Page 42 - Week 01 - Tuesday, 16 February 1993
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they fulfil an important function in assessing and evaluating health services and, in particular, in investigating deaths in hospitals. The Bill gives protection to committees in relation to confidentiality and admissibility of evidence in order to encourage full and frank disclosure and discussions in these matters.
Secondly, the Health Bill substantively carries over from the Health Services Act 1990 the provisions relating to clinical privileges for, and variation or termination of, the engagement of health service providers. The right of appeal against the withdrawal or variation of clinical privilege is preserved to ensure that the capacity of health service providers to earn a living is subject to appropriate due process. Thirdly, the Health Bill provides for the determination of fees and charges, and interest on those fees and charges. Fees and charges could be levied on a fee for service basis. The determination of these fees and charges has been included in the Bill in the form of disallowable instruments in order to ensure that the determinations are subject to proper scrutiny by the Legislative Assembly.
On 29 January I signed the Medicare agreement on behalf of the ACT, and the Health Bill provides a statement of the Medicare principles and commitments. Of course, Madam Speaker, it is important that we show to the people of the ACT that we hold those principles uppermost. The adoption of those principles and commitments is a condition of the grant of financial assistance by the Commonwealth to the Territory in respect of the provision of public health services by the Territory. Madam Speaker, I suspect that we may be the first State or Territory to include those in legislation.
This legislation specifies that the following guidelines govern the delivery of public services to eligible persons in the Territory. Eligible persons must be given the choice to receive public hospital services free of charge as public patients. Hospital services are deemed to include in-patient, outpatient, emergency and day patient services consistent with currently accepted medical and health service standards. Access to public hospital services is to be on the basis of clinical need. This means that factors such as whether people have health insurance, their financial status, their place of residence or whether they elect to be treated as a public or private patient have no place in assessing priority to public hospital services. This also includes referrals to booking lists. That is where we stand very much apart from those on the other side of this chamber. Of course, they make it clear in their announced policies that those who are privately insured will be treated quite differently.
To the maximum practicable extent, the Territory will ensure the provision of public hospital services equitably to all eligible persons, regardless of their geographical location. This does not mean that local hospitals will be required to provide eligible persons with every hospital service they need. However, it does require the Territory to accept responsibility for onwards referral or transfer should a person's clinical condition require access to same, and the Commonwealth and the Territory must make available information on the public hospital services eligible persons can expect to receive as public patients. The agreement acknowledges that both the Commonwealth and the Territory will work together to format a public patients hospital charter which will be the vehicle to disseminate this information. Thus, by informing the public as to their entitlements, the Commonwealth and the Territory are committed to make improvements in the efficiency, effectiveness and quality of hospital service delivery.
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