Dunne PeterHon PETER DUNNE (Associate Minister of Health): Can I thank those members who have taken part in the debate so far for their constructive and very useful comments. I want to take some time to comment on some of the matters that they have raised and the questions that they have posed. Can I begin by taking a phrase that the previous speaker Julie Anne Genter used when she spoke of the need to maintain a careful balance and I think that that is a very accurate description actually of what we are trying to do with this piece of legislation.The Committee may be amused to know that my first association with the old Alcoholism and Drug Addiction Act was in 1983 when I was the chair of the Wellington coordinating committee on alcohol and drugs and we decided then that the 1966 legislation which was but a child of only 17 was well and truly outdated. So here we are as the Act passes into its 50th year finally putting it to a gentle rest.There are a number of points that I want to pick up but I guess the starting point is to be very clear about who and what it is we are talking about here. We are not talking about people who suffer temporary or passing intoxication from alcohol and drugs. We are talking about people who have a severe progressive long-term addiction that has proved difficult to treat in any other environment. So immediately the audience is a limited one.A speaker earlier referred to a couple of hundred patients a year. I think that is probably at the outer margin but it is a very small and discrete number. Let me just pick up some of issues therefore that members have raised. Poto Williams raised questions about gaps in capacity in terms of the ability to provide treatment services and time frames and she is right to make that point. One of the reasons why the Health Committee recommended and I certainly accept the recommendation of a 1-year lead in to the implementation of the bill—so it does not take effect until 2018—is to ensure that we have as adequate a range of facilities as we can get by that time that we also have knowledge and awareness amongst the health professionals who will be working with these people and that we will have identified some of the gaps in capacity.This legislation is a culture step forward from the previous legislation. Those health professionals who will have formed the view of the inadequacy of the current legislation will need to be brought along to understand that there is a new environment that is more reflective of their needs and therefore more able to respond to the types of circumstances that they face with their particular patients.That brings me to the point that Louisa Wall made about the principles of informed consent and do no harm. One of the really important issues here is that the health profession generally I think understands the principle of informed consent but in this instance you come back one step: the issue at heart here is not so much informed consent but the capacity of the person to be able to consent. That is going to open up another range of issues for the health sector and for those working with these people as to how that consent is obtained and whether it is of a quality that is sufficient for the purpose. If you look at the clauses of the bill post - clause 7 you will see that they really try to address this particular concern.Clause 10 makes it very clear that compulsory treatment is the option of last resort. I think that is an important point because often one comes across families who will be just absolutely frustrated that their particular loved one is in a downward spiral and nothing seems to be able to be done to intervene to help them. So by making it clear that we are looking at people who have severely impaired capacity which is defined in clause 9 that this is treatment of last resort in clause 10; and that there are very particular provisions around what is appropriate treatment the duration of that treatment and the protection of the rights of the individual during that treatment we are trying to strike what Julie Anne Genter described as that careful balance between dealing with a problem and its enormity which other people need to see the need has to be resolved while respecting the rights and the integrity of the individual who is the subject of the legislation. That I think is where the current legislation fell down. The way it was designed in 1966—it was still at the time when we had public drunkenness as an offence. If one reads the social commentaries at the time of people like James K Baxter this sort of legislation was actually used as a way to get people off the streets—find that they did not have adequate means of support suspect they had an alcohol or drug problem and bang!" the Alcoholism and Drug Addiction Act suddenly started to apply. We have moved on from that environment and I think it fell into disrepute because society had moved on also. What this legislation tries to do is recognise that there are people out there with genuine problems and genuine needs and we as a compassionate society need to have in place mechanisms that help them through that addiction and hopefully—and we can never be confident of this but hopefully—set them on the path to living reasonable and sustainable lives in the future. I hope that it is not 50 years before we have this debate again. I suspect many of us will not be here at that time and in that regard I am delighted that the Health Committee has recommended—Scott Simpson: The member will be.Hon PETER DUNNE: I probably will be yes. I am delighted that the select committee has recommended a 3-year review because I think that ensures that the legislation will remain current. I also think it ensures two other things. Firstly the points that Louisa Wall made about this whole issue of consent and how that is applied will have been tested. If it is proved to be deficient in the legislation we will be able to address it. Secondly the question that a number of members have raised about the adequacy of our services will have been identified and tested as well. So to those members who have spoken I thank them for their support and for their questions. Although this is a bit like the tortoise and the hare the tortoise is going to win eventually but just not tonight. Thank you.The question was put that the following amendment in the name of the Hon Peter Dunne to clause 11 be agreed to:in subclause (1) delete "that".Amendment agreed to.Part 1 as amended agreed to.Part 2 agreed to.Part 3 agreed to.Schedule 1 agreed to.Schedule 2 agreed to.Clause 1 agreed to.Clause 2 agreed to.Bill to be reported with amendment presently."