EXPLANATORY STATEMENT
ISSUED BY THE AUTHORITY OF
THE MINISTER FOR HEALTH
HEALTH INSURANCE ACT 1973
DECLARATION OF QUALITY ASSURANCE ACTIVITY
UNDER SECTION 124X
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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, 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 to apply to an activity, the Minister 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 the section 124X.
The Declaration is a legislative instrument for the purposes of the Legislative Instruments Act 2003. This Declaration has effect from the day after registration on the Federal Register of Legislative Instruments. Section 124X(4) of the Act prescribes that, unless sooner revoked, this determination ceases to be in force at the end of 5 years after the instrument of declaration was signed.
This declaration under subsection 124X(1) applies Part VC of the Act to the following activity:
- Royal Australasian College of Surgeons (RACS) Morbidity Audit and Logbook Tool (MALT): Audit of Surgical Care
An overview of the activity for which the Declaration pursuant to s124X is made is contained in Attachment A.
Before the Minister can make a declaration, certain requirements must be met.
Firstly, the Minister must be satisfied that the persons engaged in the activity are authorised to do so as described in paragraph 124X(3)(a) of the Act.
The activity meets the requirements of paragraph 124X (3)(a) in that the persons engaged in this activity are authorised to do so by the Royal Australasian College of Surgeons, which is an association of health professionals and an educational institution.
Secondly, paragraph 124X (3)(b) of the Act provides that the Minister must be satisfied that it is in the public interest to have Part VC of the Act apply to the activity. In doing so, the Minister must have regard to criteria prescribed by the Regulations. The criteria relevant to the activity are in regulations 23C, 23D and 23E or 23F.
The activity meets the criteria as follows:
- As required by regulation 23C, the activity includes the disclosure of non-identifying information that concerns the quality of service assessed, evaluated or studied. Information on MALT is available on the College of Surgeons website: http://www.surgeons.org/for-health-professionals/audits-and-surgical-research/morbidity-audit-and-logbook-tool/.
- 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 Australia.
- Regulation 23F applies as the activity has previously been carried out in Australia. The Minister’s re-declaration will continue to encourage full 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 does 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 practicing rights.
CONSULTATION
This included an assessment of 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. Those consulted including Department of Health’s Principal Medical Advisor, Doctor Andrew Singer.
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 Legislative Instruments.
As provided by subsection 124X(4) a declaration ceases to be in force at the end of 5 years after the instrument of declaration is signed, unless revoked earlier.
QAA No. 2/2016
ATTACHMENT A
OVERVIEW OF THE ACTIVITY
1. PURPOSE OF ACTIVITY
The Activity is for feedback and self-reflection on surgical performance during the Training/Assessment process, for all Fellows and trainees, and international medical graduates on a pathway to Fellowship of the College. It is also used with junior doctors wishing to engage with the College prior to entering into a specialty training program.
The Audit involves reviewing actual surgical performance, including outcomes. The individual’s and team’s clinical experiences are compared with accepted standards of performance, and provide stimulus for learning and quality improvement.
The objectives of the activity are:
- To identify ways of improving and maintaining the quality of care for patients in Australia;
- To assist in the continuing education of surgeons; and
- To help make the most of resources available for the provision of surgical services..