Clark DavidHEALTH PRACTITIONERS COMPETENCE ASSURANCE AMENDMENT BILLSecond ReadingHon Dr DAVID CLARK (Minister of Health): I move That the Health Practitioners Competence Assurance Amendment Bill be now read a second time. This bill amends the Health Practitioners Competence Assurance Act 2003 taking into consideration two reviews of the Act one beginning in 2007 and one that began in 2012. The purpose of the Act fundamentally is public safety. It's an important bill for ensuring that we do have safe practice amongst our medical professions our health practitioners.I want to at the outset thank those who made submissions during the select committee process and in particular those who appeared in person in front of the Health Committee. I understand there was very good and fruitful interaction and I want to thank the members of the select committee who made some suggestions about improvements to the bill through their process. So I do want to put that acknowledgment up front.The key provisions in the bill remain the same—well the same in that they were the ones that were referred to the select committee. I want to cover those off and then I want to go on to discover—discover?—to describe a few of the changes that the select committee made.Hon Ruth Dyson: Discover and describe.Hon Dr DAVID CLARK: The House will discover if they haven't been actively engaged in the select committee process.One important change that the bill makes is the introduction of performance reviews for responsible authorities. They'll be five-yearly performance reviews which will ensure public confidence in the responsible authorities and also will be carried out by independent reviewers against a set of indicators that will be developed by the Ministry of Health in consultation with the responsible authorities.Performance monitoring through these reviews will help with ongoing improvement to the regulatory system and it's easy to imagine just how that happens because when you actually start to consciously go through and check the performance of a regulatory system suggestions come up for further improvements to the regulatory system. Likewise it's a promotion of good practice because as you consider what things are coming through as you're doing a performance review What is good practice?" is a question that's naturally raised. Of course also it will lead to greater consistency across regulatory authorities as those reviews are made public. As responsible health authorities learn from the way that they're implementing the changes that this bill suggests they will share them with other responsible health authorities and we'll all be better off.Currently there is limited information available to the public about responsible authority decisions so this bill increases transparency gives better information for the public and therewith will increase the confidence of the public in the professional competence and conduct of health practitioners. It requires also the release of decisions and judgments about a practitioner's practice and competence that's been examined to the person who has notified the authority about their concerns. The bill also requires responsible authorities to develop policies and procedures around the release of names of health practitioners whose competence fitness to practise or conduct has been reviewed and investigated. Of course there's a balance here between the public interest and the privacy of the health practitioner. It's simply required that they have a policy around the release of those names that protects natural justice but also ensures that we have better practice over time. The other thing that's major that the bill does is it clarifies that responsible authorities can receive and act on information from members of the public about the practice of health practitioners. One more change is that it better supports teamwork amongst health practitioners by actually requiring them to work together and promote and facilitate interdisciplinary collaboration. Better workforce planning information is a requirement that's laid out in the Act and that helps with projecting future workforce needs because across many areas of our health system the workforce mix is changing. We also notice you know patterns of immigration and other things that affect workforce and we do need to have good data about who is in the workforce and do the modelling based on good data. So that requirement sits in the bill. It's clear also from the bill that wherever workforce information is published it will be required to be anonymised—certainly where it could reveal the identity of individual health practitioners.There are 16 responsible authorities appointed by the Minister of Health under the Act who will be required to implement the provisions in this bill. I want to acknowledge that a lot of the work for this bill was done under the previous Government's watch. There were two reviews of the Act. Those who were critical of the previous Government in the health professions are somewhat mystified why it took so long to actually work through these things but one who was being kind would say they were very thorough. They had a review from 2007-09 they had a second review from 2012-15 and then the select committee also did a thorough process during this Government from May to September. I've already thanked the select committee for the work that they've done.If we go back to the 2012-15 review of the Act which considered the underlying purpose of the Act it received 145 submissions and I've certainly received a few submissions privately from health practitioners frustrated that that wasn't progressed earlier but here we are. We're progressing it now and I would welcome support across the House for changes which will improve transparency which will tighten up how responsible authorities discipline their members.As a result of the contributions to the Health Committee a number of changes have been made to improve the bill and I'll whistle through a few of them within the time available to me. After consideration of submissions the bill now allows responsible authorities as regulators to act immediately to suspend a practitioner's practising certificate. I know this has been a matter of some conversation—certainly I've picked up on conversation around this—because the responsible authorities feel a burden to protect the public rightly and want to act to protect the public and to protect their professional reputations and they've felt that they haven't had the powers and that the balance of the previous law was wrong. So as a result of the changes suggested by the select committee there is a change in that regard that we've made.It also takes account of the electronic age we live in and email will now be an acceptable thing and the electronic communication of practising certificates and notices and so on will certainly improve the efficiency of the responsible authorities. The greater transparency I've touched on is consistent with overseas jurisdictions and with many other practices and protocols in New Zealand including those of the Health and Disability Commissioner the Health Practitioners Disciplinary Tribunal and as I mentioned some overseas jurisdictions. The requirement to inform complainants as I understand it has been improved by the select committee and the Act's cultural competence provisions have received further wording changes to be explicit about the fact that cultural competence with respect to things Māori respectful interaction and so on will be a feature so that we can have that explicitly mentioned and have a contribution with that in part to address Māori health disparities to improve outcomes in the health sector.The bill also improves the operation of the Act by giving tangible evidence of responsible authorities' performance better visibility—so making that public too. It also gives them discretion around the way that they handle concerns around people with drink-driving and so on so that instead of referring them to a professional conduct committee a responsible authority can refer their members for treatment.One other thing that should be mentioned is that the Health Practitioners Disciplinary Tribunal will now be funded by the responsible authorities. It's a very necessary part of the system to ensure a safe system. I'm advised that the costs of that will be about $1 per practitioner per year—modest for the confidence that that tribunal gives to the whole health system with the way it works through issues.The bill strengthens the framework and ensures the public can have even greater confidence in the practice of regulated health practitioners. I commend the bill to the House."