Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill

I rise to take a call on the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill. This is a piece of legislation that the Labour Party is supporting. It does make some practical changes that we endorse. I will go through some of those changes and what we are supporting.

The objectives of this particular piece of legislation are around the definition of what is a health practitioner, ensuring that there is consistency in the regulatory framework definitions that govern health practitioners—namely, the Health Practitioners Competence Assurance Act and its framework. Actually, it recognises the way that we conduct our health services in the modern age. So we are very supportive of the changes that this piece of legislation recommends.

There are about seven pieces of primary legislation that are impacted by the changes to the definition of medical or health practitioners, and the types of functions and duties that they will be able to carry out under the auspices of those several pieces of legislation. I want to talk specifically about the definitions of health practitioners in terms of nurse practitioners, the scope of practice that a nurse practitioner is now able to complete, what is defined within the practising certificate of that nurse practitioner, how the Nursing Council has been consulted and is engaged with that particular discussion, and what that actually means in terms of the practical service that they are able to deliver.

If we look at the separate pieces of legislation that this bill will amend—specifically the amendments to the Burial and Cremation Act 1964, what it looks at is determining who can sign off a certificate of death, and the conditions that sit around that particular practice. It is an important duty and function that our health practitioners are required to do. There are some specific conditions under which a health practitioner can sign a certificate of death. The definition of the health practitioner is aligned to that within the Health Practitioners Competence Assurance Act 2003, and that Act gives some practical examples of the types of scenarios under which they will be able to issue a certificate of death.

Under the amendments to the Children, Young Persons, and Their Families Act, some changes are made, specifically under section 2(1), inserted by clause 15, to the definition of psychiatric hospital, which is now just referred to as a hospital. It has been a long time since we actually referred to mental health tertiary institutions as psychiatric hospitals, so it is very much in line with our modern practices in terms of health. What it also does is it provides for those health practitioners to conduct examinations of children and young persons, as defined within the Children, Young Persons, and Their Families Act, specifically around sections 52 and 53.

Under Part 5 there are amendments to the Land Transport Act, specifically around the ability of health practitioners to conduct a couple of duties, particularly when it comes to eye checks for those applying for a driver’s licence, and the taking of blood specimens for those who have been pulled over by the police in a drink-driving blitz, for example, and have been found to be potentially over the limit and a blood specimen is required.

Also, within the bill under Part 5A are amendments to the Medicines Act—these are specifically about the ability to look at the prescribing of drugs. Under the Mental Health (Compulsory Assessment and Treatment) Act the amendments look at the scope of practice with regard to the assessments that one can conduct in relation to your mental well-being. That is often very important, particularly in times when you will not have access to a psychiatrist or some other medical professional to conduct the mental health assessment. It may be on the weekend, or it may be at a time when a person has been picked up by the police due to criminal activity or his or her behaviour, and requires a mental health assessment.

Lastly, the bill makes amendments to the Misuse of Drugs Act and that is particularly around dealing with controlled drugs. It is about the prescription and the administration of controlled drugs in a range of settings—whether it is in a veterinary setting, where you are administering to animals, or whether it is within a hospital or even a community setting such as those that would be provided by mental health community services.

They are sensible and necessary amendments to those pieces of legislation and the Labour Party will be supporting this piece of legislation.

Thank you, Mr Chair, for this brief call on the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill; it is a mouthful. Labour is very, very supportive of this bill. However it has taken such a long time for this bill to get on to the Government’s legislative agenda.

Nursing organisations and leaders have been advocating for over a decade for the removal of legislative barriers for nursing practitioners to undertake the full range of duties that they are capable of. It is really important that legislation keeps up with the evolving roles of the health workforce and that we empower rather than impede our health practitioners to use the skills and the abilities that they have.

The nursing review, after the first reading of this legislation, noted that the functions covered by the seven Acts that this omnibus bill is addressing include signing death certificates, taking blood specimens from drunk drivers, declaring people unfit to drive, prescribing controlled drugs, and signing sick-leave certificates. The current legislation means that nurse practitioners can sign ACC forms and sickness benefit forms but right now they cannot sign certificates for ordinary sick leave from work. A nurse practitioner, after this legislation goes through, is very, very useful, especially for our rural areas. This legislation will have a significant impact on our rural services.

The bill will allow several things. First, it will allow health practitioners with the required competencies and knowledge to perform more statutory functions. Secondly, it will make it easier for the public to access statutory health services. Thirdly, it will allow our health workforce to use their knowledge and skills. Lastly, it will facilitate innovative services and efficient use of practice.

Part 1 of this legislation deals with the Accident Compensation Act 2001. The rehabilitation plans under this Act will have a wide range of health practitioners who would be able to contribute to an ACC claimant’s rehabilitation plans. The effect of this amendment, in clause 4 of the bill, is that health practitioners leading the coordination of provision of treatment or rehabilitation to claimants will be given the opportunity to participate in the preparation of a claimant’s individual rehabilitation plans.

Clause 4(1) will now insert a new paragraph (c) into clause 7(3) of the schedule, and this would add “any health practitioner providing treatment to the claimant:”, to the list of people to be given the opportunity to participate in the preparation and costing of a claimant’s rehabilitation plan. We agree that this is really needed.

We now have over 50,000 nurses in New Zealand registered with the Nursing Council of New Zealand. We have looming GP retirement, with about 44 percent of them about to leave our medical profession in the next 10 years, so it is really timely that we allow our nursing practitioners to be able to assist in this manner and to be able to put their clinical services in and assist our health services.

We know that the health service has been underfunded over the last 6 years by a lot of money. We also know, honourable Minister, that quite a lot of our health practitioners, especially our doctors, are going on strike, I believe beginning tomorrow, at 20 district health boards (DHBs)—is it tomorrow or is it next week—partly because of this underfunding in the DHBs. So we totally agree with this particular legislation giving nurse practitioners more to do, especially because they are skilled and able to do so. Thank you.

I seek leave for all provisions to be taken as one question for the purposes of this debate, with a vote on each question.

Leave is sought for that purpose. Is there any objection? There is no objection. Then the question is—

💬 Louisa Wall: Mr Chair—

The CHAIRPERSON (Lindsay Tisch): You will get a call, but this is a matter I have to deal with. So the question is now that Parts 1 to 7, schedules 1 and 2, and clauses 1 and 2 stand part. Louisa Wall, you can talk about anything within the bill now.

Parts 1 to 7, schedules 1 and 2, and clauses 1 and 2