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Health Practitioners Competence Assurance Bill

Health Practitioners Competence Assurance Bill

The Association of Salaried Medical Specialists (ASMS) is a professional union that represents salaried senior doctors and dentists, the large majority of which are employed by district health boards. Earlier this month you should have received from us an Issues Paper highlighting our concerns in greater detail over the Health Practitioners Competence Assurance (HPCA) Bill that is currently before Parliament.

While the Health Select Committee has recommended some improvements, after much consideration the ASMS has come to the conclusion that the HPCA Bill is significantly inferior to the Medical Practitioners Act 1995 as a legislative regime for the protection of the health and safety of the public. In part this difficulty is due to the under-estimation of the sheer complexity of developing umbrella legislation that covers such a diverse range of occupation professions in one go and within a relatively short period of time.

We would prefer that further consideration of the HPCA Bill should be delayed until key issues can be satisfactorily resolved with health professional organisations such as the ASMS. It is wiser to delay legislation, perhaps only for a few weeks, covering public health and safety in order to get it right rather than introduce it while unresolved problems still remain. In the absence of a political willingness to delay the Bill in order to ensure that public health and safety concerns can be resolved, the ASMS is compelled to work on two fronts.

First, because it is inferior to the Medical Practitioners Act we recommend that Parliament exclude medical practitioners from coverage by the HPCA Bill. The Bill provides for a review after three years and this would provide an excellent opportunity to consider, along with other concerns, how the thorny issue of scopes of practice in the Bill can be better reconciled with registration in the Medical Practitioners Act.

Consequently the ASMS strongly recommends that you support the reported amendment by Heather Roy MP to remove coverage of medical practitioners from the HPCA Bill. This is a sensible and pragmatic initiative. It is not about the exclusiveness of doctors but about preserving a stronger legislative regime for the health and safety of the public.

The second front concerns improvements to the HPCA Bill in areas such as scopes of practice, political appointment of registration authority members, quality assurance and ethical codes. Some of our members (dental practitioners) are covered by the Dental Act 1988, (rather than The Medical Practitioners Act) which is outdated in terms of areas such as quality assurance and professional education. For them, despite many weaknesses, if some key areas were addressed, the Bill would be an improvement on their current Act. Even then it would fall short of the higher and more rigorous standards of the Medical Practitioners Act.

The ASMS is trying to resolve these matters through discussion with the Minister of Health and Ministry of Health but we are running out of time. Until late last year it had been understood that the HPCA Bill would be based on the Medical Practitioners Act which is generally recognised as successful modern occupational legislation.

Unfortunately in key areas discussed in our Issues Paper this is not the case. In the key area of scopes of practice it only became clear late last year that the concept is not the same and inferior to the registration provisions of the Medical Practitioners Act. Until then we had been led to believe that scopes of practice would be based on the registration provisions of the Medical Practitioners Act. Scopes of practice is a term largely used by the Ministry of Health rather than health professionals and its introduction is being driven top-down rather than bottom up.

The ASMS hopes to communicate to you further on our specific concerns over the Bill providing that the Bill is not rushed through the House. Unfortunately the Bill has the feel of a ‘runaway train’ about it; a bad basis for important policy and law making. We hope that MPs will not let the Bill be rushed through before the critical issues concerning the health and safety of the public have been resolved.

Ian Powell


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