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. 2/2005
Part VC of the Health Insurance Act 1973 (the Act) creates a scheme to encourage efficient quality assurance activities. The 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 the activities. In order for Part VC of the Act to apply to an activity, the Minister must make a Declaration.
The Declaration is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
This Declaration applies Part VC of the Act to the Peer Review Practice Visits for obstetricians and gynaecologists in Australia (the Activity). This Activity is managed by the Royal Australian and New Zealand College of Gynaecologists and Obstetricians (RANZCOG).
As required by Section 124W(1) of the Act, the Activity relates to the quality of health services which would be eligible for payment in respect of Medicare Benefits and Public Hospital Services and to the prescribing of pharmaceutical products under the Pharmaceutical Benefits Scheme.
The purpose of the Activity is to visit, assess and evaluate the individual practice and competence of RANZCOG Fellows. The outcomes of the program are to:
- Provide the individual Fellow with recommendations to improve the quality and risk management of their practice
- Provide peer support and feedback from Fellows working in similar circumstances
- Create a core group of Fellows who have peer review skills
Before the Minister can make a declaration, certain requirements must be met.
Firstly, the organisations engaged in the Activity must be authorised to do so as described in Section 124X3(a) of the Act. This Activity meets these requirements in that the persons engaged in this Activity 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 must be satisfied that it is in the public interest to have Part VC of the Act apply to the Activity. The Minister must have regard to criteria prescribed by the regulations. The criteria relevant to this Activity are in regulations 23C and 23E of the Health Insurance Regulations 1975. 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 services assessed, evaluated or studied or the factors affecting the quality of the service, thereby satisfying the requirement that information is provided at times and in a manner acceptable to the Minister. This Activity will be published in RANZCOG publications such as the Australian and New Zealand Journal of Obstetrics and Gynaecology, the O&G magazine and quality in health care journals. Copies of reports will made available to the Minister for Health and Ageing throughout the course of the Activity.
- As required by Regulation 23E, the Minister is satisfied that the Activity is of a kind that has not been engaged in Australia before. The Declaration is needed to ensure that the Activity has the protections of immunity from suit and prohibitions on the disclosure of information. This will make the Activity effective by encouraging the full participation in the Activity of persons who provide health services.
Written consultation on the RANZCOG application for declaration was undertaken from June to August 2005. This included obtaining advice on the potential value of declaring each activity as a quality assurance activity for the purposes of the Act, the methodologies used to conduct the activities and whether each 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:
- independent external referees nominated by the applicant; and
- members of the Qualified Privilege Advisory Group, which includes an external clinician, a legal expert, a consumer representative and a quality manager working in the field of health care quality assurance.
Comments received during the consultation process supported the declaration of the Activity.
A Regulation Impact Statement (RIS) is not necessary for this Declaration because the declaration of the activity will not have a direct or substantial indirect effect on business.
The Declaration was signed by the Minister on 11 October 2005 and comes into operation on the day after registration with 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. 2/2005