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Tuesday, 16 August 2011
Page: 8234


Ms SAFFIN (Page) (21:03): I rise to speak in support of the National Health Reform Amendment (National Health Performance Authority) Bill 2011 and in support of what this bill will do. The bill has two clear purposes. One is to insert a new chapter into the act. That will contain the provisions that will establish the performance authority. It will also amend the act to differentiate the commission from the performance authority. It will insert provisions to do with secrecy and information disclosure as well. The reason I speak in support of the bill is that, contrary to what I just heard from the opposition, it will do the things that it is designed to do. It will ultimately be about patient care and patient outcomes. That is what health is about. Why would you amend an act and set up an authority if that is not what the goal is? That is what it is all about. We talk about historic health reforms—and they are historic—but it is action, not just talk. I heard plenty of talk on the other side but there was little action over the last few years and over the 12 years they had in which to do it. They did not do it; they did not tackle the hard things in health reform.

I also speak with a little bit of experience, having served on health boards, set up health services and been a health advocate in my area. I have had some experience and involvement in some reforms that have had to happen at the local level. One of the things in health that can be difficult is measuring performance, because we measure performance in objective ways. I can understand that some of the medical and health personnel can feel a bit apprehensive about that: 'Is it measurement of me?' A lot of people can feel like that in any workplace. Originally, it was quality assurance. When that was introduced to a hospital where I was on the board there was some nervousness about it. It was being done at a local level but also at a state level when we rolled it out, and there was a whole discussion that went on around that.

I see that the National Health Performance Authority will be a good thing in terms of patients and patient care. There is widespread support for this bill. This bill does five key things at the operative level. It changes the title. That might not seem a dramatic thing, but it is really important because it brings together a number of operations. This bill changes the objects to include the performance authority and adds some corresponding definitions. It inserts distinguishing provisions regarding the members and CEO of the commission and the Australian Commission on Safety and Quality in Health, and introduces provisions relating to the secrecy and disclosure of information to the commission, which I will mention a bit more about later in my contribution. The bill does add that new chapter, which is a seminal chapter, to establish the performance authority. Then there are also some miscellaneous provisions. Firstly, I will deal with the secrecy and disclosure, then turn to the performance authority and its roles and functions and locate it within the policy framework of the federal Labor government since we were elected in 2007 together with the historic health reforms the health minister so rightly referred to, which were negotiated recently with Prime Minister Gillard. An offence provision is to be inserted so that anyone who is or has been an officer of the commission and has obtained information in that capacity is not able to use or disclose that information. To do so can incur a penalty by way of sentence. The sentence is substantial; it is two years imprisonment or 120 penalty units or both.

This bill also causes the insertion of parallel provisions relating to the commission, and there are, of course, permissive as well as prohibitive provisions, as the information I am talking about in this context is to be used for lawful purposes. The way I have read that is that the legislation gives it a coverall with some overriding application pertaining to patient protection, because that it is what this is about. It is about patients, so anything that is in the act that pertains to the patient is about patient protection. The policy that gives rise to this comes from the health reform that I talked about that was embarked upon in 2007 and has continued since then.

In looking at the benefits of the health reforms for patients, I understand that within the broad health reforms there are a couple of key things. First of all, there is more money. I am going on memory here, but I think there is $19.8 billion more going into the health system and going into patient care. More money does not resolve everything, but more money certainly helps. We know of the escalating costs in health and we know that they have been rising faster than state governments have been providing for in patient care. It is important to have that injection of funds. There has already been an injection of funds, and there are more funds that will be injected into the system over a period of years.

I know in my seat of Page that people who are patients—I know some people call them consumers or clients; I say 'patients' as I know when I use health services I still like to be called a 'patient', so I will stick with that word—have benefited in a number of ways. Firstly, there has been extra capital available, and in my area you only have to look at the integrated cancer care centre at Lismore Base Hospital to see the benefits there. There was additional money that came through from the federal government to allow it to come online one year sooner than it would have, so extra money was committed to capital costs to make sure that the centre was open a year ahead of time. That meant that people did not have to travel to get radiotherapy; they could have it in their area.

Also, across the road from Lismore Base Hospital, where the regional integrated cancer care centre is, we in the community are refurbishing and remodelling a 20-room accommodation building. We have put about $2.6 million into that and another $900,000 has gone in to make sure that patients and their families are able to stay close by when they are having treatment there. Money has also gone into Grafton Base Hospital. These are things that had not been provided and that communities were crying out for. When people in the opposition talk about no benefit to patients, it is absolute nonsense. You only have to look around Australia. It is not just in my electorate or just in Labor electorates; it is in electorates across Australia that these health reforms are starting to kick in.

This is a continuation of that package. So, even though I am straying a little bit off the bill before us, I am talking about the framework that this bill is located in. So, Mr Deputy Speaker, I am being indulged a bit but not too much as it is still within that framework. The performance authority is not merely a part of the health reform; it is a key element. It is part of COAG agreements and the National Health and Hospitals Network agreement. The heads of agreement was signed by all states and territories earlier this year, I think in February. That required that the performance authority would be established this year. The main purpose of the performance authority is to monitor and report on local hospital networks. It will cover Medicare locals as well, as they are being rolled out—another great initiative under the health reforms—and other healthcare service providers and, of course, the hospitals.

The authority will also deliver clear and transparent performance reporting, and it will be set against a new performance and accountability framework. For the first time, that will provide Australian patients and other people with information about the performance of their health and hospital services, and it will do that in a way that has consistency. It will be consistent at a national level and it will also be of relevance at a local level, because everything is local. We have to do things that sit and are situated within a national framework and we have to have a rational approach—we have to make sure it is set up like that—but it has to speak at a local level, and this clearly will do that. It will allow patients to have more information if they want it—and a lot do—on their local health services. Ultimately, if you have more information and people can access that, that leads to improvements in patient care, because that is what the system is set up to do.

The authority will also be able to report on the performance of our local hospital networks and the hospitals within them. I understand there will be regular performance reports on hospitals, and there will be reports within our Medicare Local geographic areas as well. That will be very useful for primary care in particular. These reports will include information about how well local health services are performing. They will also look not only at direct patient care but also at patient care that is preventative and at access to GP services.

We have all seen the government's establishment of the MyHospitals website, www.myhospitals.gov.au. I know that a lot of people have been looking at that, and it shows some of the emergency department and elective surgery performance; it is about looking at elective surgery performance. That is really important, again, for people to know. Local people know their local hospitals. We now have the local hospital networks in place. We have the governing councils—locally we still call them the committees—and they are in place. People who know them know well how their local hospitals are working, but this gives us another measure. It is about a system that is nationally consistent and locally relevant, and it is about having a system that is our system and is not alien to us. Sometimes the health system—how it works and how it operates—can be a bit of a mystery to people, and we live in a day and age when that is just not acceptable. Things like that have to change, and this amendment—this bill—is part of that whole national health reform package. In closing, I want to say that I commend the minister for the really good work—rather exacting work—that she has been able to do in this difficult area.