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 7/2016
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.
In order for Part VC of the Act 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 7/2016 (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:
- Royal Australasian College of Surgeons (RACS): Australian and New Zealand Audits of Surgical Mortality (ANZASM)
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 ANZASM are authorised to do so by RACS, 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 to have Part VC of the Act apply to the activity. In doing so, the Minister must have regard to criteria prescribed by regulation. The criteria relevant to the activity are in regulations 23C to 23G of the Health Insurance Regulations 1975 (the Regulations).
The ANZASM 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. This non-identifying data will be used in peer review and self-reflective components disseminated to health practitioners, hospitals and departments of health.
- 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 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 practicing rights.
CONSULTATION
The ANZASM was previously declared to be quality assurance activity under section 124X of the Act (see Declaration of Quality Assurance Activity QAA 4/2011). ANZASM applied to continue the declaration of their activity as a quality assurance activity to which Part VC applies.
An assessment of the application 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 as set out in the Regulations.
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 sooner revoked, 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 Australian and New Zealand Audits of Surgical Mortality (ANZASM) is an audit that records medical practitioners who perform surgical operations and have patient mortality occur under their care. The audit includes all deaths which occur in a hospital when the patient was under the care of a surgeon (surgical admission) whether or not an operation was performed or the patient was under the care of a physician (medical and non-surgical admission) and where there was surgical input.
The reports will be used for peer to peer feedback which involves:
- A self-reflection by the reporting surgeon and /or anaesthetist
- A review of the patient notes by an appointed surgeon/anaeasthetist or committee of surgeons/anaesthetists
- The preparation of a report to the reporting surgeon or anaesthetist
ANZASM is a group of regionally based surgical patient mortality audits. The regional audits in each jurisdiction other than New South Wales comes under the governance of ANZASM (managed by the Royal Australasian of Surgeons) and follows the ANZASM process. The New South Wales regional audit is governed by the Clinical Excellence Commission and co-managed by the Clinical Excellence Commission and the Royal Australasian College of Surgeons.
This assessment is a mandatory component of the Royal Australasian College of Surgeons Continuing Professional Development Scheme.
The objectives of the activity are to:
- Provide peer to peer feedback on factors involved in surgical patient mortality
- Collect data on the factors involved in surgical patients mortality and,
- Report upon the collected data to the health system including surgeons, hospitals, health departments and the public.
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 7/2016
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 7/2013 (the Declaration) declares the Australian and New Zealand Audits of Surgical Mortality (ANZASM) to be a quality assurance activity to which Part VC of the Health Insurance Act 1973 (the Act) applies. Part VC establishes a scheme to encourage efficient quality assurance activities. Information known solely as a result of the ANZASM, or documents created solely for the purpose of the ANZASM, will be covered by qualified privilege.
Human rights implications
The Declaration engages the right to health as set out in Article 12 of the International Covenant on Economic, Social and Cultural Right (ICESCR) 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 is aimed at encouraging participation in quality assurance activities that help ensure the highest possible health care standards are maintained. The quality assurance activities described in this Declaration will provide participants with a great degree of confidence and security that their participation is solely for the benefit of establishing and improving outcomes of the community health care.
Conclusion
This Declaration is compatible with human rights as it promotes the right to health.