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Monday, 31 October 2011
Page: 12111


Mr LAMING (Bowman) (19:57): It is with pleasure that I support the bill we are discussing tonight, but I do have significant reservations, as do the coalition, with the establishment of a hospital pricing authority as one of the three tiers to the National Health Reform Agreement signed off by COAG earlier this year—the other authorities being the Commission on Safety and Quality in Health Care and the National Health Performance Authority, now residing in the other place.

The issue of pricing in Australia has always been an incredibly vexed area because we deal with two levels of government in healthcare funding. That need not be an impossible scenario for the delivery of a world-class health system. In fact, Australia's system is rated on the human development index around one or two in the world, which is a tribute to the standard of care that Australia can offer, focused on general practice and working closely with the pillars of Medicare, the PBS and the public hospital system, as well as a very strong credentialing of private hospital and private health insurance system.

But when we look for transparency and when we are looking at activity based funding, the language of the last two decades in health reform has been focused on identifying diagnostic groups, clearly identifying the subgroups and paying service providers accordingly. The great challenge has been to clear the picture of exactly what payers are paying providers for. The great challenge has been that we have two streams of funding and providers who often have irrational, perverse incentives to not deliver in particular areas of health care, leaving what we commonly refer to as gaps and, in other areas, overlaps. To attempt to address this and to deliver transparency, we have been told by this side of the chamber that the future is a $50 million a year opacity in the form of a hospital pricing authority to help us do it and hundreds of millions of dollars to run these authorities over forward estimates. As I have said before in this place, it is okay to talk about new authorities and new bureaucracies to run our health system, but one cannot do that and not be delivering on the far more important, the far more grafting, the far more critical work in health reform, which is making sure that services are world class and making sure that Australians do not miss out for a whole host of reasons around rationing, cost containment, perverse behaviour and interruptions to service delivery.

Debate interrupted.