Chris Trevor (Flynn, Australian Labor Party) Share this | Hansard source

I rise to speak on the Private Health Insurance (National Joint Replacement Register Levy) Bill 2009. This bill creates a new act, the Private Health Insurance (National Joint Replacement Register Levy) Act 2009, for the purpose of establishing the national joint replacement register levy, for funding the National Joint Replacement Registry, the NJRR.

The NJRR was established by the Australian Orthopaedic Association in 1998. It collects data on the implantation of prosthetic joint replacement devices and reports revision rates, complications and other outcomes. The NJRR also monitors mortality rates. Its purpose is to define, improve and maintain the quality of care of patients receiving joint replacement surgery. The information collected provides an accurate measure of the success or otherwise of a procedure. This information is then used to inform surgeons, other healthcare professionals, governments, sponsors of joint replacement products and patients. The NJRR provides post-market surveillance of joint replacement prostheses, and this monitoring of the safety and quality of devices provides considerable benefit to the industry by improving consumer confidence in the safety and efficacy of joint replacement devices. Any devices showing high failure rates can be identified quickly and promptly removed from the market. This is good news for recipients.

The data produced by the registry also assists the industry by informing of the development of new prostheses, allowing manufacturers to draw on reliable performance information for existing products and designs. The cost recovery arrangements contained in the bill will ensure continuing funding for the registry, while preserving the independence of the registry. As levies will be imposed under legislation and collected by the government on behalf of the registry, there will be no possibility of funding being withdrawn from the registry by medical devices sponsors. Sections 1 and 2 of the bill will commence on the day on which the act receives royal assent. Sections 3 to 9 of the bill will commence on 1 July 2009 or on the date of royal assent, whichever occurs later.

The bill will enable the costs of operating the NJRR to be recovered by means of a levy imposed on each joint replacement prostheses sponsor, on each day specified in the Private Health Insurance (National Joint Replacement Register Levy) Rules as a national joint replacement register levy day, and on each day, if any, determined by the Minister for Health and Ageing, by legislative instrument, as a supplementary national joint replacement register levy day. There can be no more than four levy days in a financial year and the minister cannot specify more than two supplementary levy days in a financial year.

A person is a joint replacement prosthesis sponsor if a joint replacement prosthesis is currently listed in the Private Health Insurance (Prostheses) Rules—commonly referred to as the Commonwealth Prostheses List—either as a result of an application made by the person under section 72-10(2) of the Private Health Insurance Act 2007 or as listed in accordance with section 12 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007, and the person was the sponsor of that prosthesis for the purposes of the National Health Act 1953. Sponsors will be levied according to the number of joint replacement prostheses they sponsor, and the levies will be used to fund the operation costs of the registry. The bill does provide that there may be different rates set for different kinds of joint replacement prostheses, that the rate may be set at zero and that there will be a maximum rate of $5,000.

There are a wide range of prosthetic devices used in joint replacement surgery, as we know. These correspond to a great variation in benefits for different kinds of joint replacement prostheses listed on the Commonwealth Prostheses List. Benefits for some joint replacement prosthetic devices are set at less than $50, while others receive benefits as high as $67,000 per product. The Private Health Insurance (National Joint Replacement Register Levy) Rules may specify that different kinds of joint replacement prostheses may have different levies. Given the variation in benefits for different kinds of joint replacement prostheses, a maximum rate of levy of $5,000 for a financial year is considered reasonable.

Continued social integration for aged people is an important issue for their physical and mental health and general wellbeing. Unfortunately, several factors make it difficult for the elderly to achieve that goal, namely health problems, loneliness, changes in the social network structure and, importantly, mobility. In order to successfully integrate into the community the elderly need formal and informal support  by way of family care, but they also need to consider themselves as the principal architect of their own care, wellbeing and development. It has been well demonstrated that physical mobility, particularly outside the home, favours the maintenance of activities representing for the elderly a vital condition for their social integration. A high level of activity has been shown to be positive for successful ageing, health status and everyday wellbeing. Therefore, a better description of the elderly people’s daily activity patterns, referring to either necessary or leisure activities, is important for a better understanding of how older people remain integrated in the community.

A considerable amount of research has focused on the advantages of maintaining an individual’s independence at home for as long as possible and the impact of physical mobility as a means to achieve social integration. This is a major issue, considering the fact that about 30 per cent of the overall activities of the elderly take place in the community. Mobility of the elderly is not only desirable for their social connectedness but also contributes significantly to their quality of life. To a large extent a socially integrated older person is mobile, autonomous, part of a social network and engaged in meaningful social activities. One of the most relevant instrumental activities in daily life for maintaining independence and reinforcing self-identity is the ability to either drive a car or catch public transport, which represents independence and convenience and further symbolises autonomy and freedom.

A community organisation in my home town of Gladstone, called the Gladstone Aquatic Therapy Association, helps many aged people who have had joint replacements. The Gladstone Aquatic Therapy Association was formed by a small group of volunteers in 1989 to meet community demand for water therapy following construction of a heated, enclosed purpose-built pool in the city. In 1994 the organisation became incorporated and was awarded recurrent Home and Community Care Program funding, allowing the group to greatly expand their consumer case load, appoint staff to administer the service and coordinate the volunteer program. In 2009 we now see the service accommodating between 90 and 100 frail aged and children with a disability, at any given time. Gladstone Aquatic Therapy Service provides aquatic therapy classes and water exercise to the frail aged and adults and children with a disability. The association is full of wonderful community minded people who do a fantastic job for our community of Gladstone and surrounding districts.

One of the Gladstone Aquatic Therapy Association outcomes is to foster consumer independence and health maintenance. They have personal care assistants who hold aged-care certificates and coordinate the volunteer personal care assistants. The association provide a supervised aqua program to both the elderly and people with a disability to help those people improve their mobility, confidence, lifestyle, socialisation and health. They assist the frail aged, and younger and older people with moderate to severe or profound disabilities, from Miriam Vale to the south, Ambrose to the north, Many Peaks to the west, and the towns of Boyne Island, Tannum Sands, Calliope and Gladstone, which fall in between. The association assist people with arthritis, acquired brain injury, muscular dystrophy, multiple sclerosis, paraplegia and quadriplegia, those with a profound or multiple disabilities and those who have had a stroke, hip or knee replacement or some other form of serious injury. The Gladstone Aquatic Therapy Association are to be commended for their efforts. The consumer’s health, wellbeing and independence is optimised, allowing people to live, to as great a degree as possible, independently and in the local community. I commend this bill to the House.

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