Changes to health practitioner status

Important legislative changes have been made that mean suitably qualified health practitioners will be able to carry out some activities that could previously only be done by medical practitioners (doctors).

Eight separate Acts will be amended to recognise new terminology, replacing the term medical practitioner with health practitioner as defined by the Health Practitioners Competence Assurance Act.

The Ministries of Health; Transport; Business, Innovation and Employment; and Social Development are responsible for the affected legislation. Other agencies, including ACC and the New Zealand Police, will also need to implement the changes.  The Ministry of Health consulted with these ministries and other agencies, and will continue to work with them to ensure safe and effective implementation of the changes to the eight Acts.  

These amendments herald historic changes that will enable competent health practitioners to better use their skills for the benefit of the people they work with, the health workforce and the New Zealand health system as a whole.

The aim of the changes is to make health services more flexible and available when people need them. It also acknowledges and makes better use of advanced knowledge and skills in the health workforce

Eight Acts were given the Royal Assent on 7 November 2016. They were the:

The amendment Acts must all commence on 7 November 2018, if not commenced sooner.

What the changes mean

Changes to the various acts increase the range of tasks that can be undertaken by qualified health practitioners, as defined by the Health Practitioners Competence Assurance Act 2003, working in areas covered by each amended Act. Each government agency will ensure the safe implementation of their Act’s changes.

Accident Compensation Act 2001 (MBIE1) – to the extent that health practitioners are willing and able to do so, health practitioners providing treatment to a client will be given the opportunity to participate in the preparation of the client’s individual rehabilitation plans. Suitably qualified health practitioners will also be able to prescribe aids and appliances.

Burial and Cremation Act 1964 (Health) – Nurse practitioners will be able to issue death certificates for patients in their care.

Children, Young Persons, and Their Families Act 1989 (MSD) –  Health practitioners will be able to carry out medical examinations ordered by the court when considering whether children or young people have been abused, if the court considers that these health practitioners are qualified for that purpose. In addition, a social worker will be able to ask for medical examinations to be completed by health practitioners qualified for that purpose.

Holidays Act 2003 (MBIE) – Health practitioners will be able to certify proof of sickness or injury.

Land Transport Act 1998 (Transport) – Health practitioners will be able to request blood tests from drivers and assess and report on their fitness to drive. It will be illegal for someone to refuse a blood test from a health practitioner. Other amendments enable health practitioners to take blood, handle evidential specimens and appear in court to give evidence.

The Medicines Act 1981 (Health) – Will enable nurse practitioners to supervise designated prescribers.

Mental Health (Compulsory Assessment and Treatment) Act 1992 (Health) – Will allow nurse practitioners, or registered nurses working in mental health, to complete a health practitioner certificate for applications for assessment under the Act.

A nurse practitioner will be able to conduct an assessment examination if approved by the Director of Area Mental Health. The Director can delegate this approval to the Director of Area Mental Health Service

Misuse of Drugs Act 1975 (Health) – Will allow nurse practitioners, registered nurses working in addiction services and pharmacist prescribers to prescribe controlled drugs for the purposes of treating addiction.

What is the purpose of the replacement of statutory references work?

The purpose is to improve access to health services by making best use of our qualified health practitioners.  This will also improve health workforce flexibility and sustainability.   Changes will be made across eight Acts amending references to medical practitioners to include health practitioners including nurse practitioners, registered nurses and, in one instance, pharmacist prescribers.

What will it mean for New Zealanders?

People will receive health care in a more timely way because they won’t always have to wait to see a medical practitioner when another suitably qualified health practitioner is available.

For example, suitably qualified registered nurses will be able to issue sick leave certificates, if their employer and the Nursing Council of New Zealand recognise that they are competent and safe to do so.

What will it mean for health practitioners?

In New Zealand health practitioners covered by the Health Practitioners Competence Assurance Act 2003 are regulated by 16 responsible authorities.  Responsible authorities (sometimes known as registration or regulatory authorities) include, for example, the Nursing Council of New Zealand, the New Zealand Physiotherapy Board and the Pharmacy Council.

All registered practising health practitioners in New Zealand are on the public register of the health practitioner’s responsible authority.  If you want to see scopes of practice for individual health practitioners you can find these on public registers.  By replacing the term “medical practitioner” it will mean that where recognised as qualified, other health practitioners will be able to practice using the full range of their skills and will have more autonomy in treating people.

 Health practitioner scopes of practice can be found on the respective responsible authorities’ websites. For example the nurse practitioner and registered nurse scopes of practice and the register of nurses working in different scopes of practice can be found on the Nursing Council of New Zealand website. The website spells out what the scope of practice is for nurse practitioners and registered nurses

What about public safety?

Like medical practitioners, all health practitioners are accountable for their practice and answerable to their responsible authority to demonstrate their competence. For example all registered nurses are regulated by the Nursing Council of New Zealand and all registered medical practitioners by the Medical Council of New Zealand.

If you have specific concerns about the competence or fitness to practice of any health practitioner you can make a complaint to the Health and Disability Commissioner.

Anyone using a health or disability service additionally has the protection of the Code of Health and Disability Services Consumers’ Rights. The Health and Disability Commissioner administers these rights under the Health and Disability Commissioner Act 1994.

The Commissioner can be contacted on 0800 11 22 33.

[1. MBIE is responsible for the Accident Compensation Act but ACC is the agency responsible for operationalizing the Act.]

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