Craig LizDr LIZ CRAIG (Labour): Talofa lava Madam Speaker. Since the National Cervical Screening Programme started the number of people who have died from cervical cancer has dropped by nearly two-thirds and that's incredibly good news. But the issue we've got is that inequalities still remain and so we've got much higher rates for Māori and Pacific women and that's something that we really need to focus on moving forward in terms of reducing those inequalities. The good news though is that cervical cancer usually develops slowly and so it means that those pre-cancerous changes can get picked up by cervical screening allowing for early treatment and in most cases a cure. But what needs to happen for that to occur is that you need to start screening early and so the current recommendation is that if you're between 25 and 69 years old you've got a cervix and you've ever been sexually active then you should be having a cervical smear every three years—or even more often if you've had an abnormal smear. What this bill does is it makes some changes to the current screening programme so that we can actually modernise it and make it more effective and what I'd like to do tonight is just focus on two of those aspects. The first one of them is looking at how we improve access to the cervical screening register because as we've heard tonight at the moment what we've got is we've got a register that holds the information on women on the screening programme but it's unduly restrictive and so what needs to happen is that people request information. So if you're a smear-taker working out in primary care you have to request that information and then wait for a fax. I'm not even sure that many places still have faxes but apparently that's how it still happens at the moment. So clearly this needs to be sorted out. The other issues are that if you're laboratory or colposcopy staff you still need the Director-General of Health to have approval. And so what this bill will do is it will make changes so smear-takers in primary care colposcopy and laboratory staff will be able to have look-up access read-only access to the register. And so what they can do is then access that information for authorised purposes about those that they are screening. But also a number of district health boards the Ministry of Health employ people to follow up on people who have been late for their smears and this is where we are trying to make sure that we reduce inequities and inequalities in screening rates. So being able to contact people and invite them and remind them about their smear and so having access and improved access to that because a lot of this work happens in the evenings—and so again anything that's there to reduce inequities will make a huge difference.So one of the main things this bill does is just modernise the whole approach. We're not relying on faxes. We've got look-up access but it still protects all of those privacy provisions and makes sure that it's only for authorised purposes—that's closely monitored—and also making sure that no information is disclosed about identifiable individuals so those protections remain.One of the other aspects though we looked at in select committee is widening the definition because cervical smear" is relatively old terminology. And what we changed in select committee—there was a recommendation to expand the definition to include high-risk HPV tests and also cervical and vaginal cytology tests just to reflect more up-to-date approaches to screening. So what that does is it clears the way for human papillomavirus—HPV—testing which is thought to cause about 99 percent of cervical cancers the HPV virus. As has been mentioned tonight the Government invested $53 million in Budget 2021 to enable HPV testing to replace the current smear test. And what we're looking at is a start date about mid-2023. What we'll do then is we'll change over to HPV testing as the main way of cervical screening. What women will experience is quite an improvement because instead of the traditional smear test which requires a health professional to take the smear and a range of associated equipment women will be able to self-test with a vaginal swab and basically do that privately themselves. The expectation initially is that they will still come to a healthcare provider for that screen. But what that saves is a lot of healthcare professionals' time and equipment and also for the woman a much better experience. And then once women have had their test if they have a negative HPV test they can be reasonably reassured that in the next five years they would be unlikely to develop any of those precancerous changes. And so what that means is they would only need to be screened once every five years instead of once every three. But they can still if they've got any concerns consult their healthcare provider in the meantime. Then the Ministry of Health is looking at: can we even make that much easier in future? Possible options would include mailing out self-test kits if they're found to be safe and effective for women. So what this bill does by changing the definition is allowing some of these changes to occur. So this is an important bill and what it will do is improve the cervical-screening programme. It'll reduce inequalities and it will save lives. I commend this bill to the House."