Pallett Sarah; Rurawhe AdrianSARAH PALLETT (Labour—Ilam): Thank you Mr Speaker. It's an absolute pleasure to rise to speak in favour of this bill. Many of my colleagues across the House have spoken about the importance of this screening programme and of the improvements that are being made but I'd just like to refer back to my colleague the Hon Dr Ayesha Verrall when she was referencing the origins of this particular screening programme and referring back to the Cartwright inquiry. I'd just like to add my voice to hers in gratitude for the work of Sandra Coney Phillida Bunkle and of course Dame Silvia Cartwright. When I was studying midwifery was the first time I came across the Cartwright inquiry and it's deeply shocking to hear what happened for the first time to the women in this country and also to acknowledge that it happened against the current medical practice at the time. Unfortunately obstetrics and gynaecology and maternity care historically have some dark areas and that's one of them. Another area of darkness would be the development of the Sims' speculum that was done on the obviously unconsenting enslaved people. So there's an awful lot of work and an awful lot of history that we have before us.You'll understand when you hear about the Cartwright inquiry and of the experimentation that took place without the consent of the women involved that this has generated in me a lifelong commitment to informed consent and also to advocate for the best possible provision for all but for women in particular. In saying that I'd also like to acknowledge the words of my Green Party colleague on the Health Committee Dr Kerekere who was speaking of the importance of inclusive language. It is really important. Though I would acknowledge that the majority of people who are affected by this bill would probably define themselves as women; obviously not everybody with a cervix and vagina would do so. It's really important that we do use inclusive language when we're referring to these screening programmes.So we've established that 160 women a year so far develop cervical cancer and 50 of those will die from it. As my other colleague said earlier this is just a tragedy. We obviously want to do everything we can to ensure that those numbers are reduced and that cervical cancer if it exists is detected early. We're changing one of the words in this bill so we're actually referring not just to the cervix but also to the vagina because the programme screens for vaginal cancer as well as that of the cervix. So I would acknowledge too the women and other people who experience vaginal cancer and acknowledge the importance of diagnosing that early too. The National Cervical Screening Programme has reduced the incidence and death by cervical cancer by half since 1990 which is an extraordinary achievement. We still have more to do; unfortunately only 61 percent of eligible wāhine Māori have been accessing the programme and we have explored the reasons for that which of course backs up the rationale behind this bill.I'm obviously delighted that Budget 2021 has put up to $53 million into implementing a new test for human papillomavirus because this causes 99 percent of our cervical cancers. What we're moving towards in two years' time is a simple and quick swab that people can choose to do for themselves. As we said before we're moving away from the language of smearing" because what we're doing currently isn't smearing those cells on to the slide ourselves but actually using a soft brush to get some cells from the cervix and then put them into a medium before they're looked at under a microscope.To make the changes that we're hoping to make we do need new legislation. The key amendment addresses how we're going to do it and for what purpose. What we're going to be doing is improving services that are provided by health practitioners and what we're going to be doing is to enable them to access the records of participants in the screening programme more easily. At the moment and certainly historically we have had to do that via fax. My colleague Toni Severin was talking about being old enough to remember faxes. Well I'm not just old enough to remember faxes; we've actually been using them in the health service for a very long time and it's good to see us moving forward. They're horribly unreliable and it's really not the best way for us to be transmitting health information. So what we're going to be doing is allowing health practitioners who are providing cervical screening to be able to access this information and I'm looking forward to us being able to do so in a more effective way.Some people have concerns when they're looking at a direct access computer-based system around privacy and that's a completely legitimate concern and one that we have had to address obviously consistently moving forward from this bill. So just to reassure people we are looking at only a read-only look-up access so the people who are entitled to look at this information are not by and large going to be able to change it. It's going to be very secure access with a secure user name and password and everybody that's moving forward into being able to access information will also be subject to the Privacy Act 1993 and of course their relevant health professional regulatory constraints and employment and contract laws. All of their use will be subject to audit which is something that we are as health practitioners really aware of as existing currently. It's important to know that just because you are a health practitioner and providing that cervical screening yourself doesn't necessarily mean that you have access to the information for anybody that isn't one of your patients or somebody you're providing care for. And it has to be in relation to the provision of that care. There's very strictly defined access and there is going to be obviously a consistent application of disciplinary processes if those are breached.One of the other smaller changes that we're looking at in this piece of legislation: as I said we're going to be referring to the vagina as well as the cervix because of the vaginal cancer risk but we're also using a wider definition of "screening test" rather than "smear" as I explained a little earlier. I think that we can all agree across the House that this bill is an important piece of legislation and it's really reassuring to see the agreement that I have seen and heard from all of my colleagues on all sides of the House. I would like to commend this bill wholeheartedly to the House. Thank you Mr Speaker.DEPUTY SPEAKER: This is a split call. I call Harete Hipango—five minutes."