Chris Ellison (WA, Liberal Party, Minister for Human Services) Share this | Hansard source

The government’s position is that it supports part of the amendment, if I can put it that way. The opposition amendment is in three parts—the first deals with medical purchaser-provider agreements, the second with hospital purchaser-provider agreements and the third with other purchaser-provider agreements. The government does not agree with the third part of the opposition’s amendment. I therefore ask that the question be put in two parts. The first question should be in relation to subclauses (1) and (2) of the opposition amendment, and the question in relation to subclause (3) should be put separately—that is the one the government has an issue with.

I will outline the reasons for that. Certainly, we believe the wording of subclause (1) can be found in the act already, and it purports to prevent insurers from entering into agreements with hospitals that limit doctors’ clinical freedom. We have no objection to that, though we totally support the proposition that insurers should not restrain the clinical freedom of doctors—and we do not want to support anything that would do that.

Subclause (3) is a little different. We believe subclause (3) is potentially disadvantageous because it could prevent insurers from offering policies that limit the number of dental, physiotherapy or other paraprofessional services to be provided in a year. I think Senator Allison said that, where you have these limitations, it can keep these premiums down—and that is the public policy question we are weighing up in subclause (3). As I say, we are happy to limit insurers from restraining the clinical freedom of doctors, but this is different from limiting their ability to affect such things as ancillaries where part of the policy is that you can get up to six visits a year to a dentist or physiotherapist. We think that, if you open that up so that the insurer cannot limit that, you will see pressure on premiums. Because the risk posed to the insurer would thereby rise, premiums would accordingly rise.

We will be monitoring the situation very closely. The Privacy Health Insurance Administration Council will be doing just that. The Private Health Insurance Ombudsman is another entity that will be monitoring this and the government will be paying close attention to it. On the opposition amendment, we think that the wording in subclause (1) is already in the act but we agree with subclause (2). It prevents insurers from entering agreements with hospitals that limit the clinical freedom of doctors. That is a good principle.

Unfortunately, we do not believe that subclause (3) is in the same vein as the previous two. We would also point out that we have the care plan charter which was raised during the Senate inquiry. That will have principles which will be applied in relation to this. That will be incorporated in the rules. The Senate committee had something to say about that; the government is cognisant of that. I think that in the rules we can govern those areas where there is concern, but to say in subclause (3) that you cannot limit the insurer would really be opening up a huge potential for an increase in premiums. That is why we cannot support subclause (3). The government’s position is that we agree to subclauses (1) and (2), but not to (3). I would be grateful if we could put those questions separately.