Health practitioners are a significant occupational group in New Zealand – in 2015 there were almost 97,800 practitioners, not including workers in unregulated alternative practices. The range of people involved continues to expand as the boundaries of what is considered ‘health care’ expand, and as increased specialisation leads to one type of health care becoming two or more types of practice.
Historically, health practitioners included doctors, nurses and pharmacists. By the 21st century the practitioner list included midwives, radiographers, psychologists, dietitians, and speech and language therapists, as well as alternative practitioners like chiropractors, osteopaths and medical herbalists.
Regulation of health practitioners
Most health practitioners’ work is regulated by the Health Practitioners Competence Assurance Act 2003. Unregulated health practices are not covered in this legislation. The act’s main purpose is to protect the public when there is a risk of harm from malpractice.
Unqualified people cannot claim to be practitioners of regulated health professions, and those who are qualified cannot work outside the scope of their regulated practice. Health practitioners need to maintain specific competencies, and may be required to have an annual practising certificate, which is issued by the profession’s responsible authority.
Complaints about health practitioners can be made to the Health and Disability Commissioner or the authority which registers the practitioner. The Health Practitioners Disciplinary Tribunal hears and makes determinations about any disciplinary action which may result from complaints.
The Health Practitioners Disciplinary Tribunal was established in 2004. By 2015 it had received 401 complaints about individual health practitioners. Of these, 252 were found guilty of professional misconduct, while 73 received criminal convictions.
Since the late 1980s patients have been seen as health ‘consumers’ who have rights. As well as handling complaints, the Health and Disability Commissioner upholds these rights. The Code of Health and Disability Services Consumers’ Rights sets out 10 specific rights which practitioners must honour.
Teams composed of different practitioners are a feature of health care in the 21st century. Multidisciplinary health services include primary health-care organisations (PHOs) and critical assessment and treatment teams (CAT teams) who work in mental health. A PHO team may comprise medical practitioners, practice nurses, physiotherapists, social workers or counsellors, podiatrists and pharmacists. A CAT team may include nurses, psychologists and psychiatrists. This team approach extends to all areas of health provision and has resulted in more collegial relationships between health practitioners.