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The last few months have seen several changes being mooted in the health sector. In particular, the government is looking to introduce a new Accident Compensation Appeal Tribunal, legislation which will enable other health professionals to take on roles currently restricted to doctors, and a strategy to govern the next five years of medicines acquisition and control in New Zealand.

Accident Compensation Appeal Tribunal

Changes are afoot for appeals made from decisions of the Accident Compensation Corporation (ACC). Currently, appeals from ACC decisions can be heard by either a District Court Judge or the Accident Compensation Appeal Authority (membership of one). Despite the existence of the two overlapping appeal bodies, the average wait for an appeal is 650 days.

In April 2014, the Government announced a number of updates as part of the modernising Courts and Tribunals Enhanced Services Bill (the Bill). One of these was the establishment of a new Accident Compensation Appeal Tribunal (the Tribunal) which would replace the two existing appeal bodies. The goal of the Tribunal is to introduce a faster process for ACC appeals with greater resourcing flexibility.

In June 2015, following concerns regarding the lack of consultation, and in light of the progress and upcoming initiatives by ACC in early dispute resolution, Cabinet agreed to remove the introduction of the proposed Tribunal from the Bill.

Last month, Courts Minister Amy Adams and ACC Minister Nikki Kaye announced that there will be further consultation on the proposed Tribunal. In particular, consultation will be sought from targeted stakeholders including claimant support groups, advocates, lawyers, and disabled people’s organisations.

This proposal is especially timely with the release of a report from researchers in Otago who analysed over 500 judgments issued since 2009 contesting ACC decisions. This study identified the following four systemic barriers to justice for people contesting ACC decisions through the court system:

  • Barriers to access to the law, including access to the courts, statute, coherent body of case law, and competent legal counsel.
  • Evidentiary barrier including access to evidence, protection of principles of evidence law, inability to present crucial medical evidence, and disadvantage to claimants from ACC’s control over the investigation process.
  • Barriers to claimants feeling like they are being heard, that justice has been done, that an impartial person is listening to the legal issue, and that there has been a fair hearing which will secure a meaningful remedy.
  • Barriers to representation, including access to a lawyer who represents claimant’s interests and navigates the litigation process.

New legislation recognises broadening roles of health professionals

The introduction of the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill (the Bill) has been touted as a recognition of the evolution of the health workforce by relaxing restrictions on certain tasks previously requiring a medical practitioner (i.e. a doctor).

The Bill will amend seven statutes, namely the:

  • Accident Compensation Amendment Bill;
  • Burial and Cremation Amendment Bill;
  • Children, Young Persons, and Their Families Amendment Bill;
  • Holidays Amendment Bill;
  • Land Transport Amendment Bill;
  • Mental Health (Compulsory Assessment and Treatment) Amendment Bill; and
  • Misuse of Drugs Amendment Bill,

by replacing the term ‘medical practitioner’ with the broader ‘health practitioner’. This will have the effect of, for example, allowing nurse practitioners to certify the cause of death in patients they care for.

Health Minister Dr Jonathan Coleman has stated that the Bill will not pose an increased risk of harm to the public as each health practitioner is required under the Health Practitioners Competence Assurance Act 2003 to perform only those tasks that are within their scope of practice. Scopes of practice and necessary qualifications are set by the relevant responsible authorities that have been established under that Act, such as the Nursing Council of New Zealand, the New Zealand Psychologists Board, and the Pharmacy Council of New Zealand.

The Bill had its first reading on 19 August 2015, and has been handed to Select Committee for consideration and submissions by the public. View the Bill here.

Introducing a plan of action for 2015 – 2020: Implementing Medicines New Zealand

This year has seen the launch of a new medicines action plan by the Ministry of Health, entitled ‘Implementing Medicines New Zealand’. This strategy document outlines the actions the Ministry of Health intends to pursue to achieve the outcomes identified by the report ‘Medicines New Zealand’. Those outcomes include the ability of New Zealanders to access safe, high-quality, effective medicines, and those medicines being used in the best possible way.

The strategy identifies actions to be undertaken in both the short and long term in a number of areas, including the following:

  • Optimising opportunities to share health information with patients or health care consumers at every point of care.
  • Enabling shared care through an integrated health care team which uses integrated IT systems to share information.
  • Optimising use of antimicrobials in response to growing antimicrobial (drug) resistance by establishing national networks, testing services, and surveillance.
  • Empowering individuals and families/whānau to manage their own medicines and health by improving health literacy.
  • Optimising use of medicines for older people and those with long term conditions in order to reduce illness and death caused by inappropriate medicine use and lower the cost and environmental impact of medicines waste.
  • Ensuring competence and responsiveness in prescribers by reviewing the prescribing legislative framework.
  • Removing barriers to access through increased use of IT systems such as telehealth or videoconferencing services and access to after-hours dispensing in remote areas.

The strategy also refers to work being under way to develop a new regulatory regime for therapeutic products which will replace the Medicines Act 1981. The new regime will aim to modernise the regulatory arrangements for medicines, including encompassing therapeutic products such as medical devices and cell and tissue therapies. The introduction of a new regime could have wide reaching effects on both health professionals and members of the public.



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