Bishop ChrisFINANCIAL ASSISTANCE FOR LIVE ORGAN DONORS BILLSecond ReadingCHRIS BISHOP (National): I move That the Financial Assistance for Live Organ Donors Bill be now read a second time. Two months ago I met Mr Robert O'Connor. Robert had driven over 2 hours on a Tuesday afternoon to tell me his story and lend his support for this bill. Robert was a type 1 diabetic diagnosed at 6 months and I say was" deliberately because in March this year Robert received a life-changing call at 2 o'clock in the morning. There had been an awful fatal motor vehicle accident. The victim fortunately was an organ donor and the donor was a match and that match was destined for Robert. What is remarkable about Robert is that the bill we are debating tonight will not even directly affect him at all; his kidney came from a deceased donor. His donor will never be compensated for the sacrifice that they made yet he shares a trait with a lot of other organ donation campaigners which is a passion for and a commitment to helping others and a commitment to saving lives that goes beyond self-interest.This is a trait shared by previous sponsors of this bill and I would like to acknowledge the Hon Michael Woodhouse and also one of our former colleagues Dr Cam Calder for keeping this important piece of legislation in the members' ballot. I am very grateful for this opportunity to take up this important cause and bring this bill to the House. Also I would like to acknowledge at this second reading debate the work of the Health Committee under the chair Simon O'Connor. The bill spent about a year at the Health Committee. It did an enormous amount of work on the bill and I would like to thank the committee members for their work and also the officials who have enabled us to bring this bill back into the House in a substantially improved way.Also I want to say thank you to my colleague Scott Simpson who swapped out of the Finance and Expenditure Committee with me on a week-by-week basis to allow me to spend a bit of time on the Health Committee and hear from the submitters. I acknowledge the many submitters and the health professionals advocates and organ donation experts whom I have met over the past year. They are very strong advocates for improving our organ donation rates and I hope that this bill along with the Government's review of the deceased organ donor regime will bring the increase in organ donation rates that we all want to see. As I just mentioned before this bill comes back to the Parliament in a greatly improved form and I just want to run through for the House the major changes recommended by the committee which I support and the Government supports.The essential purpose of the bill remains unchanged. It is to remove a financial deterrent to the donation of organs by live donors. At select committee we heard many stories of the financial hardship that live organ donors currently have to endure to help another member of society. I was moved by these stories as I know other members were too and I am pleased that we have unanimously agreed that a change to the status quo is required. In its original form the bill set compensation for lost earnings at 80 percent of forgone income which is the formula applied under ACC. We received many submissions arguing that compensation should instead be set at 100 percent of lost income. The committee has agreed with these submissions and recommended that the new bill adopt the principle of cost neutrality for live organ donors.What that means is that live organ donors should be neither financially disadvantaged nor financially advantaged from donating and the committee has recommended we adopt the position of cost neutrality which is the position in the United Kingdom. The analogy with ACC is inappropriate for a number of reasons. Organ donors are healthy before they donate and are only temporarily unable to work while they recuperate. There is also no real necessity to maintain that gap between levels of assistance and income from employment to incentivise return to work.The second change recommended by the Health Committee that I want to highlight for the House concerns which entity is responsible for administering this legislation. The committee heard a lot of evidence about the difficulties live organ donor claimants had when obtaining financial support through the Ministry of Social Development (MSD) through Work and Income. This is totally understandable and I make no criticism of Work and Income staff in this regard. There are very few claims for live organ donor assistance through MSD currently so it is totally understandable that front-line staff would be—actually in some cases we heard—even unaware that there is provision in the current law for live organ donor assistance. The committee has recommended that responsibility be transferred from the Ministry of Social Development through to the Director-General of Health and I think that is an appropriate change.Thirdly in terms of other changes the committee has recommended to allow for new entitlements to be backdated for eligible donors to the date that the bill receives the Royal assent. This is an important change that will mitigate the risk that people intending to donate would defer the procedure until they become eligible. So that is a very important change. It also enables the Director-General of Health to pay income compensation to a donor before surgery in limited circumstances.A fourth change is the provision to futureproof the bill to allow by Order in Council a regulation declaring a type of human organ to be a qualifying organ for compensation. Although kidney and liver transplants are the only type of live organ donor transplants carried out in New Zealand other types of potentially suitable live donor transplants are medically possible and are carried out in other countries including small bowel pancreas and lobar lung transplants. So the recommendation of the committee is that we futureproof the bill to allow by Order in Council by way of the Minister those other organs into the regime in the future if so desired.In the fifth change the committee has recommended amending the title of the bill to "Compensation for Live Organ Donors" to reflect the focus on providing donors with compensation for lost income rather than merely providing financial assistance and this follows in line with the recommendation of the committee that we adopt a cost-neutrality approach and a focus on compensation for forgone income rather than just mere assistance.I do want to mention the objections raised on the bill in its original form by the Attorney-General under section 7 of the New Zealand Bill of Rights Act. Upon the bill being introduced the Attorney-General adverted to the House the fact that the bill disadvantaged individuals who receive a benefit and also earn income from working. This was because the bill in its original form compensated organ donors for lost work income only if they were not receiving a benefit. The argument from the Attorney-General was that the bill was therefore inconsistent with section 19(1) of the New Zealand Bill of Rights Act which of course prevents discrimination against individuals.The proposed amendments to the bill I believe deal with this issue raised by the Attorney-General. It is actually I would say a classic example of the section 7 report working in exactly the way it is intended which is that the Attorney-General notifies Parliament that the legal advice is the bill is inconsistent with the New Zealand Bill of Rights Act. It goes to a committee and then the error is tidied up and we can now move forward in a rights-consistent way. The amendments to the bill will mean that donors will receive reimbursement for 100 percent of forgone employment income regardless of whether or not they are a beneficiary so there is no discrimination.Let me conclude by returning to where I started which is about the motivation for this bill. New Zealand has a low organ donation rate with a large waiting list as members will be aware. There are more than 700 people currently accepted for a kidney transplant and around 40 people for liver cardiac or lung transplants. The facts are that organ transplants save taxpayers' money. Evidence put before the Health Committee from the New Zealand Initiative and Dr Elizabeth Prasad suggested that every kidney transplant saves the Government—saves taxpayers—over $120000.We need to do all we can as a society to encourage live organ donors. Donors substantially improve the lives of those they donate to. They also save as I said taxpayers' money. It is simply inequitable to effectively punish these national heroes as we do now. It is a sign of a caring and compassionate society that we recognise sacrifice and support each other. This bill does both and I therefore commend it to the House."