Paraone Pita: Health Practitioners Competence Assurance Bill Health and Disability Commissioner Amendment Bill Medicines Amendment Bill — Third Readings 
Paraone Pita: Health Practitioners Competence Assurance Bill Health and Disability Commissioner Amendment Bill Medicines Amendment Bill — Third Readings 
[Volume:611;Page:8624] 
PITA PARAONE (NZ First) 
: 
 As a first-time member of Parliament I have often been amazed at the scope of some of the legislation that has passed through this House. The range of legislation illustrates how regulated and legislated we are as a country. It also illustrates that perhaps there are too many people in here who have completely lost touch with the real world where most people live—people who just want to have a happy life and to get ahead people who are contributing to our presence in this House through their taxes and people who I suggest are getting more and more frustrated at the red tape and bureaucracy that they have to endure in order to run their businesses. In fact I know people with good business ideas who run a mile from that once they realise the course they have to run. But I digress somewhat. 
The record will show that New Zealand First opposed the legislation. But I also want the record to show the reasons for that opposition and to reassure the public of New Zealand that we in New Zealand First are not against legislation that ensures the protection of health consumers and the regulation of health practitioners as some people in this House would have others believe. 
As I mentioned during the early part of the debate the intention of this legislation is good. In fact any legislation that has the intent of assuring patient safety has to be good. However there has been a great departure from what was originally introduced. It looks good on paper to have legislation that brings all health practitioners under one umbrella with the safety of patients as its overriding goal. But I do not think enough consideration has been given as to how it will work in practice. Too much of it is theoretical and untested and I am not the only one who has serious misgivings about it. We can witness the distancing of medical practitioners from it. They want out and for good reason and I ask why? Perhaps herein lie some of the answers. They will have to work it all out on a daily basis and dare I say it define and apply the often referred-to principles of the Treaty of Waitangi which are conspicuous by their absence from this legislation yet are included in a number of other pieces of legislation. 
They are the ones who will have to comply with bureaucratic demands. They will have to figure out how scopes of practice and registration authorities will work in reality while there remains the possibility of political interference. They will have to deal with the issue of cultural competence conspicuous by the fact that no definition is given in the bill. They want out because they can see clearly that the bill does not do what it was originally presented to this House as doing. 
The passing of the legislation is a signal to them that the Medical Practitioners Act widely held to be workable and robust legislation is no longer good enough. They say that it is and we know that it is. If it ain’t broke why fix it? More appropriately if it needs only a spark plug why replace the engine? Without the support of the medical profession I suggest there will be difficulty ahead. I further suggest that we should heed the profession’s call before it is too late. 
Of course the irony of all that is that the legislation was to be modelled on the Medical Practitioners Act so that health-care professionals would be covered by more effective legislation. Medical doctors’ concerns about this legislation say it all. This legislation has completely lost any common ground it may have once had with the Medical Practitioners Act. Instead it has become a tangled web of bureaucracy with unprecedented powers afforded to the Minister. 
To say that some people within the health profession hold concerns with regard to those increased powers would be an understatement. The possibility for considerable political interference into matters of a professional nature provides the potential to undermine the very intent of this legislation—that is the safety and quality of health services to patients. 
Last night the Associate Minister in response to the many criticisms already expressed from those within and outside the health profession alluded to the fact that scopes of practice were not something new as they already exist. I tell the Minister that what is new about them is that this legislation now makes them a legislative concept. The lack of any wide discussion or consultation is the cause of much of the criticism. As the chairperson of the New Zealand Medical Association mentioned with the numerous alterations made during the passage of the legislation it is clear that the focus will be on narrow codified descriptions of each individual’s practice. Already it is not hard to imagine that narrow restrictive and bureaucratic individual codes of practice will influence employment contracts with district health boards. It is quite telling that doctors were originally amenable to the concept of the legislation. I cannot say that that is now the case. 
I urge that we reconsider the position in which we now find ourselves and take heed of the voices of experience and reason that are coming at us from all directions. As the Association of Salaried Medical Specialists recently mentioned the passing of the legislation would be the first time for a very long time if ever that legislation covering the registration and competence standards of the medical profession has been passed against the advice and despite the express opposition of the medical profession itself. 
The association also expressed its concern at the increased degree of political and bureaucratic control as an interference in the registration and standards of medical practitioners at the expense of professionalism. As a member of the Health Committee I was approached by many health-care providers and consumer groups that were deeply concerned about the implications of this legislation. I also heard and read submissions from many groups and individuals who will be affected by this legislation. I would be failing in my duty if I did not say in this forum that a lot of apprehension is out there. People are concerned about the implications of the legislation together with compliance costs and how scopes of practice will work. If this legislation is about the protection and safety of the general public then they are quite right to say that it should then be robust enough to earn the support of those experts in the field. They also note the irony in that much of the controversy surrounding the legislation could have been avoided had there been acceptance of some of the practical amendments offered consistent with the intent of the legislation. 
I also note that a number of health practitioners are yet to be included in the legislation not least acupuncturists from whom a large number of New Zealanders are able to have their health concerns addressed. I further note that the ministerial advisory committee on complementary and alternative health mentioned that there are in excess of 60 different alternative health services all of which will need registration if they are to be covered by the legislation. The bureaucratic obstacles afforded by this legislation will not provide any encouragement for those professions to want to be covered and could lead to possible undercover operations. However during the debate on the legislation New Zealand First expressed its opposition to much of it. We also supported certain parts of it; one particular part has given rise to the Health and Disability Commissioner Amendment Bill. In keeping with that support New Zealand First will be supporting that particular bill. Essentially it deals with complaints about health-care providers and disability service providers and ensures that each complaint is appropriately dealt with. 
Finally I reiterate that both patients and providers must be confident in the processes in place to protect them. The Health Practitioners Competence Assurance Bill does little if anything to inspire that confidence. Quite the contrary I maintain that health-care consumers should be at the centre of a bill that purports to protect them yet nowhere are patient outcomes shown as a major focus. Accordingly New Zealand First will oppose the Health Practitioners Competence Assurance Bill and the Medicines Amendment Bill and will support the Health and Disability Commissioner Amendment Bill.