Andrew Southcott (Boothby, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services, Health and Wellbeing) Share this | Hansard source

The registration of health professionals in Australia has been done at a state level. This has always led to problems when people move between jurisdictions, so as a result the Mutual Recognition Act 1992 provided that when someone was recognised in one jurisdiction they could apply to practice in another jurisdiction, in another state or territory. Following the case of Dr Patel in Queensland and, in the United Kingdom, the case of Harold Shipman, there has been enormous interest in improving the system of registration of health professionals in this country. Unfortunately, the national registration scheme that we have here now will do nothing to enhance patient safety; it will do nothing to enhance professional quality.

The Productivity Commission in December 2005 recommended a single national registration board, a single national accreditation board. COAG agreed to this in 2006. And so it was agreed that we move to a national registration and accreditation scheme for the health professions. It is done by way of each state passing a law. Queensland has provided the template for the national law, which has so far been passed by not only Queensland but also New South Wales and Victoria and is in train in other states and territories. The bill we are considering here, the Health Practitioner Regulation (Consequential Amendments) Bill 2010, is to ensure that medical practitioners and those health practitioners who are entitled to Medicare have the same Medicare billing eligibility. So in that sense the legislation is really tidying it up from the federal point of view. It is really the framework which is being provided from a state point of view.

A number of professional organisations—the Australian Medical Association, the Committee of Presidents of Medical Colleges, and the Royal Australian College of General Practitioners—have raised the concern that national registration will not enhance patient safety. One of the problems with the model that has been put before us is that it entrenches government interference, it bureaucratises the whole process and we will now have a remote and centralised body which will be responsible for the registration of 10 health professions with more to come in two years time.

The Senate Community Affairs Legislation Committee have already looked at a draft of this legislation and suggested a number of changes which have been adopted: to make sure the accreditation functions are independent of the government, to make sure that there is a general and a specialist register—something which is already well established with the state registration boards—to maintain a separate register for nurses and midwives, and to ensure that there is a role for continuing professional development in registration.

Those changes have been taken up, but there is remaining concern about the independence of the accreditation. The issue is the role which is played by the ministerial council. What has previously been an independent role performed by state registration boards governed by respected professionals will now be taken on by ministers—by politicians. I am concerned about what will happen when the health minister has to weigh safety and quality concerns against the issue of workforce supply. I am also concerned over the role of the ministerial council. The Senate committee recommended that the Australian Health Workforce Ministerial Council consider and evaluate its role in issuing policy directions or accreditation standards. That recommendation has not been taken up in this legislation. The scheme will do nothing to enhance professional standards or quality of care for patients.

Like everything this government touches, the devil is in the detail. One of the issues we face is that we rely on overseas trained doctors to staff our hospitals and medical practices, especially in areas of need, especially in rural and regional Australia. The issue here is what our minister will do in weighing dealing with area of need, filling a gap, against looking at whether someone is up to scratch in professional standards. One suggestion that the AMA has put forward is that there be a public interest test for the federal Minister for Health and Ageing when considering issuing directions on accreditation standards.

Another concern is the reserve powers in this legislation which allow the minister to impose additional requirements on consultant physicians and specialists to obtain provider numbers for Medicare benefit purposes. This really needs to be clarified by the minister. We need clarification of the circumstances in which she can see these reserve powers being used. We need the minister to explain the need for these reserve powers and what the constraints on the minister using them will be. This legislation shifts the responsibility for issuing Medicare provider numbers from the parliament to the minister. We need an explanation of why that measure has been adopted. It has not been the practice in the past. In the past, the issue of Medicare provider numbers has been, appropriately, the subject of legislation. It has been brought before the parliament rather than being the decision of an individual minister.

Those are the concerns I have about this legislation. I do not believe that the national registration scheme will enhance patient safety or do anything to improve professional standards. On the contrary, it will entrench government interference and bureaucracy in all of the independent health professions.

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