Dialogue: Red tape blocks capable doctors from working

Dutch-born Dr Joop Swaab has a frustrating but not uncommon problem.

Although he worked for 15 years as a medical specialist consultant in his homeland, this fully trained medical practitioner, who now lives near Tauranga, is still after six years unable to gain registration as a doctor here. All this despite favourable reports from his superiors in a number of health-related jobs in this country.

There are many cases like Dr Swaab of talented, fully qualified people who would have no problems calling themselves "doctor" and practising medicine overseas, yet through red tape and intransigence are denied the opportunity of doing so here.

Too many foreign qualified medical practitioners are not permitted to practise here. This is unfair to those involved and a waste of a valuable resource to the people of New Zealand.

The irony is that this is occurring while the medical profession complains of a brain- drain as some of our most talented people seek opportunities overseas.

Hospitals and the rural communities, in particular, have been hit hard by a shortage of qualified medical staff which is now reaching crisis point.

And yet this country maintains highly restrictive trade practices. While waiting lists lengthen, very able, qualified people are denied the right to practise medicine.

The private member's bill which I am promoting, and which will go before Parliament on Wednesday, is a sound and sensible solution. The Medical Practitioners (Foreign Qualified Medical Practitioners) Bill in essence will ensure that foreign-qualified medical practitioners who ought to be allowed to practise medicine in New Zealand, are registered and can obtain the necessary practising certificates.

At the moment, the act covering registration leaves a large amount of discretion with the Medical Council in terms of both the registration of medical practitioners and the designation of approved institutions. This has led to accusations and a widespread perception that the medical profession is acting as a closed shop, not allowing people who are equally as talented to practise medicine simply because they are outsiders.

Under the terms of the proposed amendment, the Medical Council will continue to be responsible for registering doctors, but responsibility for determining competence to practise medicine here will be assessed independently.

The process of registering overseas qualified medical practitioners would, in future, revolve around determinations of competence made by the Qualifications Authority, rather than, as in the past, leaving such determinations up to the council's discretion. This would put registration of medical practitioners on the same footing as that of many other professions which rely on the Qualifications Authority to gauge the suitability of people coming to New Zealand to work in their designated professions.

The aim is to ensure that the requirements for registration of overseas-trained doctors are more objective than is the case now.

The bill also contains provisions that allow for a general right to registration. The Qualifications Authority would be empowered to specify countries from which medical practitioners would automatically qualify for registration as doctors here.

The authority would also be able to specify institutions and qualifications in other countries that would give overseas doctors the opportunity to be registered and practise in New Zealand after they had received additional training, exams and experience as was considered necessary to achieve the required competence.

The authority would be able to call on the Medical Council for help in assessing competence. The bill also provides for consultation with the council and others, as the authority considers appropriate.

Fr this system to work properly, however, it is envisaged that final decisions and control would remain with the authority.

While this proposed bill would make the process of registering overseas medical practitioners in this country more streamlined and easier, there would be no reduction in the standard of medical care. The provisions in the bill deal with making it easier for qualified, skilled people to practise medicine here.

However, the door would remain closed to people with inadequate skills or inferior qualifications. I have no intention of promoting a lowering of clinical safety standards.

It is important that all MPs support the Medical Practitioners (Foreign Qualified Medical Practitioners) Amendment Bill. By referring the bill to a select committee, they would give the public and all interested parties an opportunity to make submissions on this topic of great interest and concern.

It is vital that the issue is opened to scrutiny, so that the medical profession and the public at large can have confidence in the integrity and fairness of the doctor registration process.

* Ken Shirley is an Act MP.