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Wednesday, 12 May 2010
Page: 3317


Mr SYMON (5:14 PM) —I rise to speak in support of the Health Insurance Amendment (Pathology Requests) Bill 2010. It will provide a choice for Australians who have been referred for a pathology service by their medical practitioner and thus encourage greater competition in the industry.

Pathology testing services are crucial to the ongoing health and wellbeing of all Australians. Pathology tests screen for numerous disorders such as infections, diseases and cancers. They also test body functions. Pathology tests include bowel cancer screening programs, pre-diabetes and cholesterol tests, women’s health programs such as breast screening, biopsies and pap smears, and also men’s health programs. They cover just about every area you can think of.

The contribution of this industry to the nation’s health cannot be overstated. In 2009 the industry delivered $2.1 billion in pathology services for Australians. Over 80 per cent of these services were bulk-billed through Medicare at a cost of $1.8 billion. At 80 per cent of all services provided, this is the highest bulk-billing rate for any medical procedure. Bulk-billing of pathology services is important to ensure that Australians who have been prescribed pathology tests by their medical practitioner go ahead and have their tests taken. Any reduction in the bulk-billing rate of pathology may lead to the situation where patients miss out on important diagnoses due to their wanting to avoid out-of-pocket expenses.

The effect of reducing bulk-billing on the community may be profound if patients choose to forgo tests in the area of pathology. As an example of the importance of pathology services, currently over six per cent of pathology tests are for the presence of type 2 diabetes. Many people who undertake these tests might have spent years not knowing that they were in that situation. So it is vital that they go to a pathology provider as soon as they have been told to do so by their medical practitioner. To reduce the damage of type 2 diabetes to our population, more Australians who are at risk need to take the test in order to find out whether or not they have it. As I said, if there is any impediment to a person undertaking a test once they have been prescribed a check-up, the damage from that delay is long term. Obviously, it accumulates.

Last year, a number of pathology providers wrote to local doctors asking them to identify healthcare cardholders so that they could charge all other patients for services that were currently being bulk-billed. This is a concerning development as it is the belief of the government that pathology services are profitable and that the current practice of bulk-billing should continue, with 80 per cent of pathology services being bulk-billed to Medicare. This bill will give patients the power to choose another pathology service if the recommended service does not bulk-bill, if the service is too far away or if they prefer to attend another practice. This amendment will put pressure on service providers to continue the practice of bulk-billing pathology tests.

The primary effect of this bill is to amend the Health Insurance Act 1973 to remove the current restriction on Medicare funding for pathology tests. Under the Heath Insurance Act 1973 a patient must attend the pathology service specified on the referral from the medical practitioner. The bill will enable patients to have the option of using a pathology service other than that recommended by their medical practitioner. The bill will remove the anomaly that exists between pathology and diagnostic imaging services whereby, under the current act, patients are able to use a diagnostic imaging provider of their choice whilst being given no choice of a pathology service provider. Patient choice is a key element of quality health care, and this bill will open up choice to patients in the area of pathology.

For organisations providing pathology services, this bill will provide them with an opportunity to attract more patients to use their services. The pathology industry estimates that there are 36,000 people directly employed in providing pathology services within Australia. As I mentioned previously, the industry has a national turnover of $2.1 billion. Pathology services generally involve local clinics in the suburbs and towns of Australia, including a number in the electorate of Deakin, as well as transportation and the major laboratories which conduct the tests. The industry covers a very wide-ranging workforce. An example of a pathology lab is Pathlab, which sits just outside the electorate of Deakin, in the suburb of Burwood. Pathlab is an independent lab that was established in 1994. It employs pathologists, graduate scientists, technicians, trained pathology collectors, couriers, clerks and ancillary personnel. In total, over 80 people are employed at Pathlab. For those working in the industry, it is a highly skilled and specialised industry that provides many opportunities. The industry also has many close links with higher education institutions.

The government supports this industry, and I believe that this reform will provide an opportunity for providers of pathology services to differentiate themselves and grow their business. Under this reform, pathology providers will be able to continue producing ‘branded’ request forms and providing them to medical practitioners. The forms may include a list of the locations of that provider’s collection centres and their logos. However, from 1 July 2011 there will be a requirement that the request forms have a clear and understandable and obviously positioned statement, making patients aware that these forms can be taken to any approved pathology practitioner or approved pathology authority. Patients will then be able to make their own choice as to which provider offers them the best service at the best location. Also, for most patients, a key determinant will be whether or not the service provider bulk-bills. Pathology providers can continue their relationships with medical practitioners and, at the same time, build their reputation in the community to grow their business.

This bill will ensure that patients have a right to choose their pathology provider and that they are made aware of that fact. I am sure it will lead to increased competition and better service among providers. This bill will remove anomalies whereby patients can chose providers of medical services other than those offering pathology services. Pathology services make up a substantial part of our health system. Approximately 34 per cent of Medicare activity relates to pathology. In 2007-08 there were 29 million pathology services claimed under Medicare. This bill will provide an opportunity for the industry to compete for patients who have been referred for pathology testing, and it will give patients the power to choose.

The Health Insurance Amendment (Pathology Requests) Bill 2010 is just one part of the Rudd government’s decisive action in delivering a better health system for all Australians. Providing choice of pathology service will give patients the freedom to decide which service they use, and it will give those in the industry an opportunity to differentiate their services from that of others. I commend the bill to the House.