Since 1979 the Society and the Physiotherapy Board have made submissions to the Department/Ministry of Health and the Minister of Health to have the Physiotherapy Act 1949 revised.
Since 1979 the Society and the Physiotherapy Board have made submissions to the Department/Ministry of Health and the Minister of Health to have the Physiotherapy Act 1949 revised. The provisions in the Physiotherapy Act 1949 for discipline and impaired fitness to practice are at variance with current thinking and do not allow the Board to manage these issues in the way which provides the best protection for the public. Provision for the maintenance of on-going competency needs to be included in any major revision of the Act. Although President Michael Lamont thought it was unlikely the Act would be reviewed in 1982 the NZSP resolved to make submissions to it if it should be reviewed.[1]
One aim for the Society in 1983 was that there should be either a new Act, or a Bill before the end of the year.[2] An editorial in the December 1983 NZJP noted that although many amendments to the Act had been passed it still did not reflect the modern approach to physiotherapy. However by October 1983 the proposed amendment to consolidate the Physiotherapy Act had been withdrawn from the legislative programme for 1983 - the Minister of Health suggested a combined Act which the Society strongly opposed. [3]
There was no progress in 1984. The situation remained where the Society had been trying to get the Act re-opended for the last four years. Government were still considering a combined Act with other health professions, but the Society wanted the Physiotherapy Act re-written and a Physiotherapy Council to be established.[4]. Micahel Lamont (President) had a meeting with other health professionals and a long document was written explaining why more of them wanted to be included. Executive expressed total opposition to the Bill at the 1985 annual general meeting, and the alternative of not being administered by the Health Dept. Branches held meetings.
This changed in 1985 when Executive selected from nominees the final recommendation to the Minister of Health[5].
Canterbury Branch had had a meeting in February 1985 about the Health Registration Bill with a lawyer present[6]. They had some most helpful comments. The NZSP in association with other health professionals produced a significant submission setting down the disadvantages for them to be included in a “Common” Act.
A Postal Ballot was conducted in July 1995. 1800 ballot papers were sent out to APC holders. 807 returned by due date; 636 wished the Physiotherapy Board to be Body Corporate and 170 did not This meant 80% were in favour. However because there was only a small return rate the Minister would not accept the result saying “he did not want to be accused of listening to the silent majority”.[7] A sub Committee of Ros. Ham, Michael Lamont & Erwin Drok was set up in December 1985 to consider re-writing the Physiotherapy Act .
At the beginning of 1986 the Minister of Health deferred the question of the Board becoming a Board Corporate and the need to hold a further ballot. The Society received a very comprehensive estimate of costings prepared by the Department for running the Board, which showed than it ran for a loss of approximately $68,000 a year. The budget prepared by the Society proved unacceptable to the Department, and in an endeavour to overcome the impasse the Society commissioned an independent assessment of costs by the Business Development Centre of the Otago University.[8]
The Society did not accept the Preliminary Draft Physiotherapy Bill in October 1986 - a meeting was arranged with the Dept of Health Society representatives by President & Chairman of Legislative Committee[9]. Following a meeting with the department it was realised that the Society would not have the opportunity to see the draft legislation before it went to the Minister and then the Parliamentary Committee. Branches agreed that the draft act should reflect the legislation required by the profession and that a copy of the amended draft be seen by the Society prior to its placement on the legislative calendar even if this means an initial delay.
A letter dated 21 November 1986 was sent to the Dept advising that the Society wished to see the draft legislation before it passed into the Parliamentary Committee stage.
At the 1987 AGM the meeting gave unanimous support to the Body Corporate Proposal, and a letter to this effect was sent to the Minister of Health. Almost immediately the Minister replied that “The Physiotherapy Board will continue to be serviced by the Health Department for at least 3 years”. The NZSP did not accept that, and in April 1987 using the Official Information Act the Society was able to access background material leading up to the Department decision. [10].
The Department was actively pursuing the aim of an independent Physiotherapy Board in 1988. The proposed new Ministry would not be responsible for administering the Boards and therefore alternative arrangements would have to be made. The mainpoint was financial viability. Could the Physiotherapy Board stand alone or should it combine with other Boards to share costs? The Executive believed that the only compromise to absolute independence was a liasion with other boards which did not in any way conflict with the interests of Physiotherapy[11] .
A booklet called Occupational Licensing in NZ had been considered by Executive in October 1988 and will produce a draft incorporation their comments[12]. Physiotherapy Board Autonomy was discussed in December 1988 - National Executive preferred the Physiotherapy Board to stand alone as its first option but if not financially possible its second option would be for the Physiotherapy Board to provide accommodation and administration for the following Boards - Dietitians, Opticians/ Optometrists, and Dispensing Opticians[13].
At the AGM in April 1989 members were told about Society submissions during the year made to the Working Group on Occupational Legislation, and background papers on the Physiotherapy Board Body Corporate Proposal, as well as briefing papers to the Minister of Health Helen Clark[14]. Although the Society preferred the Stand Alone option the Department believed this proposal would be too expensive for the Society. The threat to physiotherapists at this time was total deregulation of the practice of physiotherapy. Following strong representation from the NZSP the need for regulation of physiotherapists has been retained.
The Board convened a sub Committee in March 1989 to look at the proposed legislation about Physiotherapy Board Independent Administration and decided the NZSP Legislative Sub Committee and the Physiotherapy Board Sub Committee should meet to co-operate on the legislative update[15]. The Physiotherapy Board endorsed the Society’s aim in September 1989 yet in December 1989 the Health Department said they would continue to administer the Board for another 18 months.
Plans to introduce a draft revisionary Bill into Parliament during 1989 were frustrated by the higher priority given to the introduction of other legislation. This factor of prioritising need has continued to the present time with a full revision of the Act still on the “drawing board”.
Society representatives met with the Occupation Regulation Sub group in February 1990. The Society’s position on various matters which may be covered by legislation was sought. A paper brought to the meeting covered most points.
At the 1990 AGM Eriwn Drok felt the meeting held in March 1990 had been a waste of time and expense for the Society. The Minister advised the Physiotherapy Legislation was not a priority. The Physiotherapy Board would remain with the Dept. until such time as the Dept. evolved to a Ministry[16]. She was not prepared to discuss ACC Regulation matters raised by the Society. The Society was concerned about various matters concerned with the running of the Board in August 1991, and discussed these with the Minister of Health.
These concerns were
The Associate Minister of Health K.O’Regan, advised in February 1992 that she would be reviewing the Physiotherapy Act in 1992.[18]. The proposal to have the Physiotherapy Board independent of the Health Department continued. The February 1992 Newsletter stated that the Physiotherapy Act would be opened and revised during the year. The proposal to have the Physiotherapy Board independent of the Health Department continued. National Executive Objectives for 1992 included increasing communication with the Physiotherapy Board, and seeking the co-operation of the Board to enforce changes to the Physiotherapy Act and the move to Body Corporate Status. The February 1992 Newsletter stated that the Physiotherapy Act would be opened and revised during the year. The proposal to have the Physiotherapy Board independent of the Health Department continued.
Objectives for 1993 again included the need for good communication with the Board, and the continued need to lobby for the ammendment to the Act. A letter from K.O’Regan Associate Minister of Health stated that there was little likelihood of finding space on an already crowded legislative program. The Ministry of Health was considering amendments of occupational legislation for possible inclusion in the 1995 legislative program.
In February 1994 Margot Skinner (President) met with K.O’Regan and discussed updating the Physiotherapy Act and staffing levels of the Physiotherapy Board[19]. Executive discussed the need for a complete review of the Physiotherapy Act in October 1994, and for previous recommendations put forward by the Society to be reviewed and brought up to date. It was anticipated that the Medical Practitioners Act would be before Parliament by the end of the year, and that this, in conjunction with the Dental Practitioners Society, would be used as a model for future health legislation.
Changes in November 1994 resulted from the newly introduced Health and Disabilities Commissioner Act. The Board now had the authority to award costs for disciplinary matters and would eventually be required to refer all disciplinary matters received to the Health and Disabilities Commissioner.[20]
The President, (Margot Skinner) and Joy Tedder met with three Ministry of Health officials to discuss the review of the Physiotherapy Act in November 1995.
Margot Skinner tabled a timetable in January 1996 for review of the Act in January 1996.
The Minister of Health met with registration boards and other professional groups in July 1995 where the Minister indicated that the Government wished to see health occupational groups reviewed as a joint project. The NZSP supported the review but not the concept of an “umbrella type” Health Occupational Groups Bill. Assurance was given that while the review would be combined initially, after introduction into Parliament it would be split into separate occupational groups’ legislation for the final reading.
In January 1996 Margot Skinner tabled a timetable for review of the Act. The initial submission was made to the Ministry of Health in February 1996. A draft Physiotherapy Act review Report was received from the Ministry of Health and comments required by 26 June 1996. In general, the review report was in line with NZSP recommendations made in the initial submission. The comments and options present in the report were discussed. Note was made of the suggestion that physiotherapy “does not involve particularly intrusive or invasive procedures and that safety risk to the public are low”. There was agreement that the potential for risk to patients is growing with the increase in the number of physiotherapists offering, eg. Manipulative therapy, acupuncture, and pelvic floor rehabilitation and re-education.” It was noted that a correction needs to be made to the last sentence under “continuing competence” where the Ministry has not recognised that the College of Physiotherapy is the autonomous body which has responsibility for the structured accreditation process for continuing education of physiotherapists.
The Minister of Health Jenny Shipley stated that at the final reading of the Combined Review Bill each profession would retain its own Act. There was a change in removing the protection of the titles masseur, masseuse and masage expert under the Physiotherapy Act.[21]
There was agreement in general with the Ministry of Health recommendation that the Physiotherapy Board be designated a Body Corporate but information is required on its funding, which could result in a financial impact on the Society. It would also be necesary to look at the problem of the registering body being both the prosecutor and disciplinary body. (This could be resolved in the new legislation with regard to the new Physiotherapy Act and the role of the Health Commissioner [22]. One concern is that the Minstry does not favour the continued use of licensing of operators of ultra sonic equipment. List of present requirement about Ultra Sound published.[23]. Details of submission were published in the Newsletter March 1996, and a complete draft of the Review in the Newsletter July 1996 page 4.
A policy paper based on the revised report was produced by the Ministry of Health mid 1997 when further submissions sought from the Society, consumer organisations Regional Health Authorities, CHEs and other interested parties at that time[24].
In 1997 the Board investigated the costs of setting up the Physiotherapy Board as a Body Corporate modelled on section 21-23 of the Medical Practitioners Act 1995, but not to be exclusive as the Medical Practitioners Act model. There was some support for the inclusion of provisions for vocational registration to be included in the new Physiotherapy Act but only if recognition of specialist areas of physiotherapy practice did not restrict physiotherapists from practising in other general areas in which they were competent but without restrictive practise. This would allow the Board to recognise a specialist position in, eg paediatric physiotherapy but would not prevent other physiotherapists from working in that speciality. In addition, the provision would not restrict physiotherapists recognised by the Board as having a specialist position form practising in other general areas in which they are competent.
Lee Gardiner (President) met Karen Poutasi (Director General of Health), and Lesley Askew (Physiotherapy Advisor) in July 1996. The review of the Physiotherapy Act was discussed, also the lack of 4th year funding, the shortage of physiotherapists and the withdrawal of physiotherapy outpatient services by some CHEs. Regular meetings were to be held between NZSP representatives and the Director-General of Health[25].
The Minister of Health Jenny Shipley stated that at the final reading of the Combined Review Bill each profession would retain its own Act. There was a change in removing the protection of the titles masseur, masseuse and massage expert under the Physiotherapy Act.[26]
Over 2,000 Physiotherapists were registered in 1996. Lee Gardiner reported in August 1997 that the Board was investigating the costs of setting up the Physiotherapy Board as a Body Corporate.
A revised Report from the Ministry of Health on recommendations for the new Physiotherapy Act was discussed in November 1996, and a policy paper based on the revised Report was produced by the Ministry of Health mid 1997. Further submissions were sought from the Society, consumer organisations, Regional Health Authorities, CHEs and other interested parties[27].
Advice was received from the Ministry of Health in October 1997 that there would be a delay of a few months before their report on Occupational Regulation legislation would be made to the Minister of Health[28].
A final draft paper was produced by the Ministry of Health in July 1997 and ciruclated for comment. The aim was to have the final Bill for presentation to Minister by end of 1997 and for legislative programme in 1998[29].
A Bill was put forward in March 1998 to make each of the Health Occupational Registration Boards (including the Physiotherapy Board) a Body Corporate, and to remove all Ministry of Health personnel from Board membership. Disappointingly, for the NZSP, the Bill was separated from the major review of the Physiotherapy Act 1949 and other Health Occupational Registration Acts which had been proceeding over the past two years. The full review of the Physiotherapy Act could be delayed until 2000. The Society made a submission on the Health Occupational Registration Act Amendment Bill in writing in April 1998 and Lee Gardiner presented it to the Health Select Committee on 15 April 1998[30].. The Society were strongly opposed to a piecemeal approach[31].
The announcement that the update on Ministry of Health Review of Occupational Regulation Statues was not included in the legislative programme for 1998 was made in April 1998[32]. The Society was originally told that the Bill might be passed in November 1998, but by September 1999 nothing had happened.
An Amendment making the Board a Body Corporate and restructuring membership of the Physiotherapy Board was passed in October 1999. It included other administrative details to assist the Board to maintain financial viability.
Both the Physiotherapy Board and the Society found the lack of a full review of the Physiotherapy Act most frustrating. There was a 6 month transition to establish the Body Corporate. For the first time since it was established in 1949 the Board had the power to elect its own Chairperson and Deputy Chairperson.
[1] E/M 24-4-82
[2] E/M 13-2-83 -
[3] E/M 17-9-83
[4] A/R 1984
[5] E/M 28-9-85
[6] E/M 17-2-85 -
[7] N/LDecember 1985-
[8] A/R 1986
[9] E/M 10-10-86 -
[10] E/M 19 - 5 - 84 -
[11] A/R 88
[12] E/M30 - 4 - 88
[13] E/M 15-12-88
[14] AGM 22 - 4 - 89
[15] E/M 3 - 3 - 89
[16] E/M AGM 19 - 5 - 90
[17] E/M 31-8-91
[18] E/M 15/16 - 2 - 92
[19] E/M 16/17 - 4 - 94
[20] E/M 27-11-94
[21] E/M N/L September 1996 page 3
[22] E/M 10-5-96 -
[23] N/L June 1996
[24] E/M 2/3 - 11 - 96
[25] E/M 20/21 - 7 - 96
[26] E/M N/L September 1996 page 3
[27] E/M 2/3 - 11 - 96
[28] E/M 4/5 - 10 - 97
[29] E/M 5-4-97 -
[30] E/M 18/19 - 4 - 98
[31]N/L April 1998 page 5
[32] N/L April 1998
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