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Thursday, 9 December 1999
Page: 13229

Dr WOOLDRIDGE (Health and Aged Care) (12:01 PM) —I move:

That the bill be now read a second time.

The Health Legislation Amendment Bill (No. 4) 1999 makes a number of amendments to the Health Insurance Act 1973. This bill will repeal the Health Insurance (Pathology) (Licence Fee) Act 1991. The Health Insurance (Approved Pathology Specimen Collection Centres) Tax Bill 1999 will operate in place of the latter act and is being considered cognately.

Approved collection centres

The principal bill addresses the arrangements for the collection of pathology specimens for the performance of pathology services eligible for Medicare benefits. The present arrangements for the licensing of collection centres exclude the public sector, do not place sufficient emphasis on the quality of service and facilities at the centres, and are in general unnecessarily cumbersome in their operation.

The proposed amendments address these issues to permit the introduction of a national approval system for specimen collection centres that is fair, open and emphasises quality. In addition it uses the level of Medicare pathology activity of an approved pathology authority as the normal basis for determining the number of collection centres that can be operated by it in any year.

The bill introduces a simplified procedure whereby approved pathology authorities apply for approvals for specimen collection centres. This replaces the existing system involving the granting of units of entitlement. Approvals will be granted in respect of a financial year and the process will be subject to the approval principles determined as a disallowable instrument under the act.

The approval principles will be able to deal with matters such as the method for determining the maximum number of approvals that can be granted to an approved pathology authority in respect of a financial year, compliance with quality guidelines, the duration of approvals and the review of decisions.

It is intended that the approval principles will prescribe a general method for determination of maximum approvals for a financial year. This will be based on the experience of laboratories operated by an approved pathology authority over a specified 12-month period as reflected in Health Insurance Commission data. This is in contrast to the previous system of allocating units of entitlement by reference to a fixed pool.

A four-year phase-in period is proposed to allow the industry time to adjust to a less regulated environment. The present policy of allowing additional approvals where collection centres are located in designated rural and remote areas will be continued.

The amendments will apply to both public and private sectors from 1 July 2000.

An approved collection centre will be required to comply with the `Collection Centre Guidelines' published by the National Pathology Accreditation Advisory Council and developed by the council and the Royal College of Pathologists of Australasia. With the inclusion of the public sector in the new arrangements, the amendments require the same level of quality for all pathology specimen collection centres at which collections are made for Medicare eligible services.

The design of the new arrangements, which will be administered by the Health Insurance Commission, has been jointly agreed with the Royal College of Pathologists of Australasia and the Australian Association of Pathology Practices, and is based on the framework contained in the 1999 Pathology Quality and Outlays Agreement.

The granting of an approval for an approved collection centre will be subject to a tax which must be paid before the minister can grant an approval to an approved pathology authority for an eligible collection centre. This will be imposed by the Health Insurance (Approved Pathology Specimen Collection Centres) Tax Bill 1999 . The tax payable by an approved pathology authority on the grant of an approval will be at the rate of $1,000 for a full year, subject to pro rata reduction).

Temporary resident and overseas trained doctors, and other minor amendments

Health Legislation Amendment Bill (No. 4) 1999 contains a number of other measures. It simplifies and clarifies the rules relating to temporary resident doctors and overseas trained doctors and the circumstances in which they can access Medicare.

The bill removes the 1 January 2002 sunset clause which requires that new medical practitioners be in an approved program or complete a recognised graduate program in order to provide services which attract Medicare. This will ensure that we continue to enjoy better quality general practice and encourage more doctors to rural Australia. Indeed, this provision is almost single-handedly responsible for the seven per cent increase in doctors in rural Australia that occurred in 1997 and 1998, and we expect an increase this year.

At present, temporary resident doctors are not medical practitioners for the purpose of the act and are therefore not entitled to provide services which attract Medicare unless they obtain an exemption. Overseas trained doctors with Australian citizenship or permanent residence are subject to a 10-year moratorium which restricts their access to Medicare benefits unless they are granted an exemption. However, the new legislation will reduce the inequities between the treatment of permanent and temporary resident doctors and streamline the procedure to establish eligibility for Medicare benefits. The bill will also reduce complexity of regulation regarding access to Medicare.

In addition, the bill makes a number of technical amendments. These include amending the definition of `quality assurance activity' to include a reference to the Health Care (Appropriation) Act 1998. The definition of `professional services' will be amended to clarify that a dental practitioner who is able to render a Medicare-payable service in respect of oral and maxillofacial surgery must have been approved for this purpose by the Minister, in writing.

The definition of `relevant offence' will be broadened to include offences under sections 23DR and 23DS of the act, and an obsolete reference to section 21 of the Crimes Act 1914 will be deleted. I commend the bill to the House, and present the explanatory memorandum.

Debate (on motion by Mr Melham) adjourned.