Hon PETE HODGSON (Minister of Health) Link to this
I move, That the Epidemic Preparedness Bill, the Health Amendment Bill, the Immigration Amendment Bill (No 2), the Parole Amendment Bill, the Sentencing Amendment Bill (No 2), the Social Security Amendment Bill (No 2), and the Summary Proceedings Amendment Bill (No 2), be now read a third time. I want to make my comments briefly. It may be that there will be relatively few speakers in the third reading debate on these bills, but this concludes a process that has been a cross-party process—one that I think has shown that when there is a threat to this nation the parties of this House can act together, and can act together sensibly, to good effect.
I therefore want to thank again the chair of the Government Administration Committee and its members, who deliberated on the legislation. Also, I thank again the Law Commission, and especially Sir Geoffrey Palmer. As well, I would like to thank those who made their submissions on this legislation, members of Parliament across all parties, and, indeed, officials, the Clerk’s Office, and all those who have worked on what has been difficult but necessary and important legislation—legislation that now finds itself divided into many bills.
SHANE ARDERN (National—Taranaki-King Country) Link to this
I thank the Minister of Health, Pete Hodgson, for his comments. This was difficult legislation for any select committee to have to deal with. The process was one of those rare occasions where Parliament worked in a totally multi-partisan way. There were no politics. It was difficult to find the politics in this legislation. I also thank the other members of the Government Administration Committee, who spent numerous hours going through what at times were tedious recommendations and suchlike from various organisations. I thank the staff of the committee, the Clerk’s Office, and all those involved. Certainly, I thank the officials from the Minister’s office, who were very articulate in the way they presented the issues to us, but were equally good at listening to the concerns of the committee, then going away and coming back with alternative recommendations. I know that at times the parliamentary staff found the job quite difficult, particularly parliamentary counsel, and I thank them for their efforts. Sir Geoffrey Palmer and the Law Commission spent time going through some of the anxiety the committee had around the executive power we were giving to whoever is in Government in relation to this legislation.
The legislation is potential law that we hope will never be needed, but if we look at history, I think it is easy to conclude that at some stage in the future it will be. In 1918 New Zealand had an epidemic the likes of which would trigger this legislation. Again, in the 1950s, a similar event occurred, although it is not as well-known as the 1918 flu epidemic, and there have been numerous other examples around the world. We all know the concerns worldwide about avian bird flu, which as yet has not gone from one species to another species. According to scientists it is only a matter of time before it does. So something was necessary, and it is only prudent to plan for such an event.
The select committee spent some time on what is now clause 5 of the Epidemic Preparedness Bill, which empowers the Prime Minister. In fact, a lot of debate took place around what should be done in respect of how to trigger a pandemic notice and have it gazetted, and who should make that decision. In the finish, the committee came down on the side of the Prime Minister being the principal person who would make that decision, having first been advised in writing by the Director-General of Health, and having the support of the Minister of Health. The committee, to try to bring balance to that executive power, then looked at how the House could be involved not only in ratifying any decisions post the event but in planning for such an event. It came out with the final recommendation that the House should be notified as soon as possible and practical after such a gazetted notice of a pandemic, and where practical and possible the House should be recalled—not necessarily in Wellington, if that was deemed to be unhealthy or unwise. The Governor-General currently has the power to decide where Parliament sits, so the committee decided that that was a reasonable balance.
During the discussions the other issue that arose was that of what would happen if there was such an event after Parliament had been prorogued, and therefore we were in between Parliaments so to speak—either during an election campaign cycle, which may not be able to take place as the result of the pandemic, or after an election, when the result was known but the new Parliament could not meet due to the pandemic. It was decided that further work needed to be done. I was heartened by the Minister’s comments in the first reading debate that the ministry was going to look at a way forward.
The committee also asked whether there were any Standing Orders that would need to be amended, and we were informed that there were. In fact, the Regulations Review Committee spent some time looking at that. We have been informed that that will take place at the earliest opportunity. The committee was reasonably comfortable that we had arrived at a place where we had struck a good balance between the amount of executive power that would be necessary for the Government to manage a pandemic of some sort that had the potential to disable large parts of New Zealand, to cause the deaths of thousands of people, and to disrupt the economy and general business, and the checks and balances on that executive power, which are needed anywhere, through a parliamentary process. I think we have the legislation about right. We will never know, until it is tested. I hope it is not in my parliamentary time. I hope it never happens, but, I guess, that is wishful thinking.
Certainly, when the legislation is tested, the media will take an interest in it. There has been a deafening silence from those who would normally have a view on this kind of thing. Throughout this process there has been overwhelming media publicity of the work the select committee has done! I am not sure how the members of the committee can cope with the publicity we have had! However, I am sure the media would be immediately interested in who was on the committee and what had been decided, in the event that a pandemic did take place.
This legislation is one of those rare occasions when Parliament has worked together. The public often screams—after watching 30-second sound bites of the most dramatic bits of what happens in here—about the childish and nonsensical way that this place operates. Now we have an occasion where Parliament has worked together, and I guarantee that there will be columns written in all the major papers, that the legislation will have at least 15 minutes of television time, and that the media will pay attention to it like nothing else!
With those few words, it is my pleasure to support this legislation. I hope the legislation is able to achieve the goal that is set out for it to achieve.
KEITH LOCKE (Green) Link to this
The Green Party will be supporting the third readings. I sat on the Government Administration Committee for the purposes of this legislation, even though the Greens are not normally represented on that committee. The reason I sat in was our concern that the powers being granted to the executive branch were, perhaps, excessive in the situation. As the legislation proceeded through the select committee, it was very good to see the way in which the input of so many people was considered—input from the select committee people themselves, from Shane Ardern, who chaired the committee quite well, from Ministry of Justice and Ministry of Health people, from human rights people, and, of course, from Sir Geoffrey Palmer, who has been mentioned, from the Law Commission. All their input was considered, and the views of the officials evolved.
This legislation changed in the select committee stage probably more than any other legislation I have ever seen in Parliament. That happened through a consensus process that ended up with a unanimous vote, and it is a tribute to the workings of Parliament. What was done was that all the controls in terms of advance regulations were brought in—a stepped-in process of the controls in the legislation as the threat of a pandemic increases, and the stepping out from those controls as it recedes. A whole lot of things were built into that process, including, as Shane Ardern just mentioned, the parliamentary supervision process, the calling together of Parliament, making sure members of Parliament have the right to challenge any regulations—those that were not arranged in advance through the regulatory process prescribed but brought in at the time of the pandemic and that were to go through a proper regulations review system. At the outset it may have been thought that because a pandemic hits so fast, so dramatically, a lot of those things might have to go by the board a bit. But I think we worked it out, after due consideration, that we can have a process. Of course, the process is difficult when a pandemic is operating, but it can work.
The other thing that Geoffrey Palmer brought to our attention, which really struck me, was how in some ways we are ahead of many other countries in world in how we have dealt with this threat, because a lot of other countries deal with such emergencies under generic legislation. Geoffrey Palmer, from the Law Commission, mentioned in his paper the United Kingdom’s Civil Contingencies Act 2004. He mentioned the positive side of that Act in terms of Parliament being called together to look at regulations made under that Act. But the other side of that legislation, which is not quite so positive compared with what we will have, is that it covers so many different types of emergencies—threats to human welfare, which can be in the areas of health, transport, communications, energy, water, and food; threats to the environment; and threats such as terrorism—all bundled up in one Act, and we can see there the potential for the executive to exert power across a number of fronts relatively unrestrained. So I think our legislation is much superior to the approach taken by some other jurisdictions, and we can be proud of that.
The other thing I would like to say, from a Green perspective, is that although we think such legislation is very necessary and that it is important for the executive branch and Parliament to have the powers worked out collectively to loosen certain laws because of people being unable to get around to fulfil certain legally prescribed functions during a pandemic—although that can operate at the national level—the real success of what we do as a country will depend on how well we work together at the community level. I think that is relevant to what Shane Ardern said earlier when he talked about publicity and the population’s knowledge both about what the Government might be doing and about pandemics as a whole. The community has to be a bit engaged with that prior to the pandemic breaking out, because with such a threat there will be a bit of panic if people think that coming into contact with an infected person might put their lives and the lives of their families in danger. There will be the stress of families divided—families who may have some members overseas who are not able to return—and all the anguish that that breeds. So calm people, like teachers, who are used to dealing with large numbers of kids, and doctors and nurses, who deal with large numbers of people in the community, will have to be geared in.
We will have to work as a community to reduce the cross-infection that might take place, but, on the other hand, keep the society going. Keeping the medical system going as much as possible, keeping our families together, working out ways of people getting goods, shopping, without too much cross-infection occurring, etc., will be a challenge. I think we as MPs have a role to play in linking what we might be doing at the national level, and what the Government and Parliament might be doing at the national level, with what is being done at the local level, which is where the dangers of a pandemic are being confronted. The Greens are supporting this bill.
TE URUROA FLAVELL (Māori Party—Waiariki) Link to this
Tēnā koe, Madam Speaker. Kia ora tātou katoa. Some debates in this House are concerned with nothing less than life and death decisions. The series of seven bills under final consideration here, which impact on the preparedness of the nation to face the onslaught of an epidemic, is exactly that. The Māori Party recognises the heavy responsibility this Parliament brings to bear, when we take into account the inevitable and disproportionate impact of an epidemic on Māori. The association with Māori of “epidemic” is one that is far too frequently made.
A month ago, Professor Martin Silink, head of the Brussels-based International Diabetes Foundation, told an international conference that the diabetes epidemic could wipe out Māori and Polynesian Islanders by the end of the century. And there is the meningococcal disease, which has been categorised as an epidemic since 1991, with demonstrably more adverse impacts on Māori and Pacific populations.
Dr Lis Ellison-Loschmann, who has been following the work of the Māori Asthma Review, has described asthma mortality rates for Māori as reaching epidemic rates in the 1970s and 1980s. Dr Neil Pearce has also described the major medical controversy around the asthma drug fenoterol, which some 15 years ago caused an epidemic of asthma deaths.
The significant and growing ethnic and socio-economic inequalities in lung cancer mortality in New Zealand, and the relatively high lung cancer incidence and mortality, particularly among Māori, mean that lung cancer has been reported in the New Zealand Medical Journal as an epidemic. The Workshop on Obesity, Food and Policy: New solutions?, held at the University of Auckland on 16 November, talked about an obesity epidemic. Associate Professor Wayne Cutfield, reporting on the situation in Auckland, has revealed an escalating epidemic of childhood obesity, wherein an estimated half of Pacific Island and a quarter of Māori children are overweight. There is also the concept of epidemic used in connection with cannabis and methamphetamine. So, in short, Māori seem to attract epidemics, if we are to believe all this information.
These are not just recent occurrences. I refer to a statement from our first New Zealand - trained Māori medical doctor, Te Rangi Hīroa—Sir Peter Buck. He said: “Various epidemics were introduced by civilisation and have remained with us ever since … measles, typhoid, scarlet fever, whooping cough and almost everything, except plague and sleeping sickness, have taken their toll on Māori.” So, indeed, almost everything has taken its toll on Māori. In the initial years following colonisation, the Māori population suffered a period of almost unbroken decline from 1858 to 1896, with the susceptibility of Māori to epidemics and other diseases introduced by the settlers being described as a major factor. But if there was one epidemic to outdo all others, it was the influenza epidemic of 1918 in which at least 2,160 Māori lost their lives. So our history provides us with visible and violent proof of the high likelihood of Māori experiencing significant mortality and morbidity in future epidemics.
Alongside our history—alongside the epidemiology of disease—there is also the policy incentive provided in He Korowai Oranga, which demands that specific provision must be made to protect and enhance the well-being of Māori and to ensure that Māori health disparities are reduced. Achievement will require a total commitment from Government, a commitment to the elimination of institutional racism across the board—in incomes, housing, employment, and justice, as well as in health. It will require an about-turn on the denial of rights for tangata whenua, for how can a person be whole and healthy when that person is assumed to have only subhuman rights?
Dr Lorna Dyall, senior lecturer in Māori health at the University of Auckland’s faculty of medical and health sciences, has suggested four integrated pathways of work to run alongside each other in the case of an impending epidemic: the need to rebuild and strengthen whānau; the need to involve Māori at all levels of decision making; the need to ensure that Māori can access and receive effective health services; and the need to ensure that a whole-of-Government approach is taken towards addressing Māori health matters. It is said that vision without action is a daydream, and action without vision is a nightmare. The Māori Party has a vision in which Māori interests are able to be placed at the very centre, with our well-being protected and enhanced so that our future and survival are assured.
The action that these seven bills could drive is the bringing on board of appropriate Māori leadership, the use of Māori infrastructures and networks, and the ability of health workers to engage with iwi and Māori communities in helping to fight the excessively high rate of mortality that all predictions expect to occur in the likelihood of an epidemic. We want action in which our whānau are actively prepared and ready to support and care for tamariki and pakeke in the event of an outbreak of an epidemic. Should avian influenza or, indeed, any infectious disease prove itself to be capable of becoming an epidemic, our communities need to be on high alert about how to preserve our most precious resource—“He tangata, he tangata, he tangata”.
The particular anxiety expressed by many tangata whenua about this legislation has been around looking at the concept of how best to minimise face-to-face contact. Questions have arisen specifically around our tangihanga, and whether the epidemic risks will entail mass burials to occur, therefore disrupting long-held expectations about the traditions associated with paying our respects to the deceased and their whānau. In this regard we welcome the recommendation from the Government Administration Committee that an epidemic notice will be issued only for outbreaks of quarantinable, rather than infectious, diseases per se. The notice should be the sole preserve of highly infectious diseases capable of becoming a pandemic.
We have considered the viability of using marae for quarantine centres. The changes to the Health Act increase the powers of medical officers of health to detain people for medical surveillance for a period of up to 28 days. We note also that the police will be able to use force to detain people suspected of suffering from bird flu. We would suggest that rather than using the enforced authority represented by either the medical officer of health or the police, it would be preferable, in the interests of safeguarding public confidence and accountability, for encouragement to be given to utilising venues that are already familiar to the people, such as marae. We would also suggest that MPs take on board the need to inform their constituencies of what can be done to be “epidemically prepared”. Accessible and widespread information will be critical to effective preparedness.
In closing, I tell members that the 2006 census results were released last week, which showed that New Zealand’s Māori population has experienced a growth exceeding 7.4 percent since 2001 to reach a grand total of 565,329. A century ago, in 1905, the Māori population hit an all-time low of 45,000 and was at risk of extinction. Not only did tangata whenua survive but we have sustained a substantial and vibrant level of population increase since then. We celebrate that growth and we look forward to it continuing. Our future as a nation depends on our young population, our Māori population, being able to thrive on many counts. We want to see our population contributing to the Māori economy of the future. We want to know our taonga will be protected for future generations. And we want to be content in the knowledge that our very survival is not at threat. Voting in support of the seven bills debated today, bills that were previously grouped together as the Law Reform (Epidemic Preparedness) Bill, is one more step along the way towards achieving that. Kia ora tātou.
BARBARA STEWART (NZ First) Link to this
On behalf of New Zealand First I rise to support this legislation and the subsequent amendments to the various Acts that it effects. This has been very important legislation for New Zealand—an important planning step in the event of any pandemic.
We are all very aware that a flu epidemic of the magnitude of the Spanish flu that occurred after the outbreak of World War I would be disastrous for New Zealand and, in fact, for the whole world. I was reading an article recently where it was estimated that a severe bird flu pandemic among humans could cost the global economy up to $2 trillion, according to Jim Adams, who is the World Bank vice-president for east Asia and the Pacific, and head of the avian flu task force. He said that represented more than 3 percent of the global economy’s gross national product.
If we use the same base percentage figure for New Zealand, then we realise legislation and prompt action on the part of the Government are absolutely essential. We need to have a timely response in order to attempt to minimise the crisis that we will find ourselves in, and of course to ensure that after the epidemic wanes, normal life is resumed as soon as possible. As a country we have no option but to be prepared. Other countries have legislation in place; so must we. The reality is that all countries will be dealing with the crisis that they have, and their efforts will be concerned solely with their individual situations and not ours here in New Zealand.
Many Acts are affected by these bills. However, if we are logical about this, we realise it means that this type of crisis does indicate that widespread efforts will need to be made across many fronts for some time. A pandemic threat such as bird flu or any derivative of it is far too important an issue for petty party politics to come into play. This is legislation that must be supported by every party in this House, and I can see the National member nodding in agreement from the back seat.
Preparations such as those outlined in this legislation are absolutely essential, and New Zealand First supports this legislation.
JUDY TURNER (Deputy Leader—United Future) Link to this
I rise on behalf of United Future to take a call on the third readings of this legislation. The Epidemic Preparedness Bill contained legislation that we hope never has to be enacted. The provisions are triggered by an announcement by the Prime Minister and the Minister of Health, in collaboration with the Director-General of Health, that we are threatened by a pandemic. Pandemics are rare. We have about two or three every century. They can strike at any time. They are highly contagious and have a high fatality rate; there is no human resistance. The number of lives taken by the Spanish flu of 1918 is unclear but it was anywhere between 50 million to 100 million worldwide. Over 8,000 people died in New Zealand, 25 percent of the entire population of Western Samoa died, and 20 percent of French Polynesia died.
The strength of what has legislatively been put forward in this legislation is that health officials and officials in other Government departments are required to act predictively and make, in advance, as many of the regulations as they reasonably can. All regulations will be reviewed after the crisis. Most other jurisdictions have similar legislation, but New Zealand is perhaps a forerunner in designing regulations specifically geared to the conditions that prevail during a pandemic. A pandemic is different from other crises—for instance, a natural disaster where people pull together to support each other. The nature of a pandemic is such that we would most likely be actively discouraging social contact, because that would add to the existing risks associated with a pandemic.
Ongoing work is required at community level. For example, most supermarkets stock only enough food to cover themselves for 2 to 3 days. Public education about civil defence - type emergencies remains current, and ignorance on this matter is unhelpful. Although overreacting is also unhelpful, so is under-reacting. This discussion now needs to move beyond Government departments and towards neighbourhoods and homes. As others have mentioned, this is not a matter to be treated as a political football.
I thank the select committee for the tone, and working environment, that it created, and also for welcoming me, as a non-voting member, on to the committee for the duration of consideration of this legislation. United Future is happy to support the combined third readings of the seven bills resulting from the original legislation.