Anthony Chisholm (Queensland, Australian Labor Party, Assistant Minister for Education) Share this | Hansard source

I thank the senators who've made a contribution on this bill. The Health Insurance Amendment (Prescribed Dental Patients and Other Measures) Bill 2023 amends the Health Insurance Act 1973 to improve health care for all Australians. The amendments will remove age restrictions for accessing cleft and craniofacial services on the Medicare Benefits Schedule; enable Services Australia to automate management of the register of approved placements; and rectify inconsistencies between the act and the Health Insurance (Bonded Medical Program) Rule 2020 to make amendments enhance administration of the bonded medical program.

Patients with eligible cleft and craniofacial conditions will benefit from the removal of age restrictions, allowing time for their conditions to be appropriately planned and treated. Under the current legislative arrangements, Medicare eligibility for treatment under the Cleft Lip and Cleft Palate Scheme requires a patient to meet complex and problematic access restrictions, with some patients being denied Medicare reimbursement for treatment based on age alone. Age limits for some patients were previously amended under the health insurance amendment bill 2022; however, there continues to be a small number of patients who are denied treatment based on age. These changes will provide equity of access for treatment to those patients who suffer from certain cleft and craniofacial conditions, relying upon a clinical requirement rather than age.

In addition, the bill provides the facility for Services Australia to develop a system to place a doctor on or remove a doctor from the register of approved placements under section 3GA of the act. Specified bodies such as the Department of Health and Aged Care and general practice colleges are responsible for determining if a doctor is eligible to be placed on the register of approved placements. Services Australia places doctors on the register of approved placements based on notifications from specified bodies. The specified bodies will notify Services Australia on the decision, and Services Australia will manually place doctors on and remove doctors from the register of approved placements accordingly. The act does not currently allow this to occur via computer system. This change will reduce the time frames for doctors to start providing Medicare rebated services to their patients at a time critical with workforce shortages in primary care.

The bill also corrects inconsistencies between references to three years and one year in part VD of the act and the definitions of how a participant accrues a week of their return of services obligation under the Health Insurance (Bonded Medical Program) Rule 2020. With this bill, the Australian government will make it fair and equitable for young people needing cleft palate and craniofacial procedures, ensuring access to essential health care.

I note the amendment of Senator Steele-John, moved by Senator Rice, and I thank all parties for their engagement on this bill. The government appreciates the advocacy of CleftPALS and Speech Pathology Australia in raising the separate issue of access to speech therapy for those with cleft conditions. The government notes that there are separate MBS services available for some speech pathology services under the chronic disease management plans which may be applicable to cleft patients. The government also notes the advice of CleftPALS that they do not consider these sufficient for cleft patients. The government will consider the proposals from CleftPALS in conjunction with existing work being undertaken in relation to potential expansion of access to MBS services for those with severe speech and language disorders under the MBS for those with eligible disabilities following a recommendation from the MBS Review Taskforce.

The Medical Services Advisory Committee is an independent and expert committee comprising experienced clinicians and health economists. MSAC provides advice to government on whether a new medical service should be publicly funded and, if so, circumstance on and assessment of its comparative safety, clinical effectiveness, cost-effectiveness and total costs using the best available evidence. Any changes to the MBS funding for allied health services, including speech pathology for cleft patients, needs to be informed by a clinical evidence base and advice from the MSAC. For these reasons the government will not be supporting the amendments put forward by the Australian Greens. Options and pathways for further government consideration of the CleftPALS proposal will be determined by the MSAC executive. This could include consideration of further changes to the disability items in the MBS and may involve consideration of changes to the cleft scheme, as proposed by CleftPALS. The department will continue to consult with CleftPALS, Speech Pathology Australia and other stakeholders in progressing this work. The Australian government is committed to strengthening Medicare and putting the health of Australians first. I thank senators for their contribution to the debate on this bill.

Question agreed to.

Original question, as amended, agreed to.

Bill read a second time.