Health Practitioner Regulation National Law (South Australia) Bill

23 Jun 2010 archivespeech

This speech is in relation to the Health Practitioner Regulation National Law (South Australia) Bill. This bill will mean that the operation of the following professions of medical, nursing and midwifery, dental, physiotherapy, chiropractic, pharmacy, psychology, optometry, osteopathy and podiatry will transfer to the National Registration and Accreditation Scheme from 1 July.

Adjourned debate on second reading.

(Continued from 22 June 2010.)

The Hon. J.M.A. LENSINK (21:10): I do thank the honourable members who yesterday enabled me to speak last so that I could make a further contribution this evening. This bill will mean that the operation of the following professions of medical, nursing and midwifery, dental, physiotherapy, chiropractic, pharmacy, psychology, optometry, osteopathy and podiatry will transfer to the National Registration and Accreditation Scheme from 1 July. Interestingly, the occupational therapists have been excluded until 2012, and in addition, medical radiation practitioners, Aboriginal and Torres Strait Islander health professionals and Chinese medicine practitioners will come on board from 1 July 2012.

The new scheme, which is to be administered by the Australian Health Practitioner Regulation Agency, will have offices in each state or territory. A national board has been established for each of the professions, which was enabled by the passage of bill A and bill B through the Queensland parliament. I was slightly confused yesterday about the structure of all the different bodies and so forth, and so I am grateful that I have a copy of a document, which I assume was downloaded for me—

Members interjecting:

The ACTING PRESIDENT (Hon. J.S.L. Dawkins): I would also be grateful if you did not have to compete against too many conversations, too.

The Hon. J.M.A. LENSINK: Thank you for your protection, Mr Acting President—the Australian Health Practitioner Regulation Agency. It is a four or five-page document, if anybody is interested in googling it, entitled 'Frequently asked questions'. It actually has a physical drawing of the structure, which is quite useful.

So from this I understand that the peak body involved is the Australian Health Workforce Ministerial Council, under which sit the advisory council, the national boards and the agency. Beneath the national boards are accreditation authorities and national committees, state, territory and regional boards, and there are a lot of arrows going in lots of directions, so I would encourage anyone who is interested to go and find that themselves.

The ministerial council has the overarching role, which is something that is not ideal, given that it is not a directly elected body, but be that as it may, and it provides directions to the national agency and national boards about policies. There is also the Australian Health Workforce Advisory Council, which is there to provide independent advice to the ministerial council.

The agency, which I think is having a number of state staff transferred to it, is the regulatory authority, and therefore it has largely an administrative role. The boards themselves (and there will be boards to represent each health professional group) have the role of registration, standards, codes, approving accredited programs of study, assessment of overseas trained professionals, referring matters about registered health practitioners to their respective tribunals and, in addition, maintaining a national register.

The boards will consist of members appointed by the ministerial council and will have a mixture of practitioners and community and consumer bodies. It is not abundantly clear as to what the state and territory boards are exactly going to look like, and I note from the minister's second reading explanation that we can have some idea of what five of the 10 professionals will look like in that at a state level nursing, midwifery and physiotherapy will have state boards and dentistry and psychology will have a form of regional board.

I would appreciate it if the government could provide some idea of what is going to happen with the other five professions and how it was determined that those structures would be formulated in that way because it is not immediately apparent on reading all of the material that I have read, which is quite a large amount of material.

In terms of registration, there will be a number of categories: general, specialist, provisional, limited, non-practising and student registration. There will be requirements for continued professional development and having some form of professional indemnity insurance which has been in place for some time and which is why I actually dropped my own professional registration, because I was not about to pay for indemnity insurance when I was not using it.

There is a requirement for each state and territory to have an external complaints and review process, and I understand that it has been left in the hands of each of the states and territories to determine their own process. In South Australia, this will be the South Australian Health Practitioners Tribunal, and the government has tabled some amendments to that.

It will be a significant change for the health practitioners because it is the role of the boards themselves at the moment, which are larger bodies. The tribunal will have three members sitting to hear most of the complaints and so forth. Again, I think there will be some teething problems in adjusting to the way that those operate, so I wish the tribunal well in determining how it sees its way forward.

There are some other specific South Australian amendments in the bill, including licensing of pharmacies in relation to which the government again has some amendments. There will also be continued restrictions on the sale of optical appliances and protocols to ensure that there is cross-communication with the Health and Community Services Complaints Commissioner such that complaints that are received by boards must be referred to the commissioner, which is appropriate.

Again, I foresee that these provisions do have the potential to become messy given that the bill states that the relevant board and commissioner must find a way to agree. If they cannot, it defaults to the South Australian Health Practitioners Tribunal and the commissioner then has the right to complain, if you like, to the minister if they are not satisfied with that process.

We have had a lot of rhetoric about the importance of making sure that all of the provisions are identical so that it is consistent, but I note from the contribution from the member for Morphett that this has been undermined by the fact that New South Wales has succeeded in having its practitioners excluded from the new NRAS disciplinary process, which I find a little bit alarming. I think that, in the way South Australia's disciplinary matters have been managed, it has been a very important role for the boards and this should be made consistent.

In the case of New South Wales, it will not be NRAS but it will be their Health Care Complaints Commissioner.

My question for the government on that matter is: what advice has it received in relation to the risks posed by the concession to New South Wales and does it believe that there has been some compromise in the integrity of the scheme by excluding all those practitioners in Australia's most populous state? Those are my general remarks on the larger matters in the bill.

There are a few of us, I think, who received some correspondence from specific health representative bodies, and I will conclude by making some reference to those. The Australian Psychology Association, which I think has not had a great relationship with this government particularly in regard to the way they choose to consult with it, produced a 26-page submission which it provided to the government.

They have said in their correspondence to us that they sent in submissions relaying the concerns of their profession. I am disturbed that they say that they have had no reply or response to these and as such they have only just been made aware that the bill was being introduced into the Legislative Council. I regret that on this occasion we will not be able to assist them with their concerns, which we have stood for strongly in the past, mainly in relation to the issue of psychometric testing, which is defined as 'the administration and interpretation of tests of intelligence and personality'.

I have been a strong supporter of their position on this for some time. I can understand that the issue of hypnosis is a little bit harder to nail down because it is quite vague and open to different professional interpretation, but certainly in relation to psychometric testing I am very strongly of the view that they should not be tests which are administered by some sort of clerk within either a human resources company, WorkCover or any other body that may seek to use them because, if they are not applied and interpreted correctly, then the person who is being tested can be at some significant disadvantage through incorrect reports. Be that as it may, it is too hard, and I apologise to the psychologists who wish that we would be able to have that kept within legislation, but from our side of the benches we are unable to do so.

The pharmacists have also sought legal advice and, in relation to corporate pharmacy services providers and the issue of restricted pharmacy services, they are concerned that there is some grey area I think in relation to directorships and whether they would continue to be able to be involved. That is a grey area for which I understand the government has drafted amendments which we will discuss in due course.

The Australian Medical Association wrote a letter to the Chief Executive of SA Health which has been provided to a number of us. They express concern, as we have, about clause 4 of the bill. That is something that has been discussed extensively, and I will not talk about that again. They have sought a public interest test to accompany ministerial intervention. As I referred to last night, I understand there were three Senate recommendations from the committee that reported in August last year which were adopted by the ministerial council in some way. I was not able to ascertain by what means that was done—whether it is just a policy decision or whether there is some instrument—so I will seek a clarification from the government on that point. In any case, we have an amendment drafted which we will be moving in due course.

They hold concerns about exemptions for mandatory reporting in relation to spouses and partners. They also hold concerns about the use of the terms surgeon and physician. People using those terms and therefore holding themselves out and misleading the public is a consumer safety issue. There were concerns expressed with tribunal arrangements as well, but I understand that we have not actually drafted an amendment in that regard. I think that would be rather too complex from this side of the benches.

The suspension of registration in the public interest and the inclusion of the Pharmacy Practice Act provisions are in the draft bill, however that latter matter I think is fairly reasonable and we support that. I indicate those specific professional contributions we have had, to outline that not everybody has been happy with every provision in this bill. With those comments I will largely endorse the bill, except for those areas I have outlined that we are not supportive of and commend the bill to the house.