Without many in the public being aware of it, there are again further attempts being made, to change the medical assessment and certification approach in New Zealand, by following and further advancing ideas already tried and implemented in the UK. We have not yet got a “provider” like ATOS or Maximus here, but the way things are gradually moving ahead, I would not rule out that such a large outsourced assessor may also be introduced here at a later stage, together with a “test” similar to the discredited ‘Work Capability Assessment’ they have in the UK.

It certainly appears so, that our infamous Dr David Bratt, Principal Health Advisor for Work and Income NZ (WINZ), part of the Ministry of Social Development (MSD), had been commissioned to seek submissions from certain stake-holder parties, to get their views on changes MSD wish to make, in regards to who can be authorised to sign their so-called ‘Work Capacity Medical Certificates’ WCMCs). As if the draconian welfare reforms pushed through from 2010 to 2013, which also introduced work capability assessments for sick, injured and disabled in New Zealand, have not been enough. They did already make some significant changes to the medical certificates WINZ expects from general and some other medical practitioners (mostly GPs and their listed ‘Designated Doctors’) in 2013, expecting doctors to provide more information on patient’s capabilities to do some “suitable” work, and also by clarifying health conditions, and avoiding to sign persons off as unable to work too soon.

Now the talk is of proper “Fit Notes”, rather than “Sick Notes”, which sound like an attempt to bring the local system more in line with the UK certification regime, perhaps with further amendments or “tweaks”. That is at least what a submission from the ‘Royal New Zealand College of General Practitioners‘ (RNZGP) from 18 February 2015 seems to reveal, across which we stumbled very recently.


Here is the PDF containing the 8 page submission, which can be freely downloaded online:

Click to access Submission-Widening-who-can-sign-Work-Capacity-Medical-Certificates.pdf

Update, 10 Aug. 2016: Due to website changes you need to use the following link, as the above one is no longer active and results in an error message:


We can note that the RNZCGP expresses at least some concerns about what Dr Bratt and his upper level “bosses” at the MSD seem to be planning! But even the RNZCGP seems happy to consider “good work” as “beneficial” to persons’ health, having followed the recommendations by the Australasian Faculty of Occupational and Environmental Medicine (AFOEM), being part of the Royal Australasian College of Physicians. As readers here may know, it was the then President Elect Dr David Beaumont (former ATOS staff member) and the invited UK “expert” Professor Mansel Aylward, with some assistance by Dame Carol Black and also “researchers” at the former ‘UNUM Provident Centre for Psychosocial and Disability Research’ in Cardiff, Wales, who paved the way for this new approach, with the “position paper” about the “Health Benefits of Work”.


With some interest and great concern did we also take note of the introduction of a new Bill into Parliament, not long ago, in the form of a so-called ‘Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill‘. The Ministry of Health has this information available on it online:


On the Ministry website it says:

“The Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill is to amend seven Acts to increase the range of health practitioners authorised to undertake functions under those Acts by changing the current references to medical practitioners to references to health practitioners. This will increase statutory flexibility and improve consumer access to the skills of health practitioners who are qualified to provide services.”


“Regulatory impact statements”

“The background documents for removing barriers to workforce innovation are provided here. There are two Regulatory Impact Statements (RISs) which concern the Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill. One RIS accompanied the 2011 Cabinet Paper and the other RIS accompanied the 2013 Cabinet Paper.”

“Currently the legislation sets out functions to be carried out by medical practitioners. The original intent of these statutory measures was to protect public safety by ensuring that only medical practitioners (doctors) with the required knowledge and skills were permitted to perform certain tasks. However, over time the training of health practitioners has changed. New technologies and treatment have been developed and the health workforce has adapted and diversified. Many health professional groups are now capable of performing tasks that were previously solely the domain of medical practitioners, such as taking blood pressure.”

“Many health professions are regulated by the Health Practitioners Competence Assurance Act 2003. The Health Practitioners (Replacement of Statutory References to Medical Practitioners) Bill takes account of responsible authorities established under the Health Practitioners Competence Assurance Act, to govern each profession and to establish scopes of practice setting out which activities each class of practitioners is competent to carry out under this Bill.”

“The amended Acts will enable health practitioners with the required competencies and knowledge to lawfully perform certain statutory responsibilities such as participating in claimants’ individual rehabilitation plans, issuing certificates of proof of illness or injury, providing ongoing health care, arranging medical examinations of children or young people, and taking blood specimens from road users. The amendments will make it easier for the public to access the statutory services from health practitioners and will facilitate innovative and efficient practice by practitioners.”

There is a range of Cabinet Papers and so forth downloadable from the website.


Here is a link to the page on the NZ Parliament’s website, where more information can be found:


Here is a copy of the Bill on ‘New Zealand Legislation’:


While these new changes may be welcome by some, and while they may seem rather limited at this stage, they appear to be preparing the ground for more changes to come. Hence the proposed Bill raises some important questions and concerns. Since we see that MSD are keen to have more medical and health professionals authorised to sign medical or ‘Work Capacity Medical Certificates’, I would be extremely concerned, as we know what Dr Bratt stands for, having in a number of his now well known “presentations” likened “benefit dependence” to “drug dependence”. He has fully signed up to the ideas and approaches by such UK “experts” like Professor Mansel Aylward and others – many from the controversial ‘Centre for Psychosocial and Disability Research’, formerly co-funded by UNUM Provident, in Cardiff, Wales, in the UK.

I would strongly advise readers to further read up on and study what all this may mean, as we could indeed soon see a further blurring of the lines, in regards to who may in future be allowed to sign our medical or ‘Work Capacity Medical Certificates’, likely to be “Fit Notes” or “Work Fitness Notes” of whatever types, than what we have known so far. It just appears so that the new agenda is being pushed further, to attempt and declare yet more persons with serious and permanent sickness, with impairments and disabilities of whatever kind, “fit” for work, so they can throw more off benefits and also off ACC claims support.



(Note: A similar post has also been published via ACC Forum)



Some other posts of interest, that relate to this topic:

(there are further parts to the work ability assessment post!)

  1. #1 by Pam Vernon on 09/08/2016 - 6:35 pm

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