Stewart BarbaraBARBARA STEWART (NZ First): I rise on behalf of New Zealand First to take a call on the Substance Addiction (Compulsory Assessment and Treatment) Bill. New Zealand First supports this bill. The purpose of the bill is to provide provisions for the compulsory assessment and treatment of individuals with severe substance addiction who are totally unable to make decisions about their own treatment. It is definitely needed in today's world. This bill is repealing the Alcoholism and Drug Addiction Act 1966 legislation that is now 50 years old and well past its use-by date. Much has changed in the field of addictions since 1966. The types of addiction and of course the way that we treat people with addictions have changed. As we have heard from submitters when they came to the Health Committee the current legislation presents some real challenges for health practitioners when they come to use it. We are under no illusions whatsoever as to the scale of the illicit drug problem in New Zealand. We know that we have got some of the highest drug-use rates in the developed world and The New Zealand Drug Harm Index 2016 released earlier this year found that The estimated social cost of drug-related harms and intervention costs in 2014/15 were $1.8 billion." That in itself is a truly staggering figure. So it is an area that demands attention and I am pleased that we are giving it just that this evening. We know that mental health and addiction problems affect more than just the individual. They affect the community they affect the family and yet we remain concerned that there is no mention in this bill of substance addiction causing serious harm to others only to the individual. We are also concerned that there could be a lack of family involvement in a patient's care under the current provisions of this bill. The bill does provide for provisions for a friend or a family member who is "most evidently and directly concerned with the oversight of the patient's care and welfare" to be informed. However we are concerned that a whānau group may wish to be involved in decisions about the treatment and the care of their loved one and we believe that a treatment plan should in the main be fully discussed with the family and the whānau and decisions made in consultation with them if at all possible. In my office in Hamilton I have heard from distressed family members who have been left out of such decision making and this causes a lot of stress and worry for them. They want the very best for their family member and for their loved one and all of us in this House would too. We do agree that the criteria for compulsory addiction treatment in clause 7 appear to be robust. They include having a severe substance addiction having impaired informed decision-making and compulsory treatment being required.There is also in clause 7 a requirement that "appropriate treatment for the person is available." It is the sector capacity that we are concerned about and it is an issue that I raised in my first reading speech back in March. It is vitally important that a patient's condition is continually monitored and reviewed so that if the responsible clinician believes that the criteria for compulsory treatment are no longer met or that no purpose would be served by compulsory treatment the patient can be released. An aftercare plan as recommended in the bill is absolutely essential if there is to be a successful outcome for the patient. It is absolutely critical that the patient receives vital wraparound support and that they receive help not only with their addiction but where other areas in their life are concerned—for example the cause of the addiction. We are told that most of those people with addictions will have other areas in their life that are creating challenges. It could be housing and it could be mental health because that is a growing area. So it is going to be absolutely critical for Government departments to work together to break down silos and try to get the person back on track. It is not an easy road to get back on track so the more wraparound services there are the better it is. What do we see currently? Too many Kiwis are actually slipping through the cracks of our social services and every day in our communities we are seeing the results of a lack of investment in this area. The ability to review decisions is vital to protecting the rights of those affected by this bill. We agree totally that a patient or family member should be allowed to apply to the court for an urgent review if they believe that the criteria for compulsory treatment are not being met or that the compulsory treatment order should never have been made. The Health Committee received 39 submissions and we heard from 15 submitters. We must take this time to thank all of those who took the time to submit. It is not an easy area to submit on and it added greatly to our knowledge of the people who work in this area and are involved in this field every day. Of course we have to thank the officials who ensured that we had a really good understanding of the whole issue. The majority of the submitters were in total agreement as we all are here in this House that the legislation needed to be updated—that it was past its use-by date. They were supportive of the general aims of the bill and were generally of the opinion that addiction is a health issue rather than a criminal one. A major concern raised was that of service capability and capacity. Concerns were raised about the lack of medical professionals with expertise in addiction and a general lack of staffing and funding and submitters emphasised the need for continued support and treatment once the compulsory period ends. We heard that there is very little evidence that compulsory treatment is effective for those with severe addictions so there are a few concerns there. New Zealand First believes that further targeted support for addiction services needs to be implemented by the Government. We need to put more resources into preventing people from getting into the dire situation that this bill is actually intended for. We need to direct resources to our GPs and assist them in supporting those facing addiction in our communities and in helping patients back on the road to recovery. I think we need to realise that there are barriers for people trying to seek help for their addictions and these need to be removed. Such barriers include the expensive doctors visits the perceived stigma and of course lengthy waiting lists. We have previously expressed our concerns that currently we have got no idea how many Kiwis are living with severe substance addiction because mental health and substance addiction services are lumped in together. We regard this as a failing that does need to be corrected. Many Kiwis are struggling to receive mental health and addiction support. We see it in our communities and we hear the repeated calls for an independent review of our mental health services. In fact I know that there is going to be a petition presented at Parliament tomorrow that is adding to the growing sense of unease about mental health services that there is out in the public. We are concerned that longer wait times will result in tragic outcomes particularly when our suicide rates are as appalling as they are. We are pleased to support this bill. We look forward to it going through the House. We have some concerns but we believe that this is a step in the right direction and we will await the outcome of the Committee stage of this bill. Thank you."