Mental Health (Compulsory Assessment and Treatment) Amendment Bill

I present a legislative statement on the Mental Health (Compulsory Assessment and Treatment) Amendment Bill.

💬 SPEAKER: That legislative statement is published under the authority of the House and can be found on the Parliament website.

I move, That the Mental Health (Compulsory Assessment and Treatment) Amendment Bill be now read a third time.

I’m very thankful to the diligence and support of the House as this somewhat minor—not minor but—these few changes to the current mental health Act have been passed through this House. This is a response to the findings of the He Ara Oranga inquiral report of a couple of years ago that said that the mental health Act, in its current form, is out of date. It has provisions in it that are capable of seeing people’s human rights being breached. It called for a full overhaul of that piece of legislation, and that work is under way, but in the meantime it said that there are some provisions that would benefit from immediate attention, and so this bill has been about making sure that we deal with those very few pieces of that legislation that are problematic, and which changes now mean that those who are in the system or entering the mental health system, often when their decision-making capacity is compromised, can do so on the basis that their basic human rights and dignity will not continue to be breached. The House has been, as I say, very supportive of that.

So this bill does a number of things. It means that the provision that, effectively, allows for indefinite compulsory treatment orders is repealed, and so compulsory treatment orders do need to be periodically reviewed. It also means that provisions that were put in place at the beginning of the pandemic last year that allow family members to attend consultations with those who have been admitted under the Act to a mental health facility can attend by audiovisual link (AVL). The select committee, I think, applied very good scrutiny on that and said that, look, that has been very helpful and was a helpful measure, as an emergency measure, at the beginning of the pandemic, but we do need to make sure that when AVL technology is being used for these consultations that it is being done so because it is the only practical or effective way to make sure that the consultation proceeds. Ordinarily, somebody ought to have a family member or a support person present with them physically. So now a specialist who is evaluating whether AV technology should be used has to record the reasons for that and the number of occasions on which consultations and representations are made using AV technology now has to be recorded.

There’s a further provision that allows, particularly forensic, mental health patients who need to be transported and who may be a risk to themselves or others to be able to be transported with appropriate and proportionate restraints being applied. That was a gap in the current legislation, and so that can now happen that those who are responsible for transporting those patients can do so with some confidence that they can use appropriate restraints and will have the protection of the law. Then there’s some technical changes that the bill makes.

But the broader context is that we are changing the law completely. The consultation work on that law change has now started, and that has gone out to the community for feedback, and I expect, certainly by the end of next year, we’ll be in a position to know the magnitude and extent of changes that need to happen for a modern, 21st century piece of legislation that respects the rights and dignity of those who suffer the ill-health of acute mental health issues, who are incapacitated and can’t make decisions for themselves, who need those decisions to be taken by others, including under these sorts of orders, but who can do so with appropriate and modern protections in it. That’s the direction that we’re heading. This bill is a step on that way and part of the broader improvement in mental health generally that this Government has embarked on since it took office four years ago.

So, on that basis, I once again acknowledge the work of the House, the support of the House, in their examination of this bill, and getting us to the stage that we can make these changes and continue the important journey that I know we all, every member of this House, share about the need to improve our mental health services and our mental health capability in this country. On that basis, I commend the bill to the House.

The question is that the motion be agreed to.

Thank you very much, Mr Speaker. I rise on behalf of the National Party in support of the Mental Health (Compulsory Assessment and Treatment) Amendment Bill. Fair to say a quite technical bill, quite perfunctory. We are now at the third reading. I think the bill is in a good shape, going through the legislative process.

I’d like to acknowledge my colleagues in all parties on the Health Committee. We heard a number of submissions and were able to make a number of amendments based on the feedback that we received. I think the points of this bill have been well canvassed over the second and the third readings. And we did go through clause by clause in the committee of the whole House.

What I would point out—and it is one of the first points in the legislative statement, and we heard it from the Minister of Health this morning—is about this bill being a small step and part of one of the 38 recommendations, of course, part of He Ara Oranga. There was 40 recommendations in the Government’s mental health and addictions inquiry. One of those 38 recommendations was for the repeal and the replacement of the Mental Health (Compulsory Assessment and Treatment) Act, and I agree with the Minister—one of the few things we probably do—when he said it is a small step; a very small step. Because, literally, this Government’s been in power now for four years. They raised a lot of expectation in mental health. They encouraged thousands of New Zealanders to come along and tell their personal, tragic, and heartfelt stories. They promised them a lot and turned that into a report, of which they accepted 38 recommendations, yet, four years on, three years after the inquiry, the recommendation that’s pointed to in the repeal and replacement of the mental health Act on this legislative statement has still not even been started. The Minister said “Things are on track.” Well, this bill was a bit of a stocking-filler—let’s be honest—to look as though you’re kind of doing something in that space.

But, interesting enough, when we looked at the theme of the submissions, one of the biggest themes that came back through the submissions was people saying, “When are you going to start the repeal and replacement of the mental health Act?”, and, of course, because of that and the large outcry from the submissions, what did the Government do? Well, about a week ago, they opened a public consultation on the repeal and the replacement of the mental health Act. [Interruption] Well, I am speaking to the bill, Mr Speaker, because it is part of—

💬 SPEAKER: I’m now going to draw the member back to the bill. The third reading debate is a debate on the bill as it emerges from the committee stage. It’s not about what might be relevant submissions to a select committee or it’s not a broad-ranging debate like a second reading debate. The speech that he’s making now would be perfectly valid at that stage, but this is quite a narrow debate. As I’ve said, it’s on this bill, not on other bills, and not on what’s not in the bill. It’s on the bill as it emerges.

Point of order, Mr Speaker. When I look at the legislative statement for the third reading of the Mental Health (Compulsory Assessment and Treatment) Amendment Bill, the first point is about the repeal and replacement, and goes on about that within this bill, and that is exactly what I’m speaking to—the legislative statement.

💬 SPEAKER: I will be listening very carefully to the member. He hasn’t convinced me yet, but I’ll be liberal with him for a minute.

So I’ll bring that point to a close, Mr Speaker.

💬 SPEAKER: That’s a good idea, I think.

I think it’s very well canvassed that this Government raised expectations, accepted a lot of recommendations, but, actually, hasn’t followed through. In this bill, when you look at it, it has been signalled to start the repeal and replacement, but, in fact, with the public consultation only just starting, we know that’s a long way off, and I would encourage the Government to stick to what they agreed and actually bring that legislation, as promised to New Zealanders, sooner rather than later.

This bill will go some way, I think, into improving technology in supporting some of the most vulnerable New Zealanders, those with lifelong and severe, enduring mental illness. Quite often at the moment, we’re kind of quite focused on chasing the new, shiny stuff around supporting middle New Zealand—early intervention; mild to moderate—and sometimes at the expense of those New Zealanders who will have to live with lifelong, severe, and enduring mental illness for the rest of their lives. I think one thing we can do, and that this bill will allow, is the increased use of audiovisual link—or AVL—technology. That will allow these vulnerable New Zealanders to, (a) get timely assessment and treatment through the use of AVL but also allow them to include their family and their loved ones in that process.

There has been a lot of discussion along the course of this bill around ensuring the use of that AVL is right and appropriate. I suppose the last thing we want is the use of AVL being primarily driven by, maybe, more the workforce side, around efficiency of time, and what we want to make sure is that the use of AVL is introduced and used on an individual, case by case basis, it’s actually for the benefit of that patient. That’s why it’s good to see in this bill there are enhanced safeguards for the use of things like AVL, where the decision points of why the mental health professional would want to use AVL now has to be recorded, and also that will have to be reported to the director-general of mental health and will be looked to be published, so the public can understand the use of AVL going forward.

That whole principle of safeguards, reporting, and publishing also flows into another key part of this Mental Health (Compulsory Assessment and Treatment) Amendment Bill, and that was around the use for special patients and it is looking at how we transport them safely. I think we’re looking at a restraint plan for some of those special patients. Again, we wouldn’t want restraint management plans to be seen as a default. We would want to see it on a case by case basis, and probably more in exceptional terms. I think, when we’re advocating and legislating for the increased use of force and restraint, we, unfortunately, know that at times with mental health patients, there might be times, for their own safety and for the safety of people around them, that these restraints will need to be used, but I think it is important that we do have the safeguards around this as well for ensuring it is used in a way that is appropriate and for the safety of the individual as well.

Another thing this bill brings forward in its third reading is around the sunset clauses that were brought in under COVID. We know we all had to respond very differently at the height of the COVID restrictions—and, dare I say it, for some of our colleagues who are in Auckland and the Waikato region at the moment, they’re still dealing with the lockdowns—and, of course, we’d like to acknowledge our mental health and our wider health workforce, who are working in some very trying times to give people the most appropriate treatment in a time of restrictions as well.

One, I think, of the most important parts of this bill is the elimination of indefinite treatment orders. And I think it would probably surprise a lot of New Zealanders that some vulnerable New Zealanders were on indefinite treatment orders. Basically, they were put on an order and just left. And I don’t think anyone would agree, once they were aware of that practice, that that was right. I think that it is right that this bill will enact that every 12 months, for someone who is on a compulsory treatment order, this will need to be reviewed to ensure that, for that person, it’s the most appropriate treatment order for them, either compulsory or voluntary.

But, most importantly, I think that what we want to see—and this is why it’s important we move to repealing and replacing the mental health Act—is that vulnerable New Zealanders with lifelong, severe, and enduring mental illness are put at the heart of their care planning, and we make sure that the care planning around them, the resources they get, actually support them to go on and live the life that they choose, and, hopefully, a life that they can be a productive member of society.

So, I think, in summary, Madam Speaker Dean—it’s nice to see you in the Chair—this is a very small, technical, perfunctory bill that has done well out of the legislative process. But, ultimately, what we want to see from this Government is less stocking-fillers, more actions. They promised a lot in mental health, and now they need to start delivering.

Thank you, Madam Speaker. It’s an absolute pleasure to stand and speak to the third and final reading of this bill, which makes a number of really important but small changes in advance of the wider repeal and replacement of the Act. Just talking about the replacement of the Act, I’m really pleased to see that consultation is under way, and, basically, that will go right through till 28 January next year, because it’s important we take the time to get that right, because it goes to the heart of a lot of really crucial issues like informed consent and engaging patients in their own decision making. And we need to make sure we’ve got adequate public input for that.

Just on this third and final reading, I’d like to thank all of the people that made submissions on the bill, because it resulted in a number of changes, and also the officials that worked with the Health Committee to get it to this point. While it’s quite a brief and technical bill, basically, if we’re eliminating indefinite treatment orders, we’re making changes to the way special patients are transported, and we’re extending the use of AV technology, but with appropriate safeguards, it’s going to make a real difference to the patients that come under the care of this bill. So it’s a really important bill, and I’m happy to commend it to the House.

Thank you, Madam Speaker. It is a privilege for me to be able to rise to take a call on the third reading of the Mental Health (Compulsory Assessment and Treatment) Amendment Bill. And I say that it’s a privilege because, having practised as a lawyer and also as a district inspector monitoring the mental health units for a number of years, I would never have thought that I would be speaking in Parliament and having a voice to amendments, and appropriate amendments, to this bill. They’re appropriate because the tangata whaiora, the in-patients, community-based but also in the detention units, many of whom I know—and, when I go home and I see some of those people amongst our community, it is a privilege, because I know that they’re getting the appropriate care that they are required to have, and it is a privilege that, at some stage of the journey they were on, I was able to help facilitate that. So, as a member of Parliament, I’m helping to facilitate that now with the passage of this bill into law at its third reading.

A little bit of history, in terms of the process. The first reading occurred on 6 April of this year, the second reading on 28 September, and here we are today, on—is it 28, 29, October? I’ve lost track of time—28 October.

💬 Chris Bishop: Through the looking glass.

And this bill came—through the looking glass before the Health Committee, and the members there were dealing with 53 submissions; 15 of those had been heard. The bill has come about as a result of the inquiry, which was reported back in November of 2018, He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction. The repeals that are recommended of certain provisions within this bill, but also amendments, have come about from that.

When I addressed the House last, on the second reading, I recollected the memory that I had back in 2017, when the lead of this review, Ron Paterson—and I mentioned that he was a former law professor of mine and he was a former commissioner for the health and disability sector. He came to Whanganui with the panel, and I sat quietly at the back, and I observed and I listened. There were a number of people who I had helped through their journey, in my journey as a lawyer and a district inspector, who were present at that review. So I sat and I listened, and I reflected on some of the hardships and the afflictions that people continued to endure, because of the imposition of the restraints and constraints of the Mental Health (Compulsory Assessment and Treatment) Act, but also because of the lack of access to support in mental health. And so I reflect on what my colleague Matt Doocey has said. The Government came into power in 2017, and, despite the aspirations, the rhetoric, the good intention, there’s been little effect—real quality, practical effect. So may we see that that changes for the better.

Coming back to the bill, it addresses three core components, in terms of the amendments that are proposed. The first is, effectively, addressing, dispensing, doing away with, indefinite compulsory treatment orders. The making of a compulsory treatment order’s on an application, and that is heard before a judge. Often, the judge will go to the mental health facility for the hearing of that, and that requires that those persons who are not in-patients, are based in the community, are having to be transported. They either make their way themselves—and that’s a difficulty for many of our people, having access to the services, because they don’t have the means to access that, either physically by way of vehicle, or having the support of others alongside them in that journey.

So the amendment that is proposed in this legislation is doing away with indefinite compulsory treatment orders. When a compulsory treatment order is made, it’s either on the basis that the person is going to be able to be positioned and looked after and live within the community, and if they’re not, then detained within an in-patient unit. So there are two types of compulsory treatment orders. Irrespective of the nature of that, it’s required that there’s a review every six months. The first review comes about after six months, and then, if that order is to be extended, it will for another six months, then it comes back for the second review.

Once upon a time—still, until this bill is passed into law—it used to be indefinite. And that indefinite element—again, I’ve talked about the inability of people to access services. So it would often come about that the indefinite nature of the Act would be that people would be left under that compulsory treatment status, and it was about how they were able to access the services that they were deserved of. The only time that that indefinite order would be done away with was if a lawyer, who was on the journey with that particular patient, and that’s what I used to do, would take instructions and give advice to apply to the court for what was called a section 76 review to do away with the indefinite nature of that order. This amendment now says that it’s only in place for six months—for six months—and then for 12 months, no longer an indefinite nature. That is quite a significant change for the tangata whaiora, the people who have been under these orders, because it was a stigma for them. They felt the burden of carrying that stigma, of being an indefinite compulsory treatment patient.

I move to the next element of significant amendments to this bill, and that’s to do with the use of audiovisual link technology where appropriate. Now, I’ve talked about when we have patients who are community-based, and they struggle not only with day-to-day living in the mental health affliction but they struggle with accessing or getting to the venues that they need for the service support and the treatment. The audiovisual link will facilitate those of our people in the community who are under compulsory treatment orders and support.

But there are restrictions and limitations, and it’s important for members of the public and members of the House to know and to realise that this is a specialist area of law. This is a specialist area of practice, and it requires special people serving in that area, and our mental health judges are those people. The mental health judges—again, when I practised, appearing before the mental health judges, there were often difficulties in having members of the community being brought to the mental health unit. The court hearings, in the main, would occur at the facilities where our people were being treated, rather than the expectation of them being taken to a court house. So the judges would set up and go to the people where the need was to be met. The audiovisual link will only come about as a means to facilitate, as is necessary, for those in the community who have access to the technology, the devices, to be able to stream or to beam in. So this is about streamlining and to make it more efficient.

The third element of the bill is to do with those of our patients, our people, who have been brought before the court on a criminal charge, and because of the nature of their mental disorder and a finding by the criminal court to declare the level of cognition, their mental capacity, as being either unfit or declared insane—special patients with that status are placed into what is called a forensic unit. That is a special mental health unit for persons who have been charged with a criminal offence and detained especially in a forensic unit for that treatment. The third element is talking about the transportation of special patients from this forensic unit either to a parole board hearing or to the court where the criminal proceedings are before the court. Now, I speak about the distinction because I worked as a criminal lawyer and I also worked as a mental health lawyer, both very specialised areas of law, but the two do interweave and interlap. This bill will address the transportation of special patients only and the requirement for the special transportation plan to do that, and that there will be people who are specially trained to facilitate, again, access to justice.

This is a bill that’s been in the motions for way too long. The review occurred, the recommendations have been made. There is more to come. I commend the bill to the House.

Thank you, Madam Speaker. Look, it’s been a privilege to be involved in the passage of the Mental Health (Compulsory Assessment and Treatment) Amendment Bill since it was first introduced in March. As has been said, it has been widely supported across the House, and it was largely supported during the select committee process, with many passionate and some very moving submissions. So I want to acknowledge those people that took the time to make those submissions.

The bill has been polished into the final form that we speak to now. The intent of this bill is to bring an outdated piece of legislation into the 21st century, helping to secure the human rights, improve the safety, and safeguard the privacy of some pretty vulnerable New Zealanders. Through the elimination of what is most definitely discriminatory indefinite treatment orders, we can achieve that for at least some of the more than 2,500 individuals who experience a mental health issue at any given time.

At the most fundamental level, I think legislation should in some way just improve people’s lives, make lives better for people. And it’s satisfying, I suppose, in that sense, to speak for the final time in support of this bill that really clearly fulfils those obligations. So, on that basis, I do not hesitate to commend this bill to the House.

Kia ora. It’s a pleasure to stand in support of this final reading of the Mental Health (Compulsory Assessment and Treatment) Amendment Bill. I speak on behalf of my colleague Chlöe Swarbrick, who joined the Health Committee to support this bill through this process.

I particularly want to acknowledge, even though this is a small piece of legislation, my colleagues in the suicide prevention sector who will be relieved that this is going through. I want to just say in the context, when we consider Te Whare Tapa Whā, the Māori health model, this particularly relates to the taha hinengaro, our psychological and mental wellbeing, but also our taha wairua, our spirituality and our connectedness to all things in the universe—because the Greens realise that interconnectedness is critical when we’re talking about the mental health and wellbeing of our people. So whether it’s a warm, dry home, enough income to live on, enough food to eat, a life free from violence and harm, access to healthcare and support people when they need it, acceptance of diverse genders, sexualities, and sex characteristics—but a safe place to go when you’re in a mental health crisis that is not your local jail.

We also await the overhaul of the mental health system. We’re very excited that the Government has announced that consultation is now open. We will be strongly encouraging people to submit into that process.

So this bill eliminates the human rights violation of indefinite orders, that particularly discriminate against Māori people. It provides safer transport processes, makes more transparent use of audiovisual technology, which can be useful in assessment and making sure there’s whānau support when kanohi ki te kanohi is not possible, but also they must be accountable for that use. We very much support that, and removing the COVID sunset clause.

So, while we await the overhaul of the entire system, this is a small but important step forward, and we commend this bill to the House. Kia ora.

Thank you, Madam Speaker. I rise to take a short call on behalf of the ACT Party in support of the third and final reading of the Mental Health (Compulsory Assessment and Treatment) Amendment Bill. This is a small and technical bill that I’ve had the pleasure of being part of as part of the Health Committee. It does a range of small, technical amendments. One is to eliminate the indefinite treatment order, another to minimise risk of harm to the patient and members of the public and staff when transporting people under orders from place A to place B, and also removing the sunset date for the technical amendment that was done under the COVID-19 Response (Further Management Measures) Legislation Act.

I want to start off by talking a little bit about the indefinite treatment order removal. This was because He Ara Oranga report stated that we needed to be more consistent with our international human rights obligations—and I agree that we do need to do that. I’ve had the privilege of being able to visit people who are held under indefinite treatment orders and I’ve seen firsthand what that looks like, and I want to acknowledge the hard work that our carers and our mental health workforce do. I’ve seen people who genuinely become like family to people under those treatment orders—people who have worked there for 10-plus years who have known these people through their entire stays. It’s such a privilege to see how much support they give on any given day but also to see, I guess, the love that they are showing to New Zealanders to be in that position and providing that support, and I really want to acknowledge the difficult task it is to care for people who are our most vulnerable New Zealanders. I think it is right that we have eliminated the indefinite treatment order, because I do believe that we do need to align ourselves with our human rights obligations.

Secondly, when it comes to the special patient transport it is a very difficult situation to be in, where you are trying to uphold the safety of a person who is vulnerable, who may not necessarily have mental capacity, and also members of the public and other members of staff. I think it is right that we have defined how it is possible to use restraint to minimise harm to people in all aspects.

The third part about removing the sunset date for COVID-19 emergency amendments is an interesting one for me because it’s not often that the ACT Party has supported a COVID-19 response piece of legislation. But this is a very particular matter, and that was because it was about audiovisual technology. And I think it was really important that in COVID times we actually allowed for people to go through normal processes to have assessments and to use new forms of technology. And so that’s why I think this is also another very important step.

Finally, I would just like to acknowledge the people who took the time to submit in the select committee process. It is very hard at any stage of a parliamentary cycle to engage with legislation, but it’s also very hard when you’re talking about mental health. A lot of people struggle not only just to explain the experiences that they’ve had themselves or experiences that they’ve seen from their families with family and friends but to do so with members of Parliament—and to come to Parliament and to do Zoom with people, I think that is very brave. And I want to acknowledge the support that we should all show to people who go through the mental health system and to the family and friends, because mental health does not just affect one person; it affects everybody in society. And so, on that note, I commend this bill to the House.

Thank you so much, Madam Speaker. I rise in support of the Mental Health (Compulsory Assessment and Treatment) Amendment Bill. As a member of the Health Committee, I’d just like to add my grateful thanks to the submitters who very courageously, in some instances, and at personal cost, submitted to make this piece of legislation even better. Some of the things that we did—obviously, make changes, as we do in select committee to make this legislation even better. One of the things we did was requiring the reasons for audiovisual technology use to be recorded, which was something that we heard several submissions on. We’re going to be requiring practitioners to report the reasons for the use of audiovisual link technology to the Director of Area Mental Health Services, and these can be included in the quarterly reports by the director of mental health, and this will be so that it doesn’t become a default option.

This is a good piece of legislation which addresses some pressing issues whilst we continue the work on repeal and replacement of the Mental Health Act. I commend it to the House. Thank you.

I call Chris Bishop—five-minute call.

Thank you very much, Madam Speaker. I’ve got to say, it’s very disappointing to see Government members who spent quite a deal of time making merry politically over the issue of mental health in previous years—not so much these days, actually, because the record’s got so much worse, but members opposite who have spent quite a bit of time making political hay out of mental health—not even bother to take one-minute long calls on a bill to improve the system. But, you know, that’s their decision and one that, I suspect, they will regret, but there we go.

This is a sensible bill, as our spokesperson, Matt Doocey, has outlined, and the National Party is supporting it. I think Brooke van Velden also made a useful contribution to the debate on the third reading. I agree with the things that she said in her very useful speech. This is all about improving individual rights and the safety of patients and the public. It’s a reasonably short bill, but one that will make sensible improvements.

It is, of course, part of the Government’s response to He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction. It’s just worth nothing that the context with which this bill comes in has been a frustrating one, I think, for both the Opposition here now but also Oppositions in the past—of course, now the Government. I think it would be fair to say, taking politics out of the situation—

💬 Hon Member: Good.

—for a moment. Well, the member opposite says “Good.”, but that was not the attitude of the Labour Party to mental health for a good deal of time. I remember, as a new MP sitting in the Parliament as a new backbencher, watching the Hon Annette King weaponise the suffering of patients in the mental health system and callously using their bad experiences against the Government of the day, the Hon Dr Jonathan Coleman, and prior to that, the Hon Tony Ryall. So it’s a little bit rich, I have to say, for Labour members now to say that we’ve got to depoliticise mental health—a little bit rich—but I welcome the commitment.

I was making the point about how He Ara Oranga came as a response to, I think, a deep-seated sense in the community that mental health had gone awry and that despite Governments’—“Governments” plural—efforts to improve the system, that just had not happened. The Minister of Health himself has said various things like, “I pump in all this money and nothing seems to change.”, and that was the experience of the last National Government as well. Sometimes it’s not so much about the quantum—in fact, it’s deeply ironic, because we always used to say to the Minister, “It’s not so much about the quantum; it’s about what you do with it, and, of course, the structures and the systems in place.” And we were told for a very long period of time that, you know, the funding was all the issue. Now the Minister, who was the Opposition spokesperson, he says, “Oh, it’s actually not about so much the money; it’s about how you do it.”, which, of course, is the point right from the start.

So He Ara Oranga was a good-faith attempt, and it’s been a very long period of time. And, of course, this is part of the work programme to make changes, but there’s so much more to do, as I’m sure you are aware, and all members will be aware of as well.

Just yesterday, I sat on the Health Committee as we heard a petition from Brooke Lacey, a very courageous and remarkable young woman, actually, who I’ve had the pleasure of getting to know a little bit just in the last few months about her experiences with the health system. Honestly, no one who would listen to her story would think that we don’t have so many more changes that need to be made in New Zealand.

I know, in fairness to the Government, there is at least a good intention there. Whether or not that good intention translates into good policy and practice is an open question, but one that we will continue to interrogate on this side of the House. Thank you, Madam Speaker.

I call Barbara Edmonds—five minutes.

Mālō ni, Madam Speaker. In my electorate of Mana, we had the largest psychiatric hospital in the country in operation from 1887 to 2007, and the saying “if walls could speak” springs to mind. This bill is evidence that something had to change. He Ara Oranga was evidence that something had to change. The stories shared in the House today are evidence that something had to change.

These amendments in the bill are intended to improve the protection of individual rights, the safety of patients and the public, and to enable the Act to work more effectively. We don’t need to take long calls on this side of the House, because we know change is needed. There is consensus across the House. So, therefore, I lend my support to this bill and I commend it to the House.

I also believe that we need to move this with urgency and speak as quickly as possible on what is a very important part of this in protecting the individual rights and safety of patients and the public. When we do this, we know that we’re doing it from across the House; it has been widely supported. And it was good to hear earlier from the other side that they think that this bill is in good shape. And with that as well, I will commend the bill to the House. Thank you.

Thank you, Madam Speaker. I’m pleased to rise to speak in support of the Mental Health (Compulsory Assessment and Treatment) Amendment Bill in its final reading. It’s a privilege to speak alongside my National Party colleagues with such wealth of experience in this area: Matt Doocey a mental health practitioner, and Harete—

ASSISTANT SPEAKER (Hon Jacqui Dean): Order! With apologies to the member, could those two members on my left please observe social distancing. Thank you.

Thank you, Madam Speaker. Also, I acknowledge Harete Hipango, who has significant experience as a lawyer practising in this area.

Like my colleague Chris Bishop, I also regret that the Government speakers have not been able to maintain more than a few minutes speaking on this matter, which is incredibly important to people of New Zealand, and particularly a Government that campaigned so vigorously on mental health issues.

I agree that this bill has small but significant changes in it, but those changes relate, really, to those with the most significant and enduring mental health conditions. And we, really, are seeing mental health across a whole wide range of communities and levels of severity skyrocketing and ballooning out times waiting for services. So, yes, we certainly support these changes, but they should be seen in that context of a Government that promised much and has delivered little in this area, a country that is grappling with significant mental health issues, and an Act that needs much wider repeal and replacing than these minor adjustments.

I don’t want to say “minor” and take away any of the importance of the changes in this. They certainly are important, and like others who have spoken today from the Health Committee, it was a privilege to listen to the submitters, both the service providers who submitted and also the users of services. It was a really salient reminder of just how personal these changes will be for people. I think back to one of the submitters, a young gentleman who had been under a compulsory treatment order for four years, and his submission spoke of the loss of hope that that gave him, being in a compulsory treatment order that was indefinite. We can only imagine that indefinite situation, seeping hope out of your being that there is no review period. So I think about how, when this bill is passed, what a sense of hope it will give to that individual, and I think we should take much pride in that.

Many of the submitters talked about how it is a breach of human rights to have had the indefinite treatment orders, and certainly we can see when we look at the impact that it has had on individuals. So I think that is one of the most significant parts, to ensure that any compulsory treatment order is reviewed on a 12-month period, and that wasn’t without some discussion. There were a number of submitters who would have liked to have seen that a six-monthly period review. I think, probably, with the discussion that went on, we feel we came to the right place being a 12-month duration, and certainly that’ll be something that we should be looking at when the full repeal and replacement comes into place. Hopefully, we will have had a chance to see how that 12-month review period has been working.

The other part of it that there was a considerable amount of discussion around was the transportation of special patients and the need to use restraint at some times to ensure that it was the safest and least restrictive way to maintain both the patient’s safety but also staff and public safety. As you can imagine, the use of restraint is not something that any of us would want to see be used lightly, and it is something that caused considerable discussion, around the severity, the use of it, the regularity. I think that, again, through those discussions on the Health Committee, we came to a good compromise.

The other matter that, of course, COVID has made us all look at is how often we do need to be in person and how feasible it is to use audiovisual links. Again, quite an amount of discussion on what might seem a simple amendment but, listening to the submitters, obviously family that might be in rural areas, that it was quite difficult for them to attend some of the assessment meetings. This was going to add an ability for them to be present and be present in support of their friends and family. Again, it was good to be able to relate that back at a very personal level when one of the submitters spoke about how, during their assessment several years ago, they were entirely alone and how hopeless that made them feel.

So, yes, certainly, audiovisual links are a valuable and important tool, not only for the patient but also for family or caregiver support for the patient. But our conversations and our discussions around it were very much that this must not be a default place because of staffing issues or budget issues or convenience issues for officials. It must definitely be patient- and patient family - and caregiver-centred so that it is not being used as a convenience to officials but rather as an enabling opportunity for families and for the patients. So we were pleased, again, to have got to a good place there, where a requirement for reporting on how often, and the reasons why, the audiovisual was used instead of in-person assessments, and also that that reporting will be taken to a higher level to be able to look right across the country to see that there is consistency in the use of that across the country. So that gave us an element of trust that this would be used in an appropriate way.

So it was certainly a bill that had a small number of changes but very important changes that we know will make a very significant difference to people whose lives are being impacted by this. But it should not be lost that it really is small, minor changes in the context of an Act that needs significant repeal and replacement in a time when our country is experiencing an incredible issue with mental health, with the skyrocketing numbers and with the waiting times and access to services. So we do commend this bill to the House, but we do it in the hope that it will be sooner rather than later that we see the full repeal and replacement of the Act. Thank you, Madam Speaker.

Thank you, Madam Speaker. It is a great privilege to stand and take the final call on this very important bill, third and final reading. Many have reflected today on the significant mahi, very personal mahi, that has gone into this bill and the development of it—the submitters and the members of the select committee. I acknowledge you and your work.

This legislation is immediate and so impactful, as many of you have said very eloquently. It improves our ability to take care of our most vulnerable. That unity that we’ve seen in the House today, I think, shows that today we say to our most vulnerable and those who care for them: we see you. And the other thing that I think would be really important to do as the last speaker is to look forward. I’m really pleased to hear the support across the House to stand collectively and do this very important work to build a new mental health Act that has mana, it has aroha and human rights at the heart of it, so I commend this bill to the House.

Motion agreed to.

Bill read a third time.