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Thursday, 18 June 2009
Page: 3711


Senator CORMANN (1:41 PM) —The opposition will not oppose the Health Workforce Australia Bill 2009, subject to the Senate agreeing to an amendment that we have circulated in the chamber. Essentially, while there is broad support in the health community for the establishment of Health Workforce Australia, there is serious concern about the lack of quality of this piece of legislation. It does not contain any detail—and, as we all know, the devil very often is in the detail. It is not based on a sufficient degree of consultation—yet again, here is the issue of a lack of consultation. There is a serious concern that, in the way the legislation is currently drafted, it is unclear as to whether its purpose is for Health Workforce Australia to cut across the roles and responsibilities of professional colleges and other organisations responsible for the accreditation of clinical education and training for health professionals. There are no supporting regulations in place yet. There is a deliberate lack of involvement by the government of medical and health professionals in the proposed governance of Health Workforce Australia.

Even government senators share many of those concerns. There is a very insightful report by the Senate Community Affairs Legislation Committee, and I commend in particular the comments made by Senators Boyce and Adams. They are very, very insightful comments indeed. Even in the chair’s draft of the report, a number of concerns are raised, and I draw them to the attention of the Senate. The report said:

… many still expressed some concerns relating to the Bill, especially the composition of the Board and committees that would ensure that the views of a broad cross-section of stakeholders are heard; and the possibility for the HWA—

Health Workforce Australia—

to interfere with independently accredited education and training standards.

Incidentally, the opposition will move an amendment to deal with that second issue to remove doubt and make absolutely sure that that is not going to happen as a result of this bill.

The chair of the committee, in her report, put the proposition that if the consultations offered by the department were undertaken then there would be no real issue with proceeding with the legislation. But that is a big ‘if’. It is really saying: ‘Trust us; we’re from the government. We’re going to fix this in consultations.’ Why was it not fixed before this legislation came to the Senate? Why are we presented with a piece of legislation that does not have any of the detail and about which there is significant concern out there in the health community and then just told: ‘Take us on trust. All of the things that are wrong with this bill we’re going to fix afterwards?’ To be honest, I do not think that is good enough. The government ought to seriously reflect on whether that is an appropriate way of going about it.

In the amendment that we will be moving in the committee stage, we will ask for the Senate to agree with the proposition that it needs to be made absolutely clear that the functions of Health Workforce Australia do not include responsibility for accreditation of clinical education and training—for example, accreditation of individual health professional courses—and that the regulations when they come, as they have not been provided yet, must not confer on Health Workforce Australia responsibility for accreditation of clinical education and training.

From the opposition’s point of view, it is absolutely essential that we include that particular provision in the bill that is passed by the Senate to ensure that there is no doubt as to what our intentions are in passing this legislation. We would be very concerned if a very obscure piece of legislation without much detail could then be used as a vehicle to do things that we never envisaged would happen when we were debating the legislation.

I draw your attention to the evidence provided during the inquiry, for example by Ms Magarry of Universities Australia, who noted:

Our concern is that the bill does not currently provide any substantive detail on the powers and responsibilities of Health Workforce Australia  …

Professor White of the Clinical Placements Advisory Group of Universities Australia said:

… it is the lack of clarity in the bill, the lack of information and detail in the bill, that is of concern in relation to governance but also in relation to the structure and the way in which the organisation will interact with clinical placements per se.

The Australian Medical Council said:

We are not sure what the relationship will be between the bodies that currently fulfil a function related to clinical training and something like Health Workforce Australia.

I am quoting quite extensively from the minority report of Senators Boyce and Adams, a very high quality report, which said:

This uncertainty made many of the professional organisations concerned that, because of its relative size and dominance by Government representatives, HWA would seek to replace the sector’s existing and highly respected clinical training and accreditation standards. …

This clearly is a move towards centralisation, with the inherent risk of a one-size-fits-all approach. When you move towards centralisation from where there currently is a very diversified approach there is a serious risk that important issues will fall between the cracks. I do not think the government has seriously thought through all of these issues. We hope that the chair of the community affairs committee is justified in her confidence and the quality of consultation after the legislation has been considered by parliament is going to be better than the quality of consultation that took place before this legislation was considered by parliament.

As a general point, I think it is absolutely incredible that anybody would believe that, once this legislation is passed and the government is off the hook as far as support from parliament is concerned, the government will be more engaging and constructive in its approach to consultation than it has been while still seeking the support of the parliament. With those few remarks, I flag that the opposition will be moving an amendment and that our support is contingent on this amendment being passed by the Senate today.