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Wednesday, 29 September 2010
Page: 73


Ms ROXON (Minister for Health and Ageing) (9:01 AM) —I move:

That this bill be now read a second time.

The National Health and Hospitals Network Bill 2010is 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. It establishes a permanent national commission for the safety and quality of health care.

The government’s health reforms are the most significant changes 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 task forces on primary health care and preventative health.

It follows an extensive consultation process that has seen the government 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 that health services are delivered, through better access to services designed around patients’ needs, a greater focus on preventative health and the provision of care outside 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 that I am reintroducing 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, preventative health, sustainability and quality.

Capacity

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

The Gillard Labor 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 will 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 are investing 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 between the states and territories. I see the member for Hasluck is still in the House. This is an area where, particularly in the servicing of our Indigenous communities, there is huge potential for us to do things differently. The government will establish Medicare Locals, which will work with local GPs, 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.

As I have mentioned, 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, then referred to a local after-hours GP service that is open, 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 in one place.

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, which ripped $1 billion out of our hospitals.

The Gillard Labor government will invest $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.

An investment of $800 million for elective surgery will help back a target of 95 per cent of elective surgeries being 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 our 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, for example 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 the tobacco excise, which is expected to result in 87,000 fewer smokers across the country.

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.

Sustainability

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

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

These changes will mean that one level of 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, and my colleague the Treasurer will reintroduce a bill in the coming months to enable the associated changes to federal financial relations.

The government is acutely aware of its responsibility to not only outline a reform agenda but deliver those reforms and make them a reality. We are delivering reforms in six key areas: hospital projects, including expanding hospital capacity as part of the National Health and Hospitals Network, landmark health and hospital fund projects and regional cancer centres; investing in our workforce, with new GP training places on line this year and including more next year, with nursing and allied-health scholarships and locum places; primary care infrastructure, through more GP super clinics—announced recently—and the funding rounds to upgrade general practices, which are currently underway; e-health and telehealth, with the Medicare rebates for telehealth available from mid-2011 and electronic health records from 2012; systems reform, with the local hospitals network and our first Medicare Locals being established from the middle of the year; and prevention, with investment for children and in workplaces to prevent disease—these programs begin rolling out next year.

Quality

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 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 and to ensure the appropriateness of services delivered in particular healthcare settings, 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 will 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 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 then be responsible for implementing relevant national clinical standards addressing safety and quality matters once they are agreed between the Commonwealth, 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 Bill 2010 provides a framework for the establishment of the commission, including the expanded role for the commission in setting those national clinical standards and strengthening clinical governance. It is intended that arrangements under this expanded role will be further developed in consultation with the states and territories and will be subject to finalising further financial commitments.

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

The permanent commission will be able to be established—with the support of the House and the Senate—from 1 July 2011, with existing arrangements for the non-permanent 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 the improvement of safety and quality standards in health care in areas such as clinical handover and communication, infection prevention in healthcare and medication safety. I want to thank it for the important role it has been playing in our health system.

The expanded role of the permanent commission will 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. While Western Australia has indicated that it supports a permanent safety and quality commission, it is disappointing that Western Australia is choosing to opt out of other important health reforms that will improve health and hospital services for all Western Australians.

Conclusion

The National Health and Hospitals Bill 2010 marks an important step forward in delivering the Gillard Labor government’s commitment to reforming 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 and it will help deliver better health and better hospital services for all Australians. I commend the bill to the House.

Debate (on motion by Mr Andrews) adjourned.