The Nursing Council is mulling over the details of a controversial and “complex” business case proposal to merge its ‘backroom’ and regulatory functions with the 15 other regulatory authorities.
In the lead-up to the proposal, concerns have been expressed that the merger poses a threat to nursing regulation and could see an increase in annual practising certificate (APC) fees of nursing.
Nursing Council chief executive Carolyn Reed said the Council received the business case at its meeting on April 18. She said the proposal was “complex” and Council would not make any decisions on next steps until it had an opportunity to thoroughly consider it.
Council members were also due in late April to attend presentations by the business case steering group (that included Reed), which worked with Price Waterhouse Cooper to develop the proposal. Reed said Council would have further discussions at its meeting on May 30 and would not comment further until that time.
Ron Paterson, chair of the business case steering group, said the group presented what it saw as a “do-able” and “workable” proposal to the regulatory authority (RA) chairs on April 15 (including new Nursing Council chair Deborah Rowe).
“We believe that the new arrangements would mean better protection for the public and enhanced public confidence”.
Paterson said he was aware that “obviously some quarters” of the nursing profession were worried about the future regulation of nurses under a proposed shared services organisation (SSO).
He said a guiding principle of the steering group was that in any new SSO it “was important to retain profession-specific expertise in the day-to-day regulation of health professions” and not to lose “valuable institutional memory”.
Paterson said a key point was that the Nursing Council board would remain unchanged, it would have the same statutory regulatory responsibilities, would still be able to initiate initiatives like its current nurse prescribing proposal, and would have dedicated staff so it could “continue to receive nursing specific advice in making decisions”.
He also said there would be no rise in nursing APC fees as a result of implementing the proposal. “A concern that we were very conscious of in our deliberations.”
Paterson said the proposal, if implemented, was expected to generate annual savings of $3.4 million per year from 2017 onwards compared with the current baseline. He said depending on decisions made by each RA board, this could lead to on average 15 per cent lower fees or the “savings” could be reinvested into work like developing new scopes of practice or new recertification regimes.
In response to a question on how the proposal would affect Nursing Council staffing levels dedicated to nursing-specific work (in areas like regulation, competency, registration, and education) he said he didn’t have exact numbers, but “in general”, nursing staff levels in those areas “would be maintained”.
Jane Hopkirk, chair of the Occupational Therapy Board and Health Regulatory Authorities of New Zealand (HRANZ), said the 16 boards had until the end of May to make a decision on the proposal.
She said a proposed timeline for beyond that date had gone to the council chairs but it was still very early days and the next steps would depend on whether boards supported the proposal or not and also whether boards supported the proposal fully or with conditions.
Hopkirk added that boards also had different processes before they could act on such proposals including consultation with staff, the profession and in some cases the public.
The controversial proposal followed a call by Health Minister Tony Ryall in 2011 for a shared secretariat for the 16 regulatory authorities and a Health Workforce New Zealand discussion document. The regulatory authorities were divided over the call, with the Medical Council and Dental Council on one side and the Nursing Council the other, leading to the formation of the “across the divide’ steering group and Price Waterhouse Cooper being contracted to develop a detailed business case for councils to consider.
The April stakeholder bulletin from Health Workforce New Zealand said, prior to the release of the proposal, that it continued to work with the 16 RAs to develop a model for a “consolidated secretariat covering all functions of the health regulatory authorities” and “anticipated implementation” by the start of 2014. It is also understood that the Minister wants a proposal to him on a shared secretariat by July.
Meanwhile HWNZ in March had also indicated that it expected to release a second discussion document on its review of the Health Practitioners Competence Assurance (HPCA) Act 2003 “in a few weeks time’ summarising the major themes and consulting on ‘options’ before a final report was due with the government in July. By late April a second consultation document had yet to be released.
