Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

I'd like to congratulate the Minister for Health and Aged Care, the Hon. Mark Butler, for bringing the Health Insurance Amendment (Professional Services Review Scheme No. 2) Bill 2023 to the parliament. It's great to be here with Ged Kearney, the Assistant Minister for Health and Aged Care, because, even though this may seem to be a relatively routine piece of legislation, it is in fact a very important one. It's important for me, as a paediatrician now of over 40 years standing, that, as a profession, health practitioners are seen to be above board and seen to be practising to the best of their ability and providing quality health care to all Australians.

The Professional Services Review scheme is one that, for many years, has been left languishing, and there have often been calls by many people for it to be reviewed. Recently we've had concerns raised about Medicare fraud. The previous head of the Medicare review committee Dr Tony Webber, who's an old friend of mine, raised these concerns publicly, as have other previous members of the Medicare review committee, such as Professor Julie Quinlivan. So this is an issue that all medical practitioners view as very, very important. It's important that we are seen to be practising to the best of our ability and honestly to provide quality health care to all Australians.

Thankfully I have practised as a paediatrician for that period of time without ever being called before the Professional Services Review committee, and I certainly hope that continues. I know that the vast majority of my colleagues in all sections of medicine—from general practice to surgeons, physicians, paediatricians, like me, and obstetricians—do the best they can to provide quality care to Australians. But they also want to know that those few rogue practitioners are held to account, and this legislation will help do that. This healthcare insurance amendment amends the Health Insurance Act to improve the operation of the Professional Services Review scheme, and it has the support of the entire profession. I can tell you that. The AMA, which has always been seen as a very conservative organisation—in fact it's seen as probably the strongest trade union in the country, and I'm pleased to see there's another AMA member sitting opposite—are often seen to be protecting doctors' rights, but, on this occasion, I know they support this legislation, and that has been a really important thing.

The bill aligns requirements for qualifications of the PSR committee members to the definition of inappropriate practice in the act and clarifies how these requirements should be applied. It ensures that committees can be established for a practitioner with a combination of specialties even if there may be few exact peers in Australia for the practitioner who's been called to be reviewed. The bill also clarifies requirements for a person under review notifying the committee that they are unable to attend a hearing for a medical reason or for other important reasons, including that they must provide proof of that. It also provides clarification that reference to a particular practitioner can include former practitioners who may already be suspended from practice to ensure that adequate measures are put in place to prevent that practitioner from causing more harm to a person or persons.

It's not a bill that's going to cost a lot of money and it's not a bill that will cause more frequent reviews of medical practitioners. But I do know that it will be a bill that can be used to adequately assess a practitioner who may have a range of impairments or a practitioner who may be practising inappropriately. It may be able to be used to call for a review of a practitioner who may be operating fraudulently. We have seen some evidence of that in the past, and this is a very important bill that will make sure that the public understands that our government is doing the very best it can to make sure that anyone who practises in the medical field, seeing patients, is able to be seen as being well qualified and practising appropriately under the act. That is very important for all of us. When a health practitioner is held to be practising inappropriately or fraudulently, it affects all in the profession. I know, as a still-practising doctor, it is very important to me that those in my profession are seen to be practising appropriately and that I am not tainted by people who are behaving inappropriately.

As practitioners, we now deal with very large sums of money through our practices. Some specialty practitioners may have practices generating bills in the millions of dollars. That is important that that is public money, public funds, and it needs to be seen that it's being dealt with properly and earned in an appropriate manner: providing high-quality health care around Australia. I'm very glad the minister has brought this bill to the parliament. We have a health minister and a health group, if I can say that, in this parliament who are committed to making sure that we provide high-quality care around Australia and that it's seen by all Australians as being appropriate and above board. We know that sometimes it is difficult to hold practitioners to account for wrongdoing, and this bill will help simplify that and make people very confident that our health practitioners maintain high-quality, some of the best-quality, medicine around the world. I've certainly seen this from every area of Australia that I've travelled. We are very lucky with the health practitioners that we have.

This bill is mainly administrative, but it is an important one—not only making sure that our practitioners are aware of the need to practice appropriately and provide high-quality care but also assuring the general public that, when they do see a health practitioner, they are able to know that that practitioner has mechanisms in place and that he can be held accountable for inappropriate practice. It will clarify the requirements for the person under review about the need to appear, how he must appear and the fact that he will be able to be appropriately represented and will be seen by his peers. It's one of the many approaches to our healthcare system done by the present health minister that are innovative and are looking to change and prepare our health system for the 21st century, and I congratulate him for this. I recommend the bill to the House and I'm glad to have been able to speak on it.

Ged Kearney (Cooper, Australian Labor Party, Assistant Minister for Health and Aged Care) Share this | Link to this | Hansard source

I'd like to start by thanking the member for Macarthur for his positive words about the Health Insurance Amendment (Professional Services Review Scheme No. 2) Bill 2023, and we really do appreciate the work he does in this House.

Australia's universal healthcare system, Medicare, provides free and subsidised access for all Australians to most healthcare services. The government is committed to strengthening Medicare by improving the compliance framework that ensures the integrity of Medicare. This bill builds on the Health Insurance Amendment (Professional Services Review Scheme) Act 2023, which implemented priority amendments in response to the independent review of Medicare integrity and compliance undertaken by Dr Pradeep Philip, known as the Philip review. The Philip review was commissioned by the government in November 2023 to respond to concerns about the operation of the Medicare system. The Philip review recommended a comprehensive review of legislation relating to Medicare to ensure it is fit for purpose.

The bill will strengthen the operation of the Professional Services Review, known as the PSR, which will protect the integrity of Medicare. The PSR is an independent agency established under the Health Insurance Act 1973 and is responsible for protecting the integrity of the Medicare program by investigating whether a person has engaged in inappropriate practice. The investigation occurs by review undertaken by the director or by committees made up of health professional peers of the person under review.

This bill will align requirements for qualifications of committee members with the definition of inappropriate practice and will clarify how these requirements should be applied. This will ensure that committees can be properly established for a practitioner with an unusual combination of specialties or where the practitioner is providing services in a different field from their formal specialist qualifications.

The bill will also make several other amendments to clarify and improve administration of the PSR scheme. Reducing ambiguity will ensure that a person under review is aware of how the PSR scheme should apply, as well as enable the PSR to perform its role more effectively. The PSR must be able to work efficiently to achieve its objective to protect patients, the community and the Commonwealth from the risks and costs of inappropriate practice. This is essential to ensure that Commonwealth resources are directed to necessary health services and to ensure that Medicare remains sustainable. By supporting the integrity of Medicare, this bill will ultimately benefit all Australians. I thank all the members for their contributions to debate on the bill.

Question agreed to.

Bill read a second time.

Ordered that this bill be reported to the House without amendment.