Roy Heather: Health Practitioners Competence Assurance Bill — In Committee 
Roy Heather: Health Practitioners Competence Assurance Bill — In Committee 
[Volume:611;Page:8072] 
HEATHER ROY (ACT NZ) 
: 
 I would like to address the concerns that United Future member Judy Turner had about my Supplementary Order Paper. I put forward an amendment to omit the definition of medical practitioner in clause 5 and her concerns were that if the category of medical practitioners was pulled from this bill then the “restricted activities” provision might preclude them from doing the activities they have in their day-to-day business. That of course is not the case. The legislation has been drawn up very carefully to show that the practitioners want to remain where they are in terms of the Medical Practitioners Act and the restricted activities are determined by the Minister anyway. They are not set down at the moment. They will be determined by the Minister in line with the fact that the Minister will have huge ministerial control over the professions if this legislation is passed. So a simple exclusion would deal with that problem concerning the restricted activities list and that is not a worry at all. The Supplementary Order Paper is very simple despite the fact that it is quite lengthy. It has to be lengthy to deal with every single time the term “medical practitioner” is mentioned in the bill. 
However I want to go on to say that this legislation really flouts professionalism. All the medical professions support a clear regulatory construct for themselves and that was very evident when we heard from each of the professional groups who came along to the select committee and from the individuals who spoke at the hearings during the submission process. They all support a clear regulatory construct for the professions. “This framework”—and I cannot say it any better than the New Zealand Medical Association—“must however be flexible scaffolding that supports the professions and provides the needed structure but not an iron cage that rigidifies and stultifies professional functioning.” That is very pertinent I think. We want something that is flexible and that will allow the professions to go about their business so that they can provide the safety and protection that the public call for but not something that binds them and stymies the way in which they can practise and provide the professionalism they do at the moment. 
Regulation on its own is never going to improve the safety of professional practice. It cannot; it is impossible. The professions are there. They have their own codes of practices and codes of ethics and they work within those to provide protection and safety for the public. But regulation will do nothing for that. Regulation will not provide professionalism. The two are very different. What is required is an environment—and I talked about this previously—in which professionalism can flourish. This bill will not provide that. It seeks to provide competence by regulation. The environment in which professionals can flourish is one where health workers themselves are encouraged to learn and develop and one where they can discuss things freely amongst themselves. In particular I am referring to the quality assurance provisions that we will discuss in another part. If they are to provide that safe environment for patients they need to develop professionalism. 
The Medical Practitioners Act has provided that environment for medical practitioners since 1995 when it came into being. This legislation was supported by all bodies initially because they thought the environment that had been created by the Medical Practitioners Act was going to be subject to the legislation too. They felt that that would encourage their own professionalism and encourage their learning and development but in fact that will not be the case. It can be achieved only by the support of internal professional processes and not by increasing external regulation and control which will have the opposite effect and which will see an erosion of the high professional standards that hold our health system together today.