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Wednesday, 17 June 2009
Page: 6378


Ms HALL (7:05 PM) —I was pleased to hear that the member for Dickson is actually supporting the Private Health Insurance (National Joint Replacement Register Levy) Bill 2009. I was a little doubtful whether he was going to support it, or even if he knew what was included in the legislation. Before I go to my contribution on this legislation, I would very much like to touch on some of the issues raised by the member for Dickson. It is easy to see why he is the master of fear and smear in the opposition. It is not surprising—and the Australian people will learn—that on numerous occasions in question time he has been asked to leave the chamber, because he tends to get involved in the fear and smear and the abuse that he is noted for in this House.

The positions of health minister and shadow health minister are probably two of the most important positions within the parliament. It is beholden on the people in those offices to behave responsibly, to put forward their vision for health and to know what health is really about. It is important for those people that fill those offices to really know where they want the nation to go when it comes to health. There is more to being a shadow health minister than standing up and just opposing absolutely everything that comes before the parliament. I have yet to see that the shadow minister has any understanding of any of the real health issues within this country. I note he spent considerable time talking about the government’s response to the global financial crisis without even acknowledging that a global financial crisis existed. It was his decision to use his speaking time—I hope he noted I did not get up and object; I allowed him full rein—to attack and oppose every health decision and every health direction that the government has taken.

From that I assume that he opposes the very outstanding report of the House of Representatives Standing Committee on Health and Ageing, which the member for Fairfax chaired in the last parliament, called The blame game. It identified most of the key health issues facing Australia. I have to say to the shadow minister that most of the policy decisions, the directions to the future of health in Australia, that the government has taken have been following on from that report. In lighter moments when I talk to the member for Fairfax, he will say to me, ‘You’re implementing our report.’ So he sees that the Rudd government has picked up and run with the report—which, I might add, we never received a response to from the former government—which created the blueprint for health in Australia.

I know that the member for Dickson becomes very preoccupied with private health insurance. We have had that debate. There was a vote on it. He made very clear his position on the changes to private health insurance. But tonight I hear him putting up that old furphy that pensioners and people on low incomes are going to lose the 30 per cent rebate. That is what he insinuates. It is more of the fear and smear, more of being dishonest with the Australian people and more of not really understanding what health is about.

One of the most important aspects of the health system is that we have confidence in our health system. During the inquiry into health that culminated in The blame game report, we had a quote which is at the start of one of the chapters. To listen to the member for Dickson, one would believe that our Australian health system is on the verge of collapse, that this has only happened since the Rudd government came to power. It is quite the contrary; there have been so many positive initiatives taken since the Rudd government has come to power that our health system is in a much better condition. This person who gave evidence to the inquiry stated, ‘Sure, there are some problems with the health system’—and this was under the Howard government, when it was in power—‘but if you get sick there is no place in the world that you would rather be than Australia, because the quality of the health services here is second to none.’ The member for Dickson needs to be mindful of that fact.

Health is a very important debate. We on this side of the House are ready to have that debate. The review that is taking place at the moment and the report that is due to be brought down at the end of this month will form a blueprint and be a very important part of where we on this side of the parliament go. But we are also very lucky that we have a health minister that does have a vision for health in Australia. She has very much made her mark in the area of health. Every minister that holds the health portfolio is able to influence the direction that we go in with health. She has made a very strong contribution in the area of community and preventative health. As a nation, if we can address a major health issue or a disease before it becomes critical, we are going to be in a much better position. Prevention is always better than needing to put all your resources into a cure.

I have never once stood in this House and heard the member for Dickson give us a vision, give us an idea of what he believes in, as far as health goes. What he believes in as far as health goes is attacking the government. It is always ‘this Prime Minister’ or ‘this minister for health’. It is never, ‘I think that this is the direction we should go in for health.’


The DEPUTY SPEAKER (Ms AE Burke)—Member for Shortland, I ask that you come back to the bill before the House. You’ve had a good reign.


Ms HALL —I am very happy to do so, but I felt that I needed to address the comments that were made by the previous speaker. I am very happy to make my contribution to the debate. So far I have been dealing with the issues that have been raised by the shadow minister and his vision for health, which revolves around private health insurance. If he was really honest with the Australian people, he would say that people should receive the kind of health care they can afford to pay for, not the kind of health care they need.

The Private Health Insurance (National Joint Replacement Register Levy) Bill 2009 collects information about joint replacement surgery, such as for hips, knees, ankles, shoulders, wrists and spinal disc replacement procedures. It reports on the safety and the quality of and devices used in these surgeries to ensure that patients get the best outcomes. This register is extremely important, because it provides information on the types of procedures that are being undertaken, the effectiveness of the devices, whether or not the surgeries are successful and whether a particular device should continue to be on that register. This bill will impose a levy on sponsors for joint replacement prostheses to recover the cost of the National Joint Replacement Registry. I think this is a responsible way to go. I think it is very important that you have proper cost recovery procedures in place and I think it is important that something like this register be self-funded. That is exactly what will happen under this legislation.

The bill defines a sponsor as a person who has had a joint replacement prostheses if the joint replacement prostheses is currently listed in the Private Health Insurance (Prostheses) Rules—and I point out here that the Howard government streamlined the register and put in place some limits on the type of prostheses that could be listed—either as a result of an application made by the person under the Private Health Insurance Act 2007 or is listed in accordance with the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007. It defines a joint replacement prosthesis as a prosthesis listed in the Private Health Insurance (Prostheses) Rules and which is used for joint replacements. It provides a rule-making power for the rate of the national joint replacement register levy.

Joint replacements are becoming more and more common within our society. We have an ageing population. Part of the consequences of people living longer is that sometimes joints wear out. When those joint replacements take place, we need to make sure that we have full and reliable details of the operations that are happening. Around 70,000 Australians have had joint replacement surgery in the last 12 months. The National Party Whip in this parliament has had double hip joint replacements and the whip’s clerk has had hip replacements. They are quite young people. My mother has had a hip replacement. I am sure that each and every member of this parliament could identify a person close to them who has had a joint replacement.

The register estimates that the information it has provided has improved surgical practices and changed the use of particular devices, reducing the number of unnecessary revision surgeries by 1,200 Australians a year. That is very important, because every time you have a joint replacement procedure that fails and you have to have it done again the chance of success is a lot lower and the outcome is a lot poorer. People need to have the confidence that that hip or knee replacement that they have will be effective. This register is a very important instrument and piece of health information. I think members of this House should be very supportive of the role that it plays in our health system.

In addition to improving patient outcomes, it is estimated that the register has saved the health sector and consumers around $44.6 million. That is a lot of money. The expenditure on hip and knee prostheses represents around 30 per cent of the total expenditure by private health insurers on prostheses. Insurers paid over $1 billion in benefits for prostheses in 2007-08, out of a total of $74 billion spent on hospital benefits that year. This means that prosthesis expenditure represents around 15 per cent of privately insured hospital benefits outlayed.

The register assisted in ensuring this funding and that public hospital expenditure is directed to better-performing products with low revision rates. Once again, it is looking at the integrity of the prosthesis and looking to ensure that you can reduce the number of times that that procedure has to be revisited. It is therefore vital that the register continues to have a stable source of ongoing funding. How do you achieve that stable source of funding? I would argue very strongly that this legislation will do just that. Taxpayers have met the operating costs of the register for over 10 years, which is now around $1.6 million a year. It is appropriate that the manufacturers and the importers of the medical devices used in joint replacement surgery now fund the cost of the register.

The new cost recovery arrangements will be similar to the funding arrangements of the United Kingdom’s National Joint Registry, which is funded through a levy on joint replacement products. It is a sensible way to manage the register and it is a very sensible means of cost recovery. The register provides invaluable market surveillance of joint replacement prostheses and the monitoring of the safety and quality of devices provides considerable benefit to both the industry and the consumer—I think I have already touched on that—by improving consumer confidence in the safety and efficacy of joint replacement devices. Any devices showing high failure rates can be identified quickly and promptly removed from the market. Health consumers need to know that the product that they are having inserted in their body is safe and that, if there is any problem with it, it will be picked up very quickly and removed from the register.

The data produced by the register also assists the industry by informing the development of new prostheses, allowing manufacturers to draw on reliable performance information for existing products and designs. The introduction of cost recovery arrangements will produce budget savings of $5 million over four years. This is outstanding legislation. It delivers certainty to the Australian community and certainty to the users of the register. I strongly support the legislation before us tonight.