Health (National Cervical Screening Programme) Amendment Bill

So when we were last considering this bill Harete Hipango was speaking, and she has eight minutes remaining to speak if she wishes so. I take it she doesn’t. So I call—Angie Warren-Clark, my apologies.

That’s quite fine, Madam Deputy Speaker. Tēnā koe. Ngā mihi nui ki a koutou. Tēnei te mihi o Te Paremata.

[Thank you. Good evening to you all. This is a greeting from Parliament.]

I rise this evening to take the final call on the Health (National Cervical Screening Programme) Amendment Bill. This bill was brought to the House two weeks ago for its first reading, so I do intend to summarise the bill and our discussion of some of the salient points made across the House.

Firstly, I’d like to congratulate the Hon Julie Anne Genter on this excellent bill. Ko tēnei tū he tautoko, e taku tuahine—I stand in support of you, tuahine. I would also like to thank the members of this House who have provided thoughtful comments to this first reading.

I note that across the House we have agreement that this bill is commended, and it will move into the next stage at the Health Committee.

I would like to make special mention of the member Dr Shane Reti, who explained very clearly to the House two weeks ago about the role of the smear-taker and why it is so very important that they have the cervical health history of the woman before they commence taking a smear. This, if I understood the member correctly, is because this may change the way the smear is taken and may also explain what the smear-taker, the lab, or the specialist may find. I won’t go into where they may find that. Many members of this House got a little bit squeamish with Dr Shane Reti’s detailed explanation and mention of such things as brushes, spatulas, and how to perform a smear. Well, I must say that that detail provided a great context as to why it is so necessary to have efficiency of data at the point of smear-taking. Direct lookup access by certain health professionals is going to improve this system immensely.

Currently, the system works this way. The national cervical screening register is administered by authorised persons and when a woman is called in for a smear, the register administrator then searches the register, identifies the information, prints the information, and manually faxes the medical history to the smear-taker’s office. This process is manual and pages, sometimes up to 20 pages, arrive by fax. They come by fax because the medical profession recognises that emails are not necessarily secure. I do have to say that being in some of the medical offices I’ve been in that it’s also a little bit unsafe, as well, to have sheaths and sheaths of paper coming through. So I would just like to say the fax method, although it is preferred, is something that I personally feel is a little bit outdated and worrisome.

But then someone has to get the fax off the machine, pop it manually into the notes, and then the smear-taker has to read these notes. It’s slow, it’s cumbersome, and the process requires these records touching various people. Surely this can be done better. So this bill ensures a modern approach to give direct lookup access.

Now that we’ve dealt with the subject of smear-taking, why it’s important to have immediate access to that data, and how cumbersome that process is, I’ll move to the technical aspects of the bill as a wee refresher—just what you need this time of the night. The bill amends Part 4A of the Health Act 1956 to enable health professionals along the cervical screening pathway—who knew there was a pathway?—meaning the smear-takers, the laboratory staff, the colposcopy staff, and the screening support staff, to directly access info from the national cervical screening register.

Currently, this information is noted and is gathered by fax, with primary smear-takers waiting for clinical information, and laboratory and colposcopy staff can only gain access if authorised by the Director-General of Health. Therefore, these amendments would enable direct lookup access to the national cervical screening register—in other words, checking the register would be as simple as looking up a database, and it would be done by the person who’s going to be taking the smear. A small point to note, however, is that the register is not yet platform ready, which means that the future design of this database must occur. So this bill is the first step to modernising the system.

I’ll quickly traverse the legislative amendments. This is a little bit complex, so I will read some of this. Clause 4 of the bill adds a new subparagraph to section 112A(b). The purpose is to facilitate the operation and evaluation of the National Cervical Screening Programme by “enabling access … by specified classes of persons for the purpose of … screening, assessment, and treatment services and by researchers.” Clause 6 replaces section 112J of the principal Act with two new sections providing separately for access to use, retention, and disclosure of this information. The sections list who can access information and for what purpose.

Finally, clause 8, which I like to call the stickybeak clause, outlines the offences or consequences if failing to comply with the requirements—i.e., if you amend the register without permission or authority, and you look up someone’s medical notes or history without good cause or proper reason. So that’s it, in a nutshell. It’s quite simple and it just provides for the data to be accessed in a quick and simple method.

Many of us here in the Chamber, and no doubt those at home watching, will recall the Metro article by Sandra Coney and Phillida Bunkle, back in the late 1980s, which eventually moved the Labour Government to instigate what was known as the Cartwright inquiry, led by Dame Silvia Cartwright. Out of this inquiry came many positive changes to the health system for patients. The National Cervical Screening Programme was created as a recommendation of this inquiry and rolled out in 1990.

I still remember myself enrolling, and over the last 28 years I have been reminded to have my smear regularly, and indeed re-reminded when my smear is overdue. In today’s busy world, this has been a brilliant wellness tool to support us women to stay well and to get early warning signs of issues. Ultimately, it reduces deaths by cervical cancer. However, I do have to say that there are some groups within our country that are less likely to access cervical screening and they are our Māori women and our Pacific women. I’d just like to encourage everyone here and also across the land to go and have your smear. There is a poem that came from America, so it’s a little bit different to what we do here. It says, “On your birthday every year, go on down and have a smear.” Now, our smears are generally once every three years. However, you get the picture. Go do it. It’s for your safety.

So, finally, the smear-takers and the people involved with keeping our data safe and secure actually do save our lives. Therefore, I’d like to thank those smear-takers and those involved in the process of supporting our health. You do a great job. It’s time to modernise the system, to help you do your job more efficiently. I therefore take great pleasure in commending this bill to the House.

Bill read a first time.

Bill referred to the Health Committee.