Ryall Tony: New Zealand Public Health and Disability Amendment Bill (No 2) — First Reading Second Reading In Committee Third ReadingText is incorporated into the Bound VolumeRyall Tony: New Zealand Public Health and Disability Amendment Bill (No 2) — First Reading Second Reading In Committee Third Reading[Sitting date: 16 May 2013. Volume:690;Page:10198. Text is incorporated into the Bound Volume.]Hon TONY RYALL (Minister of Health): I moveThat the New Zealand Public Health and Disability Amendment Bill (No 2) be now read a third time. I would like to start by thanking the members for their contributions today even those who sought to rewrite history and demonstrated former ministerial amnesia. They all made a contribution. They are all people who I think genuinely want to do something to help those with very high and high needs. I think they may have though struggled during the best of times to give the priority to this issue that they now want to demonstrate they do have.This bill is the Government’s solution to theAtkinson case. It does shift the boundary between family and taxpayer responsibility but it has landed in a fair and reasonable place. Today New Zealand becomes only the third country in the world that will pay a wage to some family members for caring for other family members. Only Sweden and the Netherlands have done so before today. This bill makes it clear that it is the policy of this Government as it was of the former Government that families have primary responsibility for the well-being of each member within their families and the Government should not interfere in that responsibility. The role of the Government is to support family members in their care and support role assisting where families are not able to meet the needs of their loved ones.Society expects that we care for and support our family members society expects parents to support their non-adult children and society expects spouses to care for and support each other. That is because of love affection and responsibility. However the courts inAtkinson have found that it is beyond society’s usual expectations for family members to care for adult family members who are living with lifelong disabilities. So change is needed.This bill allows the Ministry of Health and the district health boards to establish family care policies that allow them to choose on a number of bases how those supports will be provided to adopt policies and to make payments to specified family members. As I have said in this debate it is not the intention of this bill to extend the Government’s responsibilities to support all family members in their caring roles.People will not generally be paid to provide health and disability services to family members. This is particularly so for parents who care for non-adult children and spouses who care for each other. Targeting for those most in need is the fairest approach.In today’s Budget we announced $92 million over 4 years to implement the family carer policy. The ministry will allocate funding to disabled people in high and very high needs situations as assessed. Within the principles articulated here there will be some flexibility within the policy to consider in particular circumstances disabled people who do not meet the eligibility criteria but where payment is clearly desirable. The case that I gave during the first reading was of those who live in very remote rural areas where they are unable to get support.This has been a very complex issue. Ministers have taken considerable legal advice. It is this legally privileged advice that caused so much of the debate and discussion in the House about the regulatory impact statement. In coming to this policy decision the Government has undertaken a very robust consultation process which I outlined in the Committee stage. The Government has also considered very very deliberately a whole range of matters that should have been taken into account when making this decision.We know that other Governments have also considered these matters and chose not to change policy. That is a decision that they will have to defend to New Zealanders. It is also a decision that they will have to defend that they oppose the progress in this bill because this does make New Zealand only the third country in the world to provide for paying for some family members to have a wage to care for others. This does not happen in Australia. This does not happen in Britain. This does not happen in Canada. It does happen in Sweden and in the Netherlands. New Zealand today will become the third country in the world to adopt that position.I think all members of this House do feel and admire the huge contribution that family carers provide throughout our country. They have a huge responsibility and so many of them undertake that responsibility quietly and are accepting of that and willing. Where those families cannot provide that support or need additional support our welfare State provides that support. Not only may the adult disabled child be receiving income support but also the parents receive additional support in terms of home support workers providing support to not only the disabled person but also the parents themselves. The Government does fund carer support and it does fund respite support for those carers. So supports are there.The Government accepts its responsibility. Today we move that balance slightly in accepting that we will pay a wage to those family members assessed as being able to get that in the way that they support their disabled family member in the circumstances outlined in the family carer policies that the ministry and the district health boards will adopt.Can I thank the members of the technical advisory group and the many hundreds of people who made submissions. Can I also thank the many officials who have worked so hard in the development of this policy. I want to thank my ministerial colleagues particularly the Associate Ministers of Health and Mrs Turia in particular for the many hours of work that we have undertaken as we have sought to find a fair and reasonable balance to make sure that we have protected the interests of the person who is being cared for of the families who are doing the caring and of the taxpayers.I think today that this solution lands in a reasonable place a fair place. It certainly is progress. The Government accepts the indications given by the courts about the need to change policy and this bill is about that. I certainly commend this bill to the House. I hope that the many people who will benefit from this will recognise that the Government and indeed the Parliament is acting with the best intentions to balance the interests of so many involved in this matter.