When the Medical Council of New Zealand receives a notification about you, it decides which of three routes under the Health Practitioners Competence Assurance Act 2003 (the HPCA Act) the concern belongs on: competence, health or conduct. It writes to you with the concern and the material it holds, asks for your written response by a date, and then decides whether to close the matter, order a performance assessment, refer you to its Health Committee, or appoint a Professional Conduct Committee. While a matter is open it can impose interim conditions or an interim suspension. Call the Medical Protection Society the same day, obtain the records, do not alter them, do not contact the notifier, and reply before the date with a response written against the record that shows what you have done since.
Who can notify the Council and what the letter contains
A notification can come from a patient or their family, a colleague, a nurse or pharmacist, an employer, a hospital, a court or another agency. Two notifications are mandatory under the HPCA Act: an employer must tell the Council when a doctor resigns or is dismissed for reasons relating to competence (section 34), and a practitioner or employer who believes a doctor may be unable to perform the functions required for practice because of a mental or physical condition must tell the Registrar (section 45). A complaint made to the Health and Disability Commissioner reaches the Council when the Commissioner refers it; the guide to how an HDC complaint reaches your Council describes that path.
The Council's letter tells you what the concern is, which route the Council has placed it on, what material is enclosed, what it wants from you and the date by which it wants it. Read it twice and write the concern out in your own words. That sentence is what your response has to answer.
The three routes and who decides
Competence. If the concern is that your practice may fall below the required standard, the Council can order a competence review under section 36 of the HPCA Act. The Council's name for its competence review is a performance assessment. Assessors review your records, interview you and people you work with, can observe your practice and can set written components, then report to the Council. The guide to the Medical Council performance assessment describes the day itself and how to prepare without changing your records.
Health. If the concern is that a mental or physical condition may affect your ability to practise, the matter goes to the Council's Health Committee. The Committee can ask you to be examined, can accept voluntary undertakings and can recommend conditions on your scope of practice. A health matter is handled separately from conduct and is confidential within the limits the Act sets. The guide to the health process under the HPCA Act explains it.
Conduct. If the concern is about behaviour rather than skill, the Council can appoint a Professional Conduct Committee under Part 4 of the Act. The Committee investigates, hears from you and recommends one of a set of outcomes to the Council, or lays a charge before the Health Practitioners Disciplinary Tribunal. The guide to how a Professional Conduct Committee process runs covers the investigation and your right to be heard.
What the Council measures you against
The Council assesses conduct against Good medical practice, its core standard, and against the statements that sit beneath it on informed consent, sexual and professional boundaries, patient records, prescribing, electronic communication and social media, cultural safety and the disclosure of harm after an adverse event. The letter, a performance assessment report or a Professional Conduct Committee's charge refers to the paragraphs that apply. The guide to how Good medical practice is used in a Medical Council investigation shows how an allegation is mapped to the standard and how to use the standard in your own response.
What happens, step by step
- The letter arrives. The Council sends you the concern, the material and a date. Call the Medical Protection Society that day and ask your practice or employer in writing for the records.
- You respond in writing. Your response sets out the facts from the record, your reasoning at the time, what fell short, what you have done since and what you have understood, with the evidence attached. The guide to how to write a response to a Council notification gives the structure.
- The Council decides the route. On your response, the records and any further enquiries, the Council decides whether to close the matter, order a performance assessment, refer the matter to its Health Committee or appoint a Professional Conduct Committee. It can also write to you with advice and close the matter.
- The assessment or investigation runs. A performance assessment is carried out by assessors who report to the Council. A Professional Conduct Committee gathers documents, can interview you and witnesses, and gives you its proposed findings to respond to before it decides.
- You are heard before any order. Before the Council imposes conditions, requires a programme, or makes an interim order, it tells you what it proposes and gives you the chance to respond in writing or in person.
- The outcome is decided and reviewed. The Council records its decision and any conditions, tells you what it has told your employer and what appears on the register, and sets when conditions will be reviewed. A charge laid by a Professional Conduct Committee goes to the Tribunal for a hearing.
Interim orders
While a Professional Conduct Committee investigation is open, section 69 of the HPCA Act lets the Council suspend your practising certificate or place conditions on your scope of practice if it is satisfied that is needed to protect the public. The Council can also make an interim order while a competence or health matter is open. You are entitled to be heard before the order is made, and the Council can vary or revoke it. A doctor who has already arranged supervision, restricted the part of practice the concern relates to, and shown that in writing gives the Council a reason to choose conditions over suspension. The guide to interim suspension and conditions on practice covers the risk test and how an order is lifted.
What you can do now
- Get advice the same day. The Medical Protection Society. Tell them the route, the date and what the Council has asked for. Ask whether a lawyer should be instructed now.
- Get the records and keep them as they are. The clinical record, prescriptions, referral letters, rosters, messages and any policy you were working under. Ask for copies in writing.
- Write the response against the record. Facts with page references, reasoning at the time, what fell short, what you have done since, what you have understood. One adviser reads every draft before it goes.
- Start remediation before you reply. Supervision with a named colleague, an audit of the part of practice concerned, a change to how your consultations or prescribing are organised, and courses completed with dated certificates. Completed steps are evidence; intended steps are promises.
The outcomes
At the first stage the Council can take no further action, write to you with advice, or send the matter down one of the three routes. After a performance assessment it can find that no concerns remain, require you to complete a programme it sets with a supervisor and a timeframe, or place conditions on your scope of practice. On the health route it can accept undertakings or impose conditions. A Professional Conduct Committee can recommend that the Council take no further action, counsel you, order a competence review, impose conditions, or it can lay a charge before the Health Practitioners Disciplinary Tribunal. The Tribunal can cancel or suspend registration (suspension for up to three years), impose conditions, censure, fine and award costs, and its decisions are published. The guide to a Health Practitioners Disciplinary Tribunal hearing describes what it weighs.
At every stage the Council asks three questions: what happened, whether it fell below the standard, and whether the public is safe now. Your conduct since the letter arrived answers the third.
Where remediation fits
The part of a Council matter you control is what you have done since the concern was raised. Courses completed before your response goes, with dated certificates attached, are evidence that you have engaged with the standard the Council is measuring you against. Ethics for Doctors and Professionalism for Doctors are written against Good medical practice and the Council's statements, so a certificate from either answers a concern that is framed in the Council's own terms. Dealing with a Complaint or Investigation covers how to engage with the Council's process and what a response needs to contain, and Insight for Fitness to Practise covers the difference between regret and insight, which is the difference the Council and the Tribunal both look for.
Each course is NZ$200, takes 2 CPD hours, is self-paced with immediate access, and ends with a dated certificate issued by Healthcare Ethics Courses that you can submit to the Council or put in your remediation plan. The remediation courses for doctors facing a Medical Council investigation are listed on one page, and the Council and Board investigation process explained shows where each course sits in the stages. The guide to showing insight and building a remediation plan explains how to present the certificates with the rest of your evidence, and the guide to what happens after a notification to any Council or Board gives the whole HPCA Act process.
Sources and further reading
- Medical Council of New Zealand: Good medical practice, the Council's statements, and its pages on concerns about a doctor, performance assessment, health and professional conduct.
- Health Practitioners Competence Assurance Act 2003: sections 34, 36, 45 and 69 and Part 4 on Professional Conduct Committees and the Tribunal.
- Health Practitioners Disciplinary Tribunal: published decisions involving doctors, with the penalties imposed and the weight given to insight and remediation.
- Health and Disability Commissioner: how a complaint about a doctor is assessed and how it reaches the Council.
Frequently asked questions
Who can make a notification to the Medical Council about a doctor?
Anyone. A patient or a member of their family, a colleague, a nurse or pharmacist, a practice manager, a hospital or an employer. An employer must notify the Council when a doctor resigns or is dismissed for reasons relating to competence, and any practitioner who believes a doctor may be unable to practise because of a mental or physical condition must notify too. The Health and Disability Commissioner refers matters to the Council, and the Council can act on information it receives through recertification, a conviction or a court.
Will my employer or the public find out about the notification?
The Council tells you who it has told and what it has asked them for. An employer can be asked for records or a report, and an employer that made the notification already knows. Conditions on your scope of practice can appear on the public register, and a charge before the Health Practitioners Disciplinary Tribunal is heard in public unless the Tribunal orders otherwise. A matter that closes at the first stage with no further action is not published. Ask the Council in writing what it will record and where.
Can the Medical Council suspend me while it looks into the concern?
Yes. While a Professional Conduct Committee investigation is open, section 69 of the HPCA Act lets the Council suspend your practising certificate or impose conditions on your scope of practice if it believes that is needed to protect the public. The Council can also make an interim order while a competence or health matter is open. You are entitled to be heard before an interim order is made. The order lasts until the matter it was made for is decided, and the Council can vary or lift it.
What is a performance assessment?
It is the Medical Council's name for its competence review of a doctor under section 36 of the HPCA Act. The Council appoints assessors who review your records, interview you and people you work with, can observe your practice, and report to the Council on whether your performance meets the required standard. The Council then decides whether no concerns remain, whether you should complete a programme it sets with a supervisor, or whether conditions should be placed on your scope of practice.
Should I contact the Medical Protection Society before I reply?
Yes, the day the letter arrives. The Medical Protection Society has advisers who know how the Medical Council reads a response. They will tell you which records to obtain, whether a lawyer should be instructed, what you can acknowledge and how to word it. A response that no adviser has read is the single avoidable risk in the first stage of a Council matter. Tell them the date in the letter when you call.