O'Connor SimonSIMON O'CONNOR (National—Tāmaki): I am delighted to take a call after the honourable member Annette King who has just taken her seat. Once again it seems that through the work of Health Committee concord has broken out across the House. All parties I believe are in agreement but I will look forward with anticipation to the contributions from New Zealand First and the Greens. So I am very pleased to take this call on the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill in its second reading. I want to begin by acknowledging all those who came before the select committee in the weeks prior to talk us through what they saw as the various perspectives on this bill. As has been noted by the last two speakers including the Minister of Health this is a relatively simple bill in what it attempts to achieve but its repercussions are quite significant I think. If time allows I might touch on a few of those. I do want to thank all of the submitters who came and spoke by and large in support but again I think it is important to acknowledge there were those speakers—I think in fact the Royal New Zealand College of General Practitioners was one—that raised some questions and I think that that has to be acknowledged. I want to thank the officials obviously who helped us to bring it back to the House to this stage. Obviously we have to go into the Committee stage after this and really begin teasing it out. But this bill is just another example of the Government's focus if you will or intentions to improve healthcare in this country. We often use the phrase quite rightly Faster sooner more convenient." sometimes even adding in "closer to home" and there is an enormous amount of examples of how that is actually working. [Interruption] I encourage those on the other side of the House even the good member who shares my last name to look at the health targets that were released today—thoroughly good reading even at 4 minutes to 10 on a Tuesday night. What this is ultimately doing is allowing the scope of practice to widen or to be transferred between specialties. Often as I am speaking to constituents or others in the community the best example is around something like a death certificate. At the moment the legislation is very clear that a medical practitioner—that being a physician a doctor—is the one who must do that. This bill as one example says that there are actually other health professionals—and we can think immediately of the likes of nurses—who are able to fill out that form. In fact we will see that through—it is an omnibus bill so this touches on seven pieces of legislation. This is also going to apply to the likes of death certificates and it is going to apply to the likes of ACC. Basically it is acknowledging that medical practice changes over time and that the scopes of practice do broaden. I think back particularly to when I was working in the private healthcare space. I was very conscious in picking the area of dermatology and plastics that what was once an area for specialists alone—so by that I am talking dermatologists plastic surgeons general surgeons and the like—is now actually being done by general practitioners. There is always a little bit of tension in this space for a variety of reasons but what we are also seeing is not only our GPs in this space now but you could imagine in the future that those working say as nurses may be able to do this. A good example of that is actually in the endoscopic space which again has usually been in the realm of specialists—endoscopists—but actually now there are nurses who would be able to act in this way. I think it is prudent for this Government and the health profession to look at how it can better coordinate. A word that was also used by the Minister was "collaboration" and I think this bill is going to help encourage and facilitate that as well. There will be better collaboration. A good example is what is already happening in the pain management zone. In fact the Government has put money into pain management teams and the long and the short of that is that it does not matter whether it is an occupational therapist or a nurse or a doctor or a social worker or whatever—they can actually work together in that space. So I think this is very positive. I do want to just draw quick attention to the fact that the scopes of practice are maintained by the respective colleges themselves in coordination with the Ministry of Health—in other words this is not carte blanche. It does not mean that just any health practitioner is able to do what they wish to do. What this is is ultimately a chance for those particular colleges and groups to decide what is and is not appropriate for a health practitioner in this modern environment today. So I think it is really important to assure the public that although we are broadening if you will the scope of various practitioners and what they will be able to do there is still plenty of oversight particularly through the Health Practitioners Competence Assurance Act. Basically there is legislation already in play that allows and strictly puts forward the way that the scope of practice of these groups is enacted. So that is going to be vitally important that that will continue. I think finally—because I am conscious of time—it is one thing amongst many. The select committee made a number of changes most of them quite small primarily around something that is just making sure that we describe doctors clinics correctly in a very modern parlance. One of the things we changed in clause 42B is to elaborate on the definition of "nurse practitioners". They will not necessarily have been all that well known to New Zealanders. People just think of nurses but actually there is a whole range of different equivalents and nurse practitioners are very important in that space. So I think with that I will end my contribution.Debate interrupted.Sitting suspended from 10 p.m. to 9 a.m. (Wednesday)"