Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

I just have a few more questions, if the minister would so oblige, following on from some questions I was asking this morning. I was wondering, Minister: when will the removal of the 400-plus items from the Prostheses List take place from?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

This is the list of items that was decided under your government. My advice is on 1 July.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

This morning in questioning I asked the representing minister if there were going to be any IT requirements to enable hospital vendors to be ready, or anybody who is impacted by the changes to this to be ready. The minister said that there were none. I'm wondering whether that's still your opinion.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

My understanding is the changes to the Prostheses List were announced a couple of years ago, and therefore I presume many of the hospitals would have made adjustments based on that. There is nothing further I can add. It's not about the bill; it's about the administration of the list by the hospitals.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Which part of this package of bills seeks to set up, the framework in terms of the operation going forward.

I'm just wondering: has the government received any concerns from the hospital sector in relation to their ability to implement the bundling of these new items that will now be considered outside of the Prostheses List under general use items? Has the government received any correspondence or any representations raising concerns from private hospitals about their ability to undertake the changes that will need to occur on 1 July for these 400-plus items to no longer be included under that mechanism of funding but under a new mechanism of funding?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

My advice is that, yes, concerns or issues have been raised, and that's why the Department of Health and Aged Care is working through these issues with the vendors.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Is the minister intending to meet with the IT vendors in relation to this particular issue?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

I think these are normally matters that are dealt with at departmental level. I'm not sure, but I will check to see whether the minister's had an approach for his diary and whether he's meeting with people. I know he meets with stakeholders extensively, as there are so many in the health sector. But I think the process is normally administratively done through the department.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Thank you, Minister, and I think that goes to the very point that I was trying to make, that so little detail has been provided—and here we are, in March—in relation to so many of the issues that we should have had more information on that we don't. But we're trying to seek that information. Just for the record, you have corrected the advice that I received this morning from the minister in relation to there being no issues in relation to IT. Clearly that was not necessarily accurate.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

I don't believe I said specifically—'have any concerns been raised': that was your question to me.

Yes, but you didn't say 'have any concerns been raised about the ICT'—

Sorry; I misheard you. I think there's a general discussion going on, but I don't think you can take that my evidence is different to Senator McAllister's.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Okay. So, can I ask whether any concerns have been raised either with the minister or with the department in relation to the capacity of the IT changes that are going to be necessary in order for the changes to take place on 1 July? Have concerns been raised, or not?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

I wasn't here for Senator McAllister's session this morning. My understanding is that there has been a range of implementation issues raised by vendors. If I can get more information for you, I will.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Thank you, Minister. This bill provides for the imposition of a cost-recovery levy on each kind of medical device and human tissue product on the list, and the amount of the levy will be set by regulations. Is that correct?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

Yes.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Looking at this bill and the explanatory memorandum, there appears to be a significant lack of detail and any other subsequent advice that seems to be out there in the wider community, which makes it impossible to determine whether the proposed arrangements are going to be consistent with the charging framework. So, first of all, can you guarantee that they will be consistent with the charging framework?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

Yes.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

On that basis, when will the government be providing the necessary details on those arrangements?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

I'm advised that the consultation paper will be going out in two weeks.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

When will that consultation paper be returning its consultation?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

The consultation will be for six weeks.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Okay. So, when will these cost-recovery arrangements come into play?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

On 1 July.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

So, they will be returned in the middle of May. How long after the advice, or the consultation information, is returned will we see the detail of those cost-recovery arrangements?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

My advice is in June.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

In what way is the government intending to ensure or protect to make sure that this framework and the way it's applied or administered or developed doesn't add additional barriers to patients accessing innovative life-saving or life-changing technologies? What is the mechanism of protection to ensure that patient priority is maximised?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

My advice is there is no impact from these changes on patients.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Thank you very much. To confirm, have you just advised the Senate that there will be no impact on patients for the changes only in the cost-recovery framework or that there'll be no impact on patients of these changes?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

LAGHER (—) (): Of the changes.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

My understanding is that there are some quite significant increases to the cost-recovery fees in the next financial year through the TGA. Is that correct?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

Perhaps if you go on to your next area and we'll see what further information we can provide you.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Thank you very much. While you're looking for that information, I'd be keen to understand if, in these additional costs and the change to the cost-recovery framework—my understanding is that the potential changes in that cost recovery are quite significant.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

In this bill?

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

No, in terms of the cost-recovery framework that you are seeking to put in place as part of this package of reforms. If there are additional costs to industry, what modelling has been done in relation to understanding the potential impact on innovation and time to market of devices and tissue products?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

I'm trying to understand. You're going to changes by the TGA, which are not part of these bills. It's not clear to me what you're after in relation to these bills. What's the question that's around the charging framework?

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

These bills, as part of a package of reforms, seek to change the levies and cost-recovery framework around prostheses and the Prostheses List. I put the TGA in there as an example. The TGA changes have a significant impact on the costs to the implementation of the private health sector, in terms of costs.

I'm seeking, more broadly, in terms of the increases to the sector, of changes as they relate to the changes of this package of bills and the overall reform package that's here, if any concerns have been raised. Has the department raised any concerns around increasing costs that may be associated with the limitation of innovation and time to market of products that sit within implantable devices?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

In terms of your question around concerns, we'll see if we can come back to you with anything useful on that. I am aware that before the new fees and levies are permitted, stakeholders will be able to contribute through the consultation mechanism, through the usual cost-recovery implementation statement process, so there is a process around it as well. I'll see if there's anything further we can provide.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Thank you, Minister. I really appreciate that because, to be fair, all I have heard in the last few months leading to this package of legislation, which was listed a few weeks ago and now has been re-listed, is that there has been a lack of consultation and a lack of information. There has been a propensity to say, 'Don't worry about what you've got here'—the outline—'we'll give you the details later.' We're standing here today at the start of March. We have started consultation on one part of it that is ongoing. We haven't even started the consultation on another part of the really important detail in regulations and requirements that sit behind the overall operation of the changes that are due to come in on 1 July. Then you tell me that people will have the opportunity for consultation.

I have to say that my feedback so far has been quite significantly that people feel like they haven't been consulted. People feel like they have been railroaded. An example that I used this morning is that the mechanism by which the bundling funding is likely to be delivered appears to have been predetermined by the consultation paper that's gone out, which has three possible scenarios through which the new funding model for the bundling might occur. Clearly, the department has drawn a line underneath it and decided that it wants to do it by facility, despite the fact that the sector has been really clear that it believes that it should be done by procedure. To that end, if the department is so hellbent on the bundling funding model to be decided by facility, has the department done any work to understand how that is likely to affect rural, regional and remote Australia? Medical health facilities in those communities are often challenged by circumstances that are quite different from larger city hospitals. We know that a lot of private health is delivered in rural and regional areas by necessity.

You have said that this consultation process is going to enable the sector to have significant input into the cost recovery framework. Is the department open to consideration of a model that would be based on the procedure that is being undertaken instead of the facility in which it is being undertaken, or has the department already mind up its mind about that? Maybe the department can answer through you, Minister. It does strike me that the department's going out with a preferred recommendation doesn't sound very much to me as though the department is prepared to listen to the sector about what they believe, as the people closest to the coalface, is going to be in the best interest of their ability to deliver for their patients.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

From my advice there is quite extensive consultation, but, I would say, it isn't unusual for this to be a contested space when changes come in. I would also say that this is framework legislation and that it's clear from the legislation that it will require legislative instruments, which will obviously come through this process as well.

What are you shaking your head over?

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Not all of them have to.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

It's not unusual to have different arrangements via legislation. My understanding is that there has been extensive consultation. There will be further consultation as we finalise some of the further detail, but this is framework legislation. Senator Ruston, if you have a whole range of stakeholders that are coming to you with concerns, I would refer them to the Department of Health so that their concerns can be addressed.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Well, thank you very much, Minister! I can ensure you that these stakeholders have been seeking to speak to the department of health and the minister. I have to tell you that many of them are extremely disappointed at the lack of access that they have been able to have to both of those agencies, both the minister's office and the department, so I'm surprised that you would stand there and say that when clearly these people would love to have the opportunity to be able to get access to the department and access to the minister. It's something that is just not happening.

I also would say this isn't a contested space. This is not a contested space. The opposition, when in government, was very clear. There was a lot of work that went into getting this reform package together. It was not easy. There were a lot of stakeholders with different requirements, and to try and get this to where it is is a credit to the good faith with which the sector has negotiated with the previous government. It is a situation that obviously was inherited by the new government, who has been in the position to bring this legislation forward.

I am merely saying that we have framework legislation that has got no substance to it at all. This is something that has been a complete track record of this government, coming in here and expecting the Senate to vote on something when they don't know the details. It's a bit like: 'Nothing to see here. Trust us. It will all be okay on the day.' You refer to legislative instruments. There are many legislative instruments that, from what I can gather in my discussions, do not even have to come back into this place in relation to regulations that sit under many of the subordinate pieces of activity that sit under this legislation.

I think, if you'd bothered to wait for a little bit longer and had actually done the work around the cost recovery arrangements and around the funding model for those items that were no longer going to be on the list and are going to be contained in general use, if you had bothered to go and do all this consultation and then brought this piece of legislation back into this place, knowing that the sector had had the opportunity to speak, had had the opportunity to provide information more broadly to other members of this chamber, because I know there are many other members of the Senate who would have been very keen to understand what the stakeholders—the private hospitals, the suppliers, the private health insurers, the patients and the clinicians—think of the details that sit underneath these changes, it would have given us a great deal more confidence that we actually had got this right. We have got no idea whatsoever whether what sits under this is going to be acceptable to the broader sector and, most particularly, we do not know, because we have no detail, whether it is going to be something that is of overall benefit to patients and whether it's going to be something that is more broadly accepted. As an example, I ask you: can you guarantee to us, without any information here around what is included and how the funding model is going to work and the like, that there will be no changes to surgeries in hospitals because they are no longer able to afford to deliver a particular type of surgery because the funding mechanism for the bundling means that the hospital decides that they're no longer going to undertake that procedure? Can you give us the guarantee?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

I'm going to start repeating myself, because, as Senator Ruston knows, this is a framework bill, so the detail can't be finalised until the framework bill passes because that's what sets up the legislative framework for the instruments that will then be finalised, following consultation, which are all disallowable. And, in terms of whether or not surgeries can change or won't change or whatever, private hospitals make those decisions all the time around a range of factors, so I don't think any person in this place could ever say that no surgeries would change at a private hospital, because they change all the time based on a whole range of factors.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Whilst I absolutely agree with you that you need the framework legislation in place before the legislative instruments can be put in place, that doesn't stop you having to find the details of those particular instruments. It doesn't stop you from having undertaken the consultation so the clarity of what will be contained in those instruments and the detail about what will actually happen on the ground is known before the framework is put in place. So, whilst I appreciate the lecture on how legislation works, I don't think I was suggesting for a minute that we put legislative instruments into this place before we had the enacting framework in terms of legislation. I was simply saying that it would have been an entirely respectful thing to do to finish your consultation with the sector on the details of what is going to be some very significant implications around changes that have been four years in the making. For four years the sector has been working together to try and come up with this particular reform package to make sure that Australians are getting cheaper access to implantable devices, to make sure that the Prostheses List is streamlined and fit for purpose and to make sure that we continue to be able to provide, through the private health system, access to these lifesaving, life-changing procedures. It would have been a respectful thing to do to finish the consultation. In some instances, this government hasn't even started the consultation for something that is going to have to be in place by 1 July. It seems like it is rushed. I'm sure you're going to move your amendment in a minute. Once again, it seems like we've rushed the legislation in an attempt to tick and flick and say: 'We've got this legislation done and out of the way. Don't worry about providing any detail; we can fix it all up later.' I really do hope that your categorical commitment that this is not going to have any impact holds true in due course.

Before you move your amendment, as I assume you're going to do, can I move on to the prescribed list guide. Where are we at in terms of the development of the prescribed list guide used for administering private medical device listing processes from 1 July?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

The guide will be going out for consultation in the next month.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

How long will it be out?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

The usual time of four to six weeks.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

The consultation will start in a month, so that's early April, and it will be out until the middle of May. How long will it take, after you've received the consultation, to finalise the guide and publish it?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

It has to be in place, as you know, by 1 July. I think it will be finalised as soon as possible following the feedback from the consultation.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Will the guide specify details about eligibility for listings under part A, part B, part C—I'm not sure if that's the correct terminology, but the different categories or listing levels?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

The eligibility criteria will be moved into another legislative instrument, which will also be consulted on.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Can I get a bit of an idea of the time frame? The consultation will come back sometime in the middle of May, and that will be turned into an instrument. Will that instrument list the categories of what's eligible?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

R (—) (): My understanding is that the eligibility will be in a separate instrument and that will be consulted on as well, I presume, as part of the whole package.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Will that be concurrent consultation or subsequent consultation?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

Concurrent.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Will there be a guide published in addition, or is it just the legislative instrument that will outline it?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

Yes.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Can I just get some clarity about items that are not implanted as part of a medical procedure? Will they automatically be eligible for reimbursement by an insurer if prescribed by a clinician?

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

Sorry, was it implantable?

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

No.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

Non-implantable?

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

Yes. So is it correct that—

Glenn Sterle (WA, Australian Labor Party) Share this | Link to this | Hansard source

Sorry, Senator Ruston. I think the minister's still on her feet to give you an answer. She might be clarifying. I'll just check so you don't miss anything.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

My understanding is that that has always been subject to a ministerial decision, and there are no plans to change that. It will go to section C of the instrument.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

So you're saying that the conditions under which a non-implantable item will or will not be eligible for payment are exactly the same as they are at the moment? Okay. I think I'm okay on the general part. You can probably move your amendment.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

I move amendment (1) on sheet UL102 circulated by the government:

(1) Schedule 2, item 4, page 12 (after line 12), after section 72-25, insert:

72-27 Matters to have regard to before exercising certain powers

In deciding whether to exercise a power under section 72-20 or 72-25, the Minister must have regard to the following:

(a) whether the exercise of the power would be detrimental to the interests ofinsured persons;

(b) whether the exercise of the power would significantly limit medical practitioners' professional freedom, within the scope of accepted clinical practice, to identify and provide appropriate treatments.

Anne Ruston (SA, Liberal Party, Shadow Minister for Health and Aged Care) Share this | Link to this | Hansard source

The reason I want to speak to this particular amendment, which relates to the exercising of the powers by the minister, is that I think it once again speaks absolutely to the fact that we have a piece of legislation that clearly has been rushed in being put together. It hasn't been well thought through. It hasn't been broadly consulted on. So what we find ourselves with here—and this is out of your own explanatory memorandum—is an amendment seeking to require the minister to have regard to matters when proposing to remove a listing from the rules or proposing not to carry out activities in relation to a debtor if there are unpaid fees and levies—because one of the bills that are sitting here actually provides the capacity for somebody who hasn't been paying their levies to have their devices or instruments removed from being eligible for reimbursement. It was very much a blanket requirement in this bill for that to be the case. Nobody had actually sat down and thought about what the implications may well be for the patients.

So what we've seen here is that today, at the eleventh hour, this amendment is being rushed in here. It was rushed in 20 minutes before it might well have been voted on had it not been that there were so many issues that I wanted to seek clarification on. This amendment now requires the minister, in exercising his powers to make a determination where somebody is going to be removed because they have not paid their fees or levies, to have regard to whether the exercise of that power by the minister 'would be detrimental to the interests of insured persons'—that is, the patient.

So we have this piece of legislation that would allow the minister, without any regard whatsoever for the potential implication on a patient, to remove a particular supplier because of unpaid fees or levies. We know that, in many instances with implantable devices, there are often ongoing requirements for the supplier to continue to provide support et cetera. So here we are. We have a situation where no-one actually bothered to think about the impact on the patient.

It also requires the minister to determine whether the exercise of these powers will significantly limit the professional freedom of medical practitioners to identify and provide appropriate treatments. So we have not bothered to worry about what the doctors might have thought. So here we are, with this piece of legislation being put through here, with no notice.

I'd also point out that there was no discussion with us either, clearly with the understanding that we have quite a strong interest in this particular suite of bills. Nobody bothered to tell us. It just arrived here 20 minutes before it could have been voted on, which significantly points out that this legislation completely and utterly disregarded, in one of these bills, the impact it potentially could have on patients and potentially could have on doctors. There's a lack of detail. It's policy on the run. It's a bit akin to building a plane while you're trying to fly it. It doesn't always end up terribly well.

This government should consider attending to the detail in the first place and making sure that its legislation has been thoroughly consulted, taking into account all of the implications, not just the implications of the top-line stakeholders but looking at who is the most important stakeholder in our health sector, and that is the patient. The government clearly forgot to bother about that here.

As we've seen in the discussion I've been having with the minister, we have no detail whatsoever. It is expected that we are just going to wave this through. I said earlier that the opposition would be supporting this suite of bills because we believe that it has been a long time coming. We must say, though, we are hugely disappointed, on behalf of the sector, on behalf of patients, on behalf of clinicians and doctors, on behalf of hospitals, on behalf of private health insurers, on behalf of device manufacturers, that we have got so little detail here.

Once again, we have created a massive level of uncertainty that we have also seen in the aged-care sector. Right now, we have aged-care facilities out there that don't know whether they're going to be closed down because of their inability to meet the mandated requirements of the legislation that has been pushed through this place that was impossible to deliver. Everybody knew at the time the legislation went through here that it would not be possible to deliver the mandated requirements because of the workforce shortages.

Once again, we have a situation where we don't want to stand in the way of policy reform. We absolutely don't, and we won't. I have to say, putting the government on notice, I'm getting sick and tired of coming in here and being expected to ask my team—and I'm sure many of the other frontbenchers on this side are sick to death of coming in here—to come in here and say, 'We want you to vote for a piece of legislation.' Then they ask you a question about that legislation, because one of their constituents has raised a particular issue, and we have our hand on heart and say, 'I don't know what the government's going to do because they're not going to tell us what they're going to do; they're just expecting us to take this in good faith.'

As I said, we will be supporting this amendment because the amendment is a good amendment. I'm really pleased that the government has actually seen that this is a good amendment. But I just really, really hope that this wasn't the only mistake that was made in the legislation. If there are more mistakes in this legislative package like this one, then we will be in a world of pain. The consequences won't be felt by the government, the opposition or the Greens, or anybody else in this place; the consequences will be felt by the patients of Australia who need medical procedures.

Unfortunately, we have a situation with the requirement of the government to push through its legislation and get it off its legislative agenda. Sadly, we are in a situation where the needs and the wants—and, I think, the obligation—that we have in this place, to pass fully informed, good legislation that is in the best interests of the Australian public, has been denied to us because of the lack of clarity and the lack of consultation that has been provided. I say to the minister: please guarantee that this is the only muck up in the legislation that is being fixed by this, because, of course, we're more than happy to support you in your rectification.

Katy Gallagher (ACT, Australian Labor Party, Minister for the Public Service) Share this | Link to this | Hansard source

For a start, if you'd paid attention you'd know it's not a rectification; it's in response to a scrutiny report. This power has existed as is since 2009 and has never been used, so if it's an issue for us it was an issue for you, for 10 years, that you didn't rectify. I think you should do your homework before you come in here and start raising a whole range of rubbish that is, frankly, just wrong.

This is in response to the scrutiny report, which recommended some additional protections which have not existed with this power since 2009—a power that's never been used. It's not an error. It's actually responding, as government should, to a scrutiny report. It's not rectification—that's the beginning. I would say: the lecture about failure to consult is a bit rich coming from a member of the former government, which announced some of these changes two years ago but—surprise, surprise—didn't see them through, negotiated behind closed doors without consultation and signed an MOU with the industry without consulting anybody else. Coming here and lecturing us about actually going through a proper process, proper consultation, is not right either.

Maybe it's the end of a long day, but, Senator Ruston, I think you know the record on this, which was a secret agreement between you and the industry. You signed an MOU, didn't consult with anyone, went out two years ago and didn't implement it. Now we're finishing the work and we're putting in place appropriate consultation mechanisms through this bill.

Jordon Steele-John (WA, Australian Greens) Share this | Link to this | Hansard source

For the benefit of the Senate, I want to briefly read out the relevant passage of the Scrutiny of Bills Committee report in relation to this amendment:

The committee is … concerned about the breadth of each discretion, particularly given that the exercise of the power … appear to have the potential to affect an individual's rights or interests.

I take the point that the finance minister has shared with the Senate this evening that the amendment is in response to the recommendation of the committee. Governments should respond to scrutiny of delegated legislation committee reports. I would say, though, that that functions in this place as a fail-safe, a last bastion of defence against the unintended consequence of badly drafted legislation. It can't be relied upon, by either side of this place when they're in government, to pick this stuff up let alone to ensure that it is actually done.

There is a reason, I would hope, that each side of politics strives to get into government. One reason, surely, is to have the resources of governmental departments at its disposal. You would think those departments would be able to pick this stuff up before a parliamentary scrutiny committee would be able to pick it up.

While it is true that the government is responding to a report, as it should, the very fact that we've come to this space is quite concerning to the Australian Greens. I would join, with the minister, in their criticism of the former government's seemingly systemic inability to effectively consult with relevant affected communities. Being in the disability space, I've experienced a lot of that. However, that's a very low standard against which to judge yourself. I should hope we can raise it just a little bit higher and we can do just a little bit better.

In relation to health policy more broadly, we will have the opportunity, either this evening or tomorrow, to really have the rubber hit the road in relation to consultation. We all know that coming up tomorrow is a bill in relation to the Therapeutic Goods Administration. We all know that right now this place is in the middle of negotiations over the implementation of a long fought for recommendation resulting from the Senate inquiry that considered, among other things, the impact of the transvaginal mesh scandal upon women. The No. 1 recommendation of that report was to have a mandatory framework for reporting of faulty medical devices by medical practitioners. It was supported at the time by the AMA, the RACGP and the Consumer Health Alliance. We will have an opportunity tomorrow to consider an amendment by the Greens to put that recommendation into effect as a product of consultation with the affected community.

We will have an opportunity in that moment to see just where the government's—and indeed the opposition's—priorities lie. Do they lie with ensuring that Australians are never again subjected to the humiliation, the pain of a faulty medical device inserted into them, used upon them, and yet never reported to the relevant authorities? Or will we see this government say: 'That sounds like it'll be a bit too much to ask of medical professionals. Even with a one-year lead-in, I think that'll be a bit too much. I think we might just have to wait, even though it has been however many years since that inquiry reported.'

I am well aware that there are individuals in the AMA who are lobbying this evening against the proposed Greens amendment in this space. I say to them: shame on you. You submitted in support of such a proposal when the inquiry took evidence. To the others in other parts of the health sector who are holding the line tonight: thank you. To those in this chamber keeping an open mind to this amendment: thank you. We keep alive tonight the possibility that this place might put in the work. It might require government departments to do their job and to not just reflectively accept the moaning of peak bodies who don't like having something sprung on them even though this has been waiting in the wings for years.

I agree with the minister. The coalition government was absolutely abysmal when it comes to consulting with community, particularly in health. This is your opportunity to do a bit better. We will see, come tomorrow, whether you take it up.

Question agreed to.

Private Health Insurance Legislation Amendment (Medical Device and Human Tissue Product List and Cost Recovery) Bill 2022, as amended, agreed to; Private Health Insurance (Prostheses Application and Listing Fees) Amendment (Cost Recovery) Bill 2022 agreed to; Private Health Insurance (National Joint Replacement Register Levy) Amendment (Consequential Amendments) Bill 2022 agreed to.

Private Health Insurance Legislation Amendment (Medical Device and Human Tissue Product List and Cost Recovery) Bill 2022 reported with amendments; Private Health Insurance (Prostheses Application and Listing Fees) Amendment (Cost Recovery) Bill 2022 reported without amendments; Private Health Insurance (National Joint Replacement Register Levy) Amendment (Consequential Amendments) Bill 2022 reported without amendments; report adopted.