House debates

Wednesday, 27 November 2019


Health Legislation Amendment (Data-matching and Other Matters) Bill 2019; Second Reading

6:47 pm

Photo of Chris BowenChris Bowen (McMahon, Australian Labor Party, Shadow Minister for Health) Share this | | Hansard source

The Labor Party will be supporting this bill, the Health Legislation Amendment (Data-matching and Other Matters) Bill 2019. This legislation updates the National Health Act 1953 and the Health Insurance Act 1973 and related legislation to improve Medicare compliance by allowing data-matching between agencies.

I will say that we looked at this legislation carefully and closely. We examined it to ensure that it is as presented, and we are satisfied that it is worthy of support and passage through the parliament. It will allow data to be matched between Medicare, the Pharmaceutical Benefits Scheme, the Australian Health Practitioner Regulation Agency, the Therapeutic Goods Administration, the Department of Veterans' Affairs and the Department of Home Affairs. To be frank, this is about cracking down on fraud. There's a very small amount of fraud. It might amount to significant amounts, but it's a small number of people who conduct it within Medicare. Government agencies should have the ability to compare data to deal with that, because the perpetrators of that fraud deserve no support, no truck from this House. Of course, these things are always a matter of balance. There are balances to be struck. I will be looking closely at the instrument that the minister eventually tables.

This legislation will not allow the government or any agency to share information with private health insurers, which is something we were concerned about. It is a one-way flow of information to better equip government agencies on compliance issues. Taken together, the bill will help identify and take action against a very small number of health providers that make inappropriate and improper Medicare claims. Whilst such providers are small in number, it is important that we identify and address them. They're doing no favours to anybody but themselves.

While this bill expands the range of data that will be available for compliance activities it doesn't change the compliance activities themselves, which are governed by separate frameworks. In particular, I welcome the minister's assurance that the compliance activities will not be automated. We were alert to that risk. We wanted to ensure it would be done by human beings so that other mistakes made in other portfolios would not be repeated in this portfolio, and the minister has provided that assurance.

There is some small risk that data matching presents to the privacy and security of patients' and doctors' information, and it's vital that that be managed. The bill requires the minister to make a legislative instrument to govern the new data-matching program. It is also the case that there are some instances of grey areas where doctors have maybe thought they were doing the right thing, and did not have the intention to defraud, so we will look at the legislative instrument. If we have any concerns about the legislative instrument, I will raise them directly with the minister in good faith and see if we can sort them through. Of course, we do ultimately have other options available to us, but we will do that cooperatively with the minister and see if we can work through any issues. I doubt there will be any issues that I choose to raise on the legislative instrument, but I just flag for the record that we will reserve that right. I do undertake to talk to the minister if we have any concerns before moving down any other options we have available to us in the parliament. I also welcome the fact, and find it reassuring, that the Office of the Australian Information Commissioner will have some oversight of the new scheme. This bill will address one risk to Medicare—that is, inappropriate claiming by a small number of providers.

Our support for this bill is not to be taken in any sense as us being happy with the government in all instances. We are very concerned about cuts in other places, and I will be moving a second reading amendment which reflects that. I don't expect the government to support the second reading amendment, but it will give honourable members the chance to express views about those matters for which we have long been on the record, in terms of the government's longstanding record on health more generally and health cuts. We will be pursuing that through the House.

I move:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House notes that the real risk to Medicare is the Government's cuts and neglect".

However, I am happy to provide the Labor Party's support for the substantive bill.

Photo of Lucy WicksLucy Wicks (Robertson, Liberal Party) Share this | | Hansard source

Is the amendment seconded?

Photo of Matt KeoghMatt Keogh (Burt, Australian Labor Party, Shadow Minister for Defence Industry) Share this | | Hansard source

I second the amendment, and reserve my right to speak.

Photo of Lucy WicksLucy Wicks (Robertson, Liberal Party) Share this | | Hansard source

The original question was that this bill be now read a second time. To this the honourable member for McMahon has moved as an amendment that all words after 'That' be omitted with a view to substituting other words. The question now is that the amendment be agreed to.

6:52 pm

Photo of Greg HuntGreg Hunt (Flinders, Liberal Party, Minister for Health) Share this | | Hansard source

In relation to the amendment, the government will not be accepting that. In relation to the bill, we thank the opposition for their support for the general bill and the compliance measures.

In particular, this bill is about cracking down on that very small proportion of practitioners, or practices or other people who may seek to defraud the Medicare system. I note that we have a wonderful medical community. We have an honest medical community. But, as in all parts of life, there are a very small number of people who seek to do the wrong thing. I thank the opposition for their support for this bill, and I actually agree with the shadow minister that we are dealing with the possibility of a small number who may do the wrong thing. I hope that this bill is actually never required, but, where necessary, it will be there in the same way that an X-ray machine at an airport is there: to deter and, if necessary, to detect.

In general, the Health Legislation Amendment (Data-matching and Other Matters) Bill 2019 amends the National Health Act 1953, the Health Insurance Act 1973, the Privacy Act 1988, the Private Health Insurance Act 2007, the Therapeutic Goods Act 1989 and the Military Rehabilitation and Compensation Act 2004 to support the integrity of Medicare through data matching for compliance purposes, while employing strong privacy and data protection provisions. While the overwhelming majority of healthcare providers claim the Medicare Benefits Schedule, or the MBS, the Pharmaceutical Benefits Scheme, or the PBS, and child dental benefits appropriately, it is unfortunate that a very small proportion do not. It is in that situation entirely reasonable for Australians to expect the government has appropriate systems in place to detect instances of Medicare noncompliance and treatment pathways proportionate to the type of noncompliance detected. This will ensure that every taxpayer dollar of our precious healthcare spend is directed to clinically necessary services for Australians. If just one-half of a per cent of Medicare payments are fraudulently, incorrectly or inappropriately billed, approximately $180 million of healthcare benefits are lost every year that could be better directed to essential healthcare services in Australia such as new PBS medicine listings. This bill enables a scheme of data-matching for related purposes to therefore improve our ability to detect fraud, instances of incorrect claiming and inappropriate practices that are not easily or efficiently detected through current data analytics activities and other intelligence sources.

To ensure strong privacy and data protections, the Minister for Health and the chief executive of Medicare are required to put in place governance arrangements for the handling of information for data matching. This includes putting in place legislative provisions to ensure that the use, storage, access and handling of data protects privacy. It is a matter of fundamental importance and a deep and abiding commitment of the government. Data matching will therefore be overseen by the Australian Information Commissioner to ensure appropriate regulatory oversight and that personal information is maintained and handled in accordance with the provisions of the Privacy Act 1988.

This bill facilitates the important public policy objective of protecting the integrity of taxpayer funded healthcare programs. It achieves this while maintaining strong and appropriate protections for data privacy and security. I thank the opposition for their constructive engagement and give my commitment that, prior to tabling the legislative instrument, we will consult with not just the opposition but also the AMA and the College of General Practitioners. I thank the opposition, the RACGP and the Australian Medical Association for their engagement, and other parts of the health and medical community. I thank also my department and, in particular, I thank my senior adviser, Kylie Wright, who is in the chamber at this moment. Kylie has put many hours into the development and consultation process surrounding this bill. I thank all members for their contribution to the debate on this bill and I commend it to the House in its unamended form.

Photo of Tony SmithTony Smith (Speaker) Share this | | Hansard source

The original question was this bill be now read a second time. To this the honourable member for McMahon has moved as an amendment that all words after 'That' be omitted with a view to substituting other words. The immediate question is that the amendment be agreed to.

7:06 pm

Photo of Tony SmithTony Smith (Speaker) Share this | | Hansard source

The question is that this bill be now read a second time.

A division having been called and the bells having been rung—

As there are fewer than five members on the side for the noes in this division, I declare the question resolved in the affirmative. In accordance with standing order 127, the names of those members who are in the minority will be recorded in the Votes and Proceedings.

Question agreed to.