Dyson RuthHon RUTH DYSON (Labour—Port Hills): Can I join the Minister who has just resumed her seat Nicky Wagner in welcoming this bill. It is long overdue as she mentioned and I am pleased to be able to support it on behalf of Labour.It is a really difficult balancing act and I want to commend the Health Committee for what appears to be very strong consideration of that balancing act. You need a very high threshold for compulsory assessment and you have to balance that with the rights of patients even though those patients might not be in a fit state to make decisions on their own behalf. It appears from the report and the comments from the submitters that the select committee took that process really seriously and I think that is to be commended.I also want to acknowledge the Minister who is responsible for bringing the bill to the House the Hon Peter Dunne. He has clearly done a lot of work on this. The legislation that it is replacing is over 50 years old and in a sector as fast moving as the health sector it clearly indicates the need but it also indicates a much more modern approach to compulsion within the health sector and also to treatment for addiction.As I said the threshold for this legislation to be triggered so that somebody is detained and compulsorily treated needs to be really high. The person has to have a very serious addiction and they have to be in an unfit state to make a decision for themselves. So that is a pretty high threshold.So although supporting this bill I also want to reflect the concerns that Labour has and also that were reflected in the submissions that were made. They are about the imposition of this number of additional patients on a system that is already clearly stressed. We have heard the tragic stories about the pressures that people with mental illness are facing because they are not able to get the treatment that they need. I do not think that we have seen this sort of situation in New Zealand in the mental health services since the 1990s. I really urge the Minister Jonathan Coleman and his Associate Ministers to not let our mental health services get once again to the point of tragedy before they say: We need additional resourcing in this sector." That is what happened in the 1990s. We had some terrible cases where people who were mentally unwell took other people's lives because they could not get the help they needed. Do not let that happen again in our country. We do not need to let it happen and we should not let it happen.In a severely overstretched system let us not just impose a greater load without recognising that somewhere in that system there will have to be some give. We are putting a significant number of new patients into the system under this compulsory treatment regime. Where are the other patients going to fall out? I do not think it is good enough that we are layering on more work without layering on the additional resources at the same time. The Ministry of Health estimated that we might get 60 to 70 new patients under this regime but it could be as high as 200. In a country the size of New Zealand that is actually a significant new imposition. Of course we should do everything that we can to offer the people who need this support and treatment access to those services but it should not be at the cost of other people trying to access health services. That is a basic fairness: if you are going to add in additional responsibilities you have to put in additional resources.At the Health Committee we had staff from district health boards expressing their concern. That is not a common occurrence. Most public servants do not make a submission and then speak up about an issue that they are involved with in the workforce; they tend to just maintain a silence and cop the flak. But in this case they were so concerned about it that they felt they had to raise their voices. I do not have confidence that the current Government understands the situation or that it is prepared to back the Ministry of Health and the district health boards with the extra resources they need. But I really implore it to think about the situations that we have had in New Zealand in the past and for members of the Government to take their responsibility so seriously and ensure that that does not happen again.The other concern that was again raised by submitters and that Labour shares is the concern that was raised by the Office of the Ombudsmen—the potential for this legislation to be breaching the United Nations Convention on the Rights of Persons with Disabilities. As the Minister at the time who was responsible for New Zealand signing up to that convention I would be the last one to want us to be passing legislation that breached it.As I said at the beginning I think there is a careful balancing act to go through a very high threshold before the criteria for compulsory treatment are triggered; balancing those with the rights of the individual person who needs these services. So that is the balancing act. If the balance is not right then we could as a nation be in breach of that United Nations convention. So we have supported a review within 6 months of this legislation coming into force so that all aspects of its operation can be considered but in particular whether or not there is a breach of that convention. If there is I would imagine that the whole of Parliament would want to rebalance the criteria to make sure that we still provide that opportunity for compulsory treatment for the people who actually are not able to determine that they need treatment and therefore access it but make sure that we do not breach the United Nations convention.I just want to conclude my comments on this bill by talking a little more broadly about the mental health services in New Zealand. I remember being hugely impressed with the Rt Hon Jenny Shipley and the Rt Hon Helen Clark—she was not "Rt Hon" at the time but of course is now. They had what seemed to me to be a very mature agreement—which may have been reached behind closed doors certainly not in the full glare of Parliament—to really take mental health patients out of being the political football that they had been previously. I had heard debates in this House about behaviour of people with mental illness that did nothing at all to improve our attitude towards people with mental illness let alone improve support for them and their families and access to services. It was the leadership of Jenny Shipley and Helen Clark that changed that in this Parliament and that should be a gold star beside both their names for ever.We then of course had the mental health campaign and more recently we have had people like John Kirwan speaking out about depression. New Zealanders as a result of that have changed their attitudes towards mental health and towards people with mental illness. We are one of the most mature countries in the world except for the Scandinavian countries in this regard and I think that is something we should be really proud of.So we must not take this step lightly. We must not fall back into the pre-1990s days when mental health funding mental health resourcing and our attitudes to mental health were something that were really swept under the carpet and nobody talked about them. We must not revert to those very dark days because it makes having a hard illness a lot harder and we should not be doing that. We should be making it easier for people to say "I've got a mental illness." to get the support they need to have the support for their families and obviously to get the treatment.It is outlined in the bill in very good terms. It talks about protecting people from harm. It talks about facilitating their assessment. It talks about stabilising their health. It talks about protecting and enhancing their mana and dignity and restoring their capacity to make informed decisions. They are the sorts of goals and ambitions that as a Parliament I think we should all be very proud of and we should be very proud of supporting. That is what we should want for every member of New Zealand society and particularly those people who because of their illness are not in a position to make decisions for themselves.So I think we have got the balance of this legislation right through the good work of the Health Committee who paid attention to submitters and advisers. It seems they worked pretty collaboratively together and as a result we have got something that should enhance people's opportunities in their lives to get better and contribute in society. It needs funding and it needs reviewing to make sure that we have got that balance right but I certainly commend its progress to the House."