Lees-Galloway Iain: Medicines Amendment Bill — First Reading 
Text is incorporated into the Bound Volume 
Lees-Galloway Iain: Medicines Amendment Bill — First Reading 
[Sitting date: 28 February 2012. Volume:677;Page:606. Text is incorporated into the Bound Volume.] 
IAIN LEES-GALLOWAY (Labour—Palmerston North) 
: 
 Well is that not just typical of this Government particularly in health? The National Party is the party that is the arch-architect of saying one thing in Opposition and doing exactly the opposite when it is in Government. This is a bizarre reversal of the usual situation because this is the party that opposes everything when it is in Opposition. It opposes good efficient productive improvements that can be made to the health system when it is in Opposition if there is political mileage to be made out of it but then just a few short years later—actually I do not know why National did not do this in the last term. Maybe it just— 
Darien Fenton 
: I can tell you. 
IAIN LEES-GALLOWAY 
: Why was that? Why was that? 
Darien Fenton 
: Because they were just politicking. 
IAIN LEES-GALLOWAY 
: Because it was just politics—that is exactly right. It was just politics. It needed to let the dust settle a little bit from back in 2005 hoping that people would forget the stance it took back in 2005 when Tony Ryall stood out on the forecourt of Parliament and told New Zealanders they would be paying more for their Berocca they would be paying more for their health supplements because the horrible Labour Government wanted to align our legislation with that of the Australians. You know what? We thought we were going to get this through. We thought we were going to get this done back in 2005. The Associate Minister of Health Peter Dunne is nodding his head because he thought it was going to happen back in 2005 as well but it was National playing pure politics that has caused this to take so long and here we are 6 years later.  
This Government’s mantra on health is “better sooner more convenient”. It is absolutely meaningless drivel. It would have been a whole lot better if we could have done this back in 2005; it certainly would have been a whole lot sooner to do it back in 2005. I bet the people who are going to benefit from these changes would have thought it a lot more convenient if we had made these changes back in 2005—but no because National likes to play politics on health.  
Just earlier today in fact Tony Ryall—him again yes—was trumpeting again what great advances this Government had made in tobacco control and everything that had happened in the last term. And do you know what? We did do some good things last term. This whole Parliament got together and did some good things on tobacco in the last term of Parliament but that was new. That was a change from the bad old days when National played politics on health and opposed every measure that the Labour Government wanted to introduce. It rarked up sentiment and it told people that the Labour Government was interfering in their lives because we wanted to introduce smoke-free environments we wanted to get smoking out of pubs and that sort of thing. That is the way that party operates. When it is in Opposition it will play politics on anything and now that it is in Government it is just quietly trying to make these things find their way through.  
This is a good bill. We would have loved to see these changes happen 6 years ago but the Government is finally going to support them and push them through. As a member of the Health Committee I am looking forward to this bill arriving at the select committee— 
Moana Mackey 
: Finally! 
IAIN LEES-GALLOWAY 
: —yes finally arriving at the select committee—so that we can give it the attention it deserves. Of course the whole purpose of this bill is to do a lot of streamlining of regulations to do with medicines. As the Minister pointed out it is important to get this balance right because medicines are drugs. The whole reason why we have medicines and supply medicines to people is that they have beneficial purposes but with every medicine comes a certain amount of risk. If we are going to be streamlining the mechanisms by which medicines are approved and by which they are prescribed and dispensed then we need to make sure we are getting that balance right so that we do not venture too far into the area of creating too much risk with the aim of improving efficiency. So I am looking forward to hearing what the experts have to say about this bill and what people who are out there in the field have to say about this bill as well.  
I am particularly interested in the provisions for the prescribing framework for nurse practitioners and optometrists and aligning those with that of medical practitioners dentists and midwives. Although it is not in this bill and it would not be appropriate to have the changes that I am about to talk about in this bill there is another thing I think we need to do in this whole area of prescribing medicines. Maryan Street talked about the sliced bread and said that we could have had the toast as well. I think there is some marmalade that we can put on that toast too— 
Shane Ardern 
: Marmite. 
IAIN LEES-GALLOWAY 
: Marmalade is my choice; Mr Ardern’s might be jam I do not know. But that would be to free up nurse practitioners so that nurse practitioners can have greater ability to work within their scope of practice. There are a number of pieces of legislation that actually prevent nurse practitioners from working on what is within their scope of practice; the legislation actually stops them from doing it. More often than not it is because the legislation specifically says a doctor must carry out those functions and therefore nurse practitioners are barred from doing so.  
In fact there are I believe 27 different Acts that need to be amended and in some of those Acts there are several sections and parts that need to be amended. My colleague the Hon Ruth Dyson has been working on some legislation to do that and hopefully by the time there is next a ballot for members’ bills a Labour member will be able to put that bill in the ballot. But of course it is at the mercy of luck the luck of the draw as to whether or not that bill comes out. It would be great if the Government actually took that issue up and took one of the next logical steps from this bill in freeing up nurse practitioners to be able to work more efficiently and more effectively within their scope of practice—including the ability to prescribe more medicines—simply to free up access. We know how difficult it is for people to see a general practitioner and if it was not necessary to see a general practitioner for everything—if that was something a nurse practitioner was able to do instead—that might improve people’s access to primary health care.  
We are certainly supportive of this bill. Many of the changes of course covered in this bill were consulted on back when Labour was in Government. There has been a lot of consultation and we hope that that will allow a fairly expedient process through the Health Committee. But please let nobody think that that means it will not get the attention that it deserves. This is an important piece of legislation that needs to be looked at closely.  
The development of the delegated prescribing proposal was originally undertaken by the then Minister of Health when Labour was in Government and we believe that there is strong support for the general proposal. The delegated prescriber role provides flexibility to allow for new developments in prescribing practices and innovative models of care. That is what we want to see: more innovation in health care and innovative ways of improving accessibility to health care.  
Delegated prescribing would allow more timely access to services for patients which is especially important in community and rural settings and in meeting the growing demands of chronic disease which may result in reduced need for specialist attention and/or surgical intervention. I have to say I find it rather surprising that addressing chronic disease is not one of the Government’s health targets because it is an area where things can be improved and where earlier intervention could reduce costs and could improve the well-being of all New Zealanders.  
This bill is a good bill. We are very happy to support it. We are disappointed it has taken as long as it has to get here. We are disappointed there has been politics played with these issues in the past but maybe we can put that behind us get on with it and make these changes which will be positive for all New Zealanders.