Hague Kevin: Medicines Amendment Bill — Second Reading 
Text is incorporated into the Bound Volume 
Hague Kevin: Medicines Amendment Bill — Second Reading 
[Sitting date: 20 March 2013. Volume:688;Page:8804. Text is incorporated into the Bound Volume.] 
KEVIN HAGUE (Green) 
: 
 It is my pleasure to take a call on this Medicines Amendment Bill and begin in the traditional way by thanking the officials who worked with the Health Committee on this bill. The arcane nature of some of the material in the bill I think meant that officials had to work particularly hard on this one and their work was appreciated. I also thank my fellow members of the Health Committee. It is a committee that works very well together under Paul Hutchison’s chairmanship and it did a great job on this bill. We actually made some substantive changes. Also I thank of course the submitters. It was I think difficult for submitters to get to grips with the nature of the bill because although some consultation had been undertaken some years previously with a limited set of stakeholders many submitters were coming to the bill for the first time because of the inadequacy of that earlier consultation process. The submissions we received were I think uniformly well thought through and appreciated. 
It is a long time ago that we were considering this bill. The Health Committee was considering submissions on this bill about a year ago and one has to wonder I think—picking up on Maryan Street’s point that this is an interim measure—why on earth it would take a year for this bill to come back to the House. If the measures were needed for the interim surely they were needed a year ago. There seems no reason at all why it could not have been progressed at that time. 
Maurice Williamson has covered some of the detail of the bill and I pick up on Paul Hutchison’s perhaps backhanded compliment to Maurice Williamson—describing it as “Gilbert and Sullivanian” perhaps. “He read all the speeches with a voice so clear that”—I am not sure what the second line would be but maybe he is deserving of a promotion within Cabinet. The revised definitions were welcomed by all. I just note the need that will arise to align the definitions of medicines in other Acts with the one that is incorporated into the Medicines Act by this bill. 
The principal change made by this bill is to extend and elaborate the framework for prescribing rights reflecting the creaky nature of the existing framework for prescribing. I think there was general support for the extension of authorised prescribers and I note in particular the change made to nurse practitioners which I think is very broadly welcomed across the country. Regarding designated providers the changes made to this category are important for the flexibility of our prescribing framework and I will come to that in a little more detail in a moment. And then regarding delegated prescribers as Maurice Williamson has set out this was not altogether uncontroversial and Iain Lees-Galloway has also spoken about that. 
I think we are cautiously of a mind still to accept this extension into delegated prescribing. I say “cautiously” because to our way of thinking this category of prescribers still does not sit easily with the Health Practitioners Competence Assurance Act. That I think is one of the matters that as we move to the permanent resolution of these issues in the Medicines Act as opposed to the interim one will need to be addressed by the Government—probably by a Government that is less supine about the need for regulatory reform in the area of health. Regarding the category of temporary prescribers as Maurice Williamson has said it was good that the select committee recognised that that further category was not needed and it has been scrapped in the bill. 
The point of our regulatory regime around medicines has got to be threefold. It has to ensure timely access to medicines. The changes that we are making in this bill to the categories of prescribers adds to our ability to provide New Zealanders with timely access to medicines and that is a good thing. Secondly the regime must provide for the safety of New Zealanders. That I think is clearly what was at the heart of some of the concerns expressed by doctors about extending prescribing rights to other categories of health professionals and I am satisfied that the provision exists for us to ensure safe prescribing of medicines. The onus now falls on the Director-General of Health and the Minister to ensure that that is carried forward. 
The third purpose is one that is not normally articulated but is I think very important in the light of this bill and that is to ensure that we make the best possible use of the health workforce that we have. This bill certainly makes a contribution in that regard. It is very important for the reason I outlined in my first reading speech—and Iain Lees-Galloway again has spoken about it—and that is the growing need for health services. A growing population an ageing population a population with more complex health needs all says our health system needs to do more and more. Against that backdrop we have a Government that has chosen to reduce health services funding in real terms and within that sinking lid for health funding to prioritise some particular areas that are of short-term importance and optical value for political gain at the expense of everything else. 
I think everyone in this House ought to be sobered by the research that was published just a couple of weeks ago from the University of Otago showing actually that one in four New Zealanders over the age of 15 either has type 2 diabetes or has pre-diabetes. That is a rate much higher than was previously thought and it is indicative of the kind of load that our health services are going to need to shoulder. Against that backdrop we have a Minister who comes to the House week after week making a smug claim about 1000 extra doctors in response to questions about senior doctors about our specialist workforce. We know that what he is doing is conflating certainly some extra senior doctors—fewer than are needed to maintain parity against the growing health need in fact—along with junior doctors and a bunch of other people. That is what he is doing. He is conflating categories to provide a politically useful answer. 
I think we also need to start drawing attention to the contribution of Health Workforce New Zealand one of the Minister’s initiatives which is still producing a programme that is hopelessly poorly geared to the need that we actually have of serious workforce development in the health sector. Its programme is chaotic haphazard and clearly inadequate for the need. 
So when we look to the extremely slow progress of this interim bill it is emblematic of this Government’s approach to health. In stark contrast to the growing extremely serious need for a comprehensive overhaul of our regulatory regime and our systems to enable this nation to cope with that tsunami of health need this Government is choosing instead to work slowly and to make cosmetic changes that are in its political short-term interests rather than grappling with the serious long-term challenges that New Zealand faces. We have a health Minister who is clearly not up to the task.