2019

 

 

 

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

 

 

 

SENATE

 

 

 

 

 

Australian Institute of Health and Welfare Amendment (Assisted Reproductive Treatment Statistics) Bill 2019

 

 

 

 

 

 

 

EXPLANATORY MEMORANDUM

 

 

 

 

 

 

 

(Circulated by authority of Senator Griff)

 

Australian Institute of Health and Welfare Amendment (Assisted Reproductive Treatment Statistics) Bill 2019

 

OUTLINE

 

This Bill amends the Australian Institute of Health and Welfare Act 1987 to require accredited assisted reproductive technology (ART) centres (fertility clinics) to report their performance statistics to the Australian Institute of Health and Welfare (AIHW) and for the AIHW to publish these statistics for each ART centre.

 

The aim of this Bill is to provide consumers with information about the performance of each fertility clinic, to allow them to make an informed choice about their prospective treatment facility.

 

The information published would include the number of women undergoing fertility procedures at the ART centre, the assisted reproductive treatments they receive, the age of each woman treated, the number of resulting clinical pregnancies and the number of resulting live births. It would be up to the AIHW how it publishes this information, and optimally it will be as a searchable online database.

 

Currently, the only statistics published for each fertility clinic are those which the clinics wish to disclose themselves.

 

Fertility clinics report annually to the Australian and New Zealand Assisted Reproduction Database (ANZARD), resulting in an annual “assisted reproductive technology in Australia and New Zealand” report, but this only provides a de-identified industry overview of outcomes.

 

The database is a collaboration between the University of New South Wales’ National Perinatal Epidemiology and Statistics Unit and all 86 fertility clinics in Australia (and eight in New Zealand), and it is funded by the Fertility Society of Australia.

 

Because of this existing reporting regime, the preparation and reporting of performance data for the purposes of this Bill is not expected to be an onerous task for industry.

 

The annual ANZARD report demonstrates that there is a wide discrepancy between the best performing and the worst-performing clinics, yet consumers have no objective means by which they can determine this.

 

According to the most recent results, for 2016, live birth rates varied from 11.6% for the poorest performer to a rate of 32% for the top performing clinic. Half of the (unidentified) clinics sat in the 17-24% range. The results were similar in 2015.

 

While a clinic’s patient demographics -such as average maternal age and causes of infertility - will have some bearing on these results, it illustrates that a woman’s chance of taking home a baby will vary depending on which clinic doors she walks through.

 

Medicare provides a substantial rebate for fertility treatments (just under half of the approximate $10,000 cost for a first IVF cycle) and the associated medication is heavily subsidised through the Pharmaceutical Benefits Scheme, so there is also a fiscal benefit to taxpayers in ensuring that infertile consumers can make informed choices about their treatment.

 

Requiring accredited ART centres to disclose this information through the AIHW will provide Australian consumers with the same transparent and consistent information currently provided to consumers in the United States and in the United Kingdom, where national registers already disclose the performance of fertility clinics.

 

In the UK, the Human Fertilisation and Embryology Authority hosts a searchable database through which consumers can view a fertility clinic’s treatments, inspection rating, patient rating, and whether its success rate falls within the national average. The information is limited, which makes the website useful but not comprehensive.

 

It compares to that in the U.S., which responded as far back as 1992 to concerns about the quality and consistency of success rate information available to women seeking  fertility treatment. It enacted a law requiring all clinics performing ART to provide annual data for all procedures to the Centers for Disease Control and Prevention (CDC) which then uses the data to publish comprehensive clinic-specific information.

 

The CDC database is not a “league table”. It allows U.S. consumers to search for a fertility clinic by name or location and to view and filter its performance data. Success rates are given according to a woman’s age group, and the data can be filtered according to treatment type and diagnosis, which allows a woman to put the data in context and find a clinic to suit her circumstances.

 

It is the type of information Australians using fertility services should be able to access. This Bill will allow this to happen.

 

 

NOTES ON CLAUSES

 

Clause 1: Short Title

 

1.                   Clause 1 is a formal provision specifying that the short title of the Bill may be cited as the Australian Institute of Health and Welfare Amendment (Assisted Reproductive Treatment Statistics) Act 2019

 

Clause 2: Commencement

 

2.                   Clause 2 provides for the commencement of this Act. The provisions of this Act commence the day after it receives the Royal Assent.

 

Clause 3 - Schedules

 

3.                   Clause 3 provides that each Act specified in a Schedule to this Act is amended or repealed as is set out in the applicable items in the Schedule. Any other item in a Schedule to this Act has effect according to its terms.

 

Schedule 1— Amendments

 

4.                   Schedule 1 amends the Australian Institute of Health and Welfare Act 1987.

 

Item 1 - Section 3 (before the definition of Board)

 

5.                   This item inserts definitions of accredited ART centre and assisted reproductive treatment .

 

Item 2 - Paragraph 5(1)(c)

 

6.                   This item inserts a new obligation on the AIHW to publish statistical information received from accredited ART centres.

Item 3 - After Part II

 

7.                   This item inserts a new part, Part IIA, under which the chief executive of each accredited ART centre is required to report the ART centre's treatment and performance statistics to the AIHW within two months after the end of the financial year. The chief executive is the person who is primarily responsible for the management of the centre.

 

8.                   New section 19A requires the chief executive of an accredited ART centre to report its statistics to the AIHW, including the number of women who underwent assisted reproductive treatments at that ART centre in the financial year, the treatments each woman received, the age of each woman, the number of resulting clinical pregnancies and the number of resulting live births.

 

9.                   The penalty for not complying with this section is 100 penalty units.

 

10.               Under this new part, the AIHW is also required to publish this data. Section 19B requires the AIHW to publish the data for each ART centre as soon as practicable after receiving it, online as a database or in another manner it chooses. Under this provision, the AIHW is also required to publish the names of ART clinics which do not comply with 19A.

 

Item 4 - Application provision

 

11.               This item stipulates that the obligations outlined in section 19A apply from the financial year commencing on 1 July 2019.

 

Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

 

Australian Institute of Health and Welfare Amendment (Assisted Reproductive Treatment Statistics) Bill 2019

 

This Bill is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011 .

 

Overview of the Bill

This Bill requires each accredited assisted reproduction technology (ART) centre to disclose its annual performance statistics to the Australian Institute of Health and Welfare (AIHW) and for the AIHW to publish this data.

The aim of the Bill is to provide consumers of fertility services, both men and women, with access to success rates and other information for each fertility clinic, to allow them to make an informed choice about their prospective treatment facility.

 

Human rights implications

This Bill does not directly engage any of the applicable rights or freedoms to which Australia is a signatory.

However, Article 10(1) of the International Covenant on Economic, Social and Cultural Rights recognises that the widest possible protection and assistance should be accorded to the family and particularly for its establishment, and this Bill aims to assist infertile couples and women to create a family by assisting them to make a more informed choice for their infertility treatment.

 

Conclusion

This Bill is compatible with human rights as it does not raise any human rights issues.

 

Senator Griff