Wendy Askew (Tasmania, Liberal Party) Share this | Hansard source

I rise today to speak on the Health Insurance Legislation Amendment (Transparent Patient Outcomes) Bill 2021, which was introduced to the Senate by Senator Griff on 23 November 2021. As chair of the Senate Community Affairs Legislation Committee I wish to make a brief contribution to the debate. I also wish to acknowledge Senator Griff's interest in, and active participation and involvement in, a number of inquiries undertaken by this committee.

Senator Griff has a particular interest in the transparency of outcomes, as evidenced by another of his bills, the Aged Care Legislation Amendment (Financial Transparency) Bill 2020, which is also before the Senate, as well as his ongoing influential and determined support for transparency in relation to IVF clinics that saw the launch of the YourIVFSuccess website this year. This website, together with a searchable database that provides comparable fertility clinic success rates across Australia, was developed in association with UNSW Sydney. The development of this informative and interactive site was funded through a Medical Research Future Fund grant provided by the Australian government and is a testament to the outcomes that can be achieved through collaboration.

The IVFSuccess estimator allows people to make informed choices about their conception options. It draws on the experience of over 600,000 IVF cycles, performed in clinics across Australia, to formulate an individualised estimate of IVF success for patients. This informs the discussion between the patient and clinicians. What a great outcome, and thank you, Senator Griff, for your determination to see it eventuate. I have many friends who have been through the IVF program and this valuable tool would certainly have assisted them at that time.

I note that in a speech to this place, around the time of the launch for the IVF website, Senator Griff foreshadowed the tabling of the bill before us today. He stated:

It is my hope that one day we will have similar performance transparency for all specialists performing all surgeries in both public and private hospitals. Transparency and accountability are key to improving health outcomes for all of us. They also mean that outliers have nowhere to hide and must lift their game, all to the benefit of patients and to the benefit of the health system.

Senator Griff believes that public disclosure of any surgical performance outcomes, including such areas as gynaecological, cardiothoracic, orthopaedic, plastic and reconstructive surgeries, would be relevant to the proposed transparency of outcome and provide consumers with greater control in determining their surgical provider.

As outlined in Senator Griff's second reading speech, this bill would enable the minister to make rules to create a transparent patient outcomes register that would include information such as the number and type of surgical procedures performed by a practitioner, their surgical revision rate, their patient mortality rate, any prosthesis device they may use, patient data and any other information deemed relevant to that specialty. When reading Senator Griff's speech, I noted that he focused on joint replacement surgery as one example of where a patient may wish to select an orthopaedic surgeon who has undertaken a significantly higher proportion of surgeries than others. As a consumer in this space, it is something I can definitely relate to, and I note that I relied on considered advice from my medical practitioner, personal investigation and research, and third-party references to determine the surgeon that I proposed to use for my knee replacement.

As outlined by Senator Griff earlier, although data in relation to orthopaedic surgeon performance and patient outcomes is collected by the Australian Orthopaedic Association National Joint Replacement Registry, which is funded by the health department, the information held by the register is not available for use for any other purpose; it's simply a quality assurance activity as required by the act. Senator Griff's bill seeks to access this data and allow the reuse of relevant data that is already being collected to be provided for the purpose of a transparent patient outcomes register. The explanatory memorandum provided by Senator Griff details how the transparent patient outcomes bill will preserve the current protections afforded to this information.

The explanatory memorandum also includes details on how the bill seeks to provide protection from liability for secondary disclosure of quality assurance data which is collected for or contained on a transparent patient outcomes register. Orthopaedic surgery is one example; however, as mentioned earlier, there are many others where shining the light on surgical outcomes may assist consumers as they make decisions about potential surgeries.

Cosmetic and plastic surgery has been highlighted over recent months through a number of media stories, including Todd Sampson's documentary Mirror Mirror. Examples of unaccepted outcomes from surgery performed by inexperienced and often barely qualified health professionals in that field have been highlighted. Interestingly, this phenomena has come to light during the Senate Community Affairs References Committee's inquiry into the administration of registration and notifications by the Australian Health Practitioner Regulation Agency and related entities under the Health Practitioner Regulation National Law. This inquiry is continuing and will report in the new year. However, from evidence received already, it is quite possible that access to more transparent and accountable patient outcomes may have enabled different decisions to have been made by those who have approached the committee with their concerns as well.

As those in this place would be aware, the Australian government is working with states and territories under the 2020-25 national health reform agreement, the NHRA, to improve access to timely, fit-for-purpose information, which is needed to make informed decisions about health care. All levels of government are working with the health sector to better understand and remove systemic barriers to improving health care and outcomes, and under the NHRA progress is being made. The national health reform agreement long-term reforms road map was endorsed by all Australian health ministers at the health ministers meeting on 17 September this year.

Providing flexibility to achieving the outcomes is a key component of the road map. Allowing jurisdictions to respond to changing circumstances, they will have the flexibility to identify priority reforms and determine the scope and timing of activities to best suit local needs and support local health system diversity, readiness and funder and provider capabilities. The road map includes an extensive plan for each reform area, including a vision statement, aim, case for change, links to other reforms, intended outcomes, key concepts and COVID-related developments. The road map identifies actions, deliverables and time frames for the following key areas of reform: nationally cohesive health technology assessment; paying for value and outcomes; joint planning and funding at a local level; empowering people through health literacy, prevention and wellbeing; enhanced health data; and interfaces between health, disability and aged-care systems.

One of the key components contained in the road map, enhanced health data, clearly aligns with the intent of Senator Griff's bill, subject to access being made available to the specified data. The rationale for the enhancement of health data, as explained in the document, states this reform supports Australia's governments in their commitment to realise the value of public health data through greater data sharing and information access to transform health care, drive efficiency and safety, create productivity gains and allow better decision-making.

It will ensure that relevant, robust and timely data is available to the appropriate people, to support shared patient-clinician decision-making, improved service delivery, evidence-informed policy development, research and analytics, and system planning. Maintaining data security and preserving individuals' privacy will be central to the reforms.

By expanding public reporting on the quality, safety and value of health services, it is possible that we will see improvements in the health system and improved accountability for outcomes. The NHRA work will build on the Australian Health Performance Framework and existing hospital-level reporting by the Australian Institute of Health and Welfare on information such as emergency department performance, elective surgery waiting times and healthcare associated infections.

The long-term health reforms under the NHRA are intended to provide better coordinated care in the community, to focus on prevention and keeping people healthier longer, and to reduce pressure on hospitals. These systemic reforms will also help improve the experiences of people using services across the health, aged-care, disability and mental health sectors. The stated intent overall is that the long-term reforms will make it easier for people to manage their health.

I understand that the Minister for Health, the Hon. Greg Hunt, has undertaken to consult further with key stakeholders in relation to Senator Griff's bill and is anticipating that a report will be provided to him early in the new year. The findings of the report will be discussed with Senator Griff and other interested parties at that time as we look to provide more information to the Australian public in support of their healthcare decisions of the future.