Bishop ChrisCHRIS BISHOP (National): Thank you very much Madam Speaker. I want to start by saying thank you to the Government particularly the office of the Hon Chris Hipkins and the office of the Hon Andrew Little for their constructive engagement over this tricky issue that the Parliament is now confronting. I think it's a good thing that we are just debating the first reading tonight of this bill and sending it to a committee for ventilation of both the scientific but also the legal issues to do with the Medicines Amendment Bill (No 2) the purpose of which is to essentially make it easier to provide a fourth dose of the Pfizer vaccine to many New Zealanders. There's a couple of issues I want to canvass in my contribution. The first is in relation to the scientific background and the COVID-19 Vaccine Technical Advisory Group or CV TAG as they've become known in the vernacular amongst the panoply of advisory groups that assist the Government in relation to COVID has recommended that people aged over 65 Māori and Pacific peoples aged over 50 years people in aged residential care and the severely immunocompromised should receive a fourth dose of the Pfizer vaccine the Comirnaty Pfizer vaccine before winter 2022 and many other countries have already moved to do that. We support the provision of the fourth dose to the groups that the Minister has outlined and that the regulatory impact statement for this bill provides for and we support the provision of the money in Budget 2022—it's quite a considerable sum of money—to provide that. The issue then becomes how to go about doing that. Up until now it's all been pretty easy because Pfizer has made an application under the Medicines Act to the New Zealand Government consent has been given and we go forward from there. The conundrum that has arisen now is that Pfizer has not made any application for a fourth dose and—I just might note in passing—that is pretty frustrating to be honest. I understand Pfizer's point of view is that they won't make any application in any country. And of course other countries are going through the process of providing a fourth dose notwithstanding the fact that Pfizer hasn't necessarily applied in those countries because of course all those countries have their own legislative schema and their own legislative requirements which differ from country to country. In New Zealand the law is Pfizer has to apply for approval and they have chosen not to do so. But the New Zealand Government advised by their experts—the CV TAG the technical advisory group—has recommended that a whole group of people about 834000 give or take possibly depending on if you use the Stats New Zealand database or the Health Survey User database access the fourth dose via a GP on an individualised basis. And so the question for the Parliament is—because I think there's broad consensus that the fourth dose should be made available—how to give effect to that. Now one of the issues that we've been canvassing in the discussions between the parties in advance of this legislation coming before the Parliament is whether or not what's called an immediate modification order pursuant to the epidemic preparedness response Act should be essentially used to give effect to the fourth dose being widely available. And it's been pointed out by people that the Immediate Modification Order (IMO) process as it's known has for example changed the time frames for the third dose from six down to four and then three months. The question is really: should that be able to be used for the provision of the fourth dose? For my part I think that is an open legal question. There is I think a strong argument that the IMO process could be used in order to give effect to the fourth dose and therefore we are potentially legislating for no good reason and that is one of the issues that I think should be explored at the select committee which is: is the bill absolutely necessary? Because it's a pretty unusual thing that we're doing. We are essentially amending the Medicines Act not under urgency—well this bill has been taken under urgency but we will not pass it under urgency. But it's a pretty unusual thing to have a very truncated select committee process to amend a pretty significant piece of legislation in New Zealand—and a very short piece of legislation: five clauses only. And so a pretty unusual situation but we do find ourselves in pretty unusual times. So we will support this bill going to committee but there's two things we're going to want to investigate at the committee. The first is the scientific rationale for the fourth dose. And I think that's pretty widely understood. But I think it would be worth ventilating the scientific rationale for the fourth dose at the committee. I think that is meritorious and I expect the Health Committee—where I expect the bill will go—will want to get into the scientific reasoning behind it and potentially get the technical advisory group in. And I see some colleagues who were formerly on the Health Committee with me—Sarah Pallett is giving me the thumbs up over there. She's a very hard-working member of the committee. We're very pleased in the Parliament actually that the Health Committee has real health sector expertise on it: Dr Shane Reti obviously from our side but also Sarah Pallett and Tracey McLellan and Liz Craig—I think Liz Craig's moved on from the chair. She's nodding her head. That's a shame because she has considerable medical expertise. But anyway the Health Committee will get to the details of the science. But then my personal view—and colleagues on this side of the House may wish to explore it further; I know Michael Woodhouse may wish to do so—is that for me the real issue is the necessity of legislation to give effect to the fourth dose. Is it correct that we have to legislate in essentially a 10- or 11-day process to allow this to happen? From my view—and bear in mind that the Crown's legal advice is privileged so we haven't had the benefit of the full legal advice—for my part I think the summary of the advice that I've seen is equivocal. I think there is an argument that an IMO process could give effect to this and we wouldn't have to be legislating through this quite unusual process. So I'll leave my remarks there but we are in a very odd situation and I do want to close by finishing where I started which is to say thank you to the Government for the good engagement on this slightly unusual piece of legislation. We appreciate the opportunity. We've had some input into—well some input; I wouldn't want to take the point too far but we've had some input. And I know Mr Woodhouse may wish to comment on some of the changes that have been made from the earlier drafts that we've seen but we've had some input into it. And there is I think a genuine desire across the Parliament I suspect to get the legislation right or to get the fourth dose provisions right and to make sure that we don't legislate in haste for something that's not actually needed. You know Parliament passes too much legislation anyway.At some point we will have to go back to the Medicines Act 1981 and have a rewrite. The Minister made brief reference to the therapeutic products Act that's coming in. I've heard that before. At some point we will have to—I see members smiling. That bill has been talked about as being passed for—Hon Michael Woodhouse: 10 years?CHRIS BISHOP: 10? I think it's even further. Hon Michael Woodhouse: Maybe longer.CHRIS BISHOP: It could be longer. I'm not making a political point here because it didn't make much progress under the last Government either but it certainly hasn't made much progress under the current Government. I think it goes all the way back to the Clark Government. But anyway I digress. At some point we're going to have to have a good look at the Medicines Act and I'm sure we will consider this in the context of it. But for the moment let's get the necessity right and let's get the science right and go forward from there. And I'm sure the committee will get into that. Thank you Madam Speaker.