Rich Katherine: Health (Screening Programmes) Amendment Bill — Second Reading 
Rich Katherine: Health (Screening Programmes) Amendment Bill — Second Reading 
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KATHERINE RICH (National) 
: 
 I take a call in this debate tonight because this is an issue that I would like to know more about. I need to have some of my concerns allayed. There is not a member in the House who would disagree with the fact that what happened in Gisborne was a terrible terrible occurrence and when we look into that case we can see that there were a number of reasons why that case happened. I was surprised for example to hear that Dr Bottrill was not a pathologist in today’s terms. He was someone who was grandfathered into the role. It is clearly one of those medical tragedies that concerned all New Zealanders and it has certainly been a huge story over the last couple of years but I am concerned that this may be overkill for a problem that cannot necessarily be resolved by this legislation. 
The concern I have is that women who have been on the screening programme for many many years—I myself have been on the programme for the last 10 years—may be put in a position whereby they feel that they have to opt out because they do not want their medical files—the files held by their general practitioners—perused by people they do not know. I want to hear more from the Minister on that and I will speak further with David Skegg in Dunedin because I am unsure about the implications of allowing general practitioners’ files to be seen by people whom those women might not necessarily know. The relationship with the general practitioner is a very special one. I know as many women in this House know that sometimes we can have conversations with our general practitioner that might not have even with our own husband or partner. Women have very personal relationships with their general practitioners and they talk about things that get noted down in the notes. It is not the same as talking to a doctor in a hospital. I think we all know that our secondary notes get looked at by all and sundry and therefore we do not have the same sort of intimate relationship. 
I am concerned that my rights to have privacy in my files can be legislated away by this bill. I understand from the Minister that the review of files will relate only to women who have developed cancer and I hope that does not happen to me or to any other woman in this House. But it concerns me that researchers will be able to look through a file. One’s cervical records are not necessarily neatly in one section of the file. Researchers will have to flick though the whole thing. We should remember that a lot of women will have things on their files that they will not want even their own families perhaps to know—things like sexually transmitted diseases a history of sexual abuse terminations depression etc. I know that the Minister has said that those things will be irrelevant to the researchers when they look through files but the issue is that the researchers will still see those things. A lot of women will be concerned that that sort of very private information will be accessed by people they do not know. They know the nurses in their local general practitioner’s practice and they know the general practitioner but they will not know the researcher who looks through their files. The researcher might be a highly regarded person but the women will not necessarily know that so there are worries. 
Of course there will be confidentiality requirements but we are a country of 4 million people. Fifty-two percent of us are women and I am concerned that in a small country those sorts of things may be discussed. The researcher who goes through Helen Clark’s cervical screening results will probably remember a whole range of other things. I would like to think that those sorts of things will never be leaked to the public but we have seen occasions on which that has happened. I want to have my concerns about those sorts of leaks allayed. We must be given the opportunity to say that if we do not want our files to be accessed— 
Mark Peck 
: You’re just making it up. 
KATHERINE RICH 
: Here is a man speaking on this. I do not think he has ever gone to have a cervical screening test so I do not think he is able to crack jokes and sit there smugly. He does not know what it is like to have the concept of somebody looking through his file and looking at things that he might not have told even his wife. These are legitimate concerns. The whole point of parliamentary debate is to bring up these sorts of concerns so that they can be dealt with. 
Mark Peck 
: What about the facts? 
KATHERINE RICH 
: Once again Mark Peck sits over there and talks about an issue that is very personal to women. The cervical screening programme has saved many women’s lives. He does not know the first thing about the sorts of personal issues that we are talking about this evening so he should keep his trap shut and not make any further comment. 
Mark Peck 
: This is turning into grubby politics. 
KATHERINE RICH 
: The member says that this is turning into grubby politics. I say that these are very sensitive issues that a lot of general practitioners have raised with me locally. I wrote to every single general practitioner in the Otago area and I asked them what they thought of the bill. Overwhelmingly they came back to me and said that over their dead bodies would they let anybody come into their practices fossick through files or demand to see their files. The problem I have with this legislation is that a lot of women will opt out. If this legislation is not changed in any dramatic way women like me who have been on the programme for years and who have enjoyed the regular call-ups—from I have to say very dedicated people who try to track women down come hell or high water to get them in for the tests—will not have the benefit of being able to have those regular call-ups because we will not want our files to be perused by people we do not know. 
Jill Pettis 
: Why not? 
KATHERINE RICH 
: We are talking about extremely sensitive issues. If Jill Pettis had had four abortions had been sexually abused and had had deep depression— 
Jill Pettis 
: But I haven’t. 
KATHERINE RICH 
: —would she want all and sundry to go through her file and see what was in it? No. That member says she has not had any of those things. There are some women in this country who have had those sorts of concerns and quite rightly they might not want a researcher—no matter how well regarded that person is—to be able to look in their files. That is why I will be doing a bit more work on this. A lot of women take their relationships with their general practitioners extremely seriously. A lot of women say things to their general practitioners that they would not say even to their own husbands or partners. That special relationship needs to be respected. 
The cervical-screening programme has been a great programme and over many years it has saved lives. I am concerned that the Minister and that party over there are presenting these changes as a salve for problems that relate to one unqualified person and that they are pretending that more deaths will not occur from cervical cancer as a result of these changes. I do not think anybody believes that. I think that the solutions lie more in the area of quality control mechanisms audit processes and making sure that pathologists are the real McCoy. We are talking about legislating away women’s rights to have some privacy when it comes to their files. That party over there can suddenly pretend that it is politically correct to bring these things up but I say that those members should think about the woman who has had a history of sexually transmitted diseases a number of terminations and depression. She might not have told her partner and she does not want a person she does not know going through her file. She does not want someone marching into her general practitioner’s office and having access to something she holds to be deeply private. 
David Benson-Pope 
: Keep your word. 
KATHERINE RICH 
: I find it remarkable that David Benson-Pope is calling out about something as deeply sensitive as cervical screening. [ 
Interruption 
] When was the last time Mr Benson-Pope had a Pap smear? [ 
Interruption 
] 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: For goodness’ sake! It is like a schoolyard. I refer members to Speaker’s ruling 51/5. Both sides should have a look at it. 
KATHERINE RICH 
: We are talking about something that is deeply personal. [ 
Interruption 
] The Labour Party can make light of these sorts of concerns— 
The ASSISTANT SPEAKER (H V Ross Robertson) 
: I ask Mr Peck to desist. He has his first yellow card. 
KATHERINE RICH 
: I am concerned that there will be a lot of women like me who will feel that they are in a position where they will have to opt out of the programme because they do not feel that their files should be accessed by anybody except their own general practitioner and the nurses from that general practitioner’s office. Rather than make light of those concerns the members on the opposite side particularly the males should be sensitive about those issues and work hard to allay those concerns. They are not just my concerns. They are the concerns of a lot of New Zealand women.