Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Hansard source

The opposition will not oppose the Private Health Insurance (National Joint Replacement Register Levy) Bill 2009. The purpose of this bill is to establish a levy to fund the ongoing operation of the National Joint Replacement Registry. The National Joint Replacement Registry was a great initiative of the Australian Orthopaedic Association with the support, at the time, of the Howard government. Indeed, on 6 July 1998, the then health minister, Dr Michael Wooldridge, announced funding for the Australian Orthopaedic Association to establish that particular register. Its purpose is to define, improve and maintain the quality of care of patients receiving joint replacement surgery. The information collected provides an accurate measure of the success or otherwise of a procedure. That information is then used to inform surgeons, other healthcare professionals, governments, sponsors of joint replacement products and patients.

The National Joint Replacement Registry also provides post-market surveillance of joint replacement prostheses. The real benefit of this is that it has helped to reduce the incidence of revision surgery. That is certainly one of its objectives. It provides information about the types of joints available and surgical techniques and collects a whole series of other information. The great thing is that all hospitals which undertake joint surgery—around 300 across Australia—do participate in the registry, which of course enables very comprehensive information about joint replacement surgery to be collected. I think that the registry has already been successful and a very effective measure over the past 10 years.

I do think that there is scope to take the use of the information that is collated one step further. One of the key cost drivers of health care—in particular, in the private system, but across the whole health system—is the increasing cost of prostheses. There is a great variety of prosthetic items, including in the orthopaedic area. There is great variety in quality and in cost. A lot of information can be obtained through this register about which are the most effective orthopaedic items, as well as other information. If we have got a particular product that is cheaper and more effective, why would we not channel all of our limited healthcare resources that way?

There is a lot of scope for us to become more cost effective and to continue to follow the lead of what has happened through the Pharmaceutical Benefits Scheme process, where we have a very rigorous process of assessing both the clinical effectiveness and the cost-effectiveness of a particular product before it is listed on the PBS. There have been attempts by the previous government, which I am sure are continuing under the current government, to go down a similar path with prosthetic items. Certainly, with this particular initiative and, with the data available through the National Joint Replacement Registry, I think that there is much more that we can do in terms of comparative analysis and assessing the cost-effectiveness of particular products that are funded either through the public system or through private health insurance funds and patients.

While we will not be opposing this bill, we are concerned that this is yet another one of the many hidden revenue grabs, one of the many cost recovery measures, that have been introduced by the government under the radar, really, in this budget. When there is a cost recovery measure, there ought to be genuine engagement with all affected stakeholders. There ought to be consultation, and that has not happened on this occasion. There is no denying that there is a significant benefit that has been derived from the Joint Replacement Registry, and it is important that the good work continues to be funded appropriately. Up until this point, it has been funded by the government. The Rudd government has now made a decision that it has to be cost recovered.

The industry would acknowledge that as sponsors they do derive a benefit from the registry, but they are by no means the sole beneficiaries and the government, in our view, should adequately justify the reason for cost recovery measures such as this. We do not believe that this has happened in an adequate fashion. The information collated by the registry is of benefit to many stakeholders, including surgeons, government and private health insurance. The levies proposed in this legislation are in addition to the application and ongoing listing fees already incurred by sponsors of joint replacement prostheses. As I have mentioned, there has been a complete lack of consultation on this measure and a lack of evidence presented by this government on what other funding mechanisms were considered. Have they essentially just gone, as they have on other occasions, for the easy revenue grab, ignoring any of the flow-on consequences?

Whilst this bill acknowledges the differing benefits applicable to prostheses, there is a reasonable expectation that consideration must also be given to the frequency of utilisation of prostheses in procedures in determining appropriate levels. We understand that the government has decided to continue to fund this very, very important initiative through a cost recovery measure. It is not something that we are very excited about, but we have come to the view that we will on this occasion not oppose the bill. With those few comments, I place the opposition’s position on record.