Health Practitioners Competence Assurance Amendment Bill

Thank you, Mr Speaker. It’s a pleasure to take a short call on this, the second reading of the Health Practitioners Competence Assurance Amendment Bill, a bill that the Health Committee worked very collaboratively and diligently on and reached some good conclusions. We come to this bill with two previous reviews over the past 10 years, and these recommendations are included in the bill, both from the first review and this, the second. We had 49 written submissions and 24 oral submissions from a wide range of submitters, which is always good and, as always, improves the bill. We had 16 responsible authorities, 10 medical professional bodies, 17 other professional groups, two individual health practitioners, one provider of health services, two interested organisations, and two Government agencies.

The committee reported back on 13 aspects of the bill. I’m not going to outline them all—it’s in the committee’s report—but the first two I will offer brief comment to. They were the ones revoking the accreditation of an educational institution, and this was previously under the Nurses Act as a provision, and the committee agreed that it should be amended to the bill so that the responsible authorities could have that jurisdiction. The second of the 13 points I wanted to talk to is electronic communications. There was almost unanimous support for responsible authorities being able to send and receive their annual practising certificates in an electronic fashion.

I think, really, the only other thing that I wanted to add to this short call tonight was to speak to the submission from the occupational therapists, which was very thoughtful and proposed a different mechanism. Rather than going straight to a professional conduct committee—that adversarial approach—what the occupational therapist said to us was this: they quite liked the idea and wanted to propose the concept of facilitated resolution. Rather than setting up a formal professional conduct committee, maybe we could have facilitated resolution. Both the officials and the committee thought that this was a very good idea and that some further work could be done on that, and that it was likely to receive the consent and approval from everyone around the table.

So, again, just concluding this short call—unanimous support from the committee, a review that had been in progress over 10 years, 13 recommendations coming back from the select committee, and all of them will help strengthen up the professional responsibilities that the medical practitioners have. I commend this bill. Thank you.

Thank you, Mr Speaker. It’s a pleasure to stand and rise on behalf of New Zealand First in support of this bill, the Health Practitioners Competence Assurance Amendment Bill. I’d just like to acknowledge, as I begin this short call on this, all the members of the Health Committee. I have just joined the Health Committee. I was sad to leave the Māori Affairs Committee because they have the best kai, but I’m looking forward to ensuring that the standard of the food in the Health Committee suddenly rises.

💬 Hon Member: It’ll be nutritious.

It surely will be. [Interruption] Yes, that’s right—I’ll put my pinny on.

So yes, I look forward to the next period of time with the Health Committee. To all who have submitted and the diligent work of the committee, unfortunately, I wasn’t there through the process of this bill going through the select committee—

💬 Angie Warren-Clark: We were diligent.

—but I do know that they worked very hard on it, so I’m looking forward to continuing their good work, as well.

The original Act, the Health Practitioners Competence Assurance Act 2003, was a bit of a groundbreaking piece of legislation—in fact, it even had some sort of international acclaim. But it has spent a long time—two reviews. In 2007, it went under review for a couple of years, and then in 2012 through to 2014, there was another set of reviews, but, finally, it has made its way all the way now through to this second reading.

Now, it’s really vital that we have mechanisms to ensure that we protect every member of the public, and we can do this by ensuring that the health practitioners are competent and are fit to practise their professions. Now, that’s absolutely vital. To claim professional status—to be a member of their profession—every health professional must actually have the appropriate qualification and, on top of that, they must also be registered with the responsible authority. Public safety, as I have mentioned, is critical and is the right of every member of our community. So this bill is important to make sure that we have safe practice amongst our medical fraternity.

Forty-nine submissions were made to the select committee, 23 were heard, and a great variety of those were in support—as Dr Shane Reti, the member before me, spoke about—in terms of bringing it into the technological age by allowing emails to be used as a form of communication in sending information. So that’s a good thing to know that, finally, they’ve become part of the electronic age.

The performance reviews are to be carried out by independent reviewers, set against some indicators that will be developed by the Ministry of Health in consultation with the responsible authorities. Just making note of the Hon Dr David Clark in his speech, when it came to the second reading earlier—one important change that the bill will make is the introduction of these performance reviews for the responsible authorities. They will be five-yearly reviews, which will ensure public confidence in those responsible authorities, so that’s really important to note.

So, really just touching very briefly on three areas where there will be changes after consideration of the submissions that came to the select committee, the bill now allows responsible authorities, as regulators, to act immediately to suspend a practitioner’s practising certificate, if that’s required. Obviously, I mentioned the updating into the electronic age that we live in—email will now be an acceptable thing, so that’s finally got there—and making note that cultural competence provisions are also made note of as well, in respect to all things Māori, and there is a respect for interaction and so on as the health professionals conduct their work. So on that short contribution this evening, I’d like to commend this bill to the House.

Thank you, Mr Speaker. I’m very pleased to rise and speak to this bill at its second reading. The select committee has worked hard at it, and I think we’ve got a good outcome. The bill is significant because it does provide a mechanism for ensuring that health practitioners are competent and fit to practise their professions, which, of course, is relevant to everybody who wants to have confidence in our health system. It also provides for appointed authorities to be responsible for the registration and the oversight of health practitioners. This is to give confidence to New Zealanders that if something goes wrong in a medical treatment, there is an authority that can be approached that can look into the incident and can take action, if appropriate.

The original Act, the Health Practitioners Competence Assurance Act, came in in 2003, and there have been a couple of reviews since that time, and it’s from those reviews that the changes have been made. But most of the changes really are procedural. There have been 14 different parts of the Act that have been changed, but otherwise the Act has worked pretty well. I think one of the most important changes has been an increase of accountability of health practitioners to patients, to their families, and to the public.

It’s something that has been actively sought by a recent petition that the Health Committee has been working on. So it’s particularly relevant. In clause 27(1) of the bill, it widens the opportunities for concerns about competence of a practitioner to be taken to the responsible authorities. In the past, only health practitioners, employers, or the Health and Disability Commissioner could take a complaint. Now anybody—a patient, a patient’s family, a member of the public—can take a complaint to the relevant authority. I think this is a huge improvement. It will give the public more confidence in the process and it will allow them to take direct action to have their concerns heard if they feel that a health practitioner has not delivered appropriate services or appropriate care. I think this is a timely and significant amendment to the legislation, and it does reflect on the petition that we were looking at. So I thank the petitioner for her comments that reinforced the need for this amendment.

So, overall, the bill is designed to ensure a sustainable, integrated, more convenient, and people-centred health system, and that’s a good thing. It’s a good thing for all New Zealanders, whether they work in the system or whether they’re patients or they’re families of patients that use the system. So National supports this bill. It believes that the amendments will improve the processes of registration of practitioners and the oversight of this work. I commend the bill to the House.

Thank you, Mr Speaker. It’s a little bit earlier than I expected, but I am nevertheless pleased to rise and take a call on the second reading of the Health Practitioners Competence Assurance Amendment Bill, which the Green Party of Aotearoa New Zealand is supporting.

This is a bill that has arisen out of two previous reviews of this legislation that arose from the Greens’ intervention in the drafting of the initial legislation, where we called for there to be a review built into the Act because we believe that oversight of our quality assurance mechanisms for health practitioners should be, I guess, a process of regular reflection and ongoing learning. So it’s good to see that now, in 2018, we’re finally getting an update to that legislation. It may seem a little bit mean-spirited of me to reflect on the fact that the first review was started in 2007 and finished in 2009, and then we had a change of Government and there was just nothing done with that review until another review was initiated in 2012, and that took three years, and then I can only assume that the work started in terms of the policy thinking towards the development of this piece of legislation that this Government introduced quite early on.

I do reference that because I think I’m just calling back to some of the comments that I’d heard previously from the Opposition that, you know, this is a technical bill and why is this Government not doing more substantive work. Well, it’s a really important piece of legislation, but, also, after nine years of stalling on a really important piece of work, it’s a little bit rich to be having a go at this Government for not getting on with the business.

Also, I’ll just clarify for people—because I think most New Zealanders might hear “health practitioner” and not really know who we’re talking about—some of the of the professions that are covered by this. So chiropractors, dentists, dietitians, doctors and other medical professionals, radiologists, midwives, nurses, occupational therapists, optometrists, osteopaths, pharmacists, physiotherapists, podiatrists, psychologists, and psychotherapists are just some of the examples. So this really covers the large majority of our health and helping services—not all of them, but a very large number of them.

It is about the quality assurance for them. So it will bring the operation of the Health Practitioners Competence Assurance Act into the electronic age, which is good progress, and should reduce the costs in the running of the authorities and improve the speed with which communications occur, and when there are complaints being dealt with, that’s actually quite important, and not insignificant.

Very pleasingly, it brings in performance reviews of the boards that oversee the practitioners and their practice. So these performance reviews are now to be carried out by independent reviewers against a set of indicators that will be developed jointly by the Ministry of Health in consultation with the responsible authorities, and the resulting reports will be published. And there’s an expectation, I guess, from the independent reviews that there will be areas where those authorities can improve their practice and oversight and that they will then report back to the Minister on which of those recommendations they’re picking up, or, if they’re not picking up any, why. So the public as well as the Minister will have oversight of this continual learning and quality improvement process over our health services. This will assure the public, hopefully, that the regulatory framework for health professions is operating as it should—surely something we all want.

Currently, there is limited information available to the public about responsible authority decisions in relation to complaints about registered health practitioners and the processes that they may use for making those decisions. Over the years, we have seen stories coming into the media where people have found out through a concern and then investigative reporting that complaints and actions have been taken against health practitioners for practice that was unethical and unsafe but that the conditions that had been put in place by the oversight board were not being monitored. So actually enabling some of that information for the person who’s laid the complaint in the first place to be able to get access to the decision builds in a new level of oversight and a safety protection that we haven’t had before, which I think is very important. And I hope that in terms of that quality assurance model, we will be keeping a good eye around the safety of practitioners once conditions have been put in place, so that we can be sure that those conditions are being met and the public is aware of those conditions where appropriate.

So it enables the responsible authorities to release information about decisions they’ve made on a practitioner’s practice to the person who notified them, as I said, around that practitioner’s competence. And the responsible authorities will now have to develop policies that set out how they make decisions about releasing the names and the fitness to practice or conduct that’s being reviewed or investigated. And health practitioners whose conduct has failed to meet expected standards may be named when it’s in the public’s interests, and it’s really important to enable that power. But, of course, it will be balanced with the practitioner’s rights to privacy and natural justice. But there are some conditions and issues that arise where, actually, the evidence is that public awareness will help ensure the safety of that practitioner in the future—to have that oversight.

The bill also supports teamwork amongst health practitioners, and this is now recognised in this legislation, which seems good progress, in that we want to move to multi-disciplinary teams, and for our quality assurance mechanisms to support that. Many complaints, unfortunately, to the Health and Disability Commissioner arise from failures in teamwork and professional communications. So a cohesive team approach across the health and disability system is integral to public safety and achieving better health outcomes for New Zealanders.

Another change in the legislation is to support better workforce information for health workforce planning and forecasting. Responsible authorities will now have a legal mandate to collect data, such as the date of birth, the place of employment, and gender, to be able to help make sure that we have enough people providing these essential services.

I do note that one of our concerns when the bill was first introduced was that there was no acknowledgement around Te Tiriti o Waitangi and the obligations for people to consider Te Tiriti o Waitangi. I understand that was considered by the select committee and that the cultural competence enables practitioners to build in that competence in their assessments. But that’s because it is not a relationship between hapū and iwi and the Crown but medical practitioners, and actually putting it into the legislation wasn’t deemed to be appropriate.

So all in all it seems like the committee did some good work, and this is a good step towards continual quality improvement within our health system.

Thank you, sir. I’m not a member of the Health Committee. I am, by virtue of the fact I’m National’s ACC spokesperson, a member of our health caucus committee, and in that capacity I’ve had the chance to sit on the Health Committee a couple of times in recent months, but I wasn’t party to the discussion of this particular bill.

It would appear that there is unanimity in the House in support of its passage, so I won’t take long to delay its progress. But I do just want to acknowledge the work that the Health Committee is doing under the leadership of the chair, Louisa Wall. It appears to me when I’ve sat on that committee that it’s a very collegial approach.

This is, nevertheless, a very important bill. I won’t repeat a whole lot of things that have already been said, but in studying it, just for the benefit of those who may be listening, as the previous speaker and others have noted, it does essentially arise out of two reviews that were undertaken in 2009 and again in 2012, so during the time of the previous National-led administration. It is a procedural bill tidying up 14 provisions in an Act that appears to be working well.

I’ve just noted, looking through the report of the committee, that there are some significant recommendations that come from it that I think would be of interest to the public, such as clarifying the power for the revocation of the accreditation of an educational institution. I’m sure that everybody in the public who might from time to time need to make use of our public health system would want to know that responsible authorities could revoke the accreditation of an educational institution if in some way it was failing to meet the requirements of a first-world health service. Authorities, I note, could revoke accreditation when concerns about the quality of education are not being addressed, and the committee expected that authorities would consult appropriately before deciding to revoke an accreditation. It almost sounds too obvious for words, but it’s good that it has come through as a clear recommendation of the committee, and I certainly endorse that.

There’s also a recommendation about essentially ensuring that the most modern forms of communications are available. We live in an increasingly digital electronic age and the committee is recommending amending the bill to reflect the common use of electronic communications, such as respectively providing for practising certificates to be issued electronically.

There are other provisions in there—the options for dealing with practitioners who’ve been found guilty of an offence. That would certainly be something that I would think that any member of the public would want to ensure was adequately provided for in the legislation. There’s a provision for the temporary suspension of practising certificates, and so on.

I can see that these are all very sound, common-sense initiatives coming out of two thorough reviews, and a committee that has clearly done its job, and I’m very happy to support its progress at this stage through the House.

It’s a pleasure to rise and speak on the Health Practitioners Competence Assurance Amendment Bill. I have to first note that it was a very collegial process. Our team worked together really well, and I mean that across the House. We had some very quality submissions, 49 in total and 23 came to submit to us. I learnt a lot from that process as well. So I’d like to thank the select committee members and the excellent and professional work of the officials to craft and hone this bill. We’ve heard that there were two reviews in 2009 and 2012. So I’d also like to commend the Minister the Hon Dr David Clark for actually bringing this bill to the House.

Time is short, so I propose to speak very briefly to three sections of this bill—first and foremost, the modernising of the practising certificate process. I bring this up, and others have as well: it’s changing section 29 and section 31 respectively of the principal Act. It’s important because the thing that I learnt was that there are over 130,000 health practitioners out there, each and every one of them receiving their health practising certificate of whatever nature in paper. It is very cumbersome, not so good for the environment, but also quite easy to store somewhere and lose. So it’s really good that these practising certificates can be online, can come by email, and also that they will be searchable online, which is awesome. It means that we can be assured, if we need to look for a practising certificate, that we can see that that person is, in fact, there.

The second aspect of this bill that I’m delighted about is the option for dealing with practitioners who have been found guilty of an offence. A new clause 13B in 67A has been inserted to allow the authorities discretion in deciding how to deal with a practitioner who has been found guilty of an offence. The professional conduct committee, or with the consent of the practitioner, can order that practitioner to undergo examination, treatment, counselling, or therapy. Now, that is in line, absolutely, with what we believe here in the Labour Party and our Government—that treatment is often a better and more appropriate response than the removal, for example, of someone who might have studied for 12 years or 15 years to get where they are, and for one small incident they may lose their practising certificate.

I think the community also, finally, would be particularly interested and pleased with the ability of the responsible authority to issue an interim suspension if a health practitioner has engaged in conduct that is being investigated or prosecuted, if that authority—and it’s quite a high threshold—believes that that conduct poses a risk of serious harm to the public. So this may be an allegation of sexual misconduct, for example. We’ve also changed—under clause 69A there needs to be no prior notice given to the suspension for that practitioner. So they get issued this immediately. However, due to the nature of this, and natural justice, this matter must be heard within 20 working days, which provides for natural justice for the practitioner but it also supports the public safety.

There’s so much more that I want to note about this bill; however, I’ve taken up all my time. I absolutely commend this bill to the House, and I thank you.

It’s a pleasure to take a call on the second reading of the Health Practitioners Competence Assurance Amendment Bill.

I must confess I wasn’t on the select committee, so I wasn’t privy to the discussions that went on, or the deliberations. But I do want to certainly acknowledge the work that the Health Committee has been doing in this area. In particular, I acknowledge the chair, Louisa Wall, and the Hon Dr David Clark for bringing this bill back to the House. Just having read the bill, I must say it’s a very good bill. It seems to make a lot of sense—common sense is a word that I’ve heard several times tonight. So I will not take too much time, but I do want to just go through.

Of course, it’s good to see this Government continue the work of the previous Government. We’ve had a number of reviews in this area—one in 2009 and then again in 2012. The 2012 review was very interesting. It looked at incentives in creating centres for health practitioners to maintain safe clinical practice. I think the purpose of this bill we’ve got unanimous agreement of—essentially, ensuring that we maintain integrity of the system and that we hold our health practitioners to a high standard, because that’s certainly what the public of New Zealand deserve.

So, just going through the purpose of the bill, it’s certainly to make sure the health practitioners are competent and fit for purpose in their professions and in our modern healthcare system. Many of the amendments that we looked at in the previous two reviews come to the fore in this amendment bill—certainly, around the concerns with practitioners and how to deal with concerns if the public have a concern about a health practitioner. There’s now a process in place for them to raise that concern. There’s certainly a sense of desire about improving collaboration and cooperation in the delivery of healthcare services and in terms of that as well.

Thirdly, that brings in the idea of independent reviews—so ensuring that health practitioners and any authority will be subject to independent reviews. Another thing that I think is really important is around data collection and sharing, and this bill enables that as well.

There are a couple of areas where in the previous reviews the general intent from the previous reviews has come through. Firstly, on a number of issues—the first is around the responsibility for authorities’ performance. So that comes through in this bill as well. There’s far better visibility of decisions about the practitioners’ practice, and that can only be a good thing, I think.

The third is around the greater recognition of the importance of the interdisciplinary nature and collaboration of the health practitioner space, and the other and final thing is around the information to the workforce as well.

So I think it’s a really good bill, and, just to kind of wrap up things, it focuses on efficiency. There’s a process for disciplining now, in this bill, health practitioners who aren’t adhering to best practice. There’s a process in place for suspending health practitioners and examining health practitioners that aren’t living up to standard. And also, finally, it is around performance reviews of authorities and ensuring they are done in an independent manner as well.

So, once again, I would like to say that this is a good bill. It makes a lot of sense. It’s something that we’re very proud to support on the side of the House. Thank you.

Thank you, Mr Speaker, for the opportunity to speak on the second reading of the Health Practitioners Competence Assurance Amendment Bill. While it’s important that we’ve discussed tonight around having reviews and having a greater process in place, the underlying benefit is for the public of New Zealand to have greater confidence in the health services that they’re receiving. That can be delivered through this bill by having transparency and increased access to information about the services that they’re receiving, and that gives us a health system that’s more robust, and it gives us a public that’s more likely to benefit from the health services that are on offer.

The key area which looks into it at the beginning of the bill is the performance reviews that can be carried out as a result—five-yearly performance reviews—and carried out by an independent reviewer with criteria and oversight by the Ministry of Health. The importance of performance monitoring is it provides ongoing improvement of the health system. So if there are issues that are going on that are not right, then that’s able to be picked up, reviewed, and rectified in order to give that greater public confidence in our health system. Performance monitoring through the reviews will help that, and it will also help greater consistency across responsible authorities.

Part of what I already mentioned is information transparency related to competence and discipline. This is where the Health Committee received several submissions in this place. Some of the submitters recommended enabling responsible authorities to act immediately to suspend a practitioner’s practising certificate without notice or to alter the scope of their practice where there is risk of serious harm to the public. But it’s important to balance that up, and, after consideration of the submissions, the bill now allows responsible authorities as regulators to act immediately to suspend a practitioner’s practising certificate in instances only where there is a risk of serious harm to the public or pending prosecution or investigation.

This change will help ensure increased public safety when practitioners may pose serious harm to patients, and it also gives increased public confidence to those who want to utilise those services. The bill takes into account also the electronic age we live in, with all the responsible authorities submitting that electronic communication should be allowed within the Act, and it’s good to see that increased access being available through alternative means of communication. The committee considered that issuing documents such as annual practising certificates electronically and serving notices electronically would improve the operation and also the efficiency of responsible authorities.

So it’s with great pleasure that I commend this bill to the House. It is one that has taken two reviews and a significant amount of time and work by officials and by Ministers concerned across two Governments to be able to bring this together in a way that brings increased confidence from the general public and increased transparency into the health services provided to New Zealanders. Thank you, Mr Speaker. I commend this bill to the House.

Thank you, sir, for the opportunity to speak on the Health Practitioners Competence Assurance Amendment Bill, speaking particularly on the changes that have been made as reported back to this House. I join with colleagues, it seems, from across the House in agreeing that the bill is a very worthwhile endeavour, and I’d like to focus in particular on the aspects that have been suggested for change as they relate to making a system more responsive, more effective, and more efficient for the people of New Zealand.

My litmus test in examining these various proposed changes is whether they would improve the lives and the health outcomes of the patients within the system but, of course, in a way that is not unfair to practitioners when it comes to disciplinary proceedings and the like. I think it’s interesting that the name of the Act that’s being amended includes the word “assurance”. So we’re not just ensuring that the system is a good one but also assuring the public that it is good and that they can have confidence in the competence accordingly.

For the first of those changes, I look to the amendments proposed by the Health Committee regarding the ability for concerns about a practitioner to be brought by any person, essentially—so not only health practitioners, employers, and the Health and Disability Commissioner, as is already the case, but also patients and members of the public—recognising that the system does belong to us all and so it is appropriate that anyone with a genuine concern should be able to raise that in good faith and have that processed in a way that takes that concern seriously.

So, too, we think about the effect on the public of having a system that encourages collaboration and cooperation in the delivery of the health services. It probably goes without saying that if we have a system that’s efficient in terms of its design and structure, then the benefits will flow not only to those who are involved in operating the system and delivering the services but to those who receive the services as well. So that also meets that standard, it seems to me, of improving outcomes for those who are most affected by the system.

I’ll just take a step back and consider the regulatory impact statement which was put together in recognition of the fact, initially, of a couple of different reviews flowing through, obviously, to this piece of legislation, and pick out a couple of areas in particular where it was recommended that the bill could be enhanced. One was to provide an assurance to the public and the Crown that the responsible authorities are carrying out their functions as intended, and also to improve transparency about disciplinary proceedings. So, again, those are really consistent with the interest that I have in considering the way that the ordinary public will be affected.

I’ll take a moment, if I may, as a footnote, to reference that great resource on Westminster democracy, namely Yes Minister, and the particular episode that featured a hospital that had no patients. It was to the delight of the bureaucracy, of course, and the horror of the Minister, which the news that there were no patients in this hospital was received. Of course, that rather dystopian satirical warning, I think, is obviously an extreme example of how we should not view our Government services in this country. In the case of our health system, considering the way that it will deliver the services to the people of New Zealand, it is, of course, the patients whom we must always bear in mind.

That said, it is also worth considering, in my remaining time, the fact that the practitioners themselves very much have an interest and a stake in the way that the system operates. I’ll just pick out by way of example the procedure for considering a complaint against a practitioner, whereby it’s been investigated that he or she might have engaged in certain conduct that’s potentially posing a risk of serious harm. Well, there’s an opportunity for suspension without prior notice. So that would be an immediate action to protect patients and would-be patients of that person, but at the same time to then allow the practitioner himself or herself to make submissions and to give their side of the story, presumably without prejudice—or, rather, the original suspension would not be a matter of record if that person were found not to have engaged in the harm. So that seems to me a balance that’s being struck, as I started my remarks, by acknowledging the interest of the people of New Zealand to have a system that is responsive and has competent professionals within it, but, at the same time, not unduly disadvantaging those who operate the system and deliver the services.

So, with that, I join colleagues on both sides of the House, it seems, in commending and wishing well the continued passage of this legislation through the House.

Thank you, Mr Speaker, and I just thank that last speaker, Chris Penk, and his reference to Yes Minister. It’s good to see that the Opposition are doing their homework there. I think Jim Hacker was a very unlikely leader that got a very circuitous route to leadership and didn’t have much success, so I just had that vision. So it’s good to see your in-service training being carried out on the opposite beaches.

But I think I should put my attention to the bill to a certain extent. What I would say this bill is about, if I were to sum it up—particularly for those watching at home—is that it’s really about who guards the guards. As much as it’s about the actions of the medical authorities, it’s really about the actions of those who oversee them, and so often we come to the case where there has been some sort of failure, particularly systemic failure.

Often, we have had faith in the system that there was someone actually keeping an eye on what was happening and that there was some authority, the “them” that we often talk about—why did they do this and what the heck happened there—and this is the “they”. It’s the regulatory authority, the responsible authorities, that we really rely on to be overseeing a profession that has changed considerably, certainly in my very short lifetime, and probably close to your own, Mr Speaker, and others. But it’s from a time when, really, our medical authorities occupied a different status in society, and what they said went. The old saying is that “Often they buried their mistakes”, but I suppose the status they occupied in our society meant that, really, they were their own regulatory authority.

That was at a time when perhaps the actions of those at that status of society weren’t really questioned. Well, really that has changed in so many ways, as has so much about that profession. We watch the television at night and we’ll see drug companies advertising miracle cures for everything from impotence through to acne, through to everything in between, and you can imagine the pressure that’s putting on the medical authorities and those that have the ability to make decisions. We have practice nurses. We have practices where the chances of seeing your own doctor when you go—if you can get an appointment—may be some days or weeks away, and often you’re offered the services of a doctor who you may not have met and are unlikely to meet again. These are the sorts of changes that those who only periodically—or some maybe never use medical services. So it is important that any oversight body, or any oversight at all into such professions, is kept modern, that it is kept effective, that it is kept relevant, and that it is reassuring to those who need that reassurance.

When I read this legislation, I see that it makes a lot of sense as we go through the various parts, with one of them being—I sort of focus here on the ability to name a medical practitioner who has perhaps run foul of best practice. I do like to see that it’s very strong and is ensuring we don’t disregard the human rights aspect of it. We ensure that any doctor who is likely to be named will, in fact, receive a fair play, and that the natural rights and natural justice will not be denied to such a person. However, there is the ability that those who are likely to come under the ministrations of that person in the future will actually know that there has been an issue, and that is extremely important.

So, without any further ado, I’ll just sum up by saying that this really is about making sure that the guardians of the profession—a changing profession; a profession that I think New Zealanders are generally very well served by—who are those we put our faith in and those that are overseeing it and ensuring that the changes in practice are relevant and are giving us reassurance and are providing a better service, are overseen. So for that I’ll commend this bill to the House.

Bill read a second time.