James McGrath (Queensland, Liberal National Party, Shadow Special Minister of State) Share this | Link to this | Hansard source

by leave—I move amendments (1) and (2) on sheet 3452 together:

(1) Schedule 4, Part 1, page 56 (line 2) to page 57 (line 15), to be opposed.

(2) Schedule 4, Part 3, page 59 (lines 1 to 15), to be opposed.

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

I simply wish to indicate that the government does not support the amendment that's been circulated by the opposition. That's essentially because, as I indicated in my contribution at the end of the second reading debate, these amendments are important to make sure that the obligations placed on participants in the Bonded Medical Program and some of the programs that preceded it are fair and in the national interest—that is, aligned with the public health interest that the program overall seeks to support.

I want to particularly draw senators' attention to the consequences of the current arrangements for students who commence a medical degree but withdraw. This bill seeks to change that to make it fairer. Currently, a student must withdraw before the census date in their second year of study and, if the student withdraws after that date, they incur a debt to the Commonwealth equal to the full cost of their Commonwealth supported place up to the date of withdrawal. This bill seeks to extend the existing grace period from the HECS census date in the second year of study to the awarding of the medical degree.

I want to put on the record for senators and anyone else who may be listening to the debate the reason that the government doesn't think that is currently fair. I have with me an email that's been recently received by ministers in our government from a participant. I will name this fellow. His name is Sharath. He says he is writing in strong support of the amendment that's currently before us and is the subject of a further amendment by the opposition. He says: 'I started doing medicine in 2020 at Western Sydney University. However, I soon realised that medicine was not the career for me. I made the difficult decision to leave medicine to pursue civil engineering at the start of 2023. Unfortunately, I had accepted a spot in the Bonded Medical Program in 2020. This meant that, upon leaving medicine, I would become liable for the full Commonwealth contribution for that part of the degree I had completed and this amounted to a total of $78,000 over three years. The purpose of this program is to give students a CSP in medicine and, in return, they will practice as a doctor rurally upon graduation for a fixed number of years. Penalties are intended to make sure qualified doctors do not try to evade their obligations to work rurally. Crucially, the intention is not to penalise students who decide to leave medicine. These students, like myself, are not depriving rural areas of a qualified doctor because they will never become a qualified doctor.'

He goes on in his email to talk about this further. He says: 'This has caused me undue amounts of distress. Since February 2023, when I deferred my medicine degree, I dreaded the day that I would need to begin repaying the amount I owed. To avoid triggering repayments, I've deferred my degree ever since 2023. Of course, I knew I could not defer my degree forever. I was delaying the inevitable.'

We want this program to work well for prospective students. We want it to deliver a workforce that can work in underserved areas across our community. But we don't wish to punish people or make peoples' lives unnecessarily difficult. I think that that email sets out the scale of the challenge that is in place under the current arrangements. It is one of the reasons why the government does not support the amendments that have been circulated by the opposition and are before the chamber at this point in time.

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Minister, schedule 1 of the bill automates the issuance of Medicare providers numbers, MPNs. 'Automation' I assume means computer software. Computers are used now for the process. What is different about the process being proposed that requires legislation to enact?

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

Thank you for your patience, Senator Roberts. I was just obtaining advice so I can advise you correctly. This new part of the act will ensure that the system can approve the use of a computer program for certain decisions relating to the allocation and management of Medicare provider numbers. It will not—and this, I think, will be important to you—enable the approval of the use of a computer program to make decisions about revoking a Medicare provider number or suspending a Medicare provider number where the suspension is not at the request of a health professional.

It will also include safeguards around the use of computer programs to make decisions relating to Medicare provider numbers. Those safeguards include a requirement to notify a person where a computer program was used to make a decision about their Medicare provider number; a requirement to make it public when the use of a computer program to make decisions about Medicare provider numbers has been approved; a power to make substitute decisions where they are satisfied that a decision made by the operation of a computer program is incorrect; and a requirement to include information in the Services Australia annual report about the number and types of substituted decisions.

Importantly, these things introduce safeguards, and they also, as is indicated in the explanatory memorandum, provide legislative support for an existing practice where some Medicare provider numbers have been allocated by use of a computer program, rather than by a human delegate.

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

I think you anticipated one of my future questions, but, in the meantime, who decides if a person is qualified for a Medicare provider number, including the decision to give a Medicare provider number to a new arrival in the country? I'm asking this to see how this automation will impinge on the process of determining qualifications.

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

May I clarify. I think what you're asking is, 'How would a new migrant to Australia have their qualifications recognised for the purpose of practising in an Australian context?' Is that correct?

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

That's part of the question. The other part concerns any Australian who's here right now; how would they be qualified?

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

I'm terribly sorry. I might ask you to clarify further. You said that you're asking about how a person who is here now would obtain a Medicare provider number. Do you mean an Australian citizen or another person? What are you trying to elicit from me?

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Anybody who's qualified to get a Medicare provider number—how would you make sure they are qualified, and how would you make sure that we're not excluding people?

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

The advice I have is that the bill that's before us doesn't change any of the existing arrangements. Those arrangements, of course, include a series of processes to ensure that a person seeking to practise within the Medicare system is qualified.

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

How extensive are the checks, and is there any hint of automation being more than just computer software? Is the bill intending to allow for the use of AI for automatic MPNs?

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

No.

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

So there's no requirement for artificial intelligence to be used in allocating MPNs?

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

The advice I have is no.

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

I'll quote from the explanatory memorandum:

The Bill will enable the Chief Executive Medicare to approve the use of a computer program to make appropriate, non-discretionary decisions relating to the registration and claims process.

Can I confirm you intend to use AI for that process? If so, what checks are in place to make sure the AI is fit for purpose?

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

The advice I have in relation to AI is that there is no intention. We do not require AI to perform the functions that are set out in the bill. In relation to your earlier question about the process by which a person becomes eligible for obtaining a Medicare number, the Parliamentary Library's bill digest in relation to this says:

To be eligible to provide a Medicare service, health professionals must meet certain criteria. Practitioners eligible to have Medicare benefits payable for their services 'at the place of practice as well as refer patients to other health professionals for Medicare eligible services, such as pathology and diagnostic imaging from the place of practice', may apply online or in writing to Services Australia for a MPN for the locations where these services/referrals/requests will be provided.

MPNs are used by health practitioners both 'as a means of identifying themselves and their place of practice for the purposes of claiming Medicare benefits for eligible services, and as an identifier to support other Medicare-related programs …

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

To clarify for constituents and to get some reassurance: you didn't hesitate when you used the word 'intention' with regard to AI and then said there was no requirement. After the robodebt fiasco, the Bureau of Meteorology website fiasco, the Australia Post software fiasco and the Border Force cargo management automation, constituents have every right to point out that these stuff-ups keep happening because of the way in which new technology is rolled out. That's a big concern. Now you're giving the software decision-making powers, and it sounds like there are no plans to do that with due care. What security steps are being taken to reassure our constituents that the automations proposed in this bill don't become yet another government stuff-up? I acknowledge that not all of the stuff-ups have occurred on your watch.

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

This bill puts in place safeguards to ensure that, to the extent that a computer is utilised, the circumstances in which a computer is being used are made very explicit. It also puts some constraints around the kinds of decisions that may be taken by a computer in the context of this process—that is, the process of obtaining a Medicare provider number. I read to you earlier some of those safeguards, which are set out in the explanatory memorandum. As I indicated to you, the advice I have is that this process, which involves the use of a computer for certain purposes that are quite tightly defined and constrained, does not require the use of AI.

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

This final question has a lengthy preamble. Item 3124ZH1 removes the requirement for students who do not complete their degree to repay the Commonwealth supported place cost. Students can currently withdraw from the program without consequence up to the HECS census date in their second year of study. If the student withdraws after that date, they incur a debt to the Commonwealth equal to the full cost of their commonwealth supported place up to the date of withdrawal in addition to any HECS or HELP liability. The proposed amendment, as I understand it, seeks to extend the existing grace period from the hex census date in the second year of study to the award of the medical degree. Can you please explain that provision? It sounds like they can pull out right at the end of their degree and not have to pay back the cost. Is that right?

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

Senator, you're correct that at the moment a person who withdraws from their degree doesn't need to pay the cost of the scholarship back if they withdraw prior to the census date you alluded to. I believe that they do remain liable for the HECS costs incurred by them in the pursuit of their studies up to that point. You are also correct that a purpose of this bill is to extend the period during which a person may withdraw without incurring a debt associated with their receipt of Commonwealth payments.

Malcolm Roberts (Queensland, Pauline Hanson's One Nation Party) Share this | Link to this | Hansard source

Sorry, that was my second-last question; I've got another one now. What is the rationale behind extending the withdrawal date so they won't have to pay it back?

Jenny McAllister (NSW, Australian Labor Party, Minister for the National Disability Insurance Scheme) Share this | Link to this | Hansard source

Earlier in the debate I read out an email from a person who has incurred a debt in precisely these circumstances, and they spoke about the hardship they had experienced as a consequence of that. This person made the point that the purpose of the bonded nature of this program is to ensure that people who do qualify as medical professionals fulfil their obligation to work in an area that is underserved by medical practitioners. The purpose is not in itself to recoup funds from students, and we simply seek to make the system fairer.

Glenn Sterle (WA, Australian Labor Party) Share this | Link to this | Hansard source

The question is that parts 1 and 3 of schedule 4 stand as printed.