House debates

Thursday, 24 June 2010

Healthcare Identifiers Bill 2010

Consideration of Senate Message

Bill returned from the Senate with amendments.

Ordered that the amendments be considered immediately.

Senate’s amendments—

(1)    Clause 5, page 2 (line 17) to page 5 (line 6), insert:

Healthcare Provider Directory has the meaning given by subsection 31(1).

healthcare provider organisation means an entity, or a part of an entity, that has conducted, conducts, or will conduct, an enterprise that provides healthcare (including healthcare provided free of charge).

Example:               A public hospital, or a corporation that runs a medical centre.

individual healthcare provider means an individual who:

             (a)    has provided, provides, or is to provide, healthcare; or

             (b)    is registered by a registration authority as a member of a particular health profession.

network organisation has the meaning given by subsection 9A(6).

organisation maintenance officer:

             (a)    for a seed organisation—has the meaning given by paragraph 9A(3)(c); and

             (b)    for a network organisation—has the meaning given by paragraph 9A(6)(b).

professional association means an organisation that:

             (a)    is a separate legal entity under a law of the Commonwealth or a State or Territory; and

             (b)    has the following characteristics:

                   (i)    its members practise the same healthcare profession;

                  (ii)    it has enough membership to be considered representative of the healthcare profession practised by its members;

                 (iii)    it sets its own admission requirements, including acceptable qualifications;

                 (iv)    it sets and publishes standards of practice and ethical conduct;

                  (v)    it aims to maintain the standing of the healthcare profession practised by its members;

                 (vi)    it has written rules, articles of association, by-laws or codes of conduct for its members;

                (vii)    it has the ability to impose sanctions on members who contravene the association’s written rules, articles of association, by-laws or codes of conduct;

               (viii)    it sets requirements to maintain its members’ professional skills and knowledge by continuing professional development; and

             (c)    has members who:

                   (i)    may take part in decisions affecting their profession; and

                  (ii)    have the right to vote at meetings of the association; and

                 (iii)    have the right to be recognised as being members of the professional association.

responsible officer has the meaning given by paragraph 9A(3)(b).

retirement, for a healthcare provider organisation’s healthcare identifier, means a state imposed by the service operator on the healthcare identifier so that it may no longer be used by the healthcare provider organisation to identify the healthcare provider organisation.

seed organisation has the meaning given by subsections 9A(3) and (4).

sole practitioner means a person who is both an individual healthcare provider and a healthcare provider organisation.

(2)    Clause 5, page 2 (before line 19), before the definition of data source, insert:

contracted service provider, of a healthcare provider, means an entity that provides:

             (a)    information technology services relating to the communication of health information; or

             (b)    health information management services;

to the healthcare provider under a contract with the healthcare provider.

(3)    Clause 5, page 2 (after line 23), after the definition of date of death accuracy indicator, insert:

Defence Department means the Department that:

             (a)    deals with matters arising under section 1 of the Defence Act 1903; and

             (b)    is administered by the Minister who administers that section.

(4)    Clause 5, page 3 (lines 9 to 17), omit the definition of healthcare provider, substitute:

healthcare provider means:

             (a)    an individual healthcare provider; or

             (b)    a healthcare provider organisation.

(5)    Clause 5, page 4 (line 27), omit the definition of service operator, substitute:

service operator means the Chief Executive Officer of Medicare Australia.

(6)    Clause 5, page 4 (after line 29), after the definition of State or Territory authority, insert:

under this Act includes under the regulations.

(7)    Clause 6, page 5 (lines 7 to 12), omit the clause.

(8)    Clause 9, page 7 (lines 6 and 7), omit “included in a class prescribed by the regulations for the purpose of this paragraph”, substitute “to whom section 9A applies”.

(9)    Clause 9, page 7 (lines 16 to 24), omit paragraphs (3)(a) and (b), substitute:

             (a)    an identifier that is assigned to an individual healthcare provider; and

             (b)    an identifier that is assigned to a healthcare provider organisation; and

(10)  Clause 9, page 7 (lines 26 to 28), omit all the words from and including “A healthcare provider” to and including “(for example, a sole practitioner)”, substitute “A sole practitioner”.

(11)  Clause 9, page 8 (lines 3 to 6), omit subclause (5).

(12)  Page 8 (after line 8), after clause 9, insert:

9A Classes of providers for the purposes of paragraph 9(1)(a)

Individual healthcare providers

        (1)    This section applies to an individual healthcare provider who is registered by a registration authority as a member of a health profession.

     (2)   This section also applies to an individual healthcare provider who is a member of a professional association that:

             (a)    relates to the healthcare that has been, is, or is to be, provided by the member; and

             (b)    has uniform national membership requirements, whether or not in legislation.

Healthcare provider organisations

        (3)    This section also applies to a healthcare provider organisation (a seed organisation ) that has:

             (a)    an employee who:

                   (i)    is an identified healthcare provider; and

                  (ii)    provides healthcare as part of his or her duties; and

             (b)    only one employee (the responsible officer) to act on behalf of the seed organisation in its dealings with the service operator in relation to the following:

                   (i)    nominating to the service operator at least one employee to be an organisation maintenance officer for the seed organisation;

                  (ii)    nominating to the service operator any network organisation of the seed organisation for which the nominated organisation maintenance officer is to be responsible;

                 (iii)    requesting the assignment or retirement of a healthcare identifier for the seed organisation;

                 (iv)    requesting the merger or reconfiguration of a healthcare identifier for the seed organisation if the seed organisation was part of a merger or acquisition; and

Example:     A request after merger activity between 2 healthcare provider organisations if one is a seed organisation, or the acquisition of one healthcare provider organisation by another if one is a seed organisation.

             (c)    an employee (an organisation maintenance officer) to act on behalf of the seed organisation in its dealings with the service operator, including:

                   (i)    nominating to the service operator, if required, at least one additional employee to be an organisation maintenance officer for the seed organisation or any network organisation of the seed organisation; and

                  (ii)    nominating to the service operator any network organisation of the seed organisation for which an additional organisation maintenance officer is to be responsible; and

                 (iii)    requesting the assignment or retirement of a healthcare identifier for any network organisation of the seed organisation; and

                 (iv)    maintaining information that is held by the service operator about the seed organisation, and about any network organisation of the seed organisation for which the organisation maintenance officer is responsible; and

                  (v)    for the seed organisation, or for any network organisation of the seed organisation for which the organisation maintenance officer is responsible, that has consented to its details being included in the Healthcare Provider Directory—providing current details to the service operator about the organisation for inclusion in the Directory; and

                 (vi)    providing any further information requested by the service operator about the seed organisation, or about any network organisation of the seed organisation for which the organisation maintenance officer is responsible; and

                (vii)    requesting the merger or reconfiguration of a healthcare identifier for any network organisation of the seed organisation, if the network organisation was part of a merger or acquisition.

Note:       More than one employee may be an organisation maintenance officer. An employee may be any or all of the following: the responsible officer, an organisation maintenance officer and an authorised employee (see section 17).

        (4)    A sole practitioner is taken to be a healthcare provider organisation to which subsection (3) applies if he or she provides healthcare and performs the roles of responsible officer and organisation maintenance officer.

        (5)    For the purposes of paragraph (3)(b), a delegate of the responsible officer, who is another employee of the seed organisation, is taken to be the responsible officer.

        (6)    This section also applies to a healthcare provider organisation (a network organisation) that:

             (a)    is part of, or subordinate to, a seed organisation that:

                   (i)    has been assigned a healthcare identifier that has not been retired; and

                  (ii)    does not object to the network organisation being a network organisation of the seed organisation; and

             (b)    has a person (an organisation maintenance officer) who complies with subsection (7) to act on behalf of the network organisation in its dealings with the service operator, including:

                   (i)    nominating to the service operator, if required, at least one additional employee to be an organisation maintenance officer for any network organisation of the seed organisation; and

                  (ii)    nominating to the service operator any network organisation of the seed organisation for which an additional organisation maintenance officer is to be responsible; and

                 (iii)    requesting the assignment or retirement of a healthcare identifier for any network organisation of the seed organisation; and

                 (iv)    maintaining information that is held by the service operator about any network organisation of the seed organisation for which the organisation maintenance officer is responsible; and

                  (v)    for any network organisation that the organisation maintenance officer is responsible for and that has consented to its details being included in the Healthcare Provider Directory—providing current details to the service operator about the organisation for inclusion in the Directory; and

                 (vi)    providing any further information requested by the service operator about any network organisation of the seed organisation for which the organisation maintenance officer is responsible; and

                (vii)    requesting the merger or reconfiguration of a healthcare identifier for any network organisation of the seed organisation, if the network organisation is part of a merger or acquisition.

Example:     A request after merger activity between the network organisation and another healthcare provider organisation, or the acquisition of one healthcare provider organisation by another if one is the network organisation.

        (7)    For the purposes of paragraph (6)(b), the person must be an employee of:

             (a)    the network organisation (the first network organisation); or

             (b)    the seed organisation of the first network organisation; or

             (c)    another network organisation that is:

                   (i)    linked to the seed organisation of the first network organisation; and

                  (ii)    hierarchically superior to the first network organisation.

(13)  Page 8, after proposed clause 9A, insert:

9B Information that may be requested before assigning healthcare identifiers

        (1)    The service operator may request an individual healthcare provider to provide the following information before assigning the healthcare provider a healthcare identifier:

             (a)    identifying information of the healthcare provider;

Note:       Identifying information is defined in section 7.

             (b)    information that shows that section 9A applies to the healthcare provider.

        (2)    The service operator may request a healthcare provider organisation to provide the following information before assigning the healthcare provider a healthcare identifier:

             (a)    identifying information of the healthcare provider;

Note:       Identifying information is defined in section 7.

             (b)    information that shows that section 9A applies to the healthcare provider;

             (c)    information identifying the healthcare provider’s responsible officer and organisation maintenance officer, including the person’s name, work address, work email address, work telephone number or work fax number.

        (3)    The healthcare provider must give the information in any form requested by the service operator.

Example:               A healthcare provider may be asked for original documentation, or for the information to be given in writing or in a statutory declaration.

        (4)    If the service operator is not satisfied by the information given, it does not have to assign a healthcare identifier to the healthcare provider.

(14)  Page 8, after proposed clause 9B, insert:

9C Review of decision not to assign a healthcare identifier

        (1)    This section applies to a decision by the service operator not to assign a healthcare identifier to a healthcare provider under paragraph 9(1)(a).

Note:   This section does not apply to a decision to assign a healthcare identifier to a healthcare recipient under paragraph 9(1)(b), or a decision by a national registration authority not to assign a healthcare identifier to an individual healthcare provider under subsection 9(2).

        (2)    The service operator must give written notice of the decision to a person whose interests are affected by the decision, including a statement:

             (a)    that the person may apply to the service operator to reconsider the decision; and

             (b)    of the person’s rights to seek review under subsection (8) of a reconsidered decision.

        (3)    A failure of the service operator to comply with subsection (2) does not affect the validity of the decision.

        (4)    A person whose interests are affected by the decision may, by written notice to the service operator within 28 days after receiving notice of the decision, ask the service operator to reconsider the decision.

        (5)    A request under subsection (4) must mention the reasons for making the request.

        (6)    The service operator must:

             (a)    reconsider the decision within 28 days after receiving the request; and

             (b)    give to the person who requested the reconsideration written notice of the result of the reconsideration and of the grounds for the result.

        (7)    The notice must include a statement that the person may apply to the Administrative Appeals Tribunal for review of the reconsideration.

        (8)    A person may apply to the Administrative Appeals Tribunal for a review of a decision of the service operator made under subsection (6).

(15)  Clause 12, page 9 (lines 23 and 24), omit paragraph (2)(c), substitute:

             (c)    the Defence Department.

(16)  Clause 17, page 12 (line 29), omit “section.”, substitute “section; or”.

(17)  Clause 17, page 12 (after line 29), at the end of subclause (1), add:

             (c)    a contracted service provider (the authorised service provider) of an identified healthcare provider, if that identified healthcare provider has, by notice to the service operator, authorised the contracted service provider to act on behalf of that identified healthcare provider under this section.

(18)  Clause 17, page 12 (line 30), omit “or authorised employee”, substitute “, authorised employee or authorised service provider”.

(19)  Clause 17, page 13 (after line 6), at the end of note 1, add:

            The authorisation extends to certain employees and contracted service providers of the healthcare provider: see section 36.

(20)  Clause 17, page 13 (line 9), at the end of note 2, add “The authorisation extends to certain employees and contracted service providers of the healthcare provider: see section 36.”.

(21)  Clause 31, page 21 (line 15), omit “section.”, substitute “section; or”.

(22)  Clause 31, page 21 (after line 15), at the end of subclause (2), add:

             (c)    a contracted service provider of an identified healthcare provider, if that identified healthcare provider has, by notice to the service operator, authorised the contracted service provider to act on behalf of that identified healthcare provider under this section.

(23)  Clause 35, page 23 (line 4), after “this Act”, insert “and the regulations”.

(24)  Clause 36, page 24 (lines 3 to 7), omit the clause, substitute:

36 Extent of authorisation

                 An authorisation under this Act to an entity (the first entity) for a particular purpose is an authorisation to:

             (a)    an individual who:

                   (i)    is an employee of the first entity; and

                  (ii)    whose duties involve implementing that purpose; or

             (b)    a contracted service provider of the first entity, if:

                   (i)    the first entity is a healthcare provider; and

                  (ii)    the duties of the contracted service provider under a contract with the healthcare provider involve implementing that purpose by providing information technology services relating to the communication of health information, or health information management services, to the healthcare provider; or

             (c)    an individual who:

                   (i)    is an employee of a contracted service provider to which paragraph (b) applies; and

                  (ii)    whose duties involve implementing that purpose as mentioned in that paragraph.

(25)  Clause 37, page 24 (line 18), after “this Act”, insert “or the regulations”.

(26)  Clause 37, page 24 (line 22), after “this Act”, insert “or the regulations”.

(27)  Clause 37, page 24 (line 26), after “this Act”, insert “and the regulations”.

8:26 pm

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

I move:

That the amendments be agreed to.

There are two pieces of legislation before the House, the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010. I want to make some very short comments that can cover both of them. Today is in fact a very big occasion for the provision of health services in Australia. Today, this parliament—this House and the Senate—is passing the very first piece of legislation required to build the e-health system into the future. It is a necessary foundation stone for us to be able to establish a national e-health record system for Australia. The amendments that were passed in the other place respond to concerns expressed in the minority report of the Senate Community Affairs Legislation Committee, including by moving a number of matters planned to be covered in the regulations into the legislation.

The government would like to thank the opposition and the minor parties for their support of this bill, which is an important step forward to improving the safety, quality and efficiency of health care in Australia. While it might seem very late on a very long day to be doing this, it does ensure that this can come into effect from 1 July—next week—as planned. Across the country, we, healthcare providers and others can get on with the job of building an e-health system for the future of this country. It is with great pride that I recommend the bill with these amendments and that it be agreed to.

8:27 pm

Photo of Andrew SouthcottAndrew Southcott (Boothby, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services, Health and Wellbeing) Share this | | Hansard source

On behalf of the opposition, I wish to say that we agree that the unique individual healthcare identifier is an important of the architecture for e-health. We are supportive of e-health for the efficiencies, the improvements in safety and the avoidance of duplication in clinical practice that it will bring. As the minister said, there was a Senate inquiry into this and there was a minority report. The opposition took up the concerns of the coalition senators raised in the minority report and drafted eight amendments. The concerns raised in six of those amendments were taken up by government amendments. There were two further amendments that addressed function creep but, following discussions with stakeholders, with NEHTA and also with Owen from the minister’s office, I am satisfied that those two amendments would not have been workable. The opposition determined in the Senate not to proceed with those amendments. We made the decision in the Senate to support the government amendments. We think that this is an important part of establishing the infrastructure for e-health. I also note that COAG has set aside $218 million for the adoption of a healthcare identifier service which runs until 30 June 2012. This money has already been allocated. Now the legislation is in place to let this go forward.

Question agreed to.