Shayne Neumann (Blair, Australian Labor Party) Share this | Hansard source

I speak in support of the Health Insurance Amendment (Pathology Requests) Bill 2010. These amendments make it clear that patients and consumers have choice. They have choice with respect to their doctor, their pathologist, their occupational therapist, their physiotherapist and their dentist. This is important in the areas of medicine and health. The bill proposes amendments to the Health Insurance Act 1973, removing the requirement that a request for a Medicare eligible pathology service be made to a particular pathology provider. Under the current Medicare arrangements, if a GP, for example, decides it is clinically appropriate and necessary, that particular doctor can refer a patient to an approved provider for a diagnostic test. Currently the legislation provides that there is a Medicare benefit. For that to be payable, a designated pathology provider must be named in the referral request. It means there is a cosy arrangement between the pathologist and the doctor.

We think it is important that consumers have their say in determining which pathology service they wish to choose as a result of discussions with their doctor. There is nothing in this legislation that would prohibit a referring doctor from recommending a particular pathologist to a particular patient of theirs. There has been some comment and criticism as to whether this would interfere in the communication between a GP and their patient, that there may be some miscommunication or some problem with the communication between the pathologist and the doctor. In this day of fax machines, emails and telephones there cannot be any real problems in that regard. In my community in Blair in South-East Queensland, pathology services are located very close to where GPs are located, and they communicate on a daily basis. This is not something that we should be worried about. To quote someone whom those opposite may quote from time to time, Milton Friedman said that there needs to be freedom to choose—freedom to choose who to engage and who to spend our money on to look after our health care.

These sorts of procedures are worrying for patients. When a doctor says, ‘Go off and get this diagnostic test,’ a lot of people find that very worrying. The Royal College of Pathologists of Australasia claimed that it is the professional right of doctors to determine to whom they refer patients. I think that is arrant nonsense. This legislation is about ensuring better competition and improving the quality of service. Doctors will still be able to communicate with their patients. It is really to criticise doctors to say that they cannot determine to whom they refer patients. Patients will inevitably decide for themselves whom they engage. Sometimes they will decide based on word of mouth and sometimes by geographic convenience, but more often than not it will be after consultation with their GP.

It does not stop the doctors from discussing these issues. It does not stop the idea of branding either. Pathology providers will continue to be able to produce branded request forms that include the company’s logo and address. That is not an indication that we are against communication and cooperation between pathologists and doctors and patients. It is just an opportunity for consumers to work out which pathologist they want to use and the circumstances. Branded request forms are not very common. You can see that when you get a referral. There would be plenty of people in this chamber who have had referrals to a pathologist.

Changes to the relevant regulations are planned to make sure the request for pathology services include a clear and understandable statement, obviously positioned so that a patient is aware of their consumer rights. I think that is appropriate. There will be a transition period—as we have said in the legislation—of 12 months in respect of changes to the regulations to minimise any impact on pathology practices and GPs, and to make sure that consumers have good knowledge of what is going on.

The Department of Health and Ageing will undertake an advertising and communications campaign to make sure that people understand what is involved. There will be communication with pathology providers and GPs. In her second reading speech on 20 October 2010 the minister said:

Informed patient choice is a key element of quality health care. This amendment will ensure that patients have a right to choose their pathology provider and are made aware of that fact, leading to increased competition and better service among providers.

My observation in my electorate of Blair is that doctors communicate with pathology providers regularly. Pathology providers are actually located in good geographic positions to be available to the public. For instance, my electorate office is in the Brassall shopping centre in Hunter Street, Ipswich, and next door is QML Pathology. As I drive in each day I see people sitting and waiting to go into QML for their tests to be done. And directly opposite, if you go out the front door of my electorate office in Blair, you can see that straight across the corridor, a matter of a few metres, there is Sullivan Nicolaides Pathology, which has been opened in the last few months.

It is not the case that pathologists are making it geographically difficult for the public to reach them. Brassall is the biggest suburb in terms of population for the whole of the electorate of Blair and it is not unusual to find a couple of pathology providers in very large shopping centres. There are doctors not far away in the same suburb, and the suburb of Brassall is not far away from the Ipswich CBD, where there are doctors everywhere. You will also see pathology providers in the middle of the CBD as well as in the medical precinct.

Doctors and pathologists will deal with each other and communicate each day. Doctors will deal with patients every day. Pathologists will deal with the public and patients every day. People will seek referrals. The world will not end. The government will continue to ensure that we are the champions of consumer rights, of competition and of the freedom to choose, because we think this is important for the public.

What amazes me about those opposite is that they claim they are the champions of consumers, the champions of choice, the champions of liberty and the champions of free enterprise, but it is Labor governments that bring in legislation like this and other legislation in consumer law and in relation to competition. It is Labor governments that stand up for those challenged, those in need, those sick, those ill and those injured. It puzzles me that those opposite express concerns and listen to the people who criticise our legislation. We think this legislation is in the best interests of consumers and in the best of interests of all concerned for our economy and for the medical and health industry. I commend the legislation to the House.

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