Compensation for Live Organ Donors Bill

I move, That the Compensation for Live Organ Donors Bill be now read a third time. Let me start my speech by explaining how I became interested in issues around organ donation in New Zealand. In July 2014 I was the new National Party candidate for Hutt South—very excited about life—and I held a public meeting at Boulcott’s Farm Heritage Golf Club with the then Minister of Education, the Hon Hekia Parata, and the then Minister of Health as well, the Hon Tony Ryall. I remember the evening quite distinctly, because one of the very first questions was from a woman—who is here, watching, this afternoon—called Sharon van der Gulik. Sharon was 68. She had been living with renal failure for more than 2 years. She could barely walk, and she needed 15 hours of dialysis a week. In fact, she could barely make it up the stairs at the golf club. She was, at one point, given just 2 weeks to live, and the dialysis had become so awful that she said she could not think of continuing with treatment past the age of 70.

By far, her best option was a live kidney transplant, and she explained to the meeting that only a few weeks earlier her brave 27-year-old grandson Matt had donated a kidney to her. But Sharon told us all at the meeting about how tough it was for Matt. He was getting only $206.21 per week from Work and Income, which did not cover half of his mortgage, and it had been difficult convincing Work and Income that Matt was entitled to the money. In fact, Sharon herself had to help keep Matt financially afloat. Sharon said to the meeting “Surely there has got to be a better way.”, and it was very hard to argue with that.

I remember sitting there at the meeting and remembering that Michael Woodhouse had had a member’s bill about this exact issue kicking around for a while. I went and talked to Sharon at the end of the meeting and I said to her “Look, if I’m privileged enough to be elected to Parliament at the 2014 election, I would be very interested in taking this issue on.”, and, of course, I was elected—very privileged to be elected—as a list MP based in the Hutt Valley. I was fortunate enough to inherit the bill from Dr Cam Calder, one of our former colleagues, who had taken it over from Michael Woodhouse when he became a Minister. Then I was very fortunate, of course, to have the bill drawn from the parliamentary member’s bill biscuit tin quite soon after being elected.

So I want to say thank you to Michael and to Cam for their custodianship of this bill in the past. I know they are both very pleased that it will pass its third reading this afternoon.

I also want to say thank you to the people whom I have talked to over the last 18 months in our hospitals, in our health agencies, and in our communities about this bill. There are many people out there in New Zealand who are passionate about increasing our organ donation rates, and I know that this is a big day for them.

There are two main purposes to this bill. The first is to more fairly compensate altruistic New Zealanders who, through the goodness of their hearts, choose to donate an organ to a friend, a loved one, or even a stranger. It needs to be said clearly for the House that live organ donors are national heroes. The current compensation regime amounts to the equivalent of the sickness benefit, and it inadequately recognises and supports the hardship that these individuals face when they make the choice to give up an organ in order to save a life.

The second purpose of the bill is to reduce the financial barriers to becoming a live organ donor. We know that one significant barrier to people becoming a live organ donor is the financial hardship that donors suffer through lost wages and other associated costs of recovery.

More than 500 New Zealanders are waiting for an organ transplant, and approximately 450 of these people are waiting for a kidney transplant. People waiting for a heart, lung, or liver may die without a successful transplant, while those waiting for a kidney transplant lead lives restricted by long-term dialysis treatment. So what this bill does is establish a legislative architecture around a compensation regime for live organ donors.

The House will be aware that in its original form the bill set compensation for lost earnings at 80 percent of forgone income during recuperation. This is in line with ACC. The Health Committee recommended that compensation should instead be set at 100 percent of lost income, and the House has adopted that recommendation, which I am very pleased to see. The bill adopts a principle of cost neutrality for live organ donors. So, in other words, organ donors should be neither financially advantaged nor financially disadvantaged from their decision to donate. This is exactly the situation in the United Kingdom. The amount of compensation payable is uncapped in a monetary sense, but it is available only for up to 12 weeks. Discretion will also exist for compensation to be paid to a donor before surgery in some circumstances, not just after surgery.

The bill has been significantly strengthened by the Health Committee, and I want to thank its members for their hard work on the bill, led by my colleague and friend Simon O’Connor. I also want to say thank you to Scott Simpson on the Health Committee as well, for swapping out with me when the Finance and Expenditure Committee was meeting so that I could attend many of the meetings and make a contribution to the passage of the bill through the committee.

The Health Committee heard many stories about the difficulties that claimants have when obtaining financial support through the Ministry of Social Development—in fact, I was in my office talking to Matt about this just now. There are currently very few claims for live organ donor assistance through the Ministry of Social Development, and the front-line staff are often unaware that the provision even exists. The bill, therefore, shifts responsibility from the Ministry of Social Development to the Director-General of Health, and I know that this change will be welcomed by many people who have either donated in the past or who are thinking about donating in the future.

It is also worth noting that the bill is futureproofed. There is a provision in the bill that will allow, by Order in Council, a regulation declaring a type of human organ to be a qualifying organ. This means that other types of potentially suitable live donor transplants that are medically possible and that are carried out in other countries, such as small bowel, pancreas, and lobular lung transplants, could be eligible in the future.

In conclusion, I believe this bill will make a difference. At the moment, live organ donors are, effectively, penalised for their altruism. This bill ends that unfairness.

The bill removes a large barrier to organ donation, thus making it more likely that people will donate. As Agnes van Diepen submitted to the committee: “A 100% contribution … will go a long way towards tipping the balance between donating and not donating.” That is what this bill is all about—tipping that balance in favour of donating rather than in favour of not donating. Or, to put it in the words of Elsie Howarth, who donated a kidney to her father: “[At the moment] you’re being penalised for working and then doing this for someone. If you want people to step up and donate, make it worth their while. Don’t make it so hard to do something for somebody else.”

Although this is not the main aim of the bill, the bill will save taxpayers money. Research at the University of Canterbury clearly shows that there are large fiscal gains for taxpayers from increased support for organ donors.

In conclusion, let me say that a caring society recognises sacrifice. A compassionate society supports those in need. This bill does both those things, and I therefore commend it to the House.

Can I begin by congratulating the member Chris Bishop who has promoted this bill—the third promoter of this bill—because it is not often that a member gets to have a bill supported by all members in the House and for it to go through all stages and become the law of the land. It is such a shame that we do not have more of this sort of an approach. So often there are very good members’ bills on the Opposition side of the House but we struggle to get the same sort of cooperation, because politics come in the way. But in the case of the Compensation for Live Organ Donors Bill, which was taken over by Chris Bishop from Cam Calder, and before that, from Michael Woodhouse, it is having its third reading today.

I noted that the member was very lavish in his praise of his parliamentary colleagues, but can I say to him that this bill would not have been improved if it had not been for the entire Health Committee. Unfortunately, it was not just Mr Simpson and others who improved it. In fact, it was improved by National, Labour, and the Greens. In its original version it was not a very good bill, and I am sorry to say that, but that is the case.

💬 Chris Bishop: So churlish.

No, I am not churlish; it is the truth. I sat on the committee, I heard the evidence, and the bill was not in a very good space. I think the member would have to admit that, because what the select committee did do, under the very good chairmanship of Simon O’Connor, was improve this bill and make this bill work for New Zealanders. I now believe that we have a bill that is fit for purpose. It is a bill for live organ donors. I agree with Mr Bishop, that those who donate live organs, those who are living human beings who give up part of their body to help another person, are heroes. They are selfless; they are there to give help to somebody—often people who are near and dear to them. You cannot be more selfless than that. Also, you can be selfless in death, when organs that are available on death can also be used.

This bill deals with those who are living. What it has done is enable people to be able to give an organ and still have income assistance while they are recuperating and recovering from that surgery. That did not exist for them, so for many people it was a financial burden to give up work, to give up income, to provide an organ to a loved one. They were going to be penalised financially. So we now enable them. We recommended the changes to provide for the cost neutrality to donors—instead of 80 percent of lost earnings based on the ACC compensation model, we have enabled them to be able to get 100 percent of their earnings. This, I think, is a good move. It also moves it away from people having to go and beg to the Ministry of Social Development, moving it to the Ministry of Health to ensure that there is no obstacle to them getting that financial assistance.

So we have ended up, I think, and landed in a very good spot. There is one part of organ donation that still does need to be addressed—and I hope it will be addressed in the near future—and that is the issue of organ donation from people who have passed on. I want to acknowledge today the work that has been done for many, many years by Andy Tookey from Christchurch. As a Minister of Health I dealt with Andy. He was relentless in raising this issue. I think that we have not finished this process until we address the issue of organs from people who are deceased. There is a huge number of organs available but very few New Zealanders who are prepared to donate—and for a number of reasons.

You may find that a person themself has said they would like to donate on their death. They are willing and able to donate. They say: “Please use my organs for the good of someone else.” But at the time of death that person is no longer considered a person. They are now the property of their family, and so often it is the family members who decide that they do not wish the organs of their loved one to be donated. I can understand that—at the time there is a lot of emotion. Your loved one has passed on and here is somebody saying: “By the way, can we have their organs?”.

I know it is not done like that, but you know what I mean. It is a very emotional time for people. So we do need to have a better way of going about this. If we could also get increased organ donation from deceased people, we could considerably increase organ donations in New Zealand. One of the issues that has been raised as helping this is having an organ donation register. It would be a register of those who are prepared to donate. I believe we would probably have to change the law to ensure that the person’s wishes are carried out—like in a will—after their death and cannot be overridden by a family.

It is interesting that Mr Bishop said that this, for him, came about when he was out with the Minister of Health at a meeting in the Hutt Valley. I have to say to Mr Bishop that this really should have been a Government bill. This is a bill that is about health issues. It has not become one—the member has picked it up and got it to where it is, and good on him. But the next part of it does require Government intervention, and that is donation from deceased people. That does require a Government measure. I believe it does require a register, and I noticed that when the Minister put out an announcement about this bill he said he did not support a register. In fact, he said it before we even heard the submissions. He did not support a register. But, unfortunately, that was a change from the position he held when he was in Opposition. In Opposition he said: “The Ministry of Health has said there is no evidence of a register improving donor rates. Well, we have heard that several jurisdictions around the world are already instituting this type of donor register. If it is good enough for the Canadians, for places in America, for the states in Australia, then one would wonder why we are not doing this in New Zealand.”

This was said by the member opposite—the Minister of Health—when in Opposition. He was in favour of it then. He said—and I agree with him on all of this—that “The problem we have at the moment is that if we register on our driver’s licence as an organ donor, there is no absolute guarantee that someone will not overrule that wish once we have passed on.” He said this: “The National Party position is that if one makes a decision about what happens to one’s body after one dies, then that should be absolutely binding and no one else should be able to overrule that decision.” There are two issues: first, the issue of a person’s decision about what happens when they die and no one overruling it, and, second, the register.

So I say to the Government that I offer congratulations to Chris Bishop on getting live organ donation through, and I hope we see a big increase in organ donation, because we do feature low down in the world. But I would like us, as a Parliament, led by a Government, to put in place measures to increase organ donation of organs from deceased people. That would finish the work that needs to be done in this area, and there is a huge saving for New Zealanders—for taxpayers and others—if they can access organs to enable them to live fuller and healthier lives.

We support this bill. It has ended up being a positive measure. It is a measure that I think the whole House supports because it is sensible, and it needs to happen. We also commend the bill to the House.

I am delighted to be taking a call on this bill, now known as the Compensation for Live Organ Donors Bill, and, because we do have, I believe—with a bit of prescience—support across the House, it is soon to be an Act of Parliament after it receives the Royal assent. I begin by acknowledging the member who has sponsored this bill, Chris Bishop, who has done a tremendous job shepherding it through the House. As many members have noted, on any of these members’ days it is a very rare chance that the biscuit tin is in your favour. When it is—in fact, how many bills have you had out now? Is it two or—

💬 Chris Bishop: Two.

Two, right. So this man is incredibly lucky. But to actually shepherd it all the way through is quite unique. So here we are at the third reading. In acknowledging Chris I do want to acknowledge the other MPs who have been involved in the past. We have heard Dr Cam Calder’s name mentioned and, before that, the initiator of this particular bill, the Hon Michael Woodhouse.

I do also want to mention—not directly with this bill—Dr Jackie Blue, who in her time spent quite a bit of effort; and in that space—and it is a sort of a linkage of names, Andy Tookey. I had the pleasure of meeting Andy many, many years ago. He will not remember but it was through Jackie Blue and he was, as the previous speaker was indicating, a very passionate advocate and was speaking with Jackie. So a number of people have been involved. But I think, really importantly, it is Chris who has brought it to the House and shepherded it through. In that regard, too, I am very grateful for the work of the select committee. It is a marvellous committee to chair, even during annual reviews sometimes. Actually, the committee has worked quite cooperatively—first and foremost with the member but also within to try to improve the bill even further.

The bill came to the committee in good shape and, in terms of the discussions we had, we were able to make some improvements. One of them—and Chris was very keen on this—was as simple as the title change. Initially the title mentioned “financial assistance” and we then moved it to “compensation”, and anyone who has followed any of the speeches in the House knows I am a great believer in words and the importance of words, and it was quite critical that we signalled that this bill is based around the altruism of those who are donating.

Again, we are talking about live transplants, live donations, and it is a compensation. In fact, you could almost go as far as to say it is still only a partial compensation, even though I will get to the whole point of 100 percent remuneration around income, there is a lot greater, well, altruism going on here, and this bill is an attempt to compensate some of that rather than sort of being some generous action of the State alone to financially assist someone.

So the committee moved that change, but the committee has also been very conscious that we have—as speakers have mentioned, and I am sure we are going to hear it from the remaining speakers—very low donation rates. I think it is about 300 over the last 3 or so years—very low. It is primarily for kidneys but there are other organs that can be live-donated—partial lungs, livers, and pancreas. Importantly, something I was quite keen on—and I am really pleased that Chris Bishop was open to it, as well—is making sure that there is a provision in this bill to add in further organs. Of course, those who are clinically minded know that there is a limit to just how much can be introduced in before we move from live to, well, not live, but there is an opportunity, if developments are such, that by an Order in Council extra organs can be added into this bill. In other words, we do not have to go through the rigmarole, if you will, of the House process of introducing a further piece of legislation.

As we said, we have low donation rates, but we also know that about, I think, 1,100 people are actually on Ministry of Social Development benefits related to kidney failure or health issues related to kidneys or other organs. And what this bill represents is actually an opportunity, and again I had better be clear before articulating this further that I am not trying to put out a purely utilitarian argument.

There are people out there in New Zealand who will obviously benefit from a donation. But from a purely governmental, let us say, accounting standpoint, the fact that there are people currently on the benefit who could actually benefit from live organ donation is not only good for them in their health but also good for the Crown’s accounts. That has been, I suppose, one of the reasons, amongst others, that we as a committee decided to move the recompense of this bill from 80 percent to 100 percent. I suppose there are lots of nuances in this debate, but, again, although we do not think that simply reimbursing a person 100 percent of their income represents the entire cost associated with the donation, we saw this as a really important step. Importantly too, we decided not to go beyond 100 percent. There was some conversation about whether we should make this 120 percent or 150 percent. Do you go even as far as 200 percent? It became a tipping point, as it were, between actively trying to support and encourage donation, but not trying to make it too much of an incentive, if I can articulate it that way. We feel we have landed in the right space.

Importantly, too, this bill recognises people who are, obviously, earning an income in some shape or form, be it as a sole trader, being salaried, right through to people on benefits, including those on ACC. I talked about this in the second reading. We had a little bit of work to do around the ACC recompense, in that we did not want someone to lose their entitlement if they were already on ACC and donating an organ. Under the current structures in legislation, someone who is on ACC, for whatever reason, who then chooses to give an organ would have had to be retested for their eligibility for ACC once they had recovered. With a bit of creativity through the committee and, certainly, with the advice of the officials, we decided that what we would do instead is, if someone is getting ACC entitlements, they would not actually be taken off but would have their entitlement reduced to zero dollars. In other words, it continues but they are just not receiving that particular income. The long and short message there is that regardless of how someone has an income or gains their income, this bill covers that.

Chris Bishop also acknowledged that we have moved the management for live organ donation from the Ministry of Social Development (MSD) to the Ministry of Health. There was pretty clear feedback, pretty early on, that it was felt that it was more appropriate, first and foremost, within the Ministry of Health. Secondly, there was some sort of confusion or misunderstanding, perhaps, with people even knowing to approach MSD. Having worked within the Ministry of Social Development many years ago, I would have to say that someone coming in to test their full and correct entitlement for organ donation does not happen all that often, and you could perceive it leading to confusion.

Jumping back, also, to the area of income—whatever someone’s income is, that is what is going to be recompensed. There is no limit. There were lots of discussion in the committee on that. Should we be actually capping the total remuneration? The answer there was no.

The other element that I just want to quickly touch on is not particularly on the live organ donation front, but the wider discussion around deceased organ donation. New Zealand certainly has a long way to catch up, and it was certainly my intention and that of the committee’s that we would have those discussions somewhat during this bill’s progression. I think it was important, naturally, that we talked about live donorship, but we also tried to touch a little bit on deceased donorship. I have talked about it before, but I think the Israeli model has some real value, particularly around those who choose to donate—that they are put, effectively, at the top of the list themselves, if they in turn require a donation. The other side—and it is not punitive; I think it is just actually realistic—is that if someone chooses to not donate an organ, then they in turn are not to be a recipient of one, in the first instance.

I do too want to just pick up on something that Annette King was talking about at the end of her speech, around how, obviously once someone has deceased, the family relationships work. This is primarily because although there are some great ideas out there of how we might manage this—and in some ways it sounds really easy—if someone who is deceased had articulated their wishes previously, they should be honoured. I think there is real merit to that. It is a difficult area. Having spent a lot of time in hospitals, it is a very traumatic moment for families when a loved one dies, particularly if they are brain dead, which is—being somewhat clinical—an ideal time for a donorship to happen. It is a very traumatic time for families.

Having been beside them, often when those conversations were being had, I suppose I am just wanting to acknowledge that, and that, obviously, this Parliament—I think it probably will be governmental. It is an awkward conversation, but it is primarily one that has to be had. It is not a simple issue, but I think and I am hoping that through this bill, further conversations will be had and more organ donations will happen. Thank you to those who are already engaging on the live organ side.

I just want to add a bit of a contribution to this discussion on financial assistance for live organ donors. I want to congratulate the member Chris Bishop on having this bill pulled from the ballot and on the bill now actually having traversed through all stages of the House. It is an important aspect of a parliamentarian’s life, I guess, to have a bill in your name actually pass through the House. Congratulations to him on that.

In my past contributions on this bill, I have referenced a friend of mine, Kathleen Jacob, who was actually on a waiting list for a kidney several years ago. Unfortunately, she was not able to take advantage of having a transplant, and she passed away some years ago. We had many conversations about why it was that our donor rates in this country are so low. One of the things that she told me about, and I thought it was a really interesting aspect, was that as the safety of our vehicles improves—as we are more compliant around wearing seatbelts, not driving drunk, and keeping to the speed limit, and as we have better-quality roads and such—when we have accidents, of course, we are not dying. Our death rates on the roads have reduced. That is one of the reasons why there are not a lot of donations from people who are deceased. It is perverse, I guess, in one way, but it is an aspect of our increasing safety on our roads—it has partly contributed to the need to have live organ donors as opposed to those who are deceased.

The other thing is that on the driver’s licence that you get, there is an indication of your availability to be an organ donor. Many of us have indicated that that is what we want, but it does not guarantee that when you do pass away your family will actually live up to those wishes and do that. I know that that happened within my own family. When my grandfather passed away, there had been a conversation at that time about him being able to provide for someone on a waiting list, and his daughter—my mum—actually overrode that decision. The family does have to actually live with that decision, and mine could not continue with it. That was sad for the person who might have received that organ, but decisions definitely happen once you are deceased that you have no control over.

As has already been suggested, this legislation, when it came to the Health Committee, was vastly different from the piece of legislation that is now going to pass its third reading. Although some members have been a little critical, it was actually a great exercise in being able to look at all the aspects of this particular scenario and make sure that we covered off as many of them as we could. We did not want to place any barriers in the way of this proceeding—for people to actually be encouraged to be donors. Given the low numbers of donations anyway, we knew that in terms of financial implications to the Government, it was not going to be huge. It gave us an opportunity to really craft a piece of legislation that covered off many things. It has already been touched on, but I want to reiterate some of them.

This legislation will often apply to people who are on low and medium incomes—not people with a lot of money—for whom the loss of income over 2 or 3 months actually has a huge impact. So that was one of the things we looked at—the recovery period for somebody who donates an organ. We set that at about 12 weeks. We felt that most people, I think, recover in about 6 to 10 weeks, but there are some times when you might need a little bit more time to help yourself recover, and there also has been built in a certain amount of discretion should the recovery not go as well as you expect. There is a certain amount of discretion within that.

The other thing that we looked at was that we took a lot of our references from what happens within the ACC legislation, because that is a good model to start from. But we also looked at those people who may be on benefits and their ability to transition from having a benefit back on to ACC or on to other benefits, so that they would not be disadvantaged by this and they would not have to go through the process of having to reapply, because that often has implications with regard to stand-down or with regard to having to reconnect with Work and Income, for example, with documentation or certificates, or the like.

The other think we looked at was ensuring that anything that happened before the donation took place, such as tests, such as appointments with doctors—anything that needed to happen beforehand that took time and therefore possibly cost the donor some money—was actually also able to be compensated for, and that discretionary earnings that that donor might then forfeit might, by application to the director-general, be able to be compensated for as well.

We looked at things like who is actually a qualifying donor. Strangely enough, we did have to include that in the legislation because this actually applies in the New Zealand health system. If you are entitled to a service in the New Zealand health system, then you qualify as being someone who can receive a donation as well as someone who can provide a donation. We looked at, as I said, recuperation periods. We looked at entitlements under the job seeker benefits and made sure there was no impact for the loss of earnings. We also made sure that there was a process within the legislation to challenge any decisions, particularly around revocation or revision.

This is a good bill. I think it warranted the amount of time and effort that the Health Committee took to make sure we got all those aspects in there. I am pleased for Mr Bishop to have this bill passed, and I am sure he will enjoy putting his name to that and will celebrate this afternoon. On that note, I commend the bill to the House.

It is nice to be back, speaking in this honourable House on a bill that I think everybody agrees on. It is a great tribute to the member behind it, Chris Bishop. I think one of the most extraordinary things about living in 2016 is that it is possible for one living person to have an organ collected from their body, and have that organ transplanted into another person in greater need and actually function within that person, allowing them to live either a better life, or in some cases, to live at all beyond a certain point. I think that is one of the most extraordinary things—to live in a time when people are willing, first of all, to be prepared to gift an organ, and, second of all, when it is medically possible to actually make such a gift work and make that organ function within another person’s body from the one it originally grew in.

Another thing about 2016 is that our Government collects taxes and does a lot of things that could be described as running a series of insurance schemes. We run insurance against accidents, for example. We have insurance against bad health. Even the State funding of education might be conceived of as insurance against having parents who, for one reason or another, will not fund you an education—a kind of insurance policy that unborn children would be smart to take out. So if we are committed to a State that insures people against different risks that they face, then why would the State’s insurance not include insuring people against the need for an organ, and, in the case of this bill, against the need for a person to gift that organ but who may be encumbered by the lack of income during the time it takes for the organ to be collected and for them to recover from that collection.

So there is really not a huge amount more to say, other than that this bill brings together one of the most beautiful things that people can do for another person. It includes the technology that we are lucky enough to have at this particular time in history, which makes it possible to do any of this—and is that not fantastic as well? It brings together the public policy of a State that is there to insure people against genuine unanticipated misfortune, and it is all brought together by a very excellent member, who I think has a very large future in politics, and who had the nous and the initiative to bring a member’s bill to the House that would genuinely assist and help with the lives of a great many New Zealanders. So without further ado, on behalf of the ACT Party I commend this bill to the House. Thank you.

Tēnā koe, Mr Assistant Speaker. Tēnā koutou e Te Whare. The Green Party will be supporting this bill as it does take a good step in the direction of making Aotearoa the sort of country that we are working for it to be, which is a place where we look after our precious natural environment, but, most importantly, where we empower and protect our people to live good lives. I think this bill, interestingly, as it has the support of so many different parties across the House, really is a perfect example of the principle that Government is there to support people when they are doing something to help others in our society, because we are all in this together, we often rely on help from others, and in the case of needing an organ that is incredibly true. It is fantastic that the Government can be there to help support people who are willing to make that sacrifice of giving a kidney—most likely, although who knows, with advances in medical technology—to someone else to enable them to live a healthier and longer life.

The Compensation for Live Organ Donors Bill, as it is now called, went through the select committee process some time ago. I was not there to hear the submissions, but there were 125 submissions to the Health Committee, all generally in favour of the principle of providing financial assistance or compensation to live organ donors. There were a variety of improvements that were mentioned at the select committee, some of which were incorporated in the final bill. The most common suggestion was to change it from 80 percent of one’s income to 100 percent, so that it was full compensation for the time during which someone might be undergoing the surgical procedure and recovering from that procedure.

There are of course other issues related to organ donation that are not addressed by this bill. The Green Party would like to see it possible for there to be greater encouragement for people to sign up to be organ donors when they have encountered an accident—a very unfortunate crash, say, or something like that, which would mean they would not be live organ donors. I myself renewed my driver’s licence this week, for the first time in 10 years, and ticked the box again to be an organ donor, should I be in that unfortunate circumstance. That is something that has always been championed in my family personally, coming from a medical family. My parents impressed upon me the importance of being an organ donor if you are in that unfortunate circumstance because we want, above all, to use resources as well as we can while we are on this planet and to enable others to do the same.

We congratulate the member who was lucky enough to have his bill drawn from the ballot, Chris Bishop—an excellent initiative. It is great to see such a constructive piece of legislation from the members’ ballot coming from Government members, which is not always the case. It is fantastic that this bill has achieved such great support across all parties in this House. It is something that we are, unfortunately, probably going to need even more in the future because we have the rising problem of type 2 diabetes, which is going to put pressure on and increase the demand, particularly for kidneys. There are other ways that the Government could be addressing the risk presented by the rise in chronic disease—in particular, type 2 diabetes. I think I read the astonishing figure that one out of three New Zealanders is either diabetic or pre-diabetic, which is a ticking time bomb and is something that we are going to have to take urgent action on if we want to avoid the long-term costs to the health system, and want to avoid a degraded quality of life for so many New Zealanders.

As I was saying before about this particular bill, which offers financial assistance and compensation to people who are willing to make that sacrifice of donating an organ, it recognises the principle and role of Government to support people who are spending their time doing something for others. I think there is also the recognition that we are all in this together, and there is an important role for Government to play in empowering and protecting citizens, particularly young people, in the face of increasing pressure and advertising around things like sugary drinks.

It is a perfect example of where the whole community is worse off because of the prevalence of sugary drinks, and there is an important role for the Government to play by, for example, taxing sugary drinks and using that revenue to fund health promotion. There is an important role for Government to play, as it designs our transport systems and our towns and cities, to make it safer and easier for kids to walk and cycle to school. All of that will go a long way in reducing the burden and the cost of diabetes in New Zealand.

I think this Government wants to do the right thing. It wants to reduce obesity and chronic diseases related to childhood obesity like type 2 diabetes, but if we look at its actual Childhood Obesity Plan there is nothing in it that is going to substantially change the trajectory. It is relying on identifying kids who are at risk and giving them some nutritional advice, but how is that going to help if they have got sugary drinks and junk food in the tuck shop at school? How is that going to help if their parents have to drive them 2 kilometres to school because it is not safe to walk and cycle?

So there are all these ways in which the Government could be taking proactive action to protect and empower citizens, to ensure that we all look after each other and we all do well. That is what the Green Party would like to see in Aotearoa.

I am pleased to rise on behalf of New Zealand First and my colleague Barbara Stewart to take the call on the third reading of the Compensation for Live Organ Donors Bill. New Zealand First has supported the member Chris Bishop’s bill through all stages in its passage through this House. This is a bill that had great intentions. It was drafted by one member, adopted by Minister Michael Woodhouse, and then adopted by Mr Bishop. New Zealand First is pleased that this bill did go through to the select committee, and we were really pleased that the Health Committee could actually scrutinise this bill and listen to the submitters and take the advice of the expert advisers. What has come back to the House—I think we have all said it today—is a bill that is more fit for purpose and that can actually, as a member’s bill, be to the betterment of citizens here in New Zealand, and also there is not a penalisation ability within the bill itself.

We have heard this afternoon that this bill seeks to address some of the problems of the low rate of organ donors here in New Zealand compared with international standards. One barrier that has become a burden on donors has been the financial burden donors have had to suffer with. To be eligible to receive only the sickness benefit, and also some childcare assistance—I was actually quite shocked when I first learnt about this. I personally know people who have donated a kidney and I do know that their recovery rate was quite different to other people who have donated a kidney. So I think that the issues with the current system have been addressed and worked really hard on by the Health Committee and its advisers. It is something that I am absolutely proud about, as I deliver our call in the House today.

As I have just said, we in this House know that recovery times for patients are not a one-size-fits-all—they all react differently. These selfless, amazing, and life-saving individuals have not only given a stranger a donation but have also given that person the ability to improve their life. I absolutely echo what the Hon Annette King said earlier, which is that these people are actually heroes. They are hidden heroes, and they have done such a good job in helping out people here in New Zealand.

New Zealand First knows that we have approximately 200,000 people who have been diagnosed with chronic kidney disease. Of these, about 2,600 are currently on dialysis, and of those 2,600, there is a waiting list of around 700 citizens desperately seeking and waiting for a kidney transplant. New Zealand does have one of the worst live organ donation rates in the world. The level has remained the same now for 5 years. Sadly, last year there were fewer than 150 kidney transplants here in New Zealand. The Ministry of Health advised the select committee that donations from both live and deceased donors are not enough, and this is where this bill can help elevate the number and encourage live donors to come forward and help a stranger to improve their life.

In the Committee of the whole House stage, New Zealand First supported the recommendations from the Health Committee to change the title of this bill from the “Financial Assistance for Live Organ Donors Bill” to “Compensation for Live Organ Donors Bill”. This was justified, because the bill will provide donors with appropriate compensation for lost income for doing such a selfless act that will have a significant effect not only on the donor recipient but also on the donors for making a life-changing decision to help improve a person’s life, rather than merely provide a perceived financial assistance payment to donors, which would play down the significance of this bill.

New Zealand First feels that newly inserted clause 3, which says “The purpose of this Act is to remove a financial deterrent to the donation of organs by live donors.”, is absolutely vital. It is vital that live donors should be neither financially disadvantaged nor financially advantaged from donating organs.

The concerns raised by the Attorney-General with regard to the New Zealand Bill of Rights Act have been taken on board by the select committee, which accepted there are beneficiaries who have income and would be entitled to compensation, or people who may have part-time work or those receiving New Zealand superannuation or a veterans pension. This clarifies the original concerns raised by the Attorney-General regarding the New Zealand Bill of Rights Act.

New Zealand First does support the cost neutrality of donors by increasing the original compensation rate from 80 percent of forgone income to 100 percent of lost income. New Zealand First recognises that there are additional issues that can be quite complex in organ donation, and this will no longer put undue pressure on donors who can donate and who want to donate to be left out of pocket financially, or to face the risk of losing employment because of pre-transplant needs and post-transplant recovery rates. This will help significantly those citizens who choose to make the selfless and life-changing choice to donate an organ.

It is great we now also have a definition of what a “qualifying organ” is. This was good to see. We in New Zealand First think that it is important not only to define that the donor is the person who donates to a person funded by the public health services in New Zealand but that the definition further sets out the “qualifying organ” as being “the whole or a part of any … human organ:” such as a kidney, liver, or “any other human organ declared by regulations to be a qualifying organ.” We do feel that newly inserted clause 29 is the regulatory tool in this bill. It states: (1) “The Governor-General may, by Order in Council made on the recommendations of the Minister of Health, make regulations declaring a type of human organ to be a qualifying organ …”. It is good to see that this bill has also been futureproofed for further live donated transplants carried out in other countries but not yet here in New Zealand. These include small bowel, pancreas, and lobular lung transplants.

We are pleased to see the Health Committee has allowed for new entitlements to be backdated for eligible donors to the date this bill receives the Royal assent. This further takes away the deterrent for people who want to donate but who hold back on donating an organ. We are also pleased to see the shift in responsibility in this bill from the Ministry of Social Development to the Ministry of Health. This actually made common sense.

So, in summary, New Zealand First supports the member Chris Bishop’s bill. This will not, however, deal with the problem of low donor rates here in New Zealand. We believe that common-sense changes have been added for the better. However, there is still so much more that we could be doing in New Zealand.

I would like to touch on what other members in the House have also said, so I do apologise that you are hearing this again. The current system here in New Zealand is difficult because the only way that we can register to be a donor is through our drivers’ licences. We believe that this could have been looked at, and maybe Mr Bishop may wish to put another member’s bill forward in the near future to look at this issue, which is a resounding issue in New Zealand. We do know that, as other members have said, when you tick that box and you become a donor on your driver’s licence, your family can actually stop that and the legal issues surrounding that cannot be enforced. That causes a lot of grief, as Poto Williams alluded to earlier. We do believe that this should be addressed in the future.

So, finally, New Zealand First supports this bill because it will enable more organ donations for people who really need help: members of our community, our family, and our friends. Thank you.

It is a pleasure to again speak on the Compensation for Live Organ Donors Bill in the third reading. As others have pointed out, it is compensation rather than the financial assistance that it was originally introduced as. It is a much better concept because people do this for love or for the willingness to help another human being, not for the financial implications of it. But it is also important that they are not out of pocket.

It has been a pleasure to be working on the Health Committee again. The Health Committee generally is working through our programmes, and it is quite common that we come in here and we are all united in one cause, which we are, behind this piece of legislation. But nothing is ever as simple as it seems. It is a no-brainer—everybody was for it—but there were obviously some pieces in the legislation that we just needed to tidy up as we worked our way through. They were mainly around the levels of compensation and some of the other details that needed to fit in with the other Acts that it affects. I would like to acknowledge the member Chris Bishop again for bringing this forward, and the Hon Michael Woodhouse, and Cam Calder before them.

A lot of people have mentioned today that live organ donors are heroes and that organ donors offer the gift of life, and this is pretty special. What better gift could you give somebody than an organ? I think it takes real courage for a person to be able to do that. To do it for a loved one is one thing, but for somebody who is outside of their family relationship I think it is an even bigger sacrifice. I really want to commend all those people who have done that.

It is important—as we know, our road toll is going down, on what it has been. Our roads are getting safer. Unfortunately, we are still having a few tragic accidents, and that is really sad, but we are trying to limit those and bring the number down. For those people who need organ donations, we have got to find a new way. I have also been listening to the conversation as we have worked our way through this bill, in terms of future discussions that we will have around organ donors on drivers’ licences and in wills, and the difficulty that family members have with honouring that donation when the time actually comes. Despite the good intentions it is not actually that easy for people to give away the organs of a family member, often after they have passed away.

It is really important to remember that these donors are not sick. I looked it up on the New Zealand donor site. If you are fit and healthy you can actually give an organ donation up to the age of 80 years of age. Although that actually seems quite a length of time, my grandmother has just turned 100 and I remember her having a hip operation well into her 80s. She was up and about a couple of days later, going: “You can’t kill weeds.” She is 100, and some 80-year-olds are in very, very good health.

We have talked about cost neutrality, and that is really important. We talked a lot about ACC and the 80 percent, but, actually, these people are giving up an income to go away and do this, and it is important that they be fully compensated.

When you end up speaking on the third reading of a bill, particularly where everybody is on the same page and you have heard all the discussions up until now, and there are a few more to come, sometimes you look in a few different places for research. I happened to be with our esteemed chair of the Primary Production Committee today, Mr Ian McKelvie, who spoke about his taxi driver who desperately needed an organ transplant. He said it was amazing. He went off to Auckland. He had the transplant. He was out of hospital within a week and he was back at work, driving Mr McKelvie around, within 3 weeks. So we can be grateful for the taxi driver, for the organ donor, and also for the fact that Mr McKelvie’s transport has not been put in danger.

We have talked about the 100 percent. We have talked about wills and drivers’ licences. We have talked about so many things through this process. It really is a no-brainer. It is just about time to move through and get on with it. One of the things that we did decide we needed to do through this process was to put it under the guidance of the Director-General of Health. It was previously under the chief executive of the Ministry of Social Development, but because of the Ministry of Health’s primary interest in organ donation it meant that that was just a much more sensible place for it to be.

Others have talked about futureproofing as well. There may be other types of organs that we are able to donate in the future. I know that a conversation happened along the way, several times, about 3-D printing. Who knows what the future might bring. We all know how slow legislation can be at times, so it is great that this is futureproofed so that we do not have to go through the whole process at any time in the future. We can just make sensible changes.

Thank you again to all of those donors. Thank you to Mr Bishop. As a member of the Health Committee it is a pleasure to be recommending this piece of legislation to the House. Thank you.

The next call is a split call. Catherine Delahunty—5 minutes.

Tēnā koe, Mr Assistant Speaker. Kia ora anō ki Te Whare. I am delighted to have 5 minutes on this bill. It is not often that Mr Bishop and I agree on things—not often. However, today we are in beautiful accord because I think he has put forward a constructive bill that will be genuinely useful to a lot of people and will send out the right signals about how our society and our Parliament value this kind of effort.

It is interesting, though, because it is not very free market, is it? Because, really, the market should decide. So if your organ is failing, well, you should be able to go out and get one on the market. Hey, why would Government step in—according to the pure market ideology, which I often hear spouted in this House? However, Mr Bishop’s bill is actually a lot more constructive than the market. He has done something positive that will allow people to be incentivised to do this, because they will have their income protected, and that is part of the role of the State. And good on him for standing up for the full role of the State in protecting the interests of all of its citizens. So we are very pleased to support this bill.

I also congratulated him on getting the bill selected. I have had five bills selected but for some really peculiar reason—I do not know why—mine have not gone through in the same way, with the same consensus around the House. I do not understand this. Mine are equally constructive, passionately argued, beautifully designed bills, but for some reason numbers are the only thing that count around here, which is a tiny bit depressing. However, I will not give up, and I am sure I will have more bills selected. But I just want to wish him all the best for having got this far, with this level of consensus.

This issue was debated at length in the Committee stage of the House—for some reason it was exhaustively debated in the Committee stage—but I think that it has brought everybody to a very positive place. It is really good to hear, for those of us who were not on the select committee, how the select committee operated constructively to improve the bill, and how much good work those members all did to make this bill better. And that is what is supposed to happen; it is not always what happens. Someone comes up with a good idea. It might be a bit rough around the edges. The select committee listens to the people, hears good submissions and makes good changes, the Government listens, and you get a better result for everybody. I wish that happened every day at my select committee. Sometimes I wonder exactly what is going on, when we continue to listen to people who tell us things and then they get ignored because the Government will not listen to them. But not in this case. We have a bill that everybody is happy to support.

The bill contains really useful provisions. I am delighted that the Health Committee persuaded the Government—not the Government, but the owner of the bill—that we should go from 80 to 100 percent compensation because there are hidden costs. There are huge stresses and there is huge courage involved with people who donate organs. So I think that that is excellent.

The wider issue of organ donation is obviously concerning when we look at the statistics. I agree with my colleague Julie Anne Genter that the statistics for a thing like diabetes are appalling. But it is complex, culturally. I have met people who are reluctant to see their family members hand over their organs, for reasons that cannot be characterised just as selfish or even as disrespecting the wishes of their loved one, because their loved one is one of them. The idea of individual rights—the individual right to dispose of your organs is all very well for people who see the world entirely as individuals, but it is not so simple when you have a more culturally interconnected view of whanaungatanga, for example. So it is not simple, and I think that we should be respectful of that.

The other parallel I would like to make with this bill is that I hope that the next bill Chris Bishop puts up is for supporting more paid parental leave because it is the same principle. Here we have people at a time in their life when they are vulnerable and when they are contributing something wonderful—a baby, or a kidney, or a liver. They are all wonderful things. Yet the Government does not seem to see the reason to support paid parental leave to the extent that it really should, for the benefit of families, yet it is a similar thing. It is about saying that at certain times there needs to be financial remuneration because the person is automatically not able to work. They really need time off work. They are doing something very positive. It is a really critical time in their recovery if they have donated organ. It is a critical time in their life if they have had a baby. I do not see the difference. I think it is the role of the State to provide these things. I look forward to Chris Bishop supporting extending paid parental leave for the same reasons that he put up this excellent bill. Thank you.

I call Rino Tirikatene—5 minutes.

Tēnā koe, Mr Assistant Speaker. I am pleased to speak in the final reading of this bill, the Compensation for Live Organ Donors Bill. This is a very worthy bill. I would add my congratulations to the member Chris Bishop on bringing this to the House, to all the parties, to the Health Committee—everyone, actually, because this is a unanimously supported bill, and it is a very worthy cause. I represent a Māori electorate, and there is a high incidence of Māori awaiting transplants and having renal issues. I have encountered many who have to travel large distances to get the dialysis treatment that they need. It is a very debilitating disease. This measure that we are implementing through this bill is very welcome. It provides for those who are very selfless to be able to get some fair compensation for their selfless act of donating their live organs. This is a very, very worthy bill, which we wholeheartedly support.

I do note the amendments that were made. Likewise, at Committee stage a lot of issues were canvassed quite extensively. But one issue that has come to my attention—and I am not a medical expert to any degree—is that there is a discretion that the director-general has to provide support for donors who forgo earnings in preparation for surgery, whereas once surgery has been carried out the assistance applies in the recovery.

I would hope that the director-general would be quite liberal with the discretion in terms of providing that support because I would imagine preparation for surgery is the most important step that a person contemplating donating their organs would have to go through, in terms of all of that preparatory work and the suitability—and I guess the purpose of this bill is to encourage people, those who want to, to be able to take that step.

I would hope that the fact that there is discretion there to provide that support would not be a stumbling block to those who would be denied financial support for going through that preparatory phase. But be that as it may, this is a really great piece of legislation. It is going to be great. It is going to make a huge difference to the lives of many New Zealanders.

Just as a case in point, I would like to pay my respects and good wishes to Kīngi Tuheitia. He is undergoing a kidney transplant operation today. His son Korotangi has generously donated his kidney to his father. I know that there is a special karakia that will be taking place tonight at Te Puea Marae. Te Kāhui Wairua interdenominational group will be there to have a special karakia for Kīngi Tuheitia. I wish him well. I wish him a speedy recovery.

Ā, kia piki te ora, te kaha, te māramatanga ki a Kīngi Tuheita, ā, me tana tama a Korotangi i tēnei wā.

[So let wellness, strength, and enlightenment be upon Kīngi Tuheitia and his son Korotangi at this point in time.]

As I say, this is a very worthy and great piece of legislation. I am looking forward to actually seeing the increase in the transplant operations that will be taking place, the lessening of waiting times, the availability of donors increasing, and the healthy lives of many New Zealanders being able to benefit through the passage of this legislation. I commend it to the House. Kia ora tātou.

I will add my congratulations to the member in charge of this bill, Chris Bishop, who introduced this bill. He was not the first member attached to this bill, but it has to be said that in the time of the consideration of this bill in the Health Committee, Chris Bishop made an impact on the very shape of the bill, including the name of the bill. So he does deserve a good deal of credit for the work that he did on the bill once it came to us at the select committee.

We considered this bill in the committee for over 12 months and gave it a lot of consideration and significant improvement on the way through. We did receive a number of submissions on this bill, and a number of New Zealanders came to submit in person to the Health Committee on this bill. What was notable around that was that it could not be ignored that those New Zealanders who have been in receipt of an organ donation—it is not only a life-changing event for them in terms of their health and their life expectancy but also a life-changing event for their families and friends. It is a large event in each and every one of those persons’ lives, so that comes to the very heart of why this bill, I believe, is being so enthusiastically supported across the House and across wider New Zealand.

What is seemingly a small legislative measure—although, I am sure Chris Bishop would argue otherwise—here in the Parliament has such a disproportionate and beneficial impact on those individual New Zealanders who are in receipt of an organ, and it will increasingly be so in New Zealand as a result of this legislation. We are, I believe, as parliamentarians—and the member in charge, Chris Bishop, certainly has raised the issue publicly, so now, I guess, we would all like to think that the issue of live organ donation and the opportunities that that brings for recipients and also donors has been much enhanced by this parliamentary process.

Also at the heart of this bill is the notion that the live donation of an organ is a very altruistic move, either promoted by love or promoted by some feeling of making a contribution to a person. Deservedly, they should expect compensation while they recover from that donation, because it is a big medical event, donating a live organ for that person, and there will be a time of recovery and adjustment. So this bill seeks to, and does very adequately, I believe, compensate those New Zealanders who big-heartedly make a donation. That was almost a joke, but not quite, because, of course, live organ donation now is restricted to kidney and liver donations, but also in this bill there is the ability to widen the scope of live organ donation as medical advances occur.

We do have in New Zealand a low organ donor donation rate. Again, I think that through the offices of this bill that is another barrier that will be removed. There are a number of strategies across Government committed to increasing organ donation, including a wider Government review of deceased organ donations. So there are many implications and ramifications of this bill. Currently there are not enough donations to meet demand. It is hoped that with Government policy enhancing the increase of organ donation rates—and in Budgets in both 2012 and 2014 there were financial increases to work towards this purpose of increasing organ donation.

I just want to close my contribution by once again thanking those submitters who took the time to submit to the Health Committee—in writing, by teleconferencing with us, or by coming in and sharing their personal stories. Those personal stories of New Zealanders giving their take on the issue based on their experience of the issue have been most effective in our consideration, so to those of them out there, I give a pretty heartfelt thankyou from the committee. With those comments I conclude my contribution, and my congratulations to the member in charge on getting this quite significant piece of legislation through the House. Thank you.

Tēnā koe e Te Māngai o Te Whare. I would like to start by just reminding the House of the title of this bill when it was first introduced. It was called the Financial Assistance for Live Organ Donors Bill, and now it is called the Compensation for Live Organ Donors Bill. What I would like to do is to congratulate Chris Bishop, because I know he sat on all the Health Committee hearings. I know that there were others involved in the Financial Assistance for Live Organ Donors Bill but, actually, Chris is responsible for the Compensation for Live Organ Donors Bill. That is actually a significant point, and I want to acknowledge his leadership in working with the Health Committee. I think it is really important, because other people have said that this has come from others, but, actually, the bill that we have before us did not come from anyone else. It came from a lot of hard work and focus by the member in charge of the bill.

I would like to reference a Stuff article I have just seen. It is dated 5 July 2014, and it had a lot of comments from a 27-year-old called Matt Heal, who donated to his 68-year-old grandmother Sharon. Sharon was receiving dialysis and had been told that if she could not find a donor she was going to pass away. Matt put up his hand, and he said—this is what was quoted in the article—that it was his good deed. He did not have any kids and this was an opportunity to pay back to his grandparents, who had given him so much. But he noted that he was being paid $206.21 per week by Work and Income, and that did not cover half of his mortgage. His grandparents assisted him through that process, and that instigated Sharon writing to Minister Ryall, who, actually, referenced a bill that Cam Calder had in the ballot. That was the Financial Assistance for Live Organ Donors Bill. It noted that the proposition of that bill was to pay 80 percent of a person’s wage. So, essentially, it was about treating donors as having had an accident and going through our ACC system. As you can see from the iteration of the beginnings of that bill in the House today, we have moved so far away from the proposition that this is an accidental relationship between a donor and the person who receives the donation.

I actually want to talk about the relevance of this piece of legislation to different parts of our society and our community. I found some statistics from a discussion paper titled “Ethnic, cultural and religious differences in relation to deceased organ donation”. In 2015 there were 442 people who needed an organ donation—who needed a kidney, actually. Of those, 170 were European. Europeans are 64.4 percent of our population, and 38.5 percent of those needing a kidney. Māori—93 needed a kidney; 16.6 percent of the population and 21 percent of the people needing a kidney. Pacific—108 needed a kidney; 7.3 percent of the population and 24.4 percent of those needing a kidney. Asians—63 needed a kidney; 9 percent of the population or 14.3 percent of people needing a kidney. The “other” group was three people. They are 2.3 percent of the population and 0.7 percent needing a kidney.

Corresponding to that were those who had actually donated. Of the 273 donations that were noted in that particular document, Europeans were 218, 80 percent of donors; Māori were 29, 11 percent of donors; Pacific were 9, 3 percent of donors; Asians were 10, 3.5 percent of donors; and “other” were 7, or 2.5 percent. So the relevance of this piece of legislation to Māori and Pacific communities actually cannot be underestimated. I do not think we have really focused on that, that this is a piece of legislation that is going to disproportionately provide, I think, better opportunities for our Māori and Pacific members of society.

What is the relevance of that? Well, kidney organ donation—in 2014 there were 139 kidney donations. Of those, 72 were live donors, or 52 percent. The reason I highlight these statistics is that I think they are really important now in engaging with our Māori and Pacific communities, who disproportionately need these live kidney donations. I think by removing the financial barrier and the financial burden, it is going to provide more opportunity for live donations from our Māori and Pacific communities. I think we are going to see a significant increase, because a lot of the barrier has been financial. In fact, the American Society of Transplantation and the American Society of Transplant Surgeons created an incentives workshop group in 2015, and that was their biggest finding: that the financial burden of organ donation was the biggest disincentive. So congratulations to the House; we have addressed that issue.

The other thing that they highlighted, though, was that careful consideration and testing of potential financial incentives for organ donation should also have been considered. They estimated that out-of-pocket expenses averaged about $5,000. That is for transportation, lodging, childcare, and lost wages. We have not gone that far. I think that, ethically, compensating people is seen as the line in the sand, but potentially that is something we should be keeping an eye out for, in terms of its relevance.

I am part of Diabetes Action Month, so for the last 3 weeks I have been “stepping” every day, to try—initially—to be part of a fitness challenge. I have managed to do that—that has become part of the finals week challenge. I am part of a group called the Diabetes NZ FitBit MoveMeant Challenge, and I have got my Fitbit. At the moment I am averaging over 25,000 steps a day. The reason that I put my hand up—actually, with Minister Coleman, Minister Lotu-Iiga, and my colleague Jacinda Ardern—and said “Yes, I want to be part of this issue.”, is that over 260,000 New Zealanders have diabetes. That is a heck of a lot of New Zealanders—59 percent European and “other”, 16 percent Māori, 12 percent Pacific, non-Indian Asian is 7 percent, and then Indian is 6 percent. The relevance of those statistics actually replicates, in some ways, the relevance of this piece of legislation.

What we have been trying to do is to highlight how we can address the issue of diabetes in New Zealand, and the best way to mitigate diabetes is actually to get moving. It is to do your steps and do some exercise. What I have read just recently is an article in the British Medical Journal that says that after you eat, you should walk for between 5 and 15 minutes. I think, culturally, some of our natural inclination is to eat and have a moe. Some people eat and have a cigarette, but, actually, what we should be doing is eating and walking. If you eat and then walk for 5 to 15 minutes, what it does—and maybe Mr Shane Reti can explain the biology. We have got to decrease the blood sugar level, and the best way to do that is to get the body moving and processing the food that we have just eaten. I have actually changed my habits, through doing this Fitbit challenge. Now, after I eat, I will walk for between 5 and 15 minutes. That is one of the things that I have now integrated into my routine.

The other part of it is about making healthy choices. I would not normally do a commercial for a business, but Pita Pit has joined Diabetes New Zealand, and it is all about making healthy choices. Pita Pit now has a range of diabetic products, so that when people go into their shop and want to eat better, they actually have some guidance that says: “If you’re a diabetic, these are the best diabetic options for you.”

What I am hoping is that through pieces of legislation like this, it is actually going to create a space for a lot more conversation about how we prevent needing donors in the first place. We want a healthy society, we want a well society, and we want people who have got information so they can make informed decisions about how they live their lives. My final mihi to the Diabetes New Zealand whānau is: thank you for all the work that you do. I really appreciate it, because by involving me you have provided an opportunity for me to get some information and to actually change my life. Nō reira, tēnā koutou katoa.

It is a pleasure to take the final call on this bill. I too would like to acknowledge the sponsor, my colleague Chris Bishop, for his tenacity and hard work on this bill. I would also like to acknowledge the Health Committee for its excellent guidance, which gets it here today through to its third reading. For this contribution, I want to specifically acknowledge the pioneers in the transplant space, who gave us the ability to undertake the functions that this bill seeks to encourage.

Prior to 1954, and through the 1900s, live organ transplants were being explored. They were usually kidney transplants. However, recipients only lived for a day, or maybe several weeks, because we did not understand the immune system. We did not understand graft-host rejection. We have to remember that it was 1953 that Watson and Crick discovered the double helix, so it was all very new. On 23 December 1954, at Peter Bent Brigham Hospital in Boston, the first successful live organ donor operation occurred. Peter Bent Brigham Hospital was established in 1913, and through various mergers and amalgamations with Harvard-affiliated hospitals, it became what it is today: Brigham and Women’s Hospital. For 7 years my clinical appointment was just across the road at a place called Beth Israel Deaconess Medical Centre. Many, many times, I have had the privilege of being in Brigham and Women’s Hospital.

On 22 December 1954, 23-year-old Richard Herrick was lying in his hospital bed at Peter Bent Brigham Hospital, and he was dying. He was dying of kidney failure; he needed a kidney. In the room next door was his brother, Ronald Herrick. Ronald was going to donate his kidney the next day. Ronald was not just an ordinary brother—if you could have just an ordinary brother; Ronald was his identical twin. What they figured at that stage was that there was something about sameness, something about being similar, and something about similar immune systems that seemed to make a difference. They had actually tested this hypothesis. They fingerprinted both Richard and Ronald, to make sure they were identical twins, and then prior to the procedure—several months before—they had actually taken skin grafts off both of the brothers, swapped them around, and the skin grafts took. So they had every indication that maybe the surgery would take as well.

On 23 December 1954 in operation room No. 2 at Peter Bent Brigham Hospital a kidney from Ronald Herrick was given to his failing brother Richard Herrick. Remember I said that at that point in time people with kidney transplants were living for maybe days—days to weeks—because of graft-host rejection. Well, Richard got 8 more years of life, and his brother Ronald lived through to age 89. Dr Joseph Murray, who undertook the procedure that day, got a Nobel Prize for his work. As well as acknowledging my colleagues here today, I also want to say thank you. Thank you to the pioneers of history who gave us this opportunity to bring forward this bill, which gives life to others. I commend this action to New Zealanders, and it is a pleasure to commend this bill to the House.

Bill read a third time.