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. 3/2003
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 Psychiatrists - RANZCP Peer Review Groups (Item 1); the Royal Australasian College of Surgeons – Audit and peer review for isolated procedural specialists (Item 2); the Royal Australian and New Zealand College of Psychiatrists – Practice Visit Program (Item 3); and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists – Nuchal Translucency: Ultrasound, Education and Monitoring Program – Continuous Audit (Item 4) (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, Public Hospital Services and Prescribing of pharmaceutical products under the Pharmaceutical Benefits Scheme (Items 1 and 3) and the quality of health services that would be eligible for payment in respect of Public Hospital Services (Items 2 and 4) as required by section 124W(1) of the Act.
The Activity at Item 1 of the Schedule has the purpose of providing the opportunity for psychiatrists to review their own work and receive feedback on their work. The Activity at Item 2 of the Schedule has the purpose of facilitating audit and peer review activities for isolated surgeons and procedural specialist ophthalmologists.
- The Activity at Item 3 of the Schedule has the purpose of encouraging best possible evidence based practice by psychiatrists, by facilitating visits from other psychiatrists to review clinical practice, systems or procedures. The Activity at Item 4 of the Schedule has the purpose of maintaining the ultrasound practitioner’s ability to accurately measure the nuchal translucency though a process of continual audit by comparing current practice with current standards. This Activity also includes the assessment or evaluation by a person of the services, skill or performance of a health care practitioner for the purpose of determining the health care practitioner’s clinical practising rights and the making of findings on material questions of fact or law.
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 [s124X(3)(a) of the Act].
The persons engaged in the Activities at Items 1 and 3 of the Schedule are authorised to do so by the Royal Australian and New Zealand College of Psychiatrists which is an association of health professionals. The persons engaged in the Activity at Item 2 of the Schedule are authorised to do so by the Royal Australasian College of Surgeons which is an association of health professionals. The persons engaged in the Activity at Item 4 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, in accordance with section 124X(3)(b) of the Act the Minister has to be satisfied that it is in the public interest to have Part VC of the Act apply to the Activities. In considering public interest, 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, 23E, and 23F. The Activities meet those criteria as follows:
- As required by Regulation 23C, the Activities at Items 1, 2, 3 and 4 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 publish non-identifying data within publications of the Royal Australian and New Zealand College of Psychiatrists. 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 disclose non-identifying information about the findings and recommendations of the Activity in appropriate surgical journals. This information will also be provided to the Minister for Health and Ageing.
- In the Activity at Item 3 of the Schedule, the persons engaged in the Activity will publish the non-identifying outcomes of visit evaluations in the Royal Australian and New Zealand College of Psychiatrists newsletters and bulletin. This information will also be provided to the Minister for Health and Ageing.
- In the Activity at Item 4 of the Schedule, the persons engaged in the Activity will publish non-identifying reports in the Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG). This information will also be provided to the Minister for Health and Ageing.
- As required by Regulation 23E, the Minister is satisfied that the Activities at Items 2 and 4 of the Schedule are of a kind that have not been engaged in previously in Australia and the Declaration is necessary to make these Activities effective by encouraging the full participation in the Activities of persons who provide health services.
- As required by Regulation 23F, the Minister is satisfied that the Activities at Items 1 and 3 of the Schedule are of a kind that have been engaged in previously in Australia and the Declaration is necessary to make these Activities effective by encouraging, to a greater extent than in previous activities, the full participation in the Activities of persons who provide health services.
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 31 August 2004 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. 3/2003