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 9/2016
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, 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 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 9/2016 (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:
- Australian and New Zealand Society for Vascular Surgery (ANZSVS): Australasian Vascular Audit (AVA)
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 AVA are authorised to do so by ANZSVS, 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. The criteria are set out in regulations 23C to 23G of the Health Insurance Regulations 1975 (the Regulations).
The AVA 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. The ANZSVS will be presenting material at their annual meeting. This includes medical articles and publications as well as their 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 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 apply as the activity will 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 AVA was previously declared to be a quality assurance activity under section 124X of the Act (see QAA 2/2011). AVA 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 Australasian Vascular Audit aims to prospectively capture all private and public vascular surgery procedures performed in Australia and New Zealand. This includes both open and endovascular procedures.
The AVA Audit is operated by the Australian and New Zealand Society for Vascular Surgery (ANZSVS). A committee of 4 elected members forms the Audit Monitoring Committee (AMC). These members will investigate and verify any statistically significant outliers as the crucial determinant of a potential problem will be asessment of the clinical details surrounding each patient’s admission episode by these 4 experienced clinicians. A system agreed to by the membership has been established to deal with underperforming surgeons that affords natural justice to members as well as powers of discipline.
The objectives of the activity are:
- To maintain the highest achievable standard of vascular surgery in Australasia under the auspices of the ANZSVS;
- To allow real-time comparison of outcomes for an individual or unit with the peer group;
- To allow corrective action by the AMC in the event of significant adverse patient outcomes thus completing the audit loop; and
- To provide a reliable prospective collection of bi-national data for training, research and publication. This would only occur if approved by the AMC.
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 9/2016
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 9/2016 (the Declaration) declares the Australasian Vascular Audit (AVA) 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 AVA, or documents created solely for the purposes of the AVA, 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 (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 established by Part VC of the Act 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.