Kay Hull (Riverina, National Party) Share this | Hansard source

It is my pleasure to add further support for the amendments contained in the Medical Indemnity Legislation Amendment Bill 2006, which seek to amend the Medical Indemnity Act 2002 and the Medical Indemnity (Prudential Supervision and Product Standards) Act 2003. I will refer to a bit of history. This is something that, as the previous speaker said, has been going on for some time. However, contrary to the previous speaker’s assertions, I am very thankful that this government was able to listen and was in a fiscal position to be able to act. That is the difference between the coalition and the opposition—we have fiscal responsibility and a financial capacity so that, when an emergency issue breaks out, we have the resources and the will to be able to resolve such issues as they arise.

On several occasions I have spoken in the House on the issue of medical indemnity. It has always been of considerable importance in my electorate. I am a very fortunate member in that I have a very active medical workforce in my electorate, and I certainly give thanks to that workforce. But we did have a major issue when we saw the collapse of UMP, which threatened our vital health services right across the Riverina, as our specialist professionals were faced with enormously swelling insurance premiums and the possibility of practising without legal protection—an area that I am sure none of us as members want to see our professionals engaged in.

In response, the government ensured swift action to enable and assist our healthcare professionals to be comforted that they would have access to a medical indemnity cover that was provided by regulated insurance and, more importantly, was underpinned and underwritten by this government. Some 18 months before United Medical Protection did collapse, I recognised, through the very good work of an obstetrics practitioner in my electorate, Dr John Curry, that there would be a problem. There were continuing calls on the profession to provide further premiums and further underwriting of UMP. He visited me and advised me that he felt that there was an impending disaster with UMP. He advised me that he felt that there would be a collapse of this company. Their calls were getting greater and the professionals were not able to match the requirements from the company.

He raised my awareness of this matter. We travelled over to Canberra on numerous occasions. We addressed our backbenchers and, in our committee activities, I held many meetings in this House for backbenchers where Dr Curry was able to sit down and highlight the issues that were facing particularly obstetrics cover and to suggest that, unless somebody actually stepped in and did work on our tort law reform—and that was a state issue—to particularly raise the issue of the 21-year statute of limitations and the way in which the rulings of the court were giving extreme payments in compensation to affected people, there would be a serious problem. Of course, we do not deny people compensation, but the obstetrician certainly does have a difficult road to walk in that the statute of limitations does exist for 21 years and when you are looking at studying obstetrics you have to decide whether that is a road that you want to travel or whether you will just go into gynaecology.

Then another crisis emerged in the state hospital system whereby there was no indemnity and no cover for our practitioners, professionals and GPs alike to be able to practise in the state hospital system. I was very involved in the process of trying to resolve this issue with the then New South Wales state minister, Craig Knowles. The state government was a long time coming to the party—I think our practitioners ceased their cover on New Year’s Eve—and it was almost at the death knell on New Year’s Eve that Minister Knowles came in with an agreement to cover any practitioner who was going to provide services in a public hospital. It was an anguished time for all, not just for the professionals but moreover for the constituents right across the Riverina who were in a state of flux and uncertainty as to how their services were going to be delivered and how their operations were going to take place, particularly if they did not have private health coverage. We were able to resolve that, and it certainly was appreciated by my medical specialists because it enabled them to be able to offer the service for which they had trained for all those years and that they had undertaken an oath to provide.

The UMP crisis very quickly saw the exodus of specialists who had decided to retire or who were thinking of retiring in that three- to five-year bracket after the UMP downfall. They were insecure about what was going to happen in their family lives and to the assets they had built up over long periods of work, commitment and dedication to regional and rural electorates. So an enormous effort had to be put in by successive health ministers. The problem really did escalate and affected obstetrics. Obstetricians have one private outlet in the Riverina—Calvary Private Hospital—and they decided that because of the additional premium they had to pay to practise private obstetrics they would remove their services from Calvary maternity services.

We had about 600 to 700 deliveries per annum in the Calvary maternity hospital and about 700 to 800 in the Wagga Wagga Base Hospital, which is a regional base hospital. It was very obvious that the base hospital was not set up to deliver all the babies right across the Riverina, so the state system did not want the Calvary services withdrawn, because they were not able to adequately cope. We were faced with an emerging issue that may have seen normal, healthy pregnant mothers being airlifted to a Sydney or other city or metropolitan hospitals to give birth in a normal, very healthy way, and that generated a major march. About 2,000 members of the community—mums and dads with babies in prams and strollers, and grandparents—marched up the streets of Wagga Wagga to demonstrate that they needed the facility at Calvary maternity hospital to continue. The call was that we in the government should resolve the issue—and we did. The Minister for Health and Ageing, Tony Abbott, came in, as he always does—he is certainly the best friend the Riverina residents have ever had in health—and resolved the issue. It was a significant and great benefit to the people of the Riverina.

We then introduced a levy system, but some anomalies started to develop within that system. I pay tribute to the former health minister, Kay Patterson, and, more particularly, to Tony Abbott, who, as I said, is the best friend the Riverina people have ever had in health. He started to undertake the discussions that needed to take place in order to resolve a very complicated and longstanding system that was left to languish for many years before this government came into power in 1996. It certainly did not happen overnight. It was a problem that had languished for many, many years.

I turn now to one of the issues we saw emerging with new entrants coming into the system. For example, one of my professionals, a surgeon, David Littlejohn, was a new entrant to the system, and it seemed as though he was going to have to pick up the tail and pay for all the previous issues of the people who came before him. I was very keen to resolve that. Young surgeons were coming in to practise in the Riverina, and they had committed to stay in the Riverina and raise their children there, yet it looked as though they were going to have to pay for all the past issues of other surgeons. That meant that practising in the regions was not a viable option, and it forced them to move to a city area where the critical mass and turnover are greater and the ability to earn revenue is increased and you can pay for the call upon you. Of course, Tony Abbott came in and resolved that issue for us.

It has been a moving feast for ministers, because every day there has been a new and extremely significant flaw or issue they have had to deal with and try to resolve. Quite rightly, the Australian public were beside themselves, because they thought there was every chance that they would lose their services, and that had a major impact financially, socially and emotionally. We saw that people moved out of obstetrics and into the field of gynaecology in order to reduce their premiums. Because there was no certainty in obstetrics, young clinicians who were looking to practise in that field started to reassess whether they would do that or go on to another craft or another field.

What we have done is really underpin a health service that, in essence, with this government’s support and assistance—particularly with the minister’s assistance—has become better and better at delivering services that the Australian people need. We have had issues with orthopaedics and anaesthetists. We certainly had issues with anaesthetists, which the minister had to step in and resolve. This minister has had more call upon him to be able to utilise common sense and reason to get to the bottom of long and ongoing issues in medical services. He has finally been able to resolve many of those issues so that he can assist us to deliver the expectations of our regions. I am particularly interested in the regions.

The government’s original package of medical indemnity legislation in 2002 addressed the affordability of medical indemnity for doctors and the industry’s long-term viability in a period of upheaval. Thanks to these changes, our medical practitioners in private practice have been able to obtain affordable medical indemnity insurance cover and insurers have been protected against more extreme claims. However, those who have left the medical workforce, including our retirees and those on maternity leave, who are often faced with significant ongoing costs for run-off cover for incidents which occurred during their careers but had not been reported at the time, have now been able to be protected and have their issue revolved.

The ROC scheme began on 1 July 2004. It is a logical extension of the medical indemnity package designed to provide secure insurance for doctors who have left their private practice. The intention was that medical indemnity insurers would provide cover on the same basis as doctors who were still in the workforce. But, in the former case, the government would reimburse the cost of claims to insurers. Coming back to the fiscal responsibility and financial management of this government, that can only happen when you have across-the-board, good financial management and there is money in the bank. Many times this government has been criticised for the surplus that its good fiscal policy and financial management engenders. But that is why you need surpluses: when emergencies come into the system, they have to be resolved and there is money there to resolve them rather than running into deficit like the New South Wales Labor government is at the moment, where our health services are absolutely atrocious and appalling. If they had managed their financials much better then they would be providing better services to the people of the Riverina, which is honestly getting a service that is secondary to the city people with respect to public health services that are run by the New South Wales state Labor government.

What we have now is this ROCS cover, which will simplify the administration of the scheme. Many insurers and medical practitioners raised concerns. Some of the provisions of the bill extend beyond ROCS. Apart from those clarifying abbreviations, these include a relaxation of penalty provisions in relation to compulsory offers of retroactive cover and the fact that doctors who accept such an offer no longer have to respond in writing but those who refuse will. This will ensure that no doctor misses out on retroactive cover by accident. We are very aware of exactly what the predicaments are and the concerns and conditions are for these practitioners.

This bill demonstrates the ongoing commitment of the government to the medical indemnity industry, doctors and their patients and to ensuring that medical indemnity insurance continues to operate viably, fairly and efficiently for the benefit of the industry, the doctors, the patients and, No. 1, the taxpayers.

I would like to pay particular tribute to those doctors and professionals in my electorate, particularly doctors such as Gerard Carroll, John Currie, Henry Hicks, David Stewart and David Littlejohn, Richard Harrison and others, who have come to me with the concerns of the local professionals. They have been willing to sit around the table, not just to bring the problems to the member but to try to bring some sensible suggestions as to how the government might resolve these issues. Their assistance in being able to deliver some sensible outline has been very much appreciated.

I would like to take the opportunity to pay tribute to the fabulous medical workforce and those professionals in my electorate of Riverina. Their commitment to the people across the Riverina is absolutely unconditional. How fortunate we are to have these young professional men and women who have undertaken to deliver our health services and to set up practice in a regional area to provide rural people with the same level of health services as one might get in the city. In fact, I would go so far as to say that we are probably providing better health services through those very dedicated professionals.

I would like to close by thanking the Minister for Health and Ageing, the Hon. Tony Abbott, for whom I have the absolutely highest regard, particularly in this area. This was a difficult area to resolve. It was an emotionally charged area, with more good ideas coming forward than ever before—but they were short in practical application. The minister was able to surf his way through all of the issues, sideline the things that were just emotive hype, cut to the chase to get to the real crux of the problem and then provide the assistance that was required in order to resolve it. So I think that the minister should be supported in this bill.

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