Organ Donors and Related Matters Bill

on behalf of the Minister of Health: I move, That the Organ Donors and Related Matters Bill be now read a first time. I nominate the Health Committee to consider the bill.

The bill amends the Compensation for Live Organ Donors Act 2016 and the New Zealand Public Health and Disability Act 2000. The bill encourages and supports live organ donation. In the future, we will also want to make it easy for New Zealanders to make their deceased organ donation wishes known to family and whānau, and to help those involved in those decisions with the best possible support and confidence.

There are a number of parts to the bill. Part 1 of the bill amends the Compensation for Live Organ Donors Act 2016 in relation to earnings compensation to be paid to live organ donors while they recuperate from surgery. The bill provides for those who are currently not eligible for compensation under the Act but who clearly fall within its purposes. Currently, organ donors are eligible for earnings compensation for up to 12 weeks while they recuperate from donor surgery. Once the donor returns to work, they’re no longer eligible to receive compensation. Donors also stop being eligible for compensation if they return to work on reduced hours—being less than their usual hours of work. The bill amends the Compensation for Live Organ Donors Act 2016 to allow compensation to be paid to donors who choose to return to work for reduced hours during the recuperation period or return to work and subsequently reduce their hours due to the effect of surgery.

Currently, for a donor to be eligible for compensation while they recuperate from donor surgery, both the donor surgery and the transplant surgery must take place in New Zealand. Further, the organ recipient must be eligible to receive services funded under the New Zealand Public Health and Disability Act 2000. This means that a donor who donates, for example, as part of a proposed trans-Tasman kidney exchange programme, and where the transplant surgery then takes place in Australia, that New Zealand donor is not eligible for compensation. The bill then amends and futureproofs the compensation for live organ donors by amending the principal Act to provide for compensation to be paid to donors of organs if the donor surgery is undertaken as part of any future approved overseas organ exchange programme.

Part 2 of the bill amends the New Zealand Public Health and Disability Act 2000 to enable the establishment of a national organ donation agency, which in future will provide oversight and clinical governance of the organ donation and transplantation system. The national strategy for increasing deceased organ donation and transplantation sets out a number of initiatives to help New Zealand increase our organ donation and transplantation rates from deceased organ donors. The national agency could play a role in raising the profile of organ donation and by providing expert advice and information to the sector, to the Government, to the media, and to the public. It will also support effective clinical governance and work in the health sector to coordinate donation and transplantation processes. To enable this, the bill amends the New Zealand Public Health and Disability Act 2000 to provide for a broadening of the functions of the New Zealand Blood Service, which will then allow it to serve in this national leadership role. On behalf of the Minister of Health, I commend this bill to the House.

Thank you, Madam Deputy Speaker. I am pleased to advise the House that the National Party will be supporting this bill at its first reading, and I see no impediments to that support being right through the passage of the legislation. We do so because, while the Minister who moved the motion didn’t have anything to say about the genesis of the reasons for this bill, both of the main changes being made had their genesis in the previous Government, firstly, as a member’s bill drafted by me many years ago, but then made good by my colleague and friend Chris Bishop. It was the Financial Assistance for Live Organ Donors Bill—it’s got another name now—and Mr Bishop made it so much better and passed it into law. Encouragingly, it has been very successful in increasing the volume of live organ donation, not that that was its purpose; it was more about removing barriers rather than providing financial incentives. But it is clear that there have been some issues that were raised in the practical determination of the financial support, and I commend the Government for making these changes to make sure that the policy intent and the breadth and scope of support for live organ donors are as practicably wide as possible.

Of course, the report, the strategy that has given effect to the establishment of the New Zealand Blood Service as the agency vehicle for delivering the national strategy, was the previous National Government’s. A previous Minister of Health the Hon Dr Jonathan Coleman commissioned the ministry to go and highlight strategies that could increase cadaver donation—deceased organ donation and transplantation—and that was reported back to the previous Government in June 2017.

One of the recommendations, strategy priority five, was to establish the national agency, and one of the things that the Ministry of Health was advised by stakeholders was that it shouldn’t be a continuation of the status quo or an enhanced status quo where a district health board (DHB)—in that case, the Auckland District Health Board—was the agency. They were very clear that the public consultation identified that the governance of this new agency should be a stand-alone entity rather than within a DHB. So we have kind of a hybrid here: we are annexing the organ donation agency into an existing stand-alone entity, the New Zealand Blood Service, which the National Party has no problem with, necessarily, but I would add the corollary that the current appropriation being proposed to manage the transition is a relatively small sum of money at just $100,000 in this financial year and $225,000 in the next.

Now, that is a very small amount of money to do a very significant piece of work and to establish the agency as the voice and the adviser for the increase of both live and deceased organ donation. It would be a shame if chump change—well, the absence of it—was used to prevent the really good goals that the strategic document has highlighted from coming to fruition.

It would be remiss of me as the shadow Minister of Health, and one who has, I guess, a quantitative lens but a firm belief in the value of targets—a belief that this Government apparently doesn’t have, having removed all health targets, having committed to replacing them but not doing so—not to say that strategic priority six in the strategic document highlights the importance of measuring progress, and in order to measure progress, we need to set some kind of target. Now, we’re not going to see that, I have no doubt, but I think it’s a really, really good idea and I encourage the Government to be aspirational and set stretch targets for both live and deceased organ donation.

The last thing I want to mention about the establishment of this agency is that one of the other strategic priorities—number two—was “Improving New Zealand’s system of registering and sharing donation intent for individuals, families and clinicians.” This will be really, really important—almost a raison d’être—for the agency, along with an information campaign.

Now, we are having a conversation at the moment about the autonomy of the individual, and it’s being discussed in the context of the End of Life Choice Bill. One of the things that has become very clear about that is that the sponsor of the bill and the supporters of that legislation value autonomy over everything else. I mention that because one of the barriers to deceased organ donation is the so-called family veto—that my autonomous right to choose what happens to me in the event of my death can be usurped by a family member. It’s questionable. While we have a noble goal in the second strategic priority for this agency, we actually, I think, have a task to review whether or not a person’s wishes, which could be articulated—they are currently articulated in the driver’s licence system but are not presently being used by clinicians necessarily, except to simply start a conversation. Actually the goal of strategic priority two is to increase the register and improve the quality of the information, but it does not stop the possibility of that autonomy, that preference that I might have, to donate organs in the event of my demise from being respected. It’s questionable whether the Human Tissue Act already enables this to happen. I draw members’ attention to section 31 of the Human Tissue Act, which actually describes who can give consent for tissue or organs to be used for any purpose. The first person—and it’s in a ranking order—in my view is actually the individual.

So in supporting this piece of legislation, what I’d also like to encourage this new agency to do is to be a bit braver about having a conversation about whether a register could include something like an advance directive, something that I as a former hospital manager had to deal with from time to time for elderly patients going through serious surgery, a do-not-resuscitate order, or for religious reasons where the patients may not be willing to accept a blood or blood product transfusion. That is something that we would absolutely respect. I think an advance directive, in a register that this agency could manage, could also include an advance directive that says, “In the event of my demise, I have chosen”—I have chosen—“to donate my organs to enable somebody else to live.” Actually, that could be a strength for clinicians at a time when they’re having to deal with the trauma of the loss of a loved one, to actually give some comfort to the family that my wishes will be obeyed.

That said, while the establishment of this is going to be a very good milestone, I think it’s also fair to say there are a number of other conversations that we can have to increase both live organ donation and deceased organ donation. I look forward to a time when New Zealand actually has a much higher rate of donation than it presently has. We support this bill.

Tēnā koe, Madam Deputy Speaker. As the chair of the Health Committee, it’s my pleasure to rise in support of the Organ Donors and Related Matters Bill at this, the first reading. Actually, I want to start in 2006, when Dr Jackie Blue had the Human Tissue (Organ Donation) Amendment Bill before the House. It made it through to the select committee stage but then was defeated at the second reading.

I find it incredibly not ironic but the right thing to have happened that, 13 years later, Dr Jackie Blue is the deputy chair of the New Zealand Blood Service. So the fact is that she now has an opportunity to germinate, so to speak, the ideas that she had in the bill from 2006, which was about public information campaigns, about creating donor information, and about working with the Land Transport Safety Authority to make sure that donors’ wishes were not overridden by their family members.

So it’s a pleasure, actually, that this piece of legislation has come to the House and is expanding the compensation regime that Chris Bishop initiated in his bill, because, essentially, they are the two expansions of this bill to the current regime: more people being eligible and the national organ donation agency being formed.

I guess my only other contribution was to say that this is relevant to 550 New Zealanders. That’s the number of people on the waiting list now for transplants. It’s been interesting, if you look at, I guess, this whole area since 2013, when there were only 36 donors: in 2014, there were 46 donors, in 2015, there were 53 donors, in 2016, there were 61 donors, and in 2017, which is the last stats, there were 73 donors, but those 73 donors helped 215 individuals.

So, essentially, what we really need to do is look beyond deceased organ donors, which have classically been the ones who have provided organs for New Zealanders who need them. There were a couple of cases. The most recent one I could find was on 28 February this year: a 16-year-old boy at a motocross event in Auckland. He died from injuries he sustained at the motocross event, and he donated because “he wanted to get to live on”—which was a quote in the paper—but his organs helped seven other people.

So I think that for people who are engaged specifically in this area, it is based on their experiences of having family members either who have died and contributed organs or who have been the recipients of organs. So I think this bill is incredibly important. I think it’s beyond time that we focused on it. If we can have a waiting list that is every year cleared because we have enough organs to meet the needs of our fellow New Zealanders, then I think that this piece of legislation and the history of it will actually fulfil the legacy of people like Dr Jackie Blue who bring these issues to our Parliament. Kia ora.

Thank you, Madam Deputy Speaker. I rise to speak in support of the Organ Donors and Related Matters Bill, a bill that of course we support, because on this side of the House we did a lot of work on it, and the Hon Michael Woodhouse and Chris Bishop—I nearly called you “Hon”; not quite there yet, Chris, but, you know, keep going with these good bills and you never know what might happen.

💬 Hon Member: That’s right.

Indeed. I think that this is a bill—and we’ve talked about it and had a conversation around New Zealand for many years about the need for more organ donations. But what do we do? What do we do about that? We need more organs, and others—in fact, the member who just sat down, Louisa Wall, talked about the ability of one person’s death to provide life for others. A young Canadian man who died in Wellington at the end of last month—his family were pleased that he had donated his organs, because he died in New Zealand and his father, Darryl Bates, told the news that his thrill-seeking teen had been on a vacation, coming here for one month. He died, but with the donation of his organs he has saved five lives today, and the family of that visitor to New Zealand took great comfort from it.

It has been an ongoing challenge. I was just googling before about what happens in different parts of the world. This is really carrying on the narrative from the Hon Michael Woodhouse as to how we can engage people more and make it easier for them to register and for that knowledge of their wishes to be carried out after their death. In Canada, they’ve gone a few steps further around this, and they want to be able to register their intent to become a donor by visiting a site. I was somewhat surprised, although perhaps I should not have been, that they have a National Organ and Tissue Donation Awareness Week. It’s not very catchy, is it? The acronym is not great! But apparently it really works and people have that focus and they write it down, and so they have harvested a remarkable number of organs.

On a sadder note, with the euthanasia debate yesterday, it became apparent that patients who went through euthanasia could be kept alive but their organs harvested over a period of weeks and months, which, personally, I found a bit creepy, but that’s what they’re doing and, of course, a live donor is a very important part of a life continuing. So the idea of a national organ donation agency that’s needed to oversee and to lead the implementation makes perfect sense.

We need to raise the profile and the need to have organ donation. Effective clinical governance is very important. Some years ago, around the Christmas period, a neighbour of mine needed a liver transplant. A young man had had a car accident and so my neighbour was shaved and sedated and wheeled in but, by the time the family had discussed whether the organ should in fact be donated—because that’s what the young man had written on his driver’s licence—the organs had passed their ability to be useful. So it was wasted, and I’ll never forget having a conversation with my neighbour, who was very upset indeed. He went through that process three times.

I think working with the health sector to coordinate donation and transplantation processes is also a very important part of this on a practical level, and providing expert advice and information to the sector also seems to me to be very sensible, because we do need to achieve the aim of having more organ donors both alive and dead. We’re doing well, but we could do a lot better, and we need to ensure those rates keep on rising. I wasn’t aware that Dr Jackie Blue had sort of invented her own job well in advance and was now at the New Zealand Blood Service. Perfect symmetry, really, isn’t it? And I’m sure she’ll guide it very wisely, because she would understand, with her medical background as well as her political one, how important these things are and how it needs to be very well governed to be able to work.

I think, having done the report that was commissioned under the Hon Jonathan Coleman—it was delivered in the middle of 2017—it really made perfect sense. On this side of the House, we support it because it has had the kind of lead-in time and rigorous evaluation process that we have brought to our legislation and which is now being picked up by the Government, which is good, and filling the Order Paper, which is also good. So I won’t delay the time of the House any further, but I do certainly commend this bill to the House.

Thank you, Madam Deputy Speaker. It’s a pleasure to rise on behalf of New Zealand First in support of the Organ Donors and Related Matters Bill. We’re pleased to be able to support this bill, noting that it contains a number of improvements to our organ donation programme. That really is long overdue. We like it because it helps to meet the needs of living people who donate an organ and also the families of deceased people who donate. We also like the fact that it will fold neatly and very cost effectively into the New Zealand Blood Service, which has the experience and the ability. They’ll be able not only to manage the programme very well but also to promote the service to get the numbers up, because that’s what this bill is all about; it’s about increasing the number of donors for all of those who require an organ donation.

It’s also a very sensible and not unnecessarily coercive type of bill. It comes from the strategy to increase New Zealand’s organ donation and transplantation rates, and we believe that the resulting bill actually covers a number of areas that will actually help to achieve that goal. It’s an omnibus bill, and we will see that it will amend the Compensation for Live Organ Donors Act 2016 as well as the New Zealand Public Health and Disability Act 2000.

It’s really, when you think about organ donation, an unconditional gift of life. The very word “donation” implies that there’s no direct compulsion. So we strongly believe in this particular ethos. In New Zealand, we don’t have very high organ donation rates. Some countries like Singapore and Israel lead the world in organ donation transplant rates, but they’re also known for the fair amount of pressure that they put on grief-stricken families, when we’re talking about deceased organ donation. That could actually border on coercion. So that’s not an area where we want to go, but we would like to see that there is greater ability to have families understand their young people, perhaps—like the Canadian young man who’s been mentioned—how they can feel that they can make those decisions, particularly if they didn’t know that that person wanted to be an organ donor. So this will create a great pathway for that.

We have a number of kidney transplants. I’d like to speak to those briefly in New Zealand. In 2017, there were 187 recipients of kidney transplants in New Zealand: 69 were living donor and 118 were deceased donor kidney transplants. The year before, in 2016, there were only 172 donor transplants. Three district health boards around New Zealand conduct these. They provide kidney transplant procedures. They’re in Auckland, Wellington, and Christchurch. Auckland has the most. In 2017, there were 126 in Auckland, 37 in Wellington, and 24 in Christchurch, giving that overall total of 187.

To give the gift of life is the most selfless gift you can possibly give, and organ donations are actually a very sensitive issue, a very emotive issue, and in New Zealand we have around 200 or so ethnicities. Each ethnicity has its own cultural practice that must be respected and understood. This is a new area, and I’d like to speak to this briefly in terms of Māori and looking at this gift of an organ as being a taonga—as a gift. So that is an area that I’d like to note that Dr Lance O’Sullivan has made discussion about, and the question being, in his mind, “What if an organ donation actually didn’t diminish tapu? What if it actually enhanced it?” So that’s a conversation within Māoridom that is ongoing, and this bill will certainly link to the donation in terms of how it can work through into various communities of New Zealand.

I’d just like to make mention of the Māori man who made a live kidney donation. He made a request that, when that recipient eventually dies, a long time into the future, he would actually like to have kidney returned back to him after he’s passed on and to go into the grave with him. So there are all sorts of ways that society and community are looking at what it means to be an organ donor and giving that gift of life. New Zealand First absolutely believes this bill is a very important bill to make that process and increase those donation rates. And so we’d like to see it speed its way through the House as it works to give more people the gift of life. Thank you, Madam Deputy Speaker.

Thank you, Madam Deputy Speaker. It’s a pleasure to rise and speak to this, the Organ Donors and Related Matters Bill. I, too, would like to acknowledge Mike Woodhouse as the genesis of the bill, and then Chris Bishop, through the members’ ballot, who successfully negotiated it through to where we have it today.

I recall that coming to the Health Committee, and it seemed an interminable amount of time to get that bill through the committee. The challenging part was actually the IT software interface with the Ministry of Social Development. That was the part that took a lot of time. These were quite a complex set of changes. And I would note that since that bill has passed—almost two years ago now—almost 100 people have obtained full compensation for donating live organs. This is a 500 percent increase in organ donors receiving compensation than the year previously.

Now, this bill here does several things. First of all, it seeks to implement recommendations from the 2017 strategy, Increasing Deceased Organ Donation and Transplantation. This particular document had six priority areas, which I’ll very briefly touch on. The very first priority area was improving public awareness, in the understanding that public awareness campaigns overseas have shown that educating the public about organ donation and busting common myths clearly increases organ donation. I think what’s also interesting here is the number of high profile public people who are very willing to lend their names to organ donation. Maybe our most famous is Jonah Lomu, but I would submit that maybe Billy T before that with his heart transplant was, also, very famous in the organ recipient space. In fact, in my final med school exams I was set up to examine Billy T at Middlemore in the late 2000s. I only knew that about three hours afterwards when Professor John Collins, who was organising the exams, told me he was too sick that day to bring him down from the ward, and they were very intrigued to see how I would cope in the stress of your final exam interviewing Billy T, and examining Billy T. But it didn’t actually eventuate: he was too ill that day.

The second priority in the strategy document of 2017, is improving New Zealand’s system of registering and sharing donation. This talks about exploring the option of recording individuals’ donor information, not just on the driver’s licence, but also in developing electronic health records. I’ll be interested to see how that goes hand in hand with the Government’s intentions. The third priority: enhancing capability and consistency through improved training. It is kind of interesting that only 30 to 50 percent of intensive care physicians have done organ donation training; that would seem to be a relatively simple area to have some impact on, as compared to moving organ donation to the blood transfusion service or the Blood Service. So that’s another piece of work that could maybe be picked up and looked at.

The fourth priority: increasing hospital-based capacity for deceased organ donation. This is talking about having specialist donation teams that work within the hospital. The second to last: establishing a national agency to lead the Increasing Deceased Organ Donation and Transplantation. Of course, this is the transfer that this bill does of these responsibilities to the Blood Service. I’ll echo what my colleague Michael Woodhouse was saying, that the resources need to be commensurate with that responsibility, and need to follow.

The sixth and final strategy which this bill looks to enable is to measure progress. That is our ability to critique how well we do with organ donation against a number of measures, and, particularly, to benchmark how well we do that against international measures.

There are other things this bill does. It addresses compensation, particularly those who come and go from work, and our international collaborative responsibilities. This is a bill that we’ve had a large part in and that we will support, and I certainly commend it to the House. Thank you.

Thank you, Madam Deputy Speaker. Well, it’s a real pleasure to be speaking on the first reading of this bill. Just reading through the Organ Donation New Zealand website, it’s a really good reminder of the transformational impact that an organ donation can have on somebody’s life. There’s a whole range of stories; it’s worth going and reading some of them. I think the one that stood out to me was baby Ruby who was born with biliary atresia and ended up spending a huge amount of time in hospital before she received a lifesaving liver transplant. What the reality is, though, is in New Zealand there’s a large number of people waiting for organ transplants, many more than the number of organs available. Organ Donation New Zealand estimates there are about 550 people currently waiting for a transplant here in New Zealand, so what this bill does is it aims to make it easier for people to become organ donors.

There’s two parts to this bill. The first part is for live donors, and at the moment somebody who’s made an organ donation can receive up to 12 weeks earning compensation for that, but the understanding is that you then take that time off work and you don’t return to work. But what this bill does is it allows for people to come back to work at less than their usual hours and still receive compensation. So either you’re working reduced hours when you come back, or if you do come back to work at your normal hours and then you find that you are unable to continue at those hours because of the effects of surgery, this allows that compensation to be paid.

The other aspect in terms of live donors is that it allows regulations to be made which can approve overseas organ exchange programmes. What it specifies is a few criteria that those overseas countries have to meet, but it makes that possible under the New Zealand regulations and legislation.

The second part to the bill looks to expand the functions of the New Zealand Blood Service—they’re already outlined in the New Zealand Public Health and Disability Act. But what it does is allows oversight and clinical governance for organ donation and transplant system, because there’s a recent strategy that many other speakers have alluded to—the national strategy for Increasing Deceased Organ Donation and Transplantation—and what this really does is create that dialogue and encourages people to share their wishes about organ donation with their families. Also, the strategy aims to provide that support to the families that are having to make those donation decisions. What the strategy talked about, though, was the need for an organisation to oversee the implementation of that strategy.

So what this bill does is it identifies the New Zealand Blood Service, which was felt to be the most appropriate Crown entity to host such a national agency, and it expands the functions of the Blood Service to provide oversight and clinical governance of organ donation and transplantation. So those two key elements—the aim is to increase the amount of organ donation that is happening in New Zealand. So, as a result, I’m very pleased to commend this bill to the House. Thank you.

Thank you very much, Mr Assistant Speaker. National is very pleased to be supporting this bill because organ donations can save lives, and give sick people another chance to live a good quality of life. National has been working to lift the rate of organ donation in New Zealand for many years, and this is the next step in the programme.

As early as 2006, National MP Dr Jackie Blue introduced a member’s bill to increase organ donation. Unfortunately, at the time, it was voted down by Labour, New Zealand First, and the Greens but, fortunately, they have changed their minds about that. However, National has always been committed to increasing donation numbers and has employed a number of strategies to improve transplantation rates. In 2012, we started with a $4 million budget to raise awareness and to encourage more people to donate organs. That was followed, in 2014, with the establishment of the National Renal Transplant Service to increase the number of live kidney donor transplants. At that time, we also provided funding to establish donor liaison coordinators, and these people have done an enormous amount of work to raise the rate of donations. Following that, National MP Chris Bishop introduced a member’s bill in 2016 which introduced the payment for compensation for live organ donors. That was important because it was a barrier for people to make donations. Since then, there’s been a huge lift in the number of donations. I think the new system is much better, it’s fairer, and it has made a big difference to people waiting for organs and for transplants.

In 2017, the National Government announced a national strategy to increase deceased organ donation and transplants, and this bill implements recommendations from that strategy. So I’m very pleased to support the bill. It builds on the work that National has done for over a decade, and it will make a real difference to people who require transplant, and their families. So I commend this bill to the House.

This is a split call—five minutes.

Thank you, Mr Assistant Speaker. I’m very pleased to be participating in this Organ Donors and Related Matters Bill. I’d like to thank the Minister of Health for bringing this forward, and I would like to encourage everyone in the community, if they have an interest, to submit on this bill. We look very much forward to hearing from people.

As we have heard from all the members tonight, the bill does two things. One, it implements—by creating—a national organ donation agency to increase the Increasing Deceased Organ Donation and Transplantation strategy. The second part is the compensation part for people who are live donors returning to work partially.

I am going to make a very brief call tonight. However, what I would like to talk about is the importance of the conversation that we must all have with our family members in regards to organ donation. I’m a donor myself and I’ve had that conversation with my family as to what my wishes are. People are probably not aware when they put “donor” down on their driver’s licence that that is only their wishes and the family itself gets to make the final decision. So it is very important that this conversation, as awkward as it may be, is had if a person ends up in the state where they are donating organs.

I would also very much like to talk very briefly about Wairangi Te Rupe. Now, Wairangi is watching this tonight from Australia. Wairangi Te Rupe is the sister of my daughter Danah, and Wairangi had at eight weeks biliary atresia. Now that is a life-threatening illness. It is a fatal illness without treatment. Wairangi had various treatments but they all failed and she needed to have a liver transplant. She was in liver failure and her family knew that they would lose her if they weren’t able to have that organ donated. Essentially, what happened was that she was given the gift of life from an unknown person in Australia who had passed away under the circumstances that donation can occur under. That was a tremendous gift to the family. So, personally, you know, this is a little girl who is now 10 years old, who loves life and unicorns and all the things that you would expect a small child to like and enjoy, and she was given that gift because someone gave that gift of life to her. So what I would like to do is encourage people to have this conversation and to think that it is really important that we increase the numbers.

I would just like to finish with a quote from Sam, her mother: “If Wairangi didn’t get her liver in time she would have passed away. People die on waiting lists all the time. That’s why we give thanks for her liver every single day. A very special person passed away. A brave family carried out their loved one’s wishes and said yes to giving Wairangi their liver and they let their special person pass away so that Wairangi could live.” Thank you.

Chris Bishop—five minutes.

Thank you very much, Mr Speaker. This bill amends what started life as my legislation, and I think I haven’t been in the situation before where a Government bill has amended an Act that started life as a member’s bill in my name. It actually started life, as Michael Woodhouse my colleague pointed out earlier, as Michael Woodhouse’s member’s bill. It lay dormant in the ballot, as so many member’s bills do, before it magically got pulled, I think, probably two months after it got lodged in my name. But it’s something that I care very deeply about.

Look, as the original sponsor of the original piece of legislation, I support the amendments to the Compensation for Live Organ Donors Act 2016. We were very well served, may I say, on the Health Committee that I subbed on to when we considered that legislation. We were very well served by the Ministry of Health advisers. They had to do quite a lot of work, actually, to include in the bill a series of, kind of, operative clauses that would allow the bill to work. In particular, we had to deal with the quite tricky issue about how you calculate income and how you calculate when people are working part time and what it means to actually receive 100 percent compensation. And, you know, we didn’t get everything right, obviously, and Parliament’s now doing what it absolutely should do, which is to come back and just make a couple of clarificatory amendments.

Clause 6 of the bill deals with what happens when people return to work on reduced hours. That’s very sensible. And then it also deals with what happens when an organ donor returns to work on their usual hours but then happens to work reduced hours because of the effects of the surgery. It also allows for organ donations that are done with an approved international agency.

Now, it’s also an omnibus bill and it’s slightly strange in some ways. I suppose it is an omnibus bill because Part 2 of the bill deals with the New Zealand Public Health and Disability Act and it makes it easier on the Blood Service—basically, the approved agency for organ donation in New Zealand. I do have to throw a bouquet to the Government for advancing the legislation but also a brickbat, which is to say that it is far too late for the Government to be doing this. They should have done it far earlier. Those in the organ transplant community, organ donation community, have been crying out for the announcement of the New Zealand Blood Service as that agency for months, if not years. It should have happened very soon after the Government took office, but David Clark was too busy scaremongering about mould and things like that.

Anyway, it’s good that they’re doing it now, and we’re looking forward—well, I’m not going to be on the Health Committee that considers it, but I’m sure my colleagues on the Health Committee, led by Matt Doocey, and the rest of the team will be considering that, and I look forward to it passing into law.

Can I begin my contribution in this debate by commending the Minister for the continuation of the vision that has been demonstrated by other members in this House who have a passion for ensuring that New Zealand’s organ donation numbers increase. And I want to commend the member who just resumed his seat, Chris Bishop. He ended on a sour note, but that’s OK. I don’t blame him. He probably still feels a bit resentful, being in the position he is. But I want to commend him for the work that he did on improving organ donations, and I think it made a difference. He raised the issue in this House. He inherited the bill—he didn’t actually write it himself; Michael Woodhouse actually wrote it. But in any event, the bill got through to this Parliament and enjoyed a lot of good debate and it raised the awareness outside, and that’s part of increasing the donations, and it’s great to see cross-party support on this issue.

I think that the legislation’s proposal to have the strategy run from within the New Zealand Blood Service is correct. I also think that the staging of various bits of progress in the implementation of the organ donor strategy is a good one. In 2017 we had the highest number of organs donated in New Zealand. That’s something we should all be very proud of, and I hope that continues to increase. We know why we want organ donations to increase, because it transforms or saves lives. So, clearly, people who have died are not using their organs any more, but somebody who needs them can receive them and it can literally save their life. That is a huge and generous gift that that person who’s just lost their own life is able to give to someone else. But the opportunity for a donation comes at the worst possible time for a family to make a big decision such as agreeing to have their dying family member’s organs donated.

That’s why it’s so important that everyone in this House and everyone who’s listening and everyone who’s interested in this topic talk to their family about their desire to have their organs donated when they’ve died. You can do as I’ve done, have a living will, have a will that then formally lays out that you’ll donate whatever part of your body can make a difference to someone else. It could be an organ. It could be your brain for research. It could be your eyes for giving someone else the gift of vision. So talk to your family about the fact that we were debating this bill in the House and that it’s really important that they know of each of our intentions to donate organs upon death.

I want to conclude by just taking a moment to reflect on the generosity of those people and their families who have donated their organs as they have passed away and have made such a huge difference to the lives of so many others. It’s the ultimate gift and it’s one that we should be very thankful for. Thank you, Mr Assistant Speaker.

Thank you very much, Mr Assistant Speaker. What a loss to the House it will be when the Hon Ruth Dyson does retire. How she can get across such negative comments with a smile on her face, I think, is a real skill, and it will be a loss to the House. But I do want to pick up on her final point of generosity, and that is what this bill is, well, hopefully, going to support: more generosity of people and their families.

We know in New Zealand, there’s a lot more people waiting for organ transplants than ones who are actually going to receive one. There was a tragic case of a 19-year-old recently who fell off a building in Wellington and his family donated his organs, and he saved five people’s lives. What was an increasing generosity in that story was that young person was actually a visiting Canadian tourist. I think this bill goes some way in supporting the strategy of implementing their recommendations. But when I listened to a range of speakers over the course of the last 30 or 40 minutes—I would hate for us to fall into a mindset that everyone is supportive, it’s all good here, nothing to see, let’s move on. I hope we do have a very productive and robust select committee stage where we do hear a full range of submissions, because I think, potentially, there is a lot more that we can do around this issue.

My caution is that legislation will only go some way in addressing this issue. It’s probably a cultural shift that we need to see across New Zealand’s population. We do know that national and international research in this area clearly shows that people favour the donation of organs, but, when it comes to their own organs, there seems to be a disconnect between their sharing of that information between either a national register, or with their friends and families. What also we get caught up in is when a person like myself has ticked the box to donate, but then you get, potentially, pushback from the family, which puts medical professionals in the middle of that as well. So what I would be looking for in this new agency is that it be resourced effectively to ensure that we have the educational programme to ensure that more people are choosing to donate their organs, but also that that choice is respected and that happens as well.

What we’re also seeing from international research around organ donation is, in fact, that the biggest initiative for increasing organ donation is ensuring you have the specialist medical and nursing profession in place and the right clinical pathways. A barrier we have to overcome in New Zealand is the barrier of geography. Now, I was with the National Party health caucus yesterday; we’re visiting medical services in the West Coast—Hokitika and Greymouth. Now, that is one of the most rural healthcare systems practically in the world. So if we are going to ensure this clinical process is in rural areas, we need to make sure that we have the professionals in place, the protocols in place, but also the resourcing as well. As discussed tonight, the initial figures of up to $10 million do seem a bit light, and I do hope that we are able to get down into this detail with the financials in the select committee process to ultimately ensure that we do go through and come out at the other end with legislation that will provide more organ donations, and ultimately more lives saved. Thank you, Mr Assistant Speaker.

Kia ora, Mr Assistant Speaker. Ngā mihi nui ki a koutou. Kia ora. I rise to support this legislation on behalf of the Green Party. Look, when you look at last year, we saw 62 organ donations in New Zealand. Now, that’s an incredibly small number vis-à-vis the rest of our population, but when you think each of those are 62 unique people with lives, with history, with loved ones, and with whānau—62 families, wider communities impacted—you see what a blessing, what a gift, organ donation can be: as has been canvassed in this debate tonight, it is literally the gift of life.

Now, while it’s a small number, when you look at the other side of the ledger, there are 550 New Zealanders, according to Organ Donation New Zealand, that are awaiting donations. It’s heartbreaking when you look at the front page of their website, where they quite frankly say that people will die in New Zealand waiting for an organ. It’s a tragic set of affairs, a tragic case for those individuals, those whānaus, and those communities. That’s why it’s so important that Parliament is coming together unanimously tonight to support organ donation, to make it easier to see organs donated, and to put in place a more effective regime that’s literally going to save lives.

So this comes out of the expert advisory group that the previous Government worked on. I know Chris Bishop talked before, and I acknowledge the work that he’s done through his member’s bill, but this legislation tonight is truly a cross-party effort involving experts, involving those with lived experiences on the ground, to develop the national organ donation strategy. A key centrepiece of this will be the establishment of a national organ donation agency, most likely the New Zealand Blood Service. Now, this is common overseas. I understand, doing a little bit of research, this is what has driven the increase in organ donation, both in the UK and Canada, which have a regime.

If you look at the New Zealand stats, we’ve got about 13 out of a million deceased organ donations in New Zealand per annum. When you look at Australia, it’s more than that; it’s 20. If you look at the United Kingdom, it’s 21.4, so substantially more—again, more stories, more real people, and more families and communities impacted. So we think the establishment of a central body to raise the profile, to support effective clinical governance, to work with the health sector to coordinate donation transplantation, and to provide expert advice will make a difference.

Now, the second big part of this legislation that will make a difference for Kiwis awaiting organ donation is changing some of the compensation rules to donors. There is a situation under the previous, older regime where, when people return to work part-time, they aren’t eligible. This is cleaning that up to make sure those people will be eligible. The second area is around where compensation is to be paid to donors, even if the doctor’s surgery is undertaken overseas. Now, there’s an important caveat to this: that this is only in approved organ donation examples. But for Kiwis that have to go overseas, this is going to make a huge difference. So the Green Party is very proud to be working in this space. I know associate health Minister Julie Anne Genter is doing a great deal of work, in association with the Hon Dr David Clark, improving the health situation for New Zealanders. So this is a positive step forward that’s going to make a real difference, so it is great to be joining with other parties, making a difference for Kiwis. Kia ora koutou.

Bill read a first time.

Bill referred to the Health Committee.