EXPLANATORY STATEMENT
HEALTH INSURANCE ACT 1973
Health Insurance (Quality Assurance Activity – Australian Orthopaedic Association National Joint Replacement Registry) Amendment Declaration 2020
Authority
The Health Insurance (Quality Assurance Activity – Australian Orthopaedic Association National Joint Replacement Registry) Amendment Declaration 2020 (the Declaration) is an amending declaration made under subsection 124X(1) of the Health Insurance Act 1973 (the Act).
Under subsection 33 (3) of the Acts Interpretation Act 1901, where an Act confers a power to make, grant or issue any instrument of a legislative or administrative character (including rules, regulations or by-laws), the power shall be construed as including a power exercisable in the like manner and subject to the like conditions (if any) to repeal, rescind, revoke, amend, or vary any such instrument.
Purpose of the Instrument
Part VC of the Act creates a scheme to encourage efficient quality assurance activities in connection with the provision of health services. Those activities help to ensure the quality of health services that are funded by the Government, including through the Medicare Benefits Schedule, the Pharmaceutical Benefits Scheme, and 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.
Subsection 124X(1) of the Act provides that the Minister may, by legislative instrument, declare a quality assurance activity described in the declaration to be 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 3/2017 (Principal Declaration) declares the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to be a quality assurance activity to which Part VC of the Act applies.
The purpose of the Declaration is to amend the Principal Declaration so as to include the collection of Patient Reported Outcome Measures (PROMs) in the description of the declared activity, being the AOANJRR.
The Declaration is a legislative instrument for the purposes of the Legislation Act 2003. The Declaration commences on the day after registration on the Federal Register of Legislation.
Details of the Declaration are set out in Attachment A.
CONSULTATION
The Australian Orthopaedic Association (AOA), as the applicant for declaration of the activity, and the Australian Commission on Quality and Safety in Health Care were consulted in relation to the content of the Declaration.
Further consultation was not considered necessary as the quality assurance activity relates only to the conduct of the NJRR activity, which is an activity undertaken by the AOA.
The amendment of the declared activity to include the collection of PROMs will not result in any direct or substantial indirect effect on business.
ATTACHMENT A
Section 1 – Name
This section provides for the Declaration to be referred to as the Health Insurance (Quality Assurance Activity – Australian Orthopaedic Association National Joint Replacement Registry) Amendment Declaration 2020 (the Amendment Declaration).
Section 2 – Commencement
This section provides that the Declaration commences on the day after it is registered on the Federal Register of Legislation.
Section 3 – Authority
This section provides that the Declaration is made under subsection 124X(1) of the Health Insurance Act 1973.
Under subsection 33 (3) of the Acts Interpretation Act 1901, where an Act confers a power to make, grant or issue any instrument of a legislative or administrative character (including rules, regulations or by-laws), the power shall be construed as including a power exercisable in the like manner and subject to the like conditions (if any) to repeal, rescind, revoke, amend, or vary any such instrument.
Section 4 – Cessation
This section provides that the Amendment Declaration will cease to be in force on the day of cessation of the Declaration of Quality Assurance Activity under section 124X of the Health Insurance Act 1973 – QAA 3/2017 (Principal Declaration), unless sooner revoked.
Section 5 – Repeal
This section provides that the Amendment Declaration will be repealed when it ceases to be in force in accordance with section 4 of the Amendment Declaration.
Section 6 – Schedule
This section provides that Schedule 1 amends the Principal Declaration.
Schedule 1 – Amendments
Item 1 – Item 1, Schedule 1 (Description of Quality Assurance Activity)
This Item replaces the description of the declared activity in Schedule 1 of the Principal Declaration with a new description that includes the collection of PROMs as part of the AOANJRR.The amended description in this Item provides that the AOANJRR is a registry that improves the outcome of all types of joint replacement surgery by identifying the factors affecting the outcome of joint replacement surgery and knee osteotomy procedures, and educate stakeholders on the comparative performance of and different approaches towards joint replacements. The Item describes the health services the AOANJRR relates to as all joint replacement and knee osteotomy procedures and the information that is collected and used for public disclosures to be made by the AOANJRR.
The aim of the AOANJRR is to improve the outcome of all types of joint replacement surgery by identifying the factors affecting the outcome of joint replacement surgery and knee osteotomy procedures, and educate stakeholders on the comparative performance of and different approaches towards joint replacements. The AOANJRR also collects Patient Reported Outcome Measures (PROMs) data which capture the patient’s perspective on the success of their treatment.
PROMs are collected through pre and post-operative surveys covering the extent of the pain and disability prior to surgery, as well as the extent and timing of recovery and the presence of complications. Information derived from PROMs is used to enhance outcomes, and assist in the design, delivery and funding of health services by aligning clinical outcomes and patient satisfaction with value and efficient, best practice care.
The data collected through PROMs augments surgeons’ ability to evaluate their performance by linking the patient’s view with the surgeon’s reflections on the outcomes of the procedure. PROMs data is also translated into population based statistics that will be used to inform clinical practice and patient care standards.
Statement of Compatibility with Human Rights
Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011
Health Insurance (Quality Assurance Activity – Australian Orthopaedic Association National Joint Replacement Registry) Amendment Declaration 2020
This Declaration 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 3/2017 (the Principal Declaration) declares the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 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 conducting the activity, or documents created solely for the purposes of the activity, will be covered by qualified privilege.
This Declaration amends the Principal Declaration so as to include the collection of Patient Reported Outcome Measures (PROMs) in the description of the declared activity, being the AOANJRR.
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 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 qualified privilege scheme as it applies to the Principal Declaration as amended by this Declaration will provide participants with a greater degree of confidence and security that their participation is for the benefit of establishing and improving outcomes of community health care. Specifically, information derived from PROMs is used to enhance outcomes, and assist in the design, delivery and funding of health services by aligning clinical outcomes and patient satisfaction with value and efficient, best practice care. PROMs data is also translated into population based statistics that will be used to inform clinical practice and patient care standards.
This Declaration also engages, but does not limit, the right to privacy as contained in Article 17 of the International Covenant on Civil and Political Rights by involving the collection, storage, security, use, disclosure or publication of personal information. Data collected as part of the quality assurance activity will be de-identified to ensure that no individual or individuals are identified prior to disclosure of the information outside of the declared activity.
Conclusion
This Declaration is compatible with human rights as it promotes the right to health and does not limit the right to privacy.
Professor Paul Kelly
Acting Chief Medical Officer
Department of Health