Registration

About the HPCA Act

What is the principle purpose of the HPCA Act?

The principal purpose of the HPCA Act is ‘to protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions’.

The Act is designed to increase public safety.

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Why are we discussing regulation of ambulance services using the HPCA Act?

The HPCA Act the mechanism by which the government regulates health professionals in New Zealand. The Ministry of health website gives more information about the HPCA Act http://www.moh.govt.nz/hpca

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In recent years there have been several groups who have called for regulation of ambulance officers and NZDF medics under the HPCA Act, such as the Health Select Committee Inquiry into provision of ambulance services in New Zealand in 2008 and the New Zealand Ambulance Service Sector Strategy which was released in 2009.

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What does regulation under the HPCA Act mean in practice?

The HPCA Act requires a Responsible Authority to set up a register and allows them control over those in the profession.

  • Who enters the profession and who gets on the register; ensuring those that are registered are fit and competent to work as a registered health practitioners.
  • Who stays on the register so that the public can trust that those on the register are able to practise safely and do maintain their competence.
  • Who is removed from the register either for a short or longer period because they have shown to be wanting in ability or fitness to practise or are not in good health2

Each year a practitioner has to apply for an Annual Practising Certificate (APC). The Responsible Authority would have a system to monitor the practitioner’s fitness and competence to practice. They would recertify that the practitioner is fit to practice for another year by issuing the APC.

The HPCA Act also sets outs a number of more dangerous activities that can only be performed by certain registered health practitioners – these are called restrictive activities.

While the Act sets the framework for dealing with matters such as registration of practitioners, complaints and competence, the Responsible Authority can develop its own processes and procedures for dealing with these matters within that framework.

Once it is agreed that a health profession is to be registered, the Minister of Health appoints people to make up a Responsible Authority. Most of these people come from the profession. The balance would be members of the public who are there to represent ‘public interest’.

The members on the Responsible Authority act as the governance group or board. They need to make sure the HPCA Act is implemented. They usually appoint a Registrar and, if needed, other staff to carry out the work of the Authority.

Using the HPCA Act, the Responsible Authority, with input from the profession, is able to set enforceable standards and measures to protect the public and has mechanisms to deal with complaints and maintenance of competence.

The HPCA Act is regarded as an innovative piece of legislation as it:

  • Emphasises the maintenance of competence of practitioners.
  • Separates out complaints investigation on patient care which is initially done by the Health and Disability Commissioner (HDC). The HDC may refer a complaint back to the regulator for further action. This is usually to ask the RA to do a competence review or to see if more serious action needs to be taken.
  • Makes the discipline of practitioners the responsibility of the Health Practitioners Disciplinary Tribunal (HPDT).

2 Thomson. (2005) Understanding Medical regulation - A guide to good practice. London: HLPS Consulting.

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