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Kevin Hague speaks on the Health (Protection) Amendment Bill

Kevin Hague MP
Kevin Hague MP
kevin [dot] hague [at] parliament [dot] govt [dot] nz (Email)
Tag: Health
All law is in some way a restriction of personal liberty. That is the point of law.
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I would like to start off where the previous speaker left off, on the issue of balancing rights or balancing harms. All law is in some way a restriction of personal liberty. That is the point of law. When we pass a law we have to be confident that that restriction of liberty is justified by the protection of the person whose liberty is thus constrained from harm or detriment, or harm or determent to some other person or people. In this House what we need to consider is that balance between the protection from harm and the restriction of liberty. So I want to pass that test over the various provisions of this bill at this point.

I want to come first of all to this issue of UV tanning. Paul Hutchison may well be watching this debate, and if he is I extend my best wishes to him. We could actually frame this clause the "Paul Hutchison clause" in the bill. I was going to say memorial, but that would be wrong. The provision in this bill is at the most timid level imaginable. I was intrigued to hear Jonathan Coleman in his contribution to this debate saying that the age limit of 18 was struck because there was evidence of disproportionate harm to persons under the age of 18. I would be very interested indeed to see that evidence at the select committee. I was intrigued that there was not—as we usually have, actually, in the case of age limits on behaviours—a case made based on maturity or otherwise to make a decision about the harm that is being incurred with an activity. That was not the Government's case. It was instead a case based on disproportionate harm. So I am going to be very interested to see that.

I would argue that the evidence actually is that there is significant risk of harm at every age. That is the evidence I have seen, and that would also be consistent with the point that Jonathan Coleman made about the fact that the voluntary code of practice that his predecessor put in place has not worked. The industry has not complied with the voluntary code. What a surprise. That is usually what we experience with these voluntary codes of practice. The fact is that people who use these UV tanning beds or salons incur significant risk of skin cancers. They do so in a situation where the information that is available to them is insufficient for them to form a reasonable view and make an informed decision about the level of risk that they are incurring. That is a case for not allowing these to exist at all. I will be very interested to hear the evidence at the Health Committee .

It is particularly important, because at least three states in Australia are now banning these things altogether from the end of this year. What that means is that a substantial problem we currently have, which is that some of the equipment that is available in these tanning salons is already second-hand and of substandard quality, is going to get worse, because there will now be a glut of second-hand machines from those states in Australia that are banning this altogether. We will get the cast-offs from those Australian states, which will pose a greater risk that the New Zealand public and the customers of those salons will unaware of and uninformed about.

I will come now to the communicable disease provisions in the bill—the obvious companions to UV tanning facilities in this bill. These are around contact tracing, notifiable diseases, and the restriction of liberty. Members may be aware that these are provisions that I have considerable familiarity with in relation to my previous work with the New Zealand AIDS Foundation . Again, there are various balances to be struck. When contact tracing becomes compulsory, as it does under this bill, then there certainly is a restriction on the liberty and rights of the person who is being required to, for example, reveal who their sexual contacts have been. There are potentially also some problems with revealing who those sexual contacts have been that are familiar to contact tracers in the public health field. In the relation to the balance that this House must strike, there is an issue with whether, in fact, we enhance or inhibit our ability to actually contact trace by making it mandatory.

A previous speaker has already alluded to that, that if someone knows that they may be required to reveal who their sexual contacts have been, they may not present for treatment. They may not present to health services; that has been our experience. Striking the balance correctly is going to be very important. Also, making a disease notifiable, clearly that can be useful, but again, if a person knows that this bill provides—as it does—for the medical officer of health to be able to require a testing laboratory to reveal the identity of the person who has just tested positive for HIV, syphilis, or gonorrhoea, what may happen in that situation is that the person may not present. I believe—and I would be interested to hear the evidence—that it may be better to provide for anonymous testing as we do for AIDS, which is a notifiable disease. The select committee needs to consider that.

The balance around the restriction of liberty and the public good that is gained is particularly apparent in the new powers of medical officers of health to compel various levels of behaviour. As I say, I was at the AIDS Foundation, and had to use all of these provisions from the existing 1956 Act , an Act that came into place largely reflecting the experience of New Zealand in managing tuberculosis. We needed to deal with modern disease and modern circumstances, such as the HIV epidemic, with powers that were created for a different, bygone era, and a totally different kind of disease. We found them all to be inadequate for the purpose. That is why we were strong supporters, back in 2001, when I had to deal with the Christopher Truscott case, which some members of this House may recall, using these archaic powers of the Health Act. The AIDS Foundation has been a strong supporter of the Public Health Bill .

I am grateful to Annette King for outlining some of the history of that bill. Annette King did not mention that the bill introduced in 2007 was merely the latest attempt to have a public health bill and that previous attempts had also foundered. As she said, this bill, which was reported back from the select committee to this House in 2008 —and members of the public have already had a chance to express a view about many of the provisions in relation to that public health bill—has languished near the bottom of the Order Paper since that time. It would have been much better to simply advance the Public Health Bill further up the Order Paper. We would have had cutting edge legislation that was able to deal these issues much more quickly than we will have in dealing with this bill had we done that. Why have we not done so? We have not done so for the reasons that National outlined in its minority view in the select committee's report back of the Public Health Bill. Essentially it opposed the provisions in that bill that dealt with non-communicable diseases, and it opposed them because of its proximity to the very industries that drive the epidemics of non-communicable disease in New Zealand. The conflicts of interest that were apparent in National's opposition to the Public Health Bill are the very conflicts of interest that are now coming back to bite it over its management of the Katherine Rich - Health Promotion Agency issue. It has to figure out where it stands.


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