Clark DavidHon Dr DAVID CLARK (Minister of Health): I want to pick up on one or two things that have been said—briefly—to discuss and also to speak to the Supplementary Order Papers (SOPs) which I probably might have done in my initial contribution but will do now. I think one of the things that Dr Reti raised that I haven't covered is the review of the authorities every five years which I think is a valuable thing which will give the public confidence and having that now enshrined in the Act is a very useful thing. The member Louisa Wall just raised the issue of cultural competence. I'm assuming that that will also be covered as they go through that review. So I do want to thank the Health Committee for the various suggestions they've drawn out in the process of receiving so many submissions. I want to again draw attention to the fact that this legislation may not make great headlines. It might in the New Zealand Doctor or some such but we probably won't have the cover of the New Zealand Herald tomorrow if my sources are correct on this particular topic. But this legislation matters a great deal actually for New Zealand and it matters certainly to the practitioners who are practising that they can have confidence in the way that they are regulated and that they are being held to account and that the public can know that the professionals in our health system are doing a good job. So I think it's important that the House appreciates how significant this legislation actually is although it may not capture the headlines in the way that some other legislation does. Dr Reti also drew attention to the fact that the costings of the tribunal essentially amount to $1 per health practitioner per year and I think that's extraordinary that's good and that points to efficiency. Of course some of some of the changes we're making around electronic certification and so on allowing documents to be electronic will improve efficiency further and bring the Act into the modern era where that is contemporary practice and there's no reason why we shouldn't have that in any case. Now I wanted to speak to a couple of the SOPs which make minor technical amendments but don't really represent a change in policy per se. One is that we will be reverting to the current provision in section 80 of the Act rather than proceeding with the proposed amendment in the bill to amend section 80 of the Act to allow professional conduct committees to make a determination to place one or more conditions on a practitioner's scope of practice. This is something I've had a few conversations with the responsible authorities about. It's come to an amicable conclusion where everybody's happy with the outcome but it actually required a bit of working through. It's one of those things that I think around the select committee process there were some submissions one way and another. Actually the conversation amongst the responsible authorities had not concluded at the stage that the select committee process itself had concluded so it was nice to have the extra run-on time to work through those issues and get to the right place so that we actually continue to allow them to have the jurisdiction that is appropriate. The other SOP—a minor technical amendment—is one around section 116A of the Act that enables the Director-General of Health to publish in the New Zealand Gazette a consolidated list of all responsible authorities and the health professions for which they are appointed. So it stated that the main change to the bill in this SOP is the retention of the current section 80 of the Act which means that professional conduct committees will continue to be able to recommend that a responsible authority review a health practitioner's scope of practice but it will not be able to make a determination to place conditions on a practitioner's scope of practice. So overall the bill's changes including those in the SOPs will improve information available and it will give confidence to New Zealanders that when something goes wrong in health treatment there is an authority besides the Health and Disability Commissioner that can look into the incident and take appropriate action if possible. The changes will improve operation and will improve responsiveness to people's concerns about practitioners improve public confidence in the operations as they do that and improve integrated services through encouraging collaboration between different responsible authorities and the practitioners that sit under them.