Coleman Jonathan: Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill — First ReadingText is incorporated into the Bound VolumeColeman Jonathan: Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill — First Reading[Sitting date: 23 July 2015. Volume:707;Page:5310. Text is incorporated into the Bound Volume.]Hon Dr JONATHAN COLEMAN (Minister of Health): I move That the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill be now read a first time. I nominate the Health Committee to consider the bill. This bill will amend seven statutes to enable a wider range of suitably qualified health practitioners as defined under the Health Practitioners Competence Assurance Act 2003 to undertake certain functions currently restricted to medical practitioners.In response to changing health care needs the manner in which our services are delivered is changing. The emphasis is shifting to delivering new models of care and better services to patients closer to the communities in which they live. In response to this the health workforce is evolving. Many health professional groups are now capable of performing tasks that were previously the sole domain of medical practitioners. In the future health care will be delivered by multidisciplinary teams in an integrated team environment. Health professionals will be supported to practise to the full extent of their skills and to engage in collaborative evidence-based practice that delivers high-quality interventions for patients. Expanded scopes will be more common and innovative practice will be encouraged.These trends in health care service delivery will have significant benefits for patients. Such benefits include improved patient experience early access to preventative healthcare and where necessary early intervention and a greater availability of health care services closer to people’s homes. In addition patients will have a sense of a continuum of service delivery where health practitioners have a common understanding of patients’ health care needs and are able to make more timely and appropriate interventions than at present.Current legislation does not support the new direction of the health care workforce. The amended statutes will enable health practitioners with the required competencies and knowledge to perform certain statutory responsibilities lawfully under those statutes. There are currently seven statutes that allow only medical practitioners to undertake certain functions. Other practitioners are unable to perform them. This bill if approved will enable more health practitioners to undertake some of the functions currently limited to doctors. More services could be delivered in the community rather than in hospitals and patients’ access to services will be improved.The bill will not pose an increased risk of harm to the public. Each health practitioner is required under the Health Practitioners Competence Assurance Act 2003 to perform only those tasks that are within their scope of practice. Scopes of practice and the qualifications that practitioners must obtain in order to perform tasks within each scope of practice are set by the relevant responsible authorities that have been established under the Health Practitioners Competence Assurance Act 2003 such as the Nursing Council of New Zealand the New Zealand Psychologists Board and the Pharmacy Council of New Zealand.Although the bill has been a long time in the making the amendments are a welcome change as they recognise and enable a greater range of health professionals to work together to deliver safe and timely services to the people of New Zealand. I am advised that although the initial work to identify legislative barriers originally considered the potential contribution of nurses given the significant role that nurses play in health care service delivery the proposed amendments will also enable the potential contribution of other regulated and suitably qualified and experienced health practitioners particularly in the primary care context.I would like to provide some examples of where this bill can make a real contribution. The Holidays Act 2003 allows only medical practitioners to provide proof of sickness. The Accident Compensation Act 2001 limits who can participate in claimants’ rehabilitation plans. The Land Transport Act 1998 states that only medical practitioners and optometrists can provide medical reports on persons unfit to drive. The Children Young Persons and Their Families Act 1989 restricts medical examinations of children to medical practitioners whom the court considers qualified for the purpose. Amendments under the bill will extend these duties to appropriate health practitioners other than doctors such as nurses with the appropriate knowledge skills and training. The Government relies on competent suitably qualified health professionals in the health sector and supports expanding the role of nurses pharmacists and others to improve health service delivery.This bill will contribute to making the best possible use of our available health workforce. By enabling more health practitioners to undertake the functions currently limited to doctors there will be real benefits to patients and their families. Changes to the Mental Health (Compulsory Assessment and Treatment) Act 1992 will allow health practitioners other than doctors to request patients under their care to have further assessment or treatment by their medical practitioner when required. This change will enable health practitioners involved in mental health care to more easily refer patients under their care for medical help. The amendments to the Misuse of Drugs Act 1975 will enable suitably qualified nurses to treat drug addiction where unfortunately there is a growing need.The passing of this bill will also mean that nurse practitioners caring for patients will be able to certify the cause of death under the amended Burial and Cremation Act 1964. That change is especially important in rural areas and in aged-care services. Currently where there is not an available medical practitioner to certify the death there may be unnecessary delays for family and whānau to be able to move their family member from the place of death for burial. This bill means that current arrangements for certifying death will be more in line with what happens overseas. For example in the United States registered nurses have been able to sign death certificates since 2004.I would like to acknowledge the contribution made by the nursing sector in the creation of this bill. The Ministry of Transport the Ministry of Social Development the Ministry of Business Innovation and Employment the Accident Compensation Corporation the Police the Ministry of Justice the State Services Commission and Treasury have also been involved in the development of the bill so you can see that there has been quite extensive and wide input. I commend this bill to the House.