions that it received. Overseas organ exchange programmes—that's a key change to Part 1 of the bill. Part 1 of the bill provides for earnings compensation to be paid to organ donors who donate under an overseas organ exchange programme. As introduced approvals of an overseas organ exchange programme would be made under regulations by Order in Council. Instead Schedule 5 has been inserted into the bill as a more streamlined mechanism to approve programmes and to identify any conditions to be eligible for compensation.The Australian and New Zealand Paired Kidney Exchange Program has recently been put in place and so the opportunity's been taken to approve it directly in the bill by including it in Schedule 5. A separate Order in Council to approve this programme will no longer be required. New Zealand donors under this exchange programme will now be able to seek compensation as soon as Part 1 of the bill commences. As such the commencement of Part 1 has been brought forward so that New Zealanders who participate in the Australian and New Zealand Paired Kidney Exchange Program can receive compensation as soon as possible. Because the Australian and New Zealand Paired Kidney Exchange Program has already commenced there may be those who have donated under this exchange programme prior to the commencement of this bill. Clause 8 has been amended to provide for those to be back-paid compensation on commencement of Part 1.Submitters raised the point that as introduced the bill may have inadvertently allowed overseas donors who donate as part of an approved overseas organ exchange programme to be eligible for earnings compensation under the bill. This does not align with the bill's intent. In response the committee has recommended an amendment to clause 5 to provide for any conditions for eligibility for compensation to be identified in Schedule 5. For example in the case of the Australian and New Zealand Paired Kidney Exchange Program donors must be registered with the New Zealand Kidney Exchange Programme. This Schedule 5 condition will ensure that it is only New Zealand participants who are eligible for compensation. Overseas organ exchange programmes and conditions may be added to or removed from Schedule 5 by Order in Council. As a safeguard a duty is being included under clause 7 of the bill for the Minister to consult those likely to be substantially affected before adding or removing any overseas exchange programmes or conditions to or from Schedule 5. This balances flexibility with accountability.Definition of usual hours": Part 1 of the bill also provides for earnings compensation to be paid to donors returning to work on reduced hours or hours less than the donor's usual hours during their recuperation period. The definition of "usual hours" under clause 4 has been amended to clarify how usual hours will be calculated; this will help to determine a fair and reasonable estimate of what the donor would otherwise have earned had they not donated an organ.Key changes to Part 2 of the bill. The changes in Part 2 of the bill relate to the New Zealand Blood Service taking on a national role within the organ donation and organ transplantation systems. Clause 11 has been amended to reflect submitters' views on the different roles that the New Zealand Blood Service would have in the organ donation system and in the organ transplantation system. Submitters noted that these systems are distinct although often conflated. Each has its own clinical governance structures. The new function of the New Zealand Blood and Organ Service is now to provide oversight and clinical governance of the organ donation system and is more appropriately limited to providing support to the organ transplantation system.In response to submitters' comments Part 2 now provides for a statutory name change of the New Zealand Blood Service to the New Zealand Blood and Organ Service. This reflects the additional statutory functions; this does not create a new statutory entity. The New Zealand Blood and Organ Service will be the same organisation as the New Zealand Blood Service with a new statutory function added. We expect a managed transition into this new role over time. I consider that these changes as recommended by the Health Committee improve and add clarity to the bill.I just want to note that on my driver's licence which I just renewed it is clearly identified that I am an organ donor—that's on top of being a blood donor. I recommend and commend this bill to the House."