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

The Health and Other Legislation Amendment Bill 2012 covers a number of areas; I want to start, though, with the non-contentious ones, if you like. The first is in relation to the Food Standards Australia New Zealand Act 1991, which is a good example of cross-Tasman cooperation. Food safety, labelling, additives, energy and foods are addressed through the Australia New Zealand Food Standards Code. Amendments in 2010 to the food standards act created referencing inaccuracies which this bill intends to address.

Food from Australia and New Zealand enjoys a reputation for high quality in both domestic and international markets. It is important that our regulatory regime supports the continuation of that reputation—although it is interesting that the amendments were not dealt with at the time of the original changes in 2010.

This bill also raises the issue of medical training by seeking to amend the Health Insurance Act 1973 to include Medicare benefits for supervisors of trainee medical specialists. Australians benefit from world-class medical specialists. The training of new specialists is naturally required to meet attrition and to grow our nation's specialist medical workforce. The supervision of trainee medical specialists is an important part of the professional development of the next generation of specialists. As a nation, we need to ensure that there are no impediments to such training and all parties involved are appropriately remunerated.

As described in the explanatory memorandum, this amendment provides that a professional service performed by a specialist trainee under the supervision of another medical practitioner is deemed to have been undertaken by the supervising medical practitioner. This ensures that the supervising medical practitioner attracts the Medicare benefit for the professional service. Normally, only the medical practitioner performing the service is able to attract the Medicare benefit. Since 2011, delegated legislation has enabled this process. This amendment will create primary legislation for that purpose.

Of course, the training of medical specialists is only one of many issues that need to be addressed in relation to our health workforce. Unfortunately this is another area of the health portfolio which has been touched by the health minister's management style. The minister is fond of character assassination of the Leader of the Opposition—so much so, I think, that her portfolio is neglected. And why? Well, you only have to look at their respective legacies to understand why this minister would seek to denigrate Tony Abbott's outstanding performance as health minister. The contrast is indeed very telling.

The Leader of the Opposition was responsible for delivering nine new medical schools to build our medical workforce. The current health minister failed to plan ahead for internships for trainee doctors. This issue should not have been a surprise to an attentive minister. Australia should not export world-class medical graduates that we desperately need for our own nation, all because the minister failed to plan ahead. Similarly, Tony Abbott set up the Chronic Disease Dental Scheme, which has invested billions of dollars into dental care for those needing it most. The current minister ripped out a billion dollars from dental care. Tony Abbott's investments in policies as health minister achieved excellent outcomes in many other areas of the portfolio, including the introduction of graphic health warnings on cigarette packs. This made a significant contribution to the coalition achieving a dramatic reduction in smoking from 23.8 per cent in 1995 to 16.6 per cent in 2007. In government, the coalition presided over substantial investment in health, going from $19½ billion in 1995-96 to $51.8 billion in 2007-08, meaning Tony Abbott left the portfolio having completed this 166 per cent rise in health funding. This pattern was repeated across the portfolio. Indeed, child immunisation was dramatically increased from a low of 52 per cent in 1995 for 0-to-6-year-olds to an all-time high of 90 per cent of children aged 12 to 15 months being fully immunised. In just two years to November 2005, under the Strengthening Medicare initiative, 750 GP practices began to employ nurses. Tony Abbott initially boosted medical research infrastructure by $200 million and then followed that up with a massive commitment in the 2006-07 budget for $500 million for the National Health and Medical Research Council and $170 million for new research fellowships. Contrast that to this minister, who presided over claims of ripping money out of medical health and research in the last budget in May last year. As minister, Tony Abbott put an extra $2 billion into our nation's hospitals. Tanya Plibersek has ripped out $1.6 billion from hospitals in MYEFO this year alone.

This bill also amends the Industrial Chemicals (Notification and Assessment) Act 1989. The Australian Customs and Border Protection Service have a mammoth task in protecting our nation. It is important that the legislative framework they rely upon keeps pace with their operations. This bill seeks to amend the Industrial Chemicals (Notification and Assessment) Act 1989 to reflect how chemicals are actually kept under the control of customs during transhipment. Transhipment of chemicals involves the import of a chemical into Australia with the express intention of re-exporting the chemical without opening the package, within 30 days. The bill removes the requirement that Customs keep the chemical at the port or airport during the period of transhipment. Given the government's challenges in relation to border protection—which are anything but routine, and of their own making—relatively routine matters such as this seem to be the extent of what the government is able to competently manage.

That leaves us with the contentious issue of this bill—that is, the issue surrounding Medicare. It is Labor's latest health hiccup. Medicare is a brand which belongs to the Australian people and, as the law currently stands, the use of the name 'Medicare' is protected by section 41C of the Human Services (Medicare) Act 1973. That creates an offence for the use of the name 'Medicare' in connection with a business, trade, profession or occupation.

In 2010, when the member for Griffith was Prime Minister and the Attorney-General was then health minister, they initiated a so-called health reform agenda. It is now a matter of public record that their working relationship was less than ideal and, no doubt, that was part of the reason why health reform never really got off the ground. Labor's health agenda included primary healthcare organisations to be known as Medicare Locals. Medicare Locals have since been established as companies, and I am advised that these entities may be guilty of an offence pursuant to section 41C. Indeed, item 22 of this bill seeks to repeal subsection 41C(6) and replace it with an exemption from offence provisions for activity authorised by the secretary or a prescribed delegate. This has the clear purpose of retrospectively legalising the government's franchising of the Medicare brand to Medicare Locals and also gives the government great scope for similar future activities.

The reason I say that this is the latest Labor health hiccup is that this government obviously, when they dreamt up the idea of Medicare Locals, were assisted by the same advisers who talked about Fuelwatch and GroceryWatch. Really, it was a pitch to the average Australian; it was not founded in trying to deliver better health services.

Indeed, when you talk to many of the Medicare Local offices around the country, they are at pains to point out that they did not want to be called Medicare Locals. They do not deliver medical services at a Medicare Local. They do not process Medicare claims at a Medicare Local. You cannot go in off the street with your sick child to a Medicare Local to claim back or to seek advice about a Medicare claim or a visit to a doctor or specialist. That is not what a Medicare Local is about. And this government, in quickly getting policy together which branded these things as Medicare Locals, gave no consideration to the value of the brand of Medicare this country has known for a long period of time. Really, they were about a cheap line in a Sunday newspaper. This has come back to bite this government because what they did in the process was to set up a potential breach of the act—their own act—by these entities which have been set up as companies and are failing to meet the legislation, it seems, and that is why the government seeks to move in relation to this matter.

I have put on the public record in the past that I do support some form of coordination at a primary care level. The game as we continue to age as a population, the game as we continue to have this rapid onset of chronic disease, is to manage care as best as we can and try to keep people away from tertiary settings. That is the aim of private providers, health insurance and medical products; equally, it is the aim of people within the public sector. We must as a country make sure that we provide every assistance to those people, so it is right that we have some form of primary care coordination.

That indeed is the reason Tony Abbott established a different network, the Divisions of General Practice, which provided coordination of task and role to provide assistance to GP services. But the delivery of primary care otherwise has to be targeted in a fashion whereby we can keep people away from expensive tertiary settings, where they are inclined to pick up a common bug in a public hospital, particularly if they are an older patient. For all of these reasons, which have been well documented, which go beyond these couple of reasons, it has to be the task to make sure that we keep people away from tertiary hospitals if that is at all possible. We support a coordination role but what we do not support is the mushrooming of bureaucracy and the huge cost that goes with that. That seems to underscore every single judgement this government makes. We want to make sure we can get money back into the hands of patients. We want to make sure that doctors and nurses get to deliver services that are going to help these patients.

Let us look at the Gillard government record on health. People think: 'A Labor government should be good at health. They are not good at the economy, they are not good at education, they are not good at inspiring business to invest and grow, because they keep whacking these great big new taxes on Australian industry. So, surely, they must be good at health.' But it is interesting to look at the record of the Gillard government on health. They have cut $2.8 billion by means-testing private health insurance rebates and a further $700 by not paying the rebate on private health insurance increases above CPI. They have cut $390 million by completely removing rebates from lifetime health cover loading. They have robbed over $1 billion in dividends from Medibank that should have been putting downward pressure on premiums. Another $1 billion has been cut from the dental health scheme by abandoning chronically ill patients who are now lining up on public lists and will wait in pain a lot longer to receive those services. In some cases, those people will not receive those dental services at all. There have been hundreds of million of dollars in multiple cuts to the Medicare safety net, including obstetrics and IVF. That is the record of the Gillard government. They have limited the number of new medicines going onto the PBS by politicising the process and ignoring the independent evaluation of those listings and the ultimate advice that flows to government to list those drugs, in some cases to make for a much better life or transform the lives of sick patients.

The Gillard government also dramatically cut, by $1.6 billion, the health payments to states and territories only a few weeks ago when the Treasurer announced the MYEFO. And the reason that this is particularly offensive to Australian patients is that many of the cuts come in this financial year alone. This is the case. I was in a regional hospital in Geelong last week. That hospital had already budgeted for this financial year but is going to have money ripped away from it for proceedings it has already performed over the last six months. What sort of government says to a health service in regional Victoria or in regional Queensland, or to an Indigenous community in the Northern Territory, 'You've set your budget for this financial year. We're now going to come along now and cut part of that budget out'? That is an unacceptable arrangement for anybody and it raises the issue quite dramatically in my mind of sovereign risk. It is one of the hallmarks, sadly, of this government.

You cannot say to health services, 'We want you to continue to perform elective surgery and to put on doctors and nurses and open up extra beds and perform extra work to try to help people alleviate some of the pain that they might have because they have got a bung knee or need a hip replacement.' You cannot say to those people, 'We're now going to strip out funding for those services'—those services having already been performed. What that will ultimately lead to is a downgrading in services for the rest of the financial year.

In the case of Geelong last week, if you are ripping up to $5 million out of a six-month period, that has the effect of taking $10 million out of that budget over the course of 12 months. What is going to happen in a situation where up to 70 per cent of your hospital expenditure is wages? You are going to cut back on those wages. You are going to say to doctors and nurses, 'We don't want you to perform that surgery.' That is what is going to happen and that is the legacy of this government. That is why, when we talk about these health bills, it is so important that we talk about the impact on patients.

What is quite often lost in these debates when Labor talks about putting on new bureaucrats and building up the bureaucracy is that the patients are the ones that suffer. The Labor Party may be well intentioned in setting up new bureaucracies—they have created 12 of them over the last five years—but, in the end, what it does is deprive money from patients, from frontline services. As Sarah Henderson rightly pointed out the other day, if the Geelong Hospital or elsewhere cuts back on elective surgery it is the patients, real people—people's mums and dads, grandparents and brothers and sisters—who are the ones that are going to miss out on valuable elective surgery.

To make it worse, this government hits those that have private health insurance. And, because we have universal health system in this country, if people drop their private health insurance they can turn up at a public hospital the next day. They have the same entitlement, regardless of income, to turn up at a public hospital and demand to be treated in an emergency department or to see a doctor or to be put on a waiting list. That puts enormous additional pressure on public hospitals.

I do not think anybody in this place would suggest that public hospitals right around the country are in a state where they can take thousands of more admissions each week without additional assistance. That is the crazy arrangement that this government has created over the course of the last five years. People say: 'What has Labor done? What achievements can Labor chalk up or be proud of in health?' They have cut now almost $4 billion, as I say, from private health insurance. They have cut out $1.6 billion over the forward estimates to hospital funding. This minister ripped a billion dollars out of the chronic disease dental scheme, and people who are waiting desperately for that service will be put to the back of the queue or join public waiting lists and that will make it harder for those people who are already on those public waiting lists.

That is the legacy of this Gillard government. The fact that they have presided over yet another health hiccup when it comes to the name of Medicare should not surprise anybody. This government did not think that Medicare was a brand that needed protecting. They did not think that they were unwittingly directing companies into breaking the law. But it seems, on the advice that I have, that that is exactly what this government did. Do you know why? Because they did not think through the policy. They wanted to have a good headline in a newspaper somewhere. That was it—start, finish. This government really have treated the health portfolio as they have treated every other portfolio, and that is with contempt and incompetence. This health minister treated the health portfolio as they have treated every other portfolio, and that is with contempt and incompetence.

This health minister can come into this chamber and explain to the Australian people why a billion dollars has been ripped out of the chronic disease dental scheme and why, when 80 per cent of people who used that scheme were concessional card holders, those people have been denied those services going forward. Why is it that this government have ripped $1.6 billion out of hospital funding when they say to the Australian public that they are going to put so much more money into public hospitals? Why do they do that? And why would they do it out of this year's budget, the money having already been budgeted for? In most cases, if not all cases, the money has at least partly been spent. Why would this government preside over such a debacle? Because they are not a government worthy of governing this country.

There will be amendments in relation to this bill, and there will be a lot more scrutiny applied to this government because people understand, day by day, that this government really has not achieved in the health portfolio anything like what it is they want the Australian people to believe they have achieved. We will be having more to say in the coming months and in the run-up to the next federal election about why we think this government has failed in relation to health, why this government has failed pensioners and self-funded retirees around the country who are reliant on our health system. Why is it that this government has not delivered for those people in particular? Why, for children suffering with chronic diseases who require urgent dental work, has $1 billion been ripped out of that scheme that went to help those sick children before? These are the questions that people will be asking themselves in the run-up to the next election.

It is the position of the opposition to oppose bad policy where we see it and to try and praise the government where they have good policy. But, as I say, it is increasingly difficult to distinguish this portfolio from communications, which has been a disaster for the government; from education, which has been a disaster for the government; from economic management, which has been a disaster for the government. That is the position of the opposition.

Kelvin Thomson (Wills, Australian Labor Party) Share this | Link to this | Hansard source

The Health and Other Legislation Amendment Bill 2012 amends the Food Standards Australia New Zealand Act 1991 to correct referencing inconsistencies within the act, including those related to the Australia New Zealand Food Standards Code. I would like to take the opportunity that this bill provides to speak about the issue of palm oil labelling, which is relevant to the issue of adequate food standards and labelling in Australia. Just as we have been tackling the root cause of illegal timber production through the historic reform of the Illegal Logging Prohibition Bill 2011, so too we have to tackle the root cause of unsustainable palm oil production. For this reason I strongly support the mandatory labelling of palm oil in Australia. The Don't Palm Us Off campaign by Zoos Victoria, which I have mentioned in the parliament before and which I support, aims to expose the link between consumers and orangutan survival in order to drive the production of certified sustainable palm oil through fair and mandatory labelling.

Just as we should be a responsible consumer of timber, we should also be a responsible consumer of palm oil. Palm oil is found in almost half the products on our supermarket shelves, yet it is not labelled. Labelling will help us create a consumer-driven market for certified sustainable palm oil—a form of palm oil that is produced in a more environmentally, socially and economically responsible way. Australian consumers want this, most of our major food manufacturers want this, and I believe it is the right thing to do for our community and for those communities in our neighbouring countries.

For over a year a fierce battle has raged over Indonesia's Tripa peat forest, an internationally protected region that is covered by a two-year moratorium on new forest concessions. It is being burnt and cleared at an alarming rate and it is being done so illegally in order to produce palm oil. The forest is home to people and wildlife and stores huge quantities of carbon. In 1990 almost 2,000 orangutans lived in the area. Today there are fewer than 200, as a result of illegal clearance and burning of their habitat for palm oil plantations. The smoke that has been generated by the illegal fires has devastated communities across the region and overwhelmed cities hundreds of kilometres away, causing people to seek medical treatment for smoke inhalation. So far more than 20 local communities have been impacted by the illegal clearing, including losing their land and livelihoods and suffering ill health.

In the report, Our land, our lives, Oxfam reveals a worrying rush to control the world's farmland and demands action to safeguard the welfare of poor and vulnerable communities. The report gives the following example:

In 2007, indigenous people in West Kalimantan, Indonesia complained to the World Bank that a palm oil company it supported had cut down their forest and forced them from their land. The Bank's complaints ombudsman investigated and discovered serious systematic problems, as a result of which Bank standards had been contravened and Bank staff had been able to claim (incorrectly) that the project would have 'minimal, or no direct, adverse social or environmental impacts'. There was such a controversy that the then Bank President, Robert Zoellick, suspended the Bank's lending to the palm oil sector for 18 months until a new strategy was in place, supposedly intended to ensure that such problems did not happen again.

Oxfam have called on the World Bank to institute a temporary freeze on investments involving large-scale land acquisitions. They believe a freeze would create space to develop policy and institutional protections to ensure that no bank supported project resulted in land grabbing and would allow time for the wider impacts of land transfers on poverty and food security to be assessed. Australia imports more than 130,000 tonnes of palm oil each year, which makes us a participant in illegal forest clearing, such as that that we have seen in the Tripa peat forest. It takes about 320 square kilometres of palm oil plantation to produce that 130,000 tonnes of palm oil, and this is a volume that continues to increase.

Deforestation releases large volumes of greenhouse gases. This is particularly severe in tropical forests growing on peat soils. In just one province of Indonesia, the Riau Province in Sumatra, the average annual greenhouse gas emissions between 1990 and 2007 were an estimated 0.21 gigatonnes of CO2 arising from deforestation, forest degradation and the resulting peat fires. This deforestation destroys the habitat of iconic and endangered species like the orangutan, the Sumatran tiger, the Asian elephant and the Asian rhino. Of course, these species are just a small part of the entire threatened ecosystem.

It has been suggested that up to 300 football fields of forest are cleared every hour. The United Nations Environment Programme acknowledges that, in Malaysia and Indonesia, the main driver for this rainforest destruction is the development of palm oil plantations. The growing demand for palm oil is adding to the mounting pressures on the world's remaining rainforest areas. Forest loss and the draining of peat lands for palm oil plantations is contributing to climate change and displacing local people who rely on the forest for food and shelter. Palm oil is one of the world's most in-demand crops and land is being given over to it in Southeast Asia as well as in West Africa and South America.

There is an alternative to this, however, with certified sustainable palm oil, CSPO. This is palm oil that has been produced by plantations that have been well managed with good environmental, social and economic standards. For example, certified sustainable palm oil has to be sourced from plantations that were established on land cleared before 2005. So, by buying certified sustainable palm oil, major users of palm oil can avoid contributing to the ongoing destruction of forests in Southeast Asia.

In 2003 the WWF began to address the problem of deforestation to produce palm oil by setting up the Roundtable on Sustainable Palm Oil with other non-government organisations and the palm oil industry. Since then they have worked with the industry to ensure that the Roundtable on Sustainable Palm Oil standards contain robust social and environmental criteria, including a prohibition on the conversion of valuable forests. Millions of people rely on this industry for their livelihood. By promoting sustainable palm oil certified by the Roundtable on Sustainable Palm Oil we provide the growth of a sustainable palm oil industry that sets new environmental and social standards. However, at present there is only a small market for sustainable certified palm oil, so it is actually more cost effective for manufacturers to use palm oil from sources that destroy virgin rainforest.

The WWF are working hard towards creating consumer demand for certified sustainable palm oil by: raising public awareness about the issue; exposing the link between unsustainable palm oil, deforestation and threats to important ecosystems and species; and supporting the mandatory labelling of palm oil. The WWF produced a scorecard in 2011 that measured the performance of 132 major retailers and consumer goods manufacturers against four areas to show whether or not these companies were acting responsibly. That scorecard revealed that there had been some progress on sustainable palm oil since the 2009 assessment, but their conclusion was that the new commitments were not translating fast enough into increased use of certified sustainable palm oil. They concluded that time is running out for palm oil buyers to take action and that companies need to seize the opportunity to support sustainable palm oil and help to avoid the irrecoverable loss of tropical forests and the unique species that inhabit them. This is a chance to show the world that they are part of the solution rather than a part of the problem.

Palm oil production is the single biggest threat to Southeast Asian rainforests and biodiversity and the species which depend on them. The Sumatran orangutan is classified as critically endangered while the orangutan from Borneo is considered endangered. Populations of both species are decreasing rapidly and, given the current rates of decline, it is likely that they could become extinct in the wild within as little as 10 years.

As I mentioned earlier, in terms of carbon storage, deforestation from palm oil production releases large amounts of carbon that is stored in the vegetation. Oil palm plantations are estimated to hold even less carbon than a logged forest, made worse by the fact that these plantations are only viable for 25 years. Furthermore, more and more plantations are being cultivated on vulnerable peat soils, one of the largest naturally-occurring carbon deposits worldwide.

I believe that, in addressing the problems associated with palm oil production, we need to look at the issue holistically which includes utilising the Roundtable on Sustainable Palm Oil more effectively to ensure sustainable palm oil production becomes the norm rather than the exception. As a result we can reduce deforestation and at the same time we can enable people in developing nations to have a livelihood. Mandatory labelling has a role to play in the solution to heighten consumer awareness and thus drive demand for certified sustainable palm oil.

The Australian Competition and Consumer Commission has released new information sheets on country of origin labelling and new information sheets regarding olive oil. These new guides for consumers provide information about the different types of olive oil products and how they differ as well as some storage tips. The guide is about providing consumers with information to help them make informed purchasing decisions, and I welcome this initiative. But there is no requirement at present to label palm oil or its derivatives in a product's ingredients list. I believe this needs to change so that consumers can choose or demand the alternative to unsustainable palm oil.

The United Kingdom has recently announced that they will be certifying sustainable palm oil compliance by 2015. The British government, supermarkets, manufacturers, charities and the World Wide Fund for Nature have joined forces to work towards ensuring that by 2015 all palm oil used in everyday food and products, such as soaps, biscuits and cosmetics, is responsibly produced and does not contribute to deforestation. The British environment minister, Richard Benyon said:

People want to know that the products they are using are not contributing to deforestation and climate change and many UK businesses are already starting to make changes. Producers, manufacturers and charities will continue working together to speed up the move to 100 per cent sustainable palm oil in everyday products.

This announcement also has accompanied work through the international Roundtable on Sustainable Palm Oil and the fact is that, at present, Australian consumers cannot tell whether they are contributing to deforestation and the accompanying threat to the survival of orangutans and other species, because palm oil is not clearly labelled on most food products. Changing food-labelling legislation in Australia to mandate the labelling of all food products containing palm oil would change this and create a market for certified sustainable palm oil by giving consumers their right to choose products that do not push endangered species to extinction. I commend this bill to the House.

Andrew Southcott (Boothby, Liberal Party, Shadow Parliamentary Secretary for Primary Healthcare) Share this | Link to this | Hansard source

I rise to speak on the Health and Other Legislation Amendment Bill 2012. This bill makes a number of technical amendments to various acts of parliament. I will briefly cover the details of two amendments before moving on to the amendments to the Human Services (Medicare) Act, which I would like to discuss in more detail.

The first amendment I want to discuss is to the Food Standards Australia New Zealand Act. The bill makes minor technical amendments to the Food Standards Australia New Zealand Act to correct referencing inaccuracies, which were the result of previous amendments. The FSANZ Act was amended in 2010, however, certain section references to the amended provisions were not amended at that time. These amendments are consequential in nature and do not change the intent of the act, and the coalition does not oppose them. It is interesting to note, however, that this is a rewrite two years on; it has taken the government two years to identify this issue.

Then there is the ICNA amendment. The amendment to the Industrial Chemicals (Notification and Assessment) Act makes a minor technical change to correct an inaccurate description of how chemicals are stored by Customs during transhipment. Goods are often stored outside the port or airport, but still in the complete control of Customs—for example, at a Customs bonded warehouse. As the legislation currently reads, the chemicals are required to be stored 'at the port or airport' while waiting for transhipment. The amendment will delete the references to 'at the port or airport' within the bill to more accurately reflect best practice. This will still require the chemical to be under the control of Customs at all times before being transhipped out of Australia.

I want to talk about the use of the word 'Medicare' and there is one amendment on this that I need to cover in detail, the proposed amendments to the Human Services (Medicare) Act 1973. Currently, under section 41C of this act, any person who uses the name 'Medicare' in connection with a business, trade, profession or occupation is guilty of an offence. Subsection 41C(6) of the Human Services (Medicare) Act provides the exception that 'proceedings under this section shall not be instituted without the consent in writing of the Attorney-General'. This means that an organisation can be guilty of an offence by using the Medicare name, but will not be prosecuted unless the Attorney-General consents to doing so.

The bill before this parliament seeks to remove this subsection, and replace it with an exemption to the offence for any activity authorised by the secretary or prescribed delegate. This would allow the secretary to grant an exemption to allow any organisation to use the Medicare name with approval. What the government and the health minister have not been straight or upfront about here is why they are moving this amendment. We need to go back two to three years in time to the moveable feast that was national health reform and the recommendations of the National Health and Hospitals Reform Commission. One of the recommendations that came out of that was we needed to have primary healthcare organisations to replace the divisions of general practice. At some point, someone—the member for Griffith or the member for Gellibrand—had a bright idea that instead of calling them primary healthcare organisations they should be called Medicare Locals. These primary healthcare organisations had nothing to do with Medicare, which is a comprehensive national health insurance scheme. But they replaced the divisions of general practice with 61 bodies called Medicare Locals.

We now have the extraordinary situation that one of the very people who came up with this name is now the person who as Attorney-General decides whether to prosecute someone for using the name 'Medicare'. The question I ask is this: would the government be moving this amendment unless the advice was that the use of the word 'Medicare' in the name 'Medicare Locals' was in fact a breach?

The opposition believes that there was no need to rename the divisions of general practice and that, if they did need renaming, the name did not need to include the word 'Medicare'. The current chair of the Australian Medicare Local Alliance, Dr Arn Sprogis has admitted that the Medicare Locals name was 'a shocker'. He is also on record as saying, 'We will live with the name even though it's got nothing to do with Medicare'. If you look at similar organisations in the United Kingdom or New Zealand, they are primary care trusts or primary care organisations. But this bright thought bubble came out of the then Prime Minister and the then health minister. There was no need to include Medicare in the name of the primary healthcare organisations. Those opposite are getting very good at fixing problems of their own creation. They created this mess and are now moving amendments to fix it.

As of July this year, all 61 Medicare Locals are operational, and all 61 may be breaching the Human Services (Medicare) Act by using the term 'Medicare' within their name as required by the government. We have the extraordinary situation of primary healthcare organisations doing what they have been asked when what they have been asked to do is in breach of legislation.

The amendment we are being asked to consider retrospectively legalises the government's mistake. It will also allow future governments to dilute the Medicare brand by allowing its use for other organisations if it so chooses. The simple and prudent fix would have been for the minister to admit the mistake and change the name of these organisations. No-one wants the name 'Medicare Local'. Instead, they have tried to bring this legislation before the parliament to hide their errors.

The coalition believe that the name 'Medicare' should be protected, and not used for political or commercial advantage. Let me be clear. This debate is not about the merits of primary healthcare organisations. The coalition believe that there is a very important place for a coordinating role in primary care. This debate is purely about the use of the protected name 'Medicare'. It is a name, and a brand that should be protected. That is why the coalition will be moving amendments to this bill which omit the provisions relating to the use of the term 'Medicare'.

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

I rise to support the Health and Other Legislation Amendment Bill 2012. Prior to my main contribution to this debate I would like to pick up on a couple of things that the previous speaker said. To me it underlines the fact that he does not really understand what a Medicare Local is. He said in his contribution to this debate that he does not know why the Medicare Locals could not remain as the urban divisions of general practice. Now, the urban divisions did a wonderful job. I have had two very strong urban divisions within the area I live—the Hunter and the Central Coast. They did wonderful jobs, but a Medicare Local is not an urban division of general practice. A Medicare Local involves a number of health professionals. A Medicare Local works as a bridge between the primary care in the community and the public sector. So the first point I would like to make in this debate is that a Medicare Local is not an urban division of general practice. I am sure the previous speaker will take that on board.

This legislation has four major parts to it. It looks at the Food Standards Australia New Zealand Act 1991 to correct referencing inconsistencies within the act. These are fairly minor inconsistencies. They arose when the act was last amended in 2010. At the time, certain paragraphs were repealed and substituted with new subparagraphs. But the reference to the repealed paragraphs were not consequently adjusted to reflect the changes—removing references to changes under subparagraphs 146(6)(b)(i) and 146(6)(b)(ii) and replacing them with references in 146 and removing references to changes being picked up under 146. So those are quite minor amendments to items that needed to be corrected.

This legislation also recognises the ability for specialist trainees at any recognised medical college to perform certain procedures under direct supervision in the private setting, with the procedures being deemed to have been performed by the supervising specialist and with the supervising specialist retaining the right to any bulk billed Medicare fees. This is a very important change. It expands the training capacity and will now allow trainee specialists to perform procedures in the private sector. This widens the scope. Previously it was only surgeons who were able to act in such a way. These changes will allow other specialists such as in orthopaedics, ophthalmology, and obstetrics and gynaecology to work in the same way as the surgeons can. This is very fair and it needs to happen.

We have all heard how the state system has not been able to provide enough places, particularly in New South Wales where the O'Farrell government tends to want to cut public services and health. There have been enormous cutbacks in health by that government whilst the federal government is giving money to health and investing in the training of doctors. The state government is ripping money out of health.

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

You're ripping $1.6 billion out.

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

I know it must really upset the shadow minister for health. I only have to refer to some of the research that has been done, including research that has been done by this parliament, when we put together the Beyond the blame game report. Many of the recommendations in that report were accepted by the government.

It is good to see that the shadow minister for health is in the chamber. He opposed the changes in relation to dental care that were a direct result of the report by the Standing Committee on Health and Ageing in 2006, which was a unanimous report. It was supported by all members of the committee including those from the other side of the chamber. To me it seems that we have such a negative opposition—an opposition that will object to anything at any time without putting in place sound reasons for their objections.

This is one of those pieces of legislation that will, yet again, focus the opposition on negativity—saying no and being obstructionist. There is only one opposition that I have ever known that has performed in this way. I know that when we were in opposition we tried to work things through and be positive so that we could deliver to the Australian people. Unlike us, the current opposition are just negative, negative, negative. And who suffers? The Australian people suffer. They do not get the health care that they need. To be so pedantic about the legislation that we have before us today beggars belief. I was really surprised to see the shadow minister speak as long as he did in relation to this because his contributions are usually fairly short and sharp. Obviously, when he can be negative about something, he gets in there for all he is worth.

The previous speaker was referring to the change in relation to human services. Currently under section 41C of the Human Services (Medicare) Act 1973 it is an offence for any person other than the Commonwealth to use the name 'Medicare' or 'Medicare Australia' in connection with business, including in any trading name or any activity, implying it is in any way connected to the Commonwealth. The opposition have decided that this is one little area that they can be negative about. They are objecting to the fact that we have Medicare Locals, which are connected to Medicare and provide a very important adjunct to Medicare. The Medicare locals really—

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

It's nothing to do with Medicare.

Kelvin Thomson (Wills, Australian Labor Party) Share this | Link to this | Hansard source

Order! The shadow minister was heard in silence and will extend a similar courtesy to the member for Shorten.

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

Thank you, Mr Deputy Speaker, but I am used to the shadow minister for health. I know that he finds it very difficult to get all his comments into a debate and likes to call across the chamber very negative comments whenever he can. So I accept the fact that he is going to interject during my contribution to the debate. He has to make up for the lack of strength in his arguments by interjecting across the chamber.

As I was saying about Medicare Locals, Medicare Locals are very good, sound bodies. They are not urban divisions of general practice, as the previous speaker tried to indicate. They are a very important part of our health system and represent a reform that is bringing about change in the health system. Currently, though, the act is administered by the Department of Human Services, and any procedure under 41C—which refers to the use of 'Medicare', as I referred to earlier—must be initiated by the department and requires the written consent of the Attorney-General at the time of publication. No prosecutions have been brought under his section, and the government wants to ensure that there are no such prosecutions.

The proposed amendments will authorise Medicare Locals and certain other bodies seeking to do so to use the term 'Medicare'—I emphasise 'authorise'. I think Medicare Locals are fine bodies to be granted that authorisation. When they are granted that authorisation they will not be breaching the act. The amendment also removes the requirement that the Attorney-General's consent must be obtained before offence proceedings can be brought under 41C. This will simplify the operation of the provision.

As I said previously, the members on the other side of this House always take the low road. They are always negative. They never look at being constructive and they never try and facilitate change. I believe that this is a very important change. It means that the Commonwealth will not be caught up in legal proceedings. It means that Medicare Locals can operate and do the job that they have been given to do, and that is to ensure that Australians have the best possible health services available to them. Medicare Locals are coordinating health services within local communities. They are not urban divisions of GPs. I emphasise again they are not divisions of GPs. They do not do the work of urban divisions of GPs. To categorise Medicare Locals as such shows a total lack of understanding of the role of Medicare Locals within our communities and within the health system.

There is another section of this legislation that I should briefly mention. That is the Industrial Chemicals (Notification and Assessment) Act 1989. There is an amendment to that. Under the ICNA Act, certain industrial chemicals that represent a low risk are exempt from notification and assessment provisions, in keeping with the best practice principle that the regulator impost to industry should be in accordance with the risk posed. That is very sensible, very straightforward and something that this House should support. One such exemption relates to chemicals kept under the control of Customs during transhipment where those chemicals are exported within 13 days of import. The current act limits the transhipment provision to chemicals under the control of Customs at the point of introduction. Once again, this is streamlining and making the act much more effective. The bill therefore makes a technical amendment to the act to correct the inaccurate description of how new industrial chemicals are kept under the control of Customs.

This is important legislation. This legislation will lead to better provision of health services within our Australian community. The extension of the ability of medical colleges to provide specialty trainees with the opportunity to perform certain procedures under direct supervision in private settings is important. That opportunity should not be restricted to the College of Surgeons. It means that, obstetrics, gynaecology and other areas can enjoy the same situations enjoyed by the College of Surgeons. Once again, that will benefit the Australian people. That is what we are in this parliament for: to enact legislation that is going to benefit the Australian people.

The changes to the Food Standards Australia New Zealand Act are very minor. Once again, we will see that the act operates effectively and efficiently. The changes in relation to Medicare, which those on the other side seem to be so excited about, I believe are very, very important. Medicare Locals are important bodies. They are not urban divisions of GPs. They support the Medicare service. Once again, changes to the industrial chemicals act of 1989 should be supported by this House. I encourage members on the other side of this parliament to think for themselves, to remember just how important Medicare is, to note the important services that Medicare Locals provide in our communities and to accept the fact that these changes are needed and that we are here to support our communities and not to play political games and be totally negative on every aspect that comes before the parliament.

Robert Oakeshott (Lyne, Independent) Share this | Link to this | Hansard source

My only reason for speaking on this legislation tonight is to raise the issue around the name 'Medicare Locals'. I strongly support the aims, the funding and the work of these new bodies—the new Medicare Locals—but it is my view that the name is a stinker. There should be no relation at all with the ongoing work of what is widely known as the Medicare brand.

I think—as do those who work in my Medicare Local, many members of the medical profession locally and many members of the general community on the mid-north and North Coast—that the role of these Medicare Locals is one of primary health, preventative health and the non-hospital-based services in health care in the community. They are not a payment house for Medicare as it is traditionally known. I have heard a fair bit of confusion from residents in my electorate who have not realised that Medicare Locals are intended for the purpose of primary health services. I think there is a real question about the Medicare brand and whether it should or should not extend to these services that are for preventative and primary health care within communities.

That is not to say that their aims and responsibilities are wrong. I disagree with the Liberal-National Party position in regard to removing Medicare Locals from communities such as the mid-north and North Coast of New South Wales. But I also disagree with the government's view in this legislation on expanding the number of people who can use the term 'Medicare', which I think will really add to the confusion at a community level.

I had proposed an amendment today. I am pleased that, through negotiation, we now look to have a process where the pros and cons of this name at a local level will be considered and there will be a review done of the Medicare Locals name. In that regard, I am comfortable not pursuing that amendment. There is a cost to changing the branding just as they have been established, but I hope that many people who have expressed their concerns to me about the Medicare Locals brand participate in this process of review—I include other members of parliament in that—and that we can then find a more appropriate name for what are valuable primary healthcare bodies in regions such as mine.

I strongly endorse the process and the point that that these Medicare Locals are trying to achieve, but I reiterate as a personal view based on feedback from many that I think that branding is confusing. I think it is a stinker. I am pleased that we now have a process where that can be reviewed. Hopefully a much better name can be put forward in the future.

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

I speak in support of the Health and Other Legislation Amendment Bill 2012. The member for Shortland went through the changes to the Food Standards Australia New Zealand Act 1991. She also mentioned the Industrial Chemicals (Notifications and Assessment) Act of 1989 and the changes that have been made to that. I have no intention of also dealing here with the Health Insurance Act 1973 amendments which recognise the ability of specialist trainees of any recognised medical college to perform certain procedures under direct supervision in private settings.

I, like the previous speaker, the member for Lyne, want to deal with the issue of the name of the Medicare Locals. Medicare is a name and a brand which is accepted widely and respected widely by the Australian public. Indeed, a system of universal healthcare coverage is something that this side of politics is very proud of. We fought election after election in relation to it. It was former member of parliament Bill Hayden, when he was a minister in the Whitlam Labor government, who fought strenuously for Medicare's forerunner, Medibank, only to have the whole system corrupted under the previous Fraser Liberal government when they came to power. Medibank was nothing like what it was proposed to be under the Whitlam Labor government; it was supposed to make sure that all Australians could get access to decent and humane health care and that decent health care was not the province of the rich but available universally to all of us, young or old, rich or poor and whichever state or territory we lived in.

Medicare was brought in by the Hawke Labor government and has been accepted grudgingly and with difficulty by those opposite, but I am pleased to say that in recent years they have accepted that Medicare is something that the Australian public wants. I was pleased to see a brand so well respected and, indeed, loved by the Australian public used in this regard when we came up with the idea of the Medicare Locals. In fact, I have an electorate where there are two Medicare Locals. I will speak about those in a minute.

What this legislation does in terms of the Human Services (Medicare) Act 1973 is enable the Medicare Locals and other bodies seeking to use the term 'Medicare' to apply for authorisation to use the term without breaching the act and remove the requirement that the Attorney-General's consent be obtained before offence proceedings can be brought. This legislation permits that branding so widely respected in our community to be used by those Medicare Locals.

We had a troubled history in my community with the Ipswich and West Moreton Division of General Practice. Indeed, the Brisbane south division effectively had to be brought in to make sure that the Ipswich and West Moreton Division of General Practice could run in collaboration, that it was administered properly and that the primary healthcare services offered through that division were to the benefit of the people of the Ipswich and West Moreton region. I am pleased that the then CEO of the Brisbane South Division of General Practice, Vicki Poxon, subsequently became the CEO of the West Moreton-Oxley Medicare Local. I will mention her again shortly.

I have another Medicare Local covering my area, and that is the Metro North Brisbane Medicare Local. I am pleased with the work they do. I note that they have been recognised for the work they do, particularly in offering a certificate IV course in partnership with Healthfirst Training Australia, a registered training organisation, providing nationally accredited qualifications in health training. They were recently awarded the 2012 education and training provider award in the category of the Health and Community Services Workforce Innovation Awards. They have been honoured in that way for what they do. I want to pay tribute to the CEO of the Metro North Brisbane Medicare Local, Abbe Anderson, for the work that she does. Like Vicki, Abbe has had a lot of firsthand experience in the health field. She was a medical assistant in the United States and she has really championed the introduction of primary health care in Australia, particularly in the Metro North Brisbane Medicare Local.

That Medicare Local covers the Kilcoy area. The rest of my electorate comes under the West Moreton-Oxley Medicare Local, which goes into south-west Brisbane, covering the Lockyer Valley and also the Scenic Rim areas. It covers the whole of the Somerset, the whole of Ipswich and areas around Oxley, Inala, Durack and the Centenary Suburbs around Brisbane. I am so pleased about the work that they are doing, and I can see that locally on the ground—for instance, the work that was done in the Metro North Brisbane Medicare Local, particularly in the Kilcoy forum which they held on 4 October. They got together the leading citizens of the local area, not just politicians—the mayor of the Somerset region and a number of councillors were there—but lots of local doctors, nurses and community organisations, and took feedback from the local community.

The two Medicare Locals in my area are part of the network of 61 Medicare Locals across the country. The Metro North Brisbane Medicare Local was created on 1 July 2011. It was established by GPpartners Ltd, a division of general practice located on the north side of Brisbane. It has two offices—one around North Lakes and one around Lutwyche—and it covers up to the rural part of Kilcoy.

What I was so pleased about was the forum that was held there. In a region that covers 871,000 residents, 272 general practices, six public hospitals and 95 residential aged care facilities, they took the opportunity to go to Kilcoy, which is right up in the far north of my electorate but also in the far north of the area. So they were clearly there to hear the views and to take the pulse of the people in that area, and that is in fact what they did. The forum was called Taking the Pulse. I have the report that they provided, and the feedback from the area really showed the challenges and the local knowledge and awareness. This is just another demonstration of what this federal government wants to hear: the local response, local ideas, local problems identified with local solutions being offered to the government and certainly to the Metro North Brisbane Medicare Local.

Partnerships are clearly being made with organisations like Kilcoy Country Companions, a local organisation that provides assistance to so many people, and the Connecting Kilcoy Community group. So many other local organisations were there, including the Kilcoy RSL, which is where the forum was held. There were many other organisations there, including local pharmacists, local general practitioners and other interested parties. I look forward to the Metro North Brisbane Medicare Local acting on those recommendations and the issues raised.

I want to also mention the West Moreton-Oxley Medicare Local and the work they are doing in my area and in a number of federal electorates, including those of the member for Wright, the member for Moreton and the member for Oxley. One of the things that I was pleased about was the need for further after-hours services in the Brisbane Valley, particularly around Fernvale. The Medicare Local partnered with Stellar Medical Centres and the principal GP, Dr Paul Crowley, to extend after-hours services at the centre in Fernvale from 6 pm to 10 pm weekdays and on Saturdays from 8 am to 12 noon. This will make sure that non-critical conditions, illnesses and other problems, particularly for the burgeoning population in that area—the young families with children, people who are busy during regular work hours—and people who are concerned that their condition or illness may deteriorate over the weekend can also be covered. Non-critical conditions, of course, do not just afflict people from nine to five. Colds and flus, injuries and illnesses can afflict people on weekends and after hours. That is an example of how they have done great work in partnership with a local general practice, Stellar Medical. I was pleased to open that after-hours service on 7 June this year.

I also note the work that West Moreton-Oxley Medicare Local are doing with their regular email, the Practice Pulse. This terrific organisation offers a lot of information by way of email—about PPP programs, about programs to help local doctors, about e-health records and even about how practice receptionists are urgently required, and there is a whole list of other areas about which they have sought and provided information and run fora. I was pleased that they have partnered as well with headspace in Ipswich Central, which will be operated by Aftercare and will open in January 2013. West Moreton-Oxley Medicare Local will be a significant partner of Aftercare in supporting the headspace program, which will help young people between 12 and 25 years of age in the whole of the Ipswich and West Moreton region. I have congratulated Aftercare. They have met with me on many occasions to indicate what sort of work they are going to do. They are pleased with the work they are conducting with the West Moreton-Oxley Medicare Local.

Some of the highlights for the West Moreton-Oxley Medicare Local include the after-hours service they are providing at Fernvale, in consultation with Stellar Medical; the Mind Health and Wellbeing Program in Ipswich that they are providing; their community advisory group, which I am pleased to say that many leading people in the West Moreton region and Ipswich are members of; their website, which, as I said, has been particularly helpful—they have a successful patient feedback website, including patient opinion, which I think is particularly innovative, and I have met with them to talk about that; and the opening of the youth program headspace, as I mentioned. Already we have seen about 400 people in our region receive free mental health services thanks to the Access to Allied Psychological Services, or ATAPS, program, which they assist, particularly through Artius, who run that program in consultation and associated with UQ Health Care, the GP superclinic at the University of Queensland Ipswich campus. But they have not forgotten the rural areas. I am particularly pleased with the great work they are doing in the rural areas. Recently, the Minister for Health joined the member for Oxley and I at the Springfield office of the West Moreton-Oxley Medicare Local for an interactive tour. I was pleased to see the emphasis not just on urban areas like Inala but also on rural places like Gatton and Fernvale. I am pleased with the work they are doing in that regard.

I want to make reference to the CEO, Vicki Poxon, and the work that she has done. Vicki has indicated that she will be relocating to Melbourne. She has been a terrific ambassador and has worked very hard to overcome the challenges faced by any start-up organisation. She has a new and expanding team and she has been acting like an Aussie Rules ruck rover in many ways, in the way she has conducted herself. I have always found her to be a very committed and community minded individual with a huge passion for health services in the region. Under her guidance, the Medicare Local has established a great foundation in the local area. They have been very active in the community, including attending the DisabiliTEA that I had in Brassall Shopping Centre and the recent forum we had with the Minister for Mental Health and Ageing, Mark Butler, at the Cabanda Aged Care facility in Rosewood, where they were getting people to complete Taking the pulse forms. I was pleased to see Tanya McKenna, a teacher at Ipswich State High School, arranging for young people from Ipswich State High who were attending our DisabiliTEA to complete those Taking the pulseforms as well as the senior citizens and older Australians at Rosewood. Congratulations, Vicki. You have done a great job as the first CEO of West Moreton-Oxley Medicare Local. I am sure that Dr Kay Pearse, the West Moreton-Oxley Medicare Local board chair, and the committee will find a suitable replacement, but you go with our love and respect. Thank you for the great work you have done in the whole region.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to speak in support of the Health and Other Legislation Amendment Bill 2012. I thank the member for Blair for his contribution, because, even though we have the member for Oxley between us, we share the West Moreton-Oxley Medicare Local. I will touch on Vicki Poxon's departure and the great work done by Dr Kay Pearse, but up-front I echo his fine words about the great work being done by the West Moreton-Oxley Medicare Local. I also want to thank him for his contribution about health care generally and the Labor-Liberal divide in approaches to community and public health. It was great to touch on those attacks on Medibank and Medicare by the Fraser government and how it was Labor policy and Labor hard work—and the forbearance and unity of Australian unions and workers—that ensured that these great social contracts when it comes to health care are now enshrined and taken for granted on both sides of the chamber. Even though I have only been in the House for five years, I have seen debates about means-testing of the baby bonus and health benefits and how it was going to be the end of civilisation as we know it. Somehow it has not panned out that way—people are still taking out private health insurance—so I guess there can be a bit of rhetoric in this place every now and then.

The bill before the chamber makes minor amendments to the readability of the Food Standards Australia New Zealand Act 1991 and does not alter the intent of the act or its regulations. Another amendment is to the Health Insurance Act 1973. This stems from a change to a regulation on 1 July 2011 which allows specialist trainees from an approved professional medical college to conduct certain procedures in private settings under the direct supervision—and I stress 'direct supervision'—of a supervising specialist. This change has proved effective with stakeholders and is expected to increase training capacity for specialist trainees.

As every federal MP would know, specialist trainee positions are at an absolute premium at the moment. One of the problems associated with the decision by Health Minister Wooldridge, I think it was, about cutting off the production line for GPs is that, although Labor made steps to redress this short-sighted gatekeeping and bean counting, it will have health consequences, budget consequences and training consequences for many, many years to come, and we are just sorting that out. So this amendment is welcome, and, whilst it has been in effect for some time, this bill seeks to enshrine the policy in legislation rather than by regulation.

The main elements of this bill that I would like to speak on today are the amendments to the Human Services (Medicare) Act 1973 that aim to clarify that the term 'Medicare Locals' does not breach the act. At present, it is an offence for any person other than the Commonwealth to use the term 'Medicare' or 'Medicare Australia'. This legislative change is a common-sense approach to ensure that the use of the term 'Medicare Locals' is not in contravention of the act.

Like the member for Blair, I am fortunate to have two Medicare Locals in my electorate, the West Moreton-Oxley Medicare Local, which was described by the member for Blair, which is to the west of my electorate, and the Greater Metro South Brisbane Medicare Local, which covers probably 80 or 90 per cent of my electorate. The West Moreton-Oxley Medicare Local is chaired by the very, very hardworking and indomitable Dr Kay Pearse, and the Greater Metro South Brisbane Medicare Local is chaired by Dr John Kastrissios. Obviously, these are only two of the 61 Medicare Locals spread out across Australia, but these two, which I know very well, do an excellent job in ensuring that they coordinate and deliver primary healthcare needs to our local community and connect patients with a range of healthcare services, meaning that there is better and more efficient access to health care. It is particularly in that job that they have in making the connections, bringing the stakeholders together, educating and reaching out to the public, particularly in primary health and preventative health, where we are starting to change those, making the wise investments that will pay off in the future as Australia ages and, sadly, as Australia becomes more and more unhealthy.

The West Moreton-Oxley Medicare Local was founded on 1 October 2011, covering an area of almost 10,000 square kilometres from Ipswich to Boonah, from Laidley, Esk and Springfield through to Oxley, Corinda, Chelmer, Sherwood and Graceville—right up to the Indooroopilly bridge, in fact—which are the suburbs in my electorate. These patches, particularly to the west in that Ipswich corridor, are particularly booming, and there will be increased demand to meet the growing needs of this population.

The West Moreton-Oxley Medicare Local provides a range of programs to assist the needs of our community. From an after-hours GP service to mental and Indigenous health, e-health—some great advances there—and also immunisation, it is doing some great things. This Medicare Local provides access to quality services when and where people need them. The CEO, Vicki Poxon, who is departing, will be a very, very sad loss. I knew her particularly when she headed up the southside division of GPs. I still drive past their former office every day on the way to work. She will be sadly missed, and I wish her well in her move to Melbourne.

The Greater Metro South Brisbane Medicare Local, or GMSBML—obviously that is not a three-letter acronym, so I might just call it Metro South—has a critical planning and integration role to identify any gaps in service delivery and ensure that all parts of the primary healthcare sector on the southside, which is a huge area, come together so that patients have the best possible care, provided through one central coordinating agency. Metro South was one of the first Medicare Locals to be established as part of the federal government's national health reform program. This Medicare Local covers over 3,700 square kilometres, including both urban and regional areas, and includes a diverse demographic of 890,000 patients from almost the Brisbane CBD right down to the Scenic Rim.

Regardless of what these organisations are called, they do a phenomenal job, and their role is only just kicking off. I love the fact that they have those patient-centred care outcomes and their particular focus in preventative health. The week before last I was with the Minister for Health, Tanya Plibersek, the member for Sydney, who came to my electorate for a breakfast, where we met with a lot of stakeholders, and then went on to some GP medical practices at Acacia Ridge and Sunnybank Hills, two completely different practices doing great engagement work and preventative health work.

I had three seniors forums in that same week. At one at Corinda State High School I was lucky enough to have the West Moreton-Oxley Medicare Local people come along to focus on some of the preventative health. It was amazing how desperate the seniors community was for information about so many preventative health matters. I think I am going to have to increase the number of seniors forums that I have, because we went over time and still did not have enough time for them to hear from all the speakers.

I was also lucky enough to have the Minister for Mental Health and Ageing, Minister Mark Butler, the member for Port Adelaide, visit a seniors forum held at St Brendan's, Moorooka. He also touched on a lot of those ageing issues in particular and also on some of that preventative health.

West Moreton-Oxley and Metro South are doing great work. I am sure that the member for Dickson, the shadow minister, is very supportive of the great work that they do. I look forward to continuing to work with the chairs, their committees and their people on the ground for years to come. I commend the legislation to the House.

Deborah O'Neill (Robertson, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak in support of the Health and Other Legislation Amendment Bill 2012. This is a bill for an act to amend the law relating to a few critical things—food regulatory measures, health, Medicare and industrial chemicals—and 'for related purposes'. That is a term that we hear in this parliament all of the time, a term not so commonly used out in the public but one that is vital for us to get on with the job of delivering real things that actually improve the lives of ordinary Australians as the core business of the work that we do in this place.

A lot of work that we do with legislation is like work done in other places; it is not always glamorous. This legislation would not be called a glamorous piece of legislation, and perhaps it might not attract a headline. It might not even attract a question in question time. Nonetheless, when it is enacted it will have a significant and positive impact on the way that entities involved in medical fields work with the government to deliver positive outcomes for Australians.

The first set of amendments in this bill relates to the Food Standards Australia New Zealand Act 1991. The amendments correct referencing inconsistencies and make the act easier to read. They are minor and do not change the intent of the act or alter any of the regulations. The Australia-New Zealand food standards system is a cooperative arrangement between our two great nations. It is helpful for the constant flow of business and leads to improvements in communication, safety and productivity on both sides of the trench if we implement uniform food standards. Food standards are developed by Food Standards Australia New Zealand, FSANZ. Responsibility for enforcing food standards in Australia rests with the authorities in the states and territories and the Australian Quarantine and Inspection Service, and in New Zealand with the New Zealand Food Safety Authority. The legislative change we are presenting today will help those very important and responsible agencies do their work better.

The second set of amendments relates to the Health Insurance Act 1973. On 1 July 2011, a change to the Health Insurance (General Medical Services Table) Regulations allowed specialist trainees from an approved professional medical college to conduct certain procedures in private settings under the direct supervision of a supervising specialist. This is important in terms of access to services. The procedures are deemed to be performed by the supervising specialist, who will retain the right to any bulk-billed Medicare benefit in relation to the procedures.

This has been a very popular change with stakeholders. It really enhances the training capacity for specialist trainees across the system. In terms of value for money, it ensures we can alleviate, at no extra cost, some of the training capacity issues for trainee specialists. This is a challenge being faced by health systems across the country. The government considers that it is appropriate that the policy should be recognised in legislation, which will happen once this piece of legislation passes through the parliament.

The third set of amendments relates to the Human Services (Medicare) Act. It is still an offence for any person, other than the Commonwealth, to use the term 'Medicare' or 'Medicare Australia' in connection with a business, including in any trading name or in any activity that implies it is connected to the Commonwealth. That presents an issue for Medicare Locals and other bodies seeking to use the term 'Medicare'. The proposed amendment will enable such bodies to apply for an authorisation to use the term without breaching the act. Thankfully, Medicare Locals are alive and well across the nation at the moment. They are a major reform to our health industry delivered by the Labor government. It is important that they are able to use the term 'Medicare' within the bounds of the law, and this legislation will enable that.

I would like to outline for those who might be listening to this debate—either here in the House or perhaps as they are driving the kids home from dancing classes somewhere in the back streets of the Central Coast—what Medicare Locals are. Medicare Locals are vital new organisations of our health professionals. Basically, all health professionals are starting to have conversations with each other, providing a model of care which wraps around the patient rather than the patient having to move from one agency to another. The time when you are at your most vulnerable and feeling the weakest is not the time that you want to find out how to negotiate a complex medical structure. Medicare Locals have the role of making it easier for patients to access services when they need them. There will be a formal linkage between the local GP, nurses and other health professionals, along with hospitals and aged-care and Aboriginal and Torres Strait Island health organisations, keeping up-to-date local service directories.

I am very pleased to say that when I was in my electorate on the Central Coast last week, I was able to briefly attend two events that were convened by Medicare Locals. The first one was an evening function held at the very beautiful Wamberal Surf Lifesaving Club, overlooking the Pacific Ocean. It is a beautiful seat in which we live; nonetheless, people face health issues. Of course, after-hours access to a doctor is a critical issue for families who might have an illness they are concerned about. They do not necessarily want to have to take up the resources of a hospital. They do not want to be sitting in the emergency ward at Gosford or Wyong hospitals when they could be accessing after-hours care and getting better and more sustained, regular treatment from somebody who gets to know them personally.

Approximately 40 of our local GPs gathered together on that evening for the dinner, at which there was a sustained and very fruitful conversation about how after-hours care can be delivered on the Central Coast. I know that there will be some adjustments from the current processes and, on the feedback that I have had from Medicare, we are certainly increasing and enabling a much more seamless connection for people with that vital after-hours service. One of the reasons that Medicare Locals are quite different and that we are already seeing important conversations happen between all these related but often disconnected health professionals is that Medicare Locals work very closely with our local hospital networks. This is to make sure that primary health care services and hospitals work together for their patients. The term 'primary health care' has been a focus for this government. Let's talk about prevention; let's talk about early intervention; let's talk about support. They are the things that happen when we talk about primary health, as opposed to tertiary health, which is a response to a crisis. The more we can prevent ill health, the more we can help people to be healthy in the environment, the better the outcomes are for every Australian citizen and, indeed, for the bottom line of our health budget.

Apart from supporting after-hours face-to-face care, helping GPs manage that and get better models in place, Medicare Locals will also be the agency that is tasked with finding out where the services are missing. They are going to audit gaps where there are disconnects, and I do not think that they will find it too hard to get engagement from the local communities. They say: 'I went to my GP, but I couldn't get to a podiatrist. I went to a podiatrist, but I couldn't get the help that I needed for the other conditions that are related to my diabetes.' The role of Medicare Locals is to coordinate and address those service gaps. They will also support the connection between many allied health professionals, who have been sitting off in their own little satellites, disconnected from the general health network.

About two months ago I was able to attend one of those Medicare Local events, where allied health professionals who had had no engagement with GPs were meeting with the Medicare Local for the first time and through that event they were meeting one another for the first time—physios meeting physios, physios meeting chiropractors, chiropractors and physios speaking about what they could do collaboratively. All of them were noting that networks for connection until that time were quite difficult to come by. They came to see how much they could enhance each other's work.

These Medicare Locals will be able to use the term 'Medicare' much more comfortably after this piece of legislation passes, but I am sure that they will continue to be very mindful of their need to be accountable to their local communities—and that is the other term. Yes, it is about Medicare; yes, it is about access to the health care that Australians have come to expect since the Labor government brought it in, restored it and has made sure that it continues to work. But it is also about making sure that things happen for people locally in their local area.

The Medicare Local on the Central Coast was in the third tranche of Medicare Locals that were released. It basically opened for business from last July. They really have got off to a flying start, and I am really very proud of the local people who have been leading it. I want to put on the record this evening the work in particular of Richard Nankervis, who is the CEO leading this very significant improvement to health access for our locals and improved communication between local health professionals. I would also like to acknowledge Graham McGuinness, who has had a long and distinguished career in the health sector. He is bringing his great wisdom and experience to bear on assessing where the gaps are in service provision on the Central Coast and developing and delivering real, practical, enabling and very good-value-for-dollar responses to that reality. I would also like to acknowledge the many, many years of service given to the forerunner of our Medicare Locals, which was our Division of General Practice on the Central Coast, and in particular the work of Dr Phil Godden. When I first assumed the role of member for Robertson, it was of great assistance to me in familiarising myself with local issues to have a conversation with a physician, who not only has great experience in running the business side of his practice but also has a great heart for people. He is a physician in the largest sense of the word—a great carer of the human person; he has looked after so many people across the coast.

That former Central Coast Division of General Practice set a really good standard for what our Medicare Locals might achieve. They worked to improve the quality and safety of health services through our Primary Care Collaboratives program, which is proving to underpin a great model for how we might advance with Medicare Locals. They implemented the palliative care gold standard project, aimed at strengthening the capacities of GPs to deal with that very important issue of end of life and manage that in such a way that people get the care they need. They did much more work than that, particularly with our frail older people in the Coast Nutrition Home and Community Care program. They even included people from special needs groups and younger people with a disability and their carers in their consultations. That is the style of our Medicare Locals and the way it will work.

Finally, this legislation will make some amendments to the Industrial Chemicals (Notification and Assessment) Act 1989 and that will bring the regulatory impost for companies into line with the risks that those chemicals pose. While this legislation, as I said, is not particularly glamorous, I can speak to the House about the visit of the very energetic and determined Minister for Health to the Central Coast to inspect the $57 million investment in health infrastructure that is happening in the seat of Robertson. I hope that I will able to bring her back very shortly to see our superclinic, our regional cancer centre and our Woy Woy rehab centre opened.

Tony Zappia (Makin, Australian Labor Party) Share this | Link to this | Hansard source

From the outset I can say that my view is that this legislation makes some common-sense changes to a number of existing acts—those acts being the Food Standards Australia New Zealand Act 1991, the Health Insurance Act 1973, the Human Services (Medicare) Act of 1973 as well and the Industrial Chemicals (Notification and Assessment) Act 1989.

The Food Standards Australia New Zealand Act 1991 was last amended in 2010, and other speakers have referred to this having been the case. The changes in this legislation corrected some typographical errors and deleted some obsolete references. From time to time it is appropriate to go through acts and delete what is no longer relevant or pick up on any typographical errors that have been encountered in the course of the administration of the act in question.

The Food Standards Australia New Zealand Act 1991, as its name implies, essentially sets out the standards under which food is to be sold and marketed here in Australia. The act is administered by a combination of all the states and territories as well as by the federal government of Australia and the New Zealand government. Whilst there are clearly some benefits in having all these parties working together on food standards for Australia, the reality is that, when changes are needed to the act, it quite often takes an incredible amount of time to make them. When this government came to office in 2007, one of the first things it did was carry out an inquiry into food labelling in this country. Food labelling laws, which govern the labels placed on food, were regularly being raised with members on all sides of the House, so the Hon. Neal Blewett, a former member of this place, was engaged to carry out an inquiry on food labelling laws. After he had carried out the inquiry, he reported back to the House. Highlighted in the inquiry was the fact that there was room to make a number of improvements to food labelling across Australia. It was also highlighted how long it takes to put any recommendations into effect because of the fact that any change requires the agreement of so many different parties.

It seems to me that, at a time when we often see changes in society occur very quickly, we need to have in place processes which enable the government to respond very quickly to such changes. I ask whether the Food Standards Australia New Zealand Act of 1991 continues to serve us as well today as it did back in 1991 and whether it is a time to have a complete review of the act. The states have finally transferred responsibility for water in this country to the Commonwealth, and that is a good thing. Perhaps this ought to be the case with food labelling also, because I can assure the House that food labelling continues to be raised with me by people in my electorate. They are particularly concerned about country-of-origin labelling.

I will quickly go through some other acts which are being changed, and I want to talk at greatest length about the changes to the act governing Medicare Locals. However, I will discuss first the proposed changes to the Health Insurance Act 1973, which would allow trainee medical specialists to carry out certain procedures in a private setting under the direct supervision of a specialist. Under this change to the existing act, the specialist would not only directly supervise the trainee but also be able to bill for the procedure. I believe that this would be an appropriate change to make. It has been raised with me in the past that there is a problem because the specialists involved in the training of medical graduates simply cannot set aside the time to do the training, which is done at a cost. If the supervising doctor—in this case, the specialist—were able to supervise the training and still bill for the time, I have no doubt that more specialists would be encouraged to train the trainees or that, in turn, we would end up with a much better medical workforce. Such a common-sense change would result in improved medical outcomes for the community once it were implemented.

The proposed changes to the Industrial Chemicals (Notification and Assessment) Act 1989 are also of an administrative nature. They would simply allow new industrial chemicals which represented a low risk to be exempt from notification and assessment provisions in the Industrial Chemicals (Notification and Assessment) Act. One of the proposed exemptions would allow the exemption, from the provisions, of chemicals which are to be exported within 30 days of import and which are kept under the control of Customs during trans-shipment. Trans-shipment has become a common practice throughout the world—it is not unusual for chemicals to be brought into this country and then transferred to another country. In such cases, it makes sense that the chemicals which are to be transferred not necessarily be subjected to the same kinds of assessments and procedures to which are subjected chemicals to be used in Australia. Such a change to the existing legislation would be the result of merely applying common sense to an existing practice. I note that this change has the support of industry. This is not surprising because, when you create more bureaucracy for industry to negotiate, it is costly. Allowing this common-sense change will save industry money.

The question of Medicare Locals has been raised by other speakers—in some cases, with some criticism. The fact of the matter is that, when this government came to office, it embarked on a process of reforming the national health system. Amongst those reforms were included the establishment of Medicare Locals to replace what was previously known as Divisions of General Practice. The outcome has been that we now have 61 Medicare Locals across Australia, when previously there were 109 Divisions of General Practice. In other words, there were far more of what I would call 'bureaucratic organisations' in place than we now have. What I believe has been established is a much more efficient way of providing health services across Australia.

It is fair to say that Medicare Locals have been in place only for a relatively short time. Time will tell whether they are working as effectively as the government had predicted or whether they are not. But it is certainly too early to criticise them, as some have done.

At the time the Medicare Locals were introduced into my electorate in South Australia, there was some resistance to the notion of a Medicare Local being set up, because it meant the disbandment of Divisions of General Practice. Again, I can well recall some of the arguments being put at the time, and I accept some of the criticism, which I believe was made in good faith. However, the Medicare Local has now been in operation for some time and since its establishment I have not had brought to my attention any specific areas of concern in respect to the work and responsibilities of the Medicare Locals. So I can only assume by that that it is working well. It certainly covers a much larger region that the original Division of General Practice, but, again, I do not see that necessarily as being a bad thing because it enables the Medicare Local to coordinate services across a larger region. That in turn fits in better with the state government's provision of services in South Australia, where it too has established what I would call a regional basis for the provision of health services in the area.

What we do know is that the Medicare Locals will be responsible for ensuring that primary healthcare services are tailored to best meet the needs of each local community. And if we can do that, the patients will clearly benefit. We know that if we can link patients not only to their GPs but also to the range of allied health services they may require after having seen their GP, that will also make life for people in the community much easier. If you have a medical problem, the last thing you want to do is be confronted with one problem after another, because as you get referred from one service to another you either do not know where to go or it is a service that is not easy for you to access. By having Medicare Locals, my view is that we will be able to better provide the whole range of services that someone might be in need of after having seen their GP, all within close proximity or easy to access proximity for the person. That in itself must be a huge relief for a person who has a medical problem to begin with.

I also note that since July of this year Medicare Locals have been provided with the flexibility to spend funds allocated to them in a way that they believe best suits the needs of their local community. Again, that is not only a good thing, but it is a smart thing, because nobody knows better than the professionals in a local region what the priorities should be and where money should be spent. With respect to that I believe that the Medicare Locals also will serve the very important service of identifying where there are health gaps within the system, what those gaps are and how they can best be fulfilled.

The issue of Medicare Locals works in and links in very closely with one of the initiatives in my electorate of Makin, and that is the establishment of a GP Plus Super Clinic. This was a Super Clinic commitment that was made by the government back in 2007. In conjunction with the state government, who also made a similar commitment to the local region, $25 million was set aside for the establishment of the Modbury GP Plus Super Clinic. Health Minister Tanya Plibersek officially opened the GP Plus Super Clinic only a couple of weeks ago, on 8 November. We went through the facility on the day and I can say that it lives up to every expectation that we had of what the GP Plus Super Clinics would provide by way of health services, once it was completed. In fact, it is one of two facilities that come under the umbrella of the GP Plus Super Clinic, the other being at a place a few kilometres away, where it provides what we call an outreach service.

But, in essence, this is a facility that provides not only general practice but also nursing services, dentistry, medical specialist services and allied health services, including physiotherapy, occupational therapy, dietetic, diabetes nurse education and mental health services. The new clinic will also have a strong emphasis on education and training of health professionals and will have a focus on clinical services, including chronic disease management, health promotion and early intervention services. Importantly, the clinic will complement services provided at the Modbury hospital, located almost adjacent to the new clinic. That was one of the primary reasons it was committed to back in 2007. Because we knew that the Modbury hospital was having to provide services, particularly in the outpatients department of the hospital, that could have otherwise been provided at a local GP service, had one been available. The number of people who were going to the outpatients of Modbury hospital at the time was causing an over-demand for services in outpatients, and that in turn was making people wait longer than they should have, particularly those people who were there for legitimate hospital services.

As I said from the outset, this legislation simply makes a number of common-sense changes to some of the existing health acts. I commend the legislation to the House.

Debate adjourned.