Senate debates

Wednesday, 9 September 2009

Aviation Transport Security Amendment (2009 Measures No. 1) Bill 2009; Resale Royalty Right for Visual Artists Bill 2009; Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009; Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009; Midwife Professional Indemnity (Run-Off Cover Support Payment) Bill 2009

Second Reading

3:41 pm

Photo of Joe LudwigJoe Ludwig (Queensland, Australian Labor Party, Manager of Government Business in the Senate) Share this | | Hansard source

I table a revised explanatory memorandum relating to the Resale Royalty Right for Visual Artists Bill 2009 and move:

That these bills be now read a second time.

I seek leave to have the second reading speeches incorporated in Hansard.

Leave granted.

The speeches read as follows—

AVIATION TRANSPORT SECURITY AMENDMENT (2009 MEASURES NO. 1) BILL 2009

The framework of Australia’s aviation security legislation has a number of layers to ensure the deterrence, detection and prevention of acts of unlawful interference with an aircraft.

That framework is under constant review to ensure it is responsive to changing threats to the Australian aviation industry.

This Bill contains four key amendments to the Aviation Transport Security Act 2004 to strengthen the enforcement powers of the Office of Transport Security, Australia’s aviation security regulator.

The first amendment will enable the Secretary of my Department to designate, by notice, a security controlled airport as a particular category of airport. Currently, the declaration of an airport as a security controlled airport places the same legislative requirements on all such airports, regardless of their size, location and type of aircraft operating from the airport. This amendment will allow regulations to be made that prescribe different legislative requirements for each category of security controlled airport. This will ensure regulatory activity is better targeted to reflect the relative risk associated with each category of airport.

A second amendment will allow an aviation security inspector to enter the premises of an aviation industry participant or accredited air cargo agent who is not on an airport site and inspect their activities without notice. Currently, inspectors can only undertake these inspections on-airport, despite many critical aviation-related businesses being located well away from an airport. Current requirements to provide reasonable notice of inspections off-airport limit the effectiveness of such activity. This is particularly the case for many businesses within the air cargo sector as their security obligations are largely procedural in nature and, with notice, can be changed briefly during an inspection. Inspectors will be allowed to enter premises, observe and discuss procedures and in so doing access documents and records. This amendment does not however allow this activity to be undertaken in residences.

The third amendment would allow the Secretary of my Department to enter into enforceable undertakings with aviation industry participants in relation to all matters that are dealt with under the Act. This amendment has been developed as a result of the current lack of middle-range sanctions to address regulatory issues and contraventions of the Act. Introducing enforceable undertakings as a mid-range administrative enforcement tool enables a more responsive regulatory approach, which would generate more confidence on the part of both the travelling public and industry, and encourage better industry compliance.

Under the amendment, the Secretary would not be able to force a participant to enter into an enforceable undertaking, and at the same time, the Secretary would not be compelled to accept an enforceable undertaking. An aviation industry participant may withdraw or vary the undertaking at any time with the written consent of the Secretary. In addition, the Secretary may, by written notice given to the participant, cancel the undertaking. Should a participant breach an enforceable undertaking, the Secretary may apply to the Federal Court for an order which may include an order directing compliance with the undertaking.

Lastly, this Bill will expand the scope of compliance control directions under the Act to allow an aviation security inspector to direct operators of security controlled airports, screening authorities or screening officers to take specified action in relation to the airport or screening points at the airport. Currently, there is no scope for aviation security inspectors to issue compliance control directions to airport operators or screening authorities and there have been instances where it would have been useful for such directions to be issued. For example, an inspector may wish to issue a compliance control direction to an airport operator or a screening authority that all passengers and their luggage on a particular flight must be screened or rescreened before the aircraft can depart from the airport to ensure compliance with the ATSA.

RESALE ROYALTY RIGHT FOR VISUAL ARTISTS BILL 2009

The introduction of this Bill marks a landmark day for Australia’s visual artists, whose right to an ongoing economic interest in the value of their artistic works will be appropriately recognised in Australia for the first time.

There are currently more than 20,000 visual artists in Australia whose diversity of work spans painting, sculpture, glassware and photography.

This Government values their work; we are committed to enlarging the creative endeavour and recognising artists’ contribution to our economy, community and identity.

The decision to introduce a resale royalty right for visual artists has been a long time coming.

Historically, the achievements of our visual artists have not been recognised to the same extent as those of our composers, authors and performers, who are able to earn copyright and performance fees from their work, and thus have an ongoing financial interest in their creative efforts. Visual artists, on the other hand, have little ability to earn income from their work, other than through its initial sale. When a work sells for a large sum on the secondary art market, the artist receives no direct financial benefit from the sale.

Australia’s art market has been through a boom period in recent years and we should all be proud of the incredible talent demonstrated by our visual artists.

Auction sales in 2007 amounted to $175 million with works sold by 1,578 Australian artists, of which 379 were Indigenous. The value of the auction sales market increased by 75 per cent in 2007.

Sadly, local artists have not shared in the benefits of this substantial activity.

The Government’s resale royalty scheme, set out in this Bill, addresses a situation which is plainly inequitable, by creating a right for visual artists for a royalty payment each time their work sells on the secondary art market. It implements an election commitment.

This is a right which has now been recognised by over 50 countries around the world and is long overdue in Australia.

The scheme which the Government has developed delivers a right for visual artists, but also very importantly, introduces the right in such a way as to ensure minimal impact on Australia’s art market.

The scheme is administratively simple and straightforward to understand. A flat 5% royalty rate is fair for all artists, with no cap on the maximum royalty which may be earned on an individual resale. Joint creators of artworks will also be recognised under the scheme.

The royalty will apply for the current period of copyright, 70 years following the death of an artist, so that artists can pass on their right to their families and heirs. This is important, as it can often be the case that artists only achieve recognition and success late in life, having spent a lifetime with modest means developing their creative skills. Data on the income of visual artists demonstrates how little they earn on average from their creative work.

Royalties will be collected by a single collecting organisation which will be appointed by the Government through a competitive and transparent tender process. There are clear requirements for the collecting organisation to ensure administrative costs are kept to a minimum with the maximum revenue possible returned to artists.

The collecting organisation will be vested with the powers necessary to access the information required for it to determine quickly when and to whom royalties are payable.

Importantly the right will only apply to resales of artworks that are acquired after the right comes into effect. This is to ensure that purchasers of artworks are aware at the time they make their purchase that a royalty may be payable to the artist if they choose to resell the work. It will also allow the art market to adapt gradually to the new right. While the art market has experienced a boom in the last few years, this is likely to be tempered by the changing economic circumstances. It’s important that the resale royalty right is introduced in such a way as not to have a negative impact on the art market, which in the end would not help artists.

The resale royalty right is not just about raising additional income for artists. Introducing the right will significantly increase the transparency of the art market, which is of course particularly important for Indigenous artists who have sadly continued to be exploited by some unscrupulous dealers. The Bill requires sellers to notify the collecting agency each time a work is resold on the secondary art market. This means the collecting agency will keep detailed records on all relevant sales occurring, and will need to publish key data in its Annual Report which will be tabled in the Parliament.

Australian visual artists and their advocates have been campaigning for a resale royalty right for at least a decade. They have emphasised its importance both as a significant statement of the esteem in which Australia holds its visual arts culture and as an economic reward and incentive for the creators of high-quality art.

As the resale royalty scheme grows throughout the years, Australia’s artists – like artists from the United Kingdom, France, Germany and a growing list of other countries – will share in the proceeds of the trade in their works on the secondary market. Artists will be encouraged to know that whatever they are initially paid for the products of their hard work and talent, they will have a fair share in any future success their work achieves.

Because the right is recognised in the Berne Convention for the Protection of Literary and Artistic Works, it will be possible for Australia to establish arrangements with other countries which acknowledge the right to a royalty for Australian artists whose work is sold in those countries. Although the resale royalty schemes in operation across the world differ substantially in how they operate, each scheme has particular benefits for artists or their heirs.

As stated earlier, the introduction of this Bill marks a landmark day for Australia’s visual artists, whose right to an ongoing economic interest in the value of their artistic works will finally be appropriately recognised in Australia for the first time.

HEALTH LEGISLATION AMENDMENT (MIDWIVES AND NURSE PRACTITIONERS) BILL 2009

The Health Legislation Amendment (Midwives and Nurse Practitioners) Bill 2009 will amend the Health Insurance Act 1973 and the National Health Act 1953 to support greater choice and access to health services for Australians.

I am very proud to be introducing this Bill, one of the centrepieces of the Rudd Government’s workforce and primary health care reform agenda.

The Bill is a landmark change for Australia’s nurses and midwives. It will facilitate access by patients of appropriately qualified and experienced midwives and nurse practitioners to the Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme.

Under this reform, nurse practitioners and midwives will be able to request certain diagnostic imaging and pathology services for which Medicare benefits may be paid as well as make appropriate referrals.

In short, this Bill removes barriers to the provision of care and will lead to improved access to services for the community. It is a long overdue recognition of our highly skilled and capable nursing and midwifery workforce.

In my travels around our nation’s health system as Minister, this issue has been constantly raised with me by the nurses and midwives that I meet. It didn’t make sense to them that they were denied access to the PBS and MBS. I agree with them.

The Bill will commence on Royal Assent, with amendments relating to Medicare benefits and pharmaceutical benefits to commence the day after Royal Assent, and the new Medicare benefits and Pharmaceutical benefits arrangements made available from 1 November 2010.

The amendments that are a consequence of the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009 will commence on 1 July 2010.

The successful implementation of the Bill will also require professional indemnity cover to be available to the midwives wishing to access the new arrangements. This cover has not been available for midwives since 2002.

This will be delivered by the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009 and associated Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009, which are being introduced at the same time.

These Bills will mean that eligible midwives working in collaborative arrangements with obstetricians or GP obstetricians will be able to access the new Government-supported professional indemnity scheme.

Maternity reform

This Bill is a key plank of the Government’s $120.5 million maternity reform package announced in the Budget. This package will improve the choices for Australian women to access high quality, safe maternity care, as well as provide support for the maternity services workforce.

It is a critical step towards delivering the Government’s election commitment to develop a national plan for maternity services across Australia.

The reform initiatives supported by this legislation represent significant steps forward in maternity care in Australia within a strong framework of quality and safety for mothers and babies.

These arrangements support models of care with an enhanced role for midwives. These will develop in a way that involves collaborative team work with other members of the maternity care team, most notably obstetricians and GP obstetricians.

By making better use of the maternity services workforce, new arrangements are also expected to provide greater access to maternity care closer to home, thereby reducing family disruption.

The maternity reform package responds to the Maternity Services Review, which canvassed a diverse range of views through an extensive consultation process.

The Review heard from a wide range of stakeholders with over 900 submissions received – many from women sharing their individual experiences.

Nearly all of these women expressed frustration at the limited options available to them, and called for midwifery models of care that provide continuity of care, over the spectrum of antenatal, birthing and postnatal services.

Many professional groups participating in the Review also acknowledged the need for change, with general consensus about the importance of collaborative, multi-disciplinary maternity care.

The Government has listened to the collective voice of Australia’s mothers, and we have listened to the considered views put forward by the midwifery workforce.

Granting access to the PBS and MBS for midwives will expand maternity care options for Australian women without risking the professional relationships that are essential in providing safe, high quality maternity care.

At this stage, the Commonwealth is not proposing to extend the new arrangements for midwives to include homebirths. Medicare benefits and PBS prescribing will not be approved for deliveries outside clinical settings, and the Commonwealth-supported professional indemnity cover will not respond to claims relating to homebirths.

These arrangements will be subject to agreement with states and territories on a National Maternity Services Plan – who will be asked to make complementary commitments and investments, particularly around the provision of birthing centres and rural maternity units.

Nurse practitioner reform

Internationally, the role of nurse practitioners has been successful in improving access to primary care services.

This Bill boosts the role of nurse practitioners and enacts the Government’s 2009-2010 Nurse Practitioner workforce Budget measure which provides for access to appropriate items under the Medicare Benefits Schedule, as well as rights to refer to specialists and consultant physicians and the authority to prescribe certain Pharmaceutical Benefits Scheme subsidised medicines subject to State and Territory legislation.

Greater use of nurse practitioners will help improve overall capacity and productivity and increase the efficiency, effectiveness and responsiveness of the health workforce.

Nurse practitioners already provide advanced services and have prescribing rights in the majority of States and Territories and have been performing this role for some time.

The arrangements enabled by this Bill will facilitate better access to primary care services.

Nurse practitioners are well placed to play a key role as part of the team of health professionals providing collaborative care to the community – and this Bill will enable removal of the barriers that until now have prevented Nurse Practitioners from fully utilising their skills.

This is good news for rural and regional health services, which are still struggling with the legacy of the previous government’s decade-long neglect of our health workforce and where shortages are still chronic in places.

The Commonwealth’s reforms are designed to complement and boost the work performed by our doctors and specialists as part of a collaborative, team-based environment. Our reforms are not about challenging vested interests. Improving patient outcomes was, is, and always will be, the government’s number one priority.

Who can access the new arrangements

The Health Insurance Act and the National Health Act will be amended to provide access to the new arrangements.

Under the Health Insurance Act, a ‘participating nurse practitioner’ or ‘participating midwife’ will be able to request or provide certain Medicare services.

An ‘authorised nurse practitioner’ or ‘authorised midwife’ will be authorised to prescribe certain medicines under the Pharmaceutical Benefits Scheme.

Nurse practitioners and midwives will need to meet eligibility requirements to access the new arrangements.

The core criterion for the new Medicare and Pharmaceutical Benefits Scheme arrangements is that the nurse practitioner or midwife is an ‘eligible nurse practitioner’ or ‘eligible midwife’.

This will also be a core requirement for midwives to access the new Government-supported professional indemnity schemes, which will be established under the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009 and associated Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009.

To meet the core requirement of being an ‘eligible midwife’, the Bill requires registration as a midwife and, in addition, that requirements specified in delegated legislation must be met.

Additional requirements are likely to be based on having appropriate advanced qualifications, experience and/or competencies.

The further eligibility requirements for midwives, and for nurse practitioners if additional requirements to those provided for under State law are considered appropriate, will be determined in close consultation with relevant stakeholders.

The Government recognises that with the increasing burden of chronic and complex disease it is increasingly important to ensure that health care is co-ordinated.

At the same time, it is important that the system enables patients to see the right health care professional for their health care need at the right time.

Nurse practitioners and midwives wishing to provide treatment or prescribe under the new Medicare and Pharmaceutical Benefits Scheme arrangements will need to demonstrate that they have collaborative arrangements in place, including appropriate referral pathways with hospitals and doctors to ensure that patients receive co-ordinated care and the appropriate expertise and treatment as the clinical need arises.

The new Medicare arrangements

The Bill will support the inclusion of participating nurse practitioners and participating midwives under the Medicare Benefits Schedule.

In order for participating nurse practitioners and participating midwives to provide a comprehensive service to their patients, the Bill will enable these groups to request diagnostic imaging and pathology services appropriate to their scope of practice for which Medicare benefits may be paid.

In addition to the changes made by the Bill, new Medicare items for services provided by participating nurse practitioners and participating midwives working collaboratively with doctors will be created.

For participating midwives, this will include antenatal, birthing and postnatal care and collaborative care arrangements between these midwives, and obstetricians/GP obstetricians.

Participating nurse practitioners will be limited to providing services within their authorised scope of practice and level of experience and competency.

The details of these Medicare items will be finalised in consultation with professions and specified in delegated legislation.

The new Pharmaceutical Benefits Scheme arrangements

This Bill will amend the National Health Act to support the inclusion of authorised nurse practitioners and authorised midwives under the Pharmaceutical Benefits Scheme.

The reforms will enable patients to access certain Pharmaceutical Benefits Scheme medicines prescribed by authorised nurse practitioners and authorised midwives.

These nurse practitioners and midwives can only prescribe certain medicines under the Pharmaceutical Benefits Scheme within the scope of their practice, and in accordance with the State and Territory legislation under which they work.

The Pharmaceutical Benefits Advisory Committee will be consulted in relation to the range of medicines that each group can prescribe and the circumstances under which the medicines can be prescribed.

Advice will also be sought from clinical experts and health professionals practising in the relevant clinical fields.

These changes provide a rational and consistent basis in supporting midwives and nurse practitioners to work in their fields of expertise.

Nurse practitioners already have prescribing rights under State and Territory arrangements and have been performing this role for some time. The Government will be encouraging nationally consistent prescribing approaches across Australia.

The Bill also contains a number of consequential amendments to the Health Insurance Act and the National Health Act to ensure that regulatory provisions in those Acts apply appropriately to participating and authorised midwives and nurse practitioners. For example, a number of offence provisions have been adjusted, Part IIB dealing with prohibited practices in relation to pathology services and diagnostic imaging services has been applied, and also the Professional Services Review Scheme and Medicare Participation Review Committee processes have been applied.

Conclusion

In summary, the Bill will facilitate significant changes to the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme and demonstrate that this Government is willing to adapt and strengthen working systems to better meet the needs of Australians, without putting at risk our strong record of safety and quality.

The Rudd Government is implementing these reforms for a simple reason. We want to expand the level of health services, and access to health services, in the community. It supports our efforts to improve primary health care services, especially in rural and regional areas.

It takes us another step towards building a multi-disciplinary, highly skilled and complementary health workforce.

It will improve the overall capacity, efficiency and productivity of Australia’s health workforce. It is also a sensible and practical response to helping address the workforce shortages that this Government inherited.

This Government is a firm and passionate advocate for Australia’s nurses and midwives – the backbone of our health workforce.

MIDWIFE PROFESSIONAL INDEMNITY (COMMONWEALTH CONTRIBUTION) SCHEME BILL 2009

The purpose of the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Bill 2009 is to allow the Commonwealth to provide, via a contracted private sector insurer, affordable professional indemnity insurance to eligible privately practising midwives.

This Bill is an important component of the Government’s maternity reform package. The package will improve the choices that are available to women in relation to maternity care.

The Bill will effectively remove a long-standing barrier for appropriately qualified and experienced midwives who wish to provide high quality midwifery services to Australian women as part of a collaborative team with doctors and other health professionals.

There is currently no professional indemnity insurance product available for such midwives, as the risk is perceived to be high and the potential pool of premiums to be relatively small.

In order to address this gap, the Bill establishes a scheme to provide support for eligible midwives.

The Government will, through a tender process, engage an insurer to create a suitable insurance product for eligible midwives.

This insurer will manage claims and provide valuable support to midwives – many of whom would never have had their own professional insurance cover.

When claims arise, the Government will contribute an amount to the insurer in relation to claims against a midwife if the claim exceeds the threshold set in the legislation.

The thresholds that will apply for claims against eligible midwives are:

  • For claims more than $100,000, but less than $2 million – the Government will contribute 80 cents in the dollar;
  • For claims more than $2 million – the Government will contribute 100 cents in the dollar.

The Bill is not intended to provide for direct subsidy to individual midwives. It does, however, ensure that midwives who meet eligibility requirements and wish to purchase professional indemnity insurance will be able to purchase such cover at an affordable cost.

For the purposes of this Bill, an eligible midwife is one who is licensed, registered or authorised to practice midwifery under a State or Territory law, and who meets any other requirements specified in the rules.

The scheme proposed under the Bill will be administered by Medicare Australia. There are also mechanisms in this Bill to ensure that funds are paid out accurately and appropriately.

Overall, this Bill contributes to a new era for midwifery services in this country, by addressing a longstanding impediment that has limited the availability of a wider choice for women.

MIDWIFE PROFESSIONAL INDEMNITY (RUN-OFF COVER SUPPORT PAYMENT) BILL 2009

The scheme established by this Bill will ensure that professional indemnity insurance protection extends to eligible midwives once they have ceased to practise.

The purpose of the Midwife Professional Indemnity (Run-off Cover Support Payment) Bill 2009 is to impose a tax —the Run-off Cover, or ROCS, Support Payment.

This tax will apply to premium payments for professional indemnity insurance by eligible midwives and will help to cover the costs of run-off cover claims against their colleagues who cease to practise due to retirement, disability or maternity.

The Government will commit $5 million in 2010-11 to assist in covering such claims in the period before sufficient funds are accumulated through the ongoing contribution of ROCS Support Payments.

The Bill provides that the rate of ROCS Support Payment must not exceed 15%.

The actual rate will be set through rules detailed in a legislative instrument that will be tabled in Parliament.

It is expected that the actual rate will be initially set, on the advice of the Australian Government Actuary, at 10% of premiums.

This is the rate at which ROCS contributions started in the initial years of the Run-of Cover Scheme for doctors.

Debate (on motion by Senator Ludwig) adjourned.

Ordered that the Aviation Transport Security Amendment (2009 Measures No. 1) Bill 2009 and the Resale Royalty Right for Visual Artists Bill 2008 be listed on the Notice Paper as one order of the day, and the remaining bills be listed as separate orders of the day.