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Wednesday, 4 May 1994
Page: 156


Senator CROWLEY (Minister for Family Services) (10.33 a.m.) —I would like to pick up on a number of points before I come to the one raised by Senator Harradine. I would say to Senator Chamarette that it is not accurate to say, as she did, that while I talked about warrantless entry and search or inspection powers, they, unlike these, do not lead to criminal charges. In fact, some of them do. It is not an unprecedented example that we are putting into legislation here. In some cases, the evidence provided by those other acts I quoted does lead to the very evidence that leads to criminal charges, and we need to bear that in mind. I do not want to take issue with Senator Chamarette especially because, as I understand, this is a position she has consistently held. Really, I want to correct one of the arguments that I do not find persuasive in her argument.

  Senator Chamarette raised the other important point of whether professional peer pressure, that is, compliance investigation by professional colleagues, might work.  The evidence to this point is that, no matter the importance of professional peer pressure, clearly some of the profession are not persuaded by that. Whether or not their professional peers are coming round, we would still have to deal with the very important point raised by Senator Harradine. Would it be fair for the pathologist down the road, designated as an inspector for compliance purposes, to come in and see whether or not another pathologist is doing what he says he does or whether we would have to say, as in answer to Senator Harradine's question, `These people would have to be trained. They would also have to have some kind of understanding of the responsibilities of this sort of work.'

  I have some information in answer to Senator Harradine's question about training in particular. The balance has been always as to whether the AFP should be given the particular information to know what to look for, that is, the medical pathology and pharmaceutical expertise. The evidence is that the arrangements we have in place at the moment have not been very successful. So we turn now to whether it might be better to train the HIC, which has a much better understanding of what the medical expertise is about, and to see that they are trained to the questions Senator Harradine raised, particularly in relation to the sorts of concerns the AFP has.

  I am advised that the Health Insurance Commission employs around 30 experienced investigation officers. These officers work with medical advisers and pharmacists as a team. They work through a case management committee process in each state, and that is overseen by a central national case management committee. All officers undertake ongoing training programs and some programs are actually provided by the Australian Federal Police staff college. By the end of this financial year most of the officers will have completed a two-week tailored refresher course at the college and ongoing training programs are planned. The points raised by Senator Harradine are very important and very valid. I believe the Health Insurance Commission is aware of them and is certainly assisted by the Australian Federal Police in providing that kind of assistance for its own investigating officers.

  The Health Insurance Commission investigations are probably more sensitive to and aware of the complexity of the government as a third party financier in the doctor-patient relationship than are the police, who have a general enforcement role. Health Insurance Commission investigators are specifically trained in medifraud. Moreover, they work in tandem with the Health Insurance Commission's medical advisers, that is, with medical professionals. So in some ways that goes part way to the point Senator Chamarette raised, though I do appreciate the difference between voluntary peer review and what we have spelt out here.

  Perhaps that will assist Senator Harradine in his concern about whether such people are sufficiently trained. I think that is a very important point. The Health Insurance Commission, I believe, has taken account of that kind of concern.