Craig LizDr LIZ CRAIG (Labour): Thank you Madam Deputy Speaker. It's an absolute privilege to speak to the first reading of this bill. I think that while on the surface what this bill seems to be about is just technical amendments to Part 4A of the Health Act which governs how we access data from the cervical screening register it's actually also about trust. It's about that trust that women place in our health system when they turn up for their screening and what they're expecting is the best possible care.What they're also expecting is that if they do have an abnormality that that abnormality will be picked up and it will be treated in a timely manner. I think the problem is unfortunately for many women in our country in times past this hasn't always been the case. Our current screening system is actually informed by two previous historic inquiries. The first of those inquiries many of us know was into the unfortunate experiment that happened at National Women's Hospital and the Cartwright inquiry in 1988. But then secondly there was a more recent review of under-reporting of cervical cancer and cervical anomalies coming out of Gisborne. Both of those have completely informed how we manage our current cervical screening programme.So what I want to do briefly today is just go through—DEPUTY SPEAKER: I'm sorry to interrupt the member. Can I just ask the people in the gallery to respect the fact that the business of the House is continuing. I know you're all taking your seats but the member is trying to speak.Dr LIZ CRAIG: Thank you. What I want to do just briefly today is talk about the origins of our current screening programme and then take you through what this bill intends to do to improve it. I think the first thing to remember is that in New Zealand about 160 women every year develop cervical cancer—and 60 women die. What we also see is really large inequalities. Rates are much much higher for Māori and Pacific women than for European women.But what we also know is that cervical cancer usually develops very very slowly and so often you've got many years where you've got anomalies that can be detected by cervical screening. So what we can do is we can pick those up early and we can go in and treat women so that in most cases the cancer doesn't develop and they get a total cure. But to do that what we've got to do is we've got to screen early and often. What the current recommendations are is that for women who have ever been sexually active they start their screening at 20 years of age and they go right through with three-yearly smears right up until when they turn 70. If they've had any previous abnormal smears then they have those much much more frequently than that.But those recommendations haven't always been so clear and this is where we look back to the Cartwright inquiry back in 1988. What happened back then was there was a paper published in a medical journal and it talked about an experiment that was run out of National Women's Hospital where some doctors of the day contested the idea that cervical anomalies progressed to invasive cervical cancer. So they followed through a group of women to see what would happen and that experiment was conducted largely without the consent—DEPUTY SPEAKER: Would the member please address the bill.Dr LIZ CRAIG: —the bill?—DEPUTY SPEAKER: The bill.Dr LIZ CRAIG: —yep—or the understanding of what was happening. So as a result the recommendations coming out of that inquiry led to the establishment of our modern cervical screening register in 1990 and that register's aim now is to reduce these incidents of invasive cancer by running a high-quality screening programme.What we're going to be looking at today is the changes that this bill will make and what they relate to is the information held in the cervical screening register. The problem we've got at the moment is that the legislation was originally put in place back in the 1990s and it's very restrictive in terms of who can access information held on the register largely because we didn't have the modern IT systems that we have today.What it says at the moment is for example smear takers in primary care still need to have that information faxed to them if they're wanting to look up cases on individual women. If colposcopists and laboratory staff want to access information they have to get the direct authorisation of the Director-General of Health. The reason for faxing is because emailing isn't considered to be a secure form of communication. I think the problem of having an open-office environment where you've got bits of paper rolling off a fax machine—I'm not 100 percent convinced that that's a more secure way of communication but that's what has to happen at the moment. This is where this bill comes in.What the bill directs is that smear takers colposcopists and laboratory staff can have direct access to look up the cervical register so that they can have that direct access to the screening information. There would also be access granted to those that are directed by the Ministry of Health and district health boards to follow up women who are not responding to their recall notices. And so being able to have access to that information on hand so that they can know when the woman last had her smear and what the smear history was is very important for those conversations.All the protections that currently exist in terms of those who can access the register in terms of being granted access provisions being prohibited from revealing data on individual women—all those privacy protections—are still in place around the bill. So what that means is we're expanding access which will greatly enhance the efficiency of the way that the register operates but at the same time the privacy protections are still in place as is the ability to do evaluations using registered data. It also has that information being available to researchers so that we can identify who's not turning up and being screened and how we can follow those women up.So in summary the bill brings the practice of cervical screening into the 21st century by granting direct lookup access to many more people on that screening continuum but it also protects the privacy and the direct access of that data. I therefore commend this bill to the House. Thank you.