Kedgley Sue: Health Practitioners Competence Assurance Bill — Second Reading 
Kedgley Sue: Health Practitioners Competence Assurance Bill — Second Reading 
[Volume:610;Page:7547] 
SUE KEDGLEY (Green) 
: 
 The Green Party will support this bill which has had a long 3-year gestation and involved many people in submissions from the professions and so forth. We are pleased to support many of the provisions in the bill and that we managed to get three amendments made to the bill by the Health Committee. I will refer to those later. 
We support the idea of a consistent and transparent framework for the registration of health professionals and for robust complaints and disciplinary procedures with regard to all health practitioners with the same disciplinary processes applying to all health professions. That is a real step forward. I think we all need to recognise that consumers are disillusioned with the health system and the complaints process as a result of the Parry inquiry the Gisborne cervical cancer inquiry and numerous other inquiries. We have much work to do in order to restore consumer confidence in the health system and the complaints procedures surrounding the health professions. We need to have a system in place that protects the public where there is a risk of harm—which is the main objective of this bill—and that protects patients from incompetent practitioners. 
 We need to simplify and speed up the complaints process and to make it more consumer friendly. The present situation is labyrinthine. Up to 14 different agencies can separately investigate the same adverse medical event which is a crazy situation. For that reason we support the idea of a one-stop shop—the Cull proposal—and the idea that all complaints should go in the first instance to the Health and Disability Commissioner. We hope that the new 3-week time frames we have set will speed up the complaints process. We have heard about many consumers having intolerable delays in getting their complaints heard and in going through the system particularly in situations such as the Parry inquiry. 
We support the provision that enables the commissioner to throw out vexatious complaints because those can cause huge stress huge problems and financial loss to practitioners. In a couple of overseas jurisdictions the complementary health practitioners in particular have been targeted by groups that have taken continual vexatious complaints. I believe that midwives have had concerns about that as well. We hope this provision will avoid that pitfall here. 
We are pleased that patients whose rights have been breached will have access to the legal remedy of the Human Rights Review Tribunal and that registering authorities will be able to review the competence of practitioners and to require them to participate in competency programmes. We are pleased with the provision that two—or in some cases three—laypersons or consumers are to be members of the registration bodies. So we are very happy with many aspects of the bill and we are pleased to support them. 
But like other members we have some very real concerns about this bill and in particular about the power it gives to the Minister of Health over all the health professions that it covers—and indeed over those professions that are not directly covered. When the Minister introduced this bill she said she wanted it to strike a balance between the Government controls that are necessary to protect the public and self-regulation by the profession. In the Green Party’s view the bill does not strike the right balance because it gives wide-ranging powers and undue influence to the Minister over all the professions. In particular the Minister is given the right to personally appoint up to 14 members of every governing authority established by the bill and along with other powers the right to be the final arbiter on disputes over scopes of practice and to decide what will be the restricted activities. We believe that those powers taken all together could be used at a future time to exert undue influence covert and overt over health professionals. We only need to think about that to realise that if every member of every health profession in the land—certainly of those professions covered by this bill—is to be appointed by the Minister of Health then he or she is in a sense beholden to that Minister certainly for reappointment. That simple fact can act as a strong incentive to toe the line and can undermine the independence of the professions. 
That is why the Green Party attaches so much importance to the provisions that regulatory authorities are able to elect some members to the registration authority. We believe that allowing the professions to elect some members to their governing authority will have a very positive aspect to it. It will allow them to have some say in the make-up of their governing body—some sense that there is involvement that it is self-regulation and that it is not just all being imposed—and it will ensure some sense of ownership in their authority. Best of all it will mean that the elected members at least will not be beholden to any Minister for their reappointment. I have had some involvement with appointments processes so I have very real concerns about the ability of the process firstly to be used for patronage—for dishing out favours to people who have supported a particular Government—and secondly to act as a constraint that keeps people in line if they have any desire to be reappointed. 
We are delighted that one of the amendments we managed to get in at the select committee stage will allow appointed members to be elected. However as the previous speaker said that provision really does need to be strengthened. The present wording does not oblige the Minister to allow elections; it makes it only a possibility. Given the Minister’s comments that she is opposed to that I think that is a real concern. I foreshadow that I will introduce an amendment that will require the Minister to allow elections to be held if a registering authority requests them. I would advise all the registering authorities to do so for the reasons I have outlined. 
Another amendment I want to foreshadow will include acupuncturists within the scope of this bill. There are extremely significant risks associated with acupuncture. Just to give members one example we can imagine the harm that could occur if acupuncturists did not sterilise their needles. If we were to approach the issue of acupuncturists from a consumer perspective we would definitely include acupuncturists in this bill. In fact it is only for political reasons that they are not included. In our view acupuncturists have an equally or indeed more valid claim to statutory regulation as osteopaths. They have been seeking statutory regulation for literally two decades and the only reason osteopaths are included and acupuncturists are not is that a political promise was made to osteopaths 4 years ago. It is as simple as that. Members should not get me wrong. I am delighted that osteopaths are included but it is unfair and unjust that they are included and acupuncturists are not for no other reason than a political promise that was made. 
The omission of acupuncturists could cause significant anomalies in the future. If acupuncture is made a restricted activity as it should be then only medical and physio-acupuncturists will be able to practise and all other traditional acupuncturists in New Zealand will be prohibited from practising. That is a nonsense. There has been major progress in bringing all the parties in acupuncture together and there is no reason not to include them in this bill. 
Finally the Green Party is concerned that this bill leaves most of the detail of the new system to be decided by regulation after this legislation has been adopted by Parliament. The bill sets up a framework but provides absolutely no parliamentary scrutiny over the implementation of it. Hugely important issues such as scopes of practice which activities are to be restricted and so forth are all to be decided by Order in Council—a secret regulatory mechanism that does not allow any parliamentary scrutiny. In my view many of the issues here that are to be decided by regulation are not technical matters but are significant policy issues that should be decided by Parliament and by parliamentary scrutiny not by regulation. 
Finally we are delighted that the provisions contained in the original version of the bill that would have deregulated pharmacies have been dropped. We are pleased that the Green Party played a role in that. We are pleased our amendment to strengthen that particular provision went through and we want to see it strengthened even further.