Sepuloni Carmel: Substance Addiction (Compulsory Assessment and Treatment) Bill — First ReadingText is incorporated into the Bound VolumeSepuloni Carmel: Substance Addiction (Compulsory Assessment and Treatment) Bill — First Reading[Sitting date: 15 March 2016. Volume:712;Page:9718. Text is incorporated into the Bound Volume.]CARMEL SEPULONI (Labour—Kelston): I wish I were on the select committee for this bill; unfortunately I am not but just reading through the Health Committee’s notes before standing up to do this speech it is a really interesting area and an area that I am sure many of us in this House are concerned about. I have an electorate office in west Auckland in Glen Eden that I share with Peeni Henare and Kelvin Davis and on a regular basis we see citizens outside our office who clearly are exhibiting either mental health issues or substance addiction issues or both. So seeing this bill is of high interest to me.The Substance Addiction (Compulsory Assessment and Treatment) Bill sets out a framework for the compulsory treatment of people who are assessed as having a serious substance addiction and lacking the capacity to consent to treatment. The explanatory note states that only a small number of people are expected to be treated and treatment will be for a limited time. The departmental disclosure statement describes the aim of the bill as restoring “the capacity of people with severe substance addictions to be able to engage in and remain in treatment.”The bill seeks to repeal and replace the Alcoholism and Drug Addiction Act 1966. The Act is described as “outdated” by the Law Commission which notes that “there are difficulties in reconciling the broad powers of detention with the rights and protections in the New Zealand Bill of Rights Act 1990.” The bill’s provisions for both compulsory treatment and detention in a treatment centre have been assessed by the Ministry of Justice as being consistent with the relevant sections of the New Zealand Bill of Rights Act 1990.Labour supports this first reading to update the Alcoholism and Drug Addiction Act 1966. The Act is almost 50 years old and not in line with modern clinical practice and delivery. It is good to see that the recommendations from the Law Commission are finally being implemented in legislation. Under the current 50-year-old legislation two medical certificates are required to make an application to the court for compulsory treatment and neither has to come from a specialist drug and alcohol practitioner. We support the requirement that compulsory treatment can start only via an approved list of specialists when the criteria for compulsory treatment are met.We must safeguard the rights of patients undergoing compulsory treatment. There are circumstances where compulsory treatment is necessary due to the incapacity of the patient to make a decision on treatment for themselves. However the rights of patients must be upheld and appropriate safeguards must be in place for situations where compulsory treatment is not found to be necessary. It is important that these patients have the same rights as those held under the mental health legislation.A shorter time period for treatment—so 8 weeks with the option of extension—with the goal of moving an individual into voluntary treatment is a far more progressive approach in treating severe substance abuse when patients are unable to make a treatment decision. The statutory period for treatment under the current legislation is 2 years which far exceeds the time frame needed for treatment. Under the current legislation there is an average of 70 compulsory treatment orders per year and it is estimated in the regulatory impact statement that these changes will lead to an increase to approximately 200 orders per year.Even though it is extremely important and necessary to update this legislation we do have to make sure that at the same time we are resourcing health professionals and the New Zealand Police to enable them to carry out their duties under this bill. At this point I will point out the fact that under the National Government we have seen a $1.7 billion cut over 6 years out of the health system. Of course that has implications for areas like mental health and addictions.It is crucial that any estimated uptick in demand for mental health services is resourced and I have to say that is a criticism that we have of the National Government. Often it puts things into legislation without thinking through the implications and the additional areas that need to be resourced. So we need assurance from the National Government that it will be increasing its resourcing in this area to ensure that all of the good things that are trying to be attained through this legislation are actually able to happen. We have seen the consequences of under-resourcing in mental health and of expecting the New Zealand Police to become the front line of mental health services. It is the police—it is every social service agency that is expected to pick up where the Government has failed.I just want to point out an article that I saw in the New Zealand Herald. It was an opinion piece—I cannot remember who wrote it—over the Christmas period and it was just about the increasing levels of homelessness that this person was seeing and the fact that actually what they wanted to know was that their tax dollars were taking care of these issues so that every day they were not having to be confronted by these issues. I think all New Zealanders will agree that they want to see their tax dollars spent on areas like this so that every day when we walk out of our homes when we walk into our shopping centres and when we walk out of our offices we are not confronted by the homelessness by the mental health issues and by the drug and addiction issues that we currently are confronted by on a daily basis. Jami-Lee Ross laughs but it is not funny.Putting it in legislation creating a bill like this is all good but just going back to what I was saying it is about making sure that the support services—the health professionals the New Zealand Police and everyone who contributes to addressing these issues—are adequately resourced. So that is the challenge we have to put to the Government. The regulatory impact statement states that “Additional resources have been made available to district health boards for medically managed withdrawal beds.” but it will be interesting to see whether the $775000 of additional operating costs is sufficient to cover the increase in orders.Another serious resourcing question arises as to whether these additional costs will result in new funding being given to district health boards or whether as has become standard practice in health services the shortfall is made up from district health boards’ already overstretched baselines. We have seen in recent months—especially I think in Canterbury—cuts to mental health funding. Mental health funding drug and addiction funding—we need the Government to make sure that our district health boards are adequately resourced to be able to address those areas.The bill also creates offences relating to the ill-treatment or neglect of patients undergoing compulsory treatment or for the staff at a treatment centre assisting or allowing a patient to be absent without leave. We have seen recent media cases of patients under compulsory treatment escaping care with tragic consequences. It is noted that this risk is going to be managed by the development of a management treatment plan for each individual and there are provisions in the bill to return a person to a treatment centre by an authorised officer or the police.This is an incredibly important bill. We will be supporting this bill. Not only are we confronted on a daily basis with mental illness with drug and addiction issues and with homelessness but also we come across many families who have this as their daily reality. They are having to live through this with their children having to put up with a whole range of things whether it be the fact that they have family members who are violent because of these issues or whether they have family members who are stealing from them because of these issues—a whole range of consequences of substance addiction. I know that these families I am talking about who have to live this nightmare on a daily basis are going to be supportive of this bill as well. Thank you.