Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill

I present a legislative statement on the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill.

ASSISTANT SPEAKER (Hon Jacqui Dean): That legislative statement is published under the authority of the House and can be found on the Parliament website.

I move, That the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill be now read a first time. I nominate the Education and Workforce Committee to consider the bill.

Next year, it will be 50 years since the ACC legislation was first introduced here in New Zealand, and ACC remains a unique and world-leading scheme. It is an integral part of our social support system in New Zealand and has become part of the fabric of our country. As Minister for ACC, I want to make sure, and our Government does as well, that the system assists all New Zealanders who have had an injury and that the system is fit for purpose for New Zealand in the 21st century.

Back in March, I remember I’d just finished an interview at TVNZ’s Breakfast, I was en route to my next engagement and I read a Radio New Zealand article written by Anusha Bradley. The article was about the growing number of women experiencing injuries when giving birth, and their struggle for treatment. It included one experience shared by a woman called Susan. It was a distressing read but I instantly knew that this was something that needed to change. I asked my officials to improve gender balance, fairness, and equity in the ACC scheme, and birth injuries seemed like a reasonably important place to start. I was in the process of asking ACC for information about how different population groups, including women, were accessing support through the ACC scheme. It showed that women made fewer claims to ACC than men, have fewer injuries covered by the scheme than men, and each woman’s claim cost the scheme a third less than a man’s, on average, in entitlements.

This reflects the inherent gender disparities in the scheme that are the result of its focus on accident-related physical injuries, which are more common among men and in male-dominated types of work. It’s not surprising, given this scheme was set up to support the New Zealand workforce in the 1970s, but it is time for us to begin addressing these disparities. New Zealand looks very different from what it did 50 years ago; our workforce looks very different from what it did 50 years ago. The bill represents a first step in that mahi, by extending ACC cover to a specific list of maternal birth injuries.

Eighty five percent of women in New Zealand experience an injury when giving birth. Some of these injuries are severe and share similar features to other physical injuries covered by ACC, so it is only fair that they are covered too. The extension of cover will benefit up to 18,000 more women per year, who will be able to receive cover for maternal birth injuries. Enhanced cover will improve the support available to birthing parents suffering these injuries—in particular, by providing more timely access to surgeries and pelvic physiotherapy. For those few severe cases where individuals are incapacitated for the longer term, the additional benefits of ACC cover include access to non – means tested weekly compensation, home help, and rehabilitation.

I’m really proud to present to the House a bill that will make a huge difference for the women that experience birth injuries, and I’m very grateful for the support of a number of external groups, from Parliament and women, but also to the women in this House who have been very vocal in their support, particularly those in the Green Party and, of course, in the Labour Party women’s caucus.

This bill is also about reversing some of National’s 2010 changes. The bill also introduces changes that we meet our manifesto commitment to address the changes that National made when last in office, which unfairly disadvantaged tens of thousands of New Zealand workers. The changes in the bill will clarify the section 30 test for work-related gradual process, disease, or infection cover, and put the burden back on ACC to prove that a disease or infection is not work-related.

The bill reduces the threshold for injury-related hearing loss cover from 6 percent to 5 percent hearing loss. Claimants with 5 to 5.9 percent injury-related hearing loss have a legitimate need for a hearing aid. The exclusion of these people from ACC cover by the previous National Government was a cruel cost-saving measure. This change ensures that an additional 200 people per year can access the support they need.

The changes in the bill will also ensure that ACC considers what someone was earning before they were injured, as part of its occupational assessments. This means certainty for claimants that if they suffer a covered injury, they will be supported by ACC until they are able to return to a suitable job.

Finally, the bill makes a number of minor policy and technical changes. These changes are intended to improve the clarity and usability of the Accident Compensation Act and ensure that it is achieving its policy intent. This will improve the administration of a system that affects all New Zealanders.

In summary, this bill makes important changes to the scheme, which will provide more support to injured New Zealanders, more clarity on what is involved for gradual injury claims at work, and more equitable cover for claimants and, in particular, women. I’m very proud of this particular bill and I’m looking forward to it making its way through the select committee and hearing what the submissions bring. I commend this bill to the House.

Madam Speaker, thank you very much for the opportunity to speak on the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill first reading. I acknowledge the Minister firstly for bringing this bill to the House. National will support this bill through to the select committee process.

As the previous National spokesperson on ACC—and I do acknowledge the Hon Michael Woodhouse, who is now the spokesperson—I’m going to cover a little bit of detail and context in regards to this, because I have been quoted publicly in terms of feedback on this bill, saying that it is sensible legislation. And acknowledging it is Christmas, Minister, I did think there was going to be a positive exchange there, but you sort of jumped into a little bit of negative, and I thought, “Oh, gosh. Thought we were going to have a good night.” But I’m going to keep it pretty positive, because this is really important. This impacts between 17,000 and 18,000 women in this country every year. And it is not only a significant physical injury as a result of pressure during the birthing process—that’s all the detail that I’m going to go into—but also the post-rehabilitation and the emotional and psychological effects of this type of injury that occurs and does occur on an ongoing basis for a large number of women. I think it needs to be recognised, and that’s why on this side of the House, we are supportive of that.

I think it’s also important to acknowledge, and I refer to some reporting done by RNZ in terms of Official Information Act process, that actually there is a degree of bias within ACC towards women—and that, as reported, was driven by some of the lower claim lodgements by women, and whether this reflects the potential around unmet need, i.e., those that are living with injury but not seeking treatment or other aspects. I think this is and continues to be an area that we need to do better in, I think would be fair, in terms of particularly women and the support that they receive from ACC. I’m very much looking forward to our spokesperson for women behind me, Nicola Grigg, who will not doubt cover more of that in more detail.

💬 Nicola Grigg: Graphic detail.

Detail, yeah—underlined, bold, capitals.

I also want to refer to this bill as set in the context of some changes to the Accident Compensation Act 2001. And as the Minister has alluded to, outside of the birth injuries element there are some what we would refer to as “minor amendments”, and I’ll cover a little bit of that later on. But ACC does have its problems, and I think it is important to acknowledge that.

We’ve spoken in the House and publicly in terms of media attention, and rightly so, around the sharing of private data and the issues that have come up around that as being part of a select committee process, which, again, impacts on this bill—the attempts by us to get more focus in terms of ACC on aspects such as the case management system, which will be a system that would deal with claims relating to this bill. We’ve been blocked in terms of trying to get that conversation happening.

More recently, probably one of the last aspects that I did when I was spokesperson was trying to get the select committee to do a briefing into ACC around the ongoing issues around privacy breaches and client personal information. And you can imagine, in terms of the context of this bill, the criticality and the importance of protection of personal information and the impact of that information being available in the public domain, which is absolutely abhorrent, but we have seen examples of that this year. I think there is an absolute expectation in regards to ACC managing aspects such as this that that aspect must improve rapidly. I am pleased in a way to see that the independent review by Treasury is under way for ACC as well.

In regards to this bill, one of the aspects that we’re really keen to understand as we go through the select committee process—and as part of our democracy, the select committee process is a really important aspect of this. I expect, knowing the Minister, she will contribute and participate and let the select committee do what they need to do, but the costing element around this, as I understand, is somewhere in the region of $25 million. And while, in the context of ACC’s balance sheet, that may seem somewhat small, it is an area that I think we do need to make sure is robust in terms of its calculation. I think, going back to my comment before around the potential risks for potentially a large number of women out there that may not have previously claimed for this type of injury, what potentially is the scale of that unmet claim or the unmet need and the implications around that. I think that’s important just in terms of an overall affordability conversation, and that will be something that no doubt the select committee will undertake a robust assessment of as they go through.

The other aspect that this bill relates to is, as always—and it’s always the conversation we have in regards to the ACC scheme—where do you draw the line? Where do you draw the boundary between what is covered by the system and what is not? There is a large number of—this is a very topical area, but there are others in terms of that line. And I think the reality is though that this scheme is a scheme that is funded through employee-employer contributions, and so while it’s very easy to just include and broaden the coverage net, there is a fiscal cost to that which needs to be borne by certain groups. I think that’s always the balancing act around this specific bill and the affordability around that and other aspects around where that line is. And so, again, I expect the select committee process will go through that.

The Minister referred to a couple of changes around hearing. I think, when you start playing around with aspects around gradual change, this is a complex area. It’s a complex area in regards to the clinical assessment that is undertaken, the pre-existing conditions that an individual may or may not have, and the ability to isolate one specific aspect such as hearing loss and the absence of the environmental elements that that individual has incurred through their lifetime is often the clinical challenge around trying to say whether that injury or that aspect is covered or not covered. I think, while the Minister may be critical towards where National were in the past, it is just acknowledging that this is a complex area, and I think that needs to be noted.

I did want to comment a little bit around the element within the bill which is putting an additional board member on to the ACC board. I acknowledge that they are dealing with a complex, significant balance sheet—in the region of $60 billion. And they’ve got eight independent individuals there. Obviously, they’ve got the Hon Steve Maharey—18 years as a member of Parliament for Labour—who’s now the chairman of that board. And I’m sure he’s going to do a very thorough job, but the introduction of another board member, I think I would always question—eight’s that sort of magic number around span and control, and six of those eight board members are new to the board since 2021, right? So we’re dealing with a new board, and the introduction of, potentially, a seventh out of nine, I think places quite a significant consideration around the continuity of that board and the experience and the ability for that board to be able to get up to speed, acknowledging they have an acting CEO—actually, a new CEO, of course, as well. So in light of the challenges that that entity has in regards to its operations, I’m not really too sure what the value is, but, again, that’ll be something that will come through in terms of the select committee process.

So I wish the select committee all the very best for what will be a robust process. I look forward to watching from afar in terms of this bill going through the House. You never know, I might have the opportunity to speak on it again, but I commend this bill to the House.

Thank you, Madam Speaker. I am absolutely delighted to be standing here this evening to rise in support of this bill, and I’d just like to say how proud and grateful I am to Minister Sepuloni for bringing this to the House. I would also like to thank and acknowledge Mr Watts for his support for maternal injuries and for the work that we will be doing together.

Because as we know, a number of women experience severe birthing injuries. As I stand here, I have before me in my mind’s eye many of my former clients, but also particularly one of my constituents who came to talk to me about a severe injury that she had experienced in the course of what we would describe as a physiological birth where treatment wasn’t involved in her injuries. It was precisely those injuries that were experienced by the passage of the fetus as it was being born—and I’m struggling here not to go into too much detail, but I won’t. But it was that woman and many like her who are experiencing injuries and for whom that cover is not provided, and that’s one of the things that we’re trying to correct here.

There are going to be, should this bill pass as we hope, 17,000 to 18,000 women who will benefit from this bill—17,000 to 18,000 women is a significant amount of health benefit to those women whose permanent health has been injured: their continence affected, their sex lives affected, and many other specific injuries. We have described seven injuries in this piece of legislation. I really would encourage anybody who is interested to take a good look at what we’re proposing here and to come forward and to submit when it goes through the select committee process. I do heartily commend this bill to the House.

Thank you, Madam Speaker. I’m pleased to rise and stand in support of this legislation, the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill. Sixty thousand babies are born in this wonderful country we live in, and what most people don’t realise is that 85 percent—85 percent—of women in New Zealand experience an injury in the process of giving birth. Some are substantial and some aren’t. It’s one of those areas that I think it’s really important that we explore further, because there will be far too many women whose lives are permanently affected by this. The member before me, Sarah Pallett, spoke in terms of her professional experience of the physical and physiological impacts of giving birth, but actually just as important is then the impact on women’s maternal mental health as a result of some of these injuries, and I think it’s important that we consider this.

It’s been interesting to see the number of women who have come forward to raise these significant issues. During the course of the work that I’ve done on a member’s bill to increase post-natal stay, we had a session here in Parliament, a breakfast, of which there were a number of speakers, and the part that stood out for me was one of the speakers, a scientist, talking about the most dangerous time of a woman’s life being when she was giving birth, and the most dangerous time of a child’s life was when they are being born. I was quite shocked, and I think that we haven’t paid enough attention to the fact that it is a very physical and a very traumatic experience that can have a lasting impact on mother and, therefore, on baby. So I do think some of the changes that have happened in ACC’s approach, in terms of decisions they’ve made around birth injuries recently, have had a significant impact in a negative way on women.

What that has led to is a number of petitions, and it’s interesting because, before the review in June 2020, perineal tears topped ACC’s list of the 10 most common childbirth-related injuries for women, and claims at that time were about 30 per month. After that review, unfortunately, though, the number of claims accepted went down to about four. So I do want to acknowledge Kirsty Watt, with her petition in June 2020 asking for improvements in the rehabilitation care of New Zealand women post-birth. Because I was involved heavily in the National Party’s policy around the first 1,000 days, this was a component, and hearing the experiences of women and just how significantly it had affected them was quite devastating. It affected their relationship with their baby. It affected their relationship with their partner. It affected their ability to enjoy life in very basic ways. The very level of physical incapacity was quite staggering.

So I do want to acknowledge Kirsty Watt for bringing that petition initially and just to take this opportunity to say petitions actually do have a significant impact on our parliamentary democracy, and I would really encourage people not only to consider creating a petition but to sign one. There was a second petition, and I want to acknowledge the Green Party and the organisations that supported them, many I have been involved with, with my three-day post-natal stay, but more broadly on the campaign for women’s health and particularly in the first 1,000 days, understanding the importance of a baby’s brain development while a mother is pregnant and post-birth. Everything that affects the mother affects the baby, and I think that, potentially, in more recent years, the pendulum has swung too far in favour of the child and away from the mother. So I commend the Minister for bringing this bill to the House, for putting some of the emphasis back on the mother and ensuring, through this change to ACC, that the mother is able to get the support and treatment they require to support their ability to function, and function well, in life, not just as a mother.

I was quite staggered, actually, at that 85 percent of women experiencing an injury giving birth, and there are far too many examples where it was yet one more thing that women just put up with, and in absolutely hideous circumstances in some cases. One of the most challenging cases I spoke with was a women who was just unable to leave the house. Her injuries were so substantial she was unable to leave the house at all, and so her ability to function as a mother, as a woman, as a human being—the process and the system really disrespected her. So I do think this is an important piece of legislation to ensure that—and part of what raises women’s frustrations is their having to fight the system, and when you are physically so debilitated, in levels of agony that are quite unimaginable, in an injury that many women are uncomfortable talking about even with their closest family, to then have to fight the system to get access to financial support for treatment is, for many, the final straw. So I do think this is an important measure to enable women to get the support they need.

One of the areas I do think and hope is explored in this select committee is where the line is: what injuries are covered and which ones aren’t. And just as I have acknowledged those who have initiated the two petitions that have been a significant part in changing the law—or the introduction of this legislation—I would really encourage women with real stories and real experiences to consider submitting. A submission is a very powerful way to bring real experiences into our ability to change the law and, in this instance, to make sure that the line that is drawn in terms of which injuries are covered and which ones aren’t will be really important. I’m not on that select committee, but I would reiterate to women’s organisations—actually, not just women’s organisations, because this is not just a women’s issue; if a mother raising a baby has a significant injury like this, it affects her whole family—to make sure that we have those voices to ensure that the changes to this legislation cover more of the injuries rather than less.

The other thing I would consider—because one of the aspects of the National Party first 1,000 days policy was to actually enable women to get assistance through specialist physiotherapists. So, for some, pelvic floor damage might not be through significant tears or damage but still cause significant issues that have an impact on their quality of life. So I would really encourage people to come forward to submit, for the organisations that were involved in supporting the open letter, including groups like Mothers Matter and Perinatal Anxiety and Depression Aotearoa, for example. The College of Midwives will, obviously, be there—and the Council of Women, to name a few—to make sure that women’s voices are heard. This is a great opportunity, and we need to get it right.

Thank you, Madam Speaker. It is what I consider a real privilege to be able to stand and take a call on this piece of legislation. I want to join others from across the House in acknowledging the Minister, Carmel Sepuloni, for bringing this piece of legislation to the House. It’s an extremely important piece of legislation and it will impact on many, many women’s lives going forward.

We’ve heard tonight, and I was quite horrified when I heard and read about this, that 85 percent of women experience an injury when giving birth. I was lucky enough not to be one of those 85 percent of women. But I can’t even really imagine how it must feel when you are going through a time when it’s supposed to be an exciting and joyous moment in your life, giving birth to a child that you have wanted and been waiting for for so many months, to have it potentially go quite wrong and give you life-long injuries as a result. We’ve heard tonight how it does and can impact also on a woman’s mental health when that sort of situation occurs. It affects partners, relationships, families; we’ve heard that. What I think that this piece of legislation brings into line for women is that what they go through does matter, and just because in the past ACC has been focused on more accident-related physical injuries, now this will be something that will be considered just as seriously as those types of things.

One of the other things that is going to be changed with this piece of legislation is that ACC board members are going to increase from eight to nine board members and that should encourage better diversity or more diversity on the board as well.

Minister Sepuloni, again, I just want to commend you for bringing this piece of legislation to the House. It’s going to mean so much to so many people going forward. Thank you.

Thank you, Madam Speaker. First of all, congratulations to the Minister. This is quite an exciting moment, I think, to have positive, progressive ACC legislation in the House—it’s the first time in my living memory—and specifically making provisions that start making inroads into addressing the really entrenched sexism within the legislation that means, I think, quite often in terms of the work of ACC, the financial costs that accrue to men versus women was about a billion dollars difference in that in favour of men, which is just extraordinary. Where a rugby injury gets cover and our love and our support and then the most important job in the world where injury arises of giving birth pretty much nothing except struggle, this legislation starts us in addressing that. I’ll speak to some of the specifics a bit later in my speech, but I also want to speak to the fact that making this change will help women and birth parents be able to access support and that is to the benefit of all of us in our society: our children, our families, and all of us.

It also, I think, helps address some of the shame and the stigma and the silence around these injuries as well. I recently had a Facebook message from somebody who was talking about how they gave birth 9½ months ago and have had abdominal pain and urinary incontinence every single day since and thought that was just what happens. We had had no public discussion that had connected to her that actually this is something you can go to the doctor about, this is something you can get treatment for. That is a sign of a societal problem in itself that I hope this discussion will start addressing, because we need to remove the shame and the stigma and ensure the supports are in place.

I will speak to the some of the things—that the Greens are so stoked that this is on the table and that there are things we would like to see change through the select committee and I will speak to some of those. We see in the regulatory impact statement there was a decision to cover a specified list of obstetric injuries caused to birthing parents, and our concern over that is that it doesn’t necessarily cover all birthing injuries and even in that definition of physical injuries. And there was another option that was considered to define the fetus as a force external to the body so that all injuries caused by the fetus to the birthing parent during labour and delivery would be considered accidents under the ACC Act and that would have ensured that at least all physical injuries to the birthing parent were comprehensively covered. Unfortunately—and this is where it kind of sticks in my stomach a bit—the decision was made not to go with that option, because it risked a broader interpretation to also include injuries to the birthing parent throughout the pregnancy and the child. Oh—I’m sorry, it was not chosen because of potential cost reasons. And that, to us, if we’re looking at making sure that this works for all of our families, then actually that’s what we need to put first.

I also would just say that for the Greens, we wanted to see—as the 40,000-plus people who signed our petition in a very short period of time wanted to see—all injury, including trauma, not necessarily connected to a physical injury because there are birthing parents who experience trauma through a difficult labour, even if there isn’t a physical injury, and we want to make sure that they get that support at the time they need it in the most easily accessible way. We also would like to see the injuries to the baby covered. We know that there are lifelong injuries that are incurred through the loss of oxygen during the birth process, and it does not make sense to us in the Greens that we can cover the injuries in other contexts and not recognise that first injury because it absolutely is an injury.

So those are the areas we are absolutely looking forward to exploring through the select committee process in relation to birth injury. But I say all of that and we wouldn’t be able to explore any of those things if we didn’t have this legislation and if it wasn’t on the table and if those so many thousands of people hadn’t signed those petitions and Anusha Bradley hadn’t done some great investigative journalism—and I want to shout out and acknowledge her as well for her work.

So now I’d like to speak to the other part of the bill, which are the winding back of five changes made by Nick Smith in 2010. I’d like to speak to these. These may not be the headline parts of this legislation but they are important and we, the Greens, would also like to see these go further because I think Labour has made a commitment to unwinding those changes and they’re not doing it in this legislation and the Green Party believes they should.

The first is changing the onus of proof for gradual process, and that is great, but not re-establishing the Ministerial Advisory Panel on work-related gradual process, disease, or infection will limit the impact of this change and mean that many people with gradual process injuries, diseases, or infections will still either have to battle ACC for cover or just lose out. Words of Hazel Armstrong, an ACC lawyer known to many in this House: “Yes, it’s a first step. You might get another 200 people through, but it’s not the big game changer needed in New Zealand.”

Then there’s the requiring occupational assessors to consider pre-incapacity earnings. Also positive, but this legislation doesn’t roll back the change of definition of vocational independence from 35 hours to 30 hours per week, or the decrease that we saw in weekly compensation or the increase of time from two to five weeks before weekly compensation is raised to the statutory minimum or even the abatement of holiday pay from compensation. So it’s kind of such a miserly little measure.

And then there’s the reducing of the requirement for 6 percent hearing loss to 5 percent hearing loss. The legislation previously did not have a percentage. We don’t have a percentage of the number of bones in your body that you need to break before you can get support and I’m told by experts who know a lot more than me that actually the percentage doesn’t have meaning around functional hearing loss, that there will be people who will require hearing aids to be able to function effectively in their workplace or in their life, who may only have 3 percent hearing loss or less. So this doesn’t make sense to me at all.

Then there is the fact that the Government is ensuring dependants of a claimant with a terminal illness covered by ACC who chooses assisted death under the End of Life Choice Act can access legal entitlements. I think that’s great. But it does kind of, for me, bring into stark contrast the fact that the Government has chosen not to bring back the entitlement for people with self-inflicted personal injuries or suicide or who are in prison. At the heart of an effective and powerful ACC that we want to see is the no-fault cover and support, so I don’t—and I would be interested to see through this process whether we can get back that concept of no-fault cover to restore the power and the greatness of ACC that so many of us have been so proud of and looked at other jurisdictions that have to go through courts to battle to get their entitlements. We want that back and it doesn’t feel like we’ve got it at the moment, so there is a huge amount of work to do.

Then finally, I just want to again note the significance of this day for women. It’s a bloody good day in this House for women and I really commend the Minister for being receptive, being proactive, and getting some—

💬 Nicola Grigg: Stuff.

—stuff—thank you, some stuff done, finally, in ACC. It is well overdue and we are very much looking forward to these conversations.

I rise on behalf of the ACT Party to support the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill. It’s great that ACC will acknowledge these birth injuries, in common with a lot of other injuries that occur, however they haven’t been recognised because of us being women. There’s estimated to be around 17,000 to 18,000 women that suffer with these injuries. As has been spoken about before, 85 percent of women incur injuries during birth, but it’s not just injuries that occur; it is also the emotional side of these injuries that can have a lasting impact as well on women. With these emotional injuries, they also impact their loved ones that are there to support them, because the husbands, partners, aren’t able to support them because of the injuries, but they can help the babies, which is great.

ACC needs to improve more around women’s health with these birth injuries. It is great that this support is occurring, but there are other injuries, as has been mentioned, and sometimes women’s health gets overlooked and they don’t get that support that is needed. Also, I’d like to point out that ACC has had its problems around personal information, and that’s a concern for us in the ACT Party, because women especially do not want their information or injuries shared around with other people. So it’s very important that we make sure that these things do not continue. The other thing is the estimated cost is an unknown because we’re not 100 percent sure exactly how many will be able to claim. So it is a bit of a problem there on financing within the ACC scheme.

Overall, ACT’s very happy for the maternity birth injury side of this bill. However, there are the other matters that I’d like to raise. The main concern is actually raising the board from eight to nine. As said in the bill, a wide range of specialists and stakeholders is required on the board. That’s fine; I agree with that. However, as my colleague in National pointed out, we have already appointed new board members in February, then again in August, and then again in September. So if we were looking at having a better structure within our board, then how come the ACC, when they were appointing the board, did not look at this maybe in August or September when they were appointing these new board members?

The other thing that is really good to see is that they are ensuring the legislation certainty that dependants of claimants will not be disentitled for future injury entitlements covered under the ACC scheme following the claimant’s assisted death in accordance with the End of Life Choice Act 2019. We’re very proud for this to be included in the other matters.

Overall, we’re very, very happy, as I said, with most of these, but we’ve also got to take into account that there are other matters—who will be paying for it, and if you are aware that the ACC levies for the employees will be raised in the next coming year. So that means that more money will be going out of our everyday - New Zealanders’ pay packets, and they’re already struggling. That is something that we have to be aware of, that more money will have to be found in some of the areas within the ACC financing, and that’s usually out of our hard-working taxpayers’ dollars.

The next thing is that there are seven technical changes. Now, within these technical changes most of them are just fixing up definitions, which is fine. But there’s also one that’s enabling the ACC compensation corporation to use the most recent employer filing to Inland Revenue when determining the client’s weekly compensation. This I don’t have a problem with because that will ensure that the person that is off work due to an injury will most likely get 80 percent of their wages. Because at this stage, there’s a lot of paperwork that employers normally have to go through to prove earnings for employees or the employees themselves have to find that.

So also, the other thing I’d bring up, that hasn’t been mentioned, is aligning the ACC penalty rates with the IRD’s rules, by changing the 1 percent monthly interest rate from the day after the levy invoice is due, rather than 30 days after the payment is due. I understand that’s just general business, but it also needed to be pointed out to people that even though you think you have 30 days after not to be penalised, because people do tend to sometimes put their ACC bills aside and not organise payments. So this needed to be pointed out.

But most of all, in general, ACT is very happy with this bill. It is moving forward to help women with the injuries around birth. It’s great that people have stepped forward and put petitions to the Parliament here to speak up for these injuries. But most of all, is for the New Zealanders, hopefully listening tonight, to be made aware that submissions are open and come forward and speak what has occurred to them.

In the bill, in Schedule 2, is a list of maternity birth injuries. I would hope that people will come forward, after reading these, and even others that may have occurred that have not been put here, that they may be recognised, possibly in the future, that have occurred. And especially, I feel also, the mental health side of things may need to be looked at a little bit more, because that is a huge thing for a lot of women that suffer these birth injuries. So, I commend this to the House.

Thank you, Madam Speaker. It’s a pleasure to rise in support of this bill. This bill is all about fairness because it seeks to provide more equitable coverage for injuries covered by ACC. Tonight a lot has been said about this bill, and I just wanted to reflect on one comment, I think it was the Hon Louise Upston who mentioned that about 85 percent of women experience injuries while giving birth. This is a sobering reminder of why tonight we need this bill, and that not doing anything simply is not acceptable any more. Making this bill more equitable, more accessible is the right thing to do. It’s about time, it’s a must. I also want to add my voice to others in thanking the Minister in bringing this bill tonight. Madam Speaker, this bill is timely, it’s the right thing, it’s morally right. I commend it to the House.

Thank you, Madam Speaker. Earlier this year, following robust conversations—graphic conversations, very detailed conversations—with a lot of my girlfriends, along with deeply traumatised fathers, I started to draft a member’s bill. That member’s bill was titled the Accident Compensation Coverage for Third and Fourth Degree Perineal Tear Amendment Bill. But following media coverage, and I have to say some pretty gutsy advocacy from Green MP Jan Logie, I’m very pleased to say the Government’s beaten me to it. So I won’t go so far as to say great minds think alike, but I must commend the Minister for bringing this in front of the House.

We have now in front of us the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill and we, in the National Party, are happy to support that. While the bill does cover the other matters, as our spokesperson for women I want to focus my contributions this evening on those birth injuries. A lot has been said this evening about the 85 percent of women who tend to suffer birth injuries, but that actually translates to around 18,000 women per year. And it is those 18,000 women who have suffered the injuries, which are accidents that are not currently covered by ACC. Some of the injuries, I’m told, are particularly painful and distressing and have a long-term effect on the lives of the women who suffer them.

This bill has come in front of the House because in June 2020 ACC actually revised its guidance on its then existing cover for perineal tears that were suffered during childbirth. At the moment, the corporation only covers those tears that are the result of a treatment or the failure of a treatment, as opposed to those that are caused by the birthing process. And it’s the failure to provide that treatment that’s no longer covered by ACC. I think we’d all here agree in this House, along with those 18,000 New Zealand women, that that is wrong.

As was discovered with much horror by my young male researcher today, perineal tears are not uncommon in childbirth, but the most severe are known as third and fourth degree tears, and they can involve some really debilitating injuries. They do often require surgery under general anaesthetic. They often require ongoing pelvic physiotherapy. There’s ongoing medical issues, they can be profound. They can be life changing for these new mothers, as some can take months and months and even years to heal. The ACC cover for such injuries can be a critical enabling factor in the recovery of those mums.

So in its consideration of this bill, it asks that the select committee does consider the severe impact and ramification of those third and fourth degree tears and make it clear that they are covered in the new schedule of injuries that is going to be devised. We do have some questions around the particular injuries that are going to be covered, as the bill sets out in its list, in that Schedule 3A, which aren’t included. But we will leave it in the hands of the committee to revise those and to consider them.

So I think that this bill does make a really good first step in advancing the rights and protections of women, and it is a much-needed change for what has been a painful and unfair consequence of a legislation that could be made better in order to enable them and help them. I therefore commend it to the House.

It is my pleasure to take a short call on this bill this evening, Madam Speaker. We’ve heard a lot about the significant impact this is going to have on so many women around the country, but tonight I just want to speak very quickly about a small but significant aspect of the bill, which brings justice to thousands of New Zealand workers.

Work-related gradual process, disease, or infection cover, such as industrial deafness, will be better supported. The clarification of section 30—the test restores the burden back on to ACC to prove that such injuries aren’t work related. It lowers the threshold to 5 to 5.9 percent. Those extra 200-plus workers every year who need a hearing aid will get one. This is about restoring a little bit more justice to our workers who pay with their hearing. For those freezing workers who have industrial deafness, we see you and we hear you, and this one’s for you, Dan.

Thank you very much, Madam Speaker. I, too, rise to speak on this Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill in its first reading.

As my colleagues have said, the National Party is supporting this bill. We are supporting it to select committee at this stage, because there are some aspects of it that do need further investigation, and I note that while the regulatory impact statement has done a very broad costing, quite a rudimentary costing of around $25 million, it is not a robust investigation as to the ongoing cost of this. So I anticipate that the select committee will be a lot more thorough in that, because we need to know how many more claims this policy change is likely to generate. We don’t know if it’s 100; we don’t know if it’s 10,000. So we will support the bill at first reading to the select committee.

The bill makes changes. There’s five additional policy changes in this bill, seven regulatory and technical changes. But what clause 6 of this bill does is it amends the definition—so I went to have a look at the existing Accident Compensation Act of 2001, and it talks in there about the purpose of that Act, which is “to enhance the public good and reinforce the social contract represented by the first accident compensation scheme by providing for a fair and sustainable scheme for managing personal injury that has, as its overriding goals, minimising both the overall incidence of injury in the community, and the impact of injury on the community (including economic, social, and personal costs)”. It proposed to do that through a number of different measures. Number one of those was “establishing as a primary function of the Corporation”—the Accident Compensation Corporation—“the promotion of measures to reduce the incidence and severity of personal injury”. We all see that through the prevention programmes that are rolled out by ACC and some of the advertising programmes as well.

A second was to provide “for a framework for the collection, coordination, and analysis of injury-related information”. That, of course, is the data collection which we have heard mentioned a few times tonight and the need for that data to be absolutely secure. Next was “ensuring that, where injuries occur, the Corporation’s primary focus should be on rehabilitation with the goal of achieving an appropriate quality of life through the provision of entitlements that restores to the maximum practicable extent a claimant’s health, independence, and participation”. So in those instances, we are talking about the recovery from an accident. And in the next item, “ensuring that, during their rehabilitation, claimants receive fair compensation for loss from injury, including fair determination of weekly compensation and, where appropriate, lump sums for permanent impairment”. Of course, that is speaking to the support that is offered to those people who have legitimate ACC claims. The last item is to ensure “positive claimant interactions with the Corporation through the development and operation of a Code of ACC Claimants’ Rights.” And that speaks to the relationship between claimants and the ACC Corporation.

The Accident Compensation Act of 2001 also goes on to define what is not considered an accident in section 25, in Part 2 of the Act, and it states that an accident does not include “(a) any of those kinds of occurrences if the occurrence is treatment given (i) in New Zealand, by or at the direction of a … registered health professional”. I guess this is where we are with this bill that we are now debating, that these are the types of injuries that are now going to be recognised as an accident in terms of the definition of the ACC Act.

One of the items that I have a particular interest in is in Part 3, clause 8. It talks to the injuries that are work-related, gradual process, disease or infection described in section 30. In reading that, I had to wonder whether it will mean that our firefighters who are exposed to a range of toxic fumes in the process of fighting fires will be covered under this clause. There was nothing that led me to believe that it would, because it’s not specified in the bill. But I do hope that, during the select committee process, that will be identified as a legitimate clause and a claim that is able to be made by firefighters who are exposed over a lengthy period of time to toxic fumes.

This was brought to mind when I visited, with a number of other members from across the House, the Rotorua training facility for our firefighters. I was most impressed by the standard of training that they enjoy out there but also the standard of the facility that they get to train in. But at the end of the day, we were invited back into the building, their smoko room, and we were discussing this very issue around the long-term impacts of being exposed to the toxic fumes within a burning building.

It wasn’t something that I had turned my mind to at all, but, of course, when a firefighter goes into a building of any sort, they have no idea about what the content of that building contains, what the furniture is made of, or, if it’s an industrial building, what might be inside that building—and so the toxins within that, of course, can differ. So they may not always be fully prepared for what they are exposed to. So this was something that the Firefighters Union and Fire and Emergency New Zealand were very keen to see progressed—that those workers, the firefighters that risk their lives going into burning buildings to save people and property, are fully compensated at the end of their work life if they do have these specific problems, mainly lung diseases and high rates of cancer that are currently not recognised.

I do note that in the national health policy that was released a year or two back that we actually did include the injuries and the illnesses for firefighters that were exposed to these toxic fumes. So I do hope that the select committee identifies that as part of the consideration of this bill.

There’s a lot being said about the birth injuries—and I do have to wonder why it’s called maternal birthing; I don’t know that we have paternal birthing anywhere that I’m aware of, maybe seahorses. But this, of course, is for women who suffer from these physical injuries during childbirth, and, I have to say, in looking through some of the data, it did make my eyes water and it brought back a flashback for me as well. Some of these injuries are debilitating, it’s time we recognised them for women and gave them the support post-birth that they deserve, and I have great pleasure in commending it to the House.

Thank you, Madam Speaker. It’s a pleasure to take the last call on this first reading of the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill. I am on the Education and Workforce Committee, and I look forward to hearing the submissions that people will make on this bill. It’s heartening to see support from all over the House for this proposal today.

We know that the bill does four specific things that have been canvassed: extending the compensation scheme to cover birth injuries, taking steps to reverse changes made in 2010, increasing the size of the ACC board, and making a number of smaller technical changes. But what I would like to focus on in my speech is the main part of this bill, which is maternal birth injuries, and wanted to recognise, also, the Minister Carmel Sepuloni for seeing an issue within a portfolio she was responsible for and seeking to remedy that very quickly, actually, because it was the right thing to do. So I commend her for that and thank the members of the House for supporting this.

We know that women make fewer ACC claims than men. We know, when women make claims, they’re less successful at obtaining ACC cover, and even when they are successful, they receive less money than male applicants. Statistics like this are not an oddity. They may mean the system is not fully meeting the needs of women, which is, as we know, over half the population.

As we’ve heard tonight, giving birth is one of the greatest health risks that women of childbearing age face. It’s one of the hardest and most physical things that a person can do, and birth injuries, as we know, are a regular occurrence. They can be extremely serious and debilitating, and they can affect mental health. So I commend the Minister for bringing this bill to the House, and I want to let women who have suffered birth injuries know that it’s nothing to be ashamed of. I’m sure we’ll hear difficult stories at select committee, but it is time that we heard them. So I commend this bill to the House.

Motion agreed to.

Bill read a first time.

The question is that the Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill be considered by the Education and Workforce Committee.

Motion agreed to.

Bill referred to the Education and Workforce Committee.

ASSISTANT SPEAKER (Hon Jenny Salesa): Members, the House is suspended, and I will resume the Chair at 9 a.m. tomorrow for the extended sitting. Pō mārie.

Sitting suspended from 9.57 p.m. to 9 a.m. (Wednesday)