Health (Protection) Amendment Bill

Thank you for the opportunity to speak in the third and final reading of the Health (Protection) Amendment Bill. I want to acknowledge my fellow members of the Health Committee, who tussled our way through this bill. On most aspects of the bill, we were in agreement. A number of measures were discussed; in fact, generally, three areas of measures to further protect the public from risks associated with the spread of infectious diseases of concern to the public health system and with artificial UV tanning. You might well wonder what those things have got in common, but they were put together in the bill.

With regard to protecting the public from the risks associated with infectious diseases, the bill amends the Health Act of 1956. What it does is it improves the tracing of people who may have an infectious disease or have been exposed to one. Why is that important? Because with a number of highly contagious infectious diseases that enter into our population, such as measles, it is very important that health officials, where necessary, have the ability to trace those people who have been infected and those people with whom they have had contact or been exposed to. The bill increases the range of infectious diseases that are notifiable and provides options for the management of individuals with significant infectious diseases whose behaviour puts other people at risk of contracting a disease. Not all people who have been exposed to a disease wish perhaps to have that notified, so there is discretion now. There is the ability to show some pragmatic discretion to maintain people’s sense of privacy and safety but also to make sure that any highly infectious disease they may have been exposed to is not going to be further transmitted through the population.

Finally, just a few words on artificial UV tanning. The Government settled on, and it is proposed in this bill, the age restriction of 18 years and over for people to be able to use UV tanning. Some members of the select committee and other parties wanted to go for a blanket ban. Not so for our Government, and I, in the readings in this Parliament, have cited each time the fact that there are a number of people who use UV tanning salons, or UV tanning beds, to help treat diseases like psoriasis, and they get a benefit. Those people get a benefit out of that type of UV tanning use. We also believe that people should be able to make an informed choice about whether, when they are over the age of 18, they choose to use a sunbed or a tanning device. With that said—and I know I will find disagreement around the House over that one caution only—this is a good bill. It does provide protection for the New Zealand population. I commend it to the House

To refresh my memory of what this bill is about—it seems to have taken a very, very long time to come back. Interestingly, the first part of the bill, which deals with the powers of medical officers of health and modernises that regime, actually drew those sections largely from the Public Health Bill. When I was refreshing my memory about this bill, I noted that in my first reading speech I spoke about the fact that the Public Health Bill was reported back to the House on 26 June 2008, and at the time of the first reading of this bill, the Health (Protection) Amendment Bill, the Public Health Bill stood at No. 34 on the Order Paper—in other words, towards the lower end of the Government’s priorities. Modernising public health legislation was not a priority; and if it was not a priority then, it is even less of a priority now, because the bill has now entirely disappeared from the Order Paper. So the other changes that were intended with the Public Health Bill are now, presumably, lost to this Parliament, at least until there is a change of Government.

Jacqui Dean, in her contribution just now, put her finger on something that has always puzzled me, which is: how did it come to be that these powers of medical officers of health in relation to communicable diseases were placed in the same bill that actually dealt with the regulatory regime that should apply to sunbeds? These two matters actually relate to quite different types of control, and if one were to be regulating sunbeds, there are some other matters that could also be regulated at the same time if one took an objective perspective on controlling some of the risks of non-communicable disease to New Zealanders. One thinks, particularly, of the food environment, for example.

So I have had a very interesting personal experience in my work career that related to the issue of the powers of medical officers of health. When I was the chief executive of the New Zealand Aids Foundation, I had to deal with a couple of situations where we had become aware of a person who had HIV engaging in multiple and frequent behaviours that posed a risk of transmitting that HIV to other people; and no amount of conversation with these two people seemed able to change their behaviour in any way. So, on that occasion, I sought advice from the Ministry of Health, and asked: “What are the measures that the ministry could recommend to me that I could take that would reduce the risk of transmission to other people?”. The ministry took a while to provide some advice, and the advice that it provided in the end was fairly equivocal, but what it amounted to was that there is one power in law that medical officers of health have had since the Health Act, which is one of those very longstanding pieces of legislation. They have pretty sweeping powers that aim to detain people indefinitely, with very little in the way of checks and balances on their human rights, and that is about it—you know, that was the power that was available under New Zealand law.

Since that time, I have been a very strong advocate for modernising that provision, because although that provision might be necessary in the most extreme case, there are many less extreme cases in which some degree of exercise of power by the medical officer of health would seem to be appropriate and necessary, without going to that length and while retaining greater recognition of the human rights and, indeed, civil rights of the individual whose liberty or freedom is in some way being constrained. I had some significant involvement in the drafting of the clauses that appeared in the Public Health Bill, and so it was with some sadness that I saw that bill languishing—and it is with some relief, more than pleasure, that I see this bill finally moving through its third reading and becoming law today.

I want to say a little bit about sunbeds, because the decision made by the Government to retain sunbeds and restrict them just on the basis of age really flies in the face of the evidence that the Health Committee heard, and it is contradictory to conclusions that other Governments have made when faced with the same evidence. The select committee heard some extremely powerful evidence, particularly from Consumer New Zealand. Consumer New Zealand referred to the mystery shopper surveys that it had undertaken with providers of these solaria services. What it was particularly looking for was the extent to which the regulation and the guidance that the Ministry of Health had provided for the industry were actually being relayed to customers of the industry. And the answer was: hardly at all. This was not just a one-off intervention on the part of Consumer New Zealand; in fact, it has held a number of mystery shopper surveys of the industry, and I guess the Government’s position might be supportable if those surveys had showed some kind of progress—perhaps not complete implementation of the regulation by the ministry, and perhaps not perfect education of clients using those services, but at least improving it. It does not.

Despite the best efforts, presumably, of the Ministry of Health, the industry is still not complying with regulation. It is still not providing information to the clients of those services that would enable them to make an informed decision—as Jacqui Dean has just spoken about—about whether or not to use a service that actually poses to them a significant risk of skin cancer. So, in a situation where consumers of a service cannot, in fact, make that judgment for themselves—they simply do not have the information—and the industry refuses to meet its obligation to provide that information, how should a Government respond? Sunbeds offer—in almost all cases, apart from a very small number of medical uses—no actual benefit to their users, and they pose a very substantial risk that the industry is not willing to mitigate. That is a case of market failure. That is a case where a responsible Government would step in to protect its citizens, and this Government should have done that.

I am pleased to rise on behalf of New Zealand First to speak to the third reading of the Health (Protection) Amendment Bill. This bill seeks to amend the Health Act 1956 around infectious diseases, and it will repeal the Tuberculosis Act 1948. New Zealand First supports these provisions of the bill.

However, the provisions to continue to support artificial UV tanning services is where New Zealand First must draw the line. There is nothing more important than the protection of New Zealanders’ health, and there are provisions within this bill that aim to do just that. I have been rather fortunate to sit on the Health Committee on a few occasions, and I can tell you, firsthand, of the hard-working individuals who comprise the select committee. As my colleague Barbara Stewart has said and pointed out, it is a brilliant committee and it works hard to improve the health of all New Zealanders, working constructively towards meeting those needs.

We know that the bill has three main aims pertaining to infectious diseases. Firstly, it is to increase the number of diseases that are notifiable, which will result in improved monitoring. There are incremental options to manage individuals with certain infectious diseases who are at risk of infecting others. And there is improved contact tracing to inform and provide treatment if necessary to those who have, or who may have, been exposed to an infectious disease. New Zealand First supports these aims of this bill.

We are pleased that sexually transmitted infections are being treated more seriously. The infection chlamydia has been added to the list of notifiable diseases, which we view as essential, given it is the most common sexually transmitted disease in New Zealand. Often there are no symptoms or signs of chlamydia, so it is important that sexual partners are contacted so they can receive treatment in a timely manner. We know that if chlamydia is left untreated, it can cause permanent damage, including infertility. New Zealand First supports the Ministry of Health in its continuing effort to improve the communication of these risks to young people and the importance of seeking treatment.

We remain of the opinion that provisions within this bill must be proportionate to the level of the risk to the general public. That said, the provisions pertaining to artificial tanning services are disappointing. The lack of a total ban falls short of what is actually required. New Zealand First knows that this Government is gutless and is running scared at the thought of the outright banning of artificial UV tanning services. Minister Coleman himself knows that fewer New Zealanders are using sunbeds. It is not just the Opposition parties on this side of the House that can see the logic in the outright banning of UV tanning services. The submitters told us to ban it. The Cancer Society told us to ban it. The Medical Council of New Zealand told us to ban it. The World Health Organization advised us to ban it. But this National-led Government, sitting up there in its ivory tower, does not see the real, devastating effects of sunbed use. It has taken a soft approach and decided to age-restrict UV tanning services. That is gutless. That is absolutely gutless.

New Zealand First would like to point out to this National-led Government that skin cancer, melanoma, does not discriminate against age. Unfortunately, we saw this firsthand with the sad passing of Holly Devine at just 26 years of age, on Friday, 17 June—a life ended far too early by melanoma. This is just not an age-related cancer, so it makes no sense that a ban on sunbeds would apply only to those persons under the age of 18. We believe that banning commercial sunbeds would have been a very positive and proactive step to protect the future health of New Zealanders. We know that we have the highest rate of melanoma in the world, along with Australia. Yet, the Government does not seem to regard this as a big enough health issue to implement a ban on a device that is known to cause skin cancer. Overwhelming evidence provided by the World Health Organization shows that UV tanning devices are carcinogenic. That should have been enough to lead this Government to ban sunbeds completely. The Ministry of Health tells us that from 2009 to 2013 there were 1,477 new cases of melanoma in those aged under 44 years. In plain language, New Zealand has the highest rate of invasive melanoma in the world.

💬 Barbara Stewart: And the highest death rate.

And the highest death rate, as my colleague Barbara Stewart said. Let us remember that before the age of 35, the risk of developing melanoma shoots up by 75 percent. An estimate of the number of skin cancers treated every year in New Zealand is a staggering 67,000. This is not an insignificant number, and it should tell us that we must do more. The Cancer Society estimates skin cancer to cost over $123 million each year to the health system and in lost productivity. Not only is there a human cost but there are high financial costs as well.

Why will the Government not get some guts and show some leadership and ban UV tanning beds here in New Zealand? Without the ban on sunbeds, voluntary regulations will remain. We have heard from other speakers on this bill about how they do not believe that this will actually be enforceable. We know that many operators in salons and nail studios are not actually complying with this voluntary regulation. I have seen the evidence of this myself in hair and beauty salons and nail clinics. The requirements are to wear protective goggles and to give a thorough skin analysis and consultation per tanner.

I want to just briefly talk about that. Salons that have sunbeds within them, or sunbed-only tanning salons, simply download whatever they choose off the internet to be deemed sufficient to ask three or four questions that are absolutely irrelevant to giving a precise consultation to sun tanners, or to ensure that their skin meets the sufficient requirement to tan on the beds in the first place. In all the years that I have been in the industry, we have never had tough monitoring at all under a voluntary regulation, and I am aware that is still occurring today. At the very least we should ensure that minimum standards are upheld and are mandatory.

Not only that, there are simply not enough feet on the ground in terms of people power to check this within these businesses around New Zealand. I am aware that in Auckland they have very limited resources in the council to send out health inspectors into hair salons and the beauty industry sector, and, in fact, some of them are lucky if they get visited once a year. So how on earth is this going to be policed? The Government is adamant that extra compliance measures for sunbed operators will put people off having them in their businesses. Well, I absolutely agree with that, because what is going to happen is they will pull those beds outside of their businesses and they will take them home and offer services to clients there. This will force the sunbed tanning industry to go underground, at home, so that it cannot be monitored. As I stand here, I know that there are more than 10 people right now having those services within homes.

In conclusion, this Government is out of touch. New Zealand First asked about the lives that are lost and the effects on families from skin cancer and melanoma death. We believe that the Government has missed an opportunity to do something positive for the future health of this country. The Government seems determined to go against the consensus and, indeed, common sense. New Zealand First supports Part 1 of this bill, but we have drawn a line in the sand and will not tolerate the soft measures taken by this Government in Part 2 of this bill. It is really important that New Zealanders know that New Zealand First will stick to our guns when bills such as this one, in its entirety, are not fit for purpose and make no sense at all. For this reason, New Zealand First will abstain from voting on this bill.

It is a pleasure to speak on the third reading of this Health (Protection) Amendment Bill. It is a pleasure to be part of the Health Committee, and we had some really good discussion as we were going through this debate and the submissions. I also want to thank the officials for their efforts during this process.

Good health is hugely important to New Zealanders, and the contact tracing part of this bill is hugely important in maintaining that, because we have to improve the tracing of people who may have an infectious disease or may have been exposed to one. So we are amending an Act that was written in 1956. For a change, we are doing a bill that is actually older than me, which I am quite pleased to say.

This is really about streamlining our legislation, also. To me, sometimes we have so many bills relating to the same thing that the more we can simplify this for the public and those people who are deemed to be affected by it, the better. It is also streamlining to include tuberculosis as a notifiable disease under the Act. The consequence of this is repealing the Tuberculosis Act, which was actually made in 1948. It just makes sense to roll that all into one.

It is important, I think, for people to note that when we talk about contact tracing and notifiable disease, the first option under this piece of legislation is always about people voluntarily consenting to come forward. This is not about chasing people, this is not about witch hunting, but this is about protecting the vulnerable people who are likely to be around a person who is carrying a notifiable and infectious disease. If voluntary consent is not gained, then it introduces a duty on a person who may have an infectious disease first of all, but if they do not consent, then it is up to the practitioners to be able to notify. It is important to note that clause 5(3C)(a) allows the sex, date of birth, and National Health Index number of a person with a notifiable disease to be disclosed. So it actually gives the medical officer access to the valuable information.

I will make note here of Supplementary Order Paper 127 in the name of the Hon Dr Jonathan Coleman, which is about the identifying information. It means the person’s name, address, place of work, and any other information specified in the regulations under the Act would not be disclosed. That is important, I think, as a protection. We want privacy to come out to protect people but not to actually expose people. It is my pleasure in supporting this piece of legislation. Thank you.

The next call is a split call. Jan Logie—5 minutes.

It is my pleasure to take a short call on behalf of the Green Party on the Health (Protection) Amendment Bill, which is relatively simple and is made up of two parts, in effect. One part of the bill is to strengthen the range of infectious diseases that are considered notifiable and to give the medical officer of health more options in terms of contact tracing for when people have an infectious disease that is on that list.

I would like to speak briefly and specifically to the fact that chlamydia, which is New Zealand’s number one sexually transmitted infection, has finally been added to this notifiable disease list. I think that is well overdue, as mentioned by one of the earlier speakers, particularly because that is an infection that quite often has no symptoms, so that people may not realise that they have the infection to prompt them to go to the doctor. Once somebody has a diagnosis, it will be very helpful for us as a society to put the motions in train so that other people whom they have had sex with are able to be told they are at risk and to go and get checked. So that is very good news in this bill.

I would just like to commend the contribution that my colleague Kevin Hague made earlier in this debate and throughout this process and to mention again to the House his experience in this area as the previous head of the AIDS Foundation and his experience of working with people in the community who were HIV positive, engaging in risky behaviour, and were not wanting to change that behaviour, and the very few options that he found available to him. Really, the advice he was given was that it could lead to the medical officer of health intervening and detaining those people indefinitely, with very few checks on their human rights or balances on that power. That, certainly, in this day and age, is far too extreme an option and is not conducive to providing the environment of good public health that will enable people to come forward and get tested in the first place. We need to have that range of options to support people to come forward and enable more people to know that they should be tested. The Green Party absolutely supports this part of the bill, although we would have liked to see the Public Health Bill also back on the table for more holistic changes and more changes across the spectrum to update our practice in that area.

The Green Party does not support the Government’s decision in relation to sunbeds, though, which is the other significant part of this bill. We have joined with other Opposition parties in expressing that—that the Government has said that it will ban the use of sunbeds for those under 18, whereas the World Health Organization’s evidence was very clear that it classified sunbeds as carcinogenic in 2009, and the evidence is very clear that use of a sunbed before the age of 35 will increase your risk of getting melanoma by 75 percent. There is no place for these beds of death in our society. Our rates of melanoma are too high as it is. Too many people are affected by this, and the evidence that came before the committee was that the industry is not following the existing regulations as it is, and there are still people in this industry who deny a link between the use of sunbeds and cancer. In fact, apparently, there was a provider who came in front of the committee and presented a couple of reports they had found on the internet that said there was no link. If people are that out of step with the science and are wilfully ignoring the harm to people, I think that is a clear indication that the Government needs to step in and protect people. The Government has failed, sadly, to do that in this case.

I call Carmel Sepuloni—5 minutes.

I have not been on the Health Committee, but I have heard my colleague the Hon Annette King speaking at much length about this bill. She has given us some fairly robust discussion in regard to this and has made us very aware of what she, being on the select committee, supports and what she does not support. I guess I will just start by saying that it is great to see that the National Government is finally acting on something that the previous Labour Government started—8 years later in fact, because it was Pete Hodgson who, 8 years ago, actually introduced a public health bill in relation to this. I am glad that we have finally got to this point.

We know that the bill will increase the range of infectious diseases that are notifiable to a medical officer of health without requiring identifying information of the patient or diseased person. This will include HIV infection, gonorrhoea infection, acquired immunodeficiency syndrome, and syphilis. Concerns that the current legislation does not fully support public health practice have been articulated by staff and health agencies over a sustained period of time, which is why this bill is necessary and long overdue. Three measures are being introduced: contact tracing, an increase in the range of diseases that are notifiable, and options for the management of individuals with significant infectious diseases whose behaviour puts people at the risk of contracting a disease.

The restrictions around sunbeds—as our colleague from the Green Party Jan Logie has said—do not go far enough. We should be banning sunbeds like they have in Australia. Coleman has taken a limp-wristed approach to restrictions on sunbeds. He is now getting the Ministry of Health to consult on further restrictions on sunbeds. Why is he doing this when the legislation is now being passed through the House? It is because he knows that the restrictions do not go far enough and he is on the wrong side of the public health debate in relation to this issue. The Ministry of Health has said that banning sunbeds fails one of its key objectives for public health intervention and: “would prevent access to sunbed services by adults who are well informed and choose to take the risk of [artificial] UV tanning for cosmetic purposes.”

So a key test of public health intervention under this Government is the right of people to increase their risk of getting melanoma by 75 percent for cosmetic reasons. It does seem irresponsible, and if we look at other public health debates, for instance around tobacco, then there seems to be a bit of a contradiction here. We are not saying with tobacco: “Well, actually, we’ll leave it as is, because it is your right to choose.” In that instance, we are saying: “Actually, we must increase taxes.” In that instance, we are saying that we will do everything we can to try to make smoking less of an attractive option to people, because it is such a big public health issue. Here we had an opportunity to ban sunbeds because it is such a public health issue, but, instead, the Government is saying: “Well, actually, you know, as long as adults are well informed, if they choose to take the risk, then it is up to them.” So I think we have got a bit of a contradiction around public health messages being put out by that Government.

The Ministry of Health—Coleman’s department—said it “has been concerned for some time about the use of sunbeds in New Zealand, given the clear evidence that they pose significant risk of increased skin cancers to users.” The Government should have voted for the Hon Annette King’s Supplementary Order Paper 80, which would have restricted sunbeds to being used for medical purposes only, for persons of all ages. How difficult would that be? We are talking about public health issues here. We are talking about something that we know increases the risk of melanoma by 75 percent. That Supplementary Order Paper, which was put up by the Hon Annette King, was a sensible Supplementary Order Paper. It just seems nonsensical that the Government would not support that.

We are supporting this bill. I guess I could go on and on, but I will not. Our major issue here is that the Government has not done enough in respect of the sunbed issue. Australia has been much more responsible in this regard. It is banning them, and, unfortunately, we are probably going to be on the receiving end of all those old sunbeds that Australians are no longer allowed to use. It is very unfortunate, and I think, with regard to that aspect of this bill, the Government should be quite embarrassed.

It is a pleasure to speak to this, the third reading of this bill. This bill has been topical for a number of reasons, but particularly for its attention to the UV suntanning component. I think that if we look back at Hansard, we will see that attention has been paid to that part of the bill at a ratio of maybe 3:4, but I actually want to echo what one of my colleagues has said regarding the infectious diseases component, because I think that part may have one of the bill’s greatest long-term impacts for New Zealanders.

I say that because of the manner in which it places chlamydia on the infectious diseases schedule. It will be a non-notifiable disease included under the Health Act, schedule 1, Part 2, as amended by clause 10 of the bill. A 2014 report by the Institute of Environmental Science and Research looking at 2013 district health board data suggested there were 25,000 positive chlamydia tests. This might seem like a nuisance condition compared with potentially fatal melanoma, but those are 25,000 positive tests that can have significant long-term implications, such as pelvic inflammatory disease, ectopic pregnancies, and Reiter syndrome. In fact, a quarter of all infertility cases may be due to chlamydia. So it remains my view, actually, that this section of the bill may have more impact on more people than the tanning component of the bill, which I want to turn to here, more in reflection of a comment that my colleague across the House, Ria Bond, made in the Committee of the whole House that was kind of interesting.

She raised a question as to whether UV nail lamps should be included in the bill and said that the UV nail industry had been completely forgotten about. That is kind of interesting, because you can certainly get melanomas around the fingernails. Under the fingernails, you call them subungual, and around the fingernails, you call them periungual, and they are actually a problem. They are a problem because they are painless, and people often mistake them for catching their finger in the door or hitting it with a hammer inadvertently, because they get that brown stain under the nail like you would normally do with a bruise. It is a bruise, but, in fact, the bruise does not go in 3 weeks; it lasts for 6 weeks, 8 weeks, 9 weeks, and by the time they realise they have had it that long, it is often actually too late.

I thought this was a really interesting question: whether UV tanning around the nail and in nail tanning clinics actually had any implications. I wrote to Melanoma New Zealand to seek its advice on that, and it wrote back saying: “The risk from nail curing UV lamps is thought to be small, though there are still limited robust randomised controlled studies. Currently we would recommend using sunscreens or UVA-protective gloves to limit the risk, or avoid drying by this method.”. So yes, clearly, there may be some increased risk.

In the overall context, I think this is a very important bill. I appreciate how long it has taken to get to this, the third reading, but I think this bill now lands in a sensible and functional place that will benefit the health of all New Zealanders. I commend this bill to the House.

Kia ora, e Te Māngai o Te Whare. Thank you very much for the opportunity to contribute in this third reading of the Health (Protection) Amendment Bill. During the passage of this piece of legislation, I had the fortune of sitting on the Health Committee, and I would like to say that this piece of legislation was a bill of two halves, essentially. There was 100 percent support for the first half, and that support was for a focus on infectious diseases. I too want to reiterate that the history of this bill originated from the Hon Pete Hodgson, when the Public Health Bill was submitted to this House 8 years ago.

We all agree 100 percent with Part 1 of the bill. I really just want to focus on increased notifiable diseases within the sexually transmitted infection (STI) space. Sexually transmitted infections are incredibly valid as a topic of focus. In addition to HIV/AIDS, I really want to talk about gonorrhoea and syphilis, because in 2014 the gonorrhoea rate in New Zealand was 70 per 100,000. The implications in areas like Tai Rāwhiti for Māori and Pacific youth, where, actually, the rate is four times that of the national average, are that this will now provide us with information so that we can start addressing and managing some of these sexually transmitted infections. For me, that is the value of this piece of legislation—that it is now going to be proactive. It is going to involve a public health perspective—not treating these infections as individual infections that actually have no ongoing interest or ramification in our community. It will now lead to a better-targeted approach and support, because what we do know is that people who suffer from STIs end up with infertility issues, chronic pain, and issues with neonatal morbidity. There is also a relationship with certain types of cancers. So we support 100 percent anything that we can do to be proactive to protect our community and, within that context, ensure that there are not any privacy issues with individuals’ information. That was the general consensus of the select committee.

In terms of Part 2, I think there was an emerging consensus from the Opposition that we do not support Part 2 of the bill. Part 2 of the bill prohibits the commercial provision of artificial UV tanning services to under-18-year-olds. I just want to quote Minister Coleman from his contribution in this third reading. He said: “A complete ban on the provision of artificial UV tanning services would prevent access to artificial tanning services by adults who are well informed and choose to take on that risk.” He also made the point of saying that if you are over 18, then, basically, you are capable of making that decision. Our contention has been that, actually, young people are not in a position to make that decision and that it is more relevant to those who are under 35 or under 30, based on the international research. We would say that when we know a product is causing so much harm, then, actually, we have a responsibility as a Government to protect all of our citizens. That information came from the International Agency for Research on Cancer, which said that artificial UV tanning services increased the risk of melanoma to those under 30 by 75 percent. What is the relevance to us here in New Zealand? In 2012, 2,324 New Zealand citizens were registered with melanoma. In that particular year, we had 354 deaths.

I want to highlight one of the submissions that we received from dermatologist Louise Reiche from Palmerston North, who led the charge at Palmerston North City Council. The MidCentral District Health Board region has a melanoma rate of 51.55 per 100,000. It was her contention that 75 percent of those people diagnosed with melanoma between the ages of 18 and 29 had used artificial UV tanning services. That was her contention. She was supported in her submission and that of the Palmerston North City Council by Jessie Anitoni, who started using tanning machines as a 16-year-old. She was diagnosed with melanoma. She moved to Brisbane, and, basically, called for a complete ban on these UV tanning machines based on her own experience.

I want to highlight that the first country in the world to ban UV tanning machines was actually Brazil, in 2009. Australia followed them in 2014. But 2014 was an interesting year, because on 1 July 2014 Auckland Council implemented a by-law that banned under-18-year-olds from using tanning machines. For the council, it was a focus with operators on explaining the risks and also on ensuring that they displayed warning notices in their clinics so that people were informed and could make informed decisions about whether or not they used their machines. The relevance of that to this debate is that 30 percent of operators in New Zealand reside in Auckland, and over 50 percent of the tanning machines are in Auckland. So, in fact, this piece of legislation is relevant only to the other 50 percent of tanning machines, which are not used in the Auckland area.

When you look at the options that this Parliament had, rather than following Brazil and Australia, this Parliament is actually following the Auckland Council. It does not quite make sense to me. I would have thought that, as a responsible Government, we would have followed what other countries have done based on evidence, not followed what a local body entity has done—no disrespect to Auckland Council.

In March 2016 research from the QIMR Berghofer Medical Research Institute in Brisbane, published in the Journal of Investigative Dermatology, said that New Zealand had overtaken Australia and become the most melanoma-prone country in the world. Six countries and their rates of melanoma between 1982 and 2001 were analysed. In 1982 the melanoma rate in New Zealand was 26 per 100,000; today it is over 50 per 100,000. Those countries that were analysed were Australia, the UK, the US, Norway, Sweden, and New Zealand. When commenting on that piece of research, Associate Professor Tony Reeder from the Department of Preventative and Social Medicine at the University of Otago, said: “New Zealand has lacked high-level commitment and adequate investment in skin cancer prevention ...” Dermatologist Ben Tallon commented that we need to “wake up”. It is time that New Zealand and this Government woke up. So in 2002 melanoma was identified as a priority in the New Zealand Cancer Control Strategy.

In summary, we do not support Part 2 of this piece of legislation. This bill is actually a sad indictment not only of the Minister but also, unfortunately, of the Ministry of Health. The ministry’s mandate, or its function, is to improve, promote, and protect the public health of New Zealanders. I am incredibly disappointed that the ministry did not adequately advise the Minister—or if it did, that the Minister did not listen to his ministry and ensure that this Health (Protection) Amendment Bill does protect New Zealanders. That is what is incredibly disheartening about the title of this piece of legislation—the Health (Protection) Amendment Bill. It is actually a disingenuous title. We have missed the opportunity to protect the health and well-being of our fellow New Zealanders. Labour is supporting this bill, but we categorically, with the Greens and New Zealand First, do not support Part 2. Thank you.