Part 1: Introduction

Our insights into five health regulatory authorities.

1.1
The health sector receives significant public funding. In 2023, an estimated $26 billion (about 16% of total government expenditure) was spent on providing safe, accessible, and quality healthcare to New Zealanders.

1.2
There are 18 responsible authorities in New Zealand, which regulate a workforce of nearly 140,000 registered health practitioners.3 These authorities have an important role in keeping the public safe from harm. They register health practitioners and subsequently certify that those practitioners remain competent and fit to practise. They also set clinical and cultural competence standards for practitioners and manage complaints and notifications about their conduct or competence.

1.3
As the auditor of all 18 responsible authorities under the Public Audit Act 2001, the Auditor-General provides independent assurance to Parliament and the public that the authorities are fairly reporting on their financial performance (and, where applicable, their service performance).4

1.4
In this report we highlight the role of responsible authorities and their contribution to the wider health sector.

1.5
This report explains:

  • the responsible authorities’ role in ensuring patient safety and contributing to workforce planning;
  • the independent performance reviews of responsible authorities, which are managed by the Ministry of Health (the Ministry);5 and;
  • what we have seen in recent audits of five of the larger responsible authorities.

What we looked at

1.6
This report focuses on five of the 18 responsible authorities. These are the:

  • Dental Council;
  • Medical Council of New Zealand (the Medical Council);
  • Nursing Council of New Zealand (the Nursing Council);
  • Pharmacy Council; and
  • Physiotherapy Board.

1.7
The responsible authorities use different operating models. We focused on these five responsible authorities because they are large, collectively regulate the majority of the regulated workforce, and function as standalone organisations.6

1.8
Our findings are based on our annual audits and publicly available information published by these five responsible authorities. This includes information from annual reports, strategic planning documents, workforce reports, and independent performance review reports.

3: The 18 responsible authorities are the Medical Council of New Zealand, the Dental Council, the Nursing Council of New Zealand, the Midwifery Council, the Pharmacy Council, the Physiotherapy Board, the Chiropractic Board, the Optometrists and Dispensing Opticians Board, the Osteopathic Council, the Podiatrists Board, the Psychologists Board, the Dietitians Board, the Medical Sciences Council of New Zealand, the Medical Radiation Technologists Board, the Occupational Therapy Board, the Psychotherapists Board, the Chinese Medicine Council of New Zealand, and the Paramedic Council.

4: For 2022/23, the Medical Council of New Zealand voluntarily reported on its service performance, which formed part of its annual audit.

5: The reviews are carried out by an external independent organisation (a designated auditing agency).

6: The Nursing Council provides corporate and regulatory support servies under contract to 11 other authorities that we did not look at. The Medical Sciences Council and Medical Radiation Technologists Board jointly own a company (Medical Services Secretariat Limited) that provides corporate services to the remaining two authorities we did not look at.