EXPLANATORY STATEMENT
ISSUED BY THE AUTHORITY OF
THE MINISTER FOR HEALTH AND AGEING
HEALTH INSURANCE ACT 1973
DECLARATION OF QUALITY ASSURANCE ACTIVITIES UNDER SECTION 124X
QAA No. 1/2003
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, for example, through Medicare benefits. The scheme encourages participation in such activities by protecting certain information from disclosure, and also by protecting the persons engaged in those activities, in good faith, from civil liability in respect of those activities. In order for Part VC to apply to an activity, the Minister must make a Declaration.
This Declaration applies Part VC of the Act to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Gynaecology Oncology Subspecialty Practice Improvement Critical Event Project (GO SPICE) (Item 1) and the the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Clinical Ultrasound in Gynaecology (Item 2) (the Activities).
The Declaration is a disallowable instrument for the purposes of section 46A of the Acts Interpretation Act 1901.
The Activities relate to the quality of health services that would be eligible for payment in respect of Medicare Benefits and Public Hospital Services (Items 1 and 2).
The Activity at Item 1 of the Schedule has the purpose of evaluating the circumstances surrounding six defined critical events in gynaecology oncology and developing strategies to minimise adverse outcomes from these events. The Activity at Item 2 of the Schedule has the purpose of improving the accuracy in the diagnosis of patients who present with common gynaecological symptoms.
Before the Minister can make a declaration, certain requirements must be met.
Firstly, the persons engaged in the activities must be authorised to do so. The authorisation can be by an association of health professionals, by a body that provides health care, by an educational institution or by a body established for the purposes of research.
The persons engaged in the Activities at Items 1 and 2 of the Schedule are authorised to do so by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists which is an association of health professionals.
Secondly, the Minister has to be satisfied that it is in the public interest to have Part VC of the Act apply to the activities. The Minister must have regard to criteria prescribed by the Health Insurance Regulations 1975 (the Regulations). The criteria relevant to the Activities are in Regulations 23C, 23D, 23E, and 23F. The Activities meet those criteria as follows:
- As required by Regulation 23C, the Activities at Items 1 and 2 of the Schedule include the disclosure of non-identifying information that concerns the quality of service assessed, evaluated or studied or the factors affecting the quality of the service, and satisfy the requirement that information is provided at times and in a manner acceptable to the Minister.
- In the Activity at Item 1 of the Schedule, the persons engaged in the Activity will present the outcomes of the activity to the Australian Society of Gynaecology Oncologists, and a report of the activity will be published in the College’s O&G Magazine. This information will also be provided to the Minister for Health and Ageing. In the Activity at Item 2 of the Schedule, the persons engaged in the Activity will publish a report in the College’s O&G Magazine and/or the Australian and New Zealand Journal of Obstetrics and Gynaecology. The report will contain an outline of the activity, information on the practice profile of participants and the change in knowledge and skills demonstrated at various stages throughout the project. This information will also be provided to the Minister for Health and Ageing.
- Regulation 23D does not apply to the Activities as set out at Items 1 and 2 of the Schedule which are activities being undertaken in more than one State or Territory.
- As required by Regulation 23E, the Minister is satisfied that the Activities at Items 1 and 2 of the Schedule are of a kind that have not been engaged in previously in Australia. Persons who provide health services will be unwilling to participate in the Activities without the protection relating to disclosure of information and civil suit offered by Part VC of the Act. Accordingly the Minister is also satisfied that the application of Part VC of the Act is necessary to make these Activities effective by encouraging the full participation in the Activities of persons who provide health services.
- Regulation 23F does not apply to the Activities as set out at Items 1 and 2 of the Schedule which are activities of a kind that have not been engaged in previously in Australia A Regulation Impact Statement (RIS) is not necessary for this Declaration because the declaration of these activities will not have a direct or substantial indirect effect on business.
The Declaration was signed by the Minister on 21 March 2003 and comes into operation on the date of gazettal. 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. 1/2003
Overview
The Health Insurance Act 1973 was enacted to address the need for a regulatory framework that ensures the quality of health services funded by the government, such as through Medicare benefits. This Act, overseen by the Australian Parliament, aims to facilitate efficient quality assurance activities by providing a scheme that protects specific information from disclosure and shields individuals participating in these activities from civil liability, provided they act in good faith. The enactment of Part VC within the Act specifically seeks to encourage participation in quality assurance activities by creating a protective environment that fosters collaboration and innovation in healthcare services. The Minister for Health and Ageing has the authority to make declarations under section 124XA of the Act, which apply Part VC to particular quality assurance activities, as exemplified by the Quality Assurance Activity Declaration No. 1/2003. This declaration applies Part VC to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists’ subspecialty practice improvement and clinical ultrasound projects, aiming to enhance the quality and accuracy of gynaecology oncology services and gynaecological diagnoses respectively.
Scope and Application
The Health Insurance Act 1973, through its Declaration of Quality Assurance Activities under section 124XA, extends its Part VC to the specific quality assurance activities undertaken by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. This includes the Gynaecology Oncology Subspecialty Practice Improvement Critical Event Project (GO SPICE) and the Clinical Ultrasound in Gynaecology project. These activities are designed to enhance the quality of health services eligible for government funding, such as Medicare benefits. The protection offered by Part VC shields the information disclosed during these activities from unwarranted public disclosure and safeguards the participating health professionals from civil liability, provided they act in good faith. The Minister for Health and Ageing made this declaration on 21 March 2003, and it will remain in effect for five years unless revoked earlier. The declaration is applicable nationwide, as it pertains to activities that have not been previously engaged in Australia, thus necessitating the protections provided by the Act to encourage participation. The declaration also complies with the criteria outlined in the Health Insurance Regulations 1975, ensuring that the information is shared in a manner acceptable to the Minister and that the activities are in the public interest.
Key Provisions
The Health Insurance Act 1973 (the Act) includes a provision under Part VC, which establishes a scheme designed to foster efficient quality assurance activities in health services funded by the government, such as those provided through Medicare. This scheme, which was put into effect by the Minister for Health and Ageing, seeks to safeguard certain information from being disclosed and to protect individuals engaged in these quality assurance activities from civil liability when acting in good faith. The scheme is applied to specific activities through a declaration made by the Minister, as outlined in Declaration of Quality Assurance Activities under section 124XQAA No. 1/2003. This particular declaration applies to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists' Gynaecology Oncology Subspecialty Practice Improvement Critical Event Project (GO SPICE) and the Clinical Ultrasound in Gynaecology activities, which are identified as Item 1 and Item 2 respectively in the declaration.
The Act imposes several obligations and requirements on the parties involved in the quality assurance activities. Firstly, the individuals or entities involved in these activities must be authorised to conduct them. This authorisation can come from an association of health professionals, a healthcare provider, an educational institution, or a research body. In the case of the specified Activities, authorisation is granted by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Additionally, the Minister must be satisfied that the application of Part VC of the Act to these activities is in the public interest, taking into account specific criteria outlined in the Health Insurance Regulations 1975. These criteria include the disclosure of non-identifying information at times and in a manner acceptable to the Minister, among other requirements.
Breaches of the provisions outlined in the Act may result in various consequences. For instance, unauthorised disclosure of protected information may lead to civil liability, although the Act provides protection against such liability for individuals acting in good faith. Furthermore, the declaration itself is a disallowable instrument under section 46A of the Acts Interpretation Act 1901, meaning that Parliament can review and potentially disallow it. The declaration is also subject to a sunset clause, ceasing to be in force five years after it is signed unless revoked earlier.
In terms of penalties and consequences for non-compliance, the Act does not explicitly state specific penalties for breaches. However, unauthorised disclosure of protected information could result in civil liability, as the Act provides immunity from such liability only when activities are conducted in good faith. Additionally, the Minister's decision to apply Part VC to certain activities can be challenged if it is found to be not in the public interest or if the criteria set out in the Health Insurance Regulations 1975 are not met. The declaration itself can be disallowed by Parliament, which would render the application of Part VC to the specified activities ineffective.