Page 4755 - Week 15 - Wednesday, 7 December 1994
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is preferred because it is more precise in that specifically tissue, not general material, is taken from the cervix of a woman for the purpose of histological examination to determine whether she has cancer or precancer. The test is a biopsy of that particular tissue.
The third amendment seeks to omit the current definition of "cervical smear" and substitute the following definition:
"cervical smear" means cells scraped from the cervix of a woman for the purpose of cytological examination to determine whether she has cancer or a precursor to cervical cancer.
The definition should be changed because a smear does not consist strictly of tissue but of exfoliated cells. The fourth amendment again substitutes "tissue" for "material", as does the fifth amendment. The sixth amendment concerns an issue that I feel quite strongly about. The current regulations give a woman, a patient, the right not to be part of the register, which we would all totally agree with. Unfortunately, at this stage the regulations do not empower or require anyone to tell her of that right not to be part of the register. My initial amendment proposed that the health practitioner who is responsible should achieve that end and tell the woman involved. I am now told that probably the more efficient way to go is to suggest that the Medical Officer of Health shall inform the patient of her right to choose not to participate in the program and contribute data to the register and that failure to participate in the program will not affect her right to have a test performed. The reason it would appear that the Medical Officer of Health is the more appropriate person is that that is where the information about the register comes from. In real terms, that person is the register. Hopefully, this information is going to be passed out to women; but I think it is really important, in any of these areas where we suggest that somebody has a right to do something or not to do something, that we ensure that, in regulations, a person knows about that right.
The seventh amendment again concerns the issue of "material" versus "tissue". The eighth amendment proposes that after the word "taken" we insert "or other recommended follow-up". The reason for this is that appropriate action, including other tests and treatment, may have been taken following the previous test, so the timing of the next test may depend on those factors as well as the previous test. I think that is patently obvious. The ninth amendment proposes that we omit "reasonable excuse" and substitute "good reason". The reason for that is that the word "excuse" has overtones of extenuation, justification for a questionable action, or apology. It is important for the Act not to imply that a woman can get away with anything but to be positive in requiring clear, demonstrable and beneficial reasons for disclosing particulars on the register - in other words, not a reasonable excuse but a good reason. The tenth amendment also substitutes "good reason" for "reasonable excuse". The eleventh amendment substitutes "tissue" for "material". The twelfth amendment proposes that after the word "results", we add "either" and that at the end of the clause we add ", or the details of other management recommendations (that is, colposcopy plus biopsy).". The reason for this is that, as well as knowing the time when a medical practitioner was advised to take another smear, there could be occasions when it would be more useful to know of other management recommendations.
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