Chadwick Steve: Public Health Bill — First Reading 
Chadwick Steve: Public Health Bill — First Reading 
[Volume:644;Page:13841] 
Hon STEVE CHADWICK (Associate Minister of Health) 
 on behalf of the  
Minister of Health 
: I move  
That the Public Health Bill be now read a first time. 
 At the appropriate time I intend to move that the bill be referred to the Health Committee for consideration and that the committee present its final report on or before 24 June 2008. The proposed Public Health Bill will update New Zealand’s currently fragmented and very outdated legislation for public health and become the primary health statute. It will replace the Health Act of 1956 and the Tuberculosis Act of 1948. In fact that Act will be almost 60 years old at the passing of this bill. This bill is designed to improve promote and protect public health—truly a primary health measure. It sets out specific responsibilities for the identification and management of risks to public health in particular those arising from communicable diseases—diseases that can be spread from person to person such as tuberculosis HIV and AIDS and non-communicable diseases such as diabetes and cancer and also protections to the environment. 
A particular new feature of the bill is that it provides for an all-risks approach—that is an approach that allows for comprehensive management of all significant and emergent threats to public health. The Public Health Bill is an extensive piece of legislation covering many facets of health. The bill will continue the traditional public health focus that we all know on communicable disease control and on environmental health issues such as water quality food safety and drinking-water monitoring. 
The bill will also expand on health emergency provisions in the Health Act which currently deal only with epidemics of communicable diseases to all actual or even potential public health emergencies irrespective of the cause. We have all realised the need for an all-of-Government response to potential pandemics and this bill takes account of changes in international travel patterns and threats such as SARS and pandemic influenza to enable the range of risks to public health to be managed at New Zealand’s own borders. New Zealand can be congratulated on its planning approach. The bill includes new provisions aimed at reducing risks of non-communicable diseases which include the power to issue guidelines and to make regulations. There are several reasons why this new public health legislation is required. 
Public health legislation has traditionally focused on controlling infectious disease and on ensuring a safe environment—for example by preventing overcrowding in houses or providing for sewerage systems. The bill continues that focus because it is important but modernises and updates approaches and terminology to reflect the 21st century. In particular the bill reflects that human rights and the notion of individual freedoms have advanced significantly since the Health Act was enacted some 60 years ago. The bill ensures that public health powers are exercised within a human rights framework. This means that individuals are informed about the applicable law time frames are given and the right to appeal is explicit. The bill balances the rights of the individual against those of the public interest to be protected from diseases or other threats to public health—a very important aspect. Where individual rights are limited in the public interest the bill ensures that safeguards are provided—also a very important aspect. 
The current Health Act tends to provide an all-or-nothing approach for managing risk. For example in relation to communicable disease the only power currently available is to detain a person with a communicable disease which is a very old-fashioned approach. In contrast the bill provides that public health risks are managed with responses that are commensurate in proportion to the risk. Throughout the bill tiered options or pick-and-mix menus are provided depending on the disease confronted and that is very important. Further action must be proportionate to the risk. The bill provides that the least restrictive option and alternative must be applied when managing health risk. 
Another reason we need this new public health legislation is that our current legislation focuses on issues that were only current 50 years ago. Fifty years ago our public health issues were communicable diseases such as tuberculosis and typhoid and environmental health. Issues such as a lack of sewerage and non-sanitary buildings are a picture of long ago. Although communicable disease and environmental health are still important issues we now face other threats to public health. For example when the Health Act was drafted ships were the predominant mode of international travel. Now most people fly between countries making the spread of conditions that are a very serious risk to public health so much easier. These changes in international patterns and new threats such as SARS and the pandemic influenza mean that we need to be able to manage all kinds of risks at our borders. The bill updates and clarifies provisions to protect our borders and expands the current emergency provisions that deal only with disease epidemics. 
Heart disease and cancer are now the two leading causes of death in New Zealand as well as being significant drivers of health expenditure. In order to reflect the significant impact that non-communicable conditions have on death and ill health in New Zealand the bill has new provisions for dealing with non-communicable disease risk factors. Health has never been about hospitals and surgical volumes alone. The bill provides for the Director-General of Health to issue non-binding codes of practice or guidelines about non-communicable disease risk factors. It also provides the option of making regulations to reduce or to assist in reducing risk factors associated with communicable diseases. 
As indicated the Public Health Bill covers a wide range of public health issues and is one of the foundation pieces of legislation that supports a modern health system. The Health Act has served us well for 50 years but it is time that it is replaced with modern legislation. The Public Health Bill will enable New Zealand to be more effectively protected from all risks to public health. I am very aware of the high level of interest from public health officers medical officers of health and practitioners in the introduction of this bill tonight. I commend the Public Health Bill to the House.