New Zealand Public Health and Disability Amendment Bill

Kia orana, Madam Speaker. I move, That the New Zealand Public Health and Disability Amendment Bill be now read a third time.

In 2018, this Government committed to overturning the discriminatory Part 4A of the New Zealand Public Health and Disability Act, which has caused national and international concern. Today, we’re delivering on that commitment. I would like to thank all of our submitters for your valuable feedback on this bill, as well as the committee of the whole House for your consideration of the bill.

This is a brief bill that represents a huge victory for our disabled New Zealanders, their families, and their whānau and carers. For far too long, our disabled people, families, and carers have had a fundamental right removed from them. It is wrong that some disabled New Zealanders have been silenced from being able to challenge the carer policies that affect them in this way.

Today, I would like to thank the Health Committee for their consideration of the bill. I acknowledge and thank everyone who made a submission and those who appeared before the committee, especially during level 4 lockdown. I would also like to acknowledge the deliberation and input of all parties to this bill, which is one part of a three-part work programme to change funded family care, including legislation, policy, and implementation.

The Ministry of Health has worked with the sector in the development of the changes to funded family care since 2018. Positive policy changes have been implemented for funded family care policies administered by both the Ministry of Health as well as the district health boards. These changes will result in a fairer policy for people with high or very high care and support needs and their families, whānau, aiga, and carers.

With changes to the funded family care, we’ve expanded carer eligibility to spouses and partners so that they are able to be paid to provide care to people with high or very high support needs. We’ve expanded carer eligibility to 16- to 18-year-old family members, so our young carers are able to be paid to provide care to the people with high or very high support needs, and we’ve also expanded client eligibility to include under-18-year-olds with high or very high support needs. We’ve also removed the current requirement for an employment relationship to exist between a disabled person and their resident family member in order to receive paid care for disability support services, and we’ve lifted the pay rates for family carers from the minimum wage of $20.50 to $25.50 per hour.

Extending eligibility to these key groups will enable more people to be eligible and to receive care and support in their preferred way. Changes to the funded family care eligibility will pay rates that will help improve the health and wellbeing of people with high or very high support needs and their families and whānau and carers. These changes will be especially welcome for several groups, especially our Māori and Pacific people, and those who are on lower incomes and those who may not currently be accessing these services.

The disability sector has been eagerly awaiting the changes to funded family care and the repeal of Part 4A for a very long time. I’d like to acknowledge the contribution our disability sector have played in raising their concerns, providing input into the policy changes and the ongoing work in monitoring the implementation of the changes and the outcomes for those receiving care and for those providing care. I would also like to acknowledge and thank the Minister for Disability Issues, the Hon Carmel Sepuloni; the Disability Rights Commissioner, Paula Tesoriero; and disabled people’s organisations for their work and advocacy in terms of repealing Part 4A.

I’m really pleased to commend this bill in its final reading to the House. Thank you, Madam Speaker.

Thank you, Madam Speaker. I rise on behalf of the National caucus and party to be able to give our support to this bill. We believe that the New Zealand Public Health and Disability Amendment Bill does address some concerns. I just want to raise, I suppose, for the House, and also for the public, that we are in support of this bill. Part of its history is that, actually, in 2013 it was the Hon Tony Ryall who had introduced the original parts of the bill which allowed for funded family care. In fact, it was the first time internationally that this was enacted in a way that gave legislation that began the pathway of exploring what that would look like.

Now, today, as this amendment bill is repealing Part 4A of the bill, which talks about the ability to be able to give the opportunity for kin carers, for family carers, to take on the roles to be able to be the carers of their loved ones and their family members. We think that’s the right thing to do. We are in support of that because that will allow, having given a period of about seven years—we were at that point where we matured in our understanding about the funding and the roles of opportunity that can be afforded to those family members as well. We see that as being critically important.

So the bill, as introduced, amends the New Zealand Public Health and Disability Act 2000 by repealing Part 4A of the Act, as introduced under the New Zealand Public Health and Disability Amendment Bill in 2013. We believe that this is critically important. We heard from a number of submitters that this is a small, technical bill but a bill that allows us to continue on to provide that support that’s critically important. One of the things that’s important in the disability sector is that they often reflect that they are the poor cousin—in fact, even worse, they don’t get the support that they are needing over a period of time to provide for those services. In particular, what this will allow for them to do is to be able to have—what was introduced in 2013, the disability flexibility fund. This allows for them to provide a bespoke service. Often these disabilities are complex. They are difficult and they are challenging, both for family members and for other clinical carers as well. So we support this bill. It’s the right thing to do. It’s small and technical, but, at the same time, it does provide what we believe is the necessary pathway for kin carers, for family carers as well. So the National Party supports this bill in its third reading to the House.

Tēnā koe e Te Māngai o Te Whare. Tēnā koutou katoa. It’s my pleasure, as the chair of the Health Committee, to speak on this, the third reading of the New Zealand Public Health and Disability Amendment Bill.

To begin, I’d actually like to recognise those families who were involved in Ministry of Health v Atkinson, which was a Court of Appeal case in 2012. Those whānau involved were Atkinson, Bransgrove, Burnett, Carter, Humphreys, Robinson, and Stoneham, and there were two adult disabled children who joined that particular suit against the Crown. They were Stuart Burnett and Imogen Atkinson. The basic premise of what they had gone to the Court of Appeal about was the ability of family members, as the Hon Alfred Ngaro has said, being recognised by the State as caregivers, and being remunerated for being caregivers. What it did expose was, I guess, a philosophy across the public sector that it was families’ responsibility to look after their disabled children—in fact, because it was families’ responsibility, they should do it without any Government support. Strangers, however, who stepped in and became caregivers of disabled children were supported by the State. I’ll quote what the judgment said—because, basically, the policy was prima facie discriminatory—“we consider differential treatment will be discriminatory if, when viewed in context, it gives rise to a material disadvantage.” It held that “the denial of paid work to the parent respondents performing the specified services and the denial of choice to the adult disabled children amounted to material disadvantage.”

So I want to highlight that this bill will reverse the piece of legislation that was rushed through in response to this Court of Appeal decision, and the other aspect that I want to highlight, in terms of response from anybody in our society who feels that they’re being discriminated against, is that they can use the institutions that are available to us—the Human Rights Commission, the courts—because that was something else that was taken away from those parents; they weren’t allowed to seek redress given the Government’s response. I want to highlight that.

And, just finally, as the chair, I’d like to thank my deputy, Dr Shane Reti, and also the Hon Alfred Ngaro, because, in the end, this bill was a collaboration across the House. We were affected by COVID, but we were able, after hearing from our 44 submitters—hearing from 13 of those orally—to progress this bill as quickly as we could. So I would like to thank them, particularly for allowing this House to consider this bill tonight. Finally, I just want to acknowledge the Minister, the Hon Jenny Salesa, for making sure that the Government followed through on its commitment. Kia ora.

Thank you, Madam Speaker. It’s a pleasure to speak to this bill, which, as previous members have said, we’ll also be supporting through. I want to acknowledge also the Health Committee, led by Louisa Wall. It has been a very productive committee through this Parliament and a pleasure to work with, actually. I also want to thank all the committee members, some who have come and gone. This has been a good experience, and I think we’ve been very productive.

This was a bill that in 2013 was progressive in its time, and the circumstances as they were were how we came to the conclusions we did. Here we are seven years later, and we’re saying it’s a different set of circumstances. We’re looking at this with new eyes and we’re making different decisions and are pleased to be doing that.

Fundamentally, what this does, as has been said, is it gives two options to people to have their home-care support. The first is individualised funding, where they can choose from a menu of providers what best suits them—so that very personalised delivery of care. The second is through a home and community support provider who will do it all for them. You can choose either/or—whichever of those two options best suits you. Fundamentally, what it does is it allows family members, where previously they have not been allowed to be in your employ, to be your funded family carer—that was the previous name for it, but to be your provider and be funded by the State to be your provider.

Here, today in 2020, are a different set of circumstances to 2013, and that’s why the National Party is supporting this bill through to its conclusion. Thank you.

Thank you, Madam Speaker. A privilege and a pleasure, in fact, to take a call on behalf of New Zealand First on this, the New Zealand Public Health and Disability Amendment Bill. I’d like to acknowledge all those from the Health Committee for the collegial way in which we worked together on this bill. It was always—well, generally it’s a pretty collegial committee, and we have progressed a large amount of legislation over the course of this Parliament. So acknowledging my fellow members.

Interesting to note, the speaker who’s just resumed his seat, the good doctor from the North, Shane Reti—Dr Reti has now seen this piece of legislation after the 2013 bill that went through; he sees it now with new eyes. That’s really good to hear. Perhaps it’s because of his view from the front row of the bench. So well done to you, Mr Reti, for your promotion to the front row.

I would like to acknowledge the submitters that came to the committee. We heard oral evidence from 13 submitters via video conference; 44 submissions in total to this bill. When I first jumped into the political ring, I met a woman called Margaret, who was a woman who also came to the select committee with her submission. So I met her three years ago and then just recently heard her story again, which I have heard a number of times over the course of the parliamentary term. I know that Margaret will be really excited to hear when this piece of legislation has passed into law, because she has been affected by it as she is a woman in her 70s with a 50-year-old disabled son. So she will absolutely be pleased that we are passing this law to ensure that she is able to continue caring for her child and be paid accordingly.

Part 4A of the Act allows the exclusion of certain resident family members from being paid for providing support and prevents complaints to the Human Rights Commission about family care policies. We are repealing that here tonight. It is the right thing to do. It’s a small bill, but it will make a really big difference to the lives of those who have disabled people in their families and their whānau. So I’m very pleased to note that, as a result of this bill, disabled people and their family carers will be treated fairly; their human rights will be upheld; and, alongside our full package of funded family care reforms, family and whānau wellbeing will be much improved. I commend this bill to the House.

Thank you, Madam Speaker. It’s a pleasure to make this contribution to the New Zealand Public Health and Disability Amendment Bill. It’s been heard in the House tonight a number of times that this is the right thing to do, and I echo those sentiments. We are, effectively, repealing Part 4A of the New Zealand Public Health and Disability Act. It was absolutely clear that it was a discriminatory part of the Act in terms of who is valued in terms of the care that they give to their family members.

I would just like to also acknowledge the members of the Health Committee and the chair, Louisa Wall, for your work on this bill. I’d also like to acknowledge that there were 44 written submissions on the bill, and I didn’t come into those hearings, but, undoubtedly, for every family that came to share their story—and, of course, they would have been heart-breaking stories in terms of what they go through to care for their loved ones—there would be many other families that would also be behind each one of those stories. I’d also like to acknowledge a family friend—it’s actually a friend of my mother’s—and she was also caring for her disabled son. He’s a young adult now—he’s an adult man. I know very well the toll that that does take on the family and, actually, also on the marriage—on the mother and the father in terms of the care. It takes a toll on their work life and on their business life.

So it is right that those carers are supported. The National Party does see that that is such a crucial role in terms of providing that support to families who are caring for their disabled loved ones. I commend this bill to the House.

I’d like to take a short call on behalf of the Green Party because this is an issue that first came to my attention from my colleague the former—retired now—Green MP Catherine Delahunty, who was one of the first champions in Parliament to stand up for the family carers, to listen to their stories, and to really understand the difficulty that they went through to get proper financial support to do an incredible service—one that, of course, they do because of love for their family member, and it’s selfless and compassionate. But it also benefits everyone in our society to have people with serious disabilities able to be looked after. Of course, family members should receive fair financial support for the care that they give.

My colleague Catherine Delahunty I think was an absolute champion of this issue, and I’m so pleased that we can stand tonight in the House and vote to repeal the discriminatory part of the health and disability Act that was put in place under urgency on Budget night in 2013 that prevented family members of disabled people from accessing the courts to access justice simply for a very mean-spirited approach of assuming that we need to protect the fiscal risk of the Crown, when, in fact, it’s the responsibility of the Crown and this place and our Government to support and look after people, especially the most vulnerable people in society. So as Associate Minister of Health with responsibility for disability, in the first year and a half of this term of Government, I had the privilege of working on this issue and championing it. My colleague James Shaw, who was Acting Minister in my stead when I took maternity leave, also fought very hard for this issue, and I’m really pleased to see the consensus that has broken out in this place, in the House. I know that all three parties of Government had campaigned on making this change, but it wasn’t straightforward to make it, and I’m so, so happy that we can be making this small step in the direction of justice tonight.

Bill read a third time.