Logie JanJAN LOGIE (Green): Thank you Mr Speaker. It's a little bit earlier than I expected but I am nevertheless pleased to rise and take a call on the second reading of the Health Practitioners Competence Assurance Amendment Bill which the Green Party of Aotearoa New Zealand is supporting.This is a bill that has arisen out of two previous reviews of this legislation that arose from the Greens' intervention in the drafting of the initial legislation where we called for there to be a review built into the Act because we believe that oversight of our quality assurance mechanisms for health practitioners should be I guess a process of regular reflection and ongoing learning. So it's good to see that now in 2018 we're finally getting an update to that legislation. It may seem a little bit mean-spirited of me to reflect on the fact that the first review was started in 2007 and finished in 2009 and then we had a change of Government and there was just nothing done with that review until another review was initiated in 2012 and that took three years and then I can only assume that the work started in terms of the policy thinking towards the development of this piece of legislation that this Government introduced quite early on.I do reference that because I think I'm just calling back to some of the comments that I'd heard previously from the Opposition that you know this is a technical bill and why is this Government not doing more substantive work. Well it's a really important piece of legislation but also after nine years of stalling on a really important piece of work it's a little bit rich to be having a go at this Government for not getting on with the business.Also I'll just clarify for people—because I think most New Zealanders might hear health practitioner" and not really know who we're talking about—some of the of the professions that are covered by this. So chiropractors dentists dietitians doctors and other medical professionals radiologists midwives nurses occupational therapists optometrists osteopaths pharmacists physiotherapists podiatrists psychologists and psychotherapists are just some of the examples. So this really covers the large majority of our health and helping services—not all of them but a very large number of them.It is about the quality assurance for them. So it will bring the operation of the Health Practitioners Competence Assurance Act into the electronic age which is good progress and should reduce the costs in the running of the authorities and improve the speed with which communications occur and when there are complaints being dealt with that's actually quite important and not insignificant. Very pleasingly it brings in performance reviews of the boards that oversee the practitioners and their practice. So these performance reviews are now to be carried out by independent reviewers against a set of indicators that will be developed jointly by the Ministry of Health in consultation with the responsible authorities and the resulting reports will be published. And there's an expectation I guess from the independent reviews that there will be areas where those authorities can improve their practice and oversight and that they will then report back to the Minister on which of those recommendations they're picking up or if they're not picking up any why. So the public as well as the Minister will have oversight of this continual learning and quality improvement process over our health services. This will assure the public hopefully that the regulatory framework for health professions is operating as it should—surely something we all want.Currently there is limited information available to the public about responsible authority decisions in relation to complaints about registered health practitioners and the processes that they may use for making those decisions. Over the years we have seen stories coming into the media where people have found out through a concern and then investigative reporting that complaints and actions have been taken against health practitioners for practice that was unethical and unsafe but that the conditions that had been put in place by the oversight board were not being monitored. So actually enabling some of that information for the person who's laid the complaint in the first place to be able to get access to the decision builds in a new level of oversight and a safety protection that we haven't had before which I think is very important. And I hope that in terms of that quality assurance model we will be keeping a good eye around the safety of practitioners once conditions have been put in place so that we can be sure that those conditions are being met and the public is aware of those conditions where appropriate.So it enables the responsible authorities to release information about decisions they've made on a practitioner's practice to the person who notified them as I said around that practitioner's competence. And the responsible authorities will now have to develop policies that set out how they make decisions about releasing the names and the fitness to practice or conduct that's being reviewed or investigated. And health practitioners whose conduct has failed to meet expected standards may be named when it's in the public's interests and it's really important to enable that power. But of course it will be balanced with the practitioner's rights to privacy and natural justice. But there are some conditions and issues that arise where actually the evidence is that public awareness will help ensure the safety of that practitioner in the future—to have that oversight.The bill also supports teamwork amongst health practitioners and this is now recognised in this legislation which seems good progress in that we want to move to multi-disciplinary teams and for our quality assurance mechanisms to support that. Many complaints unfortunately to the Health and Disability Commissioner arise from failures in teamwork and professional communications. So a cohesive team approach across the health and disability system is integral to public safety and achieving better health outcomes for New Zealanders.Another change in the legislation is to support better workforce information for health workforce planning and forecasting. Responsible authorities will now have a legal mandate to collect data such as the date of birth the place of employment and gender to be able to help make sure that we have enough people providing these essential services.I do note that one of our concerns when the bill was first introduced was that there was no acknowledgement around Te Tiriti o Waitangi and the obligations for people to consider Te Tiriti o Waitangi. I understand that was considered by the select committee and that the cultural competence enables practitioners to build in that competence in their assessments. But that's because it is not a relationship between hapū and iwi and the Crown but medical practitioners and actually putting it into the legislation wasn't deemed to be appropriate.So all in all it seems like the committee did some good work and this is a good step towards continual quality improvement within our health system."