Janelle Saffin (Page, Australian Labor Party) Share this | Hansard source

I rise to speak in support of the National Health and Hospitals Network Bill 2010a historic bill. The health reforms that are reflected in this bill are the largest reforms since the advent of Medicare. I want to talk about some of the local issues in the health service that covers my area of Page—and also covers the areas of Richmond, Cowper and Lyne. The previous speaker, the member for Lyne, spoke about issues I am quite familiar with because we share the North Coast Area Health Service.

This bill gives the legislative framework to enable the government to shepherd in the health reform agenda, a key part of the government’s program, and the establishment of the permanent body, the Australian Commission on Safety and Quality in Health Care, which will become an independent statutory authority under the Commonwealth Authorities and Companies Act 1997. That is a good thing because for the health reforms to kick in we need to have this as a standing body and a statutory authority. The agreements in the health reform agenda entered into with the states, with the exception of Western Australia, were endorsed on 20 April this year. The new National Health and Hospitals Network will have a performance and accountability framework. That is important because the framework will include national standards and the commission will be able to work on developing those.

The member for Lyne spoke about equity and efficiency, issues I also give some attention to. Under the new health reforms we are going to have case-mix funding, which does operate already in other jurisdictions. Case-mix funding is not new but what is new is that it will be part of the health reform agenda. In New South Wales we have the resource distribution formula, the RDF. In the area that I live in, even though the RDF has been improving over the years the North Coast Area Health Service has been underfunded, according to the RDF. I have said that the case-mix funding will correct that and some of the local doctors have also said that and have welcomed it. That is one of the issues that I am quite pleased about and that we will not have to continue to grapple with it. The other issue is that the small hospitals will be given block grants, and other measures will be looked at to ensure they are able to operate really well.

This bill will involve establishing the Independent Hospital Pricing Authority—that is the agreement that this bill is premised on. It will establish the National Performance Authority and it will amend the Federal Financial Relations Act. The permanent commission will formulate and monitor quality and safety standards. The explanatory memorandum sets this all out quite well.

The commission will also provide advice to the Commonwealth, state and territory health ministers about which standards are suitable for implementation as national clinical standards, and I know that there will be clinical input into that as well through the local hospital networks. In my area the ads recently appeared in the paper, inviting people with particular interests and skills to nominate for the local hospital network governing council. They will be responsible for implementing the national clinical standards once they are agreed to. This is a good thing. I know that, in practice, it will take some working out, some negotiation and lots of goodwill, but it is important that we have it in place.

The bill also talks about consultation, which is particularly important in the area of health. One key area of consultation will be the expanded role of the permanent commission. It will complement the activities that were undertaken by the temporary commission and will come up with guidelines and indicators as well.

I want to talk about another part of the national health reforms, which is the lead clinicians groups. These will be set up and funded by the federal government to deliver a greater say for local health professionals. These will certainly be helpful to the local health and hospital networks in implementing the clinical standards that come from the permanent commission. I will just say a little bit about lead clinicians groups. Fifty-eight million dollars was made available to establish these groups in local hospital networks and at a national level. They will provide local health professionals, as you would expect—doctors, nurses and allied health professionals—with a permanent and influential voice in the National Health and Hospitals Network. A key finding from the government’s health reform consultation process was that clinicians felt locked out and disengaged from the operation of public hospitals. Even though they are a key feature of public hospitals and operate in them all the time, they wanted more say, particularly in clinical and medical pathways. Within the public system there are lots of existing administrative pathways but they particularly wanted more say in the clinical and medical areas.

Lead clinicians groups in local hospital networks will ensure that local health professionals have a say in improving quality and safety in hospitals. That is always a work in progress, but under the new system, particularly with the commission, it will be foremost in our minds. They will plan the most efficient allocation of services within a local hospital network, which is also important. At a local level we often want everything to happen at our local hospital. That is normal; that is what communities ask for. But sometimes it is not possible, and not in our best medical interests, to have things happen at certain hospitals. Within a local hospital and health network we can work out where those services can be delivered with the best trained and most appropriate medical personnel.

It will also be about developing different solutions that best address the needs of local communities. As a bit of a snapshot, in my area, particularly across one valley, we have a very high incidence of diabetes. It is for a whole range of reasons. It is to do with our ageing population; it is to do with our Indigenous population. If you look at the North Coast area, which is covered by the North Coast Area Health Service, you see that nearly 11 per cent of the population are Indigenous, which is quite a significant number of people.

With regard to the health reforms in general, for the first time we will have health that is funded nationally, with the Australian government taking on the dominant funding responsibility for the health system to end the blame game. There was a report called The blame game: report on the inquiry into health funding produced by the Standing Committee on Health and Ageing, and it is a matter that has been debated in the parliament. The reforms will eliminate waste and meet rapidly rising health costs. The networks will be run locally, which is really important to locals. They want their hospitals run in the best possible way with the best medical service available but they also want to have input. They did feel shut out, which is one thing that the federal government kept in mind in planning its reforms.

I want to thank Minister Roxon for the wonderful work she has done in this area. I also thank the former Minister for Indigenous Health, Rural and Regional Health and Regional Services Delivery, who visited my electorate at different times, along with Minister Roxon. Minister Snowdon visited every hospital in my seat. It was quite a busy two days.

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