Hutchison Paul: Health Practitioners Competence Assurance Bill — In Committee 
Hutchison Paul: Health Practitioners Competence Assurance Bill — In Committee 
[Volume:611;Page:8092] 
Dr PAUL HUTCHISON (NZ National—Port Waikato) 
: 
 Part 3 is hugely important particularly so because of the area around quality assurance activities. I am very glad to see that the bill makes a big effort to pursue that seriously from clauses 52 to 60. It points out that the purpose of those clauses is to encourage effective quality assurance activities in relation to health services performed by health practitioners by a variety of methods and to give immunity from civil liability to persons who engage in such activities in good faith. Clearly the underlying principle is to ensure that continual efforts are made to improve standards in order to protect the public. 
Of great worry in New Zealand in the 1990s was the abandonment of the various mortality committees because of the increasing and extraordinary fear of the litigation that has been occurring in New Zealand. We have seen the abandonment of the maternal mortality the perinatal mortality and the anaesthetic mortality committees and it has been hugely damaging not to be able to collect the wisdom of the past and apply it to improve clinical practice in the future. 
Clauses 52 and 52A concern me and I believe that my colleague Dr Lynda Scott has proposed some very constructive amendments that I hope the Minister will take note of. During discussions on the health and disability legislation I tried to persuade the Minister that it was important to have one strand of quality assurance activity that was immune under all circumstances. I pointed out that in the state of New South Wales in Australia perinatal mortality committees were indeed immune. The state allowed one strand where practitioners nurses and the whole spectrum of people involved in the care of newborn babies were able to discuss clinical situations completely freely and be immune from litigation. That resulted in a very effective collation of epidemiological and clinical data that was fed back to the shop floor of hospitals and birthing units resulting in a very effective strand that deeply involved trust. So in relation to clause 52(1) the point that the Minister may confer protection on quality assurance activity concerns me. My colleague Lynda Scott has suggested that applications for protection of a quality assurance activity must be made to the Director-General of Health so that instead of a political person being involved in that process it would be the Director-General of Health. 
Perhaps more important is clause 52A(1) which states that a quality assurance activity “does not form part of a protected quality assurance activity to the extent that the quality assurance activity—(a) is concerned with particular acts and omissions; and (b) is carried out at a time when those acts or omissions” are subject to a variety of things. This completely negates that one strand of immunity that I believe is incredibly important. My colleague Lynda Scott has suggested on her Supplementary Order Paper that clauses 52A 53 54 and 54A be omitted and I think that is entirely appropriate. We must not forget what happened in the 1990s with those very important mortality committees. 
I can see the Minister shaking her head. She is not aware of the enormous concern and fear it has put right throughout the whole spectrum of health practitioners in terms of having this litigation hanging over their heads.