Health (National Cervical Screening Programme) Amendment Bill

I shall take a brief and final call in the Committee stage of this cervical screening programme legislation, because I only want to redress some accusations that were levelled last night at myself and United Future by National member Pansy Wong. If Ms Wong had been a member of the Health Committee she would know that no one on the committee, including myself, ever discussed or suggested punishing women who opt off the programme. Ms Wong’s comments reflect politicking of the kind that leaves most New Zealanders highly disappointed in the parliamentary process.

What I did was attempt to remind the House that, historically, women in New Zealand have a very good track record in working unselfishly for the benefit of others. That commitment to the common good needs to be promoted as part of this bill, because every woman who participates in the programme contributes to its overall success or failure.

For whatever reason, women who opt off the programme are not cut off from access to cervical screening. My concern was, and is, that those opting off need to understand that the programme is the poorer for that choice. United Future believes that the right of women to opt off is essential, but we would like them to make that decision when it is accompanied by all the information about the implications of their choice—implications both for themselves and for others enrolled on the programme. That is all I need to say at this point.

It gives me great pleasure to speak to the title phase of the bill. I note the title has changed from the Health (Screening Programmes) Amendment Bill to the Health (National Cervical Screening Programme) Amendment Bill. In fact, that is a very good change and one that I, along with many other members of the Health Committee, pushed for. Many committee members felt that not all screening programmes could be covered by the bill. They felt it was inappropriate that other screening programmes that might later come to light should be part of this legislation. Rather, they felt those programmes should have their own legislation governing them. The rules and regulations surrounding cervical screening might be, and probably are, very different from those that would be necessary in programmes for prostate screening or breast screening, for example. So the title is a good change and is very much welcomed. ACT New Zealand is supporting the bill in its entirety, and is very supportive of the change of title.

It is very important to remember that screening programmes are a public good. There were many discussions in the select committee, and we spent a long time discussing the privacy issues surrounding screening programmes. I think they have been dealt with and we have reached a consensus. Compromises have been made, but they are necessary ones if we are to save lives with programmes of this nature.

The cervical screening programme costs $35 million of taxpayers’ funding a year. I put in a written question about the programme’s cost to the Minister of Health and that was the response that came back. That is a lot of money, but it is important to remember that many lives are saved with programmes of this nature. Certainly, there is very good international experience and research to support that position.

In New Zealand we have seen significant improvements in the mortality rate relating to cervical cancer—particularly over the last decade, and, in fact, over the last 20 or so years. Although it is difficult to specify just what exactly has brought about that change, it is thought that the National Cervical Screening Programme has had a significant part to play in it.

I really just wanted to take a brief call to address the title, which in this case was changed part way through the process, but for very good reason. ACT takes great pleasure in supporting this bill and we look forward to a further improvement in the mortality rate from cervical cancer in New Zealand, as a result of the very good and cooperative work achieved through the processing of this bill.

I take delight in being able to take another call in the debate on this Health (National Cervical Screening Programme) Amendment Bill. I agree with ACT’s Heather Roy in the sense that, in modern days and in the recent history of Parliament, all political parties seem to agree that the title of a bill should be more specific about, and descriptive of, its contents. To simply call the bill the Health (Screening Programmes) Amendment Bill is not in itself very enlightening, because screening programmes can cover a variety of programmes, whereas this particular amendment bill is addressing the issue of cervical screening.

I reflect also that the previous title, the Health (Screening Programmes) Amendment Bill, did not, for the public who were listening to this debate, throw a lot of light on the bill’s background and the very fine balance that has to be struck in its content. I think the background to the bill was due to the disastrous failure of the screening programme, which led to the Gisborne inquiry. We have learnt how a lack of quality control and auditing in the programme led to disastrous results for the women concerned.

The debate on this bill has not been easy, even though the public may think that, because most political parties agree with the bill, its passage must be a matter of fact. But in the National caucus I certainly know of the deliberation and the consideration by our spokesperson on health, Dr Lynda Scott. She had to go to great lengths to maintain the very sensitive balance of making sure the participation rate in the cervical-screening programme was high enough for the results to be credible while, at the same time, improving that programme by introducing an auditing process whereby women have to submit their primary health records for auditing purposes.

Therefore, I think this bill’s title should at least include words like “audit”, and “halfway consent process”. Why do I say “halfway consent process”? Unfortunately, the Minister of Health and the United Future party rejected an amendment by my very good colleague Dr Lynda Scott, to the effect that, when letters are sent to all the women who participate in the programme, they are given the opportunity to say, whether for personal or very valid reasons, they do not want to submit their medical records for auditing—and they are still allowed to stay on the programme. It was to our great disappointment that the Minister of Health and United Future rejected that amendment. I think it is very punitive to say that women should be excluded because they will not give consent for their medical records to be subject to audit. That is why I think the words “halfway consent” should be included in the title.

None the less, our party will support the passage of this bill, because we believe that an improvement in quality control is necessary to maintain the credibility of the programme. But we certainly want to reserve our position in order to see what impact the introduction of the auditing process has. We want to see whether the participation rate remains high, and whether a quality audit is carried out with integrity so that women participating in the programme can have the belief that their records are being respected. I am delighted to be able to take a call, but I certainly appeal to the Minister in charge of the bill to ensure that in future the title of a bill should be more descriptive of its content.

I move, That the question be now put.

Motion agreed to.

Clause 1 agreed to.

I raise a point of order, Mr Chairperson. The Greens voted against it.

The result has already been declared. I called it, and I heard nothing else.

Bill reported with amendment.