Scott Lynda: Health (National Cervical Screening Programme) Amendment Bill — In Committee 
Scott Lynda: Health (National Cervical Screening Programme) Amendment Bill — In Committee 
[Volume:615;Page:11263] 
Dr LYNDA SCOTT (National—Kaikoura) 
: 
 It is with pleasure tonight that I take the first call on the Health (National Cervical Screening Programme) Amendment bill that amends the Health Act which is referred to as the principal Act in the bill. The commencement provisions in Part 1 have been changed. The Act is to come into force on 1 July 2004—that date having been changed from 1 July 2003 which is well past. 
This legislation has been somewhat contentious. Initially the legislation that was to come into force on 1 July 2003 was to be an omnibus bill for health screening programmes although it had been based almost exclusively on the need to have an effective National Cervical Screening Programme. There was a great deal of debate throughout the Health Committee as to whether this bill should apply to all screening programmes or whether it should be specific to the Cervical Screening Programme. The decision of the committee was that it would be specific to the Cervical Screening Programme. Hence there has been a great deal of consultation on this bill and that is why it now comes into force on 1 July 2004. 
However amendments in the Minister’s Supplementary Order Paper state that only new section 112D and section 6 come into force on 1 July. New clauses provide that the Act comes into force 12 months after the date on which it receives the royal assent. That is to allow the appointment of appropriate people to be made under the Act so that they can implement the provisions in the bill. 
If one looks at cervical cancer statistics in this country in 1981 12 women per 100000 developed cervical cancer and five per 100000 would die of it. In 2000 after the screening programme was set up in 1990 to show how effective that programme was the incidence of cervical cancer had gone down and 10.6 women per 100000 now develop cervical cancer in this country and three die. That is a 46 percent reduction in the death rate. It is a very significant reduction in the death rate from a terrible disease that killed too many New Zealand women. With no screening one in 200 women would die. With screening one in 1280 women die. 
That is a huge difference. That is why it is so important for this country to develop screening programmes. But for that to happen an effective measure is needed by which to screen. Screening for cervical cancer is not a really exact science. When one is looking down a slide in a laboratory to find abnormal cells it is a bit like looking for a needle in a haystack. The cell does not jump out and say: “Hey I’m cancer here.” One has to be very skilled. Part of what we have been doing with this programme has been in response to the McGoogan report to the inquiry in Gisborne making changes to cervical-screening programmes so that we can ensure we have a gold standard programme here that will ensure effective delivery at the coalface—where women are screened—in the laboratories and by the clinicians. Then there is the treatment for those women. That is why we need to get this legislation into effect as soon as possible and why its commencement needs to be this year 1 July 2004. 
In 2001 191 women developed invasive cervical cancer and 71 died. We still have more ground to cover. We want to see women on the programme. At the moment 1 million women are on the programme. We want to ensure that those women can have absolute confidence in the National Cervical Screening Programme. We also want to make sure that if this programme is used for other sorts of screening we have a standard that we can apply. Later in the debate we will be talking about the specifics that have delayed this bill to some degree which is why it is now coming into force in 2004 and not 2003 and looking at why the programme changed from “opt-on” to “opt-off”. It became an opt-off programme looking at access to primary-care records. But that is for further debate later in the bill. We know that other screening programmes are being developed in New Zealand for breast cancer and prostate cancer.