Nash StuartSTUART NASH (Labour—Napier): Let us start with the assumption here which I think this bill works under and it is that donating our organs is a good thing—OK? It gives quality of life to people who have not got it or better still it actually saves lives. So when I look at clause 9 in this I wonder why this is limited only to people whose surgery is carried out in New Zealand. I am talking about paragraphs (b) and (c) of clause 9(1) where the qualification is that the surgery must be carried out in New Zealand and the recipient of the organ is eligible to receive services funded under the New Zealand Public Health and Disability Act". The reason I ask this is that medical science is advancing at a great rate of knots. It is one of the areas where a significant amount of money is being invested around the world but more so in other countries. I would have thought that if we started with the premise that saving lives or giving quality of life is the overriding premise—if in fact a person is better served or the country is better served or our community is better served by the donor and the donee going across and having the surgery in Australia or America or Israel or anywhere else around the world and that is going to actually create a benefit over and above the cost then why would we not make provision for the donor to actually have compensation no matter where this is undertaken? Keep in mind that this is not talking about the payment for the surgery itself; it is talking only about the compensation to the donor. So my question to Mr Bishop the member in the chair is this: why limit this to New Zealand? One of the unintended consequences here may be that as a result of this bill a number of people decide they can now afford to do this because previously they could not see a way forward even though they wanted to do it. An unintended consequence is that in fact the number of surgeries required to meet the demand reaches a point where the waiting list is such that it does not meet that overriding objective of saving lives. I would have thought that in order to overcome this what we should do is say that no matter where that transplant takes place the donor is going to be compensated. So do not just limit it to New Zealand because what we do know is that the New Zealand health system actually under certain circumstances for example sends patients to Australia. It certainly used to. My question is that if advances in medical technology are occurring at a great rate of knots in other countries where the surgery could be expedited and lives saved and the overriding outcome or objective of this bill met then why do we not open this up to every country? Why do we not say that no matter where the donor goes to have the surgery or the donor and the donee go to have the surgery we are going to pay compensation? If that means that the donor and the donee have to come up with $50000 to go across to America to have the surgery then so be it. But I do not think that it should be limited purely to New Zealand because I think the unintended consequences of this may be that the overriding purpose of the Act is actually denied which is to save lives and to increase quality of life. There may well be a rationale for this that I have just completely overlooked but I have looked through the reports I have looked through the regulatory impact statement I have looked through the debate pack and I cannot see any reason why this must be in New Zealand. Whether this is an oversight or whether we think we are actually doing the New Zealand medical industry or our surgeons a service or not I am not sure. Ideally of course this takes place in New Zealand. Of course that is the ideal because we know that the costs to both parties or any parties of heading overseas are going to be high. I just think that what we need to do is remove the words "carried out in New Zealand" from clause 9 and just say that we are going to compensate the donor no matter where this is undertaken. Or if you really wanted to tighten it up you would name a list of countries that we think have an acceptable health service."