Dr PAUL HUTCHISON (National—Port Waikato) : Thank you, Madam Speaker, for the opportunity to speak on this hugely important Care of Children Bill, which, I note from the commentary on the bill, “replaces the Guardianship Act 1968, and is intended to modernise the law on guardianship and care of children.” What is more important is that it states that “the child’s welfare and best interests are to be ‘the first and paramount consideration’ ”.

Two weeks ago I was part of a debate in Rotorua, at the annual conference of the New Zealand Paediatric Society, on the question of whether we in New Zealand really care about our children. As members can imagine, the evidence for the negative was quite overwhelming. I think it is worthwhile reading out part of the contribution from the Children’s Commissioner, who said: “Our lack of care is self-evident when we consider New Zealand’s third placing in the OECD child homicide league table.”—third placing in terms of being the worst. Our children die at the hands of others, commonly at the hands of those entrusted with their care, at an alarming rate. In just 12 years, from 1989 to 2000, 111 children and young people aged 0 to 14 years died as a result of homicide, and 1,743 were admitted to hospital as a result of non-accidental injury inflicted by others. A recent review, conducted by Mike Doolan, of child homicides between 1991 and 2000 found that these tragic events occurred most commonly within families, with fathers, mothers, de facto partners, and other relatives, caregivers, or acquaintances accounting for all but 11 percent of those deaths. For the period between 1996 and 2000, only one in five of the children who died as a result of injuries inflicted by others was known to the Department of Child, Youth and Family Services. This is a huge indictment on our society.

If we go even further we find that, as we heard at that conference, there is 3 percent child truancy. Every Monday in New Zealand, 19,000 of our children are absent from school without authority from that school and, usually, not with the knowledge of their parents. Child obesity is up 300 percent in the last 11 or 12 years. Non-completion of immunisations and Well Child checks are such that we in New Zealand have about the worst record in the South Pacific. Suicide rates are enormously high, and, of course, so are our teen pregnancy rates, which are amongst the world’s highest.

We do indeed need a bill that will provide an appropriate legislative framework to address these very deep concerns that we have in New Zealand. Although, like many other Western countries, our child-infant mortality has come down steadily over the last 100 years, all those other, different situations have emerged, such that in many aspects, particularly child assaults and homicides, there is indeed a crisis situation in New Zealand.

It is interesting that when we read new clause 4A, and see that a child’s parents and guardians should have primary responsibility, and should be encouraged to agree to their own care arrangements, we wonder about some of the events over the last year or so that we have heard about that indicate erosion of parental ability to have responsibility. For instance, we heard earlier in the year that a school councillor and school authorities did not inform the parents of a young disabled woman that there had been an assault on her. It was 2 to 3 months later that they discovered it. She did not know how to take her medication, and she had been acting inappropriately, and finally they were told. She was not being treated for a sexually transmitted disease. It makes one wonder greatly whether the State is undermining parental responsibility. Time and time again in Port Waikato, mothers have come to me extremely distressed that the school councillor has referred young women to the doctor for contraceptives without their parents’ knowledge. We must have an ethos in New Zealand whereby every effort is made to ensure that parents are included, if at all possible. To my mind, an overemphasis, if anything, should be placed on this area.

This brings me to the controversial clause 37, and the question of whether young women under the age of 16 years should be required to inform their guardians that they are going to have an abortion. Naturally enough, I have wrestled with this issue considerably, having been an obstetrician-gynaecologist and having also been on the Abortion Supervisory Committee. One of the things that does concern me is that we have only anecdotal evidence of what the real situation in New Zealand is. I am very pleased that my colleague Judith Collins is putting a further amendment that recommends that the Abortion Supervisory Committee, under its Act, be required to collate data on matters relevant to informed consent in this very, very sensitive area. Unless we have good data, it is unlikely that we will be able to make wise legislation.

I think it is also important to point out that one of the great difficulties that face any medico such as myself is that, as I have said, I would rather be grinning from behind bars than divulge secrets that patients had given me. On the other hand, we heard earlier in the year that something in the order of 29 Government departments and agencies have the power to look at private medical records. Indeed, that makes this particular clause a very difficult one.

I have certainly heard the arguments on either side of the coin. On one side, if the information is withheld and the woman goes on to have an abortion and her parents do not know, there can be hugely severe repercussions if there was an incestuous relationship or if the woman returns to a situation of family violence. On the other side, if disclosure ofthis information is to be forced on the woman, it may well prevent her from seeking medical attention. I heard just recently of a case whereby a young woman decided to keep her baby, but having delivered it, smothered it a few days after birth. This is an extremely exquisitely sensitive and unpredictable area that requires wise legislation. That is why I would ask the House to support the second amendment that my colleague Judith Collins is presenting to the House on this issue.

I note that a variety of other areas have been traversed in the commentary. One area concerns the sterilisation of young women with intellectual disabilities. CCS raised the concern that hysterectomies of young women with intellectual disabilities are being used for the purpose of non-therapeutic sterilisation. From my own experience, having been involved in this sort of situation, where people have gone to huge lengths to look at the possibilities, I absolutely agree with the Ministry of Health that it should be done on a case by case basis.

STEVE CHADWICK (Labour—Rotorua) : I will take a short call on the Care of Children Bill to say that its replaces the Guardianship Act, which is now 35 years old. Family patterns and practices in the Family Court have changed substantially in that time. This bill takes into account the need to open up the processes of the Family Court.

I would like to say that I could never have supported Judith Collins’ first amendment that she proposed, which involved mandatory reporting to, and involvement of, parents when young children come to a medical practitioner seeking advice on pregnancy, and seeking support for a possible termination of pregnancy, because it would not have worked. It would have been an appalling thing to do. It has been in legislation for 35 years, and has been largely unchallenged for that time, and I am very pleased that we will be voting as a majority not to support that amendment.

I think that the work of the Justice and Electoral Committee on the Care of Children Bill has been largely outstanding. It has certainly put the rights of the child at the forefront, and that is where they ought to be.