Williams PotoPOTO WILLIAMS (Labour—Christchurch East): As a member of the Health Committee this was an interesting if somewhat confronting bill to work on in the select committee and we had lots of robust discussions about detaining people and the loss of freedom and the like. I think as a committee we got to a really good place. There were lots of robust conversations and I think that the legislation that we came out with is in good shape. Addictions particularly severe addictions which we are hoping to address with this piece of legislation are potentially life ending and that is where this particular legislation is pitched—at people for whom their addictions are so consuming and so overwhelming that they are unable to get the kind of treatment that they need to actually save their lives on their own or to actually stop them from being at risk of harming others significantly. So we are talking about a small but quite significant group of people who—as the Hon Peter Dunne has mentioned—have already been significant users of health services in an attempt to deal with their addictions. And they are often people who have not engaged with their community or with their whānau because they have really used their social capital up with the people who can support them and they are in a position where they need significant amounts of care and support. We did have lots of conversation about the fact that we are looking to actually take people to undergoing treatment compulsorily and you do not do that lightly. So we had to have a look at the mechanisms that are already in place to support people around compulsory treatment—and of course we looked to mental health services that have that mechanism—and what we could use from that environment to support people with severe addictions. There is often a crossover between the groups—between those who have severe addictions and those who have mental health conditions—and there was some correlation between how we could work that out. But it is not an insignificant thing to take someone's freedom away and then compel them to undergo treatment. So the whole discussion around compulsory treatment versus voluntary treatment was one that was quite interesting and I know that in the past many with addictions have relied—we have relied as a sector really—on people acknowledging that they have a problem and then seeking the support from treatment services. But in this case their addictions are so severe that it is in our interest as a society to ensure that they are compelled into treatment and for some it is their last hope. This is not about the provision of wet houses which is a mechanism that some jurisdictions use where you actually help somebody manage their addiction while they still use the substance; this is actually about making somebody stop using through the use of medication and treatment and it actually is the last ditch attempt in getting them to stop using before they actually potentially harm themselves fatally. We had a lot of discussion—and it was raised by one of the submitters—about the types of facilities that might be used to provide this support because currently I think we have about three facilities in this country that could tomorrow provide this kind of care. But we know that more are needed and that there are a range of organisations and facilities that if they were resourced appropriately could conduct the work. One of the submitters to the select committee—in fact it was the Human Rights Commission—did make the point that it was mindful that often the behaviour of a person who is using substances means that they may actually be held in a police cell or some such thing. The Human Rights Commission was concerned that that does not become a default setting for people with severe substance abuse and we had quite a robust discussion about that. We were very clear in the select committee about ensuring that the wider range of mental health facilities will also be used and be provided with the resources to conduct this treatment. So hopefully we have addressed that concern of the Human Rights Commission. One of the other things we considered was the ability for the children of patients who go into this type of facility to be notified appropriately that their loved one is in the facility and notified of the type of treatment that they are going to receive. So we are required to provide them with a range of information—details of where they are located the type of treatment they are going to receive the length of time—and that provides them with I guess some oversight from outside the facility. The other thing that we considered was the role of the district inspectors. The district inspector is a role that is well-known within the mental health sector as being the key oversight to ensure that the rights of the patient are upheld. So in the select committee we did spend some time ensuring that that role was well-defined and that access to the district inspector for the patient occurred within a 14-day period so that they could be clear that they could have their rights ensured. There are clauses within the legislation that allow patients to consult with approved specialists and they are able to get second opinions. There were some submitters who commented on the resource to be able to deliver this particular service and there are some key components that we do need to address before this service is actually able to be delivered competently. That is about ensuring that we have enough professionals with the right types of skills and the right type of ability that we have them in sufficient numbers and that the facilities to provide the work are available. The select committee had a discussion on how long an appropriate treatment period is and we did talk about having treatment that was long enough to ensure that you provided the right kind of care but not so long that it became a matter of detention. So that was a very robust discussion. I just want to quote from some of the submitters who submitted to the select committee. The Canterbury AOD Consumer Leadership Group made the comment that it was concerned that the threshold for an individual to meet the criteria for compulsory treatment would be set too low. It felt that it needed the criteria of a diagnosis to be set high enough for compulsory treatment and I think we considered that fully. The Drug and Alcohol Practitioners Association of Aotearoa - New Zealand made the comment that it was hoping for some work in terms of ensuring stronger concepts of recovery that there were provisions for the consideration of cultural needs within the treatment of people with severe substance addictions and asked that the inclusion of family and whānau and other support people in decision-making processes be included. Just to finish I want to go back to the Human Rights Commission and quote from one of its submissions: The way that the legislation is implemented in practice will [be the most] important"—I think that we all agree with that—and "this will depend to a large degree on the [availability] of suitable funding treatment centres and experienced staff." We all agree that inadequate resourcing could derail this but I think that in terms of legislation we have got to a good place and we are happy to support this bill."