Rich Katherine: Injury Prevention Rehabilitation and Compensation Amendment Bill (No 3) — In Committee 
Rich Katherine: Injury Prevention Rehabilitation and Compensation Amendment Bill (No 3) — In Committee 
[Volume:625;Page:20275] 
KATHERINE RICH (National) 
: 
 I am glad to see the real Minister Ruth Dyson in the chair rather than the stunt doubles we saw earlier. I would like to direct some of the questions that I raised earlier in the debate to the Minister. In particular the Opposition was very concerned about the new definition of a treatment injury. We agree on the Opposition side of the Chamber that the definitions that we have had in the past for medical mishap and medical misadventure were unsatisfactory and caused unnecessary administrative delays and anxiety in the community as a result of having to find fault before cover and support were given. However we are unsure that the full implications of the new definition of treatment injuries have been thought through. For example section 33(1)(b) inserted by clause 13 states that treatment includes “a diagnosis of a person’s medical condition”. As we know making a medical diagnosis can be a very difficult process. Although medicine looks as though it is very scientific we know that it is not an exact science that sometimes medics will make mistakes and that some conditions diseases and complaints are not necessarily easy to discern. So we would like the Minister to explain that new part of the definition. 
We would also like the Minister to explain whether section 33(1)(c) which is inserted by clause 13 and states: “a decision on the treatment to be provided (including a decision not to provide treatment):” just includes a doctor not providing treatment or whether it also includes individuals deciding that they do not want to be treated. We have had some high-profile cases in which people have decided that they do not want any kind of treatment and that has resulted in a deterioration of their condition. 
I would also like the Minister to talk about whether she is confident about the costings that the Department of Labour has done on this bill. It has calculated that the costs will increase by $8.69 million annually and that there will be a one-off transitional cost of $12 million. We did not really get into how that was determined. In view of the very extensive change to the definition of what constitutes a treatment injury there was some concern that there could be a blowout of costs because an increasing number of cases will now be able to be covered. We have not had a full discussion—although earlier in the debate a Minister in the chair attempted to explain this I think when I was out of the Chamber—on what happens if a deteriorating condition comes about as a result of being on a hospital waiting list or as a result of somebody simply not being able to get in and be given care in a timely fashion. For example if somebody has breast cancer and has not been able to get on a list to go in for radiation therapy or chemotherapy what happens if that patient’s condition deteriorates? I know that breast cancer is an illness or disease in the first instance. But if things deteriorate as a result of not being able to get treatment does that mean that the district health boards could be in a situation whereby they could be sued or would all of those people be covered? 
There are still some unanswered questions when it comes to the bill and it is important that the Minister take some time to explain some of the changes. We would also like her to explain some aspects of Supplementary Order Paper 365 in her name because some of the clauses look remarkably like some of the clauses in the bill. In fact in the amendment to clause 3 the words are exactly the same although there is a bit of a layout change. That amendment deals with the repealing of the definitions of various categories of health practitioners from acupuncturists to audiologists to chiropractors. I wonder why that clause has been put in the Supplementary Order Paper because there just seems to be a layout change. There does not seem to be anything different in the wording and I wonder whether anything is hidden there. Certainly I cannot discern a change so I would like the Minister to explain that as well as the other matters I have raised. 
Finally I would like the Minister to explain why she thinks there can be no choice in the sector.