Wall LouisaLOUISA WALL (Labour—Manurewa): Tēnā koe e Te Māngai o Te Whare. It is my pleasure to speak on the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill in this its second reading and to reiterate that Labour supports this piece of legislation.I would like to just confirm what the stated objectives of this bill are. I am not a member of the Health Committee but I previously have been. This piece of legislation having sat on the committee during some of its deliberation was really interesting. What it seeks to do is to allow health practitioners with the required competencies and knowledge to perform more statutory functions. What this means is that many health professional groups are now capable of performing tasks that were previously the sole domain of medical practitioners which essentially means that nurses are now able to do what doctors used to do. Actually that was the biggest discussion of the select committee. In fact the Medical Association if I put its case forward—that was its biggest issue with this bill. It thought that doctors were I guess skilled in certain areas and it had some concern about transferring that responsibility to nurses. I think some of that discussion may play out in the Committee stage but I wanted to highlight it because based on this piece of legislation the registration under the Health Practitioners Competence Assurance Act will then determine the scope of practice that all health practitioners have which includes nurse practitioners.The reason I bring it up is that at the heart of this piece of legislation it is trying to utilise all of the assets that we have in the health system to their full capacity. Now for example our nurse practitioners will be able to sign death certificates. In the past that was solely the responsibility of doctors. Some would say that that is a huge change but what the committee said was that this is actually a practical change because nurse practitioners do have the skills and they do have the competency based on their registration to be able to undertake that specific task.Nurse practitioners also have the skills to take blood specimens from drunk drivers. Again that was previously the responsibility solely of doctors. They will also under this piece of legislation be able to declare people unfit to drive. At the moment it is only doctors and optometrists who are competent enough under current legislation to say whether people can or cannot drive. What this piece of legislation does is empower nurse practitioners to make that determination. They are also now able to sign sick leave certificates. Again under current legislation only doctors can do that. They also now are empowered to prescribe controlled drugs. Again that is a role that only doctors can perform. They will also under this piece of legislation be now empowered to issue a certificate to accompany an application for a mental health assessment. This again recognises the particular competencies and skills that nurse practitioners have.It is interesting to note what we are doing in terms of empowering nurse practitioners but it is also incredibly relevant if we look at our current health workforce. We have 50000 nurses in Aotearoa New Zealand; my colleague Adrian Rurawhe has been trying to find out the number of nurse practitioners we have. To be a nurse practitioner you actually have to undertake a Master's degree in nursing. It takes an extra 2 years of academic study to qualify yourself to be upskilled—to be competent enough to do all these additional things that I have just read out based on your qualification.Within the context of 50000 nurses we have 14333 GPs. I want to continue the discussion that my colleague Ruth Dyson started and also that my colleague the Hon Annette King stated in her contribution to the House and that is that in the next 10 years 44 percent of those GPs will be leaving. That is 6306 doctors. So I think that the opportunity that we have to provide more opportunities for nurses to become nurse practitioners is a very good thing because we are actually futureproofing our workforce to undertake a number of tasks that historically only doctors have been able to perform.I think the reality particularly for some of our young doctors is that they have to work up to 16 hours a day. There have been issues in the media lately about that workload and I guess their inability to cope so if we can fully utilise the skills across our health workforce then I think that is a good thing for all of us. Currently there are 3.5 nurses to one doctor so this piece of legislation makes sense from that perspective.The other objectives of this bill as stated in the bill commentary are to make it easier for the public to access statutory health services" "allow the health workforce to use their knowledge and skills" and to "facilitate innovative services and efficient practice." In looking at the numbers again of nurses versus doctors I think that in some of our rural communities having nurse-led practices in the future makes complete sense.From the Labour side of the Chamber we do support this piece of legislation. I think just finally my acknowledgment is really to the Nurse Practitioners New Zealand board. I saw some commentary in the media by Dr Michal Boyd who was its chair in 2005. It has actually been fighting for the recognition of nurse practitioners for over 10 years now—for them to be empowered to use the skills that they have gained through the qualification of nurse practitioner to undertake many of the tasks that historically have only been the responsibility of doctors.I want to acknowledge all the champions within the nurse practitioner field who were fighting not only for the recognition of their particular qualification but also for women because as we know the nursing profession is disproportionately a profession that women are engaged in. I think that the fight from the Nurse Practitioners New Zealand association has been beneficial not only for nurses as a profession but also for women because I think that added responsibility will see in the future their ability to lead medical practices. I think that again we will see the value of that qualification rise and hopefully the equitable remuneration of that particular skill set or career. I know that was not one of the objectives of the legislation but from my perspective it is and it will be and so I hope there are more nurses who put up their hand to do extra study to become nurse practitioners because based on the evidence that we have we are going to need them.Debate interrupted.The House adjourned at 6 p.m."