Page 387 - Week 02 - Tuesday, 23 February 1993
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One thing that has happened in the ACT since the board was introduced by Gary Humphries is that the public health system has become less and less accountable. It is in the work of this Assembly in ensuring that the people of Canberra knew about the decisions of the board, they knew about the financial dealings of the Department of Health, that some members of the board were unable to deliver. They felt that there was undue interference. Certainly, we have heard this Minister argue that there was undue interference with the board. No doubt, in his concept of how the board should operate that may well have been the case. The best solution to this problem, to making health more accountable, is to ensure that the Board of Health is removed and that the Minister answers for the department as, indeed, all the other departments are represented in this house.
As I move directly to the Bill, I think it is important to note and to reiterate what my colleague Ms Szuty drew attention to - the objectives in clause 4 and the Medicare principles and commitments in clause 5. The difficulty with those is that they are undermined, to a certain extent, by clause 6, the legal effects. I will quote just a little from that:
Nothing in this Part is to be taken to create any legal rights not in existence before the enactment of this Part ...
In an interjection earlier today, the Minister suggested that the Interpretation Act gave some power to clause 4 and clause 5 in spite of the effect of clause 6. I will be interested to hear Mr Berry explain exactly how the Interpretation Act is going to achieve that. The temptation is to vote against clause 6, which would remove the legal effect and make the Medicare principles, for example, and the objectives absolutely compulsory in having legal status under those circumstances. Then we would certainly see some significant accountability to foster disease prevention in primary health care. Under those circumstances we would vote against clause 6 to ensure that the community is aware of the range of health services that is available and that patients have information that is sufficient to enable them to make informed choices. Imagine if that was a legal right enshrined in a Bill of this nature. What would be the case in terms of patients' rights? They currently have difficulty accessing information that medical practitioners within the health system have written about them.
I think that what Mr Berry has done here and the intention of these two clauses is to ensure a general principle and a general concept which underlies the whole Bill and as such sets out the tone with which Health should operate. As such, I believe that that is a useful exercise and something that is important. For example, if we were to manage to remove clause 6, we would be left with a section like 4(c), which is a legal right "to maintain a strong and viable public hospital system and a full range of community health services". "A full range of community health services" would be a legal right and it would, of course, then be up to the courts to interpret whether Mr Berry was providing a full range of medical services. One's imagination could take flight. I see Mr Connolly indicating the longbow. My imagination has already gone as to what may be drawn as a longbow in terms of a full range of community health services.
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