EXPLANATORY STATEMENT
ISSUED BY THE AUTHORITY OF THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
DECLARATION OF QUALITY ASSURANCE ACTIVITY UNDER SECTION 124X OF THE HEALTH INSURANCE ACT 1973 - QAA 11/2016
Part VC of the Health Insurance Act 1973 (the Act) creates a scheme to encourage efficient quality assurance activities. Those activities help to ensure the quality of health services that are funded by the Government including, through Medicare benefits, the Pharmaceutical Benefits Scheme, and/or Health Program Grants. The scheme encourages participation in such activities by protecting certain information from disclosure, and also by providing some protection from civil liability to certain persons engaged in those activities in good faith, in respect of those activities.
For Part VC to apply to an activity, the Minister must make a declaration pursuant to section 124X of the Act, that the activity is a quality assurance activity to which Part VC applies.
The Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 - QAA 11/2016 (the Declaration) has effect from the day after registration on the Federal Register of Legislation.
The Declaration applies Part VC of the Act to the following activity, to the extent it relates to health services provided in Australia:
- Royal Australasian College of Physicians (RACP): Professional Qualities Reflection (PQR) of the Royal Australasian College of Physicians
An overview of the activity is contained in Attachment A.
Before making a declaration under section 124X, the Minister must be satisfied that the persons engaging in the activity are authorised to do so in one of the ways set out in paragraph 124X(3)(a) of the Act. The persons engaged in the PQR are authorised to do so by the RACP, which is an association of health professionals and an educational institution (see subparagraphs 124X(3)(a)(vi) and (iv)).
Secondly, paragraph 124X (3)(b) of the Act provides that the Minister must be satisfied that it is in the public interest that Part VC of the Act apply to the activity. In doing so, the Minister must have regard to criteria prescribed by regulations 23C to 23G of the Health Insurance Regulations 1975 (the Regulations).
The activity meets the criteria as follows:
- As required by regulation 23C, the activity includes the disclosure of
non-identifying information concerning the quality of service assessed, evaluated or studied. The RACP will publish statistical information in the RACP Annual Report. - Regulation 23D does not apply as the activity will be undertaken in more than one State or Territory.
- Regulation 23E does not apply as the activity has previously been engaged in in Australia.
- Regulation 23F applies as the activity has previously been carried out in Australia. The Minister’s declaration will encourage greater participation in the activity by persons who provide health services by providing participants with a greater degree of confidence and security that their participation is solely to the benefit of establishing and improving quality assurance.
- Regulation 23G does not apply as the activity will not include the assessment or evaluation by a person of the services, skill or performance of a health practitioner for the purpose of determining the health care practitioner’s clinical practising rights.
CONSULTATION
The PQR was previously declared to be a quality assurance activity under section 124X of the Act (see Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 (QAA 2/2011)). The RACP has applied to continue the declaration of their activity as a quality assurance activity to which Part VC applies.
Assessment of the application included the potential value of declaring the activity as a quality assurance activity for the purposes of the Act, the methodology used to conduct the activity, and whether the application met the criteria required for declaration as set out in the Regulations. An application to have an activity declared under section 124X of the Act requires the applicant to provide details of two independent referees; typically members of the medical profession.
The RACP was consulted in relation to the final design and content of the declaration. Wider consultation was not considered necessary as the quality assurance activity relates only to the RACP’s Professional Qualities Reflection of the RACP program. The new declaration replaces the existing declaration that had expired and did not substantially change existing arrangements. The declaration of this activity will not result in any direct or substantial indirect effect on business.
The Declaration comes into operation on the day after registration on the Federal Register of Legislation. Subsection 124X(4) of the Act provides that, unless revoked sooner, a declaration ceases to be in force at the end of 5 years after it was signed. Accordingly, the Declaration provides that it is repealed at the end of 5 years after it is signed.
The Declaration is a legislative instrument for the purposes of the Legislation Act 2003.
ATTACHMENT A
OVERVIEW OF THE ACTIVITY
- PURPOSE OF ACTIVITY
The Professional Qualities Reflection (PQR) is designed specifically for Royal Australasian College of Physicians (RACP) trainees. The purpose of the activity is for trainees to record the development of ideas and insights that may impact on their medical professionalism through the process of reflection. It allows trainees to revisit an experience and extract learning principles through the process of guided critical reflection (review, evaluation, and discussion). The learning outcomes of the reflective process will be used to enhance future practice.
Data is collected through trainee physicians identifying a medically and professionally significant event, or series of events, and completing guided analysis. Trainees then meet with their professional development advisor (who may or may not be a fellow of the RACP) who provides feedback. The reflection is recorded in the trainee’s learning portfolio.
The PQR is operated and managed by the RACP. Participating in reflective activities is a requirement of the RACP Training Program.
The objectives of the activity are to:
- promote self-reflection and insight into the way trainees learn in order to improve and plan future learning, encourage clincal practice changes and improve patient care;
- encourage trainees to critically analyse their activities and actions, and investigate options for professional and medical management; and
- allow trainees to appraise situations and events, draw conclusions and, in due course, make decisions for the future medical and professional management of similar events and situations.
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 - QAA 11/2016
This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the
Human Rights (Parliamentary Scrutiny) Act 2011.
Overview of the Legislative Instrument
The Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 – QAA 11/2016 (the Declaration) declares the Professional Qualities Reflection (PQR) to be a quality assurance activity to which Part VC of the Health Insurance Act 1973 (the Act) applies. Information known solely as the result of the PQR, or documents created solely for the purposes of the PQR, will be covered by qualified privilege.
Human rights implications
This Declaration engages the right to health as set out in Article 12 of the International Covenant on Economic, Social and Cultural Right by assisting with the progressive realisation by all appropriate means of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.
The Qualified Privilege Scheme established by Part VC of the Act encourages participation in quality assurance activities that help ensure the highest possible health care standards are maintained. The quality assurance activity described in this Declaration will provide participants with a greater degree of confidence and security that their participation is solely for the benefit of establishing and improving outcomes of community health care.
Conclusion
This Declaration is compatible with human rights as it promotes the right to health.