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Monday, 18 June 2012
Page: 3487


Senator FIERRAVANTI-WELLS (New South Wales) (19:31): In many ways this bill, the Health Insurance Amendment (Professional Services Review) Bill 2012, is technical legislation. The coalition will not be opposing it and indeed has agreed to expedite the passage of this legislation. It is similar to a bill that was introduced into the last parliament.

This bill addresses a number of issues, including a number of court decisions, one of which was Daniel v the Health Insurance Commission and Others, a decision of the Federal Court of Australia, of 28 July 2003. That case looked at the conduct of the Director of the PSR and at various legislation involving the definition of 'inappropriate practice' and various other matters.

The legislation before us also seeks to implement certain recommendations of the review of the PSR Scheme, which are in the report of the steering committee of 2007. It also makes minor administrative changes to the scheme and, further to the bill that was presented in the last parliament, it introduces amendments in response to the decision of the full Federal Court in the case of Kutlu v Director of Professional Services Review, a decision of the full Federal Court of 28 July 2011. It looks at some technical matters there.

Senator Back is here and he will no doubt be speaking on this legislation as well. I commend the work of senators in the recent inquiry of the Senate Community Affairs References Committee. I am sure Senator Back will be speaking to the additional comments made by coalition senators in relation to that inquiry. I will pick up on some of those comments. The coalition senators did want to acknowledge those of the medical profession who were sufficiently courageous to expose some of the limitations of the PSR process. It was certainly clear from the work done by coalition senators that the processes were deficient and led to unjust outcomes. In turn, one of the obvious consequences of that will be to discourage people from joining or remaining in a medical profession at a time when there are real shortages.

As coalition senators stated, in relation to the genuine deep concerns of many in the medical profession, whether some of those concerns were exaggerated or were adequately expressed is a matter of judgment. The PSR is a peer review process and, as we know, it was established in the early 1990s. Importantly, it is charged with protecting the integrity of the Medicare system and the Pharmaceutical Benefits Scheme. The scheme currently covers medical practitioners, dentists, optometrists, midwives, nurse practitioners, chiropractors, physiotherapists, podiatrists and osteopaths who use both the Medicare system and the Pharmaceutical Benefits Scheme. It is an important process, the intention of which is to protect the public from inappropriate practice by ensuring that Commonwealth funded services, which are delivered by practitioners, are medically necessary and clinically relevant. The intention is also to ensure that the public are protected from the consequences of inappropriate practice by ensuring that payments to claimants are made in accordance with the relevant Medicare regulations and the relevant regulations under the Pharmaceutical Benefits Schedule, and most especially that the service that has been provided is adequate in the light of the associated requirements for which that payment may be claimed. The Medicare Participation Review Committee, or the MPRC, is the independent statutory body that decides whether or not practitioners who have engaged in the conduct retain the right to practise under Medicare as a consequence of that conduct. The Commonwealth currently spends nearly $18 billion on Medicare services and $10 billion on pharmaceutical benefits per annum. I place on record that the coalition does support processes which ensure the integrity of the expenditure and the appropriateness of the clinical services and does support having a process which ensures that integrity is maintained.

The explanatory memorandum states that the amendments proposed by this bill will not alter the PSR or the Medicare Participation Review Committee processes. Those amendments are intended to improve administration, to clarify issues that have been raised in recent court decisions that I made reference to and to address certain evidentiary matters. This was a point that was reiterated by the minister in her second reading speech. As I indicated earlier, the bill addresses the issues that were particularly raised by the full Federal Court in the decision in Kutlu v Director of Professional Services Review, where the court held that there was a technical problem with the appointment of PSR panel members. This bill will ensure that those appointments are treated as valid and effective and, accordingly, the coalition will not be opposing this bill.