Woodhouse MichaelHon MICHAEL WOODHOUSE (National): Thank you Madam Deputy Speaker. I am pleased to advise the House that the National Party will be supporting this bill at its first reading and I see no impediments to that support being right through the passage of the legislation. We do so because while the Minister who moved the motion didn't have anything to say about the genesis of the reasons for this bill both of the main changes being made had their genesis in the previous Government firstly as a member's bill drafted by me many years ago but then made good by my colleague and friend Chris Bishop. It was the Financial Assistance for Live Organ Donors Bill—it's got another name now—and Mr Bishop made it so much better and passed it into law. Encouragingly it has been very successful in increasing the volume of live organ donation not that that was its purpose; it was more about removing barriers rather than providing financial incentives. But it is clear that there have been some issues that were raised in the practical determination of the financial support and I commend the Government for making these changes to make sure that the policy intent and the breadth and scope of support for live organ donors are as practicably wide as possible. Of course the report the strategy that has given effect to the establishment of the New Zealand Blood Service as the agency vehicle for delivering the national strategy was the previous National Government's. A previous Minister of Health the Hon Dr Jonathan Coleman commissioned the ministry to go and highlight strategies that could increase cadaver donation—deceased organ donation and transplantation—and that was reported back to the previous Government in June 2017. One of the recommendations strategy priority five was to establish the national agency and one of the things that the Ministry of Health was advised by stakeholders was that it shouldn't be a continuation of the status quo or an enhanced status quo where a district health board (DHB)—in that case the Auckland District Health Board—was the agency. They were very clear that the public consultation identified that the governance of this new agency should be a stand-alone entity rather than within a DHB. So we have kind of a hybrid here: we are annexing the organ donation agency into an existing stand-alone entity the New Zealand Blood Service which the National Party has no problem with necessarily but I would add the corollary that the current appropriation being proposed to manage the transition is a relatively small sum of money at just $100000 in this financial year and $225000 in the next. Now that is a very small amount of money to do a very significant piece of work and to establish the agency as the voice and the adviser for the increase of both live and deceased organ donation. It would be a shame if chump change—well the absence of it—was used to prevent the really good goals that the strategic document has highlighted from coming to fruition.It would be remiss of me as the shadow Minister of Health and one who has I guess a quantitative lens but a firm belief in the value of targets—a belief that this Government apparently doesn't have having removed all health targets having committed to replacing them but not doing so—not to say that strategic priority six in the strategic document highlights the importance of measuring progress and in order to measure progress we need to set some kind of target. Now we're not going to see that I have no doubt but I think it's a really really good idea and I encourage the Government to be aspirational and set stretch targets for both live and deceased organ donation.The last thing I want to mention about the establishment of this agency is that one of the other strategic priorities—number two—was Improving New Zealand's system of registering and sharing donation intent for individuals families and clinicians." This will be really really important—almost a raison d'être—for the agency along with an information campaign.Now we are having a conversation at the moment about the autonomy of the individual and it's being discussed in the context of the End of Life Choice Bill. One of the things that has become very clear about that is that the sponsor of the bill and the supporters of that legislation value autonomy over everything else. I mention that because one of the barriers to deceased organ donation is the so-called family veto—that my autonomous right to choose what happens to me in the event of my death can be usurped by a family member. It's questionable. While we have a noble goal in the second strategic priority for this agency we actually I think have a task to review whether or not a person's wishes which could be articulated—they are currently articulated in the driver's licence system but are not presently being used by clinicians necessarily except to simply start a conversation. Actually the goal of strategic priority two is to increase the register and improve the quality of the information but it does not stop the possibility of that autonomy that preference that I might have to donate organs in the event of my demise from being respected. It's questionable whether the Human Tissue Act already enables this to happen. I draw members' attention to section 31 of the Human Tissue Act which actually describes who can give consent for tissue or organs to be used for any purpose. The first person—and it's in a ranking order—in my view is actually the individual.So in supporting this piece of legislation what I'd also like to encourage this new agency to do is to be a bit braver about having a conversation about whether a register could include something like an advance directive something that I as a former hospital manager had to deal with from time to time for elderly patients going through serious surgery a do-not-resuscitate order or for religious reasons where the patients may not be willing to accept a blood or blood product transfusion. That is something that we would absolutely respect. I think an advance directive in a register that this agency could manage could also include an advance directive that says "In the event of my demise I have chosen"—I have chosen—"to donate my organs to enable somebody else to live." Actually that could be a strength for clinicians at a time when they're having to deal with the trauma of the loss of a loved one to actually give some comfort to the family that my wishes will be obeyed.That said while the establishment of this is going to be a very good milestone I think it's also fair to say there are a number of other conversations that we can have to increase both live organ donation and deceased organ donation. I look forward to a time when New Zealand actually has a much higher rate of donation than it presently has. We support this bill."