Senate debates

Wednesday, 30 November 2016

Questions without Notice

Health Care

2:30 pm

Photo of Stirling GriffStirling Griff (SA, Nick Xenophon Team) Share this | | Hansard source

My question is to Senator Nash, representing the Minister for Health and Aged Care. The government will soon receive the second report from the Medicare Benefits Schedule Review Taskforce, outlining its recommendations on which of the 5,700 items of the $21 billion MBS—including the 12 different items relating to chemotherapy procedures—should stay or be axed. Like any surgical procedure, each of these 12 MBS items is linked to a rebate item for the associated in hospital care through which private health insurers pay the bed and nursing costs incurred by patients, mostly at no gap rates. Is the minister aware that axing any one of these items, and thus breaking the link to the rebate item for insurers, will leave cancer patients thousands of dollars out of pocket for in hospital costs, risking delays in time sensitive treatment. If so, will the minister commit to not axing any of these 12 crucial items from the MBS?

2:31 pm

Photo of Fiona NashFiona Nash (NSW, National Party, Deputy Leader of the Nationals) Share this | | Hansard source

I thank the senator for his question and for some notice of it. I note his very genuine concern in this area. As the senator has indicated, the minister is yet to receive the information as a result of the ongoing review of the MBS. The review was initiated in April 2015 by the Minister for Health and Aged Care, Sussan Ley. I think she needs to be congratulated for doing that. We have 5,700 items on the MBS. There was a very widely held view that a number of those were outdated and perhaps unsafe, unproven or overused. So I think it was very timely indeed that the minister initiated this review at that point in time.

What we have seen since then is the work of the MBS review committee, led by Professor Bruce Robinson, do a significant body of work in relation to the determination of the appropriateness of those items. That being the case, the minister is yet to receive that information. So it would not be appropriate to preempt the findings of that committee or indeed try and hazard a guess as to what might be the outcome put forward. The clinical committees and working groups that have been put in place to do this work are eminently qualified to do that. I think it appropriate that we allow them to do their work and make their recommendations in due course.

Photo of Stephen ParryStephen Parry (President) Share this | | Hansard source

Senator Griff, a supplementary question.

2:33 pm

Photo of Stirling GriffStirling Griff (SA, Nick Xenophon Team) Share this | | Hansard source

Some chemotherapy treatments can now be administered through subcutaneous injection; however, this is not specifically covered in the MBS, so some funds are refusing to reimburse in-hospital costs for this kind of treatment. As a result, many patients are electing to have intravenous chemo to avoid out-of-pocket costs. Given the lower risks associated with subcutaneous injection, will the minister add this form of treatment to the MBS?

Photo of Fiona NashFiona Nash (NSW, National Party, Deputy Leader of the Nationals) Share this | | Hansard source

I think Senator Griff raises a very good point here, actually, indicating why it has been so appropriate to do the review of these MBS items. He, of course, indicates that those injections can now be subcutaneous, which I think reflects a lot of the changes we have seen over recent times when it comes to those items that are on the MBS. So the task force, of course, will carefully consider all of the evidence and all of the input gathered from the consultations, before finalising any recommendations to the government. I am very confident that that has been a very thorough process. Indeed the consultation has been very widespread, and I am sure that the recommendations will be very well informed. But I again indicate to the senator that we do need to wait for the process to conclude.

Photo of Stephen ParryStephen Parry (President) Share this | | Hansard source

Senator Griff, a final supplementary question.

2:34 pm

Photo of Stirling GriffStirling Griff (SA, Nick Xenophon Team) Share this | | Hansard source

If the task force recommends payments for an entire course of treatment rather than individual services, will the minister confirm that these changes will not be introduced without first consulting oncologists to ensure that the reimbursements reflect the complex task of coordinating cancer care for the very sick and vulnerable patients?

Photo of Fiona NashFiona Nash (NSW, National Party, Deputy Leader of the Nationals) Share this | | Hansard source

Consultation with expert clinicians, with those across the medical sector that do have the expertise in these areas has been absolutely at the forefront, so I can certainly assure the senator that that consultation with that high-level clinical expertise has indeed been integral to the ongoing nature of this process. I can indeed indicate to the senator that that high-level consultation will, of course, be presented through the recommendations to the minister in due course. While I seem at risk of repeating myself, it is not appropriate to the preempt the outcome of that review. We need to let it take its course, let it be well-informed, let the consultation happen with the experts and with the clinicians, and await those final recommendations from the MBS Review Taskforce.