Kuriger Barbara: Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill — First ReadingText is incorporated into the Bound VolumeKuriger Barbara: Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill — First Reading[Sitting date: 23 July 2015. Volume:707;Page:5319. Text is incorporated into the Bound Volume.]BARBARA KURIGER (National—Taranaki - King Country): It is a real pleasure to stand up here on behalf of the Health Committee this afternoon and speak on this piece of legislation. Actually it is about seven statutes and it is about correcting all of those in order to be able to let our nurse practitioners operate in a way that will be really really useful for our society. You know we have heard a lot about Mrs King today and her introduction of nurse practitioners. I actually think the introduction of this piece of legislation is extremely exciting and it really is only the beginning of a number of things that we can do in this area. Some of those have been outlined today in terms of how we may be able to expand on this in the future.Really it is about primary care. It is about people being able to get access close to home to their health services and as we have heard about this afternoon it is really really critical in our rural areas not only for people to be able to get care closer to home but actually for our nurse practitioners also to be travelling closer to the people. So this Government is dedicated to developing this pattern further and investing in areas that will allow care to be delivered this way. This bill is a key step in actually helping us to enact what we are working on. I welcome the change along with the committee and I welcome this opening up of a whole range of things to nurse practitioners.What it is doing is removing the legislative barriers that we currently have to innovative practice and that is why I find it quite exciting. Since I have been a member of Parliament which has been only a short few months I have actually been tracking around and looking at various health services in my electorate particularly in relation to rural ones. I had a really really fantastic experience where I watched an operation on the Mobile Surgical Unit bus. It actually travels around the country on a 5-week cycle and the nurses from the various health boards actually participate in the area when the bus comes to that area. So there is an opportunity for nurse practitioners to get more involved in terms of the scope of their work and be able to do more and help people closer to where they live.When we are talking about health we also talk about things like telehealth and Skyping health. I think this is really important. Our Rural Broadband Initiative is really going to help us to bring those nurse practitioners even closer to where people live once they have the ability to work with that equipment with the rural broadband rolling out across the electorates. We also heard the member David Clark talking about buildings and about some buildings perhaps losing services and not being up to scratch. But I am really heartened by places like Te Awamutu where we had a building that was pretty old and dilapidated that was being used for midwifery. Now that building has actually closed down and there is a core group of midwives who have started their own business and they are putting a purpose-built building in. So although in rural areas we can no longer live close to a big hospital in a lot of situations we can make purpose-built buildings.I have just recently been out at the chamber of commerce in Raglan where it is talking about building a purpose-built health centre. From that aspect we can have all sorts of nurse practitioners and all sorts of people who will come into the community and be able to work on that which saves people travelling long distances. The other thing that excites me a lot about this is that we currently have a lot of nurses who are travelling long distances to get to specific locations to do the job. The patients are also travelling long distances to those specific locations to get their medical help. If we can actually allow some of those nurse practitioners to do things closer to their home and also closer to their patients’ homes then it certainly is going to give us faster primary health care because it is going to save a whole lot of people having to travel around. I really welcome that change.The other reason that I welcome that change is that we have got 40000 nurses who are working around the country. Recently I was asked to speak and open the Rural Nurses Meeting. There are a huge number of rural nurses who are living in our communities. Actually I found out that the average age of those rural nurses is 55 years of age. There are a lot of women who are out there who are actually taking huge pride in the work they do but cannot take any further steps in their careers because of being limited because they are not able to undertake some of the duties that we are trying to open up for them today. So I think in terms of those particular people it is going to give them the opportunity if they do not already have the nurse practitioner qualification to be able to then go and get extra qualifications. They will then be able to build their own careers while they are actually still living close to home. For a lot of them I would not say that that is necessarily close to home where their children are. In some cases they actually have grandchildren in their communities. So it gives them an opportunity to be able to continue their careers for quite a long time.So really it is about a more flexible workforce. It is about people being able to be accessed from all around the community. We would actually love to have more doctors out in our rural communities and that will be part of the scope of hoping that we can work more closely with them to get them out there. But this step will actually give them a whole range of people that they can work with and it will be able to open up the scope of what we do in some of our rural places. In all that I have read related to this change in this piece of legislation it is a low risk to public safety. These nurse practitioners are very very capable people and it would really engage those people to have far better ability in our rural communities.What is really important for me is access to health and I think that since I have been on the Health Committee—and I do enjoy being on the Health Committee. It is a group that works extremely well together and we have a great collective of people and skills. A lot of what we talk about is that access to health—people’s access to primary care. Doing this in terms of what we are trying to do today will make it easier for the public to access timely and effective treatment. What we have also got is that if people cannot access timely and effective treatment people will actually go and start self-diagnosing themselves.Barbara Stewart: Which they do.BARBARA KURIGER: They are doing it now.We have actually got a wonderful initiative going on at the moment in our rural communities where we have got a doctor who used to do a TV series called Doctor Global. His name is Dr Tom Mulholland and he has bought an old ambulance and he is actually going around rural communities. He is doing health checks. He is doing blood pressure checks. He is doing diabetes checks. He goes out into rural areas like Whangamomona. He has been at Fieldays. He is travelling the country. A lot of those people would not actually get up and go to the doctor and he has picked up a few reasonably serious health situations just from those checks where he can sit in the community. It is quite amazing. You can sit for 3 hours in a community hotel where he comes in and everybody takes their turn. It is quite a supportive attitude where people are supporting each other to get these health checks and they are actually looking after each other.He is a qualified doctor and if we can get more people even out there being able to do those basic specific checks and health can come to the community rather than the community going to health then we are going to have a far better society. So I am supporting this bill and I am looking forward to being part of its passage.