Melissa McIntosh (Lindsay, Liberal Party, Shadow Assistant Minister for Mental Health and Suicide Prevention) Share this | Hansard source

I'd like to acknowledge the member for Macarthur's words and to commend the work that he does in the health field and his passion for health. Thank you. I rise to speak on the Private Health Insurance Legislation Amendment (Medical Device and Human Tissue Product List and Cost Recovery) Bill 2022 because, as the co-chair of the newly formed Parliamentary Friends of MedTech along with the member for Macarthur, I know how much technology is saving lives. The progress in this country is quite extraordinary, and we should be supporting that innovation as best we can.

I would like to start by saying from the outset that the opposition does not oppose this legislation. I understand that the bills are only the beginning of the process of much-needed reform. But I also point out that I understand that stakeholders need a bit more consultation on these bills. I hope the government will listen to these stakeholders and provide the substantive legislation quickly, with greater detail, so that the industry can properly and appropriately administer any changes that come about due to the introduction of this bill.

The part that I would like to particularly focus on in my speech today is around prostheses, also known as artificial limbs. These are devices that are designed to replace or support a missing or damaged body part, and they play a crucial role in helping people with disabilities to live a more active and independent life. The legislation sets out the requirements for the design, manufacture and supply of prostheses and ensures that they meet certain standards of safety, quality and performance. The Prostheses List also specifies reimbursement levels for prostheses—I'm going to have a fun time saying that word multiple times in this speech!—provided under the Medicare Benefits Schedule and the private health insurance arrangements.

The Prostheses List legislation is important for several reasons. Firstly, it ensures that people with disabilities have access to safe, high-quality prostheses that meet their needs and allow them to live a more active and independent life. By setting standards for design and manufacture, the legislation helps to minimise the risk of adverse events and ensures that people live and receive the best possible care.

Secondly, the list legislation, if managed properly, could help to control costs and to make health care more affordable for patients. By specifying the reimbursement levels provided under the MBS and the PHI arrangements, the legislation could ensure that people receive the care they need without incurring prohibitive costs.

The Prostheses List legislation has the ability to promote innovation, which is very important in the medtech fields, by encouraging manufacturers to develop new and improved prostheses that meet the standards set out by the legislation. It helps to spur the development of new technologies. I know people who use these technologies are always on edge waiting for a new thing that will improve their lives a little bit more. From experience, I know this is very much the case. The PL legislation is an important piece of legislation that helps to ensure, as I said, the access to safe, high-quality prostheses that meet people's needs. By controlling the costs, it promotes innovation. As I've said, the legislation plays a critical role in helping the lives of people in Australia.

Medical technology is critical to ensuring the Australian community has all the benefits of modern, reliable technology for better health outcomes. The medtech industry in Australia represents manufacturers and suppliers of medical technology used in the diagnosis, prevention, treatment and management of disease and disability. It's so broad in its range, and it provides the majority of non-pharmaceutical products used in the diagnosis and treatment of disease and disability in this country. The companies that are here and the healthcare professionals doing this extraordinary work play a critical role. I hope the reforms, if managed correctly, will improve the affordability and value of private health insurance for Australians by keeping downward pressure on premiums while still maintaining access to high-quality medical devices.

It's important to note that Australia's medtech industry has led the way and played a key role in reducing private health insurance premiums and is working through a phased reduction of prosthesis prices with the government through the Prostheses List reforms program. My friend and former colleague, the Hon. Greg Hunt, when federal health minister, vowed to pave a smoother way towards reform. He signed a memorandum of understanding with the Medical Technology Association of Australia in March 2022. The MTAA's chair, Mr Maurice Ben-Mayor, was thankful for the agreement's focus on recognising what he said was 'the explicit distinction' between the public and private markets that still guarantees patient access and doctor choice.

He was also thankful for the former minister's decision to lead the reforms 'away from abolishing the Prostheses List' and towards a process that would provide greater certainty for medtech companies. Reform is necessary in the medtech industry, and there's certainly a need for fit-for-purpose and effective reforms to the PL that would reduce premiums while protecting the patient access and doctor choice guarantee of the PL.

I would also like to further talk about to work of former minister Hunt and the coalition government's track record in the Prostheses List space. The former coalition government's budget over four years was $22 million to reduce the cost of medical devices used in the private healthcare space. This was also to assist in streamlining access to new medical devices to improve the affordability and value of private health insurance for Australians. Our plan included lowering prices for medical devices to allow for savings to flow through to customers.

Our government was committed to its support for choice, value and high-end quality services for patients and their clinicians in the private health space. We wanted to continue work to ensure a simpler and more cost-effective private health sector and deliver record-low premium changes for Australians to access private health insurance. When we left government, private health insurance membership was at record levels, with more than 14 million Australians being covered. Our reforms delivered the 2022 premium change, which was the lowest in more than 21 years and the eighth successive decline in premium changes since Labor's last year in government in 2013. We increased the investment in the patient rebate for private health insurance from $5.4 billion to $6.9 billion. We implemented new, easy-to-understand classifications for private health insurance through the standard clinical definitions; better access to mental health, which I'm really passionate about; better care in rural and regional Australia; lower prices for medical devices; and more flexibility for families and people with disabilities to receive their care.

I'm really encouraged that the member for Macarthur likes private health insurance, because it's not something the Labor government is particularly known for, but the coalition recognises that Australia's health sector is strongest with both the public and private systems working together, hand in hand, to ensure access to health care for all Australians.

Despite the coalition's support for this package of bills, there are some concerns with the lack of detail provided by the government on certain key areas. The transparency that's required, with important, substantive details sitting beneath the legislation that has been put forward to this parliament, needs to happen. There are a significant number of issues that may be subject to regulation under these bills and are yet to be resolved, including eligibility criteria, listing pathways and specifications for the calculation of cost recovery, regrouping and payments for removal items, to go into the technical details. In addition, the department has not yet provided to stakeholders the updated prostheses listing guide, although the bills confirm the regulatory status of the guide. The government seems to have also backed away from the coalition government's commitment to enabling a clear and standard pathway for non-implantable devices to be assessed for inclusion on the Prostheses List.

Across the bills included in this package of measures, it was unfortunate that stakeholders were given less than one week to consider the exposure draft of this legislation. The bills provide little detail about the extent or the specific powers to be implemented through unsighted, subordinate legislative instruments and mechanisms. The department has also flagged that PL changes will be implemented via an update to the PL rules, but it has not shared these proposed amended rules. We need to see further details on the subordinate legislation. We need answers to questions like where are the regulations? What are the next steps in the reform agenda? Will the government provide more detail so these issues of equity and affordability can be fully understood and debated? The call is to have more detail, less focus on headline announcements and aspirations, and a consideration of the important details that are necessary for the implementation of those announcements.

We are supportive of this bill, but we're putting the government on notice: they cannot continue to expect us to pass bills without seeing any of the substantive detail. I urge the government to address the significant challenges the industry faces, and to engage with them and to provide in a timely way those details that are currently missing. It's a critical industry and it's also critical that this industry understands how items on the list will be costed, setting in place a process to reduce the gap between the cost of medical devices in the public and private health sectors. It will be the patients of Australia who will suffer if this isn't done with the utmost concentration on the provision of details. I know the medtech industry is behind it, ready to support and help, but we do urge the government to please provide those details as this legislation comes forth. Thank you.

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