Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

The Health Practitioner Regulation (Consequential Amendments) Bill 2010 before us today signals the final stages of what has been a long and complex process. This bill provides consequential amendments to what is a significant reform, being the National Registration and Accreditation Scheme. It is important that we consider the wider ramifications of the Registration and Accreditation Scheme that underpins this legislation before I comment on the specifics of the bill. There has been strong in-principle support for a nationally consistent registration scheme for health professionals. Different registration and accreditation requirements between jurisdictions has, in the past, hampered workforce mobility and made it difficult to monitor the small number of practitioners who have been under scrutiny or are facing disciplinary action in a given jurisdiction.

The guiding principles of the scheme are stated as, firstly, to provide for the protection of the public by ensuring that only practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered; secondly, to facilitate workforce mobility across Australia and reduce red tape for practitioners; thirdly, to facilitate the provision of high-quality education and training and rigorous and responsive assessment of overseas trained practitioners; thirdly, to have regard to the public interest in promoting access to health services; and, finally, to have regard for the need to enable the continuous development of a flexible, responsive and sustainable Australian health workforce and enable innovation in education and service delivery.

The process commenced when the Productivity Commission recommendations came down in January 2006 for a single national registration board and a single national accreditation scheme. The previous coalition government acted on the recommendations by reaching an agreement at COAG in 2006 for the establishment of a national registration scheme. In April 2007, COAG agreed on a single National Registration and Accreditation Scheme to commence in July 2008. The health workforce underpins our health and hospital system. Health workforce issues have been prominent in political debate and in the media recently. I think it is important that we take the opportunity to revisit some of the facts. The coalition, whilst in government, delivered nine new medical schools, including in regional areas. There was a 50 per cent increase in medical school places between 2003 and 2007. Additional funding was provided in 2006 for some 605 additional medical school places being phased in from 2007 to 2011. The coalition government also provided 3,700 additional nursing places between 2005 and 2007 alone. It was the coalition that commenced funding for practice nurses through the Nursing in General Practice Initiative and later with additional MBS rebates. The coalition clearly is committed to improving the quality of Australia’s health workforce, despite this government’s best efforts to rewrite history.

Following the election of the Rudd government, the national registration scheme stalled and implementation has been delayed until July 2010. One of the primary reasons for developing a single national scheme for registration and accreditation was to reduce bureaucratic red tape across the jurisdictions. Unfortunately it seems, like in many policy areas of this government, there has been strong bureaucratic influence and interference with the establishment and proposed functions of the boards. Concerns still exist regarding the exertion of power by the ministerial council over national boards and, in particular, accreditation standards. The national law provides that the ministerial council may give directions to a national board for a proposed accreditation standard, or a proposed amendment of an accreditation standard.

The only caveat originally on the ministerial council providing accreditation directives was that the proposed standard or amendment would have a substantive and negative impact on the recruitment or supply of health practitioners. This understandably stirred up considerable concern amongst health professionals and patient groups. On the face of it, this provided health ministers with the authority to interfere with accreditation standards on the basis of workforce supply—should they be faced with a shortage, the concern was that they would be able to take shortcuts and lower the bar to increase workforce numbers. This provision did little for confidence in the safety and quality of health care in our country. It was only after the first Senate Community Affairs Legislation Committee inquiry that a requirement was included for the ministerial council to give consideration to the potential impact of the council’s direction on the quality and safety of health care.

In fact, the committee explicitly recommended that the ministerial council consider the recommendations proposed by the Australian Medical Association in relation to this issue. The AMA recommendations included: defining ‘substantive and negative impact’; requiring the ministerial council to apply a public interest test that considers, amongst other things, the potential impact on the quality and safety of patient care; requiring the ministerial council to consult with the relevant learned medical college and faculties on best practice; requiring that ministerial council decisions to issue policy direction to national boards be unanimous; providing greater transparency of policy directives by providing justification and evidence for the decisions and publishing those decisions; and including specific provisions for review of directives.

Despite the committee’s and the AMA’s recommendations, the ministerial council has provided only a very limited response. A provision has been included for the council to first give consideration to the potential impact of the council’s direction on the quality and safety of health care. This falls well short of the calls of many stakeholders. Many stakeholders maintain there is a need at the very least for a public interest test for directives on accreditation standards. Without such, it is claimed that there will not be sufficient safeguards to protect patients under the current national law.

A number of professions, including physiotherapy and psychology, have experienced delays or expressed frustration at the process for specialisation recognition under the registration scheme. Physiotherapists argue that specialisation is well established and recognised within the profession. It is claimed that specialist physiotherapists, like recognised specialists in other health professions, have extensive additional training and experience qualifying them to assess and treat complex and high-risk patients. This includes formal postgraduate qualifications and a rigorous external training and examination process. The argument is that removal of specialisation title recognition will make the referral process much more difficult for patients with specialised needs and will not be in the public interest. Clearly, the process has not been without difficulty and there remain a great number of issues to be resolved before implementation in July this year. The bill before us today amends the Health Insurance Act to streamline the recognition of health professions under the registration and accreditation scheme. The Health Insurance Act allows for the recognition of specialists, consultants and GPs for access to Medicare.

There are a number of issues which have been identified by stakeholders and are evident in the Senate committee inquiry which is due to conclude its findings. The bill specifies requirements for consultant physicians and specialists to qualify for Medicare purposes. In addition to requiring medical specialists and consultant physicians to be registered in their speciality and recognition of the speciality for the purposes of the Health Insurance Act, this bill specifies that medical practitioners and consultant physicians satisfy any other requirements prescribed by the regulation. The provision does not relate to general practitioners or other health professionals for Medicare eligibility. It is argued that specialists and consultant physicians would already be required to be registered and on the specialist register to be eligible for Medicare benefits, and there seems to be little justification for creating additional requirements.

The bill also provides consequential amendments to section 19 of the Health Insurance Act relating to Medicare benefit ineligibility for medical practitioners that are not authorised to render certain services under the practitioner’s registration. The Australian Medical Association and the Royal Australian College of GPs submit that there are a range of health professionals who are eligible for Medicare benefits. Accordingly, it is argued that the bill should be amended to extend the relevant sections to other health professions eligible for Medicare benefits.

Key nursing stakeholders have also raised some concerns regarding definitional amendments contained within the bill. Amongst other things, the bill removes the requirement that nursing care be given by or under the supervision of a registered nurse—it removes the word ‘registered’ from the definition. Whilst there can be different uses of the word ‘registered’ for nurses, it would seem appropriate that there remain clear lines of responsibility and accountability for nursing care.

The coalition understands the government is moving amendments to address a number of the issues discussed in relation to this bill. Whilst there have been extensive consultations throughout the national registration process, it does seem the government has again failed to do the groundwork for the basics on this consequential bill. It is becoming an unfortunate habit of the government to have to move amendments to their own bills because of oversights or lack of initial consultation. It is unfortunate, as I have pointed out, that the committee has recommendations which are pending, a report which is pending, but the government has not paid courtesy to that process or indeed to those people who have submitted evidence to that committee or indeed to the committee members. I hope that this process is able to provide to the government some lessons about the way in which they conduct their business and proceed with these amendments.

These are significant reforms and they impact not just on health professionals but of course on patients as well. The coalition, like the government and all Australians, wants to see a rigorous process put in place to make sure that the high standards that we have adopted for many decades in this country will remain long into the future. We want to make sure that health professionals right across the country in every profession increase their professional development and that we reduce the sorts of cases that we have seen operating in Queensland in recent times under what is a completely incompetent jurisdiction in the domain of the Queensland state government. We hope that the government will learn from this process. We hope that the government will have the ability to conduct these negotiations in a more consultative way into the future. There are unintended consequences. There is no question about that. Some of them have been ironed out and some will require amendment into the future. To be quite frank, it would seem rather unacceptable to have the Senate only with a day or so reporting potentially with further recommendations and the government not waiting to take those into consideration. Having spoken to a number of professionals in the health workforce around the country over the course of the last six or 12 months in relation to this issue, I have heard that they believe their views have not been heard. They have expressed their views strongly but they have not been heard by this government.

There is already a track record over the last couple of years of this government making lots of promises in relation to health but not having the capacity to deliver. Clearly, this is a government which promises a lot and has no problems in getting a headline but in the end just cannot deliver on the promises that it makes. Health is one of those areas and last night we have again seen that play out in the budget where the government has promised another 23 GP superclinics on top of the 36 already on offer. It has taken three years for this government to have two fully operational, yet that does not stop it from pretending that it is going to have another 23 rolling out some time, over the next couple of years or over the forward estimates, when I think it has proven to all Australians that it has a Prime Minister that does not have the capacity to deliver on his promises. Registration and accreditation is one such area where commitments have been made to the professions and again people have been let down. That is why there is a great level of frustration amongst clinicians and health professionals right across the board. I think there are certainly some lessons to be learnt from this and I hope that the government is able to take those away. As I have stated in my speech today, the coalition will not oppose the bill with the proposed amendments.

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

I speak in support of the Health Practitioner Regulation (Consequential Amendments) Bill 2010. The member for Dickson mentioned GP superclinics. There is one in his electorate and he should care to have a look at it from time to time. He did not even turn up on the day when it was opened. There is one for my electorate too. It is about to be opened in August this year.

Unlike the previous government, we have not procrastinated on this issue of national registration as they did year after year—1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003 and 2004. Eventually in 2005 a Productivity Commission report came down. They were in power all through that time and they should have known for a start that national registration and accreditation is an important factor in any profession, be it law, engineering, medicine or nursing, so any registration and accreditation should be recognised. If, for example, you live in Coolangatta or Tweed Heads it is simply a nonsense that there is not the same uniform national registration and recognition of professional qualifications. It is simply ridiculous to think that there is a notional dingo fence there. For a long time the coalition government did little. I admit that from 2007 onwards they took steps, as the Productivity Commission report came down, through the COAG process but it took them year after year to get there. If you had listened to the member for Dickson, you would think that they responded in March 1996 over this concern. They did not; they sat there and did nothing. This has been a long time coming. This is a landmark reform. This is very important. For years they blamed the states and territories. For years the current Leader of the Opposition constantly complained when he was the health minister about the states and territories. He would not meet them from time to time and in the end, before the last election, he had to simply admit that that was the case.

This legislation is important. The member for Dickson was a little disingenuous about that. He failed to recognise that we have taken up the mantle of national reform in this regard after years of failure by the coalition government. We recognise that this is important and that it was stalled but needed to be pursued. We immediately got down to discussing the issue with the states and territories and in March 2008 signed an intergovernmental agreement to progress the national scheme. As for what we are doing here today, 10 health professions are going to have national, consistent uniform standards for their workforces. This is really important stuff. I am sure that our founding fathers, when they created Australia as a federation many years ago, would not have thought about these issues but we know how important they are. All people, whether they live in Australia in Tweed Heads or in the Torres Strait, should get the same access to good and decent health care. We are going to make sure that there are health professionals in every part of this country. Whether you live in Perth, on the west coast, or in Palm Beach, on the east coast, you should have access to decent health care, high-quality and accessible health care, provided by doctors, nurses and other health professionals, such as physiotherapists and the like, who have uniform national standards of accreditation and registration. So this is an important national reform. Under the National Registration and Accreditation Scheme for the Health Professions, the national arrangements for registration and accreditation will be implemented by the states and territories as part of their jurisdiction. We know that we had to get the cooperation of the states and territories because constitutionally that was required. The societies, associations and professional bodies that govern these professions are state based and so we have had to make arrangements with them.

The member for Dickson was very critical of the Rudd government and used his speech as an opportunity to attack the government for what they have done. I can tell him that in my electorate alone we have seen major changes and reforms in health and hospital funding due to assistance by the Rudd government since we got into power in 2007. For years, the Ipswich-West Moreton area was neglected by the Howard government, whether it was infrastructure funding, school funding or health and hospital funding. With the election of the Rudd Labor government, there were immediate improvements in the area of health funding, including after-hours clinics, surgery waiting lists and operating theatres in the Ipswich General Hospital. These are important changes, and they have been made by the Rudd Labor government. We have poured money into the Ipswich and West Moreton area in my electorate of Blair. For the member for Dickson to simply cast aspersions on the government’s credibility, authority and authenticity in health reform is, I think, a nonsense when I look at the record of the previous government. They failed miserably in this regard.

We are going to train 6,000 more doctors. The member for Dickson failed to note in his dissertation on health and hospital reform that the previous government ripped $1 billion out of the health system and capped GP training places. If he had been more active in relation to health and hospital reform when he was on ministerial leather, we would have seen more changes and better reforms in this area. Certainly in areas such as the Brisbane Valley, which I inherited from him following an electoral redistribution in Queensland, there is major need for further reforms and a better health system as well as further and better health funding for the Esk Hospital. The area of the Brisbane Valley was neglected under the tenure of the federal member for Dickson. We are working hard to improve health and hospital services in the Brisbane Valley, Somerset and Ipswich, after years of neglect by the coalition government.

This bill contains important changes and reforms. It is an amendment bill. Stakeholders have been listened to and amendments have been made to the bill by reason of this listening aspect of the Rudd Labor government. The member for Dickson said that we were not taking notice of stakeholders. We did take notice of the AMA and the nursing associations and nursing professions. Amendments have been made to the legislation before us. This bill is an amendment to the original bill in relation to national registration.

We took into consideration submissions made by the Australian Medical Association concerning issues of specialist and consultant physicians. Under the proposed legislation subsection (c) required that ‘he or she had to satisfy any other requirements prescribed by regulations in relation to the specialty’. The AMA did not have any problems with being registered in a specialty under state law. They did not have any problems about the specialty being prescribed in regulations made under the Health Insurance Act, but they did have problems with other requirements. The amendments in this bill clarify the purpose of the regulation making power in paragraph (c). The AMA also sought amendments, as the member for Dickson mentioned, to sections of the legislation governing the ability to render Medicare rebatable services. Again, we have listened to the concerns of the AMA and made amendments that address stakeholder concerns. We have widened the scope of sections 19C, 19CB and 19DA of the HIA, which apply to all health professionals that render Medicare rebatable services.

The member for Dickson talked about concerns raised by the nursing profession. Again, we have listened to what they have had to say about the definitions of ‘nurse’ and ‘nursing care’ and made amendments accordingly. This legislation is about making sure our system is nationally consistent. It is about making sure that where workforce shortages exist they are addressed. Where there is a need for social mobility of employment or there is a shortage of health professionals, these issues will be addressed. This legislation is about removing barriers or obstacles of a legal, constitutional and regulatory nature to people living in regional and rural communities—the kinds of communities that I represent in the federal electorate of Blair—having the health services that they need. Let us take locum health services as an example. In many small country towns there might be a hospital or one or two GPs, and it can be a challenge to get a locum in when a GP wants to go on holidays. National registration and accreditation improves the capacity and boosts the opportunity for these communities to get a locum in from interstate. It is very important that we make sure that doctors and health professionals can move across state borders.

This legislation is a very important reform. Streamlining specialist registration and recognition will improve the health system in this country. It will also improve it in regional and rural communities. It will make sure that we have a national approach to a national issue. It will also make sure that we end the duplication and the silly eccentricities of federalism that prevent a uniform system across the country. It will obliterate red tape. It will make sure that we have the same system across every state and territory in this country with respect to national registration and accreditation. There is more work to be done, but the government is getting on with the job of listening to stakeholders, making national reform, putting in money where there was no money, making sure that nurses and health professionals get trained properly and rolling out GP superclinics, even in the electorate of Dickson.

Peter Lindsay (Herbert, Liberal Party) Share this | Link to this | Hansard source

Mr Deputy Speaker Washer, as a doctor you will understand GP superclinics and you will also understand the disappointment that I feel because, after my electorate was promised one of the 36 superclinics almost three years ago, there is still no superclinic in Townsville and no prospect of one being started before the next election. That is very disappointing.

The Health Practitioner Regulation (Consequential Amendments) Bill 2010 that the parliament is discussing today contains amendments to support the introduction and implementation of the National Registration and Accreditation Scheme for the Health Professions. It provides transitional arrangements for this scheme. It is a positive initiative, which will nationally streamline the recognition and registration of medical people working in medical professions. There are 10 healthcare professions that are involved: medical practitioners, dentists, nurses, midwives, pharmacists, psychologists, optometrists, chiropractors, physiotherapists, osteopaths and podiatrists.

In July 2006 the Council of Australian Governments agreed to set up the National Registration and Accreditation Scheme for the Health Professions, and in March 2008 COAG signed an agreement to introduce the scheme by 1 July 2010. I observe here that in health things move very slowly indeed and the current health reforms being trumpeted by the government are also moving very slowly indeed. For example, the government announced that there would be a PET scanner based in Townsville—the first PET scanner in Queensland outside Brisbane. Of course it should be in Townsville, which is more than 1,000 kilometres from the state capital, but while the government said that we would get a PET scanner it did not say that we would not get it until 2013-14. The government should have made that clear, because there is an expectation in the Townsville community that a PET scanner is coming now.

Many health reforms do not take place other than in the out years, and I think people are going to be quite disappointed that, although there is all this trumpeting about wonderful healthcare reform, they will not see anything happen for several years yet. This is the cynic in me speaking, but when it finally does happen I reckon we are going to see more of the same. There will still be the waiting lists on elective surgery, and there will still be the problems in the emergency departments. We do not seem to be able to get a handle on how to fix these problems. Often they are to do with workforce issues, particularly in the public system. One of the fundamental things that the government will not address is the workforce issues and the terrible inefficiencies that occur in the health system because of them. I will give you an example, Mr Deputy Speaker. I know somebody who was called into one of the operating theatres at the Townsville Hospital on the weekend and there were 14 people in the theatre being paid overtime. They did not know what to do with themselves. There was no work for them, but they still had to be in the theatre, whereas if the same operations were taking place in the Mater hospital there would be three people in the theatre and they would do twice as many procedures. That is the kind of sickness that is in the health system.

In November 2008, Queensland was the first state to pass a law, the Health Practitioner Regulation (Administrative Arrangements) National Law Act 2008, to deal with the issues at hand. The state then passed a law allowing a national scheme to be put in place. A national approach on this issue is important; however, the scheme has raised several contentious and important issues. There have been legitimate concerns raised in the debate, particularly by some of the key stakeholders, and the government must listen to these concerns from people who are directly involved in providing health care to Australian patients.

One of the provisions of the national registration and accreditation scheme is for mandatory reporting by healthcare professionals themselves. A medical professional seeking personal treatment would have to have this treatment reported. The Royal Australian College of General Practitioners has expressed strong concern—and I think that is understandable—that this may lead to healthcare professionals hiding their own medical conditions, which may in turn pose a great risk to patients. That is something that we should think about deeply.

The AMA has its own concerns about this bill, particularly about two of the provisions relating to requirements for medical professionals. As well as being recognised as a specialist by the state or territory where they practice, they will also be required to satisfy ‘any other requirements prescribed by the regulations’. The AMA has quite rightly pointed out that this is an unnecessary extra requirement, as the medical professions are already registered. This is symptomatic of what we seem to do to ourselves: layering on this regulation and red tape and so on. Year by year it gets harder and harder, and people ultimately find that it is too much.

The AMA has also raised an issue regarding Medicare benefit ineligibility. If a medical professional provides a service outside their authorised practice, they will be ineligible for Medicare benefits. I do not understand that. This provision is specific only to medical professionals. Why? Ten healthcare professions are identified by the scheme, yet only medical professionals are subject to this requirement. The AMA has argued that this provision should therefore apply to all health professions who would receive Medicare benefits, and that seems sensible.

The bureaucracy involved in this scheme is a big concern. If bureaucrats get overinvolved and end up dictating to health boards during the implementation of the scheme, we will lose the focus on providing better health care. That alarms me. That I am raising this concern should not come as a surprise, because the Rudd government has only one approach to Australia’s healthcare system, and that is to increase the layers of bureaucracy. Just last night in the budget we saw Mr Rudd spend an extra $500 million on more health bureaucracy. Mr Rudd and Mr Swan promised the Australian people that they would not increase health bureaucracy. They broke that promise last night, and none of the $500 million will go towards hospital services.

When the Prime Minister trumpets his healthcare agreement, he does not tell the Australian people about all the layers of bureaucracy in his plan, but when you look at it there are so many levels and departments. Not only are there 11 Commonwealth and state health departments and area health services but also now Labor is going to establish more agencies: the National Health and Hospitals Network Fund, the hospital pricing authority, the National Performance Authority and local hospital networks. Of course, ‘local hospital networks’ is a misnomer. The government has given communities around Australia the expectation that there will be a local hospital boards, but that is not right. There will be local hospital networks, but they will not be for individual hospitals.

The coalition, however, welcomes extra investment in health. It is vital that health care in Australia receives the reform and support it needs. However, under the Rudd plan all this new funding will have to go through all the different layers of bureaucracy before even coming close to those who need it the most: the patients. We know that Queensland Health, for example, is a Soviet style bureaucracy. It is so difficult and wastes so much money and, of course, the customers do not see the results of that expenditure.

Since 2007 Kevin Rudd has let down Australians in a whole host of areas. This broken health bureaucracy promise is just one of those—I can also think of GroceryWatch, Fuelwatch and the pink batts Home Insulation Program. Of course, as I mentioned earlier, he promised to build 36 GP superclinics. Here we are in 2010 and only two of these have become fully operational. I do not believe the government when they say they will build another 23 clinics. If they cannot deliver on the first 36, what will be the fate of the next 23?

In Townsville, we are still waiting. I am hopeful—the proponent who won the right to operate the superclinic in Townsville is a very, very good operator and is very much into patient care. But the results speak for themselves. There is no GP superclinic in Townsville and there is not likely to be one for at least another year. It is very disappointing when the public are given the expectation that the Rudd government will deliver but then it does not. Is it surprising to any of us that the Prime Minister gets tagged with the phrase ‘All talk and no action’ when that is the reality? However, I will be supporting the bill and thank the parliament for the opportunity to speak about it.

Julie Owens (Parramatta, Australian Labor Party) Share this | Link to this | Hansard source

I rise to support the Health Practitioner Regulation (Consequential Amendments) Bill 2010. This bill supports the implementation of the National Registration and Accreditation Scheme for the Health Professions. With this bill, for the first time there will be a national system for the registration and accreditation of 10 health professions, bringing consistency and uniform standards to our health workforce. I suspect that most Australians who may be listening today would be surprised that these 10 health professions are not already covered by a national registration scheme, as they are the most common of the medical professions: medicine, nursing and midwifery, pharmacy, physiotherapy, psychology, osteopathy, chiropractic, optometry and dental care—including dentistry, dental hygiene, dental therapy and dental prosthetics—and podiatry. These are quite common medical services that currently are covered by different registration systems in each of the states and territories.

In addition, the health ministers have agreed that from 1 July 2012 some additional areas will be covered, including Aboriginal and Torres Strait Islander health practitioners, Chinese medicine practitioners, occupational therapists and medical radiation practitioners—all will be regulated under the scheme. The scheme will modernise the regulation of health professions by creating a single regulatory environment, ending the duplication of effort and red tape caused by separate systems in each state and territory. The scheme will create a single national register, so any suspension of rights to practice or conditions on registration or deregistration will apply simultaneously in all states and territories. Queensland, New South Wales and Victoria have already passed the bills which will put in place the national system, the Australian Capital Territory and the Northern Territory have introduced their bills and South Australia, Tasmania and Western Australia are well advanced in their planning.

National registration has been a very long time coming. It was identified as an issue many, many years ago. In fact, way back in 1992 attempts were made to simplify registration and regulation process. The Mutual Recognition Act 1992 was one such cooperative attempt by the state, territory and federal governments to introduce some kind of uniformity. The act allowed individuals registered to practise an occupation in one jurisdiction to obtain registration to practice an equivalent occupation in another participating jurisdiction. Yet, in spite of that move—and it was a very important one at the time—there continued to be calls for central regulation. Reasons cited in support of reform have ranged from the ability of practitioners to move more easily between jurisdictions to safety and quality considerations—both very important considerations.

The register has been a very long time coming. The previous government, with the current Leader of the Opposition as the Minister for Health and Ageing, identified national registration as an urgent priority some years ago. Then, in December 2005, the Australia’s health workforce report by the Productivity Commission recommended the establishment of a single national registration board for health professions as well as a single national accreditation board for health professional education and training. This move was seen as a means to help deal with workforce shortages and pressures faced by the Australian health system. This was a very important recommendation which was not acted on at the time.

When the Rudd government came to power it identified national registration as an urgent priority that had been held up far too long and needed urgent action. This was one thought bubble that Mr Abbott had back in his time as health minister that really did need practical implementation quickly. We immediately got to work with the states and territories and in March 2008 signed an intergovernmental agreement to progress to the national scheme. The bill we are debating today brings that scheme into effect. Yet still we have calls for delay from the opposition. The member for Dickson this morning said we should wait for the Senate inquiry to bring down its findings. The member for Dickson is not keeping up. The Senate inquiry reported yesterday and the House will note that amendments have already been circulated that deal with the concerns raised in that report.

We know that the national scheme will reduce red tape, increase standards and improve safety for the Australian community. We also know that a national scheme will improve the mobility of the health workforce. It will stop health professionals from having to re-register as they cross borders, saving time, money and inconvenience. It will help boost locum support for rural doctors as doctors become freer to move around the country.

On 3 November 2009, the Health Practitioner Regulation National Law Act 2009 in Queensland received royal assent in the Queensland parliament. The national law set out the framework for the scheme, covering registration of health practitioners and accreditation of health education and training, complaints, privacy and information sharing, and transitional arrangements. The Commonwealth does not need to apply the act for national law; however, consequential and transitional amendments are required to the Health Insurance Act 1973 to ensure that medical practitioners continue to retain the same Medicare billing eligibility from 1 July 2010. The bill streamlines the extensive systems involved in registration and recognition of medical practitioners for Medicare purposes, ensuring reduction of red tape, and helps to maintain the currency of the Health Insurance Act 1973 regulations and adequate access to Medicare rebates and retention of practitioners in Australia.

The member for Herbert was quite scathing of the government’s attempts to reduce regulation, saying that these are not matters for patients. But I think the member for Herbert, if he thinks about it, will realise that for every minute that health practitioners spend dealing with government regulation they are not with their patients. Reducing regulation in small business, in health professions around the country, as this government has been doing, dramatically increases the capacity of professionals to do what they are trained to do rather than administer.

The current pathways to specialist, consultant physician and GP recognition in the Health Insurance Act 1973 necessitate communication exchange between Medicare Australia and relevant organisations, such as medical colleges, to ascertain Medicare eligibility. These arrangements have been put in place because previously there was variation across states and territories for the recognition of specialist qualifications and general practice qualifications in the registration process.

The national registration and accreditation scheme provides a nationally consistent means of identifying both specialists and GPs, and the mandatory requirement for continuing professional development in the scheme means that Medicare Australia is no longer required to monitor whether practitioners providing a Medicare rebateable service are meeting continuing professional development requirements. It is essential that the extensive systems involved in registration and recognition of doctors for Medicare purposes are streamlined to ensure the reduction of red tape. The currency of the health insurance regulations and the efficient access to Medicare rebates depends on that.

The Health Insurance Act 1973 provides various pathways for recognising specialists, consultant physicians and general practitioners for Medicare purposes. This bill provides an opportunity to streamline current specialist recognition processes under Commonwealth legislation. This includes removing the current vocational register of general practitioners, particularly now that the Medical Board of Australia has recommended that health ministers endorse general practice as a specialty for the medical profession. The bill will not disadvantage medical practitioners that are currently registered in states and territories. In particular, it will not disadvantage any GPs that are currently on the vocational register whether or not they have a fellowship of the Royal Australian College of General Practitioners or the Australian College of Remote and Rural Medicine. Streamlining specialist recognition will also facilitate workforce mobility and access to Medicare for international medical graduates.

The National Registration and Accreditation Scheme for the Health Professions will modernise the regulation of health professionals by creating a single regulatory environment. By ending the duplication of effort, multiple standards and red tape caused by separate systems in each state and territory, we will have a more workable registration scheme for Australian patients and practitioners that also contributes to improving the safety of our health system for all Australians. It provides the community with reassurance that health professionals across Australia will meet a common set of standards. Our health workforce will also benefit from the improved mobility and transparency the national scheme will offer. I look forward to the implementation of the national registration and accreditation scheme for the first time in Australia—a scheme that, for the first time, introduces national recognition for these important medical practitioners. This is an important piece of health reform work and I am very pleased to be commending it to the House.

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

Craig Thomson (Dobell, Australian Labor Party) Share this | Link to this | Hansard source

Before I start, I have been asked by Luch, who looks after us so well here with water and so forth, to acknowledge that his daughter and her class members from Mary MacKillop high school are here in Canberra today watching us. On behalf of a very proud father: Jessica, welcome to you and your schoolmates. I hope you enjoy today’s proceedings.

Health reform is well and truly one of the most important issues of our time. I am delighted to say this government is providing the leadership that is needed on health reform. Leadership, especially in the area of health, is a concept that was obviously absent when those on the other side were in government. When the current Leader of the Opposition was Minister for Health and Ageing he ripped a billion dollars out of the health system, seeing that as some kind of reform. Clearly, we take a very different approach on this side of the parliament.

I rise to support the Health Practitioner Regulation (Consequential Amendments) Bill 2010. The bill supports the implementation of the National Registration and Accreditation Scheme for health professionals. This will mean that, for the first time, there will be a national system for registration and accreditation in 10 health professions, bringing consistency and uniform standards to our health workforce. Queensland, New South Wales and Victoria have already passed bills which will put in place the national system. The ACT and the Northern Territory have introduced their bills, and South Australia, Tasmania and Western Australia are well advanced in their planning.

National registration has been a very long time coming. Under the previous government, the current Leader of the Opposition as the Minister for Health and Ageing identified this as a goal and then decided to sit on his hands. After years of blaming the states and territories for all the problems in the health system, he was unable to work with them to deliver this key health reform. On the other hand, this government is delivering this key health reform. Just as the opposition leader sat on the sidelines while 60 per cent of Australians suffered from a shortage of doctors, he dithered on this important health workforce reform. The Rudd government recognized that this goal was one that had stalled and needed to be pursued. We immediately got to work with the states and territories and, in March 2008, signed an intergovernmental agreement to progress the national scheme. We know that a national scheme will reduce red tape, increase standards and improve safety for the Australian community. We also know that a national scheme will improve the mobility of the health workforce. It will stop health professionals from having to reregister every time they step across a state border, saving time, money and inconvenience. This will, for example, help boost locum support for rural doctors as doctors become freer to work across state boundaries.

As I have said, the health reforms that this government are committed to constitute one of the most important issues of our time and of our generation. In my area of New South Wales—the Central Coast—health reform is an issue we do not take lightly. I have been campaigning strongly for the Central Coast to have its own truly local area health network. Currently we are part of a larger Northern Sydney system, which is clearly not suitable for our region. We need to have a health system that caters to the Central Coast’s people rather than one that is spread out over such a large geographical area. The priorities of our health system need to be in our region and not elsewhere—a system that is funded federally but run locally.

The government is delivering a GP superclinic in the northern area of my electorate of Dobell, which has the full support of not only the local community but also the Division of General Practice, the University of Newcastle, the area health services and doctors generally in the area. It also has the support of high schools. I mention this because MacKillop College, a college of the same name as that of the students who are here in parliament today, is in my electorate. It is next to this college that the GP superclinic is to be built. It is planned that this superclinic will have high standards of training. Students from the school and others in the area will be able to participate in training at the superclinic. Once the new superclinic is fully operational in the Warnervale area, it will employ more than 100 health professionals. It will take demand off the emergency department at Wyong Hospital, which is now the fourth busiest in the state. Already there are nearly 2,000 patients on the books of the temporary GP superclinic, which reflects the need for additional doctors in our areas, particularly in this area, where there is a growing number of new families moving to the Central Coast.

To further alleviate the pressure on emergency departments, including the one at Wyong, the budget outlined by the Treasurer last night, as we now know, allocates new money towards limiting the time in which patients will be seen to in an emergency department to only four hours. This will be done by increasing the capacity of the emergency departments. Through the budget, the government is acting to ensure that more Australians can more easily access appropriate health care by making a strategic investment to support and recognise the work of practice nurses. As part of the government’s nursing package, $390.3 million will be provided to better support practice nurses and for the first time provide funding to GPs in urban areas to help employ practice nurses. Annual incentive payments of $25,000 per full-time GP for a registered nurse and $12,500 per full-time GP for an enrolled nurse will be made available to eligible accredited general practices.

The government will transform the way Australians with long-term illnesses are treated, starting with improving health outcomes for the nearly one million Australians living with diabetes, too many of whom end up being treated in hospitals unnecessarily. The government is committing $449.2 million to improve care for people with diabetes. For the first time, Australians with diabetes will have the option of signing up with a GP practice. The practice will be responsible for managing all aspects of their care and will be paid, in part, for keeping patients healthy and out of the hospital system.

Through these key reforms, this government is committed to delivering better health outcomes for all Australians. The 2010-11 budget will deliver a massive $1.2 billion boost to GP and primary health care, including $355.2 million to build and upgrade GP superclinics. This will honour the Rudd government’s commitment to deliver real improvements in front-line health services for patients across Australia. The Rudd government will upgrade around 425 primary care facilities and GP superclinics and construct around 23 new dedicated GP superclinics. This strengthens the Rudd government’s $275.2 million GP superclinic program, which is delivering 36 GP superclinics across the country, including in my electorate. As I have mentioned, GP superclinics take pressure off public hospitals, provide better integrated and more accessible care, help attract health professionals to areas of need and give health professionals the option of more training in these particular facilities. Of the new GP superclinics, around nine will be large clinics where doctors, nurses and allied health professionals will be supplemented by more specialised services such as renal dialysis, minor surgical procedures, rehabilitation services and radiology. The remaining new GP superclinics will be built along the lines of the 36 clinics already under construction. By providing patients with more convenient one-stop shops, the government will help and encourage patients to get the primary care they need to stay fit and well, particularly if they suffer from chronic illnesses.

Three types of funding will be available to help existing general practices expanded their facilities, with grants of up to $500,000. These larger grants will be available to those practices that also establish teaching facilities. Additional services will be made available as a result of the infrastructure investment, with space made available in GP clinics for allied health services; group education, such as diabetes management; counselling; and community health promotion. This injection into GP superclinics builds on the additional primary care being committed to by the Rudd government, including funding for a record number of GPs, more support and training for around 4,600 practice nurses and a new innovative approach to improving the treatment of diabetes in GP practices. These infrastructure investments are part of the government’s move to take over full funding of and policy responsibility for primary care. Through the National Health and Hospitals Network, the Australian government is taking full responsibility for funding all general practice and primary healthcare services. The Commonwealth government will continue discussions with the states and territories to finalise the scope of services included in the takeover by the end of 2010.

Our region—the Central Coast—is ideal for a Local Hospital Network which will be run locally and funded federally. I will continue to fight for that outcome. My constituents take their health very seriously. That is why there is a rising tide of community opposition to plans for a large longwall coalmine in the valleys of Wyong Shire in my electorate. People not only know that there is a major risk to the region’s water supply because of the planned mine’s location in relation to the water catchment but also are worried about potential health risks. The proposed coal loader for the mine is to be located in one of the fastest growing areas of my electorate, which is popular with young families moving to the coast for the clean air and outdoor lifestyle. I am fighting against the coalmine because of the ongoing concerns about health outcomes linked to coalmining in general and, in particular, the problems they have experienced in the Hunter, just north of me. They did not move to these areas of the Central Coast to have their health and their children’s health affected by coal dust from thousands of tonnes of coal moving through their neighbourhoods. I am determined to stop that coalmine.

The bill I am speaking on today is an important part of the government’s major agenda of health reforms. On 3 November 2009 the Queensland Health Practitioner Regulation National Law Act 2009 received royal assent. The national law sets out the framework for the scheme covering the registration of health practitioners and accreditation of health education and training, complaints, privacy and information sharing, and transitional arrangements. The Commonwealth does not need to apply the act for national law; however, consequential and transitional amendments are required to the Health Insurance Act 1973 to ensure that medical practitioners continue to retain the same Medicare billing eligibility from 1 July 2010. It also streamlines the extensive systems involved in registration and recognition of medical practitioners for Medicare purposes, ensuring the reduction of red tape, and helps to maintain the currency of the Health Insurance Act 1973 regulations and adequate access to Medicare rebates and retention of practitioners in Australia.

The current pathways to specialist, consultant physician and GP recognition in the Health Insurance Act 1973 necessitate communication exchange between Medicare Australia and relevant organisations, such as medical colleges, to ascertain Medicare eligibility. These arrangements have been put in place because previously there were variations across states and territories for the recognition of specialist qualifications and general practice qualifications in the registration process.

The national registration and accreditation scheme provides a nationally consistent means of identifying both specialists and GPs. The mandatory requirement for continuing professional development in the scheme means that Medicare Australia is no longer required to monitor whether practitioners providing a Medicare rebateable service are meeting continuing professional development requirements. It is essential that the extensive systems involved in registration and recognition of doctors for Medicare purposes are streamlined to ensure the reduction of red tape, the currency of the health insurance regulations and efficient access to Medicare rebates, as we have noted before.

The Health Insurance Act 1973 provides various pathways for recognising specialists, consultant physicians and general practitioners for Medicare purposes. This bill provides an opportunity to streamline current specialist recognition processes under Commonwealth legislation. This includes removing the current Vocational Register of General Practitioners, particularly now that the Medical Board of Australia has recommended that health ministers endorse general practice as a specialty for the medical profession.

This bill will not disadvantage medical practitioners who are currently registered in states and territories. In particular, it will not disadvantage any GPs who are currently on the vocational register whether or not they have a fellowship of the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine. Streamlining specialist recognition will also facilitate workforce mobility and access to Medicare for international medical graduates.

The National Registration and Accreditation Scheme for the Health Professions will modernise the regulation of health professionals by creating a single regulatory environment. By ending the duplication of effort, multiple standards and red tape caused by separate systems in each state and territory we will have a more workable registration scheme for Australian patients and practitioners that also contributes to improving the safety of our health system for all Australians. It provides the community with reassurance that health professionals across Australia will meet a common set of standards. Our health workforce will also benefit from the improved mobility the national scheme will offer.

It is important to note that much effort has gone into where we are today with this bill. Much credit should go to all of the professional groups who have constructively engaged in an incredibly complex task over the last four years. This includes the current state and territory health professional boards, which have faced enormous change. We should also recognise the expertise and hard work of the officials who have undertaken the work that is making national registration a reality.

We should also thank the state and territory governments around the country, who are all committed to a national scheme for the registration of health professionals and have put the national interest first in supporting this change. We now look forward to the national law being adopted in the remaining jurisdictions over the coming months and the implementation of the national registration and accreditation scheme for the first time in Australia. I commend this bill to the House.

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

I speak in strong support of the Health Practitioner Regulation (Consequential Amendments) Bill 2010, as it supports the implementation of the National Registration and Accreditation Scheme for the Health Professions. In fact, it does more than support it; it provides the foundation for its establishment. This is a first. In the words of our Minister for Health and Ageing, Nicola Roxon, this bill is a landmark reform for our health system. It is. I have to thank her for the skill and competency that she brought to negotiating the final arrangements.

The bill introduces a national system for the registration and accreditation of about 10 health professions. It brings about consistency across borders in Australia and uniform standards to our health workforce. People always talk about having cooperation across the borders at the state and territory level. It sounds easy and sounds like it can be delivered in a straightforward way, but we know from experience and practice that it is not so easy to do and it does take not only skill and competency but political will to make it happen. A lot of things get put into the too-hard basket when we are looking at national standards, national schemes and national accreditation, which I will cover more later.

When the bill was introduced into this place on 24 February the minister said that Queensland, New South Wales and Victoria had already passed bills which put in place the national system. She further said that the ACT and the Northern Territory had introduced bills and that South Australia, Tasmania and Western Australia were well advanced in their planning. I hope the minister is able to give us a status update in her summation. Again it is well done that all states and territories are on board to make sure we have this national scheme.

The previous government’s Minister for Health and Ageing, who is now the Leader of the Opposition, identified this as a goal. He knew it was a problem to be fixed and then did nothing. He sat on it. That is right, he did nothing. Now he runs around proclaiming to be a man of real action. What nonsense. Any time he had to take action of any kind he shied away, except of course action that disadvantaged workers such as introducing Work Choices.

The Leader of the Opposition was not able, or not willing, to introduce these reforms. It requires a lot of policy energy, and not just policy energy directed at opposing and saying no, because it was not their idea, and running fear and smear campaigns, which is part and parcel of their modus operandi. You have to have the policy nous and the political will to start to address the challenges that face our health system. And I have to say that the then health minister, now Leader of the Opposition, never had the ticker to do it. Sixty per cent of Australians suffered from a shortage of doctors and that was put into the too-hard basket too. Worse than that, the previous health minister, now Leader of the Opposition, actually froze the number of GP training places.

This bill is about health workforce reform. It was an area that had been neglected. In March 2008 the health minister and the states and territories signed an intergovernmental agreement to progress this national scheme. That was the Council of Australian Governments working for us. A lot of people wonder about the Council of Australian Governments, or COAG, as it is called. They hear discussion about it, they hear about it in the media and they hear members of parliament talking about it, but it can seem a bit remote to them. But through the political will of governments and goodwill on all sides COAG actually works for us, and this is an example of it working for us.

In short, this national scheme will do a number of key things. It will increase standards and, particularly with health, we can never have enough of those, and it is better that they be national standards. When we have standards that operate in a certain way because of a border, differences in each state can be really difficult. Having a national standard means that we can also raise the standards and bring them to a better benchmark and a better mean and we can always bring them up to the best standard that exists across the country. Again, I know that can be hard to do, but that is how it can work. It could also reduce red tape, and that actually has an impact on health service delivery and safety.

There is a fourth benefit. It also improves the mobility of the health workforce. Anything that can improve the mobility and the ability of the workforce is a good thing, and certainly for rural health service delivery. In practice, it means that health professionals will not have to re-register every time they step across a state or territory border. That saves time, money and inconvenience, and it means that some practitioners will go to other places to work.

From my personal experience as a registered solicitor trying to register in another state, I know that it can be very complicated. I once had a situation where by the time I got the papers the time had expired for me to physically lodge them in Brisbane. I think I tried about four or five times and gave up—that one just seemed too hard. Also, the requirement to present different sets of information or to double up on it is very frustrating. I know that whole area is changing too for the legal profession.

The mobility factor is a boon for locum support for rural doctors. As doctors become freer to work across state boundaries, while we will not necessarily have all the doctors rushing to rural areas, it will make it easier and the incentive is there for that to happen. This bill is directed towards some important machinery matters that need to be addressed to give effect to the ability of medical practitioners to retain the same Medicare billing eligibility, and that will be operational from 1 July 2010. As for the amendments, they are said to be consequential and transitional, but really they are fundamental to the Health Insurance Act to give effect to this provision for medical practitioners. The Commonwealth does not need to apply the act to national law, but it is for that provision that I just talked about.

The national registration and accreditation scheme provides for a nationally consistent means of identifying both specialists and GPs and a mandatory requirement for continuing professional development. That is an important inclusion. I have that requirement in the legal profession; I have to get my 10 points each year to keep my practising certificate. There are some exceptions, of course, for doing other things—teaching et cetera—but it is important in any profession to have that ongoing mandatory requirement. It means that at least every year practitioners in whatever field they are in have to commit to certain things. It is good also if schemes can operate so that not only do you have to commit to mandatory continuing professional development but that it has some coherence built around it about what information, knowledge and skills are required each year in the area. I know that does not operate in the legal profession, but it would be good. And because I also have a teaching background, I have some feel for what should be included in continuing professional development and education.

The National Registration and Accreditation Scheme for the Health Professions modernises other regulation of health professionals by creating this one regulatory environment. It is important because any profession wants to modernise but the reality with health is that it has to serve the needs of the health profession but equally serve our needs—the consumers, the patients. This scheme addresses both. It will end the duplication of effort, it will end multiple standards and it will end the red tape caused by separate systems in each state and territory. In the words of the minister: it will be a workable registration scheme for Australian patients and practitioners that also contributes to improving the safety of our health system for all Australians.

In closing, I can say that the amendments in this bill take on board the stakeholders’ concerns raised during the Community Affairs Legislation Committee inquiry into the bill and that, because of that inquiry into the bill, there was more time, more input and more consideration of it. That is always a good process. I look forward to having a workable, practical, national registration system that will deliver for patients and health professionals alike. I commend the bill to the House.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

It is with great pleasure, anticipation and some excitement that I stand to speak on the Health Practitioner Regulation (Consequential Amendments) Bill 2010 today. I have this pleasure, anticipation and excitement because today follows the day when the federal budget was brought down in this parliament and we have seen the greatest commitment made to health in this country and the greatest reforms included in this budget that have taken place since the introduction of Medicare.

I might say it was a Labor government that introduced Medicare and, once again, a Labor government that has introduced the monumental reforms that were included in the budget and in the historic health reforms that were reached at COAG earlier this year—less than a month ago, I might add. These reforms will see 1,300 new subacute hospital beds, over 6,000 new doctors, an additional 2,500 aged-care beds, emergency department waiting times capped at four hours, elective surgery delivered on time to 95 per cent of Australians, an historic agreement to reshape mental health services and help 20,000 extra young people get access to mental health services, more coordinated care for patients with diabetes in general practice, a Commonwealth takeover of primary care and a Commonwealth takeover of aged care. They are very exciting reforms that were agreed to in the COAG agreement, and I will talk a little later about some of the wonderful announcements that were made in last night’s budget, announcements that will benefit not only those people living in Shortland electorate but all Australians.

The legislation that we have before us today will change the way registration and accreditation of health practitioners throughout Australia is conducted. Currently, all states and territories have their own separate legislations containing different rules which govern the registration. Under the Australian Constitution, states and territories are empowered to legislate to register and regulate health professionals. The requirements and conditions of registration for professionals have therefore varied across jurisdictions.

In the past some attempts have been made to simplify registration and regulation but they got bogged down and did not come to fruition. I believe this is vitally important legislation because it will bring about a number of administrative reforms. There will be a reduction in the red tape that we have heard about from previous speakers—red tape that makes it cumbersome, that impacts on professionals’ ability to practise throughout Australia and ultimately impacts on the service delivery to all Australians. That red tape is due to the need for multiple registrations that impact on people’s ability to work across jurisdictions.

I also believe there is a safety and quality consideration because there is no uniformity, there are different registrations in different jurisdictions and there have been cases in the past where a person has been denied registration in one jurisdiction and granted it in another. The introduction and the passing of this legislation will do a lot to address that problem.

There has been enormous community consultation on the current legislation and, at the COAG meeting on 14 July 2006, it was determined that there should be a single national registration and accreditation scheme for health professionals. COAG signed off on it on 26 March 2008 and the scheme will come into force on 1 July, provided it passes the parliament. I have no doubt that that will be the case. In addition to the disciplines of medicine, nursing, midwifery, pharmacy, physiotherapy, psychology, osteopathy, chiropractic, optometry, dental hygiene, dental prosthetics, dental therapy and podiatry, it is going to partially regulate Aboriginal and Torres Islander practitioners, medical radiation practitioners, Chinese medicine practitioners and occupational therapists.

This is excellent legislation. I see that the Minister for Health and Ageing has entered the chamber. I have to congratulate her on the outstanding work that she has done in bringing about the historic health reforms and in giving health such a high profile in the budget that was brought down last night. I heard Malcolm Farr say on Sky News last night that it will be very, very hard for her to do anything that will exceed the work that she has done in health to date. It really has been outstanding. Each and every Australian will benefit from the reforms and from the health items that are included in the budget. I would like to formally congratulate the minister for the outstanding work that she has done, and I commend the legislation to the House.

Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Link to this | Hansard source

in reply—I thank all members for their contributions, and I thank the member for Shortland for those very kind comments. It is of course a matter of great pride for the government that we are able to pursue so many reforms in health. If this bill, the Health Practitioner Regulation (Consequential Amendments) Bill 2010, is to pass the House today—and we hope it will be supported by the opposition in order to pass the Senate—it will take us one step closer to delivering a national registration and accreditation system for Australia. It will indeed be a landmark reform to our health and hospitals system.

National registration has been a long time coming. The previous government, with the current Leader of the Opposition as the Minister for Health and Ageing, identified it as a goal and then decided to sit on its hands. After years of blaming the states and territories for all the problems in the health system, the then health minister was unable to work with the states and territories to deliver this key health reform. When we came to office we knew that a national scheme would be able to reduce red tape, increase standards and improve safety for the Australian community, and we pursued this within months of being elected, signing an intergovernmental agreement in March 2008. This was an agreement that the previous government had failed to achieve more than a year after announcing a national scheme in July 2006.

As I said, we know that the national scheme will also improve the mobility of the health workforce. It will stop health professionals from having to re-register every time they step across a state border, saving time, money and inconvenience. This will help to boost locum support for rural doctors as doctors become freer to work across state boundaries. I am very pleased to announce that, subject to the passing of this bill here today and in the Senate in the coming weeks, the implementation of this scheme is on track to commence on 1 July 2010.

Legislation is aggressively being introduced in all parliaments across Australia to adopt and apply the new national law. The Queensland, New South Wales, Victorian, ACT and Northern Territory acts have all received royal assent. The requirement to enact consequential amendments to Commonwealth health legislation provided us with an opportunity to streamline current specialist recognition processes under Commonwealth legislation, including for GPs. One of the objectives of the scheme is to improve registered health practitioner workforce mobility across jurisdictions. The proposal to streamline specialist recognition will facilitate workforce mobility and access to Medicare for international medical graduates, in line with the national partnership agreement. It is essential that the extensive systems involved in registration and recognition of practitioners for Medicare purposes are streamlined to ensure the reduction of red tape, currency of the HIA regulations, adequate access to Medicare rebates and the retention of practitioners in Australia.

The implementation of this scheme has much to do with the ongoing valuable input of stakeholders into making sure that this very complex scheme was able to be shaped into one which was practical. I will be moving three minor amendments to this legislation, following feedback from stakeholders that was provided to the Senate committee inquiry. These amendments provide further clarity to the definition of a consultant physician and nursing care and update a provision taken from the Health Insurance Act by widening the scope of sections 19C, 19CB and 19DA to apply to all health professionals who render Medicare rebatable services. Contrary to the assertions of the opposition health spokesperson, who I see is in the chamber now, the Senate inquiry actually reported yesterday. I note that the recommendation of that Senate committee was that the bill be passed. I also note the recommendation that the Australian Health Practitioner Regulation Agency place information on their website that provides clarity for the community on the definition of protected titles and roles. I can advise the House that the government will pursue this recommendation.

Through our amendments we are also addressing the concerns raised in the coalition minority report. I thank those opposite for indicating their support for this important bill. The National Registration and Accreditation Scheme for the Health Professions will modernise the regulation of health professionals, ending the duplication of effort and the red tape caused by separate systems in each state and territory, and will improve safety for the Australian community. It is with very great pride that I commend this bill to the House.

Question agreed to.

Bill read a second time.