Wall LouisaLOUISA WALL (Labour—Manurewa): Tēnā koe e Te Heamana. Wan shang hao. Hsieh hsieh. I appreciate the call Mr Chair and I specifically want to talk to Supplementary Order Paper (SOP) 381 in the debate on Part 4 Related matters" of this End of Life Choice Bill. I have to commend Chris Penk who has been incredibly productive. Essentially his proposition is that a consumer has the right to request and receive services from only a provider who does not provide services authorised by the End of Life Choice Bill. Obviously the End of Life Choice Bill doesn't authorise specific providers. It actually is the option of any person who has a terminal illness through their own intervention to talk in the first instance to their medical practitioner. That then instigates a series of other engagements to ensure that person can give informed consent. But in highlighting this specific SOP I do want to acknowledge that today 2605 New Zealanders came to our Parliament. They presented a petition and that petition requested that Parliament provides disabled people and others the choice to receive services from only the health professionals who don't engage in assisted dying. I want to focus on the amendment on SOP 259 to the Schedule of the Health and Disability Commissioner (Code of Health and Disability Services Consumers' Rights) Regulations 1996 which is in fact proposed clause 5A "End of Life Choice Act 2017" of that Schedule. If you read through all of that particular section of the bill it makes some exemptions and those exemptions are as already codified in the health and disability consumer code of rights. So we're actually about ensuring that there isn't any conflict between that particular code and this piece of legislation—and I'll give us an example. In the proposed legislation proposed clause 5A(2) and (3) focuses on right 4(2) of the code and also on clause 7 and clause 7(1) of the end of life choice legislation. Now you have to understand what the end of life choice legislation says in order to see the relevance to the code. So those particular sections are titled "Assisted dying must not be initiated by health practitioner"—that's a fundamental principle. This bill is not about medical practitioners telling their patients that this option exists; this is about patients who are empowered choosing end of life choice themselves. Clause 7(1) is actually really important because the health practitioner "must not" initiate the discussion and they may not make a suggestion. Now where this overlaps with the whole intention of the Code of Health and Disability Services Consumers' Rights is actually an assumption within the code that people have the competence to give informed consent. One of the issues that we should be aware of is that within the code of disability rights because it's assumed people can give informed consent there is actually through the provisions of some of these rights—and I'll just focus on one in particular. This right is that if the person isn't competent and they haven't got a power of attorney the provider actually may decide the service that is best in the interests of the consumer; so what this particular clause does is suspend the code of rights and makes the provisions in this bill paramount. So that's incredibly important because based on the code of consumer rights actually the requirement to go through a series of processes that ensure the person is competent to give informed consent could be compromised if that code of rights was held to be paramount over the provisions in this piece of legislation. The other thing I wanted to highlight is that actually already contained within the code of rights—it's right 1(3)—is "Every provider must take action to—(a) inform consumers of their rights; and (b) enable consumers to exercise their rights." So in fact already contained within the Health and Disability Commissioner (Code of Health and Disability Services Consumers' Rights) Regulations 1996 is a requirement that consumers are informed of their rights and it enables consumers to exercise their rights over what health services they choose. So when you not only think about the SOP but think about it in conjunction with the petition—which is in fact what happened today; Chris Penk met the petitioners—they wanted to make sure that they don't engage with health professionals that provide assisted dying. That's already in the code. You know consumers can ask health practitioners whether they support end of life choice and if that health practitioner says yes then it's well within that person's right to say "Well I'm choosing not to be one of your patients. As a consumer I have autonomy. I can make these decisions for myself." So this is superfluous—that's the point. We don't actually need this SOP. It doesn't add any value. It certainly doesn't add any value to the section in the legislation and—Simon O'Connor: No power imbalance? LOUISA WALL: No it doesn't—not at all. In fact this would contradict the whole intention of the exclusions to the health and disability consumer rights legislation which is why we're saying right up front—because the other assumption in this is that clinicians can talk to their patients about all their options. I mean that's a part of it. Right 6(1)(b) in the Code of Health and Disability Services Consumers' Rights is "an explanation of the options available including an assessment of the expected risks side effects benefits and costs of each option;". So in fact under the code of rights currently clinicians would have the opportunity and would be able to talk to their patients about end of life choice options. So that's why the exemptions are really clear in this piece of legislation that we will not allow that to happen. You know this bill is really clear that nothing will happen unless the patient initiates it themselves. If they do not initiate the conversation with their health professional nothing can happen. If there is coercion in any form it would negate the ability and the integrity of this piece of legislation. So I'm actually just highlighting for the committee that what Chris Penk is attempting to do is already covered but also I fear that it will actually contradict the intention of this bill which is actually to empower people with a terminal illness who want to make an end of life choice decision to initiate that conversation with their health practitioner before anything else happens. Kia ora."