Roy Heather: Health Practitioners Competence Assurance Bill — In Committee 
Roy Heather: Health Practitioners Competence Assurance Bill — In Committee 
[Volume:611;Page:8085] 
HEATHER ROY (ACT NZ) 
: 
 It was hard work getting the Minister of Health to her feet but eventually she did get there and she made some quite interesting points. What she called for was some truth some facts in the Opposition debate. In fact that is what we have been dealing with all along. I suggest that she tries listening to us and listening to the professions. They would like to have been consulted a lot more than they were. They felt they were not listened to enough. The Health Practitioners Competence Assurance Bill incorporates a significant shift in the approach to registration of health practitioners that has not been debated and that did not originate out of a process of engagement between the Ministry of Health and the professions. 
The Minister also mentioned the word “competent”. I lost count of how many times she used that word and it was telling how many times she did use it. I ask the Minister to stand and define the word “competent”. We have the word “Competence” in the title. She said “competent” dozens of times but did she tell us what she meant? No. What exactly are people to measure themselves against? We have been told time and time again by officials that the words “competence” or “competent” are too hard to define. What exactly are the health professionals meant to measure themselves against? How are health professionals supposed to be disciplined when we cannot even determine the level of competence that they are supposed to achieve? 
If the Minister were really concerned about the safety of the public she would have spent more time listening to the concerns of the professional bodies. After all we do have patients and we want public safety. The National Party speakers have said at length that patient safety is paramount and I have said the same thing in some of my previous speeches. We want protection for the safety of the public. But who provides care? Who actually provides a safe environment for patients? It is the health professionals. In order to operate effectively they need to have an environment in which it is safe for them to work so that they can provide the best possible treatment for their patients. But this Government has a very anti-professional attitude which is becoming more and more apparent as this debate goes on. It is an anti-professional attitude from an authoritarian bossy “we know best” Government. We are seeing proof of that in this legislation. 
We have heard about scopes of practice already but it is worth mentioning them again. The scope of practice concept is a new and untested concept that has been described as cutting edge; apparently we are going to be world leaders in scopes of practice. The only place in the world where scopes of practice have been previously trialled is British Columbia. The Health Committee spent a bit of time looking at where this concept has been tried and British Columbia is the only place in the world where scopes of practice have been tried before. Guess what? It has canned them because many people felt they were a failure. So what are we doing in New Zealand? We are adopting them and putting them into place. There was much criticism in the submissions that the scopes of practice were ill defined and ill tested. We heard that time and time again from many submitters. 
If we look at the scopes of practice in a practical sense we see that the equivalent provisions in the Medical Practitioners Act are the specifications for the various types of registration of vocational branches which incidentally work very well. Although there is a requirement for consultation the decision rests with the politically appointed authority. When we come to scopes of practice under this bill we are told that they will be enabling and broad but when we look carefully at the legislation we find that certainly the professional bodies are not reading them as being broad at all; they are concerned that they are actually very narrow. If we look at clauses 20(1A) and 20(1B) of the redrafted bill we see that they are certainly very suggestive of narrow scopes of practice. 
I think we heard from just about all the professional bodies involved with this bill and the smaller bodies were not so concerned about scopes of practice. The occupational therapists stick in my mind because we had quite a long discussion about what they would do when it came to instituting scopes of practice. They had already done quite a lot of work and had decided that they would have only one scope of practice. So there will be very little change for them. They will carry on pretty much as they are now and the work they do now will just be defined as one scope. 
I raise a point of order Mr Chairperson. I wonder whether conversations that are not about the bill and are happening quite close to me could be carried out in the lobby. 
The CHAIRPERSON (Hon Clem Simich) 
: The member is quite right. Conversations should be held outside the Chamber.