Wednesday, 16 October 2019
Medical and Midwife Indemnity Legislation Amendment Bill 2019; Second Reading
I thank all members for their contributions to the debate on the Medical and Midwife Indemnity Legislation Amendment Bill 2019. This bill amends the Medical Indemnity Act 2002 and related legislation to reduce and simplify the legislation underpinning the medical indemnity schemes through consolidation and repeal of redundant legislation. The new legislation will continue to ensure medical indemnity insurance products are both available to and affordable for medical and allied health practitioners. Improvements have been made to the provision of universal cover for doctors who may otherwise be uninsurable. While there is a risk that poor performing doctors benefit from universal cover, the reason it exists is to protect doctors with a significant claims history from being denied cover where the claims history relates to their specialty, location or patient cohort. The risk is mitigated by increasing the risk loading which insurers can apply, and by enabling insurers to refuse cover in exceptional circumstances.
Only four of the six participating insurers have a contract with the Commonwealth. The effect of this has been that the two insurers outside of these contractual arrangements cannot be compelled to provide cover, and there is no mechanism to enforce universal cover. The effect of the contractual arrangements has therefore been unevenly distributed. Insurers will continue to be able to impose risk-management conditions on high-risk doctors and to refuse insurance in exceptional circumstances. These new arrangements will reduce administrative requirements and insurers will no longer need to contract with the Commonwealth, removing inequities between contracted and non-contracted parties. This will reduce burdensome and duplicate reporting and ensure there is an equitable and open medical indemnity insurance market.
The government will also be maintaining support for high-cost claims and exceptional claims made in respect of health practitioners who are insured by insurers presently participating in the schemes. These practitioners will need to be practising in professions accredited by the Australian Health Practitioner Regulation Authority. For allied health professions, included employed, privately practising midwives, the government will be establishing separate schemes for high-cost claims and exceptional claims. The allied health schemes will mirror the existing high-cost claims and exceptional claims schemes to include midwives and close an inequitable gap. This means that all registered midwives not covered under the midwife professional indemnity Commonwealth contribution scheme are covered under the allied health high-cost claims scheme. Claims made under these schemes will apply regardless of whether they are made against a practitioner covered by an insurance contract between the individual practitioner and insurer or by an insurance contract between the practitioner's employer and insurer. However, the claim must be against the individual practitioner. The amendments in the bill will ensure parity arrangements for doctors, allied health practitioners and midwives.
In summary, these legislative changes support the recommendations of both the first principles and thematic reviews, while addressing recommendations made by the Australian National Audit Office. The government will continue to ensure improvements are made in the monitoring of the performance of the Indemnity Insurance Fund against its objectives through the delivery of the independent actuarial evaluation, to be tabled in parliament in 2021. I commend the bill to the House.