Important legislative changes have been made that mean suitably qualified health practitioners will shortly be able to carry out some activities that could previously only be done by medical practitioners (doctors).
Eight separate amendment Acts apply new terminology, replacing the term medical practitioner with health practitioner as defined by the Health Practitioners Competence Assurance Act 2003.
The aim of the changes is to recognise the advanced knowledge and skills in the wider health workforce which will improve access to services. The amendments will enable competent health practitioners to better use their skills for the benefit of the people they care for, colleagues and the health system as a whole.
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. Each government agency will ensure the safe implementation of their Act’s changes.
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, working in areas covered by each amended Act.
The eight Acts were given the Royal Assent on 7 November 2016. They were the:
- Accident Compensation Amendment Act 2016
- Burial and Cremation Amendment Act 2016
- Children, Young Persons, and Their Families Amendment Act (No 2) 2016
- Holidays Amendment Act 2016
- Medicines Amendment Act 2016
- Mental Health (Compulsory Assessment and Treatment) Amendment Act 2016
- Misuse of Drugs Amendment Act 2016
- Land Transport Amendment Act 2016
Seven of the amendment Acts will commence on 31 January 2018 and the Transport Amendment Act will commence on 8 November 2018.
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.
Oranga Tamariki Act 1989 (MSD) (formerly the Children, Young Persons, and Their Families Act 1989) – 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.
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.
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 across eight Acts amend references to medical practitioners to include health practitioners including nurse practitioners, registered nurses and, in one instance, pharmacist prescribers.
What it will mean for New Zealanders
By replacing the term 'medical practitioner', other health practitioners who are suitably qualified will be able to use the full range of their skills and training in treating people.
This will improve access to services because people 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.
In New Zealand all health practitioners, like medical practitioners, are accountable for their professional practice. Health practitioners covered by the Health Practitioners Competence Assurance Act are regulated by 16 responsible authorities, sometimes known as registration or regulatory authorities.
They include, for example, the Nursing Council of New Zealand which regulates all registered nurses, the New Zealand Physiotherapy Board which regulates physiotherapy, the Pharmacy Council with responsibility for pharmacist registration and the Medical Council of New Zealand which regulates registered doctors.
These bodies are accountable for ensuring the standards, safety and fitness to practice of qualified health practitioners within their remit. All registered practising health practitioners in New Zealand are listed on the public register of the health practitioner’s responsible authority.
Health practitioner scopes of practice are set out on the respective responsible authorities’ websites. For example the nurse practitioner (advanced qualifications, knowledge and skills) 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. Scopes of practice for named individual health practitioner can also be found on the public registers.
- Nurse practitioner scope of practice - Nursing Council website
- Registered nurse scope of practice - Nursing Council website
- Pharmacist prescriber scope of practice - Pharmacy Council website
If there are 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 freephone 0800 11 22 33.
[1. MBIE is responsible for the Accident Compensation Act but ACC is the agency responsible for operationalizing the Act.]