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Thursday, 20 November 1986
Page: 2615


Senator GEORGES —I present report 260 of the Joint Parliamentary Committee of Public Accounts entitled `Medical Fraud and Overservicing-Response to Pathology Report'.

Ordered that the report be printed.


Senator GEORGES —by leave-This is the fourth and final report of the Committee's medical fraud and overservicing inquiry. It contains responses from the Government, the medical profession and others to the Committee's report on pathology-PAC report 236. The Committee welcomes the Government's response to the 236th report. The response is timely and establishes an appropriate legislative framework to address many of the problems outlined in the Committee's report.

The development and introduction of this legislation represents a major step forward for the Government in tackling the issue of pathology laboratory accreditation and creating effective mechanisms to review the rendering of excessive pathology services. Frameworks have been established for the administration of approved pathology practitioner undertakings and approved pathology authority undertakings and the creation and operation of a pathology services advisory committee and Medicare participation review committees. In particular it is noted that the provisions of section 129 of the Health Insurance Act, covering false statements relating to Medicare benefits, have been revised.

As previous reports for this inquiry have emphasised, a legislative response to medical overservicing is appropriate only to establish the framework within which professional review mechanisms can operate effectively. It remains that medical overservicing is a problem where the judgment of providers by their peers is required. The continued development of co-operation and consultation between the profession, the Minister for Health (Dr Blewett) and the Commonwealth's administration is essential if improvements are to be made in this area.

This report also details other responses to the Committee's pathology report. The support of the Royal College of Pathologists of Australasia, the Australian Medical Association, major specialist pathology practices, practitioners generally and members of the public for the Committee's recommendations is certainly welcomed. The Committee remains resolute in its opposition to those medical entrepreneurs who rank the pursuit of profit and market control over and above patient care. The Committee believes that it is now the responsibility of the Commonwealth and State governments, in conjunction with the medical profession, to examine the activities of medical entrepreneurs and to bring them to public account where their actions are judged not to be in the public interest. I emphasise that point because, as I have said, this is the final report of the Public Accounts Committee's inquiry into medical fraud and overservicing. I reiterate that it is now the responsibility of governments and the profession to place the house in order.

The Committee is concerned that the problems that it has uncovered in the pathology area also appear to be developing in radiology and psychiatry. In particular some medical entrepreneurs appear to be moving to exploit these areas. The Committee believes that it is the joint responsibility of the medical profession and the Government to pre-empt these moves. The Committee has also carefully examined the responses of Dr G. W. Edelsten. Because of sub judice principles, comment on Dr Edelsten's submission will be tabled at a later date.

In commending this report to honourable senators I must voice the appreciation of the Committee for the work of the secretariat and, in particular, the work of Mr Peter Mason, who has been responsible for drafting reports for the Committee's consideration from the very inception of this inquiry. The Committee is aware and I am personally aware that his dedication to this investigation has cost him considerably both in promotion opportunities and in other ways. I place on the record that this dedication and application should be recognised by the Parliament. I think the Parliament would accept that the first report for which he was responsible-the Tobruk inquiry report-was received with great approval by not only the Senate but also others who were familiar with the problem. This report is the final of our reports for which he has been responsible.

I also thank the chair person of the sectional committee which was responsible for the investigation, Mrs Ros Kelly, the honourable member for Canberra. It would be remiss of me not to acknowledge the work of members of the Committee, the sectional committee and the Committee as a whole.

I have said that this is the final report of this inquiry. I merely add that the investigation of medifraud and overservicing is not at an end because the Committee has decided that it can go no further in this matter. It is now up to governments to respond. I am obliged to reflect on the report from the Director of Public Prosecutions who outlined in his report the difficulties that he faced. I think the Parliament, and in particular the Senate, ought to address itself to the problems which the Director of Public Prosecutions faces in the area of fraud against the Commonwealth and, in particular, fraud against medical services. The briefs the Director has received have been for the most inadequate. They are inadequate because the Australian Federal Police, which is responsible for gathering evidence in support of those briefs, has not had the resources or the skill to support them. I suggest to the Government that, without apportioning blame on the institutions which are responsible, it should merely examine its own role, re-examine the resources which are available to the Australian Federal Police, acknowledge that there is a lack of expertise and technique and move quickly to supply them. After five years the Committee is somewhat concerned that medifraud has not been suitably responded to and that the number of cases being brought before the courts has been few. This is a grave reflection on the ability of the authorities to react to a very serious problem.

The major concern, of course, is overservicing. As I have mentioned before, unless the Government takes the advice which is very clearly put before it by the four reports overservicing will seriously disadvantage the delivery of health care in this country. It will certainly seriously disadvantage the provision of free medical services to the community, especially to those who are in great need. I commend to the Senate the final report of the Public Accounts Committee's inquiry into medifraud and overservicing.