The Health Practitioners Competence Assurance Amendment Bill bill also
brings in performance reviews of the Medical Council, Nursing Council and other authorities
and allows for the Minister of Health to consult and approve the amalgamation of authorities. (An unpopular attempt was made to merge the ‘backroom’ roles of the 16 health professional regulatory authorities earlier this decade as the first step in forming a single secretariat.)
The bill was introduced to Parliament last week and the Health Select Committee is now calling for public submissions.
The dusted-off bill first went to cabinet in 2015 and is based on recommendations arising from the 2009 and 2012 reviews of the Health Practitioners Competence Assurance Act 2003. The Act sets out the requirements for the 16 health professional regulatory authorities – including the Medical Council and Nursing Council – that register and provide oversight of the competency and safety of 23 health professions including medicine, nursing, physiotherapy, pharmacy, dentistry and midwifery.
Health Minister Dr David Clark in introducing the bill said it would improve the operation of the Act through “providing tangible evidence of responsible authorities’ performance, better visibility of decisions about health practitioner disciplinary proceedings, greater recognition of the importance of interdisciplinary collaboration and cooperation, and better workforce information”.
Dr Jonathan Coleman, the National health spokesman and the former Minister of Health said the new Government in introducing the bill had “resorted to scraping the bottom of the barrel, looking for the scraps and the leftovers that the National Government left them as we departed office.”
Associate Minister of Health Julie Anne Genter responded by arguing that if the bill’s requirements for workforce data been introduced earlier then a number of workforce planning issues could have been better dealt with. Including the midwifery shortage which she said she was ‘very, very interested’ in personally having recently announced her first child was due in August.
“It’s pretty clear that there hasn’t been sufficient workforce planning around midwives and a whole raft of other professions in the health sector.”
“This bill will give those responsible authorities a legal mandate to collect a range of data, which will help the Ministry of Health to support workforce forecasting and modelling,” said Genter. “This will assist better planning for developing the workforce required in order to deliver on New Zealand’s future health needs.”
Matt Doocey, National’s spokesman on mental health, called on the select committee to look at how to ensure that consumers got more information on competency and fitness to practice; how quickly mechanisms were put in place to intervene when concerns are raised about competence, scope of practice or fitness to practice; and how to ensure data was shared promptly to inform workforce planning.
Dr Liz Craig, a Labour MP and GP, said another area covered by the bill was requiring authorities to develop policies on the publication of names of those undergoing disciplinary proceedings.
“I think even though medicine now is very, very much evidence-based, as a practitioner it’s still very much an art as well as a science. Basically, mistakes do get made, and, I guess, what we’re looking at here are not those one-off mistakes but those systematic mistakes that are going to make practitioners a risk to their patients. So it’s always the balance between the public’s right to know and public interest, and the practitioner’s rights for privacy and natural justice.”
The bill also includes a requirement for the various authorities to promote interdisciplinary team work between the different health professions.
This amendment follows the 2012 review showing a strong level of agreement between stakeholders that ‘team work’ was critically important to patient-centred care. The bill stops short of requiring all the different authorities codes of ethics or conduct or standards to cover the importance interprofessional communication and team work but considered the amended Act “could provide an important mechanism for signalling the importance of team work to public safety”.
The proposed amendments include:
- The introduction of five yearly performance reviews for regulatory authorities
- Higher thresholds for suspending a health professional’s practising certificate if the health professional is under investigation or facing a pending criminal proceeding.
- Better visibility of decisions about practitioner practice Requires authorities to develop and release a “naming policy” that sets out a transparent decision-making critieria for when a health practitioners whose conduct has not met expected standards will be named (where it is in the public interest to do so) or not named.
- Requires authorities “to promote and facilitate inter-disciplinary collaboration and co-operation in the delivery of health services”.
- Requires authorities to provide the Director-General of Health with information about health practitioners registered with it including (but not limited to): the practitioner’s name, date of birth, employer, place or places of work, and average weekly number of hours worked at each place of work. (The information may be used only for the purpose of supporting workplace planning and development.)
- Clarification that responsible authorities can receive and act on information relating to the practice, conduct, or competence of health practitioners
- Improved processes to help the Health Practitioners Disciplinary Tribunal operate more efficiently