Medical Council of New Zealand – an independent regulator Presentation to the New Zealand Teachers Council Philip Pigou Chief Executive Medical Council of New Zealand
Self or independent regulation • An evolving issue – A history of the profession protecting their interests resulting in a loss of public trust – A lack of openness and transparency – Unwillingness of doctors to change how they practise – Greater awareness of patient / public rights – Developments in other professions including pilots
The Medical Council of NZ A statutory body with the principal purpose 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.” Section 3, Health Practitioners Competence Assurance Act 2003.
The responsibilities of Council • Setting standards of clinical competence, cultural competence and ethical conduct • Prescribing qualifications, and accrediting educational institutions and programmes. • Registration of doctors from NZ and overseas • Managing competence and fitness to practice of doctors • Investigation of conduct – arms length
Health Sector Regulation – MCNZ, HDC and HPDT • Separate jurisdictions / co-regulation – MCNZ’s focus is standards, competence and fitness to practice – HDC is complaint investigation and resolution – HPDT is discipline – works as an adversarial Tribunal
What are the Council’s current governance arrangements? • Twelve members all appointed by the Minister • The election of four members – costly and poor turnout • A majority of doctors – compare Ireland and UK • All members have the same role and responsibilities • Committees and delegations
An independent professional body? • 2010 review by CHRE – Effective framework for management of concerns about doctors – Need to increase openness and transparency – Appointment of Council members on basis of fair and open competition (not ministerial, not election) – Majority of lay membership • Governance and quasi-judicial decisions of Council fully independent of Minister
Catalyst for the recent review? • Future focus – patient safety and workforce needs • Consumer focus – maintaining public confidence • Safety focus – balance between independent regulator and role of employers • Cost-effectiveness – shared services
The Profession’s response • The Act is working well but Council / Board performance varies • More accountability required – KPIs, a regulator of regulators • What should be the role of lay members – a community representative or governance? • Regulation above what employers provide is needed • Elections should be retained
Future challenges • Costs to the Government of regulation • Workforce flexibility and innovation • The single secretariat – compare Australia
Questions???
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