Coleman Jonathan: Health (Protection) Amendment Bill — Second ReadingText is incorporated into the Bound VolumeColeman Jonathan: Health (Protection) Amendment Bill — Second Reading[Sitting date: 27 May 2015. Volume:705;Page:4073. Text is incorporated into the Bound Volume.]Hon Dr JONATHAN COLEMAN (Minister of Health): I move That the Health (Protection) Amendment Bill be now read a second time. I would like to thank the Health Committee for its work on this bill. The committee received 71 submissions and heard 22 oral submissions.Of course good health is hugely important to New Zealanders. I think when you look at it it would be the No. 1 priority for people across the nation. That is why I am very pleased that this bill supports the Government’s unwavering commitment to good public health as reflected in the recent Budget whereby health received over $400 million of new funding. Of course there were a number of excellent new initiatives there that are supporting working families in New Zealand in terms of their health. But it was a health Budget for all New Zealanders.Anyway this particular bill will amend the Health Act 1956. Back in October 2013 the Government decided to improve the range of measures in the Health Act in two specific areas: measures to protect the public from the risk of the spread of some infectious diseases and in the case of people under 18 years of age measures to protect them from the harm associated with artificial UV tanning. The bill will protect people from these preventable harms and it will do so through measures that are proportionate to the risks that are faced.Unfortunately New Zealand has very high levels of sexually transmitted diseases. This impacts heavily on individuals families relationships and communities. Sexually transmitted infections have a variety of complications including chronic pain infertility neonatal morbidity and genital-tract cancer. The bill adds new provisions for the surveillance and management of infectious diseases. These measures will improve the availability of information on certain conditions provide for more effective management of behaviours that put others at risk of infection and strengthen legislative provisions for contact tracing. The bill strengthens the principles applying to medical officers of health and the courts in exercising disease management powers. People exercising powers will be required to take into account any known special circumstances or vulnerabilities of the individual. These might be due to youth disability incapacity or other circumstances.The bill also requires that measures are proportionate to the public health risk that they pose. The principles also encourage individuals to take responsibility for their own health. Currently sexually transmitted infectious diseases with the exception of AIDS are not notifiable by medical practitioners and laboratories in New Zealand. The bill makes HIV gonorrhoea and syphilis notifiable on a non-identified basis along with AIDS. The notifying information needs to be sufficient to enable different kinds of public health interventions while complying with privacy safeguards. Submitters said that clause 5 and clause 6 went too far in restricting effective monitoring of serious sexually transmitted infections in favour of privacy. This is because the list of identifying information that should not be disclosed with disease notifications included sex date of birth and National Health Index number. The reported-back bill requires notification of these matters while protecting the individual’s identity from being disclosed in the first instance.Submitters were also concerned about potentially coercive actions by officers such as contacting a young person’s employer or school and asking for details about friends and associates. Reluctance to disclose information or to be diagnosed or treated could arise from fear of the consequences as a result. However that information may be absolutely vital in identifying those who may be at risk and to prevent the further spread of disease. The bill says that information requested and provided under new Part 3A will not be used or disclosed for any purpose other than the management of infectious diseases. Contact tracing is a valuable public health tool in preventing and managing infectious disease outbreaks particularly diseases with a rapid onset such as meningococcal disease and gonorrhoea. New Subpart 5 extends contact tracing powers to contacts of people suspected of having an infectious disease and that is an important change. That will allow for speedy follow-up diagnosis treatment and containment.It is important that contact tracers are trained and are suitably qualified health or community work practitioners and the bill has been changed to require that. It clarifies the interface between appointed formal contact tracers and informal contact tracers. The latter might be general practitioners sexual health clinic staff or organisations like the New Zealand AIDS Foundation. The bill will not regulate their largely voluntary contact tracing practices unless they are nominees of district health board employees or a medical officer of health.The committee was clear that existing venereal disease legislation is badly in need of an update. The current definition of “venereal disease” is not fit for modern conditions. For example it does not include HIV AIDS or chlamydia. Other outdated provisions the bill will repeal include section 79 of the Health Act. That authorises a medical officer of health to detain and isolate people likely to cause the spread of infectious disease. New Part 3A effectively replaces section 79 with graduated powers of increasing robustness when an individual is not complying with management aimed at preventing the spread of further infection.Part 2 of the bill prohibits the commercial provision of artificial ultraviolet light or UV tanning services for people under the age of 18. The Health Committee reported back that it is satisfied that the bill will protect the vulnerable under-18 age group while allowing adults to make informed decisions. That is comparable to other legislation such as legislation on the sale and use of alcohol which recognises that 18 is an age where people are capable of making their own choices.Clause 8 and clause 13 include several new provisions. These provide an infringement process to deal with breaches of the ban on providing artificial UV tanning services to people under the age of 18. This process would deal efficiently with offences and prevent expensive and time-consuming criminal prosecutions. Voluntary standards and guidelines on the operation of UV tanning beds already exist. However surveys have found consistently that there is variable compliance with those voluntary steps designed to minimise harm despite considerable effort to educate operators and to encourage compliance. I have therefore asked health officials to look into whether the licensing of premises and operators and the introduction of mandatory standards are appropriate.This bill is going to improve the protections we have for the health of New Zealanders. It is an important part of our legislative framework for managing and reducing health risks. I commend this bill to the House.