HEALTH PRACTITIONER REGULATION NATIONAL LAW (SOUTH AUSTRALIA) (MISCELLANEOUS) AMENDMENT BILL

Second Reading

Adjourned debate on second reading.

(Continued from 17 May 2012.)

Dr McFETRIDGE (Morphett) (11:02): I indicate to the house that I am the lead speaker on this bill, as the acting shadow minister for health, in the absence of the member for Waite (Martin Hamilton-Smith), who is unable to be here today. This piece of legislation is an amendment to legislation I spoke to on the first day of this session of parliament, back in May last year (25 May 2011). I will not take as long as I did on that occasion. I was reading my 38-page speech yesterday to see what I had said and what were the problems with the legislation at the time.

I am pleased to say that the legislation that was put in place after some negotiation has worked well but, as we predicted at the time, it would need some amendment. Because of the way in which we ended up framing the legislation for South Australians, those amendments are going to be open, clear and transparent. The big issue when this legislation was first put through was that, in eight lines of our legislation, the government was going to encompass over 300 pages of Queensland legislation. It was not good enough, and I am pleased that the government incorporated the Queensland legislation into the schedules of—

The SPEAKER: Order! Can I ask members to remember that they are in the other chamber and that the noise level is quite loud. I am having difficulty hearing the member for Morphett. Can members please keep their voices down, because it may also be picked up by the microphones. It is very difficult for Hansard. Sorry, member for Morphett.

Dr McFETRIDGE: Thank you, Madam Speaker. The legislation we passed back then was aimed at allowing health practitioners in a range of professions to seamlessly transfer from state to state, territory to territory and territory to state without having to carry a multiplicity of registrations. Unfortunately, in my profession, the veterinary profession, that is still the case. I look forward to national registration for veterinary surgeons, and I understand that there is discussion being held on that topic.

The legislation we have here today really is just expanding the number of health professionals who are being incorporated into the Health Practitioner Regulation National Law Act 2009, which was bill B of the original triage of bills and which listed the health professionals who were initially included. They were: the medical profession, obviously; the nursing and midwifery profession; optometry; osteopathy; pharmacy; dental, including dental therapists, dental hygienists, dental prosthetists and oral health therapists; and chiropractors.

This legislation brings in another four professions. They are: Aboriginal and Torres Strait Islander health practitioners; Chinese medicine practitioners; medical radiation practice, which involves all sorts of medical diagnostics nowadays, particularly cancer therapy, which is more commonly known; and also occupational therapists. Occupational therapy encompasses a broad range of therapists, and it is good to see that they are now able to come into this legislation. It will make the profession more appealing, in as much as there will be more opportunities across Australia for those practitioners to practice their profession.

That is one part of this amendment. The other part is clauses that make amendments that relate to the ownership of pharmacies and the regulation of those pharmacies. We dealt with this back in May 2010, and had discussions with the government, the Pharmacy Guild and other members of the pharmacy profession. I thought we had this pretty well covered, but it turns out that there are still some issues with the regulation of trusts, the ownership of pharmacy practices as that relates to trustees, and whether you need to be a practising pharmacist to be able to own a pharmacy.

The need to make sure we are not interfering with the way people have been running their businesses for many years—particularly where there is a significant investment, such as in pharmacies—is very important to us, and the bill now before the house tidies up some technical issues. It has been done in consultation with the pharmacy profession and its representative bodies, and I hope that it will be the end of it for them. I do not think there will be any outstanding issues. There are some transitional clauses in here which allow pharmacists who would be disadvantaged by any changes here to continue on as is, and to change the way they structure their businesses and also their own professional qualifications, if they need to.

The first part of this bill brings in the other medical practitioners or occupations, the next part relates to the changes in the pharmacy act, and the last part—which is really the first part in the bill—is the amendment to the South Australian Health Practitioners Tribunal, which standardises the time frames for appeals to the tribunal. In the legislation we passed in May 2010 there was an oversight in that we did not actually put in a limit on the time for appeals; this amendment introduces a 28-day time limit, that can be extended under special circumstances.

It is really an amendment of a technical nature; 28 days is a normal period for appeals, as I understand it, not being a lawyer—and by that I am boasting, not apologising. The need to have lawyers is important, but in this case I think we vets and other health practitioners are quite happy; a month is a long time and we can sort out our issues quite quickly.

It is a complex piece of legislation in total. It is important that we do get it right. I predicted at the time, because there was variation across states and territories—I will not go through those variations and combinations and permutations again now—that there would be some need for change, that there would be some concerns about the way things were being structured. That has come to fruition.

I hope there is no need to keep bringing this piece of legislation back over and over again to make sure that it is working the right way. We saw delays in the registration of health practitioners after the introduction of the initial piece of legislation, there were some significant increases in registration fees, and there was some real concern about the fact that some practitioners could have been practising without adequate or correct registration, because practising unregistered is a serious offence.

We want to make sure that we are catching people who are unfit to practise and who should not be practising. The legislation, as I see it now with these amendments, is going to make sure that South Australians (and all Australians, but particularly in my case South Australians) are getting the best oversight of the way our health practitioners are operating, that professional development is kept up to speed, that the supporting bodies and associations are able to provide that professional development, and also, if there are issues of complaint, that those complaints are going to be dealt with as expeditiously and as fairly as possible.

I finish by saying that we certainly did see some concerns and some complaints in the initial implementation of this legislation. There were some significant delays in processing some of those complaints, and some tended to disappear without trace for many months, much to the concern of those who, due to mandatory reporting, had to report one of their colleagues for various concerns. They were obliged to do that, but then those concerns seemed to disappear. I understand that has improved significantly, but there are still some concerns out there.

This legislation, though, is just tidying up some technical amendments. Some of my colleagues want to contribute to the debate, and some of my legal colleagues will add their expertise as well, and I thank them for that. With that, the opposition is supporting the legislation; there are no amendments and, unless there is a particular concern raised by my colleagues, I do not see our having to go into committee.

Ms CHAPMAN (Bragg) (11:11): The minister will recall that back in 2010 we had the primary debate to establish a national law framework for health practitioners. There were issues about the transfer, consistent with the uniform, streamlined, more efficient, cheaper promises that went with the debate that we were told would benefit not only the health professionals but also the taxpayer in having a national scheme. One of the difficulties with that sort of panacea of simplicity is that, in the negotiations for the transfer from a state-based regulatory procedure to a national scheme, the discussion between the various ministers at COAG can lead to a lowest common denominator being adopted as something that is acceptable.

The minister may recall—and, to his credit, he maintained vigilance when we were dealing with the optical professions, the opticians, ophthalmologists, and eye specialists—that we had a standard in South Australia that we thought should be maintained, and that related to the protection for children using coloured lenses. Some members might recall, or have family members who accessed this, that for young girls in particular it was seen to be attractive to have green cat's eyes, purple or violet eyes or whatever, and this was something of a fashion accessory. In fact, we had some consumer issues about the sale of them at the Royal Adelaide Show because it was an accessory that seemed to be very popular.

The specialists and the experts told us, though, that these things could be very dangerous if they were not applied appropriately and that they were not without some instruction in having access to them. So a 14 year old going to buy them at the local show stand or getting them as a prize needed some monitoring. During that time, the minister, to his credit, at least presented this argument to the COAG meetings. Although the other jurisdictions did not embrace this, provision was made so that we would still have some responsibility to ensure that children were not exposed to the risk of blindness or other optical disadvantage without the protection we were providing—even if other jurisdictions said, 'Well, we don't think this is so important.'

It is all very well to say that we have gone to a national scheme and that it produces absolute uniformity, but we have retained—and sensibly, I think—some responsible expectation in the standards that we impose in South Australia. As to the efficiency and the cheapness of it, we will see. Having just done the rail commissioner national scheme, the maintenance of all of the state offices in addition to the national office raises the question about whether these things end up being more efficient. Whether it is the rail operators or health practitioners, having a more streamlined service that ends up being cheaper, we are yet to see. In any event, this bill is to transfer across four other areas of health profession. As the lead speaker, the member for Morphett, has said, we are supporting the bill and have no objection to the transfer of these practitioners.

I am interested to note two other aspects, including the standardising of a time frame for appeals against decisions of the national board. This is obviously where a health practitioner might be denied the opportunity to be registered or the conditions are unacceptable to them or the like or that there is a general reprimand or suspension of a member. Uniformity in the time frame of 28 days has been nominated. It is important to note, fortunately, that that 28 days is to sit next to the date from which the reasons for the decision of the board are given, whichever is the latest. If the board is tardy in delivering its judgement on these things, then there is the capacity to accommodate that and, of course, there is an extenuating circumstances provision. We have no objection to that. It seems as though a number of jurisdictions have been applying that in practice, and that remedies it.

The other is to deal with pharmacy premises and pharmacy depots. This came as a result of what was already known at the time, and that was that a number of these pharmacies do not operate through a corporate structure but a trust structure. This provision is to allow the ownership of pharmacy premises and pharmacy depots in South Australia to be expanded to accommodate that. The minister has identified the unintended consequence of being over stringent in the regulation, remembering that we have a regime of protection and regulation for pharmacists. Just as we do for drugs, guns, dynamite and alcohol, we set very strict rules about allowing people to operate the distribution or retailing of these products under licence because we consider them potentially to be very harmful to the general community and, therefore, those who operate these premises should be fit and proper persons. I am pleased that is being remedied.

We are told by the government that the Pharmacy Guild (SA Branch) has brought this deficiency to the government's attention and they have attempted now to remedy it; we support them on that basis in doing so and removing some of that regulatory obligation. I note that the other changes include provision for the Governor not to have to make exemptions by proclamation; that is now to transfer from cabinet effectively to the minister's control. Currently only the Little Company of Mary Health Care Limited at Calvary Hospital has been granted an exemption with the condition that any services must be provided by a pharmacist who holds a current practising certificate. So, the regime for approval of those exemptions, I suppose to some degree, is downgraded if we see that go from cabinet to minister.

The second issue is that, in respect of the setting of fees for registration of pharmacy premises, the legislation currently requires the Minister for Health to fix those fees. An amendment under this bill will allow the transfer of power to the Pharmacy Regulation Authority SA. With those changes, we hope that the advance of the highly-principled, streamlined, unified, efficient, cost-efficient regulatory regime will prevail.

I might add that I think the government was tardy in not recognising the significance of the new rules that were established—or attempted to be established—for psychologists, and it took years then to resolve that issue before those health professionals were to be catered for. I am not privy to how that is advancing. I certainly hope that we do not have a situation where the operation of health practitioners in the psychology world, particularly for assessments for the purposes of employment and compensation claims, has been downgraded or becomes more deficient as a result.

I certainly hope that those issues have been properly addressed and that we still have a high standard of service being provided by those health professionals. With those few comments, as the member for Morphett has indicated, we will be supporting this bill.

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (11:21): I thank the members on the other side for their contributions and for their support for this legislation. As the lead speaker (the member for Morphett) said, this is really tidying up a number of errors and expanding the scope, principally to take into account the fact that the occupational therapist profession is now covered by the national registration process.

As the second speaker (the member for Bragg) indicated, the legislation also tidies up some provisions related to pharmacy and introduces a time frame for the appeals process. That was not included in the original bill, in error, I guess, because you need to have some sort of time frame in which these kinds of processes can be conducted.

I thank members for their support. I would also just in passing thank Richard Dennis, our parliamentary counsel who assisted on this, and Dr Helen van Eyk and Kathy Ahwan for their assistance from the department in preparing this legislation.

Bill read a second time.

Third Reading

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (11:23): I move:

That this bill be now read a third time.

Bill read a third time and passed.