Marcroft JennyJENNY MARCROFT (NZ First): Thank you Madam Assistant Speaker and thank you for the opportunity to stand and speak on behalf of New Zealand First on the Health Practitioners Competence Assurance Amendment Bill. New Zealand First will support this bill and would like to also congratulate the Minister of Health for finally getting these much-needed amendments before the House. So we acknowledge you the Hon Dr David Clark on doing that.Now these amendments have been through a number of reviews and have been widely discussed amongst the public and with various health practitioners and the regulatory bodies that are affected but they have languished for years. Somehow the amendments seem to have suffered the same fate as the previous Minister's leadership aspirations. We waited a long time for this legislation to come before the House and it's a credit to the new Minister that he has managed to get things moving quickly.One of the most treasured aspects of our accident compensation scheme is that we don't have great piles of litigation by tort lawyers clogging up our courts suing doctors and medical institutions. Under ACC we have a no-fault basis which means in most cases we have forgone our privilege to sue at-fault parties. Now the flipside of this though is that we better make sure that anyone practising medicine is a competent professional who knows exactly what they're doing. That is why New Zealand First strongly supports getting the Health Practitioners Competence Assurance Amendment Bill passed into law.The Health Practitioners Competence Assurance Act 2003 provided a framework for the regulation of health practitioners. The law is designed to protect the public by preventing unqualified people from claiming that they're registered practitioners. It regulates those health professionals where there is a risk of harm from malpractice. It doesn't regulate professions considered to have low risk of harm like traditional Chinese medicine for example.The Act also established separate regulatory authorities like the Medical Council of New Zealand to enact legislation for each group of health practitioners. The associations cover chiropractors dentists dietitians radiographers doctors midwives nurses occupational therapists optometrists osteopaths pharmacists physiotherapists podiatrists psychologists and psychotherapists and these health practitioner authorities were tasked with describing their provisions and scopes of practice and determining what qualifications are appropriate. They were also required to register and issue practising certificates review and promote ongoing professional competence and judge whether practitioners are unfit to practice by establishing professional conduct committees to investigate misconduct and set the standards for clinical and cultural competence and ethical conduct. This is why this Act is such a critical part of the health system in New Zealand. This is where the rubber hits the road when it comes to whether we can trust the health system is safe for all of our fellow citizens.What the amendments are seeking to do is make sure that the Act is working and that it can be seen to be working. We want to know that the responsible authorities are performing and that their decisions are visible and clearly understood. By adopting many of the suggestions in the 2009 and 2012 operational reviews we believe the amendments will ensure the various professional associations will be much more transparent with the decisions that they make. The amendments also encourage the various health disciplines to collaborate so that there is more information about the people providing the health services. It is long overdue.Now more specifically the amendments will require the health practitioner authorities to develop naming policies that will determine the circumstances in which practitioners whose competence has been investigated by the authorities are published. Furthermore we want people who may be affected or professionally interested parties to be notified about these decisions.The bill also requires the professional associations to provide the Director-General of Health professional and basic personal information about registered health professionals. This will help with workforce planning and development. As part of the drive to produce clear evidence that the associations are meeting their expectations regular performance reviews will be undertaken and these reviews will also encourage the various authorities to collaborate with the others. The bill also requires the authorities to fund the general administration costs of the Health Practitioners Disciplinary Tribunal.New Zealand First generally supports the amendments but we do have a few concerns and we hope that these could be ironed out in select committee. The Act still doesn't prevent unregistered practitioners from setting up shop and offering health services outside the associations so we'd like to see if an ambulance can be placed at the top of that particular cliff. We also want to make sure that health-associated occupations that on the face of it carry a low level of risk are not exempt from the regulations if there are indeed real risks in carrying out their services. Now take an example of the beauty therapy industry injecting facial filler. That's now quite common but it does have the potential to cause blindness and blood clots if the beauty therapist is incompetent. Beauty therapy does carry serious risks and the public should feel confident that the therapists are in fact well-trained.New Zealand First would also like to look at the status of paramedics and where they fit within the framework of this legislation. In fact we know that the paramedics themselves want this to happen. Paramedics Australasia is the professional body representing paramedics in New Zealand and Australia. They want the title paramedic" to be protected in New Zealand law so that it can be used by those who have attained a nationally recognised standard of training. Now it's pretty obvious that a paramedic who hasn't been properly trained poses a serious risk. Paramedics—they're the first responders and usually the people that are there in those vital minutes between an incident and hospital. At some point it is likely that paramedics will be regulated under the Health Practitioners Competence Assurance Act and we would like to see this happen.We're also concerned that some practitioners who provide services to the disabled—the people providing the various services are subject to the Code of Health and Disability Services Consumers' Rights whether they're regulated or not and the trouble is that if something goes wrong some practitioners may not belong to a professional body that can take action. Home-care workers may not pose a significant risk but people receiving care should be entitled to know that the caregivers are capable. So a wider discussion on who needs to be regulated and how we regulate health professionals in New Zealand should be had but we believe this could be achieved during the select committee process.So in conclusion New Zealand First supports the Health Practitioners Competence Assurance Amendment Bill. Kia ora."