Monday, 22 February 2010
Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2009
The Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2009 seeks to broaden the existing accreditation scheme for diagnostic imaging to cover practices offering non-radiological procedures. Radiology services were required by earlier legislation to seek accreditation from July 2008. Diagnostic imaging is an expanding sector of health care and an important means of detecting and aiding the treatment of many health conditions. Differing imaging techniques are being used by a widening range of health practitioner groups in an array of settings. Around two-thirds of services are provided by private practices, with the remainder carried out in public hospitals. It is estimated that approximately 70 per cent of services are funded by Medicare. That amounts to several billion dollars of expenditure annually for around 20 million diagnostic imaging services.
Accreditation ensures that organisations meet defined safety and quality standards in the delivery of services. It allows for a process of external review of an organisation’s performance. It is recognised as a way of assisting the healthcare industry to improve systems to support the delivery of safe and high-quality health care through a continuous improvement process. It provides a mechanism through which government can be assured that services supported by Medicare are being provided by organisations that are performing against those standards. Accreditation schemes are widely accepted through the health sector as a method of reviewing and improving healthcare arrangements.
The coalition introduced legislation in 2007, the Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2007, to amend the Health Insurance Act 1973 to establish the Diagnostic Imaging Accreditation Scheme. This scheme covered the providers of radiology services who were required to seek accreditation under a process begun in July 2008. At the time, the then health minister, Tony Abbott, foresaw that accreditation would eventually be extended to other diagnostic imaging procedures, and the legislation was designed to allow for the introduction of accreditation schemes for other diagnostic imaging services. The current government has decided to proceed with further legislation, and this bill will amend that 2007 legislation.
This bill will extend the reach of the accreditation scheme to all diagnostic imaging services provided to the Australian community. The initial stage of accreditation covered 2,700 practices providing radiology services which accounted for 80 per cent of diagnostic services covered by Medicare. This extension will bring another 1,400 or so practices under the scheme—those that provide non-radiology services such as obstetric and gynaecological ultrasound, cardiac ultrasound, angiography and nuclear medicine imaging. These practices account for another 16 per cent of imaging services covered by Medicare payments.
The extension coincides with the commencement of stage 2 of the Diagnostic Imaging Accreditation Scheme from July this year, although arrangements for stage 2 are yet to be finalised. This bill does not set out the arrangements that will apply under stage 2 of the scheme; rather it proposes transitional accreditation arrangements for those practices not encompassed by stage 1 of the scheme. The transitional arrangements proposed here are broadly similar to those adopted previously, although in this instance the time frames are shorter. Practices and practitioners providing non-radiology diagnostic imaging services will have three months, from April until the end of June, for their premises or mobile base to seek deemed accreditation and then a 12-month period, from July until the end of June in 2011, to obtain accreditation by demonstrating their compliance with accepted standards.
Stakeholder groups generally were accepting of the initial scheme and also of this move to widen accreditation across the diagnostic imaging sector. In general, they have not voiced major concerns and accept the scheme and its extension as an expected development and part of an ongoing, staged process. Through consultation processes, concerns that have been raised include the suitability of a single accreditation model across a diverse range of medical practices and worries about duplication, costs and administrative burdens. Departmental information has suggested the costs for accreditation would not be overly onerous. However, the government must take note of these concerns and maintain ongoing consultations with all stakeholders on these issues as they develop the accreditation process, particularly as many of the stakeholders captured under this bill are private specialist practices.
I note that the Minister for Health and Ageing has assured the House that the Department of Health and Ageing has consulted comprehensively with the health professions and industry and that the government will keep the burden of compliance to a minimum. The opposition seeks an assurance from the minister that, as the accreditation scheme moves into stage 2, an evaluation will be carried out to ensure that it is working reasonably and without onerous costs on providers—with a flow-on effect to consumers—and that the minister will make that evaluation available to the parliament.