EDITORIAL
Vol. 19 No. 3 November 2003
The Health Practitioners Competence Assurance Act 2003, (HPCA) passed
on 18 September. This passage marked the culmination of a lengthy Government legislative process of over three years involving policy development, consultation and drafting. While the average nurse or user of health services may not notice any immediate difference, the new Act, most of which comes into force on 18 September 2004, significantly changes the regulatory framework which governs nurses’ practice.
The Act replaces the Nurses Act 1977, Nurses Regulations 1986 and Nurses Amendment Act Commencement Order 1996 and eleven other Acts regulating other health professionals. It provides a consistent regulatory framework for all health practitioners. “Nurse” is not specifically defined in the Act itself, although the Act re-defines nurse in a range of other legislation as a health practitioner who is, or is deemed to be, registered with the Nursing Council of New Zealand continued by section 114(1)(a) of the Health Practitioners Competence Assurance Act 2003 as a practitioner of the profession of nursing whose scope of practice permits the performance of general nursing functions.” (Schedules 4, 5 & 6). The referral to health practitioners throughout creates some interesting possibilities including the potential appointment of health practitioners of another profession to the Nursing Council instead of nurses.
The Act provides for mechanisms to ensure that health practitioners are competent and fit to practise their professions. [s3(1)]. These mechanisms include the requirement for the responsible authority to define scopes of practice and the qualifications necessary to practice in the specific scope.
Nursing Council, in collaboration with the nursing profession, has identified three scopes: nurse practitioner, registered nurse and enrolled nurse. The Nursing Council will be collaborating with the nursing sector to develop scope definitions.
The Act increases the focus of the Nursing Council in setting professional standards and competencies and developing ways of ensuring that nurses meet them. The functions specifically refer to setting standards of clinical competence, cultural competence and ethical conduct. [s118(i)].
A major change, affecting nurses, is the introduction of provisions which enable the Council to decline to issue an annual practising certificate if the applicant has, at any time, failed to maintain the required standard of competence, failed to comply with a condition on scope of practice, or not practised within the previous three years. [s27(1)]. The Council must also receive and act on information from health practitioners, employers and the Health and Disability Commissioner about competence of nurses. It can also review the competence of individual nurses at any time.
A major change, and one which has long been sought by midwives, is the full separation of the midwifery and nursing professions with the establishment of a Midwifery Council to regulate midwives. The Midwifery Council will be appointed on 18th December in order to develop scopes of practice and qualifications required and prepare itself to take over the regulatory functions on 18th September 2004. In preparation for this change, Council has decided to issue separate practising certificates for nursing and midwifery from 1 April next year. This means that nurse/ midwives who practise in dual roles will need two practising certificates.
The Act also establishes a multi-disciplinary tribunal to hear charges of professional misconduct. The Tribunal will be chaired by a barrister or solicitor of the High Court of not less than 7 years practice [s86(a)]. Each case will be heard by a panel consisting of the Chair (or deputy), one consumer and three relevant health practitioners drawn from a panel appointed by the Minister. The direct costs of each hearing will be met by
the responsible authority.
While I have provided an outline of some of the changes in the new legislation, there are many others. All nurses and employers would be strongly advised to study the Health Practitioners Competence Assurance Act and consider information both on its website: www.nursingcouncil.org.nz and in newsletters.
Marion Clark, RN, BA, MPP, FCNA(NZ)
Chief Executive
Nursing Council of New Zealand
