The inquiry and its conduct
On 24 March 2011 the Senate, on the recommendation of the Selection of
Bills Committee (Report No. 3 of 2011), referred the provisions of the National
Health Reform Amendment (National Health Performance Authority) Bill 2011 (the Bill)
to the Community Affairs Legislation Committee for inquiry and report by 9 June
2011. The Selection of Bills Committee referred the Bill for inquiry because of
concerns about the governance, national standards and consistency and powers of
authority in the Bill. These concerns, among others, were also noted by the
Senate Standing Committee for the Scrutiny of Bills.
The Committee advertised the inquiry in The Australian newspaper
on 13 April 2011, 27 April 2011 and 25 May 2011 and invited submissions by 29
April 2011. The Committee also wrote to a number of organisations and
individuals inviting their comments on the Bill. Details of the inquiry, the
Bill, and associated documents were placed on the Committee's website.
The Committee received 18 submissions relating to the Bill and these are
listed at Appendix 1. The submissions can be accessed through the Committee's
website at https://www.aph.gov.au/senate/committee/clac_ctte/nhpa/index.htm.
The Committee thanks the organisations and individuals who contributed
to the inquiry. A public hearing for the inquiry was held in Canberra on 17 May
2011. Following receipt of submissions, the Committee wrote to the Department
of Health and Ageing (the Department) seeking clarification on a number of
matters identified by submitters. The answers provided by the Department can
also be accessed through the Committee's website.
On 3 June 2011, the Committee received from the Department of Health and
Ageing, some proposed amendments to the Bill, accompanied by a draft
supplementary Explanatory Memorandum. These addressed some of the Committee's
and submitters' concerns, and assisted the Committee in reaching its view that
the Bill should be passed.
Purpose of the Bill
The amendments proposed by the Bill would establish a new statutory
authority, the National Health Performance Authority (the Authority).
The Government first committed to establishing the National Health
Performance Authority at the April 2010 Council of Australian Governments
The commitment to establish the Authority was reconfirmed at the 13 February
2011 COAG meeting, details of which are summarised in the Heads of Agreement –
National Health Reform.
Clause 68 of the Heads of Agreement – National Health Reform provides that the
Heads of Agreement will lapse after all parties sign the National Health Reform
Agreement. As at the time of writing this report, that Agreement was yet to be
Overview of the Bill
The amendments proposed by the Bill have implications for the National
Health and Hospitals Network Bill 2010 passed by the House (with Senate
amendments) on 21 March; the National Health and Hospitals Network Bill
establishes the Australian Commission on Safety and Quality of Health Care
(ACSQHC) as a permanent agency.
If enacted, the amendments proposed by the Bill will amend the National
Health and Hospitals Network Bill 2010 by changing its title to the National
Health Reform Act 2011. It will divide the Act into several chapters and
add additional chapters.
It will make a number of technical amendments to existing chapters,
including the preliminary chapter and the chapter on the ACSQHC. It will also
introduce two new chapters: Chapter 3, which concerns the establishment of the
National Health Performance Authority and Chapter 4, which covers miscellaneous
subjects such as privacy and confidentiality, relations between this Act and
state laws, and regulation making power.
At the national level, there are currently a number of different
performance monitoring mechanisms operating including:
- The COAG Reform Council (CRC);
- The Australian Institute of Health and Welfare (AIHW);
- The Australian Bureau of Statistics; and
- The Australian Commission on Safety and Quality in Health Care
While the Government's decision to establish the National
Health Performance Authority is part of a broader commitment to increase
sustainability, transparency and efficiency of Australia's health
system, there is little publicly available consistent and comparable
information on providers' performance at this level.
In addition, there is no information about the establishment of the Independent
Hospital Pricing Authority (IHPA) and how the Authority and the IHPA will work
The National Health Performance Authority is set up through the proposed
insertion of Chapter 3 in the Bill.
The main function of the Authority is to monitor; and report on, the
performance of the following:
Local Hospital Networks (LHNs);
Primary health care organisations; and
Other bodies or organisations that provide health care services.
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