House debates

Wednesday, 12 May 2010

Health Practitioner Regulation (Consequential Amendments) Bill 2010

Second Reading

12:00 pm

Photo of Julie OwensJulie Owens (Parramatta, Australian Labor Party) Share this | Hansard source

I rise to support the Health Practitioner Regulation (Consequential Amendments) Bill 2010. This bill supports the implementation of the National Registration and Accreditation Scheme for the Health Professions. With this bill, for the first time there will be a national system for the registration and accreditation of 10 health professions, bringing consistency and uniform standards to our health workforce. I suspect that most Australians who may be listening today would be surprised that these 10 health professions are not already covered by a national registration scheme, as they are the most common of the medical professions: medicine, nursing and midwifery, pharmacy, physiotherapy, psychology, osteopathy, chiropractic, optometry and dental care—including dentistry, dental hygiene, dental therapy and dental prosthetics—and podiatry. These are quite common medical services that currently are covered by different registration systems in each of the states and territories.

In addition, the health ministers have agreed that from 1 July 2012 some additional areas will be covered, including Aboriginal and Torres Strait Islander health practitioners, Chinese medicine practitioners, occupational therapists and medical radiation practitioners—all will be regulated under the scheme. The scheme will modernise the regulation of health professions by creating a single regulatory environment, ending the duplication of effort and red tape caused by separate systems in each state and territory. The scheme will create a single national register, so any suspension of rights to practice or conditions on registration or deregistration will apply simultaneously in all states and territories. Queensland, New South Wales and Victoria have already passed the bills which will put in place the national system, the Australian Capital Territory and the Northern Territory have introduced their bills and South Australia, Tasmania and Western Australia are well advanced in their planning.

National registration has been a very long time coming. It was identified as an issue many, many years ago. In fact, way back in 1992 attempts were made to simplify registration and regulation process. The Mutual Recognition Act 1992 was one such cooperative attempt by the state, territory and federal governments to introduce some kind of uniformity. The act allowed individuals registered to practise an occupation in one jurisdiction to obtain registration to practice an equivalent occupation in another participating jurisdiction. Yet, in spite of that move—and it was a very important one at the time—there continued to be calls for central regulation. Reasons cited in support of reform have ranged from the ability of practitioners to move more easily between jurisdictions to safety and quality considerations—both very important considerations.

The register has been a very long time coming. The previous government, with the current Leader of the Opposition as the Minister for Health and Ageing, identified national registration as an urgent priority some years ago. Then, in December 2005, the Australia’s health workforce report by the Productivity Commission recommended the establishment of a single national registration board for health professions as well as a single national accreditation board for health professional education and training. This move was seen as a means to help deal with workforce shortages and pressures faced by the Australian health system. This was a very important recommendation which was not acted on at the time.

When the Rudd government came to power it identified national registration as an urgent priority that had been held up far too long and needed urgent action. This was one thought bubble that Mr Abbott had back in his time as health minister that really did need practical implementation quickly. We immediately got to work with the states and territories and in March 2008 signed an intergovernmental agreement to progress to the national scheme. The bill we are debating today brings that scheme into effect. Yet still we have calls for delay from the opposition. The member for Dickson this morning said we should wait for the Senate inquiry to bring down its findings. The member for Dickson is not keeping up. The Senate inquiry reported yesterday and the House will note that amendments have already been circulated that deal with the concerns raised in that report.

We know that the national scheme will reduce red tape, increase standards and improve safety for the Australian community. We also know that a national scheme will improve the mobility of the health workforce. It will stop health professionals from having to re-register as they cross borders, saving time, money and inconvenience. It will help boost locum support for rural doctors as doctors become freer to move around the country.

On 3 November 2009, the Health Practitioner Regulation National Law Act 2009 in Queensland received royal assent in the Queensland parliament. The national law set out the framework for the scheme, covering registration of health practitioners and accreditation of health education and training, complaints, privacy and information sharing, and transitional arrangements. The Commonwealth does not need to apply the act for national law; however, consequential and transitional amendments are required to the Health Insurance Act 1973 to ensure that medical practitioners continue to retain the same Medicare billing eligibility from 1 July 2010. The bill streamlines the extensive systems involved in registration and recognition of medical practitioners for Medicare purposes, ensuring reduction of red tape, and helps to maintain the currency of the Health Insurance Act 1973 regulations and adequate access to Medicare rebates and retention of practitioners in Australia.

The member for Herbert was quite scathing of the government’s attempts to reduce regulation, saying that these are not matters for patients. But I think the member for Herbert, if he thinks about it, will realise that for every minute that health practitioners spend dealing with government regulation they are not with their patients. Reducing regulation in small business, in health professions around the country, as this government has been doing, dramatically increases the capacity of professionals to do what they are trained to do rather than administer.

The current pathways to specialist, consultant physician and GP recognition in the Health Insurance Act 1973 necessitate communication exchange between Medicare Australia and relevant organisations, such as medical colleges, to ascertain Medicare eligibility. These arrangements have been put in place because previously there was variation across states and territories for the recognition of specialist qualifications and general practice qualifications in the registration process.

The national registration and accreditation scheme provides a nationally consistent means of identifying both specialists and GPs, and the mandatory requirement for continuing professional development in the scheme means that Medicare Australia is no longer required to monitor whether practitioners providing a Medicare rebateable service are meeting continuing professional development requirements. It is essential that the extensive systems involved in registration and recognition of doctors for Medicare purposes are streamlined to ensure the reduction of red tape. The currency of the health insurance regulations and the efficient access to Medicare rebates depends on that.

The Health Insurance Act 1973 provides various pathways for recognising specialists, consultant physicians and general practitioners for Medicare purposes. This bill provides an opportunity to streamline current specialist recognition processes under Commonwealth legislation. This includes removing the current vocational register of general practitioners, particularly now that the Medical Board of Australia has recommended that health ministers endorse general practice as a specialty for the medical profession. The bill will not disadvantage medical practitioners that are currently registered in states and territories. In particular, it will not disadvantage any GPs that are currently on the vocational register whether or not they have a fellowship of the Royal Australian College of General Practitioners or the Australian College of Remote and Rural Medicine. Streamlining specialist recognition will also facilitate workforce mobility and access to Medicare for international medical graduates.

The National Registration and Accreditation Scheme for the Health Professions will modernise the regulation of health professionals by creating a single regulatory environment. By ending the duplication of effort, multiple standards and red tape caused by separate systems in each state and territory, we will have a more workable registration scheme for Australian patients and practitioners that also contributes to improving the safety of our health system for all Australians. It provides the community with reassurance that health professionals across Australia will meet a common set of standards. Our health workforce will also benefit from the improved mobility and transparency the national scheme will offer. I look forward to the implementation of the national registration and accreditation scheme for the first time in Australia—a scheme that, for the first time, introduces national recognition for these important medical practitioners. This is an important piece of health reform work and I am very pleased to be commending it to the House.

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