Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Link to this | Hansard source

I was talking earlier about the absence in the National Health and Hospitals Network Bill 2010 of clear delineation of the particulars of enforcement methods, which was raised as part of the Community Affairs Legislation Committee inquiry and the minority report of coalition senators. I want to continue with regard to what sanctions or rewards the commission may use to achieve the desired standards of health. There was also some concern that those standards needed to be set in context for some healthcare providers facing the particular challenges of remoteness and distance.

With regard to tests of clinical performance to be employed by the proposed commission, concerns were expressed that they were inadequate and that the commission proposed to use the very screening that failed to detect the clinical performance of Jayant Patel at Bundaberg Hospital. Other concerns raised were about the make-up of the commission board, the wording of the bill and the absence of explicit references to key stakeholders that the proposed commission should consult with. Some submissions expressed concern that the legislation as it stands does not make it clear as to whether the board would include consumer representatives or even key healthcare professionals.

Accordingly, the coalition made two key recommendations: given the cost, the lack of focus and unclear governance, and the potential for duplication, the coalition urged the government to withdraw this bill; but, if the government persisted, the coalition strongly recommended that this legislation to establish the commission be deferred until the legislation for and purpose of the Independent Hospital Pricing Authority and the National Performance Authority had been fully developed.

In other words, this is another classic example—one of many—of the ramshackle way in which Minister Roxon and this government have approached health and health reform. I do not know how Minister Roxon had the front to turn up to the health ministers meeting in Hobart last week. Her position as Minister for Health and Ageing surely must be untenable at this point. The spectacular policy reversals that have become the hallmark of the Rudd-Gillard government, and now of Ms Gillard herself, have been nowhere more evident than in health, where core elements of Rudd’s so-called reform have been dumped and elements that were previously discarded reinstituted—though, quite frankly, we do not know what is still on the table and what is not because at the moment all we have is an agreement for an agreement; we do not actually have a signed agreement.

Mind you, we did not have a signed agreement under mark I anyway. It was very clear that within weeks of the mark I proposed health changes being ‘agreed’ to, the ink was barely dry before Mr Rudd, in what can only be described as a very cynical move, on the eve of the press gallery ball, dumped the national funding authority, which was part of the COAG red book—there it is at page 49 in black and white. It was the centrepiece of accountability and transparency for the COAG health changes mark I, yet the ink was barely dry when the then Prime Minister just dumped it.

Minister Roxon went out there and said: ‘Oh, no, it is inappropriate. We have talked to the states now. We don’t really need it.’ They did not need it, and now all of a sudden we have the national funding pool re-emerging in mark II. Something that was wrong last year is now right. So was Minister Roxon right or wrong last year? Is she wrong this year? This minister does not know what she is doing. I am not surprised because this whole thing is not really being driven out of the Department of Health and Ageing; it is actually being driven out of the Department of the Prime Minister and Cabinet—just like what happened under Mr Rudd.

Mr Rudd was the organ-grinder while travelling to those 100 so-called consultations. They were only whistle stops at hospitals because they sometimes did two or three in a day to give Mr Rudd and Ms Roxon the opportunity to dress up in a doctor’s coat and a nurse’s outfit while pretending that they were consulting and doing something about health. Those consultations were only about getting photo opportunities. As part of that they wasted $13 million selling a false message of ‘federally funded, locally controlled’. We know that was all about political spin.

We also know that tucked away in the fine print of the first agreement was a little line that said that the clinical expertise for local hospital networks was to come from outside the local hospital network wherever it was practical. What does that mean? It means that the doctors on the local hospital networks would come from outside the local hospital networks. That just beggars belief. The whole thing was built on a false premise and a false message about federal funding and local control. Forget what they were talking about last year with federal funding—that has gone out the door as well.

Ms Gillard’s vote is now falling and she desperately needs to sort out the mess of Labor’s first term. She is conveniently blaming everything on Mr Rudd. She is revving up this issue about the GST clawback by trying to blame the Western Australians, even though Mr Rudd did not have an agreement in the first place. She is trying to rev this up because she needs this basic PR manoeuvre. She is now trying to sell us ‘historic reform.’ Labor has been talking about reform in health since 2007. Remember the 2007 promise from Prime Minister Rudd, ‘We are going to fix the hospitals by 2009 or take them over’?

In 2007 Mr Rudd was berating the then government for not providing enough aged-care beds and saying that people were becoming bed blockers. ‘Bed blockers’—this is how Mr Rudd referred to older Australians who were forced to go into hospitals because, according to him, there were not enough aged-care beds. What actions did he take after that? This government took $276 million out of highly needed beds in residential aged care and shunted them off to long-stay hospital beds. What happened to Labor’s 2007 policy of improving the transition between hospitals and aged care?

According to Catholic Health Australia, every night there are 3,000 people who sit in hospitals who would be better cared for in aged-care homes. Prime Minister Gillard and Mr Rudd have not delivered. If you are talking about real health reform in this country you cannot have real health reform if you do not include aged care and mental health. We trawled through this in the COAG inquiry.

Helen Polley (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

What did you do in 11 years? You did nothing on aged care.

Concetta Fierravanti-Wells (NSW, Liberal Party, Shadow Minister for Ageing) Share this | Link to this | Hansard source

Just go back, Senator Polley, and see how Professor McGorry and all the other experts berated you—and continue to berate you—for your lack of attention to mental health and ageing issues in this country. Your basic problem is that you see ‘reform’ as photo opportunities in hospitals. You then put those on your My Hospital website to pump all around the country so that you can be seen as if you were doing something. In effect, you are really not doing anything. All you have to do is go into your state hospitals. Come to New South Wales and have a look at the hospitals there.

In the end, you had concerns. In the first COAG red book you set out the need for a funding authority. You needed a funding authority for transparency and accountability because you were concerned that state governments would not use the money as they should. So what did you do? You dumped your national funding authority. You have now come out with this funding pool. We do not know what this funding pool is going to be. Your department does not know. It cannot tell us what Medicare Locals are going to do. You have 5,000 people sitting in the Department of Health and Ageing and they still have not worked out what Medicare Locals are going to do or what these authorities and bureaucracies are going to do.

What is very clear from the agreement mark I and the agreement mark II is that very little will change—the states will still be in control. Despite whatever spin you try to put on this and whatever public relations manoeuvres you try, this is no actual deal and it is certainly no historic reform. You have merely revived the promise to the point where the same lines are now being delivered by Prime Minister Gillard instead of Mr Rudd.

Let me take you back to last year. There was Kevin Rudd boasting that we had agreed to the biggest reforms to the health system since the introduction of Medicare. One year on, this Prime Minister has the audacity to proclaim an agreement to reach an agreement. That is all this is: an agreement to reach an agreement—a photo opportunity so that she can say that she is doing something on health. It is all about political spin, especially when you compare it with the real reforms that not only were promised but also were delivered by the likes of Prime Minister Howard, Prime Minister Hawke and Prime Minister Keating.

Lets us try to look at this watered-down version of what she is trying to pass off as ‘reform’. It looks like Ms Gillard has again overpromised. There is an enormous amount of detail to be sorted out and contested. The government said it was going to have one-stop shops for older Australians. It cannot even deliver a simple thing like one-stop shops. It has been talking about it for three years and it still cannot deliver something that simple. How is it going to deliver by 1 July all these grand promises that it makes? The reality is—and you only have to look to the health commentators in this country to see it—that, just like mark I fell apart, mark II in my view will end up falling the same way. Mark I left so many details to be worked out and when the ink was barely dry it started to fall apart, and it started to fall apart with the National Funding Authority being dumped.

Patients all around Australia are fed up. As I said, you have only to go to a New South Wales hospital to see how bad the system is. In any case, the government is promising all of this $16.4 billion, but it is somewhere down in the never-never. By the time the government actually delivers, it will be 23 years from 2007, and that is a disgrace.

Rachel Siewert (WA, Australian Greens) Share this | Link to this | Hansard source

The Australian Council of Safety and Quality in Health Care was first established as a non-statutory body in 2000 in response to a study by the then Commonwealth Department of Human Services. The study showed an adverse event rate of 16.6 per cent across public hospitals. The council was asked to lead national systematic approaches to improvements in the safety and quality of health care with an initial focus on reducing errors. The Australian Commission for Safety and Quality in Health Care, as it is now, commenced operations in January 2006. It was given a five-year program to tackle patient rights, accreditation of health services, medication safety and hygiene. The commission was asked to report to the health ministers and link up with health departments and other government and non-government bodies. At the time, it was envisaged that a commission would have clear mechanisms to link with, and participate with, jurisdictions and key stakeholders. The commission was to be responsible for providing robust advice to the Commonwealth, state and territory health ministers and informing the development of national safety and quality strategies.

Notable achievements in this period include the Australian Charter of Health Care Rights, the National Patient Wristband Standard and the development of a national approach to surveillance of hospital-acquired infection rates. I also mention the national falls prevention guidelines and the development of the guide to clinical handover improvements. These were all endorsed by Australian health ministers. In June 2009, the National Health and Hospitals Reform Commission recommended that the commission should be established as a permanent body.

This brings us to this particular legislation, the National Health and Hospitals Network Bill 2010. The Greens believe that safe, high-quality health care is imperative to any sensible health reform agenda. The commission will be responsible for developing and monitoring quality and safety standards, working with clinicians to identify best-practice care and ensuring the appropriateness of health care. The commission will also provide advice to the Commonwealth, state and territory governments about standards that can be implemented on a national level. It is important to note, however, that national standards will only be implemented if all of the states and territories are in agreement.

The Greens are concerned that this in fact may delay implementation of a nationally consistent approach. Compromise may also be required to reach agreement on national standards. This highlights one of the deficiencies of the commission, and that is its lack of power. It provides advice on national standards for states and territories, yet this advice is only implemented on the agreement of all parties. It has a monitoring role but not a regulatory role. Further, compliance with standards is voluntary. Although I understand the Commonwealth may make compliance with standards a condition of any grant, there is concern about the actual powers or role of this commission.

States and territories cannot even agree on national data collections, reporting requirements, definition of sentinel events and a universal charter to be used for patients, so I do not hold much hope for them being able to reach agreements on national standards for safety and quality in the short term. The states, which are considered to be world leaders in certain areas, are going to be reluctant to compromise of course on areas where they consider themselves to be experts. We are concerned that there may be some aspects of their standards being ‘dragged down’. Of course, we also recognise that we need to ‘drag up’ low-performing regimes. We flag this as an issue and we will keep an eye on that.

If there is a delay in reaching agreement on standards, this will affect when implementation can commence. Under the agreement with the states, the states are the ‘system managers’ for public hospitals, including for planning and performance. Presumably, this would extend then to ensuring that local hospital networks implemented these national standards. While I suspect that most local hospital networks would implement the relevant national standards, as it would be considered in the public interest to do so and difficult to defend if they did not, the issues around accountability between the local hospital networks and the state health departments varies between state to state and has not been fully resolved.

The Greens will be moving a number of amendments to the legislation. These came directly out of concerns that have been raised with us and also from concerns raised at the Senate Community Affairs Legislation Committee inquiry into this bill. I will go through some of those concerns. The legislation states that commission standards, guidelines and indicators will be developed in conjunction with clinicians, professional bodies and consumers. During the inquiry a number of submissions from witnesses identified the issue that a clinician was often seen as a doctor. The National Primary Health Care Partnership stated:

While no definition of the term ‘clinician’ is provided in the context of the bill, the NPHCP wishes to emphasise that it is important this term is recognised as applying to nursing and allied health professionals as well as medical doctors and that these professionals are consulted in the development of standards, guidelines and indicators relevant to their scope of practice.

The Greens have some amendments that clarify the definition of ‘clinician’ so that it means more than perhaps what can sometimes be a narrow interpretation of that word. Our amendments define a clinician as an individual who provides diagnosis or treatment as a professional. This can be a medical practitioner, a nurse, an allied health practitioner or an Aboriginal health worker. We believe this makes the legislation much clearer, and it is clear that all these medical professions are involved.

The Senate inquiry also raised the concern that participation of not just public consumers but also carers on the board had to be made much clearer. The Greens have proposed amendments that provide for the commission to consult with consumers and carers before formulating standards, guidelines or indicators. We understand that representation is one thing but this is also about the way it translates to genuine engagement with the consumer. Our amendments address this issue.

The Consumer Health Forum outlined during the Senate inquiry the need for consumers to be involved at all levels of standard setting and guideline setting. While it has been great that there has been a consumer commissioner on the current body, a single person is not the answer to ensuring that you are covering the needs of all consumers and carers

With regard to the involvement of consumers, the Greens also have an amendment that deals with patient confidentiality. During the Senate inquiry the issue of clarification of the meaning of consent was raised. The Consumer Health Forum welcomed the provision requiring the commission not to publish or disseminate information that would be likely to enable the identification of a particular patient. However this provision would not apply if consent has been provided. The Greens have an amendment that changes this to ‘informed consent’. We had a discussion during the inquiry about informed consent. This was to make sure that the consumer who is able to give consent can do so in an informed manner and is fully aware of the implications of providing consent.

The Greens share the concerns raised during the Senate inquiry about compliance. This will be crucial in terms of enabling the commission to achieve the substantial ambitions that have been set out. The Greens believe that this commission could be effective, like the National Institute for Clinical Excellence in the UK, in both improving quality and lowering the costs of services through improved work practices. However it is worth remembering that since 1995, when a definitive study was undertaken on adverse events in New South Wales and South Australian hospitals, there have been a lot of committees, studies and money spent on quality and safety but little improvement.

After examining more than 14,000 hospital admissions in New South Wales and South Australia, the national cost of harm from health care in our hospitals was estimated at $4.17 billion per annum. That $4.17 billion estimate represented 23 per cent of recurrent costs in all hospitals at that time. Assuming the same percentages of mistakes in 2010-11, the cost would now be more than $11 billion. This would be a conservative estimate because complexity of cases has increased significantly since 1995. For example, the ‘re-do’ rate for joint replacements is 25 per cent. The estimate of $11 billion does not include mistakes in the non-hospital sector or the cost to the community of death and permanent disability.

As the Consumer Health Forum noted in the inquiry, there are a number of layers to all of this. There are the state governments and their role, there is the accreditation system and there are the different standards bodies, and they are all involved in this equation. The Greens believe there need to be some additional mechanisms built into the health reforms, and we look forward to seeing progress made on the development of a robust, transparent and effective performance and accountability framework for the Australian health system.

As we understand it, this framework could be used to set out clear performance standards in health care, and it could propose mechanisms for governing compliance. The Greens understand discussions are yet to specify how the framework will provide Australians with greater information about the performance of health and hospital services, but that it will include standards developed by the Australian Commission on Safety and Quality in Health Care. It will be interesting to see whether there is any provision in the National Performance Authority legislation for an accountability framework, and in particular how its roles and responsibilities would complement those of the safety and quality commission. In other words, we are looking at how these two particular bodies intersect to ensure that one complements the other.

The Greens note the submission from Choice to the NHHRC last year in which they supported the introduction of public performance reporting in the health system as a measure to drive improvements in quality and safety. They wish to see reporting developed for all aspects of the health system, not just hospitals.

The framework for implementation of national standards will be a crucial part of the reform puzzle, but it may also further compound matters as this will be the responsibility of the local hospital networks rather than state and territory health departments. As yet, the accountability frameworks between local hospital networks and state and territory health departments have not yet been defined and will vary by state and territory. Furthermore, the role of private hospitals under the local hospital networks is yet to be clearly defined and will be resolved on a state by state basis. This may further limit the extent to which a national approach can be implemented.

During the Senate inquiry it was noted that emphasis on representation of the board members provided for experience in general management of public and private hospitals but not specifically for expertise related to management of primary healthcare provider services —these could include general practices and community health services. Too much emphasis throughout the health reform process has been on hospitals and the Greens believe that much more should be done to focus on prevention measures, primary health and community services to keep people well and out of the hospital system.

We have an amendment that includes provision for the appointment of board members to include expertise relating to the management of general practice and primary healthcare services. The Mental Health Council of Australia noted in the Senate inquiry:

It is disappointing that the Bill does not make provision for specific expertise from health consumers and carers or mental health professionals as part of the Board of the ACSQHC. Such provision would be a significant step in ensuring that the activities of the Commission reflect the needs of mental health consumers and carers and would assist the Commission to better address the acute safety and quality needs in the mental health system.

The bill will be subsequently amended by parliament to establish two new statutory agencies—the Independent Hospital Pricing Authority and the National Performance Authority. However, the bill is silent on how these agencies will work together. This will be an important issue as the three agencies will likely be collectively responsible for improving the performance of the healthcare system and, more broadly, governance arrangements for health reform.

There is a growing awareness that patient care and chronic disease management require a multidisciplinary approach across a range of health sectors. The bill provides for consultation on the development of guidelines, standards and indicators, and consultation on the development of a national model accreditation scheme. The department advised the Senate inquiry that the commission has placed considerable emphasis on broad stakeholder consultation in the development of key projects. In particular, consultation with respect to the development of standards has been framed within a seven-stage methodology that includes different mechanisms through which stakeholder groups contribute and draft standards are tested.

The Greens have concerns about voluntary compliance with the guidelines, standards and indicators developed by the commission and, as we have said, there have been many concerns raised about whether the commission or reform process will have sufficient teeth to implement standards on a national basis. The Australian Nursing Federation has suggested that the lack of incentives to implement the proposed standards could lead to inconsistencies and a failure to ensure improvements in quality. The AMA has also noted the lack of obligation for state and territory governments to comply with guidelines and standards from the commission. As we have said, we will be pursuing provision for compliance in the National Performance Authority legislation and through the other legislation we are yet to see on finalising the health reform process.

During the Senate inquiry, Professor Smallwood noted that the commission is ‘expected to make things happen in a way its predecessor could not’. He suggested this could be achieved through high-quality data on safety and quality on a national level to be used for national benchmarking purposes. The Greens would support this approach. Australia does not have a nationally consistent dataset for hospitals. We believe that public pressure and accountability on performance could be a significant lever in improving standards and we hope to see measures that will provide for this in future legislation; otherwise, we will seek to amend subsequent legislation to ensure this happens.

Finally, the Greens note research from the UK and the US which has shown that consumers had made little use of performance reports in places where they were available. The problem with the reports was that they are based on non-standardised measures and are not user-friendly. The way information was presented or ‘framed’ strongly affected whether consumers understood it, how it was evaluated and whether they used it. The research found that consumers cannot be expected to weigh up measures against a wide range of indicators to rank providers. Most presentations of comparative information are based on the assumption that consumers know what is important to them and where their self-interest lies. For example, it is usually assumed that people have fixed ideas about what is important in healthcare quality and that they can pick and choose from among different performance measures displayed in a comparative report. However, both theory and evidence suggest that these assumptions are faulty. When people are in a situation in which they must sort through complex, unfamiliar and important factors to make a choice, how that information is framed and packaged will determine to a large degree what information is actually used in that choice.

As performance reporting develops, consideration will need to be given to how best present this to the public in a way that makes it accessible and understandable. In the UK, the Dr Foster website provides large amounts of information on hospitals, but most of it is inaccessible for a consumer trying to choose between providers. The UK Healthcare Commission provides a much simpler presentation. It measures a small number of indicators on a four-point scale. This is more consumer-friendly because the measures are presented in a simple and understandable way, with some form of ranking. In the past, the Minister for Health and Ageing, Minister Roxon, has indicated that performance information is partly about consumer choice. If it is to enable consumers to choose, the information needs to be presented in a way that can be understood. To determine what will work best for Australian consumers, the government needs to test options on and with the public. However the information is presented, it will need to be accompanied by an awareness and information campaign, and we look forward to further work on that issue. In the meantime, the Greens will support this legislation on the understanding that we will have a debate on the amendments we are proposing, because we believe these amendments will significantly improve this legislation.

Dana Wortley (SA, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the National Health and Hospitals Network Bill 2010, which represents a very important step towards improving health care and its delivery in Australia. This bill will establish a permanent Australian Commission on Safety and Quality in Health Care. The establishment of the commission as a new, independent statutory body will form an integral part of the new governance structure for national health reform between the Commonwealth and the states. The Gillard government’s national health reform will provide for the establishment of three new governance agencies in total: the Independent Hospital Pricing Authority, the National Performance Authority and, as already mentioned, the Australian Commission on Safety and Quality in Health Care.

An independent Commission on Safety and Quality in Health Care is a positive step forward in providing better health and better hospitals for all Australians. The new commission is indicative of the Gillard government’s determination to put quality and safety at the top of the agenda when it comes to quality health service delivery to all communities. The commission will be responsible for setting and monitoring the uptake and impact of adopting national clinical standards and working with clinicians to identify best practice clinical care. This will help to ensure the quality and appropriateness of services being delivered in specific healthcare settings. Currently, the commission is in operation as a temporary body, and by making this commission a permanent, independent body, we formalise our commitment to ensure the calibre of our health system and appropriate safeguards.

As the Minister for Health and Ageing has stated, the government’s health reforms are the most significant changes to the nation’s health and hospitals system since the introduction of Medicare. The permanent commission forms part of the national health reform between the Commonwealth and the states. The National Health and Hospitals Network Bill expands the function of the Australian Commission on Safety and Quality in Health Care as an independent Commonwealth authority. The commission will develop the performance and accountability framework of national health reform, and it will be governed by a board which will be responsible for setting the quality and standards of care.

The commission will be dedicated to improving safety in health care and our hospitals. As the minister stated last year, statistics show that one in 30 adults contract an infection while in hospital and 12,000 of these are severe hospital-acquired bloodstream infections. The terrible reality is that up to a quarter of these patients will die. This means that the number of patients who die from hospital acquired infections is approximately double the number of deaths on our roads. A national body dedicated to not only monitoring but improving safety and quality in health care will help address this problem and ensure better health outcomes from our hospitals. The harm caused by preventable errors and healthcare costs resulting from unnecessary or ineffective treatment will also be reduced and this will have a positive impact on community trust. The commission will provide advice to Commonwealth, state and territory health ministers about which standards are suitable for implementation as national clinical standards.

The government’s vision of national health reform will ensure services are better connected and coordinated. It will establish the local hospital network, which can be more responsive to local communities. The local hospital network will be responsible for implementing relevant national clinical standards once they are agreed upon by the Commonwealth, states and territories. The network will improve access to public hospital services, thereby healing the neglect from the Howard government, which callously ripped a billion dollars out of the system. Improved performance and less waste will be encouraged and rewarded through new funding arrangements. The Gillard government will invest $750 million so that emergency patients are guaranteed to be treated, admitted or referred within four hours where this is clinically appropriate. A further $800 million for elective surgery will speed up delivery and provide a guarantee that many patients, where clinically recommended, will not face excessive waiting times.

As a Labor government we strongly believe that all Australians have a right to high-quality health services. We believe a nationally consistent approach to the quality and safety of health care across Australia as part of national health reform is essential. We are working to ensure that we not only have an inspired national health reform agenda but that we make this vision a reality. Reforms are to be delivered in six key areas, including expanding hospital capacity as well as regional cancer centres, boosting new GP training places and providing increased funding to upgrade general practices. The government’s national health reform will ensure future generations of Australians enjoy world-class, universally accessible health care. The key element of this is the provision of $35.2 million in Commonwealth funding over four years to jointly fund, with the states and territories, the continuation and expansion of the Australian Commission on Safety and Quality in Health Care.

Our track record on increased funding and necessary reform, strategically staged since 2008, really does speak for itself and we will continue the much-needed process of improvement in the current term. Even before the historic COAG agreement of February, significant progress had been achieved by the Labor government in crucial areas. Hospital funding has been increased by more than 50 per cent. On-time elective surgery has been provided to a record number of Australians. In fact, more than 76,000 elective surgery procedures have been performed in the past two years. To alleviate skills shortages resulting from the Howard years of short-sightedness and neglect, we are doubling the number of GP training places to 1,200 a year by 2014. In addition, we are funding the training of 1,000 new nurses each year.

In light of population and demographic projections, the government has established the Health and Hospitals Fund to make long-term, intergenerational investments in our national health infrastructure. This fund has invested $3.2 billion in 32 projects around the country. We recognise that the life expectancy gap between Indigenous and non-Indigenous Australians is completely unacceptable. To date, we have invested $1.6 billion in an Indigenous health national partnership to close that gap. The Medicare Teen Dental Plan has delivered more than a million dental check-ups to teenagers. Aged-care places have increased by more than 10,000. This figure includes 838 new transitional care places to help up to 6,285 older Australians leave hospital sooner each year, freeing up hospital staff, beds and services.

The Labor government is committed to improved cancer research, treatment and prevention through major, specifically targeted investments. The government has already invested over $2.3 billion in fighting this terrible illness that affects thousands of Australian families each year. This sum includes: providing $526 million in infrastructure funding to build two integrated cancer centres in Sydney and Melbourne, which will provide state-of-the-art cancer treatment combined with cutting-edge research; establishing, as part of a $560 million investment, a network of 20 new and enhanced regional cancer centres across Australia to provide access to vital cancer services in closer proximity to those requiring treatment, including chemotherapy and radiotherapy; upgrading BreastScreen Australia’s national network to 21st century digital mammography equipment; and investing $70 million to expand the Garvan St Vincent’s Cancer Centre in Sydney. The Garvan Institute is renowned world-wide for its research excellence in cancer care. In addition, the government is supporting a children’s cancer centre in my own home city of Adelaide, and up to two dedicated prostate cancer research centres in Brisbane and Melbourne. It has also allocated the McGrath Foundation funding totalling $12 million to train, recruit and employ 44 breast cancer nurses, and provided financial support for women who require external breast prostheses as a result of breast cancer.

The successful passage of this bill will ensure the permanent commission will be established. Meanwhile the Gillard government remains committed to reducing the misallocation of funds and the waste and inefficiencies which were allowed to flourish under the Howard government. The bottom line is that individuals, families and communities want better hospitals. We all want better hospitals, and the way to achieve this is through national health reform. Unlike the opposition we are not prepared to sit on our hands and adopt a no-reform model which allows deteriorating care and increasing costs. It is crucial that we maintain the momentum for health reform and continue to work towards the best possible outcomes for all consumers of health and hospital services and for all stakeholders concerned with our nation’s health. I commend the bill to the Senate.

Don Farrell (SA, Australian Labor Party, Parliamentary Secretary for Sustainability and Urban Water) Share this | Link to this | Hansard source

in reply—I would like to thank firstly the members and senators for their contributions to the debate on this National Health and Hospitals Network Bill 2010. I note that the opposition moved a second reading amendment in the House to delay the passage of this legislation until the legislation to consider the Independent Hospital Pricing Authority and the National Performance Authority is debated by the parliament. Once again the opposition is playing its usual game of ransom with important health bills. How could the opposition possibly view this bill as controversial? After all, Mr. Abbott set up the Australian Commission on Safety and Quality in Health Care when he was the Minister for Health and Ageing. The opposition knows it has no future plans for issues such as safety and quality in health care. It only has one strategy in health care for the next three years and that, unfortunately, is to block everything.

Establishment of the commission as a permanent body is a critical component of the new COAG health deal. These national health reforms will call for greater transparency and accountability of health services to the public. The national body dedicated to monitoring safety and quality in health care is thus a key part to assist in holding health services to account. One in 30 adults contract an infection while in hospital and 12,000 of these are severe hospital acquired bloodstream infections and up to a quarter of these patients regrettably will die. The number of patients who die from hospital acquired infections is approximately double the number of deaths on our roads. This is a concerning statistic but one that the commission can address, ultimately promoting better health in our hospitals.

The Australian Commission on Safety and Quality in Health Care is not another layer of bureaucracy that wastes public resources, as the opposition would have us believe. Its release last year of the national hand hygiene guide and the Australian Infection Control Guidelines will be pivotal in our fight against major health issues such as hospital acquired infections. Leaving the commission as a temporary advisory body hampers its ability to give independent and informed advice to all healthcare providers and thus drive continuous quality health improvements for all Australians. Only its establishment as an independent and permanent body can best realise its full potential for ensuring patient safety and improving quality in health care.

This government will bring the legislation to establish the National Performance Authority before this parliament next week and the Independent Hospital Pricing Authority in due course. We have consulted with states and territories on the terms of reference for these bodies and are bringing these bills to parliament as planned. There is no reason why the parliament should not consider the legislation for this safety and quality commission, which is currently in operation as a temporary body and providing an excellent service for the Australian health system, a body that has also been supported by the Senate Community Affairs Legislation Committee in their report on the bill released last year. The National Health and Hospitals Bill 2010 marks an important development in reforming Australia’s health system. By establishing a permanent, independent safety and quality body, it formalises the government’s commitment to drive continuous improvements in quality and safeguard high standards of care for all Australians.

Question agreed to.

Bill read a second time.