Roy Heather: Health Practitioners Competence Assurance Bill — In Committee 
Roy Heather: Health Practitioners Competence Assurance Bill — In Committee 
[Volume:611;Page:8142] 
HEATHER ROY (ACT NZ) 
: 
 I want to address scopes of practice briefly—although that issue is not really part of this part but as the Minister addressed it I think I can probably say a little on it. The National Party member Dr Lynda Scott talked about the nurses in Opotiki in particular but it was indicative of other parts of the country where people are working in crisis situations outside what will become their scopes of practice. 
The Minister says that that is not acceptable but the point remains that those nurses are doing it out of a sense of duty and out of necessity because there is nobody else at the coalface able to deal with the public when they have medical problems. If they are not going to be allowed to do anything at all that will leave areas of the country with no medical staff at all to deal with problems. 
When something goes wrong of course somebody always has to be found to blame and that is where these things may well go to appeal as Dr Scott pointed out. I will not go down that track any longer because I think she has said everything there was to say about the matter. 
Judith Collins 
: It’s worth saying again. 
HEATHER ROY 
: I could say it again but I have other things to address so I will go ahead and do that. My concern with Part 5 is in relation to clause 106 “Court may refer matter back for reconsideration”. We have already heard that when a complaint process is in train it is often a very lengthy matter. [ 
Interruption 
] Perhaps members opposite might like to take a call instead of just shouting across the benches at each other if they have something productive to say. Obviously they do not have; they have quietened down again. 
Pita Paraone 
: It’s those Maori members. 
HEATHER ROY 
: That is right—they are very noisy. My concern about clause 106 “Court may refer matter back for reconsideration” is that it will draw this whole process out and make it very lengthy indeed. The good part about Part 4 as I said before is that hopefully the amount of time that the complaints process takes will go down significantly. In relation to the cases taken to the professional conduct committee after they have been referred on from the Health and Disability Commissioner if somebody is unhappy with the outcome it can then be taken on through the court process. As Judith Collins pointed out lawyers are the ones who will benefit from that as there is often a lot of significant cost involved. The matter can then go the courts and instead of making a determination themselves which in most cases reiterates the findings of the complaints investigation committees which will be replaced with the professional conduct committees clause 106(1) states: “Instead of determining an appeal under this Part the appropriate court may direct the authority or Tribunal whose decision or order is appealed against to reconsider”—so it can then be referred back. 
It may be the start of something just going round and round in circles making the whole process very time consuming and putting a burden on people when we are trying to get rid of that burden. The patient will be left with an unsatisfactory result or the heath practitioner will be. Hopefully vexatious complaints will be out of the system by then. However patients who are really not satisfied with a ruling that has been made are able to draw the process out significantly. 
We know that the professions are hardest on their own. We see it time and time again within the health practitioners tribunal particularly in relation to nurses. Nurses are particularly hard on their own and I have sometimes been staggered at the rulings that have been made. The majority of nurses on the tribunal have made particularly hard decisions against their own profession. Doctors too often do that as do dentists and pharmacists. As they are the professions that have the greatest number of complaints that is where we would expect to see that but that being the case going on through the appeal process then perhaps having the courts refer the matter back to the committees is in some cases asking for a great deal of trouble. 
 The National Party member Judith Collins also mentioned that the practicalities seem to have been overlooked here. A great deal of thought and input is being given to the theory but I wonder just how much input has gone into the practicalities. She is quite right when she says that the tribunals are new. The appeal processes are going to be looking at new and perhaps unresolved problems which are always difficult to anticipate when looking at new legislation. I support my colleagues in the National Party when they talk about whether the practicalities have been looked at.