Health practitioner regulation set for major reform
The Health Practitioners Competence Assurance Amendment Bill 2026 proposes substantial changes to how responsible authorities operate and how practitioners are regulated. Introduced to Parliament on 18 May 2026, the Bill would materially change how health practitioners are regulated, with important implications for practitioners, regulators, insurers, and patients.
The Health Practitioners Competence Assurance Act 2003 has long underpinned professional regulation across the health sector. While it has been effective in maintaining standards, the Government considers the current system too fragmented and insufficiently aligned with wider health system priorities. The Bill reflects the Government’s move toward greater central oversight and more consistent regulatory settings.
In brief: what’s changing?
- Ministerial control: The Minister of Health gains power to direct regulators to give effect to Government policy – a significant change from the current independent model.
- New review committee: A ministerial committee will be empowered to review and set aside regulator decisions that refuse or limit registration or scope of practice.
- Conduct matters: Professional conduct (not just clinical competence) will be explicitly incorporated into registration and practising certificate decisions.
- Interim suspension: Regulators may suspend a practising certificate or impose conditions without prior notice where there is serious risk of harm.
Key proposed changes
1) Interim suspension without notice
The Bill expands powers to suspend a practising certificate or impose conditions. Where an authority considers there is a serious risk of harm, it may impose interim suspension or conditions without first hearing from the practitioner, with an opportunity to be heard as soon as practicable afterwards.
The Bill highlights practical implications for practitioners: potential for no warning, immediate effect, and the need to move quickly once aware of an order.
2) Professional conduct given greater weight
The Bill explicitly incorporates professional conduct alongside competence into decisions about registration and annual practising certificates. Past disciplinary history (including expired orders) may remain relevant to fitness‑to‑practise assessments. Annual practising certificate applications may be referred where there is uncertainty about conduct, placing the onus on the practitioner to satisfy the authority their conduct has been appropriate.
3) New complaint resolution options
The Bill proposes alternative complaint-resolution pathways, including restorative justice and conciliation (by agreement), and allows some matters to be determined “on the papers” where appropriate. The draft notes this may streamline straightforward cases but raises questions about when paper-based determination is appropriate and whether practitioners can insist on an oral hearing in contested matters.
4) Unlawful practice and banning orders
The Bill strengthens frameworks for addressing unqualified persons holding themselves out as practitioners, including lowering the threshold for prosecution by removing an “intentional” element and introducing banning orders/interim banning orders. Breach of a banning order can carry penalties including imprisonment up to 3 years and/or a fine up to $200,000.
5) New Health Practitioners’ Review Committee
A major innovation is the establishment of a Health Practitioners’ Review Committee with power to review and set aside certain decisions that refuse or limit a practitioner’s registration or ability to practise.
- Who sits on it: chair + deputy chairs (a barrister or solicitor of the High Court of not less than 7 years’ practice) and a Minister‑appointed pool of expert/lay panel members.
- What it can do: determine complaints about refusals to register and other specified decisions limiting practice and make a fresh decision in place of the authority’s decision.
- Who pays: regulators fund it, with costs apportioned by expected volumes (and likely passed on via fees).
- What’s unclear: interaction with District Court appeals, appeal rights from Committee decisions, and the Committee’s procedures/standard of review.
6) Public input on scopes of practice
Responsible authorities would need to consult and consider views of the public before issuing notices relating to scopes of practice or qualifications required for a scope of practice. The draft frames this as a shift toward including patient/public perspectives in defining professional boundaries.
7) Increased Ministerial oversight of regulators
The Bill introduces a new power for the Minister of Health to direct responsible authorities to give effect to Government policy within their functions.
This represents a shift from the traditionally independent model of health workforce regulation in New Zealand. While the power is constrained (for example, it cannot relate to individual practitioners or qualifications, and must consider patient safety and quality of care), it could extend to matters such as scopes of practice and registration processes.
The Bill also applies aspects of the Crown Entities Act 2004 to responsible authorities, including requirements to prepare statements of intent and performance expectations in consultation with the Minister.
8) Cultural competence
The Bill removes the express reference to Māori cultural competence from authorities’ functions. While broader cultural competence obligations remain, the removal of this specific reference is likely to be a focus during the select committee process, particularly considering Treaty obligations and ongoing equity considerations.
Practical implications and key risks
For health practitioners | For responsible authorities and regulators |
· Conduct history matters more (including past disciplinary findings, even expired ones). · Interim suspension risk (potentially without notice; urgent response may be required). · New review pathway exists, but interaction with existing appeal rights is unclear. · Increased costs likely (passed through higher fees). | · Loss of independence via Ministerial direction. · New accountability regime (planning/reporting expectations in consultation with the Minister). · Review Committee oversight may influence decision-making and reasons for refusals. · Funding burden and budgeting implications. |
For insurers | For patients and the public |
· Potential professional indemnity implications and shifting risk profiles. · Changes to investigations/appeals/ADR pathways may affect cost, duration, and resolution dynamics. | · Stronger protections in theory, depending on how powers are exercised. · Faster action in urgent cases, balanced against fairness to practitioners. · Concerns may arise regarding removal of express Māori cultural competence reference. |
What’s on the horizon?
Next steps are likely to include the Bill’s first reading and referral to select committee. Submissions and hearings will follow. The draft identifies key issues likely to be tested during the select committee process, including appeal pathways, interim suspension safeguards, and the cultural competence change.
Key takeaway: If enacted, the Bill would increase Ministerial oversight and expand regulators’ tools, with flow‑on impacts for practitioners and insurers.
What this signals: A more centralised regulatory model and a stronger focus on conduct and interim risk management.
How we can help: Duncan Cotterill will continue to monitor progress and engage on issues of significance to clients. If you would like advice on implications of the Bill or the submissions process, please get in touch.
Special thanks to Special Counsel Simone Tune, Solicitor Anna Yu, and Law Graduate Olive Smith for preparing this article.
Disclaimer: The content of this article is general in nature and not intended as a substitute for specific professional advice on any matter and should not be relied upon for that purpose.
