Scott Lynda: Intellectual Disability (Compulsory Care and rehabilitation) Bill — In Committee Third Reading 
Scott Lynda: Intellectual Disability (Compulsory Care and rehabilitation) Bill — In Committee Third Reading 
[Volume:612;Page:9588] 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 Clause 29 provides for the assessment of inmates and former special patients. Subclause (1) states: “A superintendent of a prison may apply to the co-ordinator to have an inmate assessed under this subpart if the superintendent has reasonable grounds for believing that the inmate has an intellectual disability.” One of the problems in that is talking about people who have an intellectual disability people who have a mental illness and people who have committed offences. Those situations can all go together: just because somebody has an intellectual disability does not mean that that person cannot have a mental illness and vice versa. 
Sometimes that makes it very difficult to determine the level of care and where that person should most appropriately be placed. Some people end up in prison and it is not really recognised that they have an intellectual disability until they get into that strongly supervised environment. At that point the superintendent can ask for an appropriate assessment of those prisoners so that they can get the appropriate level of care. Until this bill is passed it is not possible to put someone from a prison into an intellectual-disability compulsory-care situation because we need the legislative framework to be able to do that. 
 There has also been concern for those who have been in the Kimberley Centre and Braemar Hospital which were psychopaedic hospitals where a lot of children have been placed who then grew into adults. Having those people placed in the community has been a very slow process because the hard end of the process has been reached—placing those who have very high complex needs and challenging behaviours. 
It is good to see this bill here today because the Health Committee reported it back in April 2001. It could be said that that is only 2½ years but it is a very long time to wait for legislation so that the services can be developed around it and facilities built to care for people with behavioural problems bad enough to land them before the courts or in prison. The Rt Hon Wyatt Creech who was Minister of Health at the time this bill was promoted and during the first stages of its passage through Parliament earmarked $20 million for its development. The Health Funding Authority—which to its detriment this Government merrily scrapped; instead setting up 21 district health boards which are all running over budget and developing 21 different levels of care throughout the country—initiated a service development process that included the development of best-practice indicators for the specialist support of people with high and complex behavioural needs. 
That is what needs to happen. There needs to be specialists who can arrange appropriate assessments for people who are considered to have an intellectual disability and if necessary ensure that the proposed care recipient stays within a facility. If a compulsory-care order is to be imposed there needs to be a determination when an assessment and examination is undertaken that the person has an intellectual disability. Under clause 32 on finishing the assessment of the proposed care recipient the specialist assessor or assessors sends a report of the results through to the courts. 
It is important that we understand the differences between those who actually do the assessments and who the most appropriate people are to do them. If the condition is a mental health one then it should be a psychiatrist because the appropriate level of care for people who have committed offences is an appropriate specialist. There was quite a bit of debate in the select committee about the most appropriate people to do assessments of intellectual disability and psychologists were considered.