Scott Lynda: Health (National Cervical Screening Programme) Amendment Bill — In Committee 
Scott Lynda: Health (National Cervical Screening Programme) Amendment Bill — In Committee 
[Volume:615;Page:11282] 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 The original title of the bill the Health (Screening Programmes) Amendment Bill was changed in the select committee. We consulted the Regulations Review Committee about the change. The committee felt it was not appropriate to have this bill extended to other screening programmes. The committee thought it a constitutional principle that matters of policy are set out in an Act of Parliament and the details of those matters are left for regulation and that using regulations to extend this bill to other screening initiatives infringed on this principle as any future screening programme should be a matter that is sanctioned by Parliament and not by secondary legislation. The select committee had quite a debate on that particular principle and in the end decided it would limit this legislation just to the cervical-screening programme. 
The fact is that this particular bill will be a template for other screening programmes. We have been talking about the breast-screening programme and the extension of the age and I had a couple of emails today from two men with prostate cancer. Men often ask why they do not have a really well-organised screening programme for prostate cancer. I always write back that we do not have a test that does not have a high level of false negatives and false positives but as soon as we do have a good test for prostate cancer I am absolutely certain there will be a screening programme. When I first went through medical school they said that men died with prostate cancer not from it. That is far from the truth these days. A very good friend of mine died on election day the year before last. He had only just turned 60. These days a lot of men are getting prostate cancer and they often feel that cervical cancer and breast cancer get far more attention than prostate cancer. These days more men are dying of prostate cancer and the scientific community continues to work to get a good screening programme for prostate cancer. 
 As for breast cancer we know today that the screening programme will be extended in age for free screening. It will be important that that screening programme has the capacity to be able to deliver to all the new women who will be coming into the programme for free screening. So the Health (National Cervical Screening Programme) Amendment Bill being limited to cervical screening does not mean that in the future there will not be other screening programmes that will act very much under this particular type of legislation where there will be an opt-off programme to try to get the maximum number of women or men involved in the screening programme in order to achieve a very good programme. It does not mean that a system will not be set up whereby information is gathered from a mammography for example by the radiologist who is reading it and information on what happens to the woman—the treatment she receives. It is known that there is a considerable problem in this country with being able to get timely access to radiotherapy. That can impact on the local recurrence of breast cancer and make the programme less effective. There needs to be not just the screening but also appropriate and adequate treatment. There is no point in doing massive screening if nothing can be delivered that can save people’s lives. The reason why HIV is often not screened for is that although there is treatment there is no cure. 
So what can be done for prostate cancer and breast cancer? There is no definitive test for prostate cancer yet and with breast cancer there is the problem of not being able to get as timely access to radiotherapy treatment as we would want. Certainly surgery is offered within a timely manner. It was excellent when we got to the point of learning that lumpectomy and radiotherapy gave as good an outcome for early breast cancer as radical mastectomy because then women could save a breast.