Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Hansard source

I present a supplementary explanatory memorandum to the bill, and I ask leave of the House to move government amendments (1) to (29) together.

Leave granted.

I move:

(1) Schedule 1, item 15, page 5 (line 25), omit "For the purposes of paragraph (b), body includes a part of a body.", substitute "If a body is established by or under a law of a State, the Australian Capital Territory or the Northern Territory, the Minister must not specify the body in an instrument under paragraph (b) without the written agreement of the State/Territory Health Minister of the State or Territory, as the case may be. For the purposes of this definition (other than paragraph (a)), body includes a part of a body.".

(2) Schedule 1, item 29, page 8 (line 17), at the end of the definition of public hospital, add "If a facility is situated in a State, the Australian Capital Territory or the Northern Territory, the Minister must not specify the facility in such an instrument without the written agreement of the State/Territory Health Minister of the State or Territory, as the case may be.".

(3) Schedule 1, item 130, page 24 (after line 25), at the end of Part 3.1, add:

58A Role of State/Territory Health Ministers as health system managers

(1) The Parliament acknowledges the role of State/Territory Health Ministers as health system managers in relation to local hospital networks and public hospitals.

(2) The Parliament intends that the Performance Authority should, in performing a function that is relevant to:

  (a)   a local hospital network in a State, the Australian Capital Territory or the Northern Territory; or

  (b)   a public hospital in a State, the Australian Capital Territory or the Northern Territory;

have regard to the role of the State/Territory Health Minister of the State or Territory, as the case may be, as the health system manager in relation to local hospital networks and public hospitals.

(4) Schedule 1, item 130, page 25 (line 33), at the end of paragraph 60(1)(f), add "with the agreement of COAG".

(5) Schedule 1, item 130, page 26 (after line 7), after subsection 60(2), insert:

(2A)   Subparagraph (1)(a)(v) does not apply to a particular body or organisation unless:

  (a)   COAG has agreed that that subparagraph should apply to the body or organisation; or

  (b)   both:

     (i)   COAG has agreed that that subparagraph should apply to a class of bodies or organisations; and

     (ii)   the body or organisation is included in that class.

(2B)   COAG is to give its agreement for the purposes of paragraph (2A)(a) or subparagraph (2A)(b)(i) by a written resolution of COAG passed in accordance with the procedures determined by COAG.

(6) Schedule 1, item 130, page 26 (after line 15), after subsection 60(3), insert:

(3A)   COAG is to give its agreement for the purposes of paragraph (1)(f) by a written resolution of COAG passed in accordance with the procedures determined by COAG.

(7) Schedule 1, item 130, page 27 (lines 5 to 23), omit section 62, substitute:

62 Additional provisions about reports

Scope

(1) This section applies to a report prepared by the Performance Authority under paragraph 60(1)(a) if the report indicates poor performance by any of the following entities or facilities:

  (a)   a local hospital network;

  (b)   a public hospital;

  (c)   a private hospital;

  (d)   a primary health care organisation;

  (e)   any other body or organisation that provides health care services.

Objects

(2) The primary object of this section is to assist State/Territory Health Ministers in carrying out their role as health system managers in relation to local hospital networks and public hospitals.

(3) The secondary object of this section is to authorise appropriate consultation in relation to the preparation of the report.

Local hospital networks and public hospitals—consultation with State/Territory Health Ministers

(4) If the report indicates poor performance by:

  (a)   a local hospital network in a State, the Australian Capital Territory or the Northern Territory; or

  (b)   a public hospital in a State, the Australian Capital Territory or the Northern Territory;

then, before completing the preparation of the report, the Performance Authority must:

  (c)   give a copy of a draft of the report to the State/Territory Health Minister of the State or Territory, as the case may be; and

  (d)   invite the State/Territory Health Minister to give the Performance Authority written comments about the draft report within 30 days after receiving the draft report; and

  (e)   have regard to any comments given by the State/Territory Health Minister within the 30-day period mentioned in paragraph (d).

(5) If the Performance Authority gives a copy of a draft of the report to a State/Territory Health Minister under subsection (4), then, before completing the preparation of the report, the Performance Authority must:

  (a)   give a copy of the final draft of the report to the State/Territory Health Minister (even if the final draft is the same as the draft given under subsection (4)); and

  (b)   invite the State/Territory Health Minister to give the Performance Authority written comments about the final draft within 15 days after receiving the final draft; and

  (c)   have regard to any comments given by the State/Territory Health Minister within the 15-day period mentioned in paragraph (b).

Local hospital networks and public hospitals—final draft to be given to manager of entity or facility on an "information-only" basis

(6) If the report indicates poor performance by:

  (a)   a local hospital network in a State, the Australian Capital Territory or the Northern Territory; or

  (b)   a public hospital in a State, the Australian Capital Territory or the Northern Territory;

then, at least 15 days before completing the preparation of the report, the Performance Authority must give a copy of the final draft of the report to the manager of the network or hospital. The manager of the network or hospital is not entitled to give the Performance Authority any comments about the final draft.

Consultation—general

(7) Before completing the preparation of the report, the Performance Authority may consult such persons and bodies as it considers appropriate.

(8) However, if the report indicates poor performance by:

  (a)   a local hospital network in a State, the Australian Capital Territory or the Northern Territory; or

  (b)   a public hospital in a State, the Australian Capital Territory or the Northern Territory;

the Performance Authority must not consult, and is not otherwise obliged to observe any requirements of procedural fairness in relation to:

  (c)   in the case of a local hospital network:

     (i)   the manager of the network; or

     (ii)   an employee of the network; or

     (iii)   the manager of a facility that belongs to the network; or

     (iv)   an employee of a facility that belongs to the network; or

     (v)   any other person who provides services in a facility that belongs to the network; or

  (d)   in the case of a public hospital:

     (i)   the manager of the hospital; or

     (ii)   an employee of the hospital; or

     (iii)   any other person who provides services in the hospital.

(8)   Schedule 1, item 130, page 29 (after line 24), after section 66, insert:

66A Policy principles—COAG

(1) COAG may give written policy principles to the Performance Authority about the performance of the Performance Authority's functions.

Note:   For variation and revocation, see subsection 33(3) of the Acts Interpretation Act 1901.

(2) The policy principles are to be given in accordance with a written resolution of COAG passed in accordance with the procedures determined by COAG.

(3) The Performance Authority must publish a copy of the policy principles on its website.

(4) The Performance Authority must not perform its functions in a manner that is inconsistent with the policy principles (if any).

(5) The policy principles are not legislative instruments.

(9)   Schedule 1, item 130, page 38 (line 30), omit "Minister.", substitute "Minister; or".

(10)   Schedule 1, item 130, page 38 (after line 30), at the end of subsection 90(3), add:

  (c)   a function or power under Part 3.7.

(11)   Schedule 1, item 130, page 39 (line 21), omit "Minister", substitute "Performance Authority".

(12)   Schedule 1, item 130, page 39 (line 24), omit "Minister must consult the Performance Authority", substitute "Performance Authority must consult the Minister".

(13)   Schedule 1, item 130, page 40 (line 4), omit "Minister", substitute "Performance Authority".

(14)   Schedule 1, item 130, page 40 (line 28), omit "Minister", substitute "Performance Authority".

(15)   Schedule 1, item 130, page 41 (line 10), omit "Minister", substitute "Performance Authority".

(16)   Schedule 1, item 130, page 41 (line 12), omit "Minister determines", substitute "Performance Authority determines with the written agreement of the Minister".

(17)   Schedule 1, item 130, page 41 (line 21), omit "Minister", substitute "Performance Authority".

(18)   Schedule 1, item 130, page 41 (line 23), omit "Minister", substitute "Performance Authority".

(19)   Schedule 1, item 130, page 41 (lines 25 and 26), omit "Minister must notify the Performance Authority", substitute "Performance Authority must notify the Minister".

(20)   Schedule 1, item 130, page 41 (line 28), omit "Minister", substitute "Performance Authority".

(21)   Schedule 1, item 130, page 41 (after line 29), after subsection 100(1), insert:

(1A)   The Performance Authority may terminate the appointment of the Performance Authority CEO if the Performance Authority is satisfied that the Performance Authority CEO's performance has been unsatisfactory.

(22)   Schedule 1, item 130, page 42 (line 1), omit "Minister", substitute "Performance Authority".

(23)   Schedule 1, item 130, page 42 (line 16), omit "Minister", substitute "Performance Authority".

(24)   Schedule 1, item 130, page 42 (line 19), omit "Minister must consult the Performance Authority", substitute "Performance Authority must consult the Minister".

(25)   Schedule 1, item 130, page 42 (line 23), omit "determined by the Minister", substitute "determined by the Performance Authority with the written agreement of the Minister".

(26)   Schedule 1, item 130, page 47 (after line 11), after subsection 112(3), insert:

(3A)   Before completing the preparation of the plan, the Performance Authority must:

  (a)   give a copy of a draft of the plan to each State/Territory Health Minister; and

  (b)   invite the State/Territory Health Minister to give the Performance Authority written comments about the draft plan within 30 days after receiving the draft plan; and

  (c)   have regard to any comments given by the State/Territory Health Minister within the 30-day period mentioned in paragraph (b).

(27)   Schedule 1, item 130, page 49 (after line 24), after section 116, insert:

116A Disclosure to a State/Territory Health Minister

     An official of the Performance Authority may disclose protected Performance Authority information to a State/Territory Health Minister.

(28)   Schedule 1, item 130, page 49 (lines 25 to 27), omit section 117.

(29)   Schedule 1, item 132, page 55 (lines 15 to 28), omit the item, substitute:

132 Appointment of acting Performance Authority CEO

(1) The Minister may, before the end of the 6-month period beginning at the commencement of this item, appoint a person to act as the Performance Authority CEO during a vacancy in the office of the Performance Authority CEO, so long as no appointment has previously been made to the office.

(2) An appointment under subitem (1) is to be made by written instrument.

(3) Anything done by or in relation to a person purporting to act under an appointment under subitem (1) is not invalid merely because:

  (a)   the occasion for the appointment had not arisen; or

  (b)   there was a defect or irregularity in connection with the appointment; or

  (c)   the appointment had ceased to have effect; or

  (d)   the occasion to act had not arisen or had ceased.

Note:   For more about acting appointments, see sections 20 and 33A of the Acts Interpretation Act 1901.

(4) If a person is acting as the Performance Authority CEO in accordance with an appointment under subitem (1), the Performance Authority must not appoint anyone, under subsection 94(1) of the National Health Reform Act 2011, to act as the Performance Authority CEO.

(5) If, immediately before the end of the 6-month period beginning at the commencement of this item, a person is acting as the Performance Authority CEO in accordance with an appointment under subitem (1), the appointment is terminated at the end of that 6-month period.

(6) Subitem (5) does not prevent the person from being appointed by the Performance Authority, under subsection 94(1) of the National Health Reform Act 2011, to act as the Performance Authority CEO after the end of that 6-month period.

As mentioned in my summing-up speech, these amendments take into account the resolution of a meeting of health ministers that was held on 7 June which supported in principle this legislation with these amendments. It is very important to note that these amendments give the National Health Performance Authority the power to appoint and dismiss its own CEO; set mechanisms for notification of poor performance to states and territories, local hospital networks and hospitals; deal with the definition of public hospitals and local hospital networks; consult the states on the strategic plan; allow for disclosure of information to state ministers; and deal with the act's functions.

It is not right, as the member for Lyne and on occasions the opposition have put it, that these changes give the states power to do what they want in hospitals. Nothing could be further from the truth. This bill, with these amendments, will introduce the most rigorous performance measures that have ever existed in Australia's history for our hospital system. That is of course why the states fought hard to make sure that the detail was practical. As systems managers of our hospital system, they would be aware of and responsible for the fixing of problems within our hospital system—something I would think all members would be keen to support.

These amendments have, by the nature of the process for getting agreement through a COAG arrangement, been subject to extensive consultation with my state and territory colleagues. They also address issues that were raised through the Senate Community Affairs Legislation Committee hearing. These amendments will ensure that the act has the support and cooperation of state governments so that the authority can properly undertake its role as a watchdog of public hospital, local hospital network, private hospital and Medicare Locals performance.

By addressing these amendments we will achieve what has long been wished for in the Australian health system: independent, hospital-by-hospital reporting of performance. I cannot think of anything that is a better indicator of how we will improve performance year after year after year than making sure that we have an independent system which assesses the performance of each hospital and allows us to make sure that those that are underperforming improve and those that are doing well can be copied around the country. I am very proud of these amendments and the bill as a whole. I think it is a historic part of our agreement, and I think the view that the states and territories might occasionally like to have put in the media that they had a big win on this just is not supported by the evidence of what is in this bill and these amendments. I commend these amendments to the House.

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