Effective and respectful interaction with Māori: How the regulators of health professionals are responding to the Health Practitioners Competence Assurance Amendment Act 2019

AIMS: To ascertain the response of registered health professional regulators to the legislated requirement under the Health Practitioners Competence Assurance Amendment Act 2019 (HPCA Amendement Act) that practitioners are culturally competent and, specifically, enabling "effective and respectful interaction with Māori". METHOD: A document analysis of the extent to which the culturally competent requirement is indicated in information about professional competencies within publicly available information of the 17 responsible authorities (RAs) that govern health practitioners under the Health Practitioners Competence Assurance legislation. RESULTS: Three years after the amendment to the original Act (HPCA Act) requiring health professionals to be culturally competent specifically in relation to interacting with Māori, only four of the 17 RAs fully reference the amended requirement, and only two RAs link this specific cultural competence to the requirements of the amended Act (HPCA Amendment Act). The majority of the RAs have yet to integrate references to engaging with Māori in this way into their professional competencies. CONCLUSIONS: Culturally competent practice is only meaningful once it is enacted by individual practitioners in their interactions with others. It is imperative for RAs to include the cultural competence requirement into their published information about professional competencies as this would signal to the profession, practitioners, and wider community that effective and respectful interaction with Māori is a fundamental expectation of all health practitioners in this country. Other issues identified during the analysis suggest an emphasis on administration and bureaucracy. This presents an opportunity for consolidating the practice of RAs including how key functions are expressed and promulgated.

Transforming the system to enable good lives for disabled people

Health and disability Structures and systems convey meaning, and locating disability sector resources and leadership within MoH has been seen by some as conflating disability with illness, and particularly medicine.5 Living with a disability does not mean a person is unwell and this sense that resources and support are linked to diagnosis and treatment extends to messages of needing or seeking cures. The New Zealand Government ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD)11 in 2008, the year it came into force. The experience and impact of this during the Omicron outbreak, compiled in a Human Rights Commission reportit2 and summarised in Table 2 below, provide insight into the issues. While work to reform the disability support system has been underway for more than a decade, substantial investment is required to meaningfully support people with disabilities" (p. 23) Working with the EGL approach Moving to a new structure and model for managing resources presents new opportunities and also a number of challenges.

Overcoming barriers to COVID-19 testing and vaccination - everything matters

The position of health professionals Most of us have not lived through a pandemic before, but those familiar with the world of health professional practice have a head-start in understanding what has unfolded across the world in the last 18 months. Health-care staff can improve access through building relationships and rapport with people.1 Health professionals have a practical understanding of testing and vaccination. The challenges health professionals face as they work in risky settings, manage uncertainty, and interact with people experiencing stress are recognised as problematic in specific settings2 and also in the context of the COVID-19 response.3 A practitioner may pay minimal attention to inflicting pain and discomfort, or minimise it as only being for a few seconds for each patient, as a useful strategy in a crisis, enabling them to keep going. The fact that home-based screening for cervical cancer in Aotearoa New Zealand has only recently been introduced is an example of our slowness to adopt less-invasive approaches to screening, which has had a significant impact on access for Māori women.4 The cervical screening issue is another reminder to think about equality in terms of access, culture, and context.