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Monday, 21 November 2011
Page: 9072


Senator FIERRAVANTI-WELLS (New South Wales) (18:23): As foreshadowed in my contribution on the second reading, I move opposition amendment (1) on sheet 7178, as circulated:

(1) Schedule 1, item 21, page 19 (after line 18), after subsection 144(4), insert:

   (4A) The Minister must ensure that at least one member of the Pricing Authority has:

   (a) substantial experience or knowledge; and

   (b) significant standing;

in the provision of services in hospitals other than hospitals owned and operated by the Commonwealth, a State or a Territory.

The amendment to schedule 1, item 21 goes to the membership of the pricing authority. The minister must ensure that at least one member of the pricing authority has substantial experience or knowledge and significant standing in the provision of services in hospitals other than hospitals owned and operated by the Commonwealth, a state or a territory.

As I indicated, the bill provides for the formation of two committees to assist the pricing authority—firstly, a clinical advisory committee to advise on the formulation of casemix classifications for health care and other services that are provided by public hospitals; and, secondly, a jurisdictional advisory committee which will maintain a schedule of public hospitals and the services that each of those hospitals provide, advising on funding models for those hospitals and determining adjustments to the national efficient price to reflect variations in the costs of delivery of healthcare services.

The pricing authority is established as a body corporate with perpetual succession, with a seal. It is able to sue and be sued as well as deal with real and personal property under proposed section 142. Proposed subsection 63 and proposed section 143 effectively set the minimum number of members of the pricing authority at nine members, including the chair and deputy chair. Members, including the chair, are appointed by the minister and can be appointed on a full-time or a part-time basis for up to a maximum five-year period and can be reappointed as provided for in proposed sections 144 and 145. Proposed section 144 provides that at least one of the members of the pricing authority is to have substantial experience or knowledge and significant standing in regional or rural health care.

The coalition's amendment ensures that one member of the pricing authority will have substantial experience or knowledge and significant experience in the provision of services in hospitals other than public hospitals. This reflects in principle the submission by Catholic Health Australia, which recommended that a member of the pricing authority have experience in the operation of non-government public hospital services. As I indicated earlier, one only has to look at the state of our public hospitals as at June 2010 to see that 43 per cent of the hospitals in Australia are private hospitals and that they include day surgery facilities. There are 1.2 private hospital beds per 1,000 people as against 2.5 public hospital beds per 1,000 people. There are 756 public hospitals in Australia, with about 56,000 available beds. Hence, it is very important that non-public hospitals be included as part of the framework of this legislation. It has certainly been an oversight by the government in this legislation. One only has to look at the government's attitude towards private health insurance and at what Minister Roxon has tried to do once and failed, tried to do a second time and failed, and now, no doubt, there will be a third time, to see this government's ideological attack on private health insurance. That will be for another day. However, it reflects, I think, the ideological standard of this government towards private health and private hospitals. But I digress.

Catholic Health Australia highlighted one of the major potential problems with this legislation. While the cost base for treatment in Catholic public hospitals is different from that of state public hospitals, there is no guarantee of representation for non-government hospitals on the pricing authority. Senator Eggleston mentioned this in relation to major private hospitals in Western Australia. St Vincent's Hospital is one of the major examples in metropolitan Sydney. This issue was outlined by Mr Martin Laverty, the CEO of Catholic Health Australia. He said:

Very specifically, senators will be aware that Catholic Health Australia represents about 10 per cent of the nation's hospital beds. Within that there are 2,700 public hospital beds operated by Catholic hospitals, mostly on the east coast, but broadly around Australia. For the bill to be effective it needs to have regard to the unique nature and the slightly different legal status under which those 2,700 public hospital beds actually operate. We do not see that reflected in the bill at present, but we think minor amendments can adequately incorporate the impacts of the differing legal structures that operate those 2,700 public hospital beds, and we have proposed that to you in our submission.

Progress reported.

Proceedings suspended from 18:30 to   19:30