Boyack RachelRACHEL BOYACK (Labour—Nelson): Tēnā koe Mr Speaker. It's a pleasure to take a call tonight on the Health (National Cervical Screening Programme) Amendment Bill and like my colleague before me Vanushi Walters I want to begin by briefly acknowledging our colleague in this House Kiritapu Allan. Last week I spent two days in Kiri Allan's electorate alongside my colleague Dr Tracey McLellan and it was obvious to us how loved Kiri is by the people in her electorate who wanted to wish her well everywhere we went.This bill is for all the women of New Zealand who are at risk of cervical cancer and especially those women who have lower rates of participation in the National Cervical Screening Programme as has been pointed out: Māori women Pasifika women and Asian women. This bill will address those lower rates of participation by removing barriers to participation. This bill will save lives and I just want to note Kiri's words to not be whakamā and to get it done.I want to thank and acknowledge the various Ministers who have worked on this bill—Dr Ayesha Verrall the Hon Julie Anne Genter and Dr Jonathan Coleman—alongside our current Minister of Health Andrew Little for the measures announced in Budget 2021 that will assist with the implementation of this bill. I'd also like to acknowledge the Health Committee and the officials for the high quality of their work on this bill along with all the people who made submissions. I thank you for your participation in our democratic process especially on such an important topic.This bill removes barriers to participation in the National Screening Programme in two ways. The first that many have mentioned tonight is around improving the cervical cancer screening register and the IT systems in place to enable access to the register for health practitioners. The need for consistent secure and patient-focused IT systems is one of the reasons why we are implementing the health reforms necessary to ensure more consistency across all of Aotearoa and ease of access to health records for medical professionals.Last week I was speaking to a group of nurses in my electorate of Nelson about some of the IT systems they use and don't use when they are supporting patients in their care. It's quite common practice for patients to be transferred between Nelson and Christchurch and sometimes those notes that they use are based on an IT system but sometimes they're handwritten notes. It's been mentioned tonight that for the cervical register that we currently have it uses a fax system. I actually am old enough to have used a fax system in a number of my roles actually including a recent one when we all kind of couldn't quite understand those of us who joined the organisation why faxes were still being used. But it just goes to show that in many parts of our health IT systems we do have work to do to ensure that they are modern and fit for purpose. So by using a centralised register it will ensure that our health practitioners have access to current information that they can access quickly to ensure they can support their patients to get the healthcare that they need.The register will put controls in place to protect the privacy of participants on the register which is very important. It will give look-up access that is read-only for practitioners and a new offence has been added under section 112J of the Act which would make it an offence to amend the register without authorisation. As a user of health services myself I have often been quite surprised that my own health information is not always shared between the health practitioners who support me and I imagine a number of New Zealanders would also be surprised at that. We do need to balance the need for privacy with the need for sharing health information across providers and I think this bill is an excellent example of striking that balance perfectly.One example is the amendments that have been included that relate to the National Kaitiaki Group and that has been mentioned tonight about the importance of ensuring that data that is shared through the system doesn't identify individuals and those types of protections that we put in place when using the data from the register for research purposes to ensure that we're also protecting the privacy of patients.I've just gone through the first main way that this bill removes those barriers and that is around the incorporation of a new IT register and in doing so ensuring that we can have a proper and accurate tool to use to know who is actually in need of receiving their cervical screen. But the second way and another important way that this bill removes those barriers is through expanding the definitions and processes used for screening. Some of the biggest barriers to cervical screening are those barriers that are deeply personal to people. Those of us who've had cervical smears know that it is a highly necessary procedure but that it can be difficult awkward embarrassing and uncomfortable. For me it's been a procedure I've had to prepare myself for. I've sometimes been at a GP visit and been offered a smear; sometimes I've said yes sometimes I've said no because it felt awkward—not the right time—and I've declined and made another time. For people who have survived sexual assaults the idea of having a smear can be incredibly difficult. I want to acknowledge the women in this situation one of whom is a friend of mine and the doctors and nurses who do a wonderful job every day supporting women while they have these important and crucial tests. I'd particularly like to just reference my colleague Dr Leavasa from his previous I believe second reading speech when he talked about the care he takes as a male GP to undertake these screens for women. I just want to thank him for the care and sensitivity he approaches this with.This bill makes changes to the definition of cervical screening". As my colleague and chair of the Health Committee Dr Liz Craig pointed out in her speech the bill removes the phrase "smear test"—and I think this is a good thing—based on the feedback that the word "smear" can be perceived negatively. The bill makes a small amendment to the definition of "screening test" to now include an HPV test. Budget 2021 invests up to $53 million to complete the design of this new test. This will allow women to self-administer an HPV test removing a lot of that awkwardness and that difficulty that we face. It'll take away some of those challenging times when you know you need to have a test but perhaps didn't feel like it was quite the right time if you know it's something you can actually do privately and do yourself.The bill will save lives many of whom will be Māori women. The clinical modelling shows that it will save around 138 additional lives over 17 years. I'd like to reiterate the call from my colleague tonight Anahila Kanongata'a-Suisuiki that women we need to be screened. It's a step we can all take for ourselves and for our families.I'd like to finish by acknowledging the support across this House for this important bill that will improve women's health and save lives. I commend this bill to the House."