Stewart Barbara: Substance Addiction (Compulsory Assessment and Treatment) Bill — First ReadingText is incorporated into the Bound VolumeStewart Barbara: Substance Addiction (Compulsory Assessment and Treatment) Bill — First Reading[Sitting date: 15 March 2016. Volume:712;Page:9712. Text is incorporated into the Bound Volume.]BARBARA STEWART (NZ First): I am very pleased to rise on behalf of New Zealand First to take a call on the Substance Addiction (Compulsory Assessment and Treatment) Bill. New Zealand First is supporting this bill to select committee and we will be most interested to hear submitters’ views on this complex issue.As others have said the current legislation is outdated and did need to be reviewed. We cannot have an Act that is 50 years old as part of the legislative framework. When we have a look at compulsory treatment we know that there are provisions for compulsory treatment already that are followed by the courts but we also know that the process itself is very complicated and very time-consuming. Applications have to go through the District Court hence the provisions are rarely used.I was most interested to read the regulatory impact statement and to read the concerns of the Law Commission. When I read through those concerns I agreed totally with them so that is one area that we are going to be looking at in the select committee. One of the main problems that was identified was that “although two medical certificates are required before a person can be committed there is [absolutely] no requirement that either [of the medical certificates] be issued by a specialist alcohol and drug practitioner following the personal assessment”. That is quite a concern I believe.The Law Commission also said that “the statutory period of detention is two years which far exceeds what is normally necessary to undertake any form of treatment” and there again I can agree with that particular area. It said “the Act makes inadequate provision for review of the detention decision”—so quite a concern there for people’s human rights—and “there are generally insufficient safeguards to protect the rights of people held under the Act”. One of its biggest areas which I thought was most interesting was that “few treatment facilities are actually certified to accept people under the regime and consequently there is little flexibility in the type of … programme available”. Those are big issues that need to be resolved and no doubt we will be spending quite a bit of time on them at the select committee.All of us in this House know that we have got a problem with illicit drugs. In fact we have got one of the highest drug rates in the world. Although we are aware of this we are also aware that there are no real statistics on this very issue. We are operating in an area where we are uncertain of how big the problem actually is. We do not have any idea of the extent of the problem we are dealing with. We do not know how many people are even likely to be affected by this legislation. We all know though that the devastating effect that addiction has on an individual a whānau and the wider community cannot be overestimated. Of course there are all the resulting hassles that result from that: poor health and education outcomes increased crime and the breakdown of relationships and family groups.In his latest report the Director of Mental Health reported that the number of people who accessed specialist mental health and addiction services in 2014 was quite vast because would you believe addiction treatment is not recorded separately from mental health. So really when we get down to it it is very difficult to determine how many people are actually accessing this specialist addiction treatment.We do know that district health boards are struggling to cope with increased and overwhelming demand. So we are concerned on this side of the House that if there is going to be an increase in the use of compulsory treatment provision our current workforce is resourced adequately to cope with that increased demand. We know too that we have got an “ambulance at the bottom of the cliff” approach to this bill and it is often only when one hits the bottom that the compulsory treatment report comes into being. It should only ever be used in extreme emergency situations where there is no other option. We do not want to see the open-door attitude that the United States often has to compulsory treatment. We have heard very bad stories from across in the United States.But we were pleased to see that severe substance addiction is defined as “the compulsive use of a substance that is of such severity that it poses a serious danger to the health or safety of the person suffering from it or seriously diminishes the person’s ability to care for himself …”. We would also like to see the addition of a clause that states that no other treatment options have been considered or that they have all been considered and tried.We all know that compulsory treatment is not the best way to facilitate treatment so how can we encourage those who actually need help to seek it for themselves? It is quite an interesting challenge there because the stigma towards mental health issues and seeking help has to be removed; therefore we need some funding directed towards the situation. We need education as well as treatment and that in itself is a big ask.We are pleased that there are provisions in the bill to inform family members of the person’s status and to notify them of the centre where their family member is receiving treatment as well as any other information but we believe that families should also have the opportunity to have some input into the decision making. It is difficult to see how the bill will be incorporated as part of the Director of Mental Health’s vision for mental health in 2030 for “a holistic family/whānau-focused model of service delivery”.During the select committee’s consideration we are going to be interested in discussing how the rights of the person can be protected and ensuring that the bill does not contravene the UN conventions. We are adamant on this side of the House—New Zealand First in particular—that any benefits of compulsory treatment have to outweigh any potential infringements on the person’s rights. The criteria around compulsory treatment have to be robust.Additionally we have got concerns about the lack of evidence or otherwise of the ability of compulsory addiction treatment to deter future substance abuse—and of course there are no statistics on that. It is critical that the person is actually receiving the best form of treatment—I think other people have actually mentioned this as well.When this bill passes into law—because it inevitably will—it is expected to cost $775000 to implement. We would like to know whether there is going to be new money allocated for this or whether it is expected to be taken from the existing mental health and addiction budget because that is already stretched at this point in time.New Zealand First supports the bill. We are going to be following the issues that I raised very closely. We look forward to hearing from a wide range of people to carefully consider their views and the issues that they have identified as well. Thank you.