Reti ShaneHEALTH (NATIONAL CERVICAL SCREENING PROGRAMME) AMENDMENT BILLFirst ReadingDebate resumed.Dr SHANE RETI (National—Whangarei): Thank you Madam Deputy Speaker. It's a pleasure to rise and speak on behalf of this bill and to speak in support of this bill which effectively makes cervical screening and the register a better tool. Why does it do that? How does it that? It allows cervical smear takers to eventually take up electronic look-up and to access the cervical-screening register. Why is that important? Well I think it's important if you can understand the workflow of what happens when you take a smear.I think what's important here—Minister Genter when she first introduced it said that the cervical-screening history was most important so that you didn't over-screen. I want to contest that—that's not actually the most important reason. When a woman comes in for a smear you want to know their cervical history beforehand not so you don't over-screen them but because it changes the way you do the smear.Now most of the time you'd use a spatula which is like a little sort of iceblock stick if you like but if a person has had an abnormal smear history you actually are going to change it. You might still use a spatula but you're actually going to also use a brush which is sort of like a little toothbrush if you like because—sorry to be so anatomical here but it's important to note that the real part of the history it changes what you do. It gives you a more effective result if you know that something was amiss.Furthermore when you're doing what you're doing sometimes you don't see what you expect to see and you think Oh goodness this isn't so good. I need to do something urgent."—for example if there's scarring—but if you know from their history that they've had a colposcopy it's totally explainable. That's why they've got scarring and you can proceed as normal. So I think it's very important to know that the reason that we want the cervical history is because it changes what you do in the moment.OK so how do you go about getting that history at the moment? Well you call the local District Health Board (DHB) coordinator and he or she then calls the coordinator and they look it up. I understand as I've been speaking with them over the past few days they're happy if you're authenticated to give you a verbal result. That's a good thing—one can proceed. If not what they'll then do is fax it to you as was mentioned. It's been explained to me that sometimes a cervical smear history can be 20 pages long and they're doing dozens of these a day. You can see the cumbersome sort of process that this entails. When I spoke to the registry coordinator here in Wellington she said that this is a common occurrence across a number of DHB cervical smear coordinators—so clear efficiency gains here.What's broken in the current Act? Section 112J is what's broken. It wasn't clear around disclosure in the Act when it was first created. This new legislation meets current privacy codes it meets the Privacy Act 1993—more specifically it deals to access it deals to use and retention and it also deals to disclosure.Now when we pass this bill as has been noted efficiency will improve but the real efficiency is getting the electronic look-up for a smear taker—to be able to go straight there without going through coordinators. Now there are some problems associated with that at the moment because the cervical smear register is an old register. It was actually formed in 1990 and if we go back as to why as has already been mentioned it comes out of the Cartwright inquiry of 1988 and the screening register was established in 1990. Why is that relevant? It is relevant because you can't do look-up today because it's old technology. From your GP desk you can't do direct look-up into the cervical-screening register. Now from what I understand the hope is that the bowel-screening engine—the platform to that—is actually going to have the cervical-screening register embedded into it so you will be able to do direct look-up and then I think we'll have the maximum efficiencies that this Act is entailing.So it's a good Act. I'm very pleased to support it. I think our colleagues who are smear takers will be very pleased with the efficiencies that this entails. It is primarily procedural. It's not clear to me why it's not in an omnibus bill but maybe the Government can speak to that. Either way it is a good piece of legislation and I commend it to the House."