Scott Lynda: Health Practitioners Competence Assurance Bill — In Committee 
Scott Lynda: Health Practitioners Competence Assurance Bill — In Committee 
[Volume:611;Page:8090] 
Dr LYNDA SCOTT (NZ National—Kaikoura) 
: 
 As the Chairperson has just said there are 27 clauses in Part 3 and I certainly hope we are going to be able to debate many of those clauses. Part 3 goes to the heart of trying to look at protection for the public which is what this bill is supposed to be about. This part does have some significant issues in it and I have a Supplementary Order Paper that deals with some of the quality assurance provisions. Before I get on to quality assurance I just want to say that this particular part of the bill is about competence fitness to practise and quality assurance. 
As we have heard previously this bill was supposed to be based on the 1995 Medical Practitioners Act. Under that Act quality assurance improved markedly. I was working as a doctor in a hospital in the 1990s and was very pleased to become involved with quality assurance programmes. I am sure if Steve Chadwick was here she would also be telling members that she became very involved in the hospital where she worked in developing quality assurance programmes. These programmes are all about looking at protection for the public. Quality assurance is about seeking to improve one’s practice. One does that by looking at case studies looking at near misses and looking at when the system is not quite working. It involves getting nurses doctors and other health professionals together and doing a case review on a case by case basis looking at those cases that did not go as well as one expected—whether that was because of the physical problems that the patient had or whether it was sometimes because of iatrogenic causes. Iatrogenic causes occur when the procedures or the medication that a person receives in hospital makes that person ill and that happens to about 20 to 30 percent of patients who go into hospital. When patients are severely ill sometimes the things one has to do to try to make them well can at times have unforeseen consequences—for example hospital-acquired infections. Procedures can go wrong and it is essential that the doctors and nurses in our hospitals can engage in quality assurance procedures. 
There was one isolated incident back in the 1990s when Waitemata Health refused to give some information because it was part of a quality assurance programme. That was in the Malcolm Beggs and Lachlan Jones case. A system cannot be damned by one error and that was part of the problem that occurred in this legislation under clauses 51 52 53 and 54. Changes have been made to clause 52. The Health Committee worked very well to try to get those changes so that there is the same sort of plan as provided under the 1995 Act to allow quality assurance procedures to happen in our hospitals. It would ensure that people engaging in those procedures do not feel that that information can then be used in a medical practitioners disciplinary tribunal or for accident compensation. 
One does not want to deny information but there are all the other avenues that are available. There is accident compensation to look at medical mishap and medical misadventure and there is the Health and Disability Commissioner. So any patient who ends up in our hospitals who feels that he or she has not been treated correctly has an avenue of complaint. Those posters are up in every hospital in our country so that people know we have a complaints assessment procedure at every hospital in our country. I encourage anybody who has a problem or who is unhappy with his or her care to go through the hospital complaints procedure because that is the only way a hospital can deal with those problems. 
I think that hospitals and general practitioners are far better at dealing with problems these days. We used to say it was a gold star if somebody said something was wrong because then we would be able to change it. If we were able to know somebody was unhappy with something we had to view it that way to be able to improve service. So quality assurance is just one section in Part 3 and it is very important.