Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill

Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill

Government Bill

36—2

As reported from the Health Committee

Commentary

Recommendation

The Health Committee has examined the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill and recommends that it be passed with the amendments shown.

Introduction

The Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill as introduced is an omnibus bill that seeks to amend seven Acts. It aims to increase the range of functions that can be performed under those Acts by “health practitioners”, which is a term that describes a larger group of persons than medical practitioners. Therefore, the bill would change certain references to medical practitioners to references to health practitioners.

The four major objectives of the bill are to

  • allow health practitioners with the required competencies and knowledge to perform more statutory functions

  • make it easier for the public to access statutory health services

  • allow the health workforce to use their knowledge and skills

  • facilitate innovative services and efficient practice.

The bill as introduced is in seven parts. Each part relates to one of the seven Acts being amended. The Acts are the

  • Accident Compensation Act 2001

  • Burial and Cremation Act 1964

  • Children, Young Persons, and Their Families Act 1989

  • Holidays Act 2003

  • Land Transport Act 1998

  • Mental Health (Compulsory Assessment and Treatment) Act 1992

  • Misuse of Drugs Act 1975.

This commentary covers the main amendments that we recommend to the bill. It does not cover minor or technical amendments.

Amendments to the Accident Compensation Act 2001

Rehabilitation plans

Clause 4 of the bill would amend Schedule 1 (which details entitlements, including rehabilitation plans) of the Accident Compensation Act.

We recommend amending clause 4(1) of the bill by inserting new paragraph (c) into clause 7(3) of Schedule 1. This would add “any health practitioner providing treatment to the claimant” to the list of people to be given the opportunity to participate in preparing and costing a claimant’s rehabilitation plan.

This amendment could be of benefit to a claimant if other health practitioners were involved in their ongoing treatment than those already prescribed in clause 7(3).

As a consequence of inserting new paragraph (c) we recommend inserting new paragraph (d). This would retain the existing reference to “any employer or potential employer” in section 7(3) of Schedule 1, but move it from paragraph (c) to paragraph (d).

Burial and Cremation Act 1964

We propose no changes to the bill as introduced regarding the Burial and Cremation Act 1964. The Ministry of Health assured us that it would review the amendments to the Act in practice.

Amendments to the Children, Young Persons and Their Families Act 1989

Replacing “psychiatric hospital” with “hospital”

We recommend deleting references to “psychiatric hospital”, because the term is no longer used, and replacing them with “hospital”. This would have the same meaning as in section 2(1) of the Mental Health (Compulsory Assessment and Treatment) Act 1992. This recommendation would be implemented in the amendments to clauses 15 and 23, and by the insertion of new clause 23A.

Medical examination of child or young person

We recommend amending clause 19(1) and (2) by deleting from section 53(2) and (3) of the Act the words “whom the social worker considers”. Section 53 would then provide that a social worker can arrange for a child or young person to be medically examined by a health practitioner who is qualified for the purpose, rather than a health practitioner whom the social worker considers is qualified for the purpose.

Amendments to the Land Transport Act 1998

Replacing “doctor’s surgery” and “surgery” with “medical centre”

We recommend replacing the term “doctor’s surgery” with the more commonly used term “medical centre”.

Therefore, we recommend amending clauses 27, 31A to 33, and clause 35. This would replace references to “doctor’s surgery” or “surgery” in sections 2, 68, 69, 72, 73, and 75 of the Act with “medical centre”.

New Part 5A—Amendments to the Medicines Act 1981

We recommend inserting new Part 5A, clauses 42A, 42B, and 42C to the bill. This would amend sections 2 and 105B of the Medicines Act and permit nurse practitioners to supervise designated prescribers. That is, we are proposing that the bill amend an eighth Act, in addition to the seven affected by the bill as introduced.

Definition of “nurse practitioner”

For clarification and continued consistency between legislation, we recommend inserting a new definition for the term “nurse practitioner”.

Therefore, we recommend replacing the definition of “nurse practitioner” in new clause 42B, which would amend section 2(1) of the Act. The new definition would specify that a “nurse practitioner” means a health practitioner who:

  • is, or is deemed to be, registered with the Nursing Council of New Zealand under the Health Practitioners Competence Assurance Act 2003 as a nurse whose scope of practice permits the performance of nurse practitioner functions; and

  • holds a current practising certificate.

Regulations relating to designated prescribers

Section 105 of the Medicines Act relates to regulation-making provisions.

We recommend inserting new clause 42C which would amend the regulation-making powers relating to designated prescribers in section 105B(1)(d) of the Act. This amendment would permit nurse practitioners, as well as medical practitioners and dentists, to supervise designated prescribers who prescribe prescription medicines.

Amendments to the Mental Health (Compulsory Assessment and Treatment) Act 1992

Clause 44 of the bill would insert definitions of “health practitioner” and “primary health care provider” into section 2 of the Mental Health (Compulsory Assessment and Treatment) Act.

Definition of “nurse practitioner”

We recommend amending clause 44 of the bill to insert the definition of “nurse practitioner” (as described above as an amendment to the Medicines Act in new clause 42B) in section 2(1) of the Act.

The amendment would be consistent with the definition of a “nurse practitioner” in the legislation amended in the bill. It would also provide consistency within the Act itself, because section 2(1) includes definitions of other practitioners named in the Act.

Certificate to accompany application for assessment

We recommend inserting new clause 44C which would amend section 8B of the Act. This would allow a health practitioner, who is a medical practitioner, nurse practitioner, or registered nurse practising in mental health, to issue a certificate to accompany an application for assessment. Currently, only a medical practitioner can issue these certificates.

Assessment examination to be arranged and conducted

We recommend inserting new clause 44D which would amend section 9 of the Act.

New clause 44D(2) amends section 9(3) and (4) of the Act. Currently section 9(3)(b) provides that if a psychiatrist approved by the Director of Area Mental Health Services is not available to conduct an assessment examination then the examination may be conducted by a medical practitioner who the Director of Area Mental Health Services considers qualified. New section 9(3)(b) would amend this provision so that an assessment examination may be carried out either by a medical practitioner or nurse practitioner who the Director of Mental Health considers qualified. New section 9(4) would provide that the Director of Mental Health may delegate his or her function to the Director of Area Mental Health Services.

As a consequence of this we recommend inserting new clause 50A which would amend section 91(4) of the Act in relation to the delegation powers of the Director of Mental Health.

Amendments to the Misuse of Drugs Act 1975

Definition of “nurse” and “nurse practitioner”

We recommend inserting new clause 52A, which would insert the definitions of “registered nurse” and “nurse practitioner” in section 2(1) of the Act.

Prescribing controlled drugs to people dependent on controlled drugs

We recommend amending clause 55 of the bill to insert the words “and designated pharmacist” in the heading of new section 24 and “or designated pharmacist” in new sections 24A(2) and (3) of the Act. This would allow designated prescriber pharmacists, in certain circumstances, to be able to prescribe controlled drugs when treating a person for drug dependency.

We also recommend that clause 55 provide for the insertion of new section 24A(7A). This amendment would require a specified medical practitioner, when authorising a nurse practitioner, designated prescriber nurse, or designated prescriber pharmacist to prescribe controlled drugs, to comply with any applicable guidelines issued by the Director‐General of Health.

For further clarity we recommend that clause 55 of the bill insert a definition of “designated prescriber pharmacist” into new section 24A(9) of the Act.

Appendix

Committee process

The Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill was referred to the committee on 19 August 2015. The closing date for submissions was 7 October 2015. We received and considered 28 submissions from interested groups and individuals. We heard 10 oral submissions.

We received advice from the Ministry of Health.

Committee membership

Simon O’Connor (Chairperson)

Jacqui Dean

Kevin Hague

Hon Annette King

Barbara Kuriger

Dr Shane Reti

Scott Simpson

Barbara Stewart

Poto Williams

Key to symbols used

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Hover your cursor over an amendment for information about that amendment. Download the PDF version to see this information in a form that can be printed out.

Hon Dr Jonathan Coleman

Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill

Government Bill

36—2

Contents

Commentary
Key
1Title
2Commencement
3Principal Act
4Schedule 1 amended
5Principal Act
6Section 2 amended (Interpretation)
7Section 46AA replaced (Doctor’s certificate or coroner’s authorisation required before body disposed of)
46AACertificate of cause of death or coroner’s authorisation required before body disposed of
8Section 46A amended (Stillborn children)
9Section 46B replaced (Doctor’s certificate in relation to illness)
46BCertificate of cause of death in relation to illness
10Section 46C replaced (Doctor’s certificate in relation to accidents to elderly persons)
46CCertificate of cause of death in relation to accidents to persons aged 70 years or more
11Section 46F amended (Transfer of charge of body)
12Section 54AA amended (Offences concerning doctor’s certificate or certificate relating to stillbirth)
13Consequential amendments
14Principal Act
15Section 2 amended (Interpretation)
16Section 12 amended (Duty of medical practitioner to minimise distress to child or young person)
17Section 49 amended (Court may order medical examination of child or young person)
18Section 52 amended (Medical practitioner to prepare report on examination)
19Section 53 amended (Medical examination of child or young person at request of social worker)
20Section 55 amended (Restrictions on internal examinations and examinations under general anaesthetic)
21Section 56 amended (Medical practitioner to prepare report on examination)
22Section 179 amended (Further provisions relating to medical, psychiatric, and psychological examinations)
23Section 181 amended (Court may order examination to be carried out in psychiatric hospital)
23ASection 182 amended (Release of child or young person from psychiatric hospital where detention no longer required)
24Principal Act
25Section 68 amended (Proof of sickness or injury)
26Principal Act
27Section 2 amended (Interpretation)
28Section 13 amended (Drivers and other road users to comply with directions of enforcement officers, etc)
29Section 18 amended (Doctors and optometrists to give Agency medical reports of persons unfit to drive)
30Section 60 amended (Failure or refusal to permit blood specimen to be taken or to undergo compulsory impairment test)
31Section 64 amended (Defences)
31ASection 68 amended (Who must undergo breath screening test)
31BSection 69 amended (Who must undergo evidential breath test)
32Section 72 amended (Who must give blood specimen at places other than hospital or surgery)
33Section 73 amended (Who must give blood specimen in hospital or surgery)
34Section 74 amended (Procedure for dealing with blood specimens)
35Section 75 amended (Certificates in blood-alcohol proceedings)
36Section 76 amended (Presumptions relating to blood specimens)
37Section 79 amended (Circumstances in which certificate not admissible in proceedings)
38Section 99 amended (Court may reduce disqualification)
39Section 100 amended (Agency to remove certain disqualifications)
40Section 100A amended (Agency to remove alcohol interlock requirements)
41Section 209 (Taking of blood specimens for statistical or research purposes)
42Consequential amendments
42APrincipal Act
42BSection 2 amended (Interpretation)
42CSection 105B amended (Regulations relating to designated prescribers)
43Principal Act
44Section 2 amended (Interpretation)
44ASection 2A amended (Meaning of proposed patient)
44BSection 7A amended (Medical practitioner or responsible clinician to consult)
44CSection 8B amended (Medical practitioner’s certificate to accompany application for assessment)
44DSection 9 amended (Assessment examination to be arranged and conducted)
45Section 10 amended (Certificate of preliminary assessment)
45ASection 11 amended (Further assessment and treatment for 5 days)
46Section 12 amended (Certificate of further assessment)
47Section 14A amended (Documents relating to application for compulsory treatment order)
48Section 29 amended (Community treatment orders)
49Section 76 amended (Clinical reviews of persons subject to compulsory treatment orders)
50Section 79 amended (Tribunal reviews of persons subject to compulsory treatment orders)
50ASection 91 amended (Director and Deputy Director of Mental Health)
51Section 96 amended (Visitations by district inspectors and official visitors)
52Principal Act
52ASection 2 amended (Interpretation)
53Section 6 amended (Dealing with controlled drugs)
54Section 8 replaced (Exemptions from sections 6 and 7)
8Exemptions from sections 6 and 7
55Section 24 replaced (Treatment of people dependent on controlled drugs)
24Offence to prescribe, administer, or supply controlled drug in certain cases
24AMedical practitioners, nurse practitioners, and designated prescriber nurses, and designated prescriber pharmacists may prescribe controlled drugs to people dependent on controlled drugs
56Amendments to Misuse of Drugs Regulations 1977
Legislative history

The Parliament of New Zealand enacts as follows:

1 Title

This Act is the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Act 2015.

2 Commencement

(1)

This Act comes into force on a date appointed by the Governor-General by Order in Council, and 1 or more Orders in Council may be made bringing different provisions into force on different dates.

(2)

Any provision that has not earlier been brought into force comes into force on the day that is 2 years after the date on which this Act receives the Royal assent.

Part 1 Amendments to Accident Compensation Act 2001

3 Principal Act

This Part amends the Accident Compensation Act 2001 (the principal Act).

4 Schedule 1 amended

(1)

In Schedule 1, replace clause 7(3)(b) and (c) with:

(b)

the lead health practitioner:

(c)

any health practitioner providing treatment to the claimant:

(d)

any employer or potential employer of the claimant.

(2)

In Schedule 1, replace clause 7(5) with:

(5)

In this clause,—

lead health practitioner means the health practitioner who is leading the co-ordination of the provision of treatment or rehabilitation (or both) to the claimant

services includes the key aspects of social rehabilitation, as defined in section 81.

(3)

In Schedule 1, clause 13(1)(b), replace “medical practitioner” with “health practitioner”.

Part 2 Amendments to Burial and Cremation Act 1964

5 Principal Act

This Part amends the Burial and Cremation Act 1964 (the principal Act).

6 Section 2 amended (Interpretation)

(1)

In section 2(1), repeal the definitions of doctor, doctor’s certificate, and give a doctor’s certificate.

(2)

In section 2(1), insert in their appropriate alphabetical order:

certificate of cause of death, in relation to a death or a body, means a certificate referred to in section 46B or 46C relating to the cause of death or, as the case may require, the cause of death of the person whose body it is

give a certificate of cause of death, in relation to a person’s death, means complete and sign a certificate of cause of death and give it to the person having charge of the person’s body

health practitioner has the same meaning as in section 5 of the Health Practitioners Competence Assurance Act 2003

medical practitioner means a health practitioner who—

(a)

is, or is deemed to be, registered with the Medical 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 medicine; and

(b)

holds a current practising certificate

nurse practitioner means a health practitioner who—

(a)

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 and whose scope of practice permits the performance of nurse practitioner functions; and

(b)

holds a current practising certificate

7 Section 46AA replaced (Doctor’s certificate or coroner’s authorisation required before body disposed of)

Replace section 46AA with:

46AA Certificate of cause of death or coroner’s authorisation required before body disposed of

(1)

A body must not be buried, cremated, or otherwise disposed of unless the person in charge of the disposal has been given—

(a)

a certificate of cause of death; or

(b)

a coroner’s authorisation.

(2)

After receiving under subsection (1) a certificate of cause of death or coroner’s authorisation, the person in charge of the disposal must send a copy of that certificate or authorisation to the department that administers this Act.

(3)

This section is subject to section 46A.

8 Section 46A amended (Stillborn children)

In section 46A(1), replace “doctor” with “medical practitioner” in each place.

9 Section 46B replaced (Doctor’s certificate in relation to illness)

Replace section 46B with:

46B Certificate of cause of death in relation to illness

(1)

This section applies if a person dies after an illness.

(2)

A medical practitioner or a nurse practitioner who attended the person during the illness must, immediately after learning of the person’s death, give a certificate of cause of death for the person’s death if the practitioner—

(a)

is satisfied that the person’s death was a natural consequence of the illness; and

(b)

has taken reasonable steps to consult with any health practitioner known to have subsequently attended the person during the person’s illness.

(3)

Any other medical practitioner or nurse practitioner may give a certificate of cause of death for the person’s death if (and only if) the practitioner is satisfied that the person’s death was a natural consequence of the illness and—

(a)

a medical practitioner or nurse practitioner who attended the person during the person’s illness is unavailable; or

(b)

less than 24 hours has passed since the death, and a medical practitioner or nurse practitioner who attended the person during the person’s illness is unlikely to be able to give a certificate of cause of death for the person’s death within 24 hours after the death; or

(c)

at least 24 hours have passed since the person’s death, and a medical practitioner or nurse practitioner who attended the person during the person’s illness has not given a certificate of cause of death for the person’s death.

(4)

Subsection (3)(b) and (c) does not apply if a medical practitioner or nurse practitioner who attended the person during the person’s illness has refused to give a certificate of cause of death for the person’s death because the practitioner was not satisfied, or was not yet satisfied, that the death was a natural consequence of the illness.

(5)

A medical practitioner or nurse practitioner must not give a certificate of cause of death under subsection (3) unless the practitioner—

(a)

has regard to the medical records relating to the person concerned of the health practitioner who last attended the person during the illness; and

(b)

has regard to the circumstances of the person’s death; and

(c)

has examined the person’s body.

(6)

A certificate of cause of death must not be given under subsection (2) or (3) if—

(a)

the death—

(i)

must be reported to the New Zealand Police because section 13 (except subsection (1)(b)) of the Coroners Act 2006 applies; or

(ii)

has been reported to a coroner under section 15(2) of that Act; and

(b)

the coroner has decided to open an inquiry into the death.

10 Section 46C replaced (Doctor’s certificate in relation to accidents to elderly persons)

Replace section 46C with:

46C Certificate of cause of death in relation to accidents to persons aged 70 years or more

(1)

This section applies if a person of or over the age of 70 years dies (the deceased) and, in the opinion of a medical practitioner or nurse practitioner,—

(a)

the death was caused by injuries, or injuries contributed substantially to it; and

(b)

the injuries were caused by an accident; and

(c)

the injuries, the accident, or both arose principally by virtue of infirmities that were attributes of the deceased’s age; and

(d)

the accident was not suspicious or unusual; and

(e)

the accident was not caused by an act or omission of any other person; and

(f)

except to the extent that the death involved injury by accident, it was not violent, unnatural, or in some way a death in respect of which the Coroners Act 2006 requires an inquiry to be conducted.

(2)

A medical practitioner or nurse practitioner may give a certificate of cause of death for the deceased.

(3)

Subsection (2) applies even though the death may have been reported to the New Zealand Police under section 14 of the Coroners Act 2006.

(4)

However, if the medical practitioner or nurse practitioner is aware that the death has been reported to a coroner under section 15(2) of the Coroners Act 2006, the practitioner must not give a certificate of cause of death under subsection (2) without first obtaining the agreement of the designated coroner.

11 Section 46F amended (Transfer of charge of body)

In section 46F(1)(a), (3), and (4), replace “doctor’s certificate” with “certificate of cause of death”.

12 Section 54AA amended (Offences concerning doctor’s certificate or certificate relating to stillbirth)

In the heading to section 54AA, replace doctor’s certificate with certificate of cause of death.

13 Consequential amendments

The enactments specified in Schedule 1 are consequentially amended in the manner indicated in that schedule.

Part 3 Amendments to Children, Young Persons, and Their Families Act 1989

14 Principal Act

This Part amends the Children, Young Persons, and Their Families Act 1989 (the principal Act).

15 Section 2 amended (Interpretation)

(1)

In section 2(1), insert in its their appropriate alphabetical order:

health practitioner has the same meaning as in section 5 of the Health Practitioners Competence Assurance Act 2003

hospital has the same meaning as in section 2(1) of the Mental Health (Compulsory Assessment and Treatment) Act 1992

(2)

In section 2(1), repeal the definition of psychiatric hospital.

(3)

In section 2(1), definition of residence, paragraph (c)(ii), delete psychiatric.

16 Section 12 amended (Duty of medical practitioner to minimise distress to child or young person)

(1)

In the heading to section 12, replace medical practitioner with health practitioner.

(2)

In section 12, replace “medical practitioner” with “health practitioner”.

17 Section 49 amended (Court may order medical examination of child or young person)

In section 49(1), replace “medical practitioner” with “health practitioner whom the court considers qualified for the purpose”.

18 Section 52 amended (Medical practitioner to prepare report on examination)

(1)

In the heading to section 52, replace Medical with Health.

(2)

In section 52(1), replace “medical practitioner” with “health practitioner”.

19 Section 53 amended (Medical examination of child or young person at request of social worker)

(1)

In section 53(2), replace “medical practitioner” with “health practitioner whom the social worker considers qualified for the purpose”.

(2)

In section 53(3), replace “medical practitioner” with “health practitioner whom the social worker considers qualified for the purpose”.

20 Section 55 amended (Restrictions on internal examinations and examinations under general anaesthetic)

In section 55(1)(a), replace “medical practitioner” with “health practitioner”.

21 Section 56 amended (Medical practitioner to prepare report on examination)

(1)

In the heading to section 56, replace Medical with Health.

(2)

In section 56, replace “medical practitioner” with “health practitioner”.

22 Section 179 amended (Further provisions relating to medical, psychiatric, and psychological examinations)

(1)

In section 179(1), replace “registered medical practitioner” with “health practitioner whom the court considers qualified for the purpose”.

(2)

In section 179(2), replace “registered medical practitioner” with “health practitioner”.

(3)

In section 179(3)(a), replace “registered medical practitioner” with “health practitioner”.

23 Section 181 amended (Court may order examination to be carried out in psychiatric hospital)

(1AA)

In the heading to section 181, delete psychiatric.

(1)

In section 181(1)(a), replace “medical practitioners” with “health practitioners”.

(1A)

In section 181(1), (2), and (4), replace psychiatric hospital with hospital in each place.

(2)

In section 181(3), replace “medical practitioner” with “health practitioner”.

23A Section 182 amended (Release of child or young person from psychiatric hospital where detention no longer required)

(1)

In the heading to section 182, delete psychiatric.

(2)

In section 182, delete psychiatric in each place.

Part 4 Amendments to Holidays Act 2003

24 Principal Act

This Part amends the Holidays Act 2003 (the principal Act).

25 Section 68 amended (Proof of sickness or injury)

(1)

In section 68(3), replace “medical practitioner” with “health practitioner”.

(2)

Replace section 68(5) with:

(5)

In this section, health practitioner has the same meaning as in section 5 of the Health Practitioners Competence Assurance Act 2003.

Part 5 Amendments to Land Transport Act 1998

26 Principal Act

This Part amends the Land Transport Act 1998 (the principal Act).

27 Section 2 amended (Interpretation)

(1A)

In section 2(1), repeal the definition of doctor’s surgery.

(1B)

In section 2(1), insert in its appropriate alphabetical order:

medical centre means any place where a medical examination or medical care or treatment is carried out or given

(1)

In section 2(1), definition of medical expenses, replace “medical practitioner” with “health practitioner”.

(2)

In section 2(1), replace the definition of medical officer with:

medical officer means a person acting in a hospital and who, in the normal course of the person’s duties, takes blood specimens

(3)

In section 2(1), repeal the definition of optometrist.

28 Section 13 amended (Drivers and other road users to comply with directions of enforcement officers, etc)

In section 13(3), replace “medical practitioner” with “health practitioner”.

29 Section 18 amended (Doctors and optometrists to give Agency medical reports of persons unfit to drive)

(1)

In the heading to section 18, replace Doctors and optometrists with Health practitioners.

(2)

In section 18(1), replace “medical practitioner or optometrist” with “health practitioner”.

(3)

In section 18(2), replace “medical practitioner or optometrist” with “health practitioner”.

(4)

In section 18(3), replace “medical practitioner or optometrist” with “health practitioner”.

30 Section 60 amended (Failure or refusal to permit blood specimen to be taken or to undergo compulsory impairment test)

(1)

In section 60(1)(b), replace “medical practitioner” with “health practitioner”.

(2)

In section 60(1)(c), replace “medical practitioner” with “health practitioner”.

31 Section 64 amended (Defences)

In section 64(1), replace “medical practitioner” with “health practitioner”.

31A Section 68 amended (Who must undergo breath screening test)

In section 68(2), replace doctor’s surgery with medical centre.

31B Section 69 amended (Who must undergo evidential breath test)

In section 69(7), replace doctor’s surgery with medical centre.

32 Section 72 amended (Who must give blood specimen at places other than hospital or surgery)

(1A)

In the heading to section 72, replace surgery with medical centre.

(1)

In section 72(1), replace “medical practitioner” with “health practitioner” in each place.

(2)

In section 72(2), replace “medical practitioner” with “health practitioner”.

(3)

In section 72(3), replace “medical practitioner” with “health practitioner” in each place.

(4)

In section 72(4)(a), replace “medical practitioner” with “health practitioner” in each place.

(5)

In section 72(5)(b), replace “medical practitioner” with “health practitioner”.

33 Section 73 amended (Who must give blood specimen in hospital or surgery)

(1A)

In the heading to section 73, replace surgery with medical centre.

(1)

In section 73(1), replace medical practitioner with health practitioner in each place.:

(a)

replace doctor’s surgery with medical centre; and

(b)

replace medical practitioner with health practitioner in each place.

(2)

In section 73(2), replace medical practitioner with health practitioner in each place.:

(a)

replace doctor’s surgery with medical centre; and

(b)

replace medical practitioner with health practitioner in each place.

(3)

In section 73(3), replace medical practitioner with health practitioner in each place.:

(a)

replace medical practitioner with health practitioner in each place; and

(b)

replace doctor’s surgery with medical centre.

(4)

In section 73(4), replace “medical practitioner” with “health practitioner” in each place.

(5)

In section 73(5), replace “medical practitioner” with “health practitioner”.

(5A)

In section 73(5)(a), replace doctor’s surgery with medical centre.

(6)

In section 73(6), replace “medical practitioner” with “health practitioner”.

34 Section 74 amended (Procedure for dealing with blood specimens)

In section 74(4), replace “medical practitioner” with “health practitioner”.

35 Section 75 amended (Certificates in blood-alcohol proceedings)

(1)

In section 75(2), replace “medical practitioner” with “health practitioner”.

(2)

In section 75(3), replace medical practitioner with health practitioner in each place.:

(a)

replace medical practitioner with health practitioner in each place; and

(b)

replace doctor’s surgery with medical centre in each place.

(3)

In section 75(4), replace “medical practitioner” with “health practitioner”.

36 Section 76 amended (Presumptions relating to blood specimens)

In section 76(1)(c), replace “medical practitioner” with “health practitioner”.

37 Section 79 amended (Circumstances in which certificate not admissible in proceedings)

In section 79(1), replace “medical practitioner” with “health practitioner” in each place.

38 Section 99 amended (Court may reduce disqualification)

In section 99(3)(d), replace “medical practitioner” with “health practitioner”.

39 Section 100 amended (Agency to remove certain disqualifications)

In section 100(1)(a)(i), replace “medical practitioner” with “health practitioner”.

40 Section 100A amended (Agency to remove alcohol interlock requirements)

In section 100A(1)(a)(i), replace “medical practitioner” with “health practitioner”.

41 Section 209 (Taking of blood specimens for statistical or research purposes)

In section 209(1), replace “medical practitioner” with “health practitioner”.

42 Consequential amendments

The enactment specified in Schedule 2 is consequentially amended in the manner indicated in that schedule.

Part 5A Amendments to Medicines Act 1981

42A Principal Act

This Part amends the Medicines Act 1981 (the principal Act).

42B Section 2 amended (Interpretation)

In section 2(1), replace the definition of nurse practitioner with:

nurse practitioner means a health practitioner who

(a)

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 and whose scope of practice permits the performance of nurse practitioner functions; and

(b)

holds a current practising certificate

42C Section 105B amended (Regulations relating to designated prescribers)

Replace section 105B(1)(d) with:

(d)

requiring any designated prescriber or any class of designated prescriber who prescribes prescription medicines of any specified class or description to undertake those duties under the supervision of

(i)

a practitioner, or any specified class of practitioner; or

(ii)

a nurse practitioner:

Part 6 Amendments to Mental Health (Compulsory Assessment and Treatment) Act 1992

43 Principal Act

This Part amends the Mental Health (Compulsory Assessment and Treatment) Act 1992 (the principal Act).

44 Section 2 amended (Interpretation)

(1)

In section 2(1), insert in their appropriate alphabetical order:

health practitioner has the same meaning as in section 5 of the Health Practitioners Competence Assurance Act 2003

nurse practitioner means a health practitioner who

(a)

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 and whose scope of practice permits the performance of nurse practitioner functions; and

(b)

holds a current practising certificate

primary health care provider means a health practitioner who manages and provides primary and ongoing health care to a patient

(2)

In section 2(1), definition of nurse, delete general.

44A Section 2A amended (Meaning of proposed patient)

In section 2A(b), replace medical practitioner with health practitioner.

44B Section 7A amended (Medical practitioner or responsible clinician to consult)

(1)

In the heading to section 7A, replace Medical practitioner with Practitioner.

(2)

In section 7A(1)(a), replace medical practitioner with health practitioner.

44C Section 8B amended (Medical practitioner’s certificate to accompany application for assessment)

(1)

Replace the heading to section 8B with Certificate to accompany application for assessment.

(2)

In section 8B, replace medical practitioner with health practitioner in each place.

(3)

After section 8B(5), insert:

(6)

In this section,

health practitioner means

(a)

a medical practitioner; or

(b)

a nurse practitioner; or

(c)

a registered nurse practising in mental health

registered nurse practising in mental health means a health practitioner who

(a)

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 and whose scope of practice includes the assessment of a person’s mental capacity; and

(b)

holds a current practising certificate

44D Section 9 amended (Assessment examination to be arranged and conducted)

(1)

Replace section 9(1) with:

(1)

When the Director of Area Mental Health Services or a duly authorised officer receives notice of an application made under section 8A from the health practitioner who issued the certificate accompanying that application, the Director of Area Mental Health Services must make the necessary arrangements for the proposed patient to immediately undergo an assessment examination.

(1A)

Notice of an application made under section 8A may be given by any means, including by telephone.

(2)

Replace section 9(3) and (4) with:

(3)

An assessment examination must be conducted by a health practitioner who is

(a)

a psychiatrist approved by the Director of Area Mental Health Services for the purposes of the assessment examination, or of assessment examinations generally; or

(b)

if no such psychiatrist is reasonably available, a medical practitioner or nurse practitioner (not being a medical practitioner or nurse practitioner who issued the certificate under section 8B(4)(b)) who, in the opinion of the Director of Mental Health, is suitably qualified to conduct the assessment examination or assessment examinations generally.

(4)

The Director of Mental Health may delegate his or her function under subsection (3)(b) to the Director of Area Mental Health Services.

45 Section 10 amended (Certificate of preliminary assessment)

In section 10(4)(a)(v), replace medical practitioner with primary health care provider.

(1)

In section 10(1), replace medical practitioner shall with health practitioner must.

(2)

In section 10(2), replace medical practitioner shall with health practitioner must.

(3)

In section 10(2)(d) and (3), replace medical practitioner with health practitioner.

(4)

In section 10(4),

(a)

replace medical practitioner considers with health practitioner considers; and

(b)

replace medical practitioner shall with health practitioner must.

(5)

In section 10(4)(a)(v), replace medical practitioner with primary health care provider.

45A Section 11 amended (Further assessment and treatment for 5 days)

In section 11(1) and (2), replace medical practitioner with health practitioner in each place.

46 Section 12 amended (Certificate of further assessment)

In section 12(5)(e), replace “medical practitioner” with “primary health care provider”.

47 Section 14A amended (Documents relating to application for compulsory treatment order)

In section 14A(2)(d), replace “medical practitioner” with “primary health care provider”.

48 Section 29 amended (Community treatment orders)

In section 29(6)(c), replace “medical practitioner” with “primary health care provider”.

49 Section 76 amended (Clinical reviews of persons subject to compulsory treatment orders)

In section 76(7)(b)(iv), replace “medical practitioner” with “primary health care provider”.

50 Section 79 amended (Tribunal reviews of persons subject to compulsory treatment orders)

In section 79(10)(g), replace “medical practitioner” with “primary health care provider”.

50A Section 91 amended (Director and Deputy Director of Mental Health)

In section 91(4), after Act, insert (other than the function in section 9(3)(b)).

51 Section 96 amended (Visitations by district inspectors and official visitors)

(1)

In section 96(4), replace “medical practitioner” with “health practitioner”.

(2)

In section 96(5), replace “medical practitioner” with “health practitioner” in each place.

Part 7 Amendments to Misuse of Drugs Act 1975

52 Principal Act

This Part amends the Misuse of Drugs Act 1975 (the principal Act).

52A Section 2 amended (Interpretation)

(1)

In section 2(1), insert in its appropriate alphabetical order:

registered nurse means a health practitioner who

(a)

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 and whose scope of practice permits the performance of registered nurse functions; and

(b)

holds a current practising certificate

(2)

In section 2(1), replace the definition of nurse practitioner with:

nurse practitioner means a health practitioner who

(a)

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 and whose scope of practice permits the performance of nurse practitioner functions; and

(b)

holds a current practising certificate

53 Section 6 amended (Dealing with controlled drugs)

Replace section 6(1)(a) with:

(a)

import into or export from New Zealand any controlled drug; or

54 Section 8 replaced (Exemptions from sections 6 and 7)

Replace section 8 with:

8 Exemptions from sections 6 and 7

(1)

Despite sections 6 and 7,—

(a)

any medical practitioner, dentist, or veterinarian may prescribe, produce, manufacture, supply, or administer controlled drugs:

(b)

any pharmacist or any person with the authority and under the immediate supervision of a pharmacist may produce, manufacture, or supply controlled drugs—

(i)

listed in the pharmaceutical schedule within the meaning of the New Zealand Public Health and Disability Act 2000 for the purposes of a person eligible for a subsidy for the supply of controlled drugs; or

(ii)

for the purposes of the hospital in which he or she is employed; or

(iii)

pursuant to a prescription or order issued by a medical practitioner, dentist, nurse practitioner, optometrist, midwife, designated prescriber, or veterinarian:

(c)

any person for whom a controlled drug is supplied by a medical practitioner or dentist, or prescribed by a medical practitioner or dentist and lawfully supplied, may administer that drug to himself or herself in accordance with the advice of the medical practitioner or dentist who supplied or prescribed it:

(d)

any person having the care of a patient for whom a controlled drug is supplied by a medical practitioner or dentist, or prescribed by a medical practitioner or dentist and lawfully supplied, may administer that drug to that patient in accordance with the advice of the medical practitioner or dentist who supplied or prescribed it:

(e)

any person having the care of an animal for which a controlled drug is supplied by a veterinarian, or prescribed by a veterinarian and lawfully supplied, may administer that drug to that animal in accordance with the advice of the veterinarian who supplied or prescribed it:

(f)

any district health board established by or under the New Zealand Public Health and Disability Act 2000 or other corporate body, and any individual person who is the manager or person licensed to carry on a hospital or any other institution, that has the care of patients for whom controlled drugs are lawfully prescribed or supplied may possess those drugs for the purposes of the treatment of those patients:

(g)

any person in the service of the Crown, or any Medical Officer of Health or any pharmacist approved by a Medical Officer of Health, may procure and possess a controlled drug for the purposes of and in connection with his or her official duties:

(h)

any carrier may possess a controlled drug in the course of carriage to such extent as is necessary or incidental to the carrier’s business:

(i)

any person who is permitted by or under this Act to import, export, supply, or administer a controlled drug may procure that drug from a person lawfully entitled to supply it and may possess that drug in the manner and for the purposes expressed or implied in that authority:

(j)

any person who is licensed or otherwise permitted under this Act to cultivate a prohibited plant may possess any controlled drug derived from that plant in the manner and for the purposes expressed or implied in that authority:

(k)

any person who is permitted by or under this Act to possess a controlled drug may procure that drug from a person lawfully entitled to supply it, and may supply or use that drug in the manner and for the purposes expressed or implied in that authority:

(l)

a person may, while entering or leaving New Zealand, possess a controlled drug required for treating the medical condition of the person or any other person in his or her care or control, if the quantity of drug is no greater than that required for treating the medical condition for 1 month, and the drug was—

(i)

lawfully supplied to the person by a medical practitioner, nurse practitioner, optometrist, midwife, designated prescriber, or dentist in New Zealand; or

(ii)

prescribed by a medical practitioner, nurse practitioner, optometrist, midwife, designated prescriber, or dentist, and lawfully supplied to the person in New Zealand; or

(iii)

lawfully supplied to the person overseas and supplied for the purpose of treating a medical condition:

(m)

a designated prescriber, nurse practitioner, optometrist, or midwife who is authorised by regulations made under this Act to prescribe controlled drugs of any specified class or description may prescribe, supply, or administer such drugs:

(n)

a person who is authorised to issue a standing order may include in a standing order authority to supply and administer controlled drugs of any specified class or description, and a person who is authorised under a standing order to supply and administer any controlled drugs may supply and administer those drugs in accordance with that standing order.

(2)

However, subsection (1) is subject to any prohibitions, limitations, restrictions, or conditions imposed by any regulations made under this Act.

(3)

Nothing in subsection (1) or (2) overrides—

(a)

sections 22 to 25; or

(b)

any prohibitions, limitations, restrictions, or conditions imposed under any of those sections.

(4)

Despite section 6(1)(a), any person may import, export, supply, administer, or possess any controlled drug specified or described in Part 6 of Schedule 3.

(5)

However, subsection (4) is subject to any prohibitions, limitations, restrictions, or conditions imposed by any regulations made under this Act.

(6)

Nothing in subsection (4) or (5) overrides—

(a)

section 22; or

(b)

any prohibitions, limitations, restrictions, or conditions imposed under that section; or

(c)

any other enactment.

(7)

In this section,—

(a)

a reference to a person of any of the following descriptions is a reference to that person acting in the course of his or her practice or employment:

(i)

medical practitioner:

(ii)

dentist:

(iii)

veterinarian:

(iv)

pharmacist:

(v)

midwife:

(vi)

nurse practitioner:

(vii)

optometrist:

(viii)

designated prescriber:

(ix)

person authorised under a standing order authority; and

(b)

a reference to the supply of controlled drugs includes an offer to supply a controlled drug.

55 Section 24 replaced (Treatment of people dependent on controlled drugs)

Replace section 24 with:

24 Offence to prescribe, administer, or supply controlled drug in certain cases

(1)

A health practitioner commits an offence if, in the course of, or for the purpose of, treating a person for drug dependency, the health practitioner—

(a)

prescribes, administers, or supplies a controlled drug for or to the person; and

(b)

does so although having reason to believe that the person is dependent on that or any other controlled drug.

(2)

Subsection (1) does not apply to—

(a)

the treatment of a patient, within the meaning of the Alcoholism and Drug Addiction Act 1966, while the patient is in an institution, within the meaning of that Act:

(b)

the emergency treatment of a patient in a hospital care institution within the meaning of section 58(4) of the Health and Disability Services (Safety) Act 2001 for a period not exceeding 3 days:

(c)

the treatment of any restricted person.

(3)

Subsection (1) is subject to section 24A.

(4)

In this section,—

health practitioner has the same meaning as in section 5(1) of the Health Practitioners Competence Assurance Act 2003

restricted person has the same meaning as in section 25(1).

24A Medical practitioners, nurse practitioners, and designated prescriber nurses, and designated prescriber pharmacists may prescribe controlled drugs to people dependent on controlled drugs

(1)

Section 24(1) does not apply to a medical practitioner who—

(a)

is specified under subsection (7)(a) (a specified medical practitioner); or

(b)

is—

(i)

working in a place specified under subsection (7)(b) (a specified place); and

(ii)

authorised, in writing by a specified medical practitioner working in the specified place, to prescribe controlled drugs; or

(c)

is—

(i)

employed as a medical officer in a hospital care institution specified under subsection (7)(b)(i); and

(ii)

authorised, in writing by the person in charge of that institution, who is acting under the general or specific directions of a Medical Officer of Health, to prescribe controlled drugs.

(2)

Section 24(1) does not apply to a nurse practitioner or, designated prescriber nurse, or designated prescriber pharmacist who is—

(a)

working in a specified place; and

(b)

authorised, in writing by a specified medical practitioner working in the specified place, to prescribe controlled drugs.

(3)

Section 24(1) does not apply to a medical practitioner, nurse practitioner, or designated prescriber nurse, or designated prescriber pharmacist who is acting in accordance with a written permission that is given—

(a)

by a medical practitioner to whom subsection (1)(a), (b), or (c) applies; and

(b)

for a specified period not exceeding 3 months.

(4)

A permission given under subsection (3) may from time to time be renewed for a further specified period not exceeding 3 months by—

(a)

the medical practitioner who gave it; or

(b)

any other medical practitioner to whom subsection (1)(a), (b), or (c) applies.

(5)

A period specified under subsection (3)(b) or (4) may be longer than 3 months if the Medical Officer of Health agrees.

(6)

A permission given under subsection (3) or renewed under subsection (4)

(a)

may at any time be withdrawn by the medical practitioner who gave or renewed it, by written notice to the person to whom it was given; and

(b)

is deemed to have been withdrawn when the medical practitioner who gave or renewed it is no longer a medical practitioner to whom subsection (1)(a), (b), or (c) applies.

(7)

The Minister may from time to time, by notice in the Gazette,—

(a)

specify by name any medical practitioner as a medical practitioner who may, subject to any general or special conditions imposed by the Minister on the recommendation of the Director-General of Health, prescribe, administer, or supply controlled drugs for the purpose of this section:

(b)

specify by name or description as a place at which controlled drugs may be prescribed, administered, or supplied for the purposes of this section—

(i)

any hospital care institution; or

(ii)

any clinic, or other place in which a medical practitioner specified under paragraph (a) works.

(7A)

When, for the purposes of subsection (2)(b), a specified medical practitioner authorises a nurse practitioner, designated prescriber nurse, or designated prescriber pharmacist to prescribe controlled drugs, the specified medical practitioner must comply with any applicable guidelines issued by the Director-General of Health.

(8)

The Minister may, from time to time, by notice in the Gazette, revoke or amend a notice under subsection (7).

(9)

In this section,—

designated prescriber nurse means a registered nurse who—

(a)

is a designated prescriber; and

(b)

is acting within his or her scope of practice

designated prescriber pharmacist means a pharmacist who

(a)

is a designated prescriber; and

(b)

is acting within his or her scope of practice

hospital care institution has the same meaning as in section 58(4) of the Health and Disability Services (Safety) Act 2001.

Consequential amendments

56 Amendments to Misuse of Drugs Regulations 1977

(1)

This section amends the Misuse of Drugs Regulations 1977.

(2)

In regulation 12A(1), replace “section 8(2A)(a)” with section 8(1)(m).

(3)

In regulation 29(2), replace “medical practitioner” with “medical practitioner, nurse practitioner, or designated prescriber nurse”.

Schedule 1 Consequential amendments

s 13

Part 1Amendments to Acts

Births, Deaths, Marriages, and Relationships Registration Act 1995 (1995 No 16)

In section 2, repeal the definition of doctor’s certificate.

Coroners Act 2006 (2006 No 38)

Replace the heading above section 13(1)(b) with:

For which no certificate of cause of death given

Replace section 13(1)(b) with:

(b)

every death in respect of which there has not been given a certificate of cause of death (as defined in section 2(1) of the Burial and Cremation Act 1964):

Friendly Societies and Credit Unions Act 1982 (1982 No 118)

In section 45(1)(ab), replace “doctor’s certificate” with “certificate of cause of death (as defined in section 2(1) of the Burial and Cremation Act 1964)”.

Social Workers Registration Act 2003 (2003 No 17)

In section 128(3), replace “doctor’s certificate” with “certificate of cause of death (as defined in section 2(1) of the Burial and Cremation Act 1964)”.

Part 2Amendments to other enactments

Births, Deaths, Marriages, and Relationships Registration (Prescribed Information) Regulations 1995 (SR 1995/183)

In regulation 5B(c)(iv), replace “doctor’s certificate” with “certificate of cause of death”.

Replace regulation 7(1)(a)(xiv) with:

(xiv)

the name of the health practitioner who gave the certificate of cause of death and, if applicable, the date on which the person was last attended by that health practitioner:

Cremation Regulations 1973 (SR 1973/154)

In regulation 7(1)(a), replace “doctor’s certificate” with “certificate of cause of death”.

In Schedule 1, form B, replace “doctor’s certificate” with “certificate of cause of death” in each place.

Schedule 2 Consequential amendments

s 42

Land Transport (Driver Licensing) Rule 1999 (SR 1999/100)

In clause 38(1)(b), replace “optometrist or medical practitioner” with “health practitioner”.

In clause 41(1)(a) and (b), replace “medical practitioner, a optometrist, or a occupational therapist,” with “health practitioner”.

Replace clause 56(1)(d) with:

(d)

the person consults with a health practitioner who is a member of a designated class of health practitioners at intervals specified by the Agency.

After clause 56(2), insert:

(3)

In subclause (1)(d), designated class of health practitioners means a class of health practitioners designated by the Agency.

In clause 77(2), replace “medical practitioner, optometrist, occupational therapist,” with “health practitioner,”.

In clause 82(1)(d), replace “optometrist, a medical practitioner, or a occupational therapist” with “health practitioner”.

Legislative history

25 June 2015

Introduction (Bill 36–1)

19 August 2015

First reading and referral to Health Committee