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The fifty pound penalty stated in the recent review (Grbin 2013) had actually risen to $10,000 (still inadequate) by the time the 1949 Act was replaced by the HPCAA.
Without the enactment of this important legislation, the Physiotherapy Board would neither have had the capacity nor capability for the many huge changes and operational functions it would be facing following the enactment of the HPCAA. In 1996, the Health Occupational Registration Acts Amendment Bill (HORAAB) was drafted, its purpose being to amend eleven health occupation regulation statutes, including the Physiotherapy Act 1949.
Under this Act, the Board was, for the first time, able to operate independently from the joint Occupational Registration Boards Secretariat housed in the Ministry of Health, and select and employ its own dedicated staff, which considerably improved responsiveness, efficiency and effectiveness of the Board's operational activities, and allowed the Board to prepare the operational infrastructure and develop governance policies to support the Board's activities and be ready for the additional requirements and functions under the proposed HPCAA. The Physiotherapy Amendment Act 1999 also increased the level of fines, required an Annual Report to the Minister of Health, and made the Board financially independent of the other Boards.
The Grbin review (2013) clearly sums up the value of appropriate statutory regulation, as now provided by the HPCAA, which addresses the deficiencies in prior legislation.
The notion that 'a competent practitioner is a safe practitioner' was introduced under the HPCAA (Health Practitioners Competence Assurance Act, 2003), and has since become a dominant discourse in midwifery practice and education.
Another contentious aspect of the HPCAA is the use made of the concept of "scopes of practice." These will define "the services a practitioner is competent to offer, and the parameters within which those services can be offered." (57) Each authority will be responsible for defining one or more scopes of practice for its profession and the qualifications required for each.
Health Committee, HPCAA Commentary, supra note 50 at 5-6.
New Zealand Ministry of Health, HPCA Discussion Paper, supra note 45 at 10; Health Committee, HPCAA Commentary, supra note 50 at 3.
While all who provide health and disability services in New Zealand are governed by the CHDSCR, only registered practitioners are governed by the HPCAA (and subject to the Health Practitioners Disciplinary Tribunal).
Secondly, the HPCAA (2003) empowers regulatory authorities to require individual, or indeed all health practitioners, to undertake a competence programme "for the purpose of maintaining, examining or improving" (p.
This shift is evident in New Zealand in relation to health policy (Ministry of Health, 2000) and in the HPCAA (2003), where there is a strong push for quality assurance, competence, accountability and oversight of individual practitioners.
It seems that while the ethical code addresses good practice, which comfortably encompasses developmentally focused supervision, the competence framework must closely align with the HPCAA (2003), as such, it is concerned with ensuring competence to practice.
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