Hutchison Paul: Health Practitioners Competence Assurance Bill — In Committee 
Hutchison Paul: Health Practitioners Competence Assurance Bill — In Committee 
[Volume:611;Page:8135] 
Dr PAUL HUTCHISON (NZ National—Port Waikato) 
: 
 This part of the bill focusing on complaints and discipline is very important. After all it has caused national tension over the last 10 to 20 years and a considerable amount of heartache when one goes back to the National Women’s Hospital cervical cancer inquiry the cancer inquiry at Gisborne and of course more recently the Parry inquiry. Coming out of all of those was the Cull report. Certainly one of the great concerns was that even though we had had those tragedies in New Zealand it seemed as though we were unable to learn from the mistakes of history. Helen Cull QC brought together a lot of the great problems that were occurring through a lack of connection between organisations such as the district health boards the various colleges and the Accident Compensation Corporation. Incidents were happening that were severe but no one was aware of the records being collated independently and Helen Cull quite rightly suggested that a one-stop shop should be the approach towards the legislation. Whereas I have criticised a considerable part of this bill and will continue to do so I think that on the whole it has tended to come right in terms of the recommendations of the Cull report. 
There is no doubt however that National’s contribution to getting this part right was in no small way due to the contributions of Dr Lynda Scott and my colleague Judith Collins in the select committee. The processes provided by the bill are a very big jump from the way the old disciplinary and complaints procedures were held when there were huge complaints by patients and various health practitioners that there were long delays. The whole aim of this part is to try to speed up the processes so they are fair efficient and coherent and in many respects this part on the whole has managed to achieve that. There are some worries that some of the smaller organisations will find the compliance costs associated with the requirements considerably difficult but overall because the larger organisations such as the Nurses Organisation the medical practitioners’ organisations and the dental groups have sufficient numbers their organisations are sufficient to be able to cope with the costs implied in the bill. 
When we get to clause 77 “Recommendations and determinations of professional conduct committee” it is important we remember the tribunal’s recommendation that the role of the professional conduct committee should be to ascertain whether there is sufficient evidence to justify the bringing of a charge against a practitioner before the tribunal. Clearly that is a very important issue. 
Hon GEORGINA TE HEUHEU (NZ National) 
: 
 My honourable colleague Dr Hutchison opened the debate on Part 4 “Complaints and discipline” and I am very mindful of the comments he made. Clearly this is a very important part and it behoves this Parliament given the inquiries that sit in the background of this legislation—starting with the Cartwright inquiry then the Gisborne inquiry and the Parry inquiry—to ensure that we get these provisions as good as we can get them. We do not want to see in the future more of the same that we have had in the past. 
I am mindful that my colleague Dr Hutchison is of the view that by and large this part seems to be reasonable but having said that I want to make some comments about two parts of it. The first comment is that the bill establishes a single disciplinary tribunal the Health Practitioners Disciplinary Tribunal to hear complaints against health practitioners that warrant significant disciplinary action. I want to make the point that this tribunal will be made up of ministerial appointees. In other words there is no provision for the profession to elect their own to judge them and I would query that very seriously. I ask the Minister to explain why we have gone almost from one end of the spectrum to the other. I think I am right in saying that previously there was a high degree of professional representation on the tribunal but now there is to be none. We will be subject to the Minister making all the appointments. That in itself I do not think is ever a good thing because there is always the fear of politicisation of the process. 
But it raises the other issue of there being very little degree of self-regulation. The people in the health sector after all are all professionals. A degree of self-regulation in a respectful and supportive environment is surely more likely to ensure competence—which is at the heart of this legislation—than a process that is prescriptive and that has the Minister’s hands on it. So I think that is to be regretted. There comes a time when we have to give due regard to people who are professionals. They owe it to themselves to make sure they do not bring their profession into disrepute and therefore they can be trusted with a degree of confidence to make sure they behave in ways that bring benefit to them. They know very well why they are in those professions. They have the well-being and the safety of human beings in their hands. 
The power of the Minister is the first point I wanted to raise as something I think we ought to be concerned about. The Minister also has the power under clause 83 to dismiss tribunal members at will. There again I think that that places too much power in the hands of one person and for no good reason. Other than that I suppose it is a feature of this Government that it tries to hold power at the centre but that does not always work with professionals. The other point concerns representation for the sector and its members’ own ability to self-regulate to ensure competence.