Health Practitioners Competence Assurance Bill
NO: 5-03 12 AUGUST 2003
HEALTH PRACTITIONERS COMPETENCE ASSURANCE BILL:
The Association of Salaried Medical Specialists (ASMS) is the professional union that represents salaried senior doctors and dentists, the large majority of which are employed by district health boards. This is the fifth issue of our Parliamentary Briefings to MPs that outlines our concerns on the Health Practitioners Competence Assurance (HPCA) Bill supplementing our previously forwarded Issues Paper. This issue summarises our main concerns over the Bill.
When the Ministry of Health issued its discussion paper in 2000 the ASMS welcomed the underlying principle behind the Bill of using the most modern health occupational legislation, the Medical Practitioners Act 1995 as the basis for developing new umbrella legislation for a much wider group of health occupations that had either outdated or no legislation.
But when the HPCA Bill was introduced into Parliament late last year the ASMS had major concerns because of the inadequate drafting and its serious departure from the Medical Practitioners Act. The Health Select Committee made several improvements to the Bill but in four key areas it still fell well short of the Medical Practitioners Act as a legislative regime for the health and safety of the public.
Consequently we advocated that unless more time was allowed to satisfactorily resolve these concerns, then the Medical Practitioners Act should be retained and the review process provided in the Bill be utilised to examine how best the HPCA Bill and Medical Practitioners Act could best be reconciled in the future. Owing to the outdated nature of the Dental Act, however, we have also sought to improve the Bill for dental practitioners. The ASMS has been working with the NZMA in trying to persuade parliamentarians to address these matters.
The first issue, protected quality assurance, has now been resolved to our satisfaction. While we are not in full agreement with the wording, we understand that the Minister of Health will introduce a supplementary order paper that will satisfy our main concerns and is an improvement on the wording in the Health Select Committee report back.
The second issue of scopes of practice remains unresolved, particularly our concern that the intention for broad scopes of practice are watered down by other wording implying narrow or personal scopes.
The ASMS has proposed amendments to the Bill that would make explicit and avoid ambiguity over the expressed intention of the Minister and the Select Committee for broad scopes of practice to clauses covering purpose, definitions, guiding principles, and application and authorisation.
Similarly the third issue of the effect of the Bill the appointment to registration authorities remains unresolved. Currently some of the positions for the medical, dental and pharmacy registration authorities are elected. The Bill replaces this with full political appointments by the Minister of Health (at her discretion she can allow elections).
The ASMS supports the retention of the current system of elections and has also proposed a compromise in which the Minister of Health can make appointments from within a pool of nominations provided by recognised professional associations.
The final issue, the effect of the Bill on the role and status of code of ethics developed by health professions is also unresolved. Clause 114 requires registration authorities to set standards of ethical conduct. An unintended consequence is that this seriously risks jeopardising the role and status of ethical codes developed by health professions (eg, medical, dental, nursing) that are a valuable resource for bodies responsible for administering health occupational legislation.
The ASMS has proposed amendments that would prevent this confusion. We had thought this had been resolved with the Health Ministry but this did not eventuate.
The ASMS recommends that during the committee stages MPs vote to:
1. Support the amendment to retain the Medical Practitioners Act.
2. Support amendments that make explicit the broad nature of scopes of practice.
3. Support amendments that prevent the Minister of Health from deciding what health practitioners are appointed to registration authorities.
4. Support amendments to protect the current role and status of codes of ethics developed by health professions