We’ve got Ayesha Verrall heckling, saying, “Oh, we made amendments in the Medicines Act.” Well, that’s right, because even the previous Government found it so frustrating to have to do a separate approval when it was approved overseas, and, of course, if the previous Government had fixed the problem, we wouldn’t be here. In fact, if the previous Government had fixed more problems like this, they might be over here, but they’re not; they’re over there, because they were hopeless at fixing problems. But that’s enough from Ayesha Verrall—she’s had a go. She’s had her chance.
Now, this verification pathway is actually part of the Government’s wider work programme to streamline Medsafe’s processes, find efficiencies, and speed up the public’s access to medicines while maintaining appropriate safety measures and Medsafe’s credibility as a trusted regulator, which I think is important. In this case, we have less red tape, more speed, and more access to medicines while maintaining the same level of safety, because we’ll be asking ourselves: have any two of Australia, the United States, Japan, Switzerland, Great Britain, Canada, the European Union—you know, if any two of those jurisdictions have approved a medicine, the chances are that they didn’t both get it wrong and it’s safe to use here within 30 days, and I think that that’s a wonderful improvement.
We’re also going to be making changes to prescribing. This bill will help make medicine processes more efficient by expanding the ability for more types of prescribers to prescribe unapproved medicines for their patients where those are necessary for their care, and I want to acknowledge the role that the former Minister of Health Dr Shane Reti played in this change. Medicines that are unapproved in New Zealand are sometimes necessary for a patient’s care as a last resort, and that particularly happens during a shortage, where the thing that’s gone through the consenting process in New Zealand, even with the new faster process, may not be available because, often, there are shortages, especially in recent years with supply chain troubles. At the moment, only medical practitioners can prescribe what they call “off label”: give a different medicine—a substitute—while the usual medicine is unavailable. This bill expands that ability to nurse practitioners.
Nurse practitioners have advanced education in clinical training to practice, they can work autonomously, and they’re often involved in innovative service provision. It’s time to give them a bigger role. Especially in rural and other communities, which have difficulties in accessing GP services, nurse practitioners are hugely important—not to mention in aged residential care. Now, nurse practitioners can currently prescribe a range of medicines for their patients, but enabling them to prescribe unapproved medicines within their scope of practice, I think that’s appropriate for their patients—in the scope where these are appropriate for the patient’s care, it means that the patients can access medicines faster and will not be required to seek a prescription from a medical practitioner.
Finally, in further changes to prescribing, the bill goes further and enables all authorised prescribers to prescribe unapproved but funded medicines in situations where there’s a supply shortage. For example, in 2020, Pharmac funded an alternative oral contraceptive because there was a supply shortage, and with increasing supply chain issues, as I’ve mentioned, it’s important that we have that flexibility. When there’s a supply shortage of approved medicines, Pharmac can fund unapproved medicines as a temporary alternative, and yet not have to go through a consenting process all the while. It means that for patients that may not be able to get a prescription filled when they take it to a pharmacy, they can get another prescription from a GP because the only medicine available is that unapproved alternative.
The proposed changes will mean that pharmacists, prescribers, registered midwives, dentists, nurse practitioners, dieticians, and optometrists will be able to prescribe these medicines within their scope of practice, and this is going to save time for patients, doctors, pharmacists, and other health practitioners, and it will improve the continuity of care. All of our authorised prescribers are trained professionals, and this Government wants to make the best use of our health workforce.
As I was thinking about this bill coming to the House and the work that’s gone into preparing it, I was thinking about the challenge that we face in healthcare. We have an ageing population, we have increasing amounts of medical technology, and we have enormous challenges affording the standards of healthcare that people want. I’m reminded of one of the greatest New Zealanders—that is, Sir Ernest Rutherford—who once said that we didn’t have much money, so we had to think, and this is a small contribution to that culture.
We don’t have much money, so we’ve got to think. If a medicine is already approved in two other countries, let’s make it available to New Zealanders, because we ain’t going to find anything that two other advanced countries that are already using the medicine haven’t found. Other countries are already relying on each other; we should rely on them, too. If there’s a medical shortage and there’s a person who is qualified and capable, such as a nurse practitioner, of issuing a prescription of something off label, then let’s let them do it, because if you don’t have much money, you’ve got to think.
We’re going to have to do a lot more of this in healthcare: remove red tape, enable people and empower them, and let them make a bigger difference. If we do all of that, then I think we can overcome the severe challenges that we face in healthcare in this country and across the developed world. With that, I commend this bill to the House very much.