Bills Digest no. 98 2014–15
PDF version [627KB]
WARNING: This Digest was prepared for debate. It reflects the legislation as introduced and does not canvass subsequent amendments. This Digest does not have any official legal status. Other sources should be consulted to determine the subsequent official status of the Bill.
Amanda Biggs and Alex Grove
Social Policy Section
8 May 2015
Contents
Nature
of the Norfolk Island Bills package
Purpose of the Bills
Background
Committee consideration
Statement of Compatibility with Human Rights
Policy position of non-government parties/independents
Position of major interest groups
Financial implications
Key provisions
Date introduced: 26
March 2015
House: House of
Representatives
Portfolio: Infrastructure
Commencement: Schedule
1 from each Bill commences at the same time as Part 1 of Schedule 2 to the Norfolk
Island Legislation Amendment Act 2015 commences, which is 1 July 2016.
Links: The links to the Bills, their
Explanatory Memoranda and second reading speeches can be found on the Bills’
home pages for the Aged
Care (Accommodation Payment Security) Levy Amendment (Norfolk Island) Bill 2015,
the Health
Insurance (Pathology) (Fees) Amendment (Norfolk Island) Bill 2015, the Health
and Other Services (Compensation) Care Charges Amendment (Norfolk Island) Bill
2015, the Health
Insurance (Approved Pathology Specimen Collection Centres) Tax Amendment
(Norfolk Island) Bill 2015, and the Private
Health Insurance (Risk Equalisation Levy) Amendment (Norfolk Island) Bill 2015,
or through the Australian
Parliament website.
When Bills have been passed and have received Royal Assent, they
become Acts, which can be found at the ComLaw
website.
The Bills which are the subject of this Bills Digest are part
of a package of eight Bills (Norfolk Island Bills package) that propose reforms
to the governance arrangements for Norfolk Island and propose to extend
mainland social security, health (including Medicare), immigration and taxation
arrangements to the Island.
Most of the substantive changes to governance, social
security, health and immigration arrangements are made by the Norfolk Island
Legislation Amendment Bill 2015.[1]
However, individual Bills are required when a tax or levy is to be imposed.[2]
The Bills covered by this Bills Digest are:
- the
Aged Care (Accommodation Payment Security) Levy Amendment (Norfolk Island) Bill
2015[3]
- the
Health and Other Services (Compensation) Care Charges Amendment (Norfolk
Island) Bill 2015[4]
- the
Health Insurance (Approved Pathology Specimen Collection Centres) Tax Amendment
(Norfolk Island) Bill 2015[5]
- the
Health Insurance (Pathology) (Fees) Amendment (Norfolk Island) Bill 2015[6]
and
- the
Private Health Insurance (Risk Equalisation Levy) Amendment (Norfolk Island)
Bill 2015.[7]
Together they make consequential amendments to extend tax
and levy related measures to Norfolk Island.
Two related Bills will amend taxation arrangements,
including by extending Medicare levy arrangements to Norfolk Island. These are:
- the
Tax and Superannuation Laws Amendment (Norfolk Island Reforms) Bill 2015[8]
and
- the
A New Tax System (Medicare Levy Surcharge–Fringe Benefits) Amendment Bill 2015.[9]
Aged Care (Accommodation Payment
Security) Levy Amendment (Norfolk Island) Bill 2015
The purpose of the Aged Care (Accommodation Payment
Security) Levy Amendment (Norfolk Island) Bill 2015 (the Aged Care Levy Bill)[10]
is to amend the Aged Care (Accommodation Payment Security) Levy Act 2006
to extend the provisions of that Act to the territory of Norfolk Island.[11]
Health and Other Services
(Compensation) Care Charges Amendment (Norfolk Island) Bill 2015
The purpose of the Health and Other Services
(Compensation) Care Charges Amendment (Norfolk Island) Bill 2015 (the Health
Compensation Charges Bill)[12]
is to amend the Health and Other Services (Compensation) Care Charges Act
1995 to extend the provisions of that Act to the territory of Norfolk
Island.[13]
Health Insurance (Approved
Pathology Specimen Collection Centres) Tax Amendment (Norfolk Island) Bill 2015
The purpose of the Health Insurance (Approved Pathology
Specimen Collection Centres) Tax Amendment (Norfolk Island) Bill 2015 (the
Approved Pathology Centres Tax Bill)[14]
is to amend the Health Insurance (Approved Pathology Specimen Collection
Centres) Tax Act 2000, to extend the provisions of that Act to the
territory of Norfolk Island.[15]
Health Insurance (Pathology) (Fees)
Amendment (Norfolk Island) Bill 2015
The purpose of the Health Insurance (Pathology) (Fees)
Amendment (Norfolk Island) Bill 2015 (the Pathology Fees Bill)[16]
is to amend the Health Insurance (Pathology) (Fees) Act 1991 to extend
the provisions of that Act to the territory of Norfolk Island.[17]
Private Health Insurance (Risk
Equalisation Levy) Amendment (Norfolk Island) Bill 2015
The purpose of the Private Health Insurance (Risk
Equalisation Levy) Amendment (Norfolk Island) Bill 2015 (the Risk Equalisation
Levy Bill)[18]
is to amend the Private Health Insurance (Risk Equalisation Levy) Act 2003,
to extend the provisions of that Act to the territory of Norfolk Island.[19]
Health status of Norfolk Island
residents
There is limited data on the health status of residents of
Norfolk Island. A recent draft health plan provided a summary profile of some
health indicators based on a number of sources. This included the following
findings:
- the
age profile of the population is generally older on the Island compared to the
mainland[20]
- a
majority of the adult population (75 per cent) reported more than one major
risk factor for cardiovascular disease[21]
- there
was significant under-diagnosis of hypertension in the community[22]
- there
were a high number of undiagnosed and untreated cases of diabetes[23]
- around
20 per cent of the population was considered obese[24]
- income
levels on the Island are generally lower than on the mainland[25]
and
- the
most common reason cited for financial distress was high medical Bills.[26]
A more recent survey based on a sample of 335
respondents included the following additional findings:
- a
majority of the population (83 per cent) described their health as either good,
very good or excellent[27]
- 63
per cent of the population reported being either overweight or obese[28]
- in
terms of physical activity, both men and women reported engaging in low, medium
and high levels of physical activity that exceeded the Australian benchmarks
for these categories[29]
- a
majority (64 per cent) reported low levels of psychological distress, 23 per
cent reported moderate levels of distress and 13 per cent high or very high,
broadly in line with Australian benchmarks[30]
- around
32 per cent reported alcohol consumption at moderate to high risk levels, but a
majority (47 per cent) reported consumption at low risk levels[31]
and
- a
majority (around 62 per cent) reported not smoking in the previous three
months, while around ten per cent reported smoking on a daily basis.[32]
In addition, another recent report found that some 59 per
cent of respondents reported cost was a barrier to them accessing health care.[33]
Healthcare on Norfolk Island
All health services on Norfolk Island are currently provided
through the Norfolk Island Hospital Enterprise (NIHE). Medicare arrangements do
not currently operate.
Established under the Norfolk Island Hospital Act 1985
(Norfolk Island) the NIHE currently has about 24 beds (including aged care
beds) and is the only provider of health services for the whole of Norfolk
Island.[34]
Services include typical hospital services such as surgery and obstetrics, dispensary
(pharmacy), laboratory and pathology services, x-rays, physiotherapy, dental
services, primary care services and aged care. The hospital is currently
undergoing a process to become accredited to Australian health standards.[35]
Unlike public hospitals in Australia, the NIHE is permitted
to charge for its services, but the fees must be based on the ‘true economic
cost of the services’ and requiring patients to pay for services up-front is
prohibited.[36]
In addition to this revenue, the NIHE also receives significant subsidies from
the Administration of Norfolk Island with additional revenue provided by the
Australian Government. In 2012–13, the Administration provided $1.83 million to
the NIHE while the Australian Government provided $100,000. Revenue from fees
totalled $1.33 million.[37]
Because the NIHE is required to provide health services
regardless of whether a resident owes it money, it often carries a number of
debts. It is estimated that some 43 per cent of hospital debts remain
outstanding for 90 days or longer.[38]
The latest financial statements show that the hospital operated with a deficit
of $278,160 in the last financial year.[39]
Under the Healthcare Levy Act 1990 (Norfolk Island),
most adult residents of Norfolk Island are required to pay an annual levy to
the Island’s Healthcare Fund to help meet the cost of their health care.[40]
The Healthcare Fund was established under the Healthcare Act 1989 (Norfolk
Island) and is intended to help residents meet catastrophic medical costs and
the cost of a medical evacuation if required.[41]
However, only when their annual out of pocket health expenditure exceeds an
annual threshold, are additional health costs met by the Healthcare Fund. Patients must incur charges of $2,000 before
they become eligible to receive benefits from the Healthcare Fund.[42]
As noted recently in a speech by the Assistant Minister for Infrastructure and
Regional Development, Jamie Briggs, a family of four would need to spend almost
$4,000 annually before the Island’s health insurance fund would start to assist
them.[43]
Norfolk Island recently signed an agreement with South
Eastern Sydney Local Health District (SESLHD) to provide patients with enhanced
pathways to treatment, such as allowing Norfolk Island patients to access
specialist health services remotely using Telehealth facilities.[44]
Medicare
Since 1989, residents of Norfolk Island have been ineligible
for Medicare and the Pharmaceutical Benefits Scheme (PBS). When Medicare
commenced in 1984, the definition of an Australian resident did
not extend to residents of Norfolk Island.[45]
However visitors who were eligible to stay in Australia for more than six
months were granted eligibility for Medicare, meaning residents of Norfolk
Island who visited the mainland still had access to Medicare whilst here
(although not to hospital services).[46]
In 1988, extending free access to mainland hospital services
for visiting Norfolk Islanders and giving Australian visitors to Norfolk Island
free hospital treatment was under active consideration. However, Commonwealth
health authorities advised against it and the proposal did not proceed.[47]
Amendments to the Health Insurance Act 1973 later that year further
restricted access to Medicare to persons with a legal entitlement to live in
Australia, while also excluding Australian citizens who lived overseas and
removing Medicare benefits for any services provided overseas, effectively
excluding Medicare eligibility for Norfolk Islanders.[48]
Proposed provisions in the Norfolk Island Legislation
Amendment Bill 2015 extend Medicare benefit arrangements to Norfolk Island by
including the Island in the definition of Australia.[49]
Private Health Insurance
The Norfolk Island Legislation Amendment Bill 2015 includes
a number of provisions that propose to extend Australia's private health
insurance arrangements to Norfolk Island.[50]
Transitional arrangements are proposed for the calculation of a person’s
liability for the Lifetime Health Cover loading, to allow a one year extension
to the date a person’s lifetime health cover base day is determined.[51]
Aged Care
Currently, the Aged Care Act 1997 and related acts
do not apply to Norfolk Island.[52]
Aged care services on Norfolk Island are provided by the
NIHE. The 24 bed hospital includes 12 aged care beds, and the NIHE also
provides home and community aged care services.[53]
In practice, aged care services take the form of an aged care unit in the
Norfolk Island hospital, hostel type accommodation in the hospital grounds, and
a district nurse who visits aged people in their homes three times a week.[54]
Eligible residents in the aged care unit of the hospital
qualify for a long-term care benefit, and are required to pay the fees for
their care up to 80 per cent of their income.[55]
The NIHE also receives an annual subsidy from the Administration of Norfolk
Island to meet the costs of providing health care on the island. In 2013–14 the
NIHE received $448,312 in aged care income, and a further $1.9 million subsidy
from the Administration.[56]
Aged care service provision on the island is below the
standard of mainland Australia. A 2001 report by the Joint Standing Committee
on the National Capital and External Territories (Joint Standing Committee) noted
that a lack of home support services and alternatives to nursing home care
meant frail elderly residents had to choose between leaving the island to seek
care or becoming long-term hospital patients.[57]
The Joint Standing Committee heard that the aged care accommodation provided in
former public wards of the hospital was in poor physical condition, lacked
privacy and security, as was not able to accommodate married couples together.[58]
The Joint Standing Committee recommended that the Aged Care Act be extended
to cover Norfolk Island.[59]
In 2013, consultants engaged to draft a health services
plan for the Island noted a striking lack of progress since the 2001 Joint
Standing Committee report, with the situation still characterised by ‘an
absence of appropriate aged care service options’,[60]
and a ‘skewing of health services to acute care [that] is inconsistent with the
needs of a population that is ageing’.[61]
In keeping with the 2001 recommendation of the Joint
Standing Committee, the Australian Government is now seeking to extend the
legislative provisions for subsidised aged care to Norfolk Island.
Accordingly, the Norfolk Island Legislation Amendment Bill
2015 amends the Aged Care Act, Aged Care (Transitional Provisions)
Act 1997,[62]
Australian Aged Care Quality Agency Act 2013[63]
and the Aged Care (Accommodation Payment Security) Act to extend
aged care arrangements to the island.[64]
Selection of Bills Committee
At its meeting of 26 March 2015, the Selection of Bills
Committee resolved to recommend that the Bills comprising the Norfolk Island
Bills package not be referred to Committee for inquiry and report.[65]
Senate Standing Committee for the
Scrutiny of Bills
At the time of writing this Bills Digest, the Senate Standing
Committee for the Scrutiny of Bills had not published any comments in relation
to the Bills in the Norfolk Island Bills package.
Parliamentary Joint Committee on
Human Rights
At the time of writing this Bills Digest, the Parliamentary
Joint Committee on Human Rights had not published any comments in relation to
the Bills in the Norfolk Island Bills package.
As required under Part 3 of the Human Rights
(Parliamentary Scrutiny) Act 2011 (Cth), the Government has assessed
these Bills’ compatibility with the human rights and freedoms recognised or
declared in the international instruments listed in section 3 of that Act. The
Government considers that these Bills are compatible.[66]
No statements by non-government parties in relation to the
amendments contained in the Bills discussed in this Bills Digest have been
identified. The Bills Digest for the Norfolk Island Legislation Amendment Bill
2015 contains information about the responses by government
parties/independents to the proposed reforms contained in the Norfolk Island
Bills package.[67]
No stakeholder comments in relation to the amendments
contained in the Bills discussed in this Bills Digest have been identified. The
Bills Digest for the Norfolk Island Legislation Amendment Bill 2015 contains an
overview of the positions of major interest groups to the broader reforms
contained in the Norfolk Island Bills package.[68]
The total Norfolk Island reform package is estimated to
cost the Commonwealth $136.2 million over the forward estimates, according to
the Explanatory Memorandum.[69]
However, potential revenue from the collection of levies and taxes is not
separately identified.
Aged Care (Accommodation Payment
Security) Levy Amendment (Norfolk Island) Bill 2015
The Aged Care (Accommodation Payment Security) Act 2006
guarantees the refund of accommodation payment (bond) balances to aged care
residents if their approved provider becomes insolvent.[70]
If the provider does not refund all of the balance, the Commonwealth pays the
outstanding amount to the resident.[71]
The Commonwealth can then recoup its costs by imposing a levy on other approved
providers by regulation under the Aged Care (Accommodation Payment Security)
Levy Act 2006.[72]
As previously noted, the Aged Care (Accommodation
Payment Security) Act is amended by the Norfolk Island Legislation
Amendment Bill 2015.[73]
Schedule 1 of the Aged Care (Accommodation Payment Security)
Levy Amendment (Norfolk Island) Bill 2015 amends subsection 3(2) of the Aged
Care (Accommodation Payment Security) Levy Act to insert the words ‘Norfolk
Island’. This extends the application of that Act to Norfolk Island.
Health and Other Services
(Compensation) Care Charges Amendment (Norfolk Island) Bill 2015
The Health and Other Services (Compensation) Act 1995
provides that the Commonwealth does not pay a Medicare benefit, nursing home
benefit, or residential care subsidy for a person who is in receipt of injury
compensation payments.[74]
However, the Commonwealth may recover such benefits or subsidies where they
have already been paid—but only to the extent that the recovery charge does not
constitute a tax.[75]
In order to ensure that the benefits can be recovered, the Health and Other
Services (Compensation) Care Charges Act provides for the recovery of
benefits where they may be determined to be a tax.[76]
The Health and Other Services (Compensation) Act is
amended by the Norfolk Island Legislation Amendment Bill 2015.[77]
Schedule 1 of the Health and Other Services
(Compensation) Care Charges Amendment (Norfolk Island) Bill 2015 inserts proposed
section 3A into the Health and Other Services (Compensation) Care
Charges Act so that it extends to Norfolk Island.
According to the Assistant Minister for Infrastructure and
Regional Development, Jamie Briggs, this ‘ensures that Medicare benefits,
nursing home benefits or residential care subsidies are recoverable from
persons on Norfolk Island who receive compensation or damages through a
judgement or settlement.’[78]
Health Insurance (Approved
Pathology Specimen Collection Centres) Tax Amendment (Norfolk Island) Bill 2015
Pathology broadly covers blood and tissue testing which is
used to determine the cause and progression of disease.
As stated above, all health services on Norfolk Island
including pathology are currently provided through the NIHE. There are no
independent pathology providers outside of the hospital. In 2012, the NIHE
performed 8,592 pathology tests, a slight increase on the previous year.[79]
In order to provide approved Medicare rebatable services
in future, a pathology provider needs to comply with the requirements for the
provision of pathology services as prescribed in the Health Insurance Act
1973 (HIA).[80]
The HIA places certain conditions on those seeking to obtain approval as providers
of pathology services and to operate as specimen collection centres, including
the payment of certain fees and taxes.
The Health Insurance (Approved Pathology Specimen
Collection Centres) Tax Act 2000 requires that a tax must be paid before
the Minister can grant an approval to an approved pathology authority to become
an eligible collection centre.[81]
For an approval that is granted for one year, the tax is set at $1,000. For an
approval of less than one year, the tax is calculated according to a pro-rata
formula specified in the Act.[82]
Grants of approval for collection centres located on the same premises as a
category GX or GY accredited pathology laboratory are exempt from paying the
tax. GX and GY laboratories are normally located in recognised public
hospitals.[83]
Item 1 of Schedule 1 of the Bill inserts the words
‘Norfolk Island’ as proposed paragraph 4(aa) of the Health Insurance
(Approved Pathology Specimen Collection Centres) Tax Act, in order to
extend the operation of that Act to Norfolk Island.
Health Insurance (Pathology) (Fees)
Amendment (Norfolk Island) Bill 2015
The HIA specifies the approval requirements for applicants
seeking to become an approved pathology provider or authority.
The HIA requires an applicant to give a signed undertaking
to the Minister in relation to fulfilling certain administrative and
quality-related obligations. The Minister can either accept or reject their
undertaking.[84]
The Health Insurance (Pathology) (Fees) Act specifies the payment of a
fee from the approved pathology provider to the Commonwealth when acceptance of
their undertaking is given. The fee is $500 for the acceptance of an
undertaking from an approved pathology practitioner and $1,500 from an approved
pathology authority.[85]
When a premises is approved as an accredited pathology
laboratory the Health Insurance (Pathology) (Fees) Act specifies certain
fees are payable, depending on the accreditation level of the laboratory. There
are four accreditation levels with a scale of fees. The highest accreditation
requires payment of a $2,500 fee; the second highest requires payment of $2,000;
the third highest requires payment of $1,500 and the lowest level accreditation
requires payment of $750.[86]
Item 1 of Schedule 1 of the Bill inserts the words
‘Norfolk Island’ as proposed paragraph 4(aa) of the Health Insurance
(Pathology) (Fees) Act, in order to extend the operation of that Act to
Norfolk Island.
Private Health Insurance (Risk
Equalisation Levy) Amendment (Norfolk Island) Bill 2015
Private health insurers in Australia operate under a
regulatory regime specified in the Private Health Insurance Act 2007, and
related legislation and regulations.[87]
Under this regime, private health insurers are liable for a number of levies.
One of these, the Risk Equalisation Levy is an amount each
insurer must pay into the Risk Equalisation Trust Fund (RETF). The RETF is a
pool of funds which allows for the sharing of risk across insurers—effectively
a form of reinsurance. It is a fundamental component underpinning Australia's
community rating system which prohibits insurers from charging different
premiums on the basis of health, age (other than at entry), gender or claims
history.[88]
Item 1 of Schedule 1 of the Bill inserts the words
‘Norfolk Island’ after ‘extends to’ in section 4 of the Private Health
Insurance (Risk Equalisation Levy) Act, in order to extend the operation of
that Act to Norfolk Island.
Members, Senators and Parliamentary staff can obtain
further information from the Parliamentary Library on (02) 6277 2500.
[1]. Parliament
of Australia, ‘Norfolk
Island Legislation Amendment Bill 2015 homepage’, Australian Parliament
website, accessed 7 May 2015
[2]. General
drafting practice is that Bills imposing a tax or levy are stand-alone Bills.
This is because section 55 of the Commonwealth of Australia Constitution Act
(Constitution) stipulates that ‘Laws imposing taxation shall deal
only with the imposition of taxation, and any provision therein dealing with
any other matter shall be of no effect’. Constitution,
accessed 5 May 2015.
[3]. Parliament
of Australia, ‘Aged Care (Accommodation
Payment Security) Levy Amendment (Norfolk Island) Bill 2015 homepage’,
Australian Parliament website, accessed 5 May 2015.
[4]. Parliament
of Australia, ‘Health
and Other Services (Compensation) Care Charges Amendment (Norfolk Island) Bill
2015 homepage’, Australian Parliament website, accessed 5 May 2015.
[5]. Parliament
of Australia, ‘Health
Insurance (Approved Pathology Specimen Collection Centres) Tax Amendment
(Norfolk Island) Bill 2015 homepage’, Australian Parliament website,
accessed 5 May 2015.
[6]. Parliament
of Australia, ‘Health
Insurance (Pathology) (Fees) Amendment (Norfolk Island) Bill 2015 homepage’,
Australian Parliament website, accessed 5 May 2015.
[7]. Parliament
of Australia, ‘Private
Health Insurance (Risk Equalisation Levy) Amendment (Norfolk Island) Bill 2015
homepage’, Australian Parliament website, accessed 5 May 2015.
[8]. Parliament
of Australia, ‘Tax
and Superannuation Laws Amendment (Norfolk Island Reforms) Bill 2015 homepage’,
Australian Parliament website, accessed 5 May 2015.
[9]. Parliament
of Australia, ‘A
New Tax System (Medicare Levy Surcharge–Fringe Benefits) Amendment Bill 2015
homepage’, Australian Parliament website, accessed 5 May 2015.
[10]. Parliament
of Australia, ‘Aged
Care Health (Accommodation Payment Security) Levy Amendment (Norfolk Island)
Bill 2015 homepage’, Australian Parliament website, accessed 5 May 2015.
[11]. Aged Care
(Accommodation Payment Security) Levy Act 2006, accessed 5 May
2015.
[12]. Parliament
of Australia, ‘Health
and Other Services (Compensation) Care Charges Amendment (Norfolk Island) Bill
2015 homepage’, Australian Parliament website, accessed
5 May 2015.
[13]. Health and Other Services
(Compensation) Care Charges Act 1995, accessed 5 May 2015.
[14]. Parliament
of Australia, ‘Health
Insurance (Approved Pathology Specimen Collection Centres) Tax Amendment
(Norfolk Island) Bill 2015 homepage’, Australian Parliament website,
accessed 6 May 2015.
[15]. Health
Insurance (Approved Pathology Specimen Collection Centres) Tax Act 2000,
accessed 5 May 2015.
[16]. Australian
Parliament, ‘Health
Insurance (Pathology) (Fees) Amendment (Norfolk Island) Bill 2015 homepage’,
Australian Parliament website, accessed 6 May 2015.
[17]. Health
Insurance (Pathology) (Fees) Act 1991, accessed 5 May 2015.
[18]. Parliament
of Australia, ‘Private
Health Insurance (Risk Equalisation Levy) Amendment (Norfolk Island) Bill 2015
homepage’, Australian Parliament website, accessed 6 May 2015.
[19]. Private Health
Insurance (Risk Equalisation Levy) Act 2003, accessed 5 May
2015.
[20]. Nexus
Management Consulting (NMC), Norfolk
Island - Draft Health Services Plan, NMC, October 2013, p. 8, accessed
14 April 2015.
[21]. Ibid.,
p. 9.
[22]. Ibid.,
p. 10.
[23]. Ibid.
[24]. Ibid.
[25]. Ibid.,
pp. 11–12.
[26]. Ibid.,
p. 11.
[27]. R
& S Muller Enterprise, Health
services survey report, Norfolk Island Hospital Enterprise,
3 February 2015, p. 9, accessed 9 April 2015.
[28]. Ibid.,
p. 11.
[29]. Ibid.,
p. 16.
[30]. Ibid.,
p. 26.
[31]. Ibid.,
p.39.
[32]. Ibid.,
p 35. Out of 335 respondents, 207 reported not smoking over the period and 33
reported smoking daily.
[33]. R
& S Muller Enterprise, Response
to the Draft Health Services Plan, Norfolk Island Hospital
Enterprise, 3 February 2015, p. 32, accessed 9 April 2015.
[34]. Norfolk
Island Hospital Act 1985 (Norfolk Island), accessed 5 May 2015.
[35]. R Adams
(Minister for Cultural Heritage and Community Services), Norfolk
Island Hospital Enterprise update on accreditation process, media
release, 21 March 2014, accessed 9 April 2015.
[36]. Norfolk
Island Hospital Act 1985 (Norfolk Island), paragraph 8(1)(a) and
subsection 25(2). Fees for most services were recently raised by 3.5%. See R
Adams (Minister for Cultural Heritage and Community Services), Increase
in Norfolk Island health service charges, media release,
15 January 2014, accessed 9 April 2015.
[37]. Department
of Infrastructure and Regional Development, ‘Financial
statements—Administration 2012–13: Norfolk Island Hospital Enterprise’,
Note 4G, p. 63 accessed 6 May 2015.
[38]. Nexus
Management Consulting (NMC), op. cit., p. 11.
[39]. Ibid.,
p. 49.
[40]. Section
7 of the Healthcare
Levy Act 1990 (Norfolk Island)
accessed 8 April 2015. Exemptions apply for certain low income persons and
veterans. The levy is payable quarterly. The healthcare levy was recently
raised to $220 a quarter and the evacuation levy to $80. R Adams (Minister
for Cultural Heritage and Community Services), Increase
in healthcare and medical evacuation levy proposed amendments to healthcare
legislation, media release, 21 February 2014, accessed 9 April
2015.
[41]. Section
7 of the Healthcare
Act 1989 (Norfolk Island), accessed 13 April 2015.
[42]. Originally
the threshold of expenditure was set at $2,500. See section 19(1A) of the Healthcare
Act 1989 (Norfolk Island). However, in June 2012 the threshold
was dropped to $2,000. Exemptions apply to low income earners. T Sheridan
(Minister for Community Services), Healthcare
levy and healthcare fund relief, media release, 11 May 2012,
accessed 9 April 2015.
[43]. J
Briggs (Assistant Minister for Infrastructure and Regional Development), Statement
on Norfolk Island, speech, 27 March 2014, accessed 13 April 2015.
[44]. T
Sheridan (Minister for Community Services),
Signing of MOU between South East Sydney Local Health Services and Norfolk
Island Hospital Enterprise , media release, 22 February 2013, and Patients
to have immediate access to health services in New South Wales following the
finalisation of discussions between the Norfolk Island Hospital Enterprise and
South East Sydney Local Health District, media release,
18 February 2012, both accessed 9 April 2015.
[45]. Eligibility
for Medicare is a requirement for eligibility for the PBS.
[46]. This
historical overview is drawn from Joint Standing Committee on the National
Capital and External Territories, In
the pink or in the red? Inquiry into the provision of health services on
Norfolk Island, Canberra, July 2001, pp. 133–134, accessed 9 April
2015.
[47]. In
March 1988, ‘Commonwealth health authorities advised that an agreement for
reciprocal health care could only be contemplated where there were negligible
costs to the Budget, comparability of health care systems and equality of
access’. Ibid., p. 134.
[48]. Ibid.,
p. 134. The relevant legislation is the Community Services and
Health Legislation Amendment Act (No. 2) 1988, accessed 6 May
2015.
[49]. Items
214–220 of Schedule 2 of the Norfolk
Island Legislation Amendment Bill 2015, accessed 7 May 2015.
[50]. Items
306–310 of Schedule 2 of the Norfolk Island Legislation Amendment Bill 2015
extend the provisions of the Private Health Insurance Act 2007 to
Norfolk Island.
[51]. Lifetime
Health Cover is a 2% loading on the cost of private health insurance premiums,
which is incurred when a person delays taking out private health insurance
after they turn 31.
[52]. Aged Care Act
1997 subsection 4-1(2), accessed 5 May 2015.
[53]. Norfolk
Island Government, Community
budget update 2014–15, 19 December 2014, p. 8, accessed 8 April 2015.
[54]. Norfolk
Island Living Library, ‘The Norfolk Island
Hospital’, Norfolk Island Living Library website, accessed 8 April 2015.
[55]. Section
28A of the Social
Services Act 1980 (Norfolk Island), accessed 5 May 2015.
[56]. Norfolk
Island Government, Community
budget update 2014–15, op. cit.
[57]. Joint
Standing Committee on the National Capital and External Territories, In
the pink or in the red? Inquiry into the provision of health services on
Norfolk Island, op. cit., pp. 83–86.
[58]. Ibid.
[59]. Ibid.,
p. 95.
[60]. Nexus
Management Consulting (NMC), Norfolk
Island - Draft Health Services Plan, op. cit., p. 22, accessed 14 April
2015.
[61]. Ibid.,
p. 23.
[62]. Aged Care (Transitional
Provisions) Act 1997, accessed 5 May 2015.
[63]. Australian Aged Care
Quality Agency Act 2013, accessed 6 May 2015.
[64]. Items
35–43 and 63–64 of Schedule 2 of the Norfolk Island Legislation
Amendment Bill 2015. Norfolk Island will be considered a region of New South
Wales for the purposes of allocation of places, extra service places and
residential care subsidies.
[65]. Selection
of Bills Committee, Report
No. 4 of 2015, Senate, Canberra, 26 March 2015, accessed 6 May 2015.
[66]. The
Statement of Compatibility with Human Rights can be found on page 9 of the Explanatory
Memorandum to the Norfolk Island Legislation Amendment Bill 2015 et al.
[67]. The
Bills Digest is available at the Bill homepage – see Parliament of Australia, ‘Norfolk
Island Legislation Amendment Bill 2015 homepage’, Australian Parliament
website, accessed 7 May 2015.
[68] Ibid.
[69]. Explanatory
Memorandum, Norfolk
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