Additional comments by Coalition Senators
Coalition Senators do not oppose the recommendation of the
report that this bill should be passed.
However, Coalition Senators strongly believe that the
Government's co-called health reform package is more about creating the
political illusion of health reform than any meaningful improvement or
guarantees for patients.
The illusion of reform
This so-called reform represents an enormous back-down by a
Prime Minister and Minister for Health desperate to create the impression of
health reform, despite this being the third time in only eighteen months that
the Government has claimed an 'historic agreement' on health reform. The fact
that it only bears a passing resemblance to the supposed agreement promoted by
the then Prime Minister last year and further dilutes the agreement announced
by the current Prime Minister earlier this year illustrates exactly how
desperate the Labor Government is to create the illusion of achievement in this
critical area.
Apart from the establishment of new bureaucracies, key
changes in health will not be implemented until 2014-15 – conveniently after
the next general election is due. In particular, as well as the commitment to
fund 60% of hospital costs being scrapped, the current commitment to 50% of
growth funding will not occur until 2017. Furthermore, guarantees about
elective surgery have been scrapped and targets for emergency treatment have
been watered down.
Potential for duplication
Considerable concerns were expressed about the possible
duplication of effort following the creation of the new authorities. Various
submissions commented that there was no legislative requirement for the new
authorities to cooperate with existing agencies (so as to not simply duplicate
existing work) but also to cooperate with each other.
While it may seem obvious that such cooperation is necessary
and beneficial, the lack of a legislative direction in this regard is of
concern.
Coalition Senators believe that consideration should be
given to an independent review of these agencies' and authorities' operations
after their initial establishment and implementation.
Recognition of non-government hospitals
Catholic Health Australia highlighted one of the major
potential problems with his legislation – that while the cost base for
treatment in Catholic public hospitals is different from state public
hospitals, there is no guarantee of representation for non-government hospitals
on the IHPA.
As outlined by Martin Laverty, CEO of Catholic Health
Australia:
Very specifically, senators will be aware that Catholic
Health Australia represents about 10 per cent of the nation's hospital beds.
Within that there are 2,700 public hospital beds operated by Catholic
hospitals, mostly on the east coast, but broadly around Australia. For the bill
to be effective it needs to have regard to the unique nature and the slightly
different legal status under which those 2,700 public hospital beds actually
operate. We do not see that reflected in the bill at present, but we think minor
amendments can adequately incorporate the impacts of the differing legal
structures that operate those 2,700 public hospital beds, and we have proposed
that to you in our submission.[i]
He went on to outline:
For example, in a non-government owned provider of public
hospital services, we have to account for capital, depreciation, insurances,
council rates, long-service leave and information technology, even down to
whether or not a Microsoft licence per user is applied to each cost of patient
admission. Different states and territories use different accounting systems,
which affects whether or not these various components will ultimately make
their way into what is an efficient price. For an NGO provider of hospital
services, all of these form the component of what is the price or the cost of
delivering a service. Some states and territories account for these things
differently; indeed, within states different areas at present can account for
them differently. [ii]
Coalition Senators believe that this experience and
perspective should be reflected in the IHPA.
As outlined by Martin Laverty in evidence before the
committee:
Therefore, we argue that the governance of this new
authority should allow for the appointment to its board of someone who has
experience in the delivery of NGO hospital services. [iii]
Just as section 144(4) of the Bill requires that at least
one member of the Authority has substantial knowledge or experience in the
provision of health care in regional or rural areas, Coalition Senators support
the submission of Catholic Health Australia that non-government hospitals
should also be guaranteed representation.
Recommendation:
Coalition Senators recommend that section 144(4) of the
bill be amended to add an additional requirement to include as a member of the
Authority a person who has substantial knowledge or experience in the provision
of services in non-government owned hospitals.
Senator Scott Ryan
Senator for Victoria |
Senator Sean Edwards
Senator for South Australia |
| |
|
Senator Concetta Fierravanti-Wells
Senator for New South Wales |
Senator Sue Boyce
Senator for Queensland |
[i]
Hansard of hearing
[ii]
Hansard of hearing
[iii]
Hansard of hearing
Navigation: Previous Page | Contents | Next Page