Stewart BarbaraBARBARA STEWART (NZ First): Thank you Mr Deputy Speaker. David Bennett: Barbs you missed on a question; now you've got a speech. BARBARA STEWART: I am definitely speaking on this. I rise on behalf of New Zealand First to speak on the third reading of the legislation arising from the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill. As others have said this was a massive bill divided into eight separate bills and basically the purpose is to increase the range of statutory functions that can be performed by health practitioners who previously have only been referred to as medical practitioners. So in this legislation references to medical practitioners will be changed to references to health practitioners. We are happy to support this legislation in their third and final readings and we are very pleased to see the legislation reach this point. It has been a long time actually getting to this point in the Parliament. We would like to reassure the public that this legislation is not about short-changing those people who want to visit the doctor by visiting someone who is not qualified to carry out the task. These nurse practitioners are very capable they are trained and they have got the skills and expertise to carry out these particular jobs. It is more than just relieving doctors of time-consuming paperwork. We want to ensure that basically those practitioners who have got the skills and the expertise can actually use those skills and that expertise for the betterment of the New Zealand public and New Zealand patients. This legislation is needed—very much needed. We do need to change with the times and we know that if we are to have a health system that responds to New Zealand's healthcare needs it does need to change. Many of the changes just remove bureaucratic barriers to providing care such as the current situation of a doctor needing to sign off an assessment carried out by health practitioners. As we have heard many members of this House mention on previous occasions this can be particularly burdensome in rural areas where doctors are scarce. We are very concerned as to why paramedics are allowed to continue unregulated. We believe that paramedics provide a brilliant service to New Zealanders carrying out advanced medical care in very trying conditions—often on the side of the road—yet there are no regulations to cover this. Their role in patient care needs to be recognised. So they need to become registered medical practitioners. New Zealand First will continue to advocate for the registration of paramedics as professionals in their own right. We see this as an urgent priority and we are disappointed that at this point in time they are not included in this legislation yet we hoped that they would be. We know on this side of the House that we have got a looming workforce crisis and we hope that this legislation will actually ease some of the pressure. Forty-four percent of GPs intend to leave the profession in the next 10 years with the number increasing since the previous year. In 2015 Health Workforce New Zealand reported that there were 52729 registered nurses and 14678 doctors. So this legislation is very important to enable nurses to carry out further duties. And of course we are all very aware that there is a shortage of doctors in rural areas. As was mentioned by the Green Party and Labour nurse practitioners do need to be paid more for their skills and so this is an area that we will be following very very closely. We know too that our medical workforce is ageing. Health Workforce New Zealand reported that as of 2015 40.1 percent of doctors were aged 50 or over—up from 35.3 percent 6 years previously. The situation unfortunately is very similar for nurses: 45.2 percent of nurses were aged over 50—up from 40 percent in 2009. So it is very clear to us that we do need to develop a more flexible and adaptable workforce. We have got a workforce in crisis. We all witnessed the junior doctors' strike recently and that is just one example of this. I would like to conclude by saying that although this legislation may ease a certain amount of pressure on our workforce which is one of its intended goals it will not solve the issue of an underfunded health system. Also it will not have an impact on the concerns that we have in regard to the capacity of the workforce—now and in the future—to solve the needs of an increasingly ageing population. And of course we have got the chronic conditions that are part of the health scene these days with obesity and diabetes. We have got high rates of immigration and we have got a crisis just waiting to happen unless something is changed. In New Zealand First we are very pleased to support this legislation and we look forward to its passing into law. We know that it will be of great benefit to Kiwis. Thank you.