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

I move:

That this bill be now read a second time.

Today I am introducing a significant piece of legislation into this chamber that will form part of the new backbone of a modern, integrated, high-performing health system.

It is a result of the government’s historic agreement with all states and territories to undertake fundamental reform of our health and hospitals system.

Today I am taking a critical step with the introduction of this legislation to create a National Health Performance Authority—the new watchdog for Australia’s health system.

The performance authority will work to:

• open up the performance of the health and hospital system to new levels of national transparency and accountability;
• allow for the identification of high-performing parts of the health system so those successes can be transferred to other areas;
• identify areas of the health system that require improvement so that action can be taken; and
• improve the health choices of Australians in making key decisions about their own healthcare needs.

This forms one critical element of a new health system—one that is sustainable, transparent, efficient, high performing and well resourced.

The reform of Australia’s health system is one of the most important public policy challenges of this generation.

In many ways we are lucky that Australia has one of the most impressive public health systems in the world—our doctors and nurses are world class, our public system provides free hospital care for all and it delivers outcomes such as low infant mortality and long life expectancy.

But we’re faced with a health system that is fragmented, costly, underresourced, unsustainable, overly focused on acute care and with constant pressure to deliver for more patients with more complex needs.

And our access is not truly universal—improving the health of Australia’s first peoples remains a massive challenge.

All of this would be challenge enough—but add to this the fact that Australia’s ‘baby boomers’ are now starting to retire. This population bubble will place more pressure on our hospitals as doctors and nurses retire, and more people require acute care.

We’ve attacked these challenges ferociously since we entered office in 2007. We’ve taken the short-term measures that have been needed to avert pressures becoming crises while we’ve worked to reshape our health system for the long term.

Hospital funding increased by $20 billion, over 70,000 more elective surgery operations have been delivered, the cap on the number of GPs being trained has been lifted with 475 new doctors now in training, the number of nurse places in universities has increased by over 1,000 a year, and primary care and preventative health is a renewed focus for government. And just this week I have announced 518 trainee specialist places, a tenfold increase compared to 2007.

But truly putting our health system on a sustainable path requires fundamental reform. A genuine national deal was needed to make the changes necessary to ensure our health system is not overwhelmed by the rising costs of health treatment, to provide safer and higher quality services, to manage the demand for health services from an ageing population and the need for effective reporting and monitoring on the performance of health service providers.

The government is now delivering this. Our 13 February agreement with all Australian states and territories on health reform creates a genuine partnership that will deliver much needed change to our health system.

The partnership that this government has entered into with the states and territories demonstrates our commitment to action on health reform, and most importantly, to take decisive action to deliver a better deal for patients, and a better deal for communities.

It means more money for hospital beds, increased local control of health services, greater transparency and less waste within the system.

One of the greatest challenges facing our health system is ensuring it has enough money into the future.

Therefore, the government will inject an extra $19.8 billion into public hospitals, on top of the extra $20 billion we have already provided, and develop robust national standards to make sure that money is directed straight to hospitals and patients.

The government will meet 45 per cent of the growth in efficient hospital costs by 2014-15 and 50 per cent by 2017-18. From that point, the Commonwealth and the states and territories will meet the cost of efficient hospital funding growth on an equal basis. The Commonwealth’s contribution will include funding of no less than $16.4 billion towards public hospital funding growth over the next decade, and $3.4 billion extra for emergency departments, elective surgery and 1,316 subacute hospital beds over the next four years.

A new national funding pool will be created which will deliver unprecedented transparency in the way hospitals are funded. These changes to the funding arrangements will provide security for hospital services into the future, combined with important changes in the delivery of vital health services.

But in order to drive improvements in patient outcomes, it is vital that patients have access to better information about the performance of hospitals and other key health care providers.

This government is committed to increasing the transparency of government and the services it delivers.

We firmly believe that with transparency comes a greater chance of improving public services and empowering the public to make decisions based on the best information.

There’s no better example of that than our reforms to the way that parents can make decisions about their children’s education through the MySchool website.

Building on this success in the health portfolio we have also implemented the MyHospitals website which for the first time allows all Australians to see the performance of their individual hospitals including waiting times for elective surgery procedures and emergency department care.

Our health reforms will drive this further. We’ve listened to the advice of the National Health and Hospitals Reform Commission that said performance reporting would ‘promote a culture of continuous improvement’ and improve consumer literacy of the health system.

They recommended the development of national access targets, performance reporting that compares the clinical performance of hospitals and health services (both public and private) and reporting on safety and quality performance and patient satisfaction.

Our health reform agreement delivers on that reporting, targets and transparency to improve health services.

This includes:

• new national standards for emergency department care and elective surgery to improve waiting times for patients in our hospitals; and
• a new performance and accountability framework so that hospitals will have to measure and report on a range of performance, safety and quality and output measures.

This work to improve transparency will not happen by itself. It requires dedicated resources and an independent authority to oversee the work.

So the bill I am moving today will establish an independent body to drive this performance and transparency agenda. The National Health Performance Authority will exist to improve quality, increase transparency and drive value for money in the health system.

It will drive transparency in the health system by improving Australians’ access to vital health information. Australians will have more access to information on their local hospitals, health services, primary health care and community health services.

The authority will monitor and report assessments on the new local hospital networks, public hospitals, private hospitals, and Medicare locals.

The authority will publicly report this information through new hospital performance reports and healthy community reports—that will be available for Australians to see on the internet.

These reports will show how each local hospital network and Medicare local is performing—as well as individual hospitals, private hospitals and other organisations.

To achieve this the authority will collect, analyse and interpret performance information and promote and conduct research into new and existing performance tools. Where performance needs to be measured in a new way—the authority will have the ability to develop new measurements to assess performance.

Other performance related tasks may also be referred to the authority.

Its independence will ensure that Australians know that nationally comparable information will be available and that it has been independently analysed.

It will mean that Australians will have a much better picture of how their health services are performing—and the differences in performance between big cities, outer metropolitan areas, regional centres and remote services. This will give further impetus to improve the equality of service provision across the country.

To ensure the performance authority’s membership has the necessary degree of healthcare expertise in rural and regional health issues, at least one member must have substantial experience and standing in the healthcare needs of people living in regional or rural areas, and must understand the challenges of providing first-class healthcare services to these Australians.

Seven members of the authority will be ministerially appointed in line with the health reform agreement—a chair from the Commonwealth, a deputy chair from the states and territories and five members to be appointed with the agreement of the Commonwealth and the states and territories.

Consistent with COAG’s original decision in April 2010, the performance authority is to be established as a statutory authority under the Financial Management and Accountability Act 1997, or FMA Act.

A chief executive officer will be ministerially appointed after consultations with the National Health Performance Authority. The chief executive officer will manage the authority and will be directly accountable to the Commonwealth Minister for Health and Ageing for the financial management of the agency. The chief executive officer will serve on a full-time basis for a period of up to five years, and is eligible for reappointment.

Through this bill, Australia can take another large leap on the path to a modern, high-performing health system, one that prioritises continuous improvement and accountability to the patients it serves.

This will be a powerful independent watchdog body that by using the power of accurate information will push our hospitals to deliver better services and push our primary healthcare sector to develop and improve.

It will guide policymakers to develop better solutions that give greater account to our regional differences and will help patients to make better decisions on their own care.

This is one important step on our major national health reform path—reforms which are critical to delivering for Australians a health system that delivers the services to Australians that they deserve and expect.

It gives me great pride to commend the bill to the House.

Debate (on motion by Mr Billson) adjourned.