Latest news with #HealthPractitionersCompetenceAssuranceAct2003
Scoop
23-05-2025
- Health
- Scoop
'I Can Confirm They Are Hypotheticals Drawn Largely From Anecdotes And Issues The Minister Has Heard About.'
Ian Powell discusses when health professions regulatory authorities policy is shaped by second hand anecdotes and issues. Before reading further hold on to the words in my heading above. Then consider who said, 'I can confirm they are hypotheticals drawn largely from anecdotes and issues the minister has heard about'. Further, who did the comment refer to, what was its context and meaning, and what is the significance of this meaning? The context is a review of the regulatory health professions presently being undertaken by the Ministry of Health for Health Minister Simeon Brown. However, the ideological origin of the review is the coalition Government agreement between the National and Act parties. Regulation of health professions is covered by the Health Practitioners Competence Assurance Act 2003. Its overriding purpose was to provide a framework for the regulation of health practitioners to protect the public where there is a risk of harm from professional practice. The Act included the requirement for scopes of practice for each of the regulated occupations. Eighteen regulatory authorities cover 26 professions. The authorities that cover the largest professions are the Medical and Nursing Councils. Health Ministry discussion document As part of the review the health ministry published a discussion document under the misleading 'milk and honey' title of 'Putting Patients First: Modernising health regulation'. But drill down further and a more sinister picture emerges. My drilling down was recently published by Newsroom (24 April): Threatening political meddling in health regulatory authorities. My main points about this discussion document were: It is based on a false construct that too much regulatory 'red tape' was making it more difficult to ensuring that New Zealanders 'have access to timely, quality healthcare'. There was a complete absence of evidence to justify its contentions. In fact, contentions were contradicted by evidence. It is ideologically loaded and weak arguing by insinuations and with an obviously pre-determined outcome in mind. It raised several questionable scenarios to justify regulatory change that could, in fact, be resolved within the existing system (discussed further below). The biggest threat implicit in the document was political interference in the functioning of the regulatory authorities thereby weaking their responsibility to protect the public from harm. The risks for patients being diagnosed and treated by the medical profession was succinctly outlined by the Chair of the Medical Council, Dr Rachelle Love (a Christchurch head and neck surgeon) on Radio New Zealand's Nine to Noon programme (8 May): Increased political control risk. In rebutting the claims of the Ministry's discussion document, Dr Love said that what it proposed risked leading to increased political control. Instead, the real issue was the retention of doctors which was ignored by the Ministry. General practitioners don't pull their punches Steve Forbes in a paywalled article published by NZ Doctor (17 April) reported Dr Angus Chambers, general practitioner and Chair of the General Practices Owners Association (GenPro) concerns. The latter was at his forthright best. He described the consultation practice for the Health Ministry's discussion document as poorly designed and amounted to a consultation process with a preordained outcome. If implemented, it would lower both standards of care and clinical safety guidelines. Dr Chambers assessed the process as being 'completely cynical' adding, as reported by Forbes, that: There are good reasons for the different specialised regulatory authorities to oversee various health professionals, he says. But he is concerned the consultation paper is designed to get a 'quick-fix response from the public'. Further: Opening the floodgates to new, less-qualified health professionals, such as physician associates, to plug workforce gaps isn't the solution, Dr Chambers says. 'If we had enough GPs, we wouldn't need these additional professions.' General practitioner and Chair of Women in Medicine Dr Orna McGinn also questioned the credibility of the process in her LinkedIn page: The document presents a case to further politicise the health landscape via deregulation and undermining of commitments to uphold Te Tiriti o Waitangi and thereby address inequities in health access and outcomes. We note that two government statements concerning practitioner scope and regulation were published before closure of the consultation period. This raises doubts as to the validity and legality of the process. Scenarios scam The dubious use of the above-mentioned scenarios in the Ministry of Health's discussion document to justify the 'preordained outcome' highlighted by Dr Chambers unsurprisingly attracted strong and angry responses. No wonder than NZ Nurses Organisation Chief Executive Paul Goulter called it poor quality and that it should be withdrawn. The scenarios led to the Association of Salaried Medical Specialists (ASMS) formally complain to both the Public Services Commissioner and Director-General of Health over their use. Two of the scenarios claimed that podiatrists being unable to prescribe some feet medicines and approval for new occupational groups, such as physician associates, were being obstructed by the existing regulatory system. Soon after the Health Ministry released its discussion document, approval for both issues occurred. The former made sense while the latter (which was a ministerial decision) did not. But both demonstrated that working through the existing regulatory system led to the sought outcomes. ASMS meanwhile also pursued the scenarios controversy with the Health Ministry under the Official Information Act. The response from a Ministry official to ASMS, as reported in another paywalled Forbes article (6 May) was: I can confirm they are hypotheticals drawn largely from anecdotes and issues the minister has heard about. The answers to my opening questions The official's response reinforces what many suspected. The Ministry's discussion document was largely written from within Health Minister's office. A feature of his office is the absence of health system experience understanding, including about the intent of the Health Practitioners Competence Assurance Act discussed above, is poor. Returning to my above opening questions, the Health Ministry made the comment, and it was referring to their health minister Simeon Brown. The context was a false construct that the health professions regulatory authorities were contributing to the health workforce crisis. The meaning was that political involvement was required even though this poses serious risks to the authorities prime legislative responsibility to protect the public from harm. As for the significance of its meaning it highlights the serious risks of harm to the health and wellbeing of the public (and to health professionals) when decision-making is ideologically driven and designed by those with at best minimal health system experience. No wonder, as I observed in my above-mentioned Newsroom article, the failure of the discussion document's authors was not being able to make a silk purse out of a sow's ear. They should have listened to Jonathan Swift. Given the ideological origin and consequential high level of predetermination they never had even a dog's chance.
Scoop
23-05-2025
- Health
- Scoop
'I Can Confirm They Are Hypotheticals Drawn Largely From Anecdotes And Issues The Minister Has Heard About.'
Before reading further hold on to the words in my heading above. Then consider who said, 'I can confirm they are hypotheticals drawn largely from anecdotes and issues the minister has heard about'. Further, who did the comment refer to, what was its context and meaning, and what is the significance of this meaning? The context is a review of the regulatory health professions presently being undertaken by the Ministry of Health for Health Minister Simeon Brown. However, the ideological origin of the review is the coalition Government agreement between the National and Act parties. Regulation of health professions is covered by the Health Practitioners Competence Assurance Act 2003. Its overriding purpose was to provide a framework for the regulation of health practitioners to protect the public where there is a risk of harm from professional practice. The Act included the requirement for scopes of practice for each of the regulated occupations. Eighteen regulatory authorities cover 26 professions. The authorities that cover the largest professions are the Medical and Nursing Councils. Health Ministry discussion document As part of the review the health ministry published a discussion document under the misleading 'milk and honey' title of 'Putting Patients First: Modernising health regulation'. But drill down further and a more sinister picture emerges. My drilling down was recently published by Newsroom (24 April): Threatening political meddling in health regulatory authorities. My main points about this discussion document were: It is based on a false construct that too much regulatory 'red tape' was making it more difficult to ensuring that New Zealanders 'have access to timely, quality healthcare'. There was a complete absence of evidence to justify its contentions. In fact, contentions were contradicted by evidence. It is ideologically loaded and weak arguing by insinuations and with an obviously pre-determined outcome in mind. It raised several questionable scenarios to justify regulatory change that could, in fact, be resolved within the existing system (discussed further below). The biggest threat implicit in the document was political interference in the functioning of the regulatory authorities thereby weaking their responsibility to protect the public from harm. The risks for patients being diagnosed and treated by the medical profession was succinctly outlined by the Chair of the Medical Council, Dr Rachelle Love (a Christchurch head and neck surgeon) on Radio New Zealand's Nine to Noon programme (8 May): Increased political control risk. In rebutting the claims of the Ministry's discussion document, Dr Love said that what it proposed risked leading to increased political control. Instead, the real issue was the retention of doctors which was ignored by the Ministry. General practitioners don't pull their punches Steve Forbes in a paywalled article published by NZ Doctor (17 April) reported Dr Angus Chambers, general practitioner and Chair of the General Practices Owners Association (GenPro) concerns. The latter was at his forthright best. He described the consultation practice for the Health Ministry's discussion document as poorly designed and amounted to a consultation process with a preordained outcome. If implemented, it would lower both standards of care and clinical safety guidelines. Dr Chambers assessed the process as being 'completely cynical' adding, as reported by Forbes, that: There are good reasons for the different specialised regulatory authorities to oversee various health professionals, he says. But he is concerned the consultation paper is designed to get a 'quick-fix response from the public'. Further: Opening the floodgates to new, less-qualified health professionals, such as physician associates, to plug workforce gaps isn't the solution, Dr Chambers says. 'If we had enough GPs, we wouldn't need these additional professions.' General practitioner and Chair of Women in Medicine Dr Orna McGinn also questioned the credibility of the process in her LinkedIn page: The document presents a case to further politicise the health landscape via deregulation and undermining of commitments to uphold Te Tiriti o Waitangi and thereby address inequities in health access and outcomes. We note that two government statements concerning practitioner scope and regulation were published before closure of the consultation period. This raises doubts as to the validity and legality of the process. Scenarios scam The dubious use of the above-mentioned scenarios in the Ministry of Health's discussion document to justify the 'preordained outcome' highlighted by Dr Chambers unsurprisingly attracted strong and angry responses. No wonder than NZ Nurses Organisation Chief Executive Paul Goulter called it poor quality and that it should be withdrawn. The scenarios led to the Association of Salaried Medical Specialists (ASMS) formally complain to both the Public Services Commissioner and Director-General of Health over their use. Two of the scenarios claimed that podiatrists being unable to prescribe some feet medicines and approval for new occupational groups, such as physician associates, were being obstructed by the existing regulatory system. Soon after the Health Ministry released its discussion document, approval for both issues occurred. The former made sense while the latter (which was a ministerial decision) did not. But both demonstrated that working through the existing regulatory system led to the sought outcomes. ASMS meanwhile also pursued the scenarios controversy with the Health Ministry under the Official Information Act. The response from a Ministry official to ASMS, as reported in another paywalled Forbes article (6 May) was: I can confirm they are hypotheticals drawn largely from anecdotes and issues the minister has heard about. The answers to my opening questions The official's response reinforces what many suspected. The Ministry's discussion document was largely written from within Health Minister's office. A feature of his office is the absence of health system experience understanding, including about the intent of the Health Practitioners Competence Assurance Act discussed above, is poor. Returning to my above opening questions, the Health Ministry made the comment, and it was referring to their health minister Simeon Brown. The context was a false construct that the health professions regulatory authorities were contributing to the health workforce crisis. The meaning was that political involvement was required even though this poses serious risks to the authorities prime legislative responsibility to protect the public from harm. As for the significance of its meaning it highlights the serious risks of harm to the health and wellbeing of the public (and to health professionals) when decision-making is ideologically driven and designed by those with at best minimal health system experience. No wonder, as I observed in my above-mentioned Newsroom article, the failure of the discussion document's authors was not being able to make a silk purse out of a sow's ear. They should have listened to Jonathan Swift. Given the ideological origin and consequential high level of predetermination they never had even a dog's chance.
Scoop
29-04-2025
- Health
- Scoop
Medical Council To Regulate The Physician Associate Profession
Press Release – Medical Council of New Zealand Councils focus will be on setting clear and appropriate standards for PAs working in Aotearoa New Zealand, to ensure public safety. Regulation will provide clarity for patients, PAs, and doctors about the role and expectations of PAs within our … The Minister of Health, Hon Simeon Brown, has announced that Physician Associates (PAs) will become a regulated health profession under the Health Practitioners Competence Assurance Act 2003 (HPCA Act). Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand (Medical Council) will be the responsible authority (regulator) for the profession. PAs are a distinct health profession who work in collaboration with doctors as part of the wider healthcare team. They support the delivery of medical care under the supervision of doctors. Around 50 PAs are currently understood to be working in New Zealand. Originally developed in the United States, the PA profession is now established and regulated in several countries, including Canada and the United Kingdom. Health New Zealand | Te Whatu Ora is contributing funding towards the establishment phase of PA regulation, over an initial two-year period. The Medical Council will meet with Health NZ shortly to formalise and discuss the transition of funding arrangements. Council is committed to maintaining clear and transparent financial reporting, ensuring confidence from the medical profession, the PA profession, and the public. Following the completion of the Health NZ funding, and to the extent not covered by the Health NZ, funding the costs of regulating PAs will be recovered from the PA profession itself. There will be no cross-subsidisation between professions, and no cost burden on registered doctors. Dr Rachelle Love, Chair | Tumuaki of the Medical Council, said: 'Council's focus will be on setting clear and appropriate standards for PAs working in Aotearoa New Zealand, to ensure public safety. Regulation will provide clarity for patients, PAs, and doctors about the role and expectations of PAs within our healthcare system.' The Medical Council will now develop a regulatory framework for the profession. This includes defining scopes of practice, setting competence and ethical standards, and establishing registration requirements, including qualifications needed for registration. Regulation is being introduced to help ensure public safety and support consistent standards across the profession. The Medical Council will consult with the public, the medical and physician associate professions, and other stakeholders (including other health professions) as it develops the regulatory settings. Information, including updates on consultation, will be available on the Council's website:
Scoop
29-04-2025
- Health
- Scoop
Medical Council To Regulate The Physician Associate Profession
The Minister of Health, Hon Simeon Brown, has announced that Physician Associates (PAs) will become a regulated health profession under the Health Practitioners Competence Assurance Act 2003 (HPCA Act). Te Kaunihera Rata o Aotearoa | Medical Council of New Zealand (Medical Council) will be the responsible authority (regulator) for the profession. PAs are a distinct health profession who work in collaboration with doctors as part of the wider healthcare team. They support the delivery of medical care under the supervision of doctors. Around 50 PAs are currently understood to be working in New Zealand. Originally developed in the United States, the PA profession is now established and regulated in several countries, including Canada and the United Kingdom. Health New Zealand | Te Whatu Ora is contributing funding towards the establishment phase of PA regulation, over an initial two-year period. The Medical Council will meet with Health NZ shortly to formalise and discuss the transition of funding arrangements. Council is committed to maintaining clear and transparent financial reporting, ensuring confidence from the medical profession, the PA profession, and the public. Following the completion of the Health NZ funding, and to the extent not covered by the Health NZ, funding the costs of regulating PAs will be recovered from the PA profession itself. There will be no cross-subsidisation between professions, and no cost burden on registered doctors. Dr Rachelle Love, Chair | Tumuaki of the Medical Council, said: "Council's focus will be on setting clear and appropriate standards for PAs working in Aotearoa New Zealand, to ensure public safety. Regulation will provide clarity for patients, PAs, and doctors about the role and expectations of PAs within our healthcare system." The Medical Council will now develop a regulatory framework for the profession. This includes defining scopes of practice, setting competence and ethical standards, and establishing registration requirements, including qualifications needed for registration. Regulation is being introduced to help ensure public safety and support consistent standards across the profession. The Medical Council will consult with the public, the medical and physician associate professions, and other stakeholders (including other health professions) as it develops the regulatory settings.
Otago Daily Times
28-04-2025
- Health
- Otago Daily Times
Physician associate regulations lauded by Metzler
The government's decision to regulate physician associates (PAs), has been described as "a watershed moment for the New Zealand health sector" by a Gore doctor. At the weekend, Health Minister Simeon Brown announced Cabinet had signed off the move to regulate PAs. PAs are overseas-trained health professionals who can evaluate, diagnose, and treat patients under the supervision of a doctor. They work in a range of health settings in New Zealand, including general practice and hospitals, assisting with both clinical and administrative tasks to ensure patient needs are met. At present, there are about 50 PAs spread across 29 clinics throughout New Zealand, who work in the same scope of care as their supervising doctors. Mr Brown said regulating physician associates under the Health Practitioners Competence Assurance Act 2003, demonstrated the government's dedication to patient safety and providing high quality care. "By regulating physician associates, they will be required to meet clear standards that are appropriate for the New Zealand health system, including training, supervision, and ongoing professional development." It would also promote and offer assurance of the public confidence in the PA profession. Gore Health chief executive officer Mr Karl Metzler said he and other health professionals across the country had been advocating for this critical profession to be recognised and valued through formal regulation, for the past 12 years. "It is truly a watershed moment for the New Zealand health sector. "I think there's just a massive sense of relief. "I liken it to going through some kind of complicated labour for 12 years and birthing something quite remarkable. "It's a proud moment for me." Mr Metzler said in time people would see the enormous benefit that the PA workforce had to offer. "Kiwis' access to healthcare and better healthcare is going to be improved — I have no doubt, I don't think I'm being naive in saying that." He estimated there were about a dozen PAs working across Otago and Southland at present, and that number was expected to grow significantly. "This is a circuit breaker for rural health and hard-to-staff areas in rural New Zealand. "It will make a huge difference to our healthcare system. "It's gonna come down to immigration and medical council processing their applications." He said if he advertised for a GP in Gore, he would often not get a single applicant. "But if I advertise for a PA, I'll get at least 20 applications. "And particularly in the Trump era, we're getting a lot of democratically-minded interest out of the United States now, and these guys are highly trained and highly skilled." He hoped it would eventually mean PAs would be able to work on their own unsupervised, but initially, for the sake of public safety, doctors would feel a lot happier having oversight and supervision of them. Mr Metzler said Gore Health had employed PAs since 2012 and they would not have been able to maintain the 24/7 emergency department without them. PAs provided critical support to doctors, helped reduce patient wait times and access to healthcare in under-served areas. Their presence had also reduced the load on doctors, consequently reducing burnout and retention issues. "It's so exciting that the sector is finally going to get to truly appreciate and embrace the skills PAs bring to the table."
