Dr WOOLDRIDGE (Health and Family Services) (9:40 AM) —I move:

That the bill be now read a second time.

This bill shows the government's commitment to retaining Medicare as a system, ensuring that all Australians can gain access to health services they need and ensuring that Australians enjoy a world class health system. This bill provides the basic framework for agreements between the Commonwealth and states for the provision by the states of acute health services to public patients in return for Commonwealth financial assistance.

The Australian health care agreements, as they will be known, will provide financial assistance fairly and equitably and will introduce new measures that will alleviate some of the problems that have been experienced in past agreements—problems such as cost shifting between levels of government and artificial barriers to care.

As well as providing for ongoing financial assistance, the legislation that I am introducing today provides special assistance for national health development initiatives. This assistance will provide support for major projects to enhance and improve the acute care system, improving the efficiency and effectiveness of health care delivery, improving patient outcomes in relation to the delivery of these services and addressing the factors that lead to avoidable or unnecessary hospitalisation.

The Commonwealth will not be imposing uses for this money on the states but will instead be inviting proposals from the states as to how the money might be best spent. I envisage that many projects would seek to improve the integration of the acute care sector with the wider health care system or improve the linkage of information technology across the system.

This legislation also provides for the retention of important features of previous agreements. These include agreed principles for the provision of services. States will be required to put in place arrangements to ensure equitable access to services for all eligible persons regardless of their geographic location. The legislation also retains the need for states to make available a public hospital charter and an appropriate complaints mechanism. Funding under the agreement is dependent on the services being available to the public.

As I said earlier, one of the most significant issues that has dogged current agreements has been that of cost shifting. The Commonwealth believes that the states have shifted services from public hospitals that they fund on to the Medicare benefits and pharmaceutical benefits programs that we fund. The states, on the other hand, argue that if services can be funded under Commonwealth programs, then they ought to be.

The legislation being introduced today will address this issue by establishing a health care information commissioner as a statutory authority responsible for the collection, analysis and dissemination of de-identified patient level data from the Commonwealth and the states. The commissioner will identify the movement of services around the health care system and report on how these services are funded. The commissioner's reports will be made available to all parties. The agreements will make it absolutely clear that the Commonwealth will be unable to make adjustments to states' funding except on the basis of a report from the commissioner. Subject to the agreement of the states and territories, it is possible that the functions of the commissioner will be assumed by the Health Insurance Commission. In any event, the same stringent privacy requirements that presently apply to the HIC will apply to the commissioner.

The legislation and the agreements will maintain the fundamental principle of universal access to acute health services on the basis of need, delivering on our commitment to maintain Medicare. But equally as important, agreements made under this legislation will lead to a reformed acute health care system, with better integration of different types of care, improved patient outcomes and more appropriate types of care. The agreements will provide appropriate adjustments for growth and the demand of the health system over the next five years while providing funding to restructure the system to meet demand into the longer term.

This bill will maintain Australia's reputation as having one of the best health care systems in the world and will continue to do so well into the 21st century. I commend the bill to the House. I present an explanatory memorandum to the bill.

Debate (on motion by Mr Martyn Evans) adjourned.