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Wednesday, 23 June 2010
Page: 6252

Ms ROXON (Minister for Health and Ageing) (9:15 AM) —I move:

That this bill be now read a second time.

The National Health and Hospitals Network Bill 2010 is a historic bill that delivers one of the major components of the government’s health reform agenda. It is a key step forward in providing better health and better hospitals for all Australians. I am delighted to be following the Treasurer, who has just introduced the Federal Financial Relations Amendment (National Health and Hospitals Network) Bill 2010, which is also vital for these reforms.

This package of health reforms is the most significant change to Australia’s health and hospitals system since the introduction of Medicare. We are creating a national health and hospitals network that is funded nationally and run locally.

It is the culmination of work that began with the establishment of the National Health and Hospitals Reform Commission, as well as taskforces on primary health care and preventive health.

It follows an extensive consultation process that has seen the Prime Minister, other ministers and I road testing ideas with more than 100 local communities across Australia.

We are implementing major reforms to the funding and governance of our health system, to place it on a sustainable long-term foundation.

We are changing the way health services are delivered, through better access to services designed around patients’ needs, and a greater focus on preventive health and the provision of care outside of hospitals.

We are also investing in our health system and our health workforce, to deliver better care and better access to services for patients, now and into the future.

The bill I am introducing today is a key component of this overall health reform agenda. Before turning to the detail of this bill I will outline this agenda in some key areas: the capacity of our health system, better connecting care, access to services, preventive health, sustainability and of course quality.


To ease the pressures on our health system, we need to increase its capacity and the services available. This means more doctors, more nurses and more beds.

The Rudd government is investing $1.2 billion as part of the National Health and Hospitals Network in doctors, nurses and allied health professionals. This will deliver 5,500 new or training GPs and 680 additional medical specialists over the coming decade. It will improve support for more than 4,600 full-time-equivalent nurses working in general practice, and help train and retain our valuable aged care nurses. And we will support 800 allied health professionals working and training in rural areas over the next four years.

We will also invest more than $1.6 billion for more than 1,300 new subacute beds, to reduce bottlenecks and capacity constraints in our system. These beds will be delivered in areas like rehabilitation, palliative care, and, importantly, mental health services, so that people can get the right care for their needs.

Better connecting care

As part of the National Health and Hospitals Network, the government will ensure that services are better connected and coordinated, reducing fragmentation and the blame game.

Local hospital networks will be established. They will be more responsive to local communities and new funding arrangements, such as the introduction of activity based funding, will provide strong incentives for better performance and reduced waste.

The Commonwealth will also take funding responsibility for 100 per cent of primary care, ending duplication and divided responsibilities. The government will establish Medicare Locals, which will work with local GP, allied health and community health providers, to drive local integration and coordination of services and improve access to care.

And, to bring the health system properly into the 21st century, the government will invest $466 million to establish personally controlled electronic health records, reducing mistakes and duplication, and ensuring that, with patients’ consent, doctors have the information they need, when they need it.

Better Access to Services

The National Health and Hospitals Network will also deliver better, more timely access to health services in local communities across Australia.

The government will establish a national after-hours GP and primary care service. This will enable anybody calling their GP out of hours to be referred to a nurse or a GP on the phone and, if necessary, referred to a local after-hours GP service coordinated by their Medicare Local.

The government will also invest $355 million in more GP superclinics and expanded GP clinics in about 450 locations across Australia. These will bring together in a single location services such as GPs, allied health and practice nurses, so that patients can more easily get the full range of care they need.

The National Health and Hospitals Network will also provide strong guarantees and targets to improve access to public hospital services—reversing the neglect from the Howard government ripping $1 billion out of our hospitals.

The Rudd government will invest a further $750 million so that emergency department patients will have a guarantee that they will be treated, admitted or referred within four hours, where clinically appropriate.

And an investment of $800 million for elective surgery will help back our target that 95 per cent of elective surgeries be delivered within the clinically recommended time, and a guarantee that patients facing excessive waits should have their elective surgery fast-tracked.

Preventive Health

Keeping people well and out of hospital is a critical component of the Rudd government’s health reform agenda: while we are improving our hospitals, we also need to reduce pressure on them and keep people out of hospital in the first place.

To achieve this, the government will take world-leading action to combat tobacco—which contributes to the deaths of 15,000 Australians a year. The government will introduce plain packaging for all tobacco products—a world first—in addition to raising tobacco excise, which is expected to result in 87,000 fewer smokers.

The government will also invest $449 million to improve care for people with diabetes—which is fast on the way to becoming one of the major burdens of disease. This investment will enable Australians with diabetes to have the option of signing up with a GP practice, which will be responsible for managing all aspects of their care in an integrated, coordinated way.


The Rudd government’s record of strong economic management has enabled us to make major investments in our health system. But if our health system is to be sustainable into the future, we have to provide it a secure funding base for the future.

To ensure this, the Commonwealth will take, for the first time, funding responsibility for all GP and primary care services and all aged care services. The Commonwealth will also become the dominant funder of Australia’s public hospitals, paying for 60 per cent of hospital activity and capital, as well as 60 per cent of training and research costs in public hospitals.

These changes will mean that one government will have dominant funding responsibility for all parts of the health system—ending the blame game and the perverse incentives for buck passing and cost shifting.

These changes are the most significant reforms to Commonwealth-state financial arrangements in decades, as my colleague the Treasurer today said when introducing a bill to enable the associated changes to Federal Financial Relations Act.


If we are to have a truly national health and hospitals network spanning Australia, it is essential to have strong safety and quality standards so that all Australians can be confident that they will receive consistently high-quality care wherever they live.

This bill provides for framework legislation to establish the Australian Commission on Safety and Quality in Health Care.

It is imperative that the government’s health reforms ensure that the Australian public receives safe, high-quality health care. The Australian Commission on Safety and Quality in Health Care will be established as a permanent body with an expanded remit to drive safe, high-quality care to ensure the appropriateness of services delivered in a particular healthcare setting, including primary care and mental health.

The commission will help reduce the harm caused by preventable errors, reduce healthcare costs resulting from unnecessary or ineffective treatment and have a positive impact on community trust.

The commission will formulate safety and quality standards, guidelines and indicators and work with clinicians, professional bodies and consumers to lead the drive toward practical health system improvements for the Australian public.

The commission will provide advice to the Commonwealth, state and territory health ministers about which of the standards are suitable for implementation by local hospital networks as national clinical standards addressing safety and quality matters. Local hospital networks will be responsible for implementing relevant national clinical standards addressing safety and quality matters once they are agreed between the Commonwealth and the states and territories.

These national clinical standards for safety and quality will clearly state the high expectations all Australians have of their health and hospital services.

The National Health and Hospitals Network Bill 2010 provides a framework for the establishment of the commission, including the expanded role for the commission in setting national clinical standards and strengthened clinical governance. It is intended that arrangements under this expanded role will be further developed in consultation with the states and territories and subjected to finalising financial commitments.

The commission will work collaboratively with the Commonwealth, states and territories in the performance of its functions. More detailed administrative arrangements for the commission will be underpinned through an agreement with states and territories, and all governments will also agree to the funding and work plan for the commission.

The permanent commission will be established from 1 July 2011, with existing arrangements for the commission to continue as part of the Department of Health and Ageing until 30 June 2011.

The existing, temporary commission has undertaken good work to lead and coordinate work to improve the safety and quality of health care, in areas such as clinical handover and communication, infection prevention in health care and medication safety.

The expanded role of the permanent commission would complement these activities with work on national safety and quality standards, guidelines and indicators.

At this stage, the Western Australian government has not yet signed the National Health and Hospitals Network Agreement and has chosen not to comment on an exposure draft of this bill. It is disappointing to the government that Western Australia is choosing to opt out of these important reforms, which will improve national clinical and safety standards. If Western Australia signs up to the reforms, Western Australian patients would benefit from high national standards and be assured that they will receive consistently high-quality care no matter where they are in the country.


The National Health and Hospitals Network Bill 2010 marks an important step forward in delivering on the Rudd government’s commitment to reform Australia’s health system for the future.

Establishing a permanent, independent safety and quality body formalises the government’s commitment to drive improvements in quality and safeguard high standards of care for all Australians.

It will help ensure that there is a more nationally consistent approach to the quality and safety of health care across Australia—as part of the National Health and Hospitals Network.

It will help deliver better health and better hospitals for all Australians.

I commend the bill to the House.

Debate (on motion by Mrs Gash) adjourned.