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Wednesday, 25 March 1998
Page: 1607


Dr THEOPHANOUS (10:00 AM) —The Health Legislation Amendment Bill 1997 amends various aspects of the Health Insurance Act 1973 and the National Health Act 1953. Both these acts are of major concern to us. It is important to be quite clear: Labor is absolutely determined to have universal access to publicly funded health services through Medicare. Labor is committed to maintaining the effective integrity of Medicare as a system of universal health insurance that will finance the delivery of high quality medical and public hospital services to all Australians. This includes a commitment to maintaining affordable access through bulk-billing and opposition to compulsory co-payments.

Looking at the bill in toto, the bill allows the Health Insurance Commission, the HIC, to enter into various kinds of hedging contracts without ministerial approval but within ministerial guidelines, as was originally intended.

The bill allows for electronic lodgment direct from the doctors' surgeries and the electronic payment of all Medicare claims, not just bulk-billed items. This does not mean that doctors can be electronically paid where they elect not to bulk-bill. That would herald the end of bulk-billing and the introduction of co-payments. We are encouraged that the government acknowledges this is not a backdoor attempt at either doing away with bulk-billing or introducing co-payments. We will continue to monitor this situation. Any continuation in the drop in the bulk-billing rate amongst doctors, as has already occurred under this government, would be regrettable.

It also affects fees chargeable by optometrists. Some patients elect to have their eyes tested more than once per 24 months because they wish to change their glasses as a matter of fashion rather than of need. Currently, optometrists can receive only a reduced benefit in these circumstances. The change here allows optometrists to receive the full benefit provided they inform the patient prior to the consultation—that is, the patient will bear the out-of-pocket expenses in these matters.

Medicare benefits in respect of services rendered outside Australia have been extended to cover a domestic journey beyond the 12-kilometre territorial limit. This includes, for example, a Melbourne to Hobart flight. It also includes overseas journeys where the patient, through ill health, is required to return to Australia before arrival at the intended overseas destination.

Elsewhere, the bill amends section 61 of the Health Insurance Act and will eliminate unnecessary consideration by a Specialist Recognition Advisory Committee of questions relating to the recognition of a specialist or consultant physician where recognition was intended to be short term for the purposes of a locum tenens or where the specialist or consultant physician applies to have the status ended.

Amendments to the Australian Childhood Immunisation Register will permit the HIC to release de-identified data for research purposes. This provision was inadvertently omitted from the original amending legislation.

The provision of pharmaceuticals by private hospitals and residential aged care services is to be amended to allow pharmacists to be reimbursed in certain circumstances by the Commonwealth for the supply in bulk of certain drugs—that is, pain-killers. Currently, individual scripts must be written for each patient. Savings are expected to flow from less wastage of these drugs. We note the error in the second reading speech which states `private hospital or residential care facility' instead of `approved supplier'—maybe something can be done about that.

The Pharmaceutical Benefits Advisory Committee, the PBAC, is to be extended by one to include a consumer representative. Hopefully, this may improve the antennae of this particular committee to the individual human effect when it gets decisions wrong, as it did with Neocate at $1,300 per month for older than two-year-olds. Finally, after we expressed concern over a provision that would allow the HIC to extract penalties unilaterally from doctors it had decided had rorted the system, the government has decided to drop this provision. We welcome that decision. While supporting the need for government to be vigilant in detecting and prosecuting fraud, we are pleased the government has stepped back from a system that was going to be so unilateral.

The bill makes for a number of changes to the health legislation and we are supportive of it. We are pleased to work with the government to improve our health system. We remind the House that we are committed to maintaining the effective integrity of Medicare as a system of universal health insurance. We will support provisions which maintain that. We will oppose provisions which, in our opinion, are such that they undermine the Medicare system.