Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 – QAA 5/2015

Administered by Department of Health, Disability and Ageing

Legislation au F2015L01104 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

ISSUED BY THE AUTHORITY OF

THE MINISTER FOR HEALTH

HEALTH INSURANCE ACT 1973

DECLARATION OF QUALITY ASSURANCE ACTIVITY

UNDER SECTION 124X

QAA 5/2015

 

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. 

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 to be declared under the section 124X.

 

This Declaration under subsection 124X(1) applies Part VC of the Act to the following activity:

 

  1. Accreditation for General Practices, After Hours and Medical Deputising Services and Special Interest Practices (the Activity)

 

An overview of the activities for which the Declaration pursuant to section 124X 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) as the persons engaged in this activity are authorised to do so by Australian General Practice Association Limited (AGPAL) and the Royal Australian College of General Practitioners (RACGP),  both of which are associations of health professionals.

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 activities. In doing so, the Minister must have regard to criteria prescribed by regulations 23C to 23G (inclusive) of the Regulations.

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. AGPAL will publish data in reports and presentations for relevant stakeholders, including the Commonwealth. AGPAL will provide de-identified data to medical trade publications. The de-identified data will also be used by medical indemnity companies to identify areas of high risk within general practice.
  • 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. This is a re-declaration of the activity previously declared as a quality assurance activity to which Part VC of the Act applies by declaration QAA 2/2010. The Minister’s re‑declaration will encourage increased participation in the activity by persons who provide health services by providing participants with confidence and security that documents created solely for the purposes of the Activity or information acquired by a person solely as a result of the Activity will be afforded the relevant protections from disclosure by Part VC. 
  • 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

 

Consultations regarding the application for declaration of this Activity were undertaken in June 2015 by the Chair of the Qualified Privilege Advisory Group. 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, in particular those criteria relating to whether it is in the public interest to declare the Activity.

 

Those consulted included the Department of Health’s Principal Medical Advisor,
Dr Andrew Singer.

 

The declaration of the Activity will not result in any direct or substantial indirect effect on business.

 

This Declaration has effect from the day after registration on the Federal Register of Legislative Instruments. This Declaration ceases to be in force at the end of 5 years after it is signed.

 

The Declaration is a legislative instrument for the purposes of the Legislative Instruments Act 2003.

 

QAA 5/2015


ATTACHMENT A

1. Accreditation for General Practices, including After Hours and Medical Deputising Services

Purpose

Accreditation for General Practices, including After Hours and Medical Deputising Services and Special Interest Practices, will assess general medical practices against the Royal Australian College of General Practitioners’ Standards for General Practices (the RACGP Standards). To be awarded accreditation a practice must meet all the mandatory indicators in the RACGP Standards, which confirms that the practice is undertaking quality improvement activities that comply with the standards as determined by the profession. The accreditation process is based on a continuing quality improvement (CQI) cycle, through peer surveyors assessing compliance and, where appropriate, identifying areas for improvement.

Objectives

The objectives of the activity are to:

  • support general practices to meet the RACGP Standards, with the aim of ensuring the delivery of safe, high quality health care to patients;
  • identify areas for improvement, and promote strategies and activities to support CQI in general practice;
  • analyse the impact of accreditation and CQI activities on general practice;
  • improve the standards in general practice in the interest of patient safety;
  • evaluate CQI activities and provide feedback to practices;
  • provide feedback to the RACGP on results of the activity
  •  provide feedback to the Commonwealth and other interested stakeholders on the results of the Activity, and
  •  support the Commonwealth’s focus on CQI in general practice to ensure the Australian community receives the best quality health care.


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 5/2015

 

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

This Legislative Instrument declares an activity to be a quality assurance activity to which Part VC of the Health Insurance Act 1973 applies. Information produces solely for the purpose of this activity will be covered by qualified privilege.

 

Human rights implications

This Legislative Instrument does not engage any of the applicable rights or freedoms.

 

Conclusion

This Legislative Instrument is compatible with human rights as it does not raise any

human rights issues.

 

 

 

 

 

 

Prof Chris Baggoley

Chief Medical Officer

Department of Health

Overview

The Health Insurance Act 1973, enacted by the Australian Parliament, establishes a framework to ensure the quality of health services funded by the Government, including Medicare benefits and the Pharmaceutical Benefits Scheme. The Act, through Part VC, was introduced to address the need for a robust quality assurance mechanism in the healthcare sector, aiming to protect certain information from disclosure and provide some protection from civil liability to those engaged in quality assurance activities in good faith. The policy objective is to encourage participation in quality assurance activities, which ultimately aim to enhance patient safety and the quality of healthcare services. To facilitate this, the Minister for Health has the authority to declare specific activities as quality assurance activities under section 124X of the Act, provided they meet public interest criteria outlined in the Health Insurance Regulations 1975. This legislative approach ensures that stakeholders are protected while participating in activities that enhance healthcare quality.

Scope and Application

The Health Insurance Act 1973, through Part VC, establishes a framework for quality assurance activities within the health sector, particularly those funded by the government through Medicare benefits, the Pharmaceutical Benefits Scheme, and Health Program Grants. The Act aims to enhance the quality of health services by ensuring that certain information remains protected from disclosure and by offering some civil liability protections to those participating in quality assurance activities in good faith. For an activity to be covered under Part VC, the Minister for Health must issue a declaration under section 124X, specifying that the activity qualifies as a quality assurance activity. The recent declaration, QAA 5/2015, pertains to the Accreditation for General Practices, After Hours and Medical Deputising Services, and Special Interest Practices. This declaration applies to activities undertaken by authorised entities such as the Australian General Practice Association Limited (AGPAL) and the Royal Australian College of General Practitioners (RACGP). The declaration ensures that the activity meets public interest criteria outlined in regulations 23C to 23G of the Health Insurance Regulations 1975, such as the inclusion of non-identifying information concerning service quality and the exclusion of activities that assess clinical practicing rights. This declaration has been made considering consultations with relevant stakeholders and is effective from the day after its registration on the Federal Register of Legislative Instruments, lasting for five years.

Key Provisions

The Health Insurance Act 1973 (the Act) establishes a scheme in Part VC that aims to encourage efficient quality assurance activities. Section 124X of the Act allows the Minister to declare an activity as a quality assurance activity, thereby applying Part VC to it. This Declaration (QAA 5/2015) applies Part VC to the Accreditation for General Practices, After Hours and Medical Deputising Services and Special Interest Practices (the Activity). This means that documents created solely for the Activity and information acquired as a result of the Activity will be protected from disclosure and certain persons engaged in the Activity in good faith will have some protection from civil liability. The Activity is authorised by Australian General Practice Association Limited (AGPAL) and the Royal Australian College of General Practitioners (RACGP), both of which are associations of health professionals (section 124X(3)(a)). The Minister is also satisfied that it is in the public interest to declare the Activity as a quality assurance activity (section 124X(3)(b)). The Activity includes the disclosure of non-identifying information about the quality of service assessed, evaluated or studied, which is required by regulation 23C of the Health Insurance Regulations 1975. The Activity has previously been carried out in Australia, satisfying regulation 23F. The Activity does not include the assessment of the services, skill or performance of a health practitioner for the purpose of determining the health care practitioner’s clinical practicing rights, satisfying regulation 23G. The obligations under the Act include ensuring that the persons engaged in the Activity are authorised to do so, satisfying the public interest criteria prescribed by regulations 23C to 23G, and providing the necessary information and data for stakeholders, including the Commonwealth. The Activity aims to support general practices in meeting the RACGP Standards, identify areas for improvement, analyse the impact of accreditation and quality improvement activities, and provide feedback to practices, the RACGP, and the Commonwealth. The Minister must be satisfied that the Activity meets these criteria before making the declaration. There are no specific offences, penalties, or consequences for breach mentioned in the Act or the Declaration itself. However, the Act provides for qualified privilege protection for information produced solely for the purpose of the Activity, and some protection from civil liability for certain persons engaged in the Activity in good faith. The Declaration has effect from the day after registration on the Federal Register of Legislative Instruments and ceases to be in force at the end of 5 years after it is signed. The Declaration is a legislative instrument for the purposes of the Legislative Instruments Act 2003. The Statement of Compatibility with Human Rights indicates that the Declaration is compatible with human rights as it does not raise any human rights issues.

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