Midwife, Doctor, Psychologist, Chiropractor

The New Zealand HPCA Act and what's in a name

The Health Practitioners Competence Assurance Act 2003 intends to protect the public from serious or permanent harm while also protecting health practitioners through the power to restrict certain activities and ensure that the health care practitioner (HCP) remains within their scope of practice. In short, the Act establishes who can and what is required for an individual to legally claim that they are a Nurse, Doctor, or Midwife and their responsibilities thereafter.

There are several key provisions which allow Kiwi's to determine whether the claim one makes to being a health care practitioner is valid.

It's a document that has a lot of ANDs rather than ORs when it comes to mandatory requirements.

As in (emphasis is mine),

A person may only use names, words, titles, initials, abbreviations, or descriptions stating or implying that the person is a health practitioner of a particular kind if the person is registered, and is qualified to be registered, as a health practitioner of that kind.

As well as

No person may claim to be practising a profession as a health practitioner of a particular kind or state or do anything that is calculated to suggest that the person practises or is willing to practise a profession as a health practitioner of that kind unless the person—

(a) is a health practitioner of that kind; and

(b) holds a current practising certificate as a health practitioner of that kind.

Qualifications and completion of examinations also play a key role in this process and the nuances of that end are not the purview of this article. Still, it is on completion of one's education and a national exam that a HCP is able to register as a practitioner in their chosen field.

However, being on the register is not the only thing that is required in order for a HCP to practice in their field. HCPs must submit to an ongoing recertification programme with continuing education or professional hours alongside working within their prescribed scope of practice. This is called an Annual Practising Certificate or APC; a current APC is required in order to actually work as an HCP.

Life, as it does, can get in the way. Being absent from the register is not completely nefarious; people do request removal of their own accord due to change in life circumstances such as overseas moves and retirement. Statutory bodies allow HCPs to remain on the register without an APC for a period of at least 3 years before requiring the HCP to undergo a retraining or return to practice programme to get the HCP up to speed on NZ requirements. How this is organised is on a case-by-case basis dependent on where and what the HCP was doing during the period they were not practising in NZ. Some HCP get around this by working overseas and returning to NZ intermittently to complete the core requirements necessary to achieve (and pay for) an APC that will not be used in NZ.

So, an HCP can still call themselves a nurse, psychologist, midwife, doctor, etc. without having an APC as long as they are not practising AND are still on their professional register as a practitioner in good standing BUT they can absolutely not practice NOR refer to themselves by their professional title if they are not registered. The various statutory bodies have mechanisms for the public to report people claiming to be HCP without the mandatory registration and fines up to $10,000 can be levied against the accused.

Long before the pandemic, there were always opportunistic individuals who made claims to being Doctors etc., bending the truth about their ability to practice i.e. presenting themselves as a medical Doctor when they have a doctoral degree (looking at you Dr. Phil). Mark Hanna and Jane Glover both wrote blogs about how the title of doctor can be misconstrued for advertising purposes due to the business owner holding a PhD or similar qualification. However, the case regarding homeopath consultant Dr. Preet demonstrates there are still some loopholes given how the courtesy title of doctor is awarded elsewhere around the world. On the other hand, the New Zealand Psychologists Board takes this matter very seriously.

If in doubt about claims made by someone claiming to be a health care practitioner, you can search the relevant online register that is publicly available on the website for that professions regulatory body or contact the Ministry of Health's Enforcement Team.