EXPLANATORY STATEMENT
HEALTH INSURANCE ACT 1973
DECLARATION OF QUALITY ASSURANCE ACTIVITY UNDER
SECTION 124X OF THE HEALTH INSURANCE ACT 1973 – QAA 2/2014
Part VC of the Health Insurance Act 1973 (the Act) creates a scheme (known as the Commonwealth Qualified Privilege Scheme) to encourage efficient quality assurance activities. Those activities help to ensure the quality of health services that are funded by the Government, through Medicare benefits, the Pharmaceutical Benefits Scheme, Public Hospitals 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.
In order for Part VC of the Act to apply to an activity, the Minister or his delegate must make a declaration pursuant to section 124X of the Act, that the activity described in the declaration is a quality assurance activity to which Part VC applies. Regulations 23C to 23G of the Health Insurance Regulations 1975 (the Regulations) set out the public interest criteria that must be met by quality assurance activities in order to be declared under section 124X of the Act.
The purpose of the Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 – QAA 2/2014 (the Declaration) is to declare the activity titled ‘Reflective self audit on cases and procedures within the ANZCA Training Portfolio System’ as a qualified privilege activity under section 124X of the Act. The activity is being conducted by the Australian and New Zealand College of Anaesthetists, Education and Training Committee (ANZCA).
Before the Minister or his delegate can make a declaration, certain requirements must be met:
- firstly, the Minister or his delegate must be satisfied that the persons engaged in the activity are authorised to do so as described in section 124X(3)(a) of the Act – this requirement is met as the persons engaged in the activity described in the Declaration are authorised to do so by the ANZCA, a body that is an educational institution and also an association of health professionals.
- secondly, section 124X(3)(b) of the Act provides that the Minister or his delegate must be satisfied that it is in the public interest to have Part VC of the Act apply to the activity, having regard to the criteria prescribed in Regulations 23C to 23G – the activity described in the Declaration meets the relevant criteria prescribed by the Regulations, as amongst other things, the declaration of the activity will encourage greater participation in the activity and acceptance, implementation and monitoring of any recommendations which arise from the activity.
The quality assurance activity described in the Declaration relates to the ANZCA on-line Training Portfolio System which records a trainee's progress through the ANZCA training program. Trainees are required to log their clinical experiences and are encouraged to record critical reflection on their clinical management and supervision and to provide comments on the cases logged.
The objective of reflective self audit and logging cases and procedures is to improve the quality of patient care. Recording and reflecting on procedures and patient outcomes allows review of a trainee’s clinical practice and supervision level, ensuring the best possible standard of practice and maintenance of clinical standards.
Declaring the activity as a quality assurance activity under section 124X of the Act will provide protection to persons engaged in the activity and will encourage them to make full use of the quality assurance potential that has been built into the ANZCA Training Portfolio System.
Consultation
Consultation regarding the application for declaration for this activity was undertaken in December 2013. This included obtaining advice on 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 meets the criteria required for a declaration to be made, particularly the criteria relating to whether it is in the public interest to declare the activity.
Those consulted included members of the Qualified Privilege Advisory Group, which includes an external clinician; a legal expert; a quality manager working in the field of health care quality assurance; and a consumer representative.
The declaration of the activity will not result in any direct or substantial indirect effect on business.
This Declaration commences the day after registration on the Federal Register of Legislative Instruments. Pursuant to section 124X(4) of the Act, this Declaration, unless sooner revoked, ceases to be in force at the end of 5 years after the instrument of declaration was signed.
This Declaration is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Overview
The Health Insurance Act 1973 was enacted by the Parliament of Australia to establish a scheme that promotes efficient quality assurance activities in the health sector, particularly those funded by the Government through Medicare benefits, the Pharmaceutical Benefits Scheme, Public Hospitals, and Health Program Grants. The Commonwealth Qualified Privilege Scheme, created under Part VC of the Act, aims to encourage participation in quality assurance activities by providing protection from disclosure of certain information and offering some protection from civil liability to persons engaged in those activities in good faith. To apply Part VC to a particular activity, the Minister or their delegate must declare the activity as a qualified privilege activity under section 124X of the Act. The Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 – QAA 2/2014, made in 2014, identifies the 'Reflective self audit on cases and procedures within the ANZCA Training Portfolio System' conducted by the Australian and New Zealand College of Anaesthetists, Education and Training Committee (ANZCA) as a qualified privilege activity. This declaration is intended to encourage greater participation and acceptance of recommendations arising from the activity, ultimately aiming to improve the quality of patient care.
Scope and Application
The Health Insurance Act 1973 applies to the Commonwealth Qualified Privilege Scheme established under Part VC, which is designed to facilitate quality assurance activities in the healthcare sector. These activities are essential for ensuring the quality of health services funded by the government through Medicare, the Pharmaceutical Benefits Scheme, Public Hospitals, and Health Program Grants. The Act provides protection from disclosure of certain information and from civil liability to individuals engaged in these activities, provided they act in good faith. The scheme's scope extends to any person or entity involved in the quality assurance activities as defined by the Act, which includes educational institutions and associations of health professionals such as the Australian and New Zealand College of Anaesthetists, Education and Training Committee (ANZCA). The geographic reach of the Act is national, applying across Australia. However, the specific declaration for a quality assurance activity, such as the 'Reflective self audit on cases and procedures within the ANZCA Training Portfolio System', requires ministerial approval, which must consider the public interest criteria set out in the Health Insurance Regulations 1975. The declaration not only protects the participants from liability but also encourages broader participation in quality assurance activities by assuring them of the confidentiality and legal safeguards involved. This protection is time-bound, with the declaration ceasing to be in force five years after it is signed, unless earlier revoked.
Key Provisions
The Health Insurance Act 1973 (the Act) provides for the Commonwealth Qualified Privilege Scheme under Part VC, which aims to enhance the quality of health services funded by the government. This scheme, which includes provisions for quality assurance activities, is designed to ensure that health services are of high quality by encouraging participation in such activities. Section 124X of the Act allows the Minister or their delegate to declare a particular activity as a quality assurance activity if specific criteria are met. This declaration protects certain information from disclosure and offers some protection from civil liability to individuals engaged in these activities in good faith.
The key provision that allows for the declaration of quality assurance activities is Section 124X of the Act. This section mandates that the Minister or their delegate can declare an activity as a qualified privilege activity if the persons involved are authorised to conduct such activities and if it is in the public interest to do so, considering the criteria prescribed in Regulations 23C to 23G of the Health Insurance Regulations 1975. In this case, the Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 – QAA 2/2014 specifically pertains to the 'Reflective self audit on cases and procedures within the ANZCA Training Portfolio System'. This activity is carried out by the Australian and New Zealand College of Anaesthetists, Education and Training Committee (ANZCA), which is recognised as both an educational institution and an association of health professionals.
Participating in the declared quality assurance activity imposes certain obligations on the ANZCA. They must ensure that the individuals engaged in the reflective self-audit are authorised by the ANZCA, and that the activity aligns with the criteria set out in Regulations 23C to 23G. These criteria include ensuring that the activity is in the public interest and will encourage greater participation and the implementation of recommendations arising from the activity. The ANZCA must also ensure that the reflective self-audit process is properly conducted to improve the quality of patient care by reviewing trainees' clinical practices and supervision levels.
Breaching the obligations outlined under Section 124X of the Act could result in serious consequences. The Act does not explicitly state the penalties for non-compliance with the declared quality assurance activities. However, failing to meet the criteria set forth in the Regulations could potentially lead to the revocation of the declaration, thereby removing the protections afforded by the scheme. Additionally, any misuse of protected information or failure to conduct the activity in good faith could result in civil or criminal liability. It is crucial for the ANZCA to adhere to the requirements to maintain the protections and benefits of the scheme.