Hutchison Paul: Health Practitioners Competence Assurance Bill — Second Reading 
Hutchison Paul: Health Practitioners Competence Assurance Bill — Second Reading 
[Volume:610;Page:7549] 
Dr PAUL HUTCHISON (NZ National—Port Waikato) 
: 
 I thank the Chair for the opportunity to speak on the bill. I hold this bill up with considerable dismay for a variety of reasons. One of them is that it would have been a huge triumph for Parliament and for the health system if it had been possible to have multiparty agreement on this document. It is a huge indictment on the Labour Government that all the submissions from the New Zealand Medical Association the Association of Salaried Medical Specialists and the New Zealand Nurses Organisation which represent 32000 people say that there has not been enough consultation on this very very important bill. So I hold it up with dismay for that reason. 
But I also hold it up with dismay because it is 272 pages long. It is a monolith the size of a telephone book and it is supposed to be modelled on the Medical Practitioners Act 1996. This veritable monolith of a bill consists of 272 pages and 254 clauses. It represents the typical instincts of a Labour Government to have as much complication as much bureaucracy as the machinations of its socialist mind could possibly conjure up. In many respects it is a case of great déjà vu in terms of what we had 2 years ago with the most unfortunate Health and Disability Act which resulted in the most complicated bureaucratic health organisation that New Zealand has ever seen typified by the 21 district health boards and by an ever-increasing Ministry of Health which is clearly becoming more and more dysfunctional by the day. 
The main purpose of the bill is said to be to protect the health and safety of members of the public by providing mechanisms to ensure that health practitioners are competent and fit to practise their professions. Nobody disagrees with that but I do as I say hold this bill up with great dismay that the National Party cannot support it for the very logical reasons that I have already given. I congratulate the parties and the members of the Health Committee for their forbearance and tolerance of this Labour Government which has failed to ensure that the bill truly is modelled on the Medical Practitioners Act which was so successful. 
I also congratulate the many submitters. Although I was not on the select committee I have read many of those submissions and they are thoughtful and considered. The shame of it is that the Labour Government has not taken notice of them. In fact the submitters were extraordinarily diverse. They varied from chiropractors to the Plumbers Gasfitters and Drainlayers Board—a quite unlikely but indeed important submission—to the Royal Australasian College of Surgeons. But I want to focus on some of the concerns of the New Zealand Medical Association which is a highly professional body representing some 5000 members including a broad range of specialties and including medical students. 
The association supported the basic concepts of the bill but has since had grave misgivings and now has withdrawn its support. This is what it said about consultation: “Quite simply we have no confidence in the policy development process or the consultation process behind this bill. We believe that the lack of adequate consultation has led to a number of major deficiencies within the draft legislation.” The association then went on to talk about professionalism and self-regulation: “This legislation if enacted will strongly diminish the self-regulatory concept in favour of a more politicised and bureaucratic model.” —that again must be a huge indictment on this Labour Government—“The opportunities for greater control by the Ministry of Health and by politicians are substantially increased to the extent that it is doubtful that effective self-regulation can continue. We have no doubt that professionalism is the key to effective and safe health services for New Zealanders and changes need to be made to this draft legislation to restore the concepts of professionalism and professional self-regulation.” In that respect I intend to put an additional amendment to include in the purpose clause that recognition of professional self-regulation be the basis of health practice in New Zealand. 
The association then went on to discuss the question of the complexity of the bill. It pointed out that whereas the Medical Practitioners Act is relatively simple and well-structured legislation in the association’s view this bill is overly complex unnecessarily prescriptive and hard to understand. That has to be of great concern. 
I note in the report of the select committee that there is great concern about scopes of practice. Throughout the process the professions have reflected that concern including the New Zealand Nurses Organisation. It said in its submission: “An issue that is fundamental to the New Zealand Nurses Organisation is the need for increased consultation on specific clauses.” It said that the inclusion of provision for consultation with professional bodies before scopes of practice are introduced into legislation is absolutely vital but that has not happened. It is of great concern when we have the New Zealand Medical Association amongst many submitters withdrawing its support and saying that that is one of the areas that are of great concern to it. 
I want to go on. The powers of the Minister of Health have also caused a great deal of worry. As the member from ACT just pointed out in terms of the powers of the Minister of Health the Minister in appointing representatives to the registering authorities such as the Medical Council of New Zealand has no obligation to appoint from nominations. That is a very very serious aspect. Secondly the Minister will be the final arbiter on scopes of practice—again a hugely serious worry if we are to achieve multiparty agreement on this sort of legislation which is so important for health services. 
There have been some improvements in one area quality assurance but I still remain very concerned that there is not one pathway whereby health groups whatever they are have immunity from—[ 
Interruption 
] I tell the member for Otaki that this is a very serious point. We do want to be able to improve health services in New Zealand and it is important that there is at least one strand whereby health professionals can get together and discuss clinical situations with total immunity. This happens in the New South Wales jurisdiction with perinatal mortality; there is an excellent feedback mechanism that people can use without fear that a case might be taken against them. Of course there are plenty of opportunities for the law if appropriate to come in here but quality assurance is hugely important. 
There are many other aspects of this bill that I am deeply concerned about but of most concern is the fact that the Labour Government has not listened has not consulted and has not achieved multiparty agreement.