Nurses delighted at 'barriers' bill passing first step

20 August 2015

Removing legal barriers hindering nurse practitioners – such as those stopping NPs writing sick leave certificates or prescribing controlled drugs – are a step closer following a parliamentary vote yesterday.

Nurse leaders were delighted to hear that, after a decade in the making, the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill yesterday passed its first reading and will now progress to the select committee stage.

Health Minister Jonathan Coleman said patients and families would benefit from the Bill which would enable a wider range of "suitable health practitioners" to undertake "certain functions" currently restricted to medical practitioners.

Lobbying began more than a decade ago by nurse leaders to identify and remove a range of legislative barriers to nurse practitioners' practice. Formal work began back in 2005 to go through legislation with a fine tooth comb to find references to "doctors" or "medical practitioners" where nurse practitioners and other suitable health practitioner were now qualified and capable of fulfilling the same legislative function. 

Dr Michal Boyd, past chair of Nurse Practitioners New Zealand, said NPs were very excited about the bill progressing though "getting here has been a long and winding road".

Professor Jenny Carryer, executive director of the College of Nurses, said it was extraordinary to think she had been involved since 2005 in the lead up work to the bill.  "I am just delighted that it is finally underway."

The functions covered by the omnibus Bill are from seven Acts and include signing death certificates, taking blood specimens from drunk drivers, declaring people unfit to drive, prescribing controlled drugs and signing sick leave certificates.

The current legislation means that while NPs can sign ACC forms and sickness benefit forms they can't sign a certificate for ordinary sick leave from work.  Also if a rural NP gets called to a sudden death they can't sign an 'extinction of life' certificate to allow the body to be removed but an advanced paramedic can.

Boyd said once passed the bill would promote increased access to high quality healthcare overall.  "This bill decreases substantially the lingering legislative barriers that have hindered the full realisation of Nurse Practitioner practice," she said.

The Ministry of Health said in a statement that it was pleased to see the bill progress to the select committee and it was "very encouraging to see the support from all sides of the house".

It added that the Ministry's Office of the Chief Nurse, Health Workforce New Zealand and the policy and legal units had worked hard over a number of years to ensure the Bill achieved the policy intention of removing barriers to the health workforce practising to the full extent of their knowledge and skills.

Background cabinet advice papers released by the Ministry showed that the Bill had been to cabinet in 2011 and 2013 before finally making it to parliament this year.

The next stage for the Bill is the hearing of submissions by the Health Select Committee.  The committee in late August* invited the public to make submissions - either online or in writing - by October 7.  (A copy of the bill can be viewed online at

A spokesperson for the New Zealand Medical Association said the NZMA would not make any comment before examining the bill in detail but it would be making a submission 

Coleman said with the evolving health workforce many health professionals were now capable of performing tasks that were previously solely the domain of health practitioners.  He said updating the legislation would also allow more services to be delivered in the community rather than in hospitals and access to services would be improved.

“For example, only a doctor can sign your medical certificate for sick leave and only a doctor can request additional treatments or assessments for a patient with mental health issues.

“This Bill will also mean nurse practitioners caring for patients will be able to certify the cause of death. This change is especially important in rural areas and aged care services and will help prevent unnecessary delays for families.

*Article updated August 31 to include details of bill submissions 




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