Turner Judy: Health (National Cervical Screening Programme) Amendment Bill — In Committee 
Turner Judy: Health (National Cervical Screening Programme) Amendment Bill — In Committee 
[Volume:615;Page:11273] 
JUDY TURNER (United Future) 
: 
 This is the substantial part of the bill and it is important for all of us to comment on it. I have to keep coming back in my thinking to the context of this part which is that while we have made some real progress in controlling cervical cancer in recent years our outcomes still fall significantly behind those of many other countries. Of the 70 to 75 New Zealand women who die from cervical cancer each year about 20 would not die if we had the same mortality rate in that regard as say Australia. Many of them are young women with children and it is important to keep that figure in mind because the success of the screening programme benefits not just women but the families who rely on them. 
During the Gisborne inquiry Dr McGoogan explained that in her country each case is reviewed by the examination of medical records without special consent being required. Consent to access the records is not an issue because the evaluation is regarded as routine and as an essential public health measure. Professor David Skegg described the privacy issue in this way: “In New Zealand there is currently an extreme climate about privacy and doctors are nervous about providing access to records without legislative authority.” He also commented that the current delays encountered by those who were attempting to trace women and seek their consent were “making the current audit almost unworkable”. 
Every now and then I have to step back and personalise the issue in terms of myself. I ask myself this: if my test results were part of the small group needing to be reviewed would I want to have the information that I needed additional medical diagnosis held up by an audit process predicated on privacy issues rather than on health need or would I just want to be contacted as soon as possible so that I could get on with addressing my health needs? The answer for me is obvious. 
I do have before me the very well-intentioned amendment in the name of Dr Lynda Scott that would allow women to partially opt off—the intention being I understand to allow provision for women who want to have the benefit of the screening programme without the added safeguard of allowing evaluators to access their primary health records. I weighed that amendment up very seriously because I fully believe that Dr Lynda Scott would not have put it up without serious consideration. But I have come to the conclusion that I cannot support it not because it is not well-thought-through but because I have a real difficulty with the thought that women would be happy to take advantage of the millions of dollars this programme will cost the taxpayer and then not allow their data to form part of the overall picture that may pick up a discrepancy and save lives. I believe that the safeguards that Supplementary Order Paper 184 in the name of the Hon Annette King puts in place that mean that general practitioners’ records are accessed only under supervision provide very reasonable standards of privacy to individuals without compromising the programme. It is interesting that even now general practitioner audits are conducted on general practitioners’ patient records without patient consent. That process is already common practice and we are now just applying it to this programme. 
Safe screening programmes rely heavily on high levels of participation and the issue of the common good is an integral part of their success. To legislate so that some women can opt out of their commitment to the common good is to legislate for selfishness. Although United Future in no way wants to criticise the motives of the member who proposed the amendment we cannot support it. However we have received assurances from the Minister that if sizeable numbers of women pulled off the programme over that issue she would be willing immediately to redress it—by looking for instance at the suggestion that Dr Scott is putting forward. We would like to give the programme the chance to succeed in its present form. 
I will finish my speech by quoting Professor David Skegg: 
The three members of the committee of inquiry in Gisborne recommended legislation to ensure that people engaged to carry out external or internal audits monitoring or evaluation of cervical cancer incidence and mortality should have ready access to all medical files recording the treatment of the cervical cancer by all health providers who had a role in such treatment." 
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