12. Question No. 12—ACCJAN LOGIE (Green) to the Minister for ACCQuestion No. 12—ACC12. JAN LOGIE (Green) to the Minister for ACC: How does she respond to the findings of the Helen Clark Foundation report on perinatal mental health which calls on the Government to expand cover for mental injury under the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill so that support is available for mental injuries resulting from a traumatic birth?Hon CARMEL SEPULONI (Minister for ACC): I acknowledge the important issues raised by the Helen Clark Foundation's report on perinatal mental health. Currently a mental injury is covered if it is caused by a physical injury covered under the Act and these provisions will apply to the new maternal birth injury cover in the same way they apply to all physical injuries. The result means more women will receive cover for perinatal mental health issues. However I do not intend to expand mental health cover in this legislation to women whose perinatal mental issue is not the result of a physical injury. This support will continue to be provided by the health system. Expanding this scheme to include broader cover for mental injuries would be a significant expansion and would have many complexities to work through. It would require careful analysis of the impacts and costs and significant consultation.Jan Logie: What would she say to Casey whose traumatic birth wouldn't be covered by the birth injuries bill and who submitted of her birth: I can't bring myself to process it yet simultaneously will have recurring traumatic flashbacks. I need mental health support but there is none available to me that is funded. It is devastating. It is impacting my ability to be a Mum."?Hon CARMEL SEPULONI: Of course I think every single person in this House hearing Casey's story would empathise with Casey. The piece of legislation that we have before the select committee which expands the offerings of ACC to cover maternal birth injuries is not a piece of legislation that is going to respond to the needs of all women however. I absolutely appreciate that there is more support and investment needed in the health system in particular but also acknowledge that we as a Government have invested $1.9 billion into mental health. There is still more to do and we hope to be able to continue to make progress so that we can respond better to the needs of people like Casey.Jan Logie: Does she think it's fair that a midwife assisting in a traumatic birth who experiences PTSD as a result would be eligible for ACC's support for mental injury but the mother herself would not?Hon CARMEL SEPULONI: In 2022 you know we are having much more comprehensive and expansive conversations about mental health. More than what we would have done 50 years ago when the ACC Act was implemented. We do need to consider what ACC's role is with respect to mental health cover. However we can't just pick one particular area to focus on. I think this is a longer term piece of work for ACC—certainly something that I'm interested in. However we're not going to see the expansive cover that the member would like to see in the particular bill that we have before the select committee.Jan Logie: Does the Minister think it's acceptable to leave mums like Casey with stand-alone mental injuries out of the bill when the Clark Foundation report has found that maternal suicide is the leading cause of death in Aotearoa amongst pregnant people—five times higher per capita than the UK?Hon CARMEL SEPULONI: I feel that the member's question is slightly unfair given that actually for the first time we as a Government have taken an equity lens to the ACC legislation and looked at the way in which ACC is serving the interests of population groups like women. We were able to move quickly with regards to bringing together legislation to put in front of this House to actually provide cover for up to 18000 women per year who experience birth injury. That is significant progress. Is there more to do? Absolutely. There's also more to do in the health system which we are committed to doing and our health reforms clearly demonstrate that. Not everything will be covered through ACC but we need a health system that responds effectively to the women and the injuries that that member is speaking of.Jan Logie: Is the main reason stand-alone mental injuries relating to birth aren't covered in the new bill to constrain costs; and if so how does she expect to fix the roughly billion-dollar payout difference between men and women in the ACC scheme?Hon CARMEL SEPULONI: The answer to the first part of the member's question is no. And with regards to the disparities that exist between women and men and the amount of cover and the types of cover that men get versus women we are absolutely addressing that. In fact for the first time this Government is addressing that. I'm very proud of that. We've made some significant steps already. There is more to do and I look forward to doing that.Jan Logie: Does she agree with the Clark Foundation report that: "We need our political leaders policy-makers and the stewards of the new health system to understand the evidence champion the needs and rights of pēpi and whānau in their decision-making" and if so will she as Minister for ACC adopt their recommendation to extend mental injury cover in this bill in front of Parliament?Hon CARMEL SEPULONI: I believe I already am championing this issue. I think that we are the first Government to actually put a lens to the ACC legislation to uncover the disparities that do exist and then off the back of getting that information have already acted. I'm looking forward to what else we can achieve during our term. I'm looking forward to modernising ACC and making this 50-year-old taonga of ours more representative and effective for the New Zealand of today and not the New Zealand of 50 years ago. But we're not going to be able to achieve all of that in this one bill. There's much more work to do beyond this."