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Monday, 26 November 2012
Page: 13207


Ms O'NEILL (Robertson) (18:43): I rise to speak in support of the Health and Other Legislation Amendment Bill 2012. This is a bill for an act to amend the law relating to a few critical things—food regulatory measures, health, Medicare and industrial chemicals—and 'for related purposes'. That is a term that we hear in this parliament all of the time, a term not so commonly used out in the public but one that is vital for us to get on with the job of delivering real things that actually improve the lives of ordinary Australians as the core business of the work that we do in this place.

A lot of work that we do with legislation is like work done in other places; it is not always glamorous. This legislation would not be called a glamorous piece of legislation, and perhaps it might not attract a headline. It might not even attract a question in question time. Nonetheless, when it is enacted it will have a significant and positive impact on the way that entities involved in medical fields work with the government to deliver positive outcomes for Australians.

The first set of amendments in this bill relates to the Food Standards Australia New Zealand Act 1991. The amendments correct referencing inconsistencies and make the act easier to read. They are minor and do not change the intent of the act or alter any of the regulations. The Australia-New Zealand food standards system is a cooperative arrangement between our two great nations. It is helpful for the constant flow of business and leads to improvements in communication, safety and productivity on both sides of the trench if we implement uniform food standards. Food standards are developed by Food Standards Australia New Zealand, FSANZ. Responsibility for enforcing food standards in Australia rests with the authorities in the states and territories and the Australian Quarantine and Inspection Service, and in New Zealand with the New Zealand Food Safety Authority. The legislative change we are presenting today will help those very important and responsible agencies do their work better.

The second set of amendments relates to the Health Insurance Act 1973. On 1 July 2011, a change to the Health Insurance (General Medical Services Table) Regulations allowed specialist trainees from an approved professional medical college to conduct certain procedures in private settings under the direct supervision of a supervising specialist. This is important in terms of access to services. The procedures are deemed to be performed by the supervising specialist, who will retain the right to any bulk-billed Medicare benefit in relation to the procedures.

This has been a very popular change with stakeholders. It really enhances the training capacity for specialist trainees across the system. In terms of value for money, it ensures we can alleviate, at no extra cost, some of the training capacity issues for trainee specialists. This is a challenge being faced by health systems across the country. The government considers that it is appropriate that the policy should be recognised in legislation, which will happen once this piece of legislation passes through the parliament.

The third set of amendments relates to the Human Services (Medicare) Act. It is still an offence for any person, other than the Commonwealth, to use the term 'Medicare' or 'Medicare Australia' in connection with a business, including in any trading name or in any activity that implies it is connected to the Commonwealth. That presents an issue for Medicare Locals and other bodies seeking to use the term 'Medicare'. The proposed amendment will enable such bodies to apply for an authorisation to use the term without breaching the act. Thankfully, Medicare Locals are alive and well across the nation at the moment. They are a major reform to our health industry delivered by the Labor government. It is important that they are able to use the term 'Medicare' within the bounds of the law, and this legislation will enable that.

I would like to outline for those who might be listening to this debate—either here in the House or perhaps as they are driving the kids home from dancing classes somewhere in the back streets of the Central Coast—what Medicare Locals are. Medicare Locals are vital new organisations of our health professionals. Basically, all health professionals are starting to have conversations with each other, providing a model of care which wraps around the patient rather than the patient having to move from one agency to another. The time when you are at your most vulnerable and feeling the weakest is not the time that you want to find out how to negotiate a complex medical structure. Medicare Locals have the role of making it easier for patients to access services when they need them. There will be a formal linkage between the local GP, nurses and other health professionals, along with hospitals and aged-care and Aboriginal and Torres Strait Island health organisations, keeping up-to-date local service directories.

I am very pleased to say that when I was in my electorate on the Central Coast last week, I was able to briefly attend two events that were convened by Medicare Locals. The first one was an evening function held at the very beautiful Wamberal Surf Lifesaving Club, overlooking the Pacific Ocean. It is a beautiful seat in which we live; nonetheless, people face health issues. Of course, after-hours access to a doctor is a critical issue for families who might have an illness they are concerned about. They do not necessarily want to have to take up the resources of a hospital. They do not want to be sitting in the emergency ward at Gosford or Wyong hospitals when they could be accessing after-hours care and getting better and more sustained, regular treatment from somebody who gets to know them personally.

Approximately 40 of our local GPs gathered together on that evening for the dinner, at which there was a sustained and very fruitful conversation about how after-hours care can be delivered on the Central Coast. I know that there will be some adjustments from the current processes and, on the feedback that I have had from Medicare, we are certainly increasing and enabling a much more seamless connection for people with that vital after-hours service. One of the reasons that Medicare Locals are quite different and that we are already seeing important conversations happen between all these related but often disconnected health professionals is that Medicare Locals work very closely with our local hospital networks. This is to make sure that primary health care services and hospitals work together for their patients. The term 'primary health care' has been a focus for this government. Let's talk about prevention; let's talk about early intervention; let's talk about support. They are the things that happen when we talk about primary health, as opposed to tertiary health, which is a response to a crisis. The more we can prevent ill health, the more we can help people to be healthy in the environment, the better the outcomes are for every Australian citizen and, indeed, for the bottom line of our health budget.

Apart from supporting after-hours face-to-face care, helping GPs manage that and get better models in place, Medicare Locals will also be the agency that is tasked with finding out where the services are missing. They are going to audit gaps where there are disconnects, and I do not think that they will find it too hard to get engagement from the local communities. They say: 'I went to my GP, but I couldn't get to a podiatrist. I went to a podiatrist, but I couldn't get the help that I needed for the other conditions that are related to my diabetes.' The role of Medicare Locals is to coordinate and address those service gaps. They will also support the connection between many allied health professionals, who have been sitting off in their own little satellites, disconnected from the general health network.

About two months ago I was able to attend one of those Medicare Local events, where allied health professionals who had had no engagement with GPs were meeting with the Medicare Local for the first time and through that event they were meeting one another for the first time—physios meeting physios, physios meeting chiropractors, chiropractors and physios speaking about what they could do collaboratively. All of them were noting that networks for connection until that time were quite difficult to come by. They came to see how much they could enhance each other's work.

These Medicare Locals will be able to use the term 'Medicare' much more comfortably after this piece of legislation passes, but I am sure that they will continue to be very mindful of their need to be accountable to their local communities—and that is the other term. Yes, it is about Medicare; yes, it is about access to the health care that Australians have come to expect since the Labor government brought it in, restored it and has made sure that it continues to work. But it is also about making sure that things happen for people locally in their local area.

The Medicare Local on the Central Coast was in the third tranche of Medicare Locals that were released. It basically opened for business from last July. They really have got off to a flying start, and I am really very proud of the local people who have been leading it. I want to put on the record this evening the work in particular of Richard Nankervis, who is the CEO leading this very significant improvement to health access for our locals and improved communication between local health professionals. I would also like to acknowledge Graham McGuinness, who has had a long and distinguished career in the health sector. He is bringing his great wisdom and experience to bear on assessing where the gaps are in service provision on the Central Coast and developing and delivering real, practical, enabling and very good-value-for-dollar responses to that reality. I would also like to acknowledge the many, many years of service given to the forerunner of our Medicare Locals, which was our Division of General Practice on the Central Coast, and in particular the work of Dr Phil Godden. When I first assumed the role of member for Robertson, it was of great assistance to me in familiarising myself with local issues to have a conversation with a physician, who not only has great experience in running the business side of his practice but also has a great heart for people. He is a physician in the largest sense of the word—a great carer of the human person; he has looked after so many people across the coast.

That former Central Coast Division of General Practice set a really good standard for what our Medicare Locals might achieve. They worked to improve the quality and safety of health services through our Primary Care Collaboratives program, which is proving to underpin a great model for how we might advance with Medicare Locals. They implemented the palliative care gold standard project, aimed at strengthening the capacities of GPs to deal with that very important issue of end of life and manage that in such a way that people get the care they need. They did much more work than that, particularly with our frail older people in the Coast Nutrition Home and Community Care program. They even included people from special needs groups and younger people with a disability and their carers in their consultations. That is the style of our Medicare Locals and the way it will work.

Finally, this legislation will make some amendments to the Industrial Chemicals (Notification and Assessment) Act 1989 and that will bring the regulatory impost for companies into line with the risks that those chemicals pose. While this legislation, as I said, is not particularly glamorous, I can speak to the House about the visit of the very energetic and determined Minister for Health to the Central Coast to inspect the $57 million investment in health infrastructure that is happening in the seat of Robertson. I hope that I will able to bring her back very shortly to see our superclinic, our regional cancer centre and our Woy Woy rehab centre opened.