SpeechHon MICHAEL WOODHOUSE (National): In the first reading debate on this bill my colleague and friend Louise Upston encouraged people with traumatic and negative experiences of their births to come forward and submit and we certainly had a large number. The Education and Workforce Committee had a large number of women who did just that and we heard submissions from over 790 people and 46 oral submissions. Some of them were harrowing as mums described occasionally lifelong sequela from traumatic birthing experiences and if anything that brought home to the committee and to officials the need for this I think. So I want to thank them. It brought a human story and face to the improvements that we're making to the ACC legislation. I want to also put on record my thanks to officials who were put through the mill quite a bit I think in terms of the questions that we asked—some were very technical—but I also want to acknowledge a parliamentary colleague: Sarah Pallett. It was very helpful to have a registered midwife on the committee. I have huge regard for our midwifery community. I have a sister who is a midwife of many years and I'm very proud to say that I have a daughter now who is a registered midwife at Middlemore Hospital and they have to deal with these things on a day-to-day basis. So the bill is better for this process as the Minister for ACC has acknowledged and I want to thank all the people who helped us along that journey. It was a tough one and we start with the premise that 85 percent of birthing mums are going to have a form of trauma that's likely now to be covered by this. I mention that in the context of—and anticipating the contribution by our Green colleague Jan Logie on—the Green Party view of the report. The Green Party aren't happy with the way in which we have got here with a specified list of birthing injuries and we looked at this very closely. I think we've actually struck the right list as a start point and Sarah Pallett was very helpful in that regard I must say. But I do acknowledge the reasons why Jan Logie and the Green Party have concerns about this and I have no doubt that there will be a close watch on whether or not trauma that's experienced by mums in the labour and birth process—if it doesn't end up being covered by ACC I think we'll all want to know why and there is a review built into the bill now as part of the select committee's recommendations. We've had reviews in the past that have been sort of lip-service clauses going into a bill but I think this is a really really important one and the ACC officials actually gave us a commitment that they would be looking at that very closely all the way through in any event. So there are six extra injuries that the committee is recommending be added to the bill. There were a couple of other things I think that we looked at and there were many submissions calling for this. One was mental injury and this has been a challenge for successive Governments—the degree to which mental injury should be covered. We've settled on a place that is mental injury as a consequence of physical injury and of course post-natal depression and other psychological stress that may not be related to a birthing injury is not going to be covered. I can understand why. My concern more broadly about mental injury is that—despite the backslapping that the Labour Government gives itself—our mental health services despite the extra funding is not in better shape. My worry is that like with many other conditions as was my experience as an employee at ACC and as Minister of ACC ACC becomes the default provider because the pathway to care is perceived to be shorter and better and I worry that if we do broaden out the range of the definitions of injuries and mental injuries that would be the case. I think that's also the case with the other birth sequela that Jan Logie will talk about. One area that I think we really do need to keep an eye on is injuries to the babies themselves. I remain uncomfortable at the possibility—and the difficulty actually—in understanding whether a baby born with a severe often neurological injury or condition is actually as a consequence of the birthing injury and the arbitrary distinction between when does a person get cover and when does a person exist. I think that when you're in labour you've got a human being that's about to come out and can be injured in the process. I think we need to look very closely at that and I understand ACC's reticence around that. Some are covered but those are lifelong conditions that can be extremely expensive and I'm not sure that we've actually captured all the injuries to babies that we could or should. The Minister mentioned equity and she did so also in her first reading speech. I accept the point she's making and this will close the gap between men and women in an equity sense. But as she said in her first reading speech there was billion-dollar difference I think in the costs of ACC claims—men more than women. I urge caution with that as a metric because if there is an inequity the goal is not to increase the costs to women. It's to reduce the costs incurred by men who get injured—young men particularly—who are much greater risk-takers and who have a propensity to slide their motorbikes in the gravel or to wrap their cars around lamp posts or break their legs on the rugby field or have trees fall on them in the forest. But actually the equity is not to increase the number of injury claims by women; it's to reduce the claims by men—Jan Logie is not so sure. But there's no doubt that men are less risk-averse actually and the injury prevention efforts by ACC are actually targeted at reducing those costs for our male rangatahi. Indeed injury prevention needs to be a part of birthing injury prevention as well. As I say I think we have a tremendously competent health professional group in charge of maternity care but there's no doubt that mistakes are made and they lead to injuries and now that there is cover here I think ACC can and should pay closer attention to professional standards competencies and clinical best practice to make sure that we can reduce the number and impact of birthing injuries on women in New Zealand. So it's not just reducing injuries for men that we need to do. I want to just touch in the end on the other minor changes that the Minister describes as the reversing of the terrible changes that the previous National Government made in 2010. Firstly let's have a bit of a context here. In the four years up until that change the unfunded liability on Labour's watch went from $4 billion to $13 billion and the cost of ACC claims went up by 57 percent or five or six times the rate of inflation. That's because Labour have a track record of softening and expanding the scheme and of taking their eyes off the rehabilitation ball and they haven't actually reversed that many of the changes that we made in 2010 in any event. Even with the hearing loss changes prior to 2010 there was no threshold for entitlements to hearing aids. We put in a 6 percent hearing loss because that's what Australian jurisdictions did and it's what the United Kingdom did and it actually recognised that between zero and 6 percent there was little case to be had according to the science for a hearing aid to be provided. That was still the advice that officials gave us at 6 percent. So there's a bit of virtue signalling going on here. I think there were two reversals—if you'd even call this a reversal—but that's a minor irritant in a bill that is going to improve services for birthing mums. I look forward to having a more detailed conversation in the committee of the whole House about it but in the meantime we're very happy to support it at second reading.