Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Mental Health) Share this | Hansard source

The Private Health Insurance (National Joint Replacement Register Levy) Amendment Bill 2015 is about the national joint replacement register. I rise to indicate the Labor Party will be supporting this legislation. The National Joint Replacement Registry collects data on the implantation of prosthetic joint replacement devices. It reports on the performance of those devices and any revisions that are required. Revisions are procedures involving the replacement or repair of a prosthetic implanted device. Of course, if that circumstance comes about then there has been a problem.

The work of the registry improves health outcomes for many Australians. The learning that we have gained has reduced the rate of revisions of transplanted prosthetic joints, and for that reason it has been remarkably successful. For some people, revisions require a large amount of time in hospital for recovery. They are generally more complex and more expensive, largely because they involve opening the old wounds from when the device was originally implanted.

The registry assists in getting better outcomes by tracking implantations and by providing analysis of the best devices to use in the special and unique circumstances of different patients. By avoiding revisions we get a better outcome for patients and a better outcome for public health finances.

The registry provides invaluable post-market surveillance of joint replacement prosthesis. Because of the registry we know, for example, that replacing the joint surface of a kneecap during a knee replacement lowers the rate of revisions. What works for one class of patient may not work for another. We have learnt this from having the registry. Resurfacing will work for patients with osteoarthritis but does not appear to reduce the rate of revisions for those with rheumatoid arthritis.

The registry informs clinicians of the best and most appropriate procedure for particular uses. It ultimately saves the system a lot of money, but, more importantly, it improves the outcomes for patients, particularly by assisting in reducing the rates of revision.

The registry required funding certainty in order to operate properly, which is why, in 2009, the Labor government, with the support of the then Liberal-National opposition, applied a levy on device sponsors. This ended years of ad hoc funding arrangements with industry and with government. The measures implemented by Labor in 2009 have meant that stable funding for the critical work of the registry is ensured, and it also ensures that it can continue to provide data to improve patient outcomes into the future. We are pleased to see the government's ongoing support for the registry and the levy which underpins it.

The feedback we have received on this bill from stakeholders shows it has broad support. So, Labor is pleased to support the ongoing work of the registry and will support this bill, which will see a change in the way the levy is calculated and applied to device sponsors.

Device utilisation and the value of the prosthetic device will now play a greater and determining role in the way that the levy is calculated. The changes proposed by the government will result in increased activity. The levy will therefore raise an additional $600,000 over the next four years to facilitate this, commencing with $100,000 this year and $200,000 for the following two years. Labor will of course watch with interest whether the government has got this setting correct. The levy must raise enough funds for the Australian Orthopaedic Association to effectively run the registry, which supports improved quality of care for patients.

Whilst we absolutely support this legislation, we do have legitimate reasons to raise doubts about the government's competence on matters of health policy. In less than two years, the government have sent into chaos a system which is studied and envied by countries right across the world. The headline cuts that we have seen include $57 billion cut from health and hospitals last year and another $2 billion cut from health services this year; and we have, according to the AMA, a GP tax by stealth through the freezing of the Medicare rebate, forcing doctors to charge up-front and above-schedule fees—and those are just the headline cuts.

Labor support the sensible measures that are contained in this legislation, but we do reject the chaotic approach by this government when it comes to health policy.