EDITORIAL
Vol. 20 No. July 2
The Health Practitioners Competence Assurance Act 2003 (HPCAA) becomes fully effective on September 18 of this year. It aims to protect the public by ensuring that health professionals who are practising, are fully competent to do so. It is anticipated that as a result of this Act, the public will have increased confidence in health professionals. Regulatory authorities are preparing for the September deadline. I thank Nursing Praxis in New Zealand for the privilege to write about this transition phase.
The Midwifery Council is a new regulatory authority formed under the HPCAA. Members were appointed in December 2003 and we had our first meeting in February of this year. This is a long awaited and significant milestone in the development of midwifery in New Zealand. It is consistent with, and builds on, legislation such as the 1990 Amendment to the Nurses Act 1977 which allows midwives to care for women on their own responsibility, and the Maternity Notice pursuant to Section 88 of the Health and Disability Act 2000 recognising midwives as autonomous providers of primary maternity services. The Midwifery Council has to perform the same functions as other regulatory bodies.
With a much smaller workforce than nursing we do not have economies of scale. Consequently a separate Council comes at a cost to midwives through the annual practising certificate fee, which is the Council’s only income.
Nurses and midwives have been regulated by the Nursing Council of New Zealand for over 70 years and our position within this changing legislative environment is different from other health professions because we are the only groups experiencing a ‘separation’. Some nurses and midwives, who hold dual registration have expressed their concerns about what this ‘separation’ may mean for them. The situation needs to be put into perspective.
Most of us practise in a single discipline. The fact that we have always had both registrations printed on our annual practising certificate has been a requirement under the Nurses Act and has made little practical difference to an individual’s choice. This choice does not change under the new legislation. What does change, are the expectations that the public can have with respect to the practice of any nurse or midwife.
We all, midwife or nurse, need to become comfortable with accountability by demonstrating that we are competent in what we do. The reality at present is that there are still some unknowns about how competence will need to be demonstrated. The Nursing and Midwifery Councils are responsible for ensuring this happens at the point when practitioners apply for their annual practising certificate. We are yet to finalise these decisions that will impact on individuals, employers and education institutions, but more importantly on people in our care.
I believe that the majority of nurses and midwives are competent and the HPCAA enables the Councils to capture those whose practice needs to be upgraded. The new legislation is an opportunity for regulatory authorities to work more closely with education programmes and employers to develop consistency around the scope of practice of a nurse or midwife and the competency expected of each. By doing this, they will allow the public to have more clarity and understanding about what we do or should do.
Hope Tupara
RCpN, RM, MA
Hope Tupara is of Ngai Tamanuhiri and Ngai Te Rangihouhiri descent.
She is a lecturer (0.5) in the Bachelor of Midwifery programme at Massey
University, Palmerston North campus, and continues to practise as a
locum midwife in the Horowhenua region. Hope resigned from the
Nursing Council early this year following her appointment to the
Midwifery Council.
