National Health Act 1953 - Determination pursuant to subsection 5D(1) (PSO 3/2006)

Administered by Department of Health, Disability and Ageing

Legislation au F2006L01988 Not in force Legislative Instrument

Legislation content

 

 

EXPLANATORY STATEMENT

 

Issued by Authority of the Minister for Health and Ageing

 

National Health Act 1953

 

Determination pursuant to Subsection 5D(1)

 

(PSO 3 / 2006)

 

Subsection 5D(1) of the National Health Act 1953 (the Act) provides that the Minister may, by written determination, specify services provided by, or on behalf of, a specified hospital or day hospital facility for the purposes of the definition of outreach service in subsection 4(1) of the Act.  Once a service is determined to be an outreach service then it is deemed to be hospital treatment (section 5C of the Act).  Health funds can then pay benefits for those services (and associated professional services) under applicable benefits arrangements (hospital cover policies), provided that the services are provided as a direct substitute for hospital treatment that would otherwise be provided in a hospital or day hospital facility.

 

The provisions relating to outreach services were inserted into the Act by the Health Legislation Amendment Act (No. 1) 2001.  These provisions were enacted to allow health funds to pay benefits for services that are provided to a patient as a direct substitute for hospital treatment, such as hospital in the home, under applicable benefits arrangements.  Prior to these provisions being inserted, health funds could only pay benefits for such services if regulations modifying the Act were made under subsection 140(2) of the Act.

 

Consultation

 

A facility that wishes a determination to be made in relation to an outreach service it provides makes an application to the Department of Health and Ageing.  Each application is initially assessed by the Private Sector Outreach Services Working Party (the ‘Working Party’). The Working Party members are drawn from: the Australian Health Insurance Association, the Australian Private Hospitals Association, the Committee of Presidents of Medical Colleges, the Royal College of Nursing Australia, Catholic Health Australia, Ambulatory Care Australia and the Consumers’ Health Forum. The Working Party considers each application against guidelines that contain criteria about clinical standards and patient outcomes.  The guidelines have been designed to assist the Working Party to assess whether the services to be provided are of a suitable quality.  The Working Party makes a recommendation to the Minister as to whether the services meet the guidelines, and the Minister (or delegate) decides whether to make a determination under subsection 5D(1) of the Act, taking into account the recommendation of the Working Party. 

 

This Determination specifies outreach services to be provided by, or on behalf of, Allamanda Private Hospital, Home Nurses Infusion Centre, The Northern Hospital, Broadmeadows Health Service or Bundoora Extended Care Centre, The Palm Beach Currumbin Clinic and Port Pirie Regional Health Service.

 

 

 

 

 

Item-by-item details of the Schedule

 

Specified services provided by, or on behalf of, specified hospitals or day hospital facilities.

 

 
Item 1 – Definitions

 

This item defines terms used in the Schedule.

 

Items 2 – 6   -  Specified services and hospitals

 

 

Item 2  - Allamanda Private Hospital

 

This item specifies that relevant health services provided to patients by, or on behalf of,

Allamanda Private Hospital in Queensland as part of Allamanda Outreach Services are outreach services for the purposes of subsection 4(1) of the Act.  This outreach service involves the provision of treatment (which may include nursing care, treatment by a medical practitioner or the provision of allied health services) to patients in their own homes.

 

Item 3  -  Home Nurses Infusion Centre

 

This item specifies that relevant health services provided to patients by, or on behalf of, Home Nurses Infusion Centre in South Australia as part of Home Nurses Hospital in the Home are outreach services for the purposes of subsection 4(1) of the Act.  This outreach service involves the provision of treatment (which may include nursing care, treatment by a medical practitioner or the provision of allied health services) to patients in their own homes.

 

Item 4 -  The Northern Hospital, Broadmeadows Health Service or Bundoora Extended Care Centre

 

This item specifies that relevant health services provided to patients by, or on behalf of, The Northern Hospital, Broadmeadows Health Service or Bundoora Extended Care Centre in Victoria as part of Northern Health Outreach Services are outreach services for the purposes of subsection 4(1) of the Act.  This outreach service involves the provision of treatment (which may include nursing care, treatment by a medical practitioner or the provision of allied health services) to patients in their own homes.

 

Item 5 – The Palm Beach Currumbin Clinic

 

This item specifies that relevant health services provided to patients by, or on behalf of, The Palm Beach Currumbin Clinic in Queensland as part of The Palm Beach Currumbin Clinic Outreach Service are outreach services for the purposes of subsection 4(1) of the Act.  This outreach service involves the provision of psychiatric treatment (which may include nursing care, treatment by a medical practitioner or the provision of allied health services) to patients in their own homes.

 

Item 6 – Port Pirie Regional Health Service

 

This item specifies that relevant health services provided to patients by, or on behalf of, Port Pirie Regional Health Service in South Australia as part of Port Pirie Regional Health Service/Hospital in the Home (HITH) are outreach services for the purposes of subsection 4(1) of the Act.  This outreach service involves the provision of treatment (which may include nursing care, treatment by a medical practitioner or the provision of allied health services) to patients in their own homes.

 

 

This determination commences on 1 July 2006 and remains in force until and including 30 June 2009.  The determination and this explanatory statement have been lodged for registration on the Federal Register of Legislative Instruments.

 

 

 

ACUTE CARE DIVISION

DEPARTMENT OF HEALTH AND AGEING

June 2006

Overview

The National Health Act 1953 was enacted by the Parliament of Australia to provide a framework for the delivery of health services across the nation. This legislation was introduced to address the need for a cohesive approach to healthcare, ensuring that Australians have access to necessary medical services regardless of their location. The Act allows for the specification of services provided by hospitals or day hospitals as outreach services, which are deemed to be hospital treatment, enabling health funds to pay benefits for such services. This determination, issued in 2006 under the authority of the Minister for Health and Ageing, specifies certain services provided by particular hospitals and day hospitals as outreach services. The objective is to ensure these services meet clinical standards and patient outcomes, as recommended by the Private Sector Outreach Services Working Party, and to allow health funds to cover these services under applicable benefits arrangements.

Scope and Application

The National Health Act 1953 (the Act) pertains to the provision of outreach services by specified hospitals and day hospitals, as determined by the Minister for Health and Ageing under subsection 5D(1). This Act applies to specific hospitals and day hospitals, including Allamanda Private Hospital in Queensland, Home Nurses Infusion Centre in South Australia, The Northern Hospital, Broadmeadows Health Service, and Bundoora Extended Care Centre in Victoria, as well as The Palm Beach Currumbin Clinic in Queensland and Port Pirie Regional Health Service in South Australia. These hospitals are authorised to provide outreach services, which encompass nursing care, medical treatment, and allied health services to patients in their own homes, deemed as hospital treatment under section 5C of the Act. Health funds are then permitted to pay benefits for these services under applicable benefits arrangements. The Act's application is confined to the Commonwealth jurisdiction, and it does not specify any exclusions or exemptions other than those outlined in the determination. The application of the Act may be extended or restricted through subordinate instruments, such as regulations or further determinations by the Minister.

Key Provisions

The main operative sections of this Determination (pursuant to subsection 5D(1) of the National Health Act 1953) specify which services provided by particular hospitals or day hospital facilities are to be considered outreach services, which are then deemed to be hospital treatment (sections 5C and 4(1) of the Act). Specifically, the services outlined in Items 2 to 6 of the Schedule are identified as outreach services, which include nursing care, treatment by medical practitioners, and allied health services provided to patients in their own homes by Allamanda Private Hospital, Home Nurses Infusion Centre, The Northern Hospital, Broadmeadows Health Service, Bundoora Extended Care Centre, The Palm Beach Currumbin Clinic, and Port Pirie Regional Health Service. This means that health funds can pay benefits for these services under applicable benefits arrangements, provided they are a direct substitute for hospital treatment that would otherwise be provided in a hospital or day hospital facility. The Act imposes specific obligations on the hospitals or day hospital facilities listed in Items 2 to 6 of the Schedule. These entities must ensure that the services they provide meet the criteria set out in the guidelines developed by the Private Sector Outreach Services Working Party. The Working Party, which comprises representatives from various health-related organisations, assesses whether the services are of suitable quality and align with clinical standards and patient outcomes. Facilities must comply with these guidelines to qualify their services as outreach services under the Act. Additionally, the facilities must make an application to the Department of Health and Ageing for a determination, which will be considered by the Working Party and ultimately decided by the Minister or their delegate. Breaches of the obligations under the Act can result in serious consequences. Although the specific offences and penalties are not detailed in the explanatory statement, it is reasonable to infer that non-compliance with the requirements for determining and providing outreach services could lead to legal repercussions. Typically, under the National Health Act 1953, breaches could result in fines or other penalties as prescribed by the relevant legislation. The exact penalties would depend on the nature and severity of the breach, but they could include financial penalties or other administrative sanctions. It is important for the facilities to adhere strictly to the guidelines and the determination to avoid any legal or financial consequences.

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Sourced from the Federal Register of Legislation at 26 August 2026. For the latest information on Australian Government law please go to https://www.legislation.gov.au.