Tanya Plibersek (Sydney, Australian Labor Party, Minister for Health) Share this | Hansard source

I move:

That this bill be now read a second time.

The Professional Services Review (PSR) Scheme and the Medicare Participation Review Committee process (MPRC) are important parts of the government's efforts to support the provision of high quality, appropriate and safe health services for patients. They protect the integrity of Medicare.

The Professional Services Review Scheme is a peer review process for investigating whether a practitioner has engaged in inappropriate practice in the provision of services under the Medicare benefits scheme or Pharmaceutical Benefits Scheme.

Medicare Participation Review Committees are independent statutory committees that make determinations on whether a practitioner should maintain the right to participate in Medicare.

This bill makes amendments to the provisions for the Professional Services Review and the Medicare Participation Review Committee process in the Health Insurance Act 1973 (the act).

The proposed amendments do not alter the purpose of the Professional Services Review or the Medicare Participation Review Committee process. These amendments strengthen the ability of the Professional Services Review to protect the integrity of Medicare, improve administration and clarify issues raised in recent court decisions.

The bill addresses issues raised in a recent Federal Court decision, Kutlu v Director of Professional Services Review [2011] FCAFC 94. The Federal Court's decision in this case brought into question the validity of findings of the Professional Services Review if the consultation process for appointing a person as a Professional Services Review panel member or deputy director had not been followed.

In cases where practitioners have been found by a Professional Services Review Committee to have practised inappropriately and are serving periods of disqualification, the Federal Court's decision could result in these practitioners being able to provide services under Medicare. This could compromise public health and safety.

The bill will address this issue by retrospectively validating past Professional Services Review findings that have been brought into question because a panel member or deputy director was not validly appointed. These Professional Services Review processes will be held to be valid and effective.

The government considers that retrospective legislation is necessary and justified in this case to remove uncertainty about a number of Professional Services Review findings, where practitioners have been found by a committee of their peers to have practised inappropriately.

The bill has a legitimate objective in rectifying the effect of technical errors in the appointment process. The retrospective provisions aim to ensure that action taken to protect the integrity of services provided under Medicare may be relied on.

These validating provisions are not intended to apply to parties to proceedings for which leave to appeal to the High Court of Australia has been given before the bill is assented to, if the validity of a Professional Services Review appointment is in issue in those proceedings.

However, the bill will allow the Director of the Professional Services Review to establish and re-refer matters to a new PSR Committee in such cases. This will mean that practitioners who have been found to have engaged in inappropriate practice by their peers, and have successfully challenged a Professional Services Review process on the grounds of irregularity in the appointment process, may be re-referred to a new PSR Committee for investigation if the director decides to do so.

Other provisions

The bill also includes a number of provisions that strengthen the Professional Services Review's capacity to protect the integrity of Medicare, improve the operations of the scheme, and respond to the recommendations of a review of the scheme in 2007.

The Professional Services Review currently applies to only some, not all, of the types of health professionals who can provide services under Medicare. The bill will enable the PSR Scheme to be applied to all health professionals who provide Medicare services.

The bill includes amendments to improve the protection of the public under the Professional Services Review.

If the conduct of a person under review poses a threat to patient life or health, the Director of the Professional Services Review will be required to contact the relevant body that is authorised to recall patients for independent medical review. The bill also requires the director to notify the relevant registration body.

The quality of patient care can be placed at risk if practitioners undertake unreasonably high numbers of services. In 1999, medical professional groups agreed that 80 or more unreferred attendances on 20 or more days in a 12-month period constituted inappropriate practice.

This bill clarifies in legislation that a practitioner who performs this number of services is automatically deemed by the legislation to have practised inappropriately, unless they can provide evidence that exceptional circumstances existed.

Patients will also be protected by amendments that will require all persons who are disqualified from Medicare due to a Professional Services Review or Medicare Participation Review Committee process to display a notice to inform patients that services will not attract Medicare benefits.

The bill clarifies the respective role of the Professional Services Review and Medicare Participation Review Committees, so that the PSR investigates inappropriate practice and the MPRC reviews practitioners where they have contravened a relevant civil penalty provision or committed a relevant criminal offence.

Other amendments improve the administration of the Professional Services Review following its review in 2007. These amendments include clarifying processes where a person is unable to participate due to illness, or where the person under review dies, and making minor administrative changes.

Medicare and the Pharmaceutical Benefits Scheme are two of the key pillars of Australia's health system. Robust structures to prevent inappropriate practice are essential if they are to benefit all Australians for years to come.

This bill will ensure that the Professional Services Review continues to protect the integrity of Medicare and to support high quality, appropriate and safe health services for all Australians. I commend the bill to the House.

Debate adjourned.

Leave granted for second reading debate to resume at a later hour this day.

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