Wall LouisaLOUISA WALL (Labour—Manurewa): Tēnā koe e Te Māngai o Te Whare. Tēnā koutou katoa. It is my pleasure also as a member of the Health Committee to support the Health (National Cervical Screening Programme) Amendment Bill but I do want to take the opportunity just to take us through the pathway to the formation of the National Cervical Screening Programme because as we've noted it was as a direct consequence of the Cartwright inquiry in 1988 where there was general recognition that patients' rights had actually been completely ignored and there were unethical research practices related to the treatment of women who had cervical cancer. It also led to the creation of the Health and Disability Commissioner so it was considered a watershed moment in our history.As part of the formation of that National Cervical Screening Programme one of the objectives set out in Part 4A section 112D(b) of the Health Act is to inform women and the community of the risks benefits and expected … health gains from participation in the [National Cervical Screening Programme];". I draw that to our attention because from the departmental disclosure statement it's clear that this bill will enable "National Cervical Screening Programme Register staff health professionals who provide services to women along the cervical screening pathway (such as smear takers and laboratory and colposcopy staff and associated administration staff) and screening support services staff"—and this is the bit that I think we all should just reflect on—"to directly access information from the Register for the purposes of conducting their work."Now I guess the question is how do you access data currently? What is the process? I heard my colleague Dr Jonathan Coleman talk about the bureaucratic issues with regard to the current bill but I think we should be balancing bureaucracy with safeguards. I do want to highlight a contribution from the Associate Minister of Health Julie Anne Genter when she introduced this bill. She said "The only existing regulations made under Part 4A of the Act the Health (Cervical Screening (Kaitiaki)) Regulations 1995 are retained as a result of this bill and their provisions will continue to apply." From my perspective that actually is the only issue that I have because the National Kaitiaki Group was established to approve of consent to use Māori women's data and the National Kaitiaki Group in approving the use of Māori women's data did so based on the following principles and that was the principle of the sanctity of te whare tangata [the womb] the need for culturally appropriate protection for the taonga of protected information and the need to ensure that protected information is used for the benefit of Māori women.I think it's really important that we reflect on I guess the authority that this kaitiaki group has because under regulation 6(2) of the Health (Cervical Screening (Kaitiaki)) Regulations it says "The function of the Group shall be to consider applications under these regulations for approval to disclose or use or publish protected information and to grant approval for such disclosure or use or publication in appropriate cases." The reason that I bring this up is because the substantive changes in this piece of legislation do relate to section 112J and in section 112J as described in the bill there now seems to be a lot of power given to the National Cervical Screening Programme manager; under this piece of legislation in fact they will be able to authorise the use of data.Now it's granted that a lot of the authorisation can be seen to be in relation to individuals—so these are specific people who have been provided with cervical screening services—so that seems to be an appropriate designation. In new section 112J(3) and (4) it also will enable the authorisation "for the purpose[s] of research"—so I want to pick up the comment of colleague Jenny Marcroft—and also "for the purpose of enabling the compilation and publication of statistics that do not enable the identification of the women to whom [these] statistics relate".So the reason that I bring this up now—and obviously our select committee will consider it—is that in fact in 2002 there was a review of the kaitiaki guidelines and that review was inspired by the 2000 Government inquiry into the Gisborne cervical smear issue. That occurred because there were lab results in the Tai Rāwhiti-Gisborne area that failed to identify hundreds of women who had abnormal smears and so as a direct consequence of that Government inquiry the review of the kaitiaki regulations was facilitated. What I want to highlight in that review report is this—so the review of the Health (Cervical Screening (Kaitiaki)) Regulations 1995 report was published in March 2002. I quote from that report. It says "Balancing the protection of aggregate Māori women's cervical screening data with the need to [use] data so that the National Cervical Screening Programme can be monitored and evaluated to ensure it is safe and effective for Māori women."At the heart of treating the data as a taonga was also I believe an implicit responsibility for Māori women themselves to protect that data. And I've talked to a few people who were involved in that Gisborne inquiry and those that were involved in the review of the kaitiaki guidelines and it would interest the House to know that Māori women were sceptical about participating in the cervical screening programme because actually being detected meant for some that they were labelled as being promiscuous. We have to talk about that because the reason the kaitiaki group was formed in the first place was to say to Māori women "Do not be whakamā about participating in this programme. It isn't about your behaviour; it's actually about detecting a cancerous growth that actually we can treat." So to overcome that whakamā the kaitiaki group was instituted so that Māori women would actually have faith and confidence in the cervical screening programme.So I just hope that the Minister is clear and I do want to acknowledge the Minister Julie Anne Genter because I have spoken to her about this issue and she is very clear that the intention of this piece of legislation is in no way to undermine the role of the kaitiaki group. And I think that if the House is really clear that that is the intention and purpose of this bill then we will as a House be able to progress this piece of legislation through the House and it be guaranteed to us that all the changes that we are making actually are for the benefit not only of the women individually but of Māori women collectively because of the formation of that group in 1995. Kia ora."