Nola Marino (Forrest, Liberal Party) Share this | Hansard source

I rise to speak on the Health Insurance Amendment (Diagnostic Imaging Accreditation) Bill 2009, which aims to broaden the accreditation scheme for diagnostic imaging to cover all diagnostic imaging services. This legislation will amend previous health insurance amendment acts to establish the Diagnostic Imaging Accreditation Scheme, which requires radiology services to seek accreditation. This bill, when passed, will require practices providing non-radiology services or a combination of radiology and non-radiology services, which are not currently covered by the scheme, to obtain accreditation and will provide the relevant enabling transitional arrangements.

Whilst the coalition do not oppose this legislation, we do seek assurance that an evaluation will be carried out to ensure the scheme is working reasonably without an onerous cost burden being passed on to consumers. Given the importance and cost of health services, particularly in regional areas such as my electorate of Forrest—which, as you would know, Mr Deputy Speaker Schultz, is one of the three fastest growing regions in Australia and has a significant amount of seniors—this evaluation and review process is extremely important. I call on the government to commit to an evaluation process and timetable.

This legislation has been and continues to be a work in progress. Historically, management of diagnostic imaging services was undertaken by the Department of Health and Ageing cooperatively with the diagnostic imaging sector. This management was carried out through a number of agreements known as ‘quality and outlays memoranda of understanding’. In 2007 the coalition introduced legislation to initiate an accreditation scheme for radiology, which accounts for 80 per cent of diagnostic services covered by Medicare. That accreditation scheme began on 1 July 2008, at the time when the MOUs expired. The legislation established an accreditation framework for most diagnostic imaging premises and the basis for mobile imaging equipment to make sure that organisations met defined quality and safety standards in the delivery of their services.

The Diagnostic Imaging Accreditation Scheme is being implemented in two stages. Stage 1 establishes the framework and operational arrangements for the scheme and is due to expire on 30 June 2010, when stage 2 is due to commence. The transitional accreditation process proposed by this bill is broadly similar to that introduced under stage 1 of the scheme in that it involves two main steps. The proposed transitional arrangements would apply to providers of non-radiology diagnostic imaging services in the following ways. First, they establish a three-month registration period from 1 April 2010, during which time a practice can lodge a notice with an approved accreditor for a premises to be registered for ‘deemed accreditation’. Second, deemed accreditation would cease on 1 July 2011. A practice with deemed accreditation will have 12 months to achieve accreditation either by demonstrating compliance with three entry-level standards or the full suite of 15 standards or by obtaining accreditation under the Medical Imaging Accreditation Program. Under this legislation, a practice that fails to obtain accreditation by 1 July 2011 will no longer be eligible to render Medicare rebatable diagnostic imaging services.

As we are aware, ‘diagnostic imaging’ refers to a broad range of technologies that allow medical professionals to diagnose a wide range of medical conditions—a very important process. Through consultation with stakeholders, some concerns were raised about the suitability of a single accreditation model across a diverse range of medical practices, and also about the potential for duplication, costs and administrative burdens. However, I note that stakeholders—and that includes the Australian Medical Association, the Royal Australian and New Zealand College of Radiologists and the Australian Diagnostic Imaging Association—in general have not voiced any major concerns with this legislation and accept the scheme. Some have even stated that its extension was an ‘expected development’ and part of a ‘many staged process’, in their words.

The costs of participating in the scheme and becoming accredited will be met by the practices that provide non-radiology services under Medicare. The explanatory memorandum for this bill contains information regarding some of the costs that practices will incur by participating in the scheme, as derived from the business cost calculator. The calculator estimates the likely administrative cost to practices in lodging the registration forms. These are expected to vary depending on the type of labour resources used by the practice to lodge the registration form. Practices using administrative staff to lodge the forms would face the lowest cost burden, of approximately $47, whereas those using technical staff would face a cost of around $84. Practices using a diagnostic imaging specialist to submit the form would face the highest cost, estimated at around $600. It should be noted that the cost of any lodgement fees levied by accreditors is not included in the cost calculator estimates.

One of my constituents currently works for an independent diagnostic imaging network that provides general radiography, computed tomography, ultrasound, MRI and nuclear medicine services—a practice that employs nearly 100 full-time equivalent workers throughout a network of clinical bases in regional and remote Western Australia. We asked this particular constituent about this legislation and this is what he had to say:

Although this legislation will increase the cost for practices to achieve the required standard, I believe all Australian radiology practices should already be operating at this level.

Patients should be able to walk into a practice and be confident that it uses high quality imaging equipment, adequate sterilisation process and a comprehensive method of reporting.

That is a view I imagine is shared by the many patients who undergo diagnostic imaging, whether it be an X-ray, CT scan, MRI or ultrasound to name just a few procedures. There is a continuing need for innovative health care providers who are focused on delivering services to patients irrespective of their location, something that in Western Australia is particularly important, given the size of the state, providing not only innovative health care services but also services that provide exceptional care, communication and support. Referring doctors also need to have absolute confidence in the services provided by such diagnostic providers.

In conclusion, the coalition does not oppose this legislation, which has been labelled as an ‘expected’ development. However, we certainly seek assurances that an evaluation will be carried out to ensure the scheme is working reasonably without an additional onerous cost burden being passed on to consumers.

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