Medical Council supports public safety focus in new Bill

The Medical Council is overall in favour of the Health Practitioners Competence Assurance Bill and believes it will be good for patient safety, said the President of the Medical Council, Professor John Campbell. The Medical Council appeared before Parliament’s Health Select Committee today.

“We’re right behind the Bill’s principles – the purpose to protect the public; the focus on continuing education and high standards; the power to review competence of practitioners and the hearing of discipline cases by a separate Tribunal”, he said.

The Council also supported “scopes of practice”, enabling registration of all health practitioners based on their proven skills and abilities.

But he raised one concern in particular, that quality assurance activities designed to improve patient safety would be undermined.

As the moment, some cases of harm to patients listed in the Bill cannot be reviewed in quality assurance activities carried out by health practitioners. This defeated the purpose of the activity to encourage open discussions of unexpected and unwanted outcomes, Professor Campbell said.

“Information in a quality assurance activity is “protected” from use in disciplinary or other cases. Quite understandably, the Bill does not want to create a situation where something that might become a complaint to the Health and Disability Commissioner cannot proceed because it is part of a quality assurance activity. But we must stress that quality assurance does not stop a complaint from proceeding. The Commissioner is still able to investigate all the original information giving rise to a complaint and interview health practitioners; he is simply restricted from accessing any notes from a quality assurance activity”.

Professor Campbell, public member Carolynn Bull and Chief Executive Sue Ineson submitted on several other points in the Bill:

Public members – these members should not be representing consumer groups, but, like other Council members, be independent of interest groups. It was also too restrictive to exclude public members with qualifications in other health areas;

Communication in English – practitioners must be able to communicate effectively in English. The current wording of the Bill to comprehend English was a lowering of the standard that could endanger patients;

Reporting poor practice – the Council supported the Bill’s provision for peer reporting of possible harm to patients without a mandatory requirement. However reporting by employers and by ACC of all cases of medical error and mishap should be mandatory, the Council argued, to be in line with the recent Cull report on adverse event reporting;

Complaints Investigation Committees – specifying a timelime, for example, 14 days to appoint a committee was not realistic in the case of the medical profession, but six-monthly reviews of progress should be legislated and appeals should be possible to the District Court to strengthen accountability for committees’ decisions.

Powers of suspension - the Bill should be changed so that an authority can suspend a practitioner immediately, when warranted, on health or competence grounds, without first hearing submissions from the practitioner. But submissions should be heard as soon as possible after the decision to suspend; Disciplinary charges – the Council preferred to keep the current three levels of charges in the Medical Practitioners Act. The Bill should be changed to allow the Tribunal to take previous disciplinary matters into account when determining penalty, and to allow the option of removal from the register for any level of charge;

Proposed appointment of all members of an authority – the Council wanted to retain the right to elect a proportion of its members – currently four of the ten members are elected. Elections were traditionally a part of self-regulation that encouraged allegiance to the Council’s purpose and the legislation;

Tribunal membership – the Bill should be changed back to allow a majority of peers, not public members, sitting on disciplinary cases. This would better reflect the self-regulatory purpose of the Bill. The recommended composition was three practitioners, one public member and a legal chair.

Today was the last day of hearing public submissions. The Council understands that the committee is due to report back to the House in mid-April.

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