Turner Judy: Public Health Bill — First Reading 
Turner Judy: Public Health Bill — First Reading 
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JUDY TURNER (Deputy Leader—United Future) 
: 
 I stand on behalf of United Future to support along with other parties the first reading of the Public Health Bill. I am particularly pleased to see that the House is giving this bill the opportunity to be considered by the Health Committee. It is interesting to consider that it is over 50 years since legislation was looked at in this regard. This bill also replaces the Tuberculosis Act from around that time and in discussing such legislation we are looking at a time in New Zealand’s history when the majority of New Zealanders died from communicable diseases. 
Here we are all this time later and the health environment within New Zealand has changed quite dramatically. Now New Zealand health professionals and in particular the New Zealand health dollar—which will always be rationed no matter how ideal we get the system to be—are dealing with a death rate that is largely fuelled by non-communicable diseases. So there is an intention and an attempt within this bill to bring some public health initiatives into law around non-communicable diseases. 
The bill is divided into eight parts and I want quickly to flick through them. The first concerns the powers functions and duties of various key players in the health sector such as those of the Minister of Health the Director-General of Health the Director of Public Health district heath boards territorial authorities and the like. It is very clear that under this bill the powers that those functionaries have are clearly specified and laid out. 
The second part of the bill deals with health information notification and reporting and it also includes the cervical screening provisions that were put in place in the previous Parliament. It talks about updating existing audit provisions and it provides for the notification of specified conditions which is fairly straightforward. 
The third section which is one I mentioned at the beginning of my speech concerns the issue of non-communicable diseases. It provides principles and non-binding codes for reducing the rates of non-communicable diseases. This is the controversial part of the bill. I remember that some time ago when I was on the Health Committee we had a briefing from health officials. I cannot remember what we were having a briefing on but we asked them about the different ways the Government could respond to a particular circumstance. They said there were three ways. The Government could do nothing and sometimes that is the best way to respond to a health situation—for example if it is a virus that is going around it will be gone soon so we do nothing and let it take its course. The next thing was to involve public health education and the third thing was to regulate. 
This bill brings in a fourth provision which would kind of slot into the middle of that continuum. It is the introduction of non-binding codes. This is not full-on regulation; it is a step beyond education and it certainly allows the Ministry of Health to make some sensible suggestions. One of the areas that came to mind which I think is an area where we need some non-binding codes right now in New Zealand is the issue of foetal alcohol syndrome. When I was a young mum— 
Hon Tau Henare 
: A long time ago now. 
JUDY TURNER 
: —it was a long time ago; I admit that—we were advised by our general practitioners that a moderate amount of alcohol consumption was actually OK and would not do any harm. Most of the young mums I got to know consumed mild amounts of alcohol during their pregnancies in the mistaken belief that it was perfectly safe. New scientific evidence now suggests that the advice we should be giving to young mums is that they should go nowhere near alcohol during the term of their pregnancies. There are genuine cases where it has been very clear that even moderate or mild consumption of alcohol during sensitive parts of a baby’s development has created this syndrome. We have a high incidence of that in New Zealand and we should consider that there is an area where some really interesting non-binding codes could be introduced to make a real difference to the health outcomes of literally thousands of New Zealand children. That is what this bill seeks to introduce. 
I note the speech made by the Hon Tony Ryall. He talked about clause 374 and he is quite right in his warning about that. I do not want to sound as if I am criticising him because he is quite right. When we look at clause 374 which is about the regulations around public health in a general sense we see that all the way through in paragraphs (a) (b) (c) (d) and so on it is mainly talking about communicable diseases. Then we get to a little paragraph paragraph (x) which slips in the ability for there to be some guidelines to “reducing or assisting in reducing risk factors … associated with or related to non-communicable diseases:”. That paragraph could be completely overlooked. It has been slipped in there and I would like to think that during the select committee process some clarity will be given to it. Is it about non-binding codes or is it about something that could possibly be considered to be a bit more onerous? United Future accepts that there are some concerns. I have certainly been reading some publicity around concerns on that matter and I think we need to be very clear as to what is being proposed there. 
Beyond that third part of the bill are some provisions for the management of conditions posing health risks—that is to do with communicable diseases—which basically roll over some of the existing provisions in the Act and identify some new and more modern risks of communicable diseases. The bill talks about the role of territorial authorities particularly in relation to environmental health and the provision of sanitary works. It also deals with the interesting issue of stopping “nuisances” which will be an interesting thing for the select committee to look at. It talks about regulated activities and when we look at the regulated activities we see the breadth of what this bill has to cover. Those are activities—such as hairdressing and needle and syringe exchange programmes—that currently come under some form of regulation and the bill talks about the fact that there is currently a serious gap in the heath provisions for some of those regulated activities a gap we need to look at under this bill. 
I move to the provisions concerning emergencies and border health. That is where the “all risks” approach to emergencies comes in. The “all risks” approach is specifically to do with emergencies and border controls around health issues such as severe acute respiratory syndrome bird flu and those types of issues. Part 8 of the bill covers miscellaneous provisions. 
This is a fascinating bill and United Future is disappointed that we do not enjoy representation on the Heath Committee. We wish the committee members well in their consideration of and deliberation on this bill and we are happy to support its first reading.