Roy Heather: Intellectual Disability (Compulsory Care and rehabilitation) Bill — In Committee Third Reading 
Roy Heather: Intellectual Disability (Compulsory Care and rehabilitation) Bill — In Committee Third Reading 
[Volume:612;Page:9597] 
HEATHER ROY (ACT) 
: 
 ACT New Zealand will be supporting this bill. It is necessary to address a legislative gap that has existed for the intellectually disabled in need of compulsory care since the Mental Health (Compulsory Assessment and Treatment) Act of 1992 was instituted. This gap has seen the inappropriate placement of some of those with an intellectual disability in mental health services discharged into the community when this is clearly inappropriate for both the person involved and the community but worst of all of course is their placement in prisons. Prison is no place for those who need compulsory care but have not committed a crime or have valid considerations when these are taken into consideration. 
This bill allows for the requirement of the intellectually disabled to accept care programmes when compulsory care is necessary. We heard quite a lot in the Committee stage about Barry Ryder. He is a very good example of exactly why this bill is necessary. Barry Ryder was sent to prison and was let out as the law stipulated he should be—only to reoffend again. That happened despite the fact that Neil Pugmire breached his position with regard to privacy issues by warning that Barry Ryder would reoffend again and that that course of action was completely inappropriate. Had this legislation been in place when Barry Ryder was first sentenced the consequences the lives that have been ruined as a result of his further reoffending may well not have come to fruition. So ACT New Zealand will be supporting this bill but I would like to state for the record the concerns we have about it and they are several. 
Our first concern relates to the insertion of the word “rehabilitation” into the title. We are not opposed to rehabilitation and certainly the intellectually disabled should have the same right and access to treatment that all other citizens in the country enjoy. However “rehabilitation” needs to be defined for the purposes of the bill and despite my repeated requests to the Minister for a definition this matter has not been addressed. I would have liked to see the Health Committee at least attempt to define “rehabilitation”. I suspect in this case that it really meant behaviour modification and it would have been good to have had that pointed out. The problem with talking about rehabilitation both within the bill and inserting the word “rehabilitation” into the title is that it raises the expectations particularly of the families or the caregivers or guardians of the intellectually disabled and sometimes of the patients themselves. It also places an added burden on the workforce—the health professionals who are responsible for these patients—and I think it is an unrealistic one. Rehabilitation in its broader sense means we are able to cure people but of course there is no cure for intellectual disability and that is something that should be remembered. It is very important that terms like these are defined when we are talking about very specific things in legislation. 
The second concern is the change in the Supplementary Order Paper of the definition “intellectual disability”. I was not on the Health Committee but we are told there was extensive debate about the definition. The select committee spent a lot of time and effort and listened to many opinions about what the definition of “intellectual disability” should be but despite that—and despite coming up with what I thought was a very flexible but realistic definition and one that certainly the medical profession seemed happy with—the Minister in her Supplementary Order Paper went back to the original very narrow definition. I think that will raise problems for clinicians. The third concern relates to the political correctness in this bill and in others. We are very disturbed that political correctness seems to be pervading legislation these days. The term “care recipient” was brought up by several members. They used to be called “patients” and there was nothing wrong with that term. 
Dr Paul Hutchison 
: Quite simple. Everybody understood. 
HEATHER ROY 
: Yes everybody knows what it is. When somebody was receiving care or treatment that person was a patient. That term was later changed to “client” but those people were still receiving treatment so they were still patients. The politically correct title “client” implied that someone was paying for services. Now we have moved on to “care recipient” which does not roll off the tongue. People have to stop and think: “Care recipient—what does that mean?” The word “recipient” is not even part of some people’s vocabulary. Anyway this political correctness is unnecessary and just confuses issues. The law should be simple and clear. In fact terms like “care recipient” do nothing to help in this regard. 
The fourth concern is the cultural references which I also spoke about in the Committee stage. I did attempt to have clause 23 omitted by way of an amendment but unfortunately it was not supported except by my colleagues in the National Party. My question was: why was reference made only to Maori? Perhaps this Government believes it is only Maori who suffer from intellectual disability. That is not the case of course. People from all cultures deserve the same access and same respect when being treated. So quite why Maori have to be constantly singled out is beyond me. 
Darren Hughes 
: Just listen to yourself! 
HEATHER ROY 
: I am listening to myself and if the member wants to take a call he should do so. Good clinical practice incorporates a sympathetic approach to cultural matters and it is a sad day when we put into our legislation clauses about cultural awareness. Such measures are unnecessary—they should happen as a matter of course. If we single out particular ethnic groups a mini-industry builds up around the legislation on those cultural considerations. We have seen this happen in many areas particularly in the health field but not isolated to it. When these things happen an industry builds up. There is a legal requirement on the part of the district health boards whatever areas we are talking about to institute these things and those staff members must be available even when there is not much work for them to do. 
The people working in this field are delighted that this legislation will be passed and that is why I am supporting it despite my very valid concerns. Many of those workers share those concerns with me particularly the cultural ones. It is not acceptable in this day and age to have the intellectually disabled housed in places like prisons and in some of our mental health facilities around the country. They do deserve treatment that is specific to them and caters for their needs. For that reason ACT New Zealand supports this bill.