Health Practitioners Competence Assurance BillHealth and Disability Commissioner Amendment BillMedicines Amendment Bill

I move, That the Health Practitioners Competence Assurance Bill, the Health and Disability Commissioner Amendment Bill, and the Medicines Amendment Bill be now read a third time. This legislation is about public safety. Its purpose is to protect the health and safety of members of the public by providing mechanisms to ensure the lifelong competence of health practitioners. The legislation builds on the existing framework. All the major concepts in the Medical Practitioners Act have been carried forward into this legislation, adjusted where necessary to generic terms to provide a framework that can apply to all health practitioners, not just doctors.

The basic principles of ongoing competence, separation of the registration process from the disciplinary process, and the declaration of quality assurance activities, have all been carried through to this new legislation. Major deficiencies in the mix of existing occupational legislation, and the difficulties they cause for the existing authorities, will end with this new legislation. Scopes of practice, which are a key part of this legislation, have caused much debate, which rested on the argument that the concept of scopes of practice is new and untested. That is simply not correct. The concept of scopes of practice has been there for some time—and for physiotherapy, right back to 1949. This legislation simply adapts the concept of scopes of practice behind provisional, general, vocational, and temporary registration that is found in the Medical Practitioners Act, to express broad scopes of practice in generic terms that can apply to all health practitioners.

Some concerns have been expressed by professional groups that this legislation will lead to a shift in the way that practitioners practice so that practitioners will no longer achieve a general qualificational standard and then specialise in a narrower field later in their career. It is the intention of the Government, and clearly that of the Health Committee, that broad scopes of practice apply, where practitioners are expected to have a familiarity with a full general span of the area of their profession’s expertise, and remain the starting point for each health practitioner.

There are new powers for the Minister. They are few, but they are important. They reflect the primary purpose of the legislation to protect the public, and obligations to the public from the Minister. In return for those increased powers for the professionals in respect of the clinical decisions, there are checks and balances to ensure that registration authorities are held accountable for complying with the provisions of the legislation through the Minister to Parliament. These include the Minister’s powers to appoint authority members, determining disputes over scopes of practice, and gazette-restricted activities.

The Minister’s power in respect of overlapping scopes of practice is not a power that I see intruding on the roles of authorities. It is entirely in the hands of the registration authorities and the professions as to whether this provision is ever called into effect. The incentive is to resolve disputes without having to involve the Minister.

There are some issues around cultural competence and professionalism. Some have suggested that the bill will prevent professional groups from setting codes of ethics as they have traditionally done. That is simply not true. Professional groups will continue to do so. However, there is a distinction between setting such professional codes of ethics, and the standards for ethical conduct on which professional conduct committees will be required to make judgments under the provisions of this legislation.

Under the legislation, registration authorities will have the function of setting standards of ethical conduct in the same way as they set standards in other areas, but this will not change or affect the role and status of codes of ethics currently developed by the health professions. I expect and welcome the continued role of health professions through their professional associations in setting their own codes of ethics. The most important expression of ethics will continue to be those that professions set for themselves and that guide professionals from day to day in their ordinary working lives.

Under the legislation new mechanisms for maintaining and improving the competence of health practitioners are being created. These include competence reviews, competence programmes, recertification programmes, medical examinations, and others. It is important that provisions for protected quality assurance activities are being continued, and extended to all health practitioners.

There are new reporting provisions to help safeguard the public. The legislation will include provisions for practitioner and interagency reporting when there is a risk that a practitioner may pose a risk of harm to the public.

The role of the Health and Disability Commissioner will also change through the legislation. The commissioner has gained more flexibility in dealing with complaints, which should improve the timeliness of the complaints processes.

In the area of pharmacy, the legislation introduces a new mechanism for ensuring that medicines are distributed in a safe environment by requiring operators of pharmacies to be licensed. One of the conditions of the licence will be that a pharmacist must have a 50 percent ownership position in the pharmacy. It is essential to ensure that dispensing services are available in a safe environment, and the licensing regime provides a regulatory framework to achieve that.

In conclusion, I would like to thank the Health Committee, particularly the chair, Steve Chadwick. The members did a very, very good job with this legislation, and I notice Dr Paul Hutchison over there. Although there may be some debate, I am sure their efforts have assisted to ensure that the legislation the House passes today, or maybe tomorrow, will set in place a regulatory regime that safeguards public safety, while at the same time securing the rights and protections for the practitioners themselves. I commend this legislation to the House.

Debate interrupted.

The House adjourned at 9.55 p.m.