Roy Heather: Health Practitioners Competence Assurance Bill — In Committee 
Roy Heather: Health Practitioners Competence Assurance Bill — In Committee 
[Volume:611;Page:8061] 
HEATHER ROY (ACT NZ) 
: 
 ACT New Zealand like the National Party and New Zealand First is opposing this bill. It is a large and very ambitious piece of legislation that has been over 3 years in the making. 
If we look specifically at the title we see there is quite a lot to say about it. “Health Practitioners” of course is reasonably easy to define and we know that this legislation if passed will repeal 11 other pieces of legislation governing 11 different health bodies. But when we come to the other two words in the title “Competence Assurance” I would like to ask the Minister how she will assure that competence does happen. How does one assure competence? It always worries me when a word in a title cannot be defined. Members will see if they look through the bill that there is no definition of “competence”. We were told in the Health Committee when we questioned the absence of a definition of “competence” that it was too hard. It was too hard to define “competence” but not too hard to call in this bill for competence. How can health professionals be reasonably expected to meet this standard when we do not even know what the standard is? The standard is too hard to define. What are health professionals supposed to aspire to? What level of practice should they meet? If competence cannot be determined how can judgments be made of individual health practitioners? How can competence be measured? How can their performance be measured? The answer of course is that this is not possible. 
We need to look at another title. I think the Government is trying to assure that health professionals will be held to account for every single mistake that is made. We should perhaps call this bill the “Health Practitioners Must Not Get It Wrong Bill”. That would be far more appropriate because that is what the Minister means when she is talking about competence assurance. Competence as anybody who has worked in the health field will know is about getting the right environment. We have been told often that the bill is there to protect patients. It is to offer them protection. That is a very noble thing and something that professions should aspire to. But I would contend that we should aspire to achieve that by using self-regulation. The way to ensure the best possible treatment for patients is to provide a safe working environment for the professionals to operate in and to leave them to regulate themselves; in that way the health professionals will provide the best protection for patients. 
If we look at the doctors in isolation for a moment we see that since the Medical Practitioners Act came into being in 1996 they have come a long way. Their self-regulation has developed so that they have a very good set of guidelines for quality assurance and for their vocational training. This legislation is supposed to be modelled on the Medical Practitioners Act. The other professions liked what they saw. They liked the way that things had developed for the doctors and were very keen to be part of that and that was quite right. However what we have now in this large piece of legislation is something that does not resemble the Medical Practitioners Act at all. The health practitioners who are currently working under very outdated legislation—the physiotherapists the dieticians the occupational therapists and some of the other health practitioners to a lesser extent—are very keen for change. But change for the sake of change in itself is not a good thing. The environment has to be right and this bill will not provide the right environment for those practitioners to work in. In fact it would be better for them if their current legislation were amended rather than their moving to the Health Practitioners Competence Assurance Bill. 
My Supplementary Order Paper which we will discuss when we come to some of the other parts removes doctors from this legislation. The New Zealand Medical Association and the Association of Salaried Medical Specialists are very keen to have their members the medical practitioners removed from this legislation and my Supplementary Order Paper does just that. They have decided that their requirements have not been addressed. The professional bodies especially found that their issues had not been redressed.