Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

On behalf of the Standing Committee on Health and Ageing, I present the committee’s report entitled Advisory report on the National Health Reform Amendment (National Health Performance Authority) Bill 2011, incorporating a dissenting report, together with the minutes of proceedings and evidence received by the committee.

Order that the report be made a parliamentary paper.

by leave—On behalf of the Standing Committee on Health and Ageing, I am pleased to present the committee’s Advisory report on the National Health Reform Amendment (National Health Performance Authority) Bill 2011. The bill was referred to the committee by the Selection Committee on 3 March 2011. This bill is the next step in the process of the government’s historic agreement with all states and territories to undertake fundamental reform of our health and hospitals system.

The bill amends the proposed National Health and Hospitals Network Act 2011 to establish the National Health Performance Authority, which will be the new watchdog for Australia’s health system. This new watchdog for Australia’s health system, the performance authority, will develop and produce reports on the performance of hospitals and healthcare services, including primary health services, and it will transparently and publicly report on primary healthcare services and the outcomes in local communities.

The committee takes very seriously its responsibility in dealing with a matter referred to it by the parliament. In determining the nature of this inquiry, the committee noted the history associated with this matter and, in particular, the two previous Senate inquiries into the proposed National Health and Hospitals Network as well as the separate Senate inquiry into the proposed financing arrangements to give effect to these changes. So, in executing the present inquiry, the committee was cogent of the previous inquiries conducted in to the National Health and Hospitals Bill.

The submissions that the committee received were largely supportive of the need to establish a national framework of health service standards, monitoring and reporting, and recognised the performance authority as an integral component of this. Much of the support for establishing a National Health Performance Authority was premised on the belief that the collection of robust and meaningful data is an important mechanism to drive improvement in the quality and efficiency of health services at a national level. The committee is of the view that the bill to establish the performance authority adequately sets out the authority’s essential operational and structural parameters.

The committee was particularly interested in considering different mechanisms to enhance the performance authority’s reporting requirements with a view to improving the overall transparency of the data collected on the performance of healthcare services. With greater transparency comes a greater change of improving public services and empowering the public to make decisions that are based on the best information. Accordingly, the committee recommends that the House pass this bill with a further amendment that the performance authority presents a compilation of its performance monitoring activities to the parliament annually in addition to its publication on the authority’s website.

The committee, in recommending that the National Health Reform Amendment (National Health Performance Authority) Bill 2011 be approved, concluded that the parliament, through its publicly elected members, will ultimately have to resolve this matter.

Steve Irons (Swan, Liberal Party) Share this | Link to this | Hansard source

by leave—On behalf of the coalition members of the committee, the member for Hasluck, the member for Parkes and myself, and in my capacity as the Deputy Chair of the House of Representatives Standing Committee on Health and Ageing, I rise this evening to speak to the dissenting report to the committee’s inquiry into the National Health Reform Amendment (National Health Performance Authority) Bill 2011. We cannot support the government’s sole recommendation from this inquiry that:

The Committee recommends that the House of Representatives pass the National Health Reform Amendment (National Health Performance Authority) Bill 2011 with a minor amendment to clause 60(1)(b) relating to reporting requirements.

Throughout the course of the inquiry it became clear that a wide range of stakeholders are concerned about the lack of deal in the legislation, especially with regard to the functions of this proposed authority.

In short, we believe that this inquiry has raised more questions than the government has been able to answer and, as such, should not be debated in the House before the government has clarified the areas causing concern to stakeholders. Many of these problems have been acknowledged by the inquiry in its report; yet the government response has failed to address them, saying it is of the view that the bill adequately sets out the authority’s operational and structural parameters. We do not accept this as a good enough response to some serious questions raised by the stakeholders.

As stated in the dissenting report, there is confusion over several aspects of the functions of the proposed authority. These include (1) the range of health services to be monitored; (2) how the data will be obtained; and (3) how requests for data will be enforced, given that the powers of the authority will be limited. With stakeholders suggesting that they are struggling with a significant regulatory burden already, any proposed compliance burden is clearly important and needs to be clarified and addressed.

In addition, a fourth concern has been raised by stakeholders in relation to what the reporting requirements for the proposed authority would be. We acknowledge that the report recommends an annual report be prepared by the authority and presented to the parliament, but there is no explanation as to what form this report should take. For example, it is unclear whether the authority will use the data collected to produce league tables which will be published on the MyHospitals website.

A further area of concern for the stakeholders is the relationship between the proposed authority and two other agencies the government has created or is creating. The first is the recently legislated Australian Commission on Safety and Quality of Health Care and the second is the proposed Independent Hospital Pricing Authority. As documented in the chair’s report, the Australian Medical Association in their submission stated:

We are also concerned that the legislation does not provide for appropriate interaction between the Authority and the Australian Commission on Safety and Quality in Health Care (the Commission) or the proposed Independent Hospital Pricing Authority.

It is unclear what the interactions between these organisations will entail and where the responsibilities will lie. Data-sharing arrangements, responsibilities and functions of these government agencies have not been properly justified or explained. It is unclear whether these organisations will overlap.

I want to make one more point before tabling this dissenting report on behalf of the coalition members of the committee. In addition to the concerns about the workability and functionality of this proposed authority, it is understood that a number of stakeholders who wanted to contribute to this inquiry were unable to because of the haste with which this inquiry has been conducted. As the inquiry details, the bill was referred to the Standing Committee on Health and Ageing by the Selection Committee on 3 March. We are reporting today, just 19 days later. The time allocated for submissions was little more than a week. And it is noted that more public hearings were unable to be arranged due to the short reporting time frame. In fact, there was just one public hearing and only people from the Department of Health and Ageing were allowed to attend. None of the private stakeholders concerned with this bill were given the opportunity to attend. Given this, until the stakeholders have had adequate opportunity to raise their concerns and have them properly addressed, it would be unwise for the committee to advise the House of Representatives to pass this legislation.

The coalition members of the committee believe there are too many unanswered questions about the National Health Performance Authority, its role and functions and whether it can fulfil its stated aims for the government. In conclusion, the House should not debate this bill until the government clarifies this matter.