Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Hansard source

Thank you for that poetic interjection, Senator Brandis. This bill, the Private Health Insurance Legislation Amendment Bill (No. 2) 2009, amends the Private Health Insurance Act 2007 to allow the minister to conditionally list prostheses on the Commonwealth Prostheses List and to allow her to create rules specifying criteria for listing. Prostheses are artificial devices attached to the body as an aid or substitute for body parts that are missing or non-functional. They can include cardiac pacemakers and defibrillators; cardiac stents to clear blockages in blood vessels around the heart; hip and knee replacements for sufferers of arthritis; intraocular lenses to treat cataracts in human tissues such as human heart valves, corneas; bones, part and whole; and muscle tissue. On the mention of cataracts: there was a bungle if ever I saw one.

The Private Health Insurance Act requires private health insurers to pay benefits for prostheses and for hospital treatment or hospital substitute treatment that is eligible for a Medicare rebate. Currently, more than 9,500 prostheses are listed. They are listed on the advice of the Prostheses and Devices Committee according to the mandatory and non-mandatory criteria. In order for new prostheses to be listed, an application requesting this must be made to the Minister for Health and Ageing. The minister can take advice when deciding whether or not to grant an application to list. As stated, there are also non-mandatory criteria set out in the administrative guidelines. These non-mandatory criteria state that a listed prosthesis should:

(a) be surgically implanted in the patient and be purposely designed in order to:

(i) replace an anatomical body part; or

(ii) combat a pathological process; or

(iii) modulate a physiological process …

As highlighted in the second reading speech, the bill has particular relevance for people with diabetes who use insulin pumps to control blood glucose levels. Whilst insulin pumps are currently listed, there has been some ambiguity concerning their status due to the fact that they are not surgically implanted and do not require hospital admission. Insulin pumps may not be surgically implanted but they do replicate the function of pancreatic cells, which produce insulin. Accordingly, they may be considered a prosthetic. This amendment bill will facilitate a new part of the prostheses list to include devices that are not surgically implanted but have an internal component that is integral to their effectiveness. This will remove the ambiguity for insulin pumps. The importance of this bill, by removing the ambiguity, is that it recognises the needs of many stakeholders with diabetes and the coalition supports such a move.

I would like to take the opportunity today to mention the Juvenile Diabetes Research Foundation and Kids in the House. JDRF represents 140,000 children and adults with type 1 diabetes and the tens of thousands more who care for them. I know that the JDRF is supported by many colleagues and I am proud of the support that the coalition gave them when in 2004, for example, Tony Abbott, the then health minister, committed $30 million to establish a centre for excellence for diabetes research over five years. The coalition government provided $442 million between 2000-01 and 2005-06 for Diabetes Australia and the National Diabetes Services Scheme. The scheme enables people with diabetes to access subsidies for essential products such as syringes, insulin infusion pump consumables and diagnostic products. The coalition government committed a further $667 million for the period beyond 2006-07 and supports the provisions of this bill affecting insulin pumps.

With respect to the conditional listing component of the bill, the important issue is how conditional listing is implemented in practice. The bill provides very little detail as to the process for conditional listing and the conditions which may be imposed. While we do not oppose the passage of this bill today, we have concerns about the lack of consultation undertaken and the lack of detail provided in relation to the conditional listing process.