HEALTH AND COMMUNITY SERVICES COMPLAINTS (MISCELLANEOUS) AMENDMENT BILL

Second Reading

Adjourned debate on second reading.

(Continued from 24 February 2011.)

The Hon. G.E. GAGO (Minister for Regional Development, Minister for Public Sector Management, Minister for the Status of Women, Minister for Consumer Affairs, Minister for Government Enterprises) (20:09): I understand that all second reading contributions have been completed. I wish to thank all members for their contribution to the debate on this bill and their support for it. A number of matters were raised and I would like to respond to each of these in due course.

I would like to address some of the questions raised in relation to the bill. I can advise that the Health and Community Services Advisory Council has met twice, on 16 December 2010 and 27 January 2011, with the next meeting scheduled for 22 March 2011. In the section 88 review of the act undertaken by Ms Schreiber, from Ernst & Young, it is reported that the commissioner indicated that the council has not been established due to a lack of resources to service the council. I can advise that, as part of the government's response to this review, additional funding was provided by the Department of Health to the commissioner to cover costs of sitting fees and executive support to the council.

In regard to whether or not people who contributed to the development of the Charter of Health and Community Services Rights have received any response to their input, I have been advised that this is a matter for the commissioner, not for the Minister for Health, as specified in section 19 of the act. The charter has been tabled in both houses of parliament today, 8 March 2011.

The question was asked about whether or not this bill will address issues regarding faith healers. The bill will be able to address issues concerning faith healers in the same way as it will address issues regarding social workers, naturopaths or homeopaths. It must be remembered that this bill is about unregistered health practitioners, so practitioners only come within the ambit of the bill when they are providing a health service as defined in the act.

In regard to faith healers, firstly, the commissioner will have to establish that they are providing a health service. The first definition of health service in the act is 'a service designed to benefit or promote human health'. Assuming that the faith healer is providing a health service as defined in the act, the commissioner may then undertake a preliminary assessment to determine the appropriate course of action to be taken, which may include conciliation, investigation or referral, amongst other options.

The commissioner may then commence an investigation. If the commissioner has reasonable belief that the faith healer has breached a code of conduct, which will be included in the regulations, or committed a prescribed offence, a list of which will also be included in the regulations, the commissioner then has to be of the opinion that action needs to be taken under the provisions of the bill to protect the health or safety of members of the public. If all these elements are satisfied, the commissioner may make an interim or final order which may prohibit the faith healer from practising, either permanently or for a specified period of time, or place conditions on the practices of the faith healer. There is an appeal mechanism to the District Court.

It should be noted that the bill is not about preventing people from seeking assistance from people many may consider to be bogus practitioners. It does not prevent people from seeking assistance from such people. What the bill is about is protecting the health or safety of the public from those practitioners whose behaviours or practices may compromise public health or safety. The provisions of the bill therefore only come into play when there is a need to protect the public.

It is anticipated that the provisions of the bill will make it easier for the commissioner to protect the health or safety of the public as it provides a streamlined means for this to occur. Often, health and community complaints cases can involve consumer affairs, the South Australian police or Public Health. While these agencies may continue to be involved, the commissioner will be able to make an order to protect the health or safety of the public of her own volition. Evidence will, of course, be required if an order is to be made.

In regard to the need for a standing committee to investigate the functioning of the Health and Community Services Complaints Commissioner, I would advise members to read the operational review which has been previously tabled. The review analyses a range of data and information supplied by the commissioner to the reviewers, and makes 10 recommendations.

As I have previously mentioned, the provisions in the bill concerning unregistered health practitioners are modelled on the provisions in force in New South Wales. The New South Wales Health Care Complaints Commissioner has advised that, when the new provisions were introduced in that state, there was no significant impact on the commissioner's resources. In 2009-10 in New South Wales, the Health Care Complaints Commissioner received 79 complaints against unregistered health practitioners, which was 3.5 per cent of the total complaints received.

The question has been asked as to whether or not the provisions in the bill and the proposed code of conduct, which will be established in the regulations under the act, will place undue restrictions on, for example, naturopaths and homeopaths. Members have the opportunity to comment on the proposed code of conduct in due course. It is not the intention of the bill or the proposed code to unnecessarily restrict the activities of practitioners who practise safely and ethically.

The bill is not concerned with restricting the right of people to use health practitioners of their choice. It is designed to protect the public when a practitioner places the health or safety of the public at risk. It should be noted that the commissioner is an independent statutory officer who provides advice to the Minister for Health. As such, the commissioner is autonomous, determining her own approach to the management of her office, the allocation of resources and the administration of the act.

Comment has also been made in the media about the commissioner's salary. The Remuneration Tribunal of South Australia is responsible for setting the remuneration payable to parliamentary members, the judiciary, statutory office holders (which includes the commissioner), and of course, local government allowances. The tribunal is independent from the government. The health budget is not bottomless, obviously, and resources must be allocated carefully.

The review suggests that a number of changes are needed within the Office of the Health and Community Services Complaints Commissioner, and it is the view of the government that these changes should be made as soon as possible. The role of the commissioner is to assist the public and the taxpayers who fund the activities of the office.

In response to questions raised by the member for Morphett in another place, that were raised during the committee stage of this bill about the Community Visitors Scheme (CVS) under the Mental Health Act 2009, I can advise that part 8 division 2 of the Mental Health Act 2009 establishes a Community Visitors Scheme in South Australia. The purpose of the Community Visitors Scheme is to provide further protection of the rights of people with mental illness who are admitted to treatment centres in South Australia.

To this end, the CVS will provide an opportunity for community visitors to visit treatment centres and other incorporated or private hospitals to inspect premises and consult with consumers and staff to ensure that people with serious mental illness are receiving appropriate care and treatment.

The act requires the CVS to be in place and operational by 11 June 2011 (within two years of the date of enactment of the legislation) and assigns ultimate responsibility for the scheme to the Minister for Mental Health and Substance Abuse. The act seeks out a basic framework for the operation of the CVS and leaves key details of the scheme to be established accordingly. Significant work is currently being undertaken to set up the necessary governance, administrative and operational structures for the CVS prior to its commencement. Key elements of the CVS are currently being developed, and they include:

community visitors will be trained volunteers who will be independent of mental health services and appointed by the Governor for a term not exceeding three years;

community visitors will be required to undertake comprehensive training before commencing their role and will be reimbursed for costs incurred per visit, as well as receiving an annual honorarium;

a principal community visitor will be appointed by the Governor to oversee, advise and assist community visitors in their role, report on matters of concern regarding the care and treatment of consumers and assist with the resolution of issues relating to the care, treatment and management of patients; and

the CVS will visit treatment centres as required by the act.

Over the coming months, targeted information packages and education sessions promoting the CVS will be rolled out across mental health services and also the wider community. I commend this bill in enabling the commissioner to act in a more timely and effective manner if and when it is determined that the health and safety of the public is being compromised by an unregistered health practitioner.

Bill read a second time.

Committee Stage

In committee.

Clauses 1 to 5 passed.

New clause 5A.

The Hon. R.L. BROKENSHIRE: I move:

New clause, page 3, after line 9—After clause 5 insert:

5A—Amendment of section 16—Annual report

Section 16—after subsection (1) insert:

(1a) Without limiting matters that may be included in a report of the Commissioner under subsection (1), each report—

(a) must include the following information relating to the relevant financial year:

(i) the number, type and sources of complaints made;

(ii) a summary of all assessments and determinations made under the section 29 in relation to a complaint;

(iii) a summary of all determinations under section 33 to take no further action in relation to a complaint;

(iv) if a complaint was referred for conciliation—the outcome of the conciliation;

(v) if a complaint was dealt with under Part 7—the outcome of any action taken by a registration authority;

(vi) a summary of all investigations conducted by the Commissioner under Part 6, including the outcomes of those investigations;

(vii) a summary of the time taken for complaints to be dealt with under the Act;

(viii) a summary of all complaints not finally dealt with by the Commissioner; and

(b) may include the following information relating to the relevant financial year:

(i) such information relating to complaints (other than that required to be included under paragraph (a)) as the Commissioner thinks fit;

(ii) any report made to the Minister under section 54;

(iii) if a complaint was dealt with under Part 7—a summary of any advice, notification or information provided to the Commissioner in relation to the complaint by a registration authority.

(1b) Matters included in a report under subsection (1)—

(a) are to be reported, as far as practicable, according to professional groupings (as determined by the Commissioner); and

(b) must not identify a person who has made a complaint, a person in relation to whom a complaint has been made or a person who has been subject to an investigation under this Act, unless the identity of the person has already been lawfully made public.

In summary, this amendment is pretty self-explanatory. It simply provides that, with respect to the annual report, there would be a far more detailed summary of the matters that are dealt with in respect of that office during the preceding 12-month period.

It is not singling out this particular office; I put that on the public record. I am concerned about the lack of transparent reporting generally with a lot of agencies and offices. I think it makes it harder for us as legislators to be able to make assessments on whether we support the government or the opposition with respect to issues that may arise around budgetary components and other matters to do with offices.

It is not singling them out but, having said that, when I have had a look at the reports (some of which, I might add, have been quite late in being tabled) and the concerns we have had over the charter—and the list goes on, way back for several years—I believe that this is an important amendment to ensure transparency. I commend the amendment to my colleagues.

The Hon. J.M.A. LENSINK: I rise to indicate support for this amendment. The mover spoke about transparency. I think there is also a lot of very important information that can be collected from agencies such as this which can inform our health system. The report in The Advertiser, which I assume is referring to the annual report, refers to 708 complaints in a year, and I think that if we are able to break down that data as per the amendment to this bill moved by the Hon. Robert Brokenshire, that would be very useful in informing our health services.

I would have thought that it would be fairly standard practice for any complaints commissioner or ombudsman or such agency whose role is to deal with complaints and investigations to collect the sort of data that this amendment outlines to be provided in the annual report, and I think that that sort of information is also important to us as legislators to assist us to understand the operations of the health system. With those words, I indicate support for this amendment.

The Hon. G.E. GAGO: The government also supports this amendment. The amendment will require the commissioner to provide further information in her annual report. The government has asked the commissioner for her advice on the proposed amendment, and she has expressed concerns about the amendment, primarily that the current resources available to her will not enable the commissioner to extract all the data required under the proposed amendment.

I have to say that this is not a claim the government has had the opportunity to fully assess. However, despite the concerns raised by the commissioner with respect to this proposed amendment, there appears to be support for the amendment in this house, therefore the government will not impede this parliamentary process and will, in turn, support this amendment.

The Hon. T.A. FRANKS: I rise briefly to indicate that the Greens also support this amendment. As we said in our second reading speech, having this sort of information and having an effective complaints body creates a cost reduction in the longer term in our health and community sector. We think that the more comprehensive the information that can be provided in an annual report the fewer problems we will have in the longer term because we will be able to see emerging trends and issues, so we welcome this amendment from the Hon. Rob Brokenshire.

New clause inserted.

Remaining clauses (6 to 14) and title passed.

Bill reported with amendment.

Third Reading

The Hon. G.E. GAGO (Minister for Regional Development, Minister for Public Sector Management, Minister for the Status of Women, Minister for Consumer Affairs, Minister for Government Enterprises) (20:27): I move:

That this bill be now read a third time.

Bill read a third time and passed.