Kedgley Sue: Health Practitioners Competence Assurance Bill — In Committee 
Kedgley Sue: Health Practitioners Competence Assurance Bill — In Committee 
[Volume:611;Page:8150] 
SUE KEDGLEY (Green) 
: 
 This is a very critical point I believe. Whether health professionals’ organisations should be entitled to elect some members to their governing bodies is an absolutely critical issue in this bill. The Minister talked about the situation back in 1997 when all the positions were appointments but we are not interested in 1997. We are interested in 2003 in this bill and in trying to improve the situation for the future. 
The fact of the matter is that this bill gives very wide-ranging powers to the Minister of Health over all the health professions covered by it. In particular it gives the Minister of Health the right to appoint personally up to 14 members of every single governing authority established by this legislation. If every single member of every health professionals’ organisation is appointed by the Minister those members are in a sense beholden to the Minister for their reappointment. That simple fact can act as a strong incentive to toe the line and can ultimately undermine the independence of the professions. We have seen that situation with the chief executives of the district health boards. The Minister of Health personally appoints them all they are beholden to the Minister of Health and they are given very clear instructions to toe the line in respect of district health boards. That is one of the reasons that those chief executives are so quiet and that some of them do not even allow members of their boards to speak out publicly. 
So the Greens attach great importance to the provision that the health professions should be able to elect some members to their registration authorities. Indeed allowing the health professions to elect some members to their governing bodies will mean that there is some involvement by those professions so that they have a sense of ownership of their authorities and do not feel that the membership is just all imposed on them. The way that this bill is at the moment means that we are not talking about self-regulation at all; we are really talking about a very very high degree of control by the Government over those professions. 
 I have been involved in a marginal way in some of these appointments and I have seen how very easily such appointments can be really just a matter of dispensing patronage. It is a case of dispensing patronage and also of making the reappointment process dependent on the Minister so that everyone knows that really they cannot rock the boat. We then end up with a whole lot of compliant authorities that basically will all ultimately do the Minister’s bidding. 
That is why the Green Party has an amendment to this clause to make it absolutely clear that upon receipt of a request from an authority to do so the Minister must make regulations enabling and ensuring that at least half the health practitioners appointed to an authority are elected from among the health practitioners registered with that authority. This amendment goes further than Dr Scott’s amendment. I am perfectly happy with Dr Scott’s amendment as far as it goes but it states that only the existing health professions should be able to elect half their members. What about osteopaths? They may want to hold elections. What if at some distant time—say after another 20 years—acupuncturists are finally allowed to have their authority and they want to elect its members? I think that most health professions will end up wanting to elect half the members of their authorities when they realise the degree of patronage and control that is exerted by having the Minister make every single appointment to the governing authority of every health profession in New Zealand. 
So in my view this issue is absolutely critical and I really urge the Government to support democratic elections. What is wrong with a little bit of democracy in the health professions? The Government has introduced a degree of democracy with the district health board elections so why on earth should we not do the same thing here and allow some members of the various health professions’ governing authorities to be elected? According to the way that the bill is worded at present the Minister is not required to allow those professions that wish to hold elections to do so and that is why we have moved an amendment to require that.