Wednesday, 7 January 2009

DOWN TO THE DOCTOR'S: Public Health Bill = Totalitarian Medicine

New Libertarianz leader Dr Richard McGrath runs his eye over the proposed Public Health Bill, and doesn't like what he sees ...

An interesting letter appeared in the 12 December 2008 edition of the New Zealand Medical Journal, written by three staff members from the Otago University Department of Public Health. In it, they point out the archaic nature of the Public Health Act 1956, a law which compels travellers on buses, aircraft, trains and ferries to notify the driver, pilot, ship’s captain, etc., if they (the passenger) have any sexually transmitted or other communicable diseases.

Yes, you read that correctly. New Zealanders are currently required to provide the master of any state-owned vehicle or vessel in which they travel with up-to-date information on their currently active social diseases. And let’s not forget it is still an offence to return library books or post letters if they have been handled by a sick person, unless they have been properly disinfected.

The writers offer two possible solutions to the absurdities outlined above. First, that we carry an electronic swipe card containing information about one’s sexual health and medical history, thus providing bus drivers with hours of amusement; or secondly, that we replace the Health Act 1956 with new legislation which would do away with the need to disclose a list of one’s currently active contagious diseases to bus drivers, but which would allow collection of the same information in more sophisticated ways and would also reinforce the disparity in power between the government and the people. And wouldn’t you know it - such a law has already been drafted: the Public Health Bill.

Generally speaking, when the government gives with one hand, it takes with the other. What it usually takes is an important little piece of freedom which you don’t miss until it’s too late.

According to the writers, a new Public Health Act will allow New Zealand to “reach full compliance with the new International Health Regulations.” These new regulations, to quote an earlier article in the New Zealand Medical Journal, “expands the range of events which must be notified to WHO”, and “expands the range of surveillance sources that WHO can use.” In other words, once this law is passed details of your private health status can and will be transmitted internationally, with or without your consent.

If enacted, the Public Health Bill will replace not only the Public Health Act 1956 but also the Tuberculosis Act 1948, a draconian law under which New Zealanders can be imprisoned and drugged using physical force. But this proposed new Act will do nothing to curb these infringements on our civil liberties; instead it will broaden the front on which our privacy can be invaded. Not only will the government have the authority to forcibly treat people suspected of harbouring infectious disease, it will “expand health emergency provisions, which currently deal only with epidemics of communicable diseases, to all actual or potential public health emergencies irrespective of the cause.” This provides enormous scope for increasing government encroachment into people’s lives via the public health system.

Not only will the state be able to act where there is perceived danger to the “public good”; the Public Health Bill also includes “new guideline provisions aimed at reducing risks of non-communicable disease.” Which means the state will have greater power to intervene when a person has risk factors for conditions such as cancer and cardiovascular disease that cause significant morbidity and mortality. This will not be good news for fatties, smokers, people with high blood cholesterol levels, diabetes or hypertension, and people with unfavourable family medical histories. Such people will find their private lives under increasing scrutiny, and their health providers under financial pressure to improve the overall risk profiles of their customers.

A logical consequence of the flow of money within state-run health services is that doctors and other providers will withhold or distort information that might impact negatively upon their funding. Word surfaced a few years ago of a British doctor who declined to record a patient’s blood pressure in the clinical notes because it wasn’t within the target range for blood pressure set under National Health Service guidelines. To have recorded less than perfect data could have jeopardised the flow of taxpayer funds to that medical practice, and impacted on the income of the doctor’s colleagues.

An online summary of the proposed Public Health Bill notes that “reliable flows of information are fundamental to all health policy and action”, and that “information flows are necessary to support funding of services.” Apparently the exercise of authority (i.e. use of coercion) allowed under the Bill contravenes even the minimal protection offered by the Privacy Act 2003. Too bad.

Should this Bill become law, there will be a greater requirement for doctors and medical laboratories to notify the authorities when they encounter patients with certain medical conditions. The government, of course, dictates which medical conditions will be made notifiable. The Bill aims to “build on” provisions within the current Act to incarcerate and treat with or without consent, with no right of appeal, for indefinite periods of time, anyone with a ‘notifiable’ condition. Powers that can be exercised by Medical Officers of Health will range from requiring a person to refrain from employment or travel, to “detention or compulsory medical examination.”

Medical practitioners will be able, under the proposed Bill, to approach employers and demand information about an individual – so that people can be hunted down and forcibly treated. Doctors will be able to disclose confidential information about individuals to their families and sexual partners. (Why stop there? Why not release medical information into the public domain so that the undesirables can be weeded out rapidly and ‘cured’ of their afflictions more efficiently?)

The Bill will allow public health zealots to supervise the ongoing regulation of private business owners such as hairdressers, importers and manufacturers of microwave ovens, camping ground proprietors and funeral directors. During emergencies, Medical Officers of Health will have wide-ranging powers including the ability to lock people up in quarantine, close down businesses, “requisition things” (i.e. seize private property) and redirect aircraft. The emergencies in question might have arisen in another country but that is immaterial. It’s all about the exercise of unlimited power - something for which statists live, and of which they dream.

Totalitarian medicine, as outlined in the Public Health Bill, was practiced by the Axis powers during the Second World War, in the post-war Soviet Union, and in a smattering of dictatorships at various times since then. It is a particularly invasive violation of personal freedom. At least two of the writers who propose the Public Health Bill as an answer to the antiquated Health Act 1956 - Nick Wilson and Michael Baker – are longstanding health bureaucrats. Wilson is a leading nico-Nazi. These guys will be right in their element, as the Bill is characterized by sweeping government powers of arrest, detention and compulsory treatment, at the expense of individual liberty.

As Benjamin Franklin is alleged to have said, those who would give up essential liberty for temporary security deserve neither. It is the government’s job to protect and defend our rights, not trample all over them. I am confident that the private sector, in a free market economy, could successfully co-ordinate the containment of infectious disease in New Zealand. But it will probably never be given a chance. The proposed Public Health Bill aims to entrench and expand the footprint of Big Government in the health industry. The Key administration will no doubt pass this Bill into law without thinking through the dangers inherent in putting so much power in the hands of so few. That’s because, despite what they say, conservatives don’t place a high priority on human freedom. Like their leftist counterparts they just love the trappings of power and bossing people around.

The obvious way to avoid having to disclose your medical history to a bus driver would be to privatise both the transport industry and medical services and allow open competition between providers. No bus company that wanted to remain solvent would dare to demand sensitive personal information from its passengers and then pass it onto a third party. Alas, privatisation of the health industry won’t be happening any time soon. The grand plan by New Zealand’s two major political parties, loyally supported by the health ministry, academics such as Wilson and Baker, and other statist scum, is to fully ‘socialise’ all aspects of health care (i.e. drive private players out of the market and then force them to pay for a state monopoly), thus ensuring a drop in quality of the service and creating price distortions that tend to make the product more expensive in the long run.

* * Read Doc McGrath every week here at NOT PC * *


  1. Very interesting, and very concerning. This is the first I had read of this bill and I will be keeping my ear out for more discussion on it.

    "The Key administration will no doubt pass this Bill into law without thinking through the dangers inherent in putting so much power in the hands of so few. That’s because, despite what they say, conservatives don’t place a high priority on human freedom."

    No, it is because Key is not a conservative (although some in his party are), he's a mild leftie. I am a conservative, and having read your analysis I am very concerned about this proposed bill.

    Any law that allows people to be forcibly treated for an illness is extremely dangerous, especially if it allows forcible treatment of mental illnesses. It could pave the way for people to be eventually forcibly incarcerated and treated for extreme religious or political views (e.g. "he believes in an invisible God, he must be mad" or "he thinks the state is conspiring to take away his freedoms, he must be manic").

    How do you define someone with a mental illness? Ultimately it is someone with thoughts that you consider unreasonable. How do you define unreasonable? Well, that is up to you...

    Laws like this open a door to let people be incarcerated without a trial, and forcibly treated (in the case of mental illness, possibly brainwashed) against their will.

    Now I certainly don't think anyone currently in government would want to do that (note I didn't say "parliament", just "government"!). But to pass such a law does open the door for a future, less honest administration to do something more dodgy.

    It also opens the door for people within the Ministry of Health to put in place dodgy procedures without parliamentary debate (as updating the lists of which illnesses are to be treated will no doubt be up to the Ministry).

  2. The argument to be promoted by the Reichsministerium runs thus:

    1/. Person is infected with contageous disease

    2/. Person mixes in society and comes into contact with other people.

    3/. The other people are at risk of infection as a result of their contact.

    4/. It is necessary to make sure that individuals infected with contagious diseases are controlled, excluded from society if necessary, thus prevented from infecting other people.

    5/. Thus the individual must be limited in favour of the greater good.

    Now since no-one relishes the thought of being infected, with nasties such as (say) drug resistant TB, the idea of controlling those with certain diseases is readily accepted as reasonable. After all, who wants to get infected by some infected disease carrier? Better that such individuals are controled, even quarantined, so that the heathy are not endangered. As all right thinking people know, that's the right thing to do!

    In the end, that's the position you are up against. This Bill will pass as there is no argument or alternative that apeals to the general public strongly enough for them to embrace or stand up for.

    BTW it is likely that it will eventually become illegal (a crime) for an individual not to submit to regular health inspections in order for his or her status to be determined and recorded and actioned upon. This is, if anything, even more important to the well-being of the community than is the regular reporting and inspection of an individual's financial affairs. It is surprising that this oversight has been allowed to continue for such an extended period.


  3. Interesting. The only place i've heard about this bill was at Kiwiblog, where during Labour's term David decried it as 'the ultimate nanny state bill'. Now that it's apparently National's Bill I expect some endorsement, due to 'common sense modifications'...

    However, I don't see any links to National's intentions to enact this Bill into law, so why do you think this is so likely?

  4. Agree with LGM.
    This has in fact happened in South Africa where patients with drug-resistant TB were kept in hospital to prevent the spread thereof. Not withstanding instances where similar patients were released by incompetant officials.
    However I think the "disease" should be specifically defined. No open-ended, wide-ranging statements should be allowed.
    For is the common cold not contagious? What about HIV? I foresee many little "camps" holding those with diseases - for their own good.

  5. Frank Cobain:
    "However I think the "disease" should be specifically defined. No open-ended, wide-ranging statements should be allowed."

    You're dead right there, that is where my concern about the Ministry of Health comes from. If diseases are left to them to define, some nameless official in the Ministry gets to choose who gets locked up with no parliamentary debate on it. That would be completely open to blatant abuse.

  6. "some nameless official in the Ministry gets to choose who gets locked up with no parliamentary debate on it"

    That's the intention of the legislation, not an abuse of it.

    BTW are you suggesting that it is right and proper that parliamentarians decide whether to lock someone up or not?


  7. I am not saying it is right and proper, but if the government is trying to lock someone up I'd prefer they had to get it through open parliamentary process rather than being able to sneak it in through the back door without such debate.

  8. Parliamentarians, it would seem, are about to have that "debate" now (when the bill goes to the house). What difference is there between parliamentarians deciding to exert arbitrary coercion upon an individual and a bureaucrat empowered by said parliamentarians doing exactly the same thing? From the victim's persepective the answer is, nothing

    Better if parliamentarians don't have that sort of power at all. Their attributes render them unsuited to weilding control over any other people.


  9. BTW, as an aside, how would you propose to deal with the carriers of a contageous disease?


  10. The difference is that if they debate a bill that just says they can lock up people, without specifying who, there will be little public outcry. If they say they can forcibly lock up people suffering x, y and z then it will bring it home to the public and there will be stronger debate. Thus if they have to put each disease through public debate they are less likely to be successful, which I and I presume yourself would certainly prefer.

    I don't actually know how best to deal with a contagious disease. I can see the value of a law like this to deal with highly contagious things only (despite the moral problems with that of course), unless you can propose a viable alternative. I would hope people would be sensible and seek treatment, allowing the free market to solve such issues, but the NZ population has been mollycoddled for so long there may be individuals who need to be told what to do. My concern is that the law may be applied to conditions that are not contagious and be used to limit peoples liberty for little benefit to the general public.


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