Genter Julie AnneHon JULIE ANNE GENTER (Green): Tēnā koe Madam Assistant Speaker. Tēnā koutou e Te Whare. I am very happy to be speaking on this bill this evening the Health Practitioners Competence Assurance Amendment Bill. What I will note just in response to remarks made by the Hon Jonathan Coleman at the beginning of this debate who was complaining that the bill is technical in nature and asking why the Government doesn't have more substantive bills in the House—actually I think that this says a lot about the previous Government. This Government has come in and we do have a lot of substantive work that we need to do and the process of good lawmaking is such that you can't just rush legislation to the House. We actually have our work cut out for us in order to—Hon Nicky Wagner: Nine years.Hon JULIE ANNE GENTER: No actually nine years in Opposition Nicky Wagner. You may not realise you're not in control of the Government departments who actually have to go out and consult and do the work. And of course the Government departments have been horrifically run down by the previous National Government—totally under-resourced—and haven't been able to do the good policy work that this Government is planning to do. So here we are. We've got a mountain of excellent policy work being done and it's going to take some time to get robust well done legislation before the House but in the interim we can finally catch up on the housekeeping that the National Government never got around to.Perhaps if the National Government actually had acted on this minor technical amendment bill earlier—because there were two reviews of course. The first review was back in 2007—Hon Nicky Wagner: 2009.Hon JULIE ANNE GENTER: —and there were a number of changes recommended—2007 to 2009 there was a review and by the end of 2009 there were a number of operational amendments that needed to be made. But then instead of making those amendments we had to wait till there was a substantive policy review in 2012—2012. That was six years ago. What was the last National Government doing? Why didn't they get these changes made? If they support them and they were important changes—perhaps if they'd made these changes particularly around the workforce planning so that the Ministry of Health was able to collect good data on the workforce we wouldn't be having the crisis that we're having across many areas in the health system right now. Like for example midwives—it's pretty clear that there hasn't been sufficient workforce planning around midwives and a whole raft of other professions in the health sector.So now this Government which is absolutely committed to finally fixing the problems with our health system is left with quite an enormous task of having to do the work that the last National Government didn't do and to make up for nine years of underfunding our core public services. We're seeing every day—I think there's going to be another front-page story about a crisis in midwives that there aren't enough. And of course as many people in the Chamber will know suddenly I'm very very interested personally in the availability of midwives. Going through the public system I am very much aware that the Auckland District Health Board (DHB) is struggling but there are stories around the country of there not being enough midwives and we know that there is a significant number of workforce planning issues that could have been dealt with if this bill had been progressed under the last Government. Well luckily it is going to be progressed now.Speaking to the specifics of the workforce data and how that's going to work basically what this bill does is it has to do with the responsible authorities for different aspects of the professional bodies in the health sector. This bill will give those responsible authorities a legal mandate to collect a range of data which will help the Ministry of Health to support workforce forecasting and modelling. This will assist better planning for developing the workforce required in order to deliver on New Zealand's future health needs.Given that we have a population that's growing very rapidly in some parts of the country particularly in Auckland it's extremely important that the Ministry of Health is able to have the data on what is happening in our workforce so that we can be planning ensuring that there are the right places at university and other tertiary education providers and that we have the right immigration settings so that we're able to prioritise those professionals who we have a significant lack of here in New Zealand and so that we can be forecasting and modelling the budgets that are going to be required to ensure that we have training places. For example we have a shortage of nurses in many parts of the country. There are unfilled vacancies in many of our DHBs and yet there are graduate nurses who come out and they don't have places for their first year. There aren't enough jobs for them. So we need to be able to match up Government policy and funding to ensure that we have the pipeline of jobs available for graduates so that they can advance and then we have qualified nurses. It's not rocket science but there is a lot of work to do because of nine years of mismanagement. It's important to note that wherever workforce information is published it will be anonymised or summarised to protect individual identity so the Privacy Commissioner is across this.The bill is also aiming to support better teamwork amongst health practitioners and I think this is something that we could all really benefit from. I know that an integrated health approach will often be more than just a GP by themselves or a specialist by themselves. We actually need to have an integrated approach where you might have the GP working alongside a midwife for example or a GP working alongside physiotherapists and psychologists. They can get quite good outcomes when it comes to things like pain management simply by taking a much more integrated approach. Many complaints to the Health and Disability Commissioner arise from failures in teamwork and inter-professional communications so this bill supports a one-team approach under the current New Zealand Health Strategy. I think that's definitely going to be a benefit.The previous speaker Dr Shane Reti gave a very short speech unfortunately but it was very accurate and he summarised the five recommendations that came from the second review of this legislation. So I don't know that I need to go through all the specific details of that but people at home might be interested that the bill will also introduce performance reviews for responsible authorities. Those are the ones who register and certify the competence of health professionals. Currently there's no way for the public to be sure these authorities are carrying out their function as intended by the Health Practitioners Competence Assurance Act and so this bill introduces a five-yearly performance review for those responsible authorities. This provides the Crown and the public the assurance that the responsible authorities are discharging their functions as they should be.Reviews are going to be done by independent reviewers assessed against indicators developed by the Ministry of Health in consultation with responsible authorities and they'll be publicly accessible on the responsible authorities' websites. Monitoring performance will allow for continuous improvement within regulatory frameworks. This will make it easier to promote good practice and increase consistency across the responsible authorities' policies and processes because at the moment there isn't that consistency necessarily.Information about disciplinary decisions will be public. At the moment the public has limited information about decisions that are related to complaints about registered health practitioners and the process that was used for making those decisions. This bill will require responsible authorities to release information about the decisions they make on a practice to the person who has notified them with concerns about the practitioner's competence.All in all I think probably the most important part of this bill and why it's so critical is the ability for the Ministry of Health to collect that data for the purposes of workforce planning.I think it is going to take a long time. I mean if there's one thing that I've realised since becoming part of this fantastic Government it's that it's going to take a certain amount of time for us to undo the damage of the last nine years and to build back up the Public Service to where it should be. It's going to take time for us to get robust quality legislation that is evidence-based ready to be in front of the House and it's going to take time to build up the capacity of our health sector in particular. It breaks my heart to have to say to people that there's no quick fix to this midwife crisis—there is no quick fix—but it's something that we're absolutely committed to fixing over time and we will be involving all of those in New Zealand who are working in this sector listening to their views and ensuring that they are taken into account. Thank you Madam Assistant Speaker.