Seymour DavidPart 3 AccountabilityDAVID SEYMOUR (Leader—ACT): Thank you very much Madam Chair. As you say we move to the debate on Part 3 of the End of Life Choice Bill which is entitled Accountability". There has been a lot of discussion on this bill about safeguards and what sorts of protection there are for people who want nothing to do with this bill or who want to ensure that if they do take advantage of the End of Life Choice Bill they will have their rights protected. Many of those safeguards occur at the level of the consultation between a doctor and their patient and those safeguards were debated extensively in Part 1 where we debated in particular the definition of a person who is eligible for assisted dying and in Part 2 where we debated the process that is required to be followed by people under the bill. Part 3 is also a part which is about safeguards but at a macro level. It talks about some of the procedures and establishes some bodies to ensure that assisted dying is done in a safe transparent way where people are able to see that there is oversight at a public level.First of all in clause 19 the bill establishes the Support and Consultation for End of Life in New Zealand (SCENZ) Group requiring the director-general to establish Support and Consultation for End of Life in New Zealand. The role of the SCENZ Group is to keep records—lists that is—of medical practitioners who are prepared to act as replacement medical practitioners in the case that a doctor conscientiously objects and a patient wishes to find a replacement medical practitioner. They also keep a record of psychiatrists. I note that my Supplementary Order Paper (SOP) 259 amends this from "specialist". It cannot be a psychologist or a psychiatrist; it must now be a psychiatrist. They keep a list of those who might be called upon if one of the medical practitioners involved in the process we discussed in Part 2 decided to call on a psychiatrist to check that somebody was indeed mentally sound and a person eligible for assisted dying under this bill. They also keep a register of pharmacists and the SCENZ Group also sets out procedures in relation to the administration of medication.The SCENZ Group has a membership of people that the director-general considers to have collectively knowledge and understanding of matters relevant to the functions of the SCENZ Group. And I might take that opportunity to address some of the amendments that have been put on the Table in relation to the SCENZ Group. For example SOP 336 in the name of Paulo Garcia has put an amendment suggesting that the committee put in statute that the SCENZ Group should actually have to write down its procedures and release that. I don't think that's something that belongs in statute; I think anybody put in charge of maintaining a statutory body would write down their procedures. And of course we have open government in New Zealand—a range of procedures that people can use to discover them if that is truly of interest.Agnes Loheni says that SCENZ must keep the records for seven years. That's already covered by the Public Records Act so would be redundant. Melissa Lee talks about conflicts of interest in SCENZ if SCENZ is considering the action or inaction of a person. First of all it's not clear in what circumstance SCENZ would be considering the action or inaction of a person but a theme with many of these amendments—conflicts of interest are something that the New Zealand public sector routinely manages. It seems rather odd to suddenly start putting statutory requirements to manage conflicts of interest in a specific place.Jo Hayes has said that the qualifications of people on SCENZ should be published. Again the Minister already has a requirement to appoint people who have adequate knowledge to fulfil the role of SCENZ. It's not entirely clear why it's necessary to put in statute that those qualifications would be declared. But again if they didn't declare them there's a range of ways that people can find out—through the Official Information Act; parliamentary questions written and oral they could ask; or they could even check on LinkedIn to see what sorts of qualifications the people had. It hardly seems to be something that we need to put in statute.Melissa Lee—SOP 332 is saying that nobody on SCENZ should ever be the subject of a complaint to anybody about anything in relation to the End of Life Choice Bill. The difficulty with that amendment is that it doesn't say what the result of the complaint should be. So any vexatious complaint would disqualify anybody from being on SCENZ. That would be an extraordinary thing for the committee to legislate.Agnes Loheni says that there should be no conflicts of interest in SCENZ. Of course the director-general in appointing SCENZ would already be required to consider that.Paulo Garcia says that the skills of people on SCENZ should be listed in statute. Again if he was to look at clause 19(1A) of my amendment number 259 he would see that indeed the director-general is already required to put in place people who have the requisite skills and knowledge to carry out the role of SCENZ. It's not clear why this committee should try and second-guess the director-general in what those skills should be. There may well be omissions that the House would live to regret and so on.Kanwaljit Singh Bakshi says that he wants to specify the number on SCENZ. Again he should look at clause 19(1A) in my SOP 259 which has been in the public domain for several months now. It says that people have collectively the knowledge and understanding to carry out the role of SCENZ. So that implies that he will get the right number. Why this committee would decide to second-guess him in what that number is I'm not really sure.Simon O'Connor came up with a very interesting amendment. He suggests that instead of saying that SCENZ should be established it should also point out that SCENZ needs to be maintained. I don't know how much work Simon O'Connor put into it but if he was to look at section 103 of the Financial Advisers Act section 150 of the Anti-Money Laundering and Countering Financing of Terrorism Act 2009 or section 56 of the New Zealand Superannuation and Retirement Income Act 2001 he would see that there are many precedents and that it's quite normal for an Act to require somebody in the Government apparatus to establish a committee—and yes that implies that it be maintained. It's also the case that it would be impossible for this Act to function without SCENZ. So if the civil service can't work out that not only do they need to establish but also maintain SCENZ we are in much bigger trouble in this country than I'd hitherto realised.Chris Penk says that he wants a lawyer to be on SCENZ. He seems I think to have misunderstood the role of SCENZ. The role of SCENZ is to keep lists and stipulate what medical procedures are. I don't think that's something that a lawyer would be required for but of course it's quite possible that the director-general will disagree with me and if the director-general did then they could indeed put a lawyer on SCENZ. There's no reason they can't do that and who knows it may be that Chris Penk is right but if he is I'm sure the director-general will agree with him. If the director-general disagrees with Chris Penk then perhaps it's wrong to pass this amendment.And finally Chris Penk wants term limits on SCENZ and also diversity quotas. I'm actually tempted to support this simply because it would be so ironic that Chris Penk was introducing diversity quotas into the bill. However this is a very serious matter and time limits have a problem that is characteristic. The problem with time limits is that they mean that you will never accumulate experience in an institution. Funnily enough the state of California is a very good example of this. Because of their time limits they often have very inexperienced politicians and I note that Chris Penk who put up this amendment has been here only just on two years. He might gain a lot more experience if he was to stick around but of course his amendment would prevent that from happening.That takes us to clause 20. Clause 20 establishes the Review Committee. The Review Committee consists of a medical ethicist and two health practitioners—previously two medical practitioners but under my SOP 259 two health practitioners one of whom must be a medical practitioner and most people would say a doctor experienced in end of life care. Making it "health practitioners" raises the possibility for example of a nurse practitioner. I'd like to acknowledge the New Zealand Nurses Organisation who have been in touch about this and said "Look these nurse practitioners play an important role and could offer an important perspective." So that possibility has been raised. We have put in place the possibility of a nurse practitioner being in place for instance by making it a health practitioner. So three people in total. It must consider reports sent to it by medical practitioners who are engaged in end of life choice.They have to report to the registrar whether it considers that the information is adequate. So every time somebody goes through the procedures in this bill the forms get sent through to a review committee which informs the registrar which we'll get to in clause 21 as to whether or not in their view the doctors are doing the job right. And of course they can direct the registrar to follow up on any anomalies. So this is actually a fairly compact and straightforward group. They receive the reports and they advise the registrar. The easiest way to think about the review committee is that they are advisers to the registrar and their membership is a combination of medics and medical ethicists. I should turn to some of the amendments that have been raised in relation to that. For example we have the idea from Chris Penk in Supplementary Order Paper 342 an amendment that there should be a person on there who has obtained relevant qualifications and experience in the disability sector. I think that's a very worrying trend. Of course we would hope that all appointments in New Zealand would be taking into account the needs of disabled New Zealanders and certainly people who are involved as health care practitioners would be very conscious of the needs of people in the disability sector. I think to suggest that we need to explicitly include that would actually be the start of a worrying trend. We've got Kanwal Bakshi who has suggested that there should be somebody who is qualified in geriatric care and somebody in palliative care. There's already a requirement of having a medical practitioner experienced in end of life care. It's not obvious why Kanwal Bakshi wants to make that amendment or what change it would make given the role and size of the committee. Paulo Garcia again seems to have reprised an earlier amendment that I commented on to the SCENZ Group saying that if there's been any kind of written complaint to any relevant professional body regardless of what the outcome of that complaint was the person can't serve on the review committee. The basic natural justice implications of that are terrible. If someone complains about a person then they're disqualified from membership. I think that's very much in the "Whisky Tango Foxtrot" file. Agnes Loheni's Supplementary Order Paper 345 has said that the Minister has to publish an up-to-date list of members of the review committee and a description. I think you know frankly it would be very unusual if the Minister didn't publish a group and also that the Minister would have to be responsible to all of the open government procedures that we're used to in New Zealand. And if indeed people were genuinely interested and the Minister was trying to keep it a secret there's no facility for a Minister to do that under New Zealand law so I'm not entirely clear why that amendment is necessary.We then have Supplementary Order Paper 346 from Melissa Lee—if a person has a close association with a person involved in the review committee they must recuse themselves. I think if in the State sector it was not normal for people to do that we would have a serious problem with conflicts of interest. Of course that is something that would be done. If we need to use statute to define how to respond to every conflict of interest in New Zealand then we are in serious trouble. Jo Hayes has said that the review committee must keep written records of its operations. Again that appears to be perhaps even plagiarised off another amendment. Some people should talk to each other because the objection of course is that under the Public Records Act that's already a requirement. And finally on this particular clause clause 20 Melissa Lee has said that again they must regulate their own procedures for performing functions and duties and make them publicly available. Well of course the review committee is going to write down how it performs its functions and duties. I don't think that's something that this committee needs to put in statute. There's several more amendments here but I suspect that I'm going to run out of the patience of the Chair if I go through every single one. So let's move on to the registrar. The registrar is a person an agent within the Ministry of Health and the registrar—[Time expired]"