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House of Assembly - Fifty-Second Parliament, First Session (52-1)
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HEALTH PRACTITIONER REGULATION NATIONAL LAW (SOUTH AUSTRALIA) BILL

Second Reading

Adjourned debate on second reading.

(Continued from 11 May 2010.)

Dr McFETRIDGE (Morphett) (15:05): This piece of legislation before us today has been brought to this place after quite a history—a national tour, almost—and a lot of consultation and deliberation. Its aims are absolutely worthwhile, and the opposition supports the intent, the aims and the objects of the legislation.

I, for one, as a recent veterinary practitioner, am more than aware that one of the aims of this legislation is to allow the smooth movement of registered health practitioners across the nation between states and territories. I will give a quick illustration of that. When I was practising in Western Australia, I was working for an airline. I could be in Western Australia, South Australia, Victoria and then even go to New Zealand all on the same day, and the legal paperwork that was involved in my entering those jurisdictions and complying with registration and legislation was very expensive and time-consuming.

Having a system where we have national registration and trans-Tasman recognition of qualifications and registration is something that needs to be supported. The big concern, though, for the opposition is the way this legislation has been presented to this parliament. The Minister for Health has presented this as a piece of legislation that adopts a national law that was passed through the single house of the Queensland parliament back in October last year.

The sad news today is that, while the opposition supports the intent of this legislation—it is admirable, it is desirable, and it should be implemented—we cannot support this legislation in its current form. The minister knows this. At the last briefing we had on a Thursday lunchtime, I said, 'There's good news and bad news, Minister. The good news is we support the intent of the legislation. The bad news is that we don't want to present it as adopting legislation. We want it presented as corresponding legislation.'

Just to briefly explain that, if we do as is being presented by the minister in this piece of legislation, we are adopting 308 pages of a Queensland piece of legislation that contains 305 clauses in the bill with 138 clauses and seven schedules into eight lines of our own bill here.

The opposition does not have any problems with the vast majority of our bill, but clause 4 is the issue, and I will talk about why that is an issue for the opposition and about the way this legislation has been developed. I start by thanking the minister's staff for their cooperation in this, and they have answered the questions for me. They have not been able to answer the political questions, and I do not expect them to do that, but that is what this has really come down to.

This should not be a matter of politics: it is a matter of protecting the people of South Australia not only from dodgy medical practitioners but also from the way this legislation is being put before us, because I think there are real issues that may mean, unintentionally, that we may not be protected from dodgy medical practitioners or health practitioners if this legislation is allowed to go through in its current form. I have no doubt at all that the minister will try to scare the horses and say that the sky will fall in but, as the Chair of the Psychology Board of Australia wrote—and this is one of the new boards that is being formed under this legislation—when introducing the national scheme in a recent letter to registrants:

If, for any reason, the State in which you are registered is not participating in the national scheme on July 1 2010, your registration in that state will continue to be covered by your existing registration until that State joins the national scheme.

For some reason, if we cannot agree on a position with this legislation over the next few weeks and it is delayed, and if the implementation does not happen by 1 July, the sky will not fall in.

There will be some additional costs. There may be some confusion, but that can be easily clarified. There may be some logistical problems, but that can be sorted out. The thing that we do need to recognise is that this legislation needs to be presented to this parliament by this government, and I make that distinction regarding the separation of powers. The executive and the parliament are separate. This legislation needs to be presented to this parliament as a piece of legislation that is acceptable to the parliament, not just acceptable to the executive of the government.

The current system is working well. We do hear about the Dr Patels of this world, and that is deplorable. But I want to quote from the New South Wales Medical Board's press release of March 2008 as follows:

The deregistration or suspension of a doctor in New South Wales—

and this applies in South Australia—

will be immediately recognised in any other Australian jurisdiction in which he or she was registered or seeking registration.

So, we have mutual recognition at the moment so that qualifications are recognised across borders. You do need to register separately in each state, and that is an issue as I have said before, not only with medical practitioners but also with veterinary practitioners.

The current system is not working as seamlessly or perhaps as cheaply as one may hope—and I will talk about fees a bit later—but we should not rush this legislation through this place. The logistical problems will be sorted and any registration problems will carry on, as the Chair of the Psychology Board of Australia has said in his letter. There are not going to be any insurmountable problems here. We need to get this right.

Any pre-emptive action that has been taken by the intergovernmental ministerial council in setting up the various boards, management committees and agencies is understandable because this is well-intended legislation, and you would expect it to come through all of the various jurisdictions eventually. How quickly that will happen is something that is up to this government, and we will enter into those discussions further as we proceed with the debate.

The thing we do have to avoid, though, is the executive of government dictating to parliament. That is something that I and the opposition will not accept and that is what the sticking point is on this legislation. We need to make sure that this piece of legislation is going to be well and truly examined by this place here. The bill that has been presented to us is 68 pages in length, with 83 clauses and some schedules. It is not a massive piece of legislation per se and, as I say, we have no real issues with the vast majority of that legislation. What we have an issue with is clause 4 of this bill—and this is what it all comes down to—where we have eight lines of the South Australian bill before this parliament referring to 308 pages of the Health Practitioner Regulation National Law Act 2009 that was enacted through the single house of Queensland's parliament back in October last year.

The government is pushing to get this bill through. I am surprised that the minister allowed this bill to be listed on the Notice Paper today—and in this week's sitting agenda—for completion of debate this afternoon. I understand the bill was expected to be done and dusted by 6 o'clock this evening. It is now five past four, and I would be surprised if I have finished my contribution by 6 o'clock. I am happy to sit as late as it takes and to work through the issues with the minister.

There will be a significant committee on this bill, because I will insist that the legislation that is the nuts and bolts of this national registration scheme is examined in detail, that all 305 clauses are considered and that the 138 clauses and the seven schedules are examined. If necessary, I will read all 308 pages of the bill into the Hansard. It is so important that the people of South Australia do not have to get onto a computer or write or phone to get copies of this legislation from another jurisdiction.

The minister has tabled this bill for members of parliament, but there is no easy access for South Australian citizens to this piece of legislation—and that is not good enough. Even Queensland, the lead legislator, attached it to the schedule. New South Wales has attached a note to its legislation. Why was it not presented to us in that way in order to show respect for this Parliament of South Australia? That has not happened.

There was plenty of time to look at this bill. This bill started in 2005, with the former federal Liberal government looking at the health workforce and the need to ensure we were providing for the future of the health workforce in Australia. The bill which is now before us was put out for consultation in late January, with a little over four weeks for consultation. That is not good enough.

My office contacted the minister's office on 22 September last year—over eight months ago. The letter states:

Can you advise when the mirror legislation (as we then thought it would be) to the national registration accreditation scheme affecting health professionals is expected to be introduced into parliament?

A month later the minister wrote back, and the letter states:

Thank you for your letter of 22 September. As you may be aware, the Australian Health Workforce Ministerial Council has oversighted the implementation of a national scheme...The state of Queensland is to host the substantive legislation and other states and territories are to enact adopting legislation following the Queensland legislation. The South Australian legislation is currently being drafted.

This was in October last year. It continues:

It will then be released for public consultation over the coming months.

We have four-year fixed terms in South Australia. We all knew the election was to be held on 20 March 2010. We knew that the implementation date of this national scheme was going to be 1 July 2010. We knew that was going to happen. There was no ambiguity or confusion about it. Nothing was going to change that.

We have had the election. This national scheme is to be introduced, hopefully, on 1 July and, hopefully, with the participation of South Australia. The minister cannot say he has not had time to pass this legislation. We could have sat more days last year. We could have sat in February this year. We could have sat on a number of occasions in order to ensure this legislation was not rushed through this place and to ensure the legislation, as we have seen on today's Notice Paper, was not pushed through in a matter of hours.

It is not acceptable. It is bordering on arrogance to expect this parliament to be a rubber stamp of the executive of government. I will not accept that, the opposition does not accept that, and I understand that many other members, both in this place and the other place, have concerns about that.

Despite my letter of 22 September last year—eight months ago—inquiring about this legislation, the draft bill was only put out for consultation in January. Dr Tony Sherbon, the Chief Executive, signed a letter on 27 January 2010—it's my birthday, so it's a good day but it was a sad day for South Australia. This bill took that long to be exposed to the public and the stakeholders in South Australia.

We should remember that Queensland released its exposure draft bill on 12 June last year, a matter of a week or two away from being 12 months ago. So there were no secrets about where we were going with this legislation. This piece of legislation should have been looked at last year—it could have been done and should have been done—and we will not be jamming it through in a matter of a few minutes in this place today.

This particular legislation is known as bill C, but the original bill B on which this scheme and legislation is based passed the Queensland parliament on 29 October last year. The minister wrote to me in a letter dated 21 October saying 'an act adopting legislation following passage of the Queensland legislation', and on 29 October the legislation was passed in Queensland. So there has been plenty of time for this legislation to be examined by the government, put together and drafted and put to this house before today. Today we have the piece of legislation the government wants to put to us, and we sit here and are supposed to not look at it or examine it but just rubber stamp it.

I, for one, hope that the Attorney-General is listening to this debate, because I know that, in the past, as a backbencher he had a fair bit to say about the way this legislation was put together. I will be very interested to see whether he makes any contribution on the constitutional validity of the regulations and the disallowance clauses of the regulations and, more importantly, because of what he said in this place in the past, the role of ministerial councils. Let me quote from what the Hon. John Rau (now Attorney-General) said in this place on 13 October 2009 when he was commenting on the Fair Work (Commonwealth Powers) Bill. Mr Rau, member for Enfield and now the Attorney-General, said:

I am profoundly sceptical about ministerial councils making decisions and then bringing them back here and directing us to do various things.

That is exactly what we are expected to do with this legislation. I will repeat that. The Hon. John Rau, the Attorney-General, said in this place on 13 October last year:

I am profoundly sceptical about ministerial councils making decisions and then bringing them back here and directing us to do various things.

To me, that is the nub of all this. We are handing over, once again, the sovereignty of this parliament to an unelected body, a ministerial council, which is not only made up of the state and territory ministers but also includes the commonwealth minister, all of whom have political and economic agendas that may influence their decisions. I know they are all honourable men and women, but I become more of a cynic, sceptic and doubter the longer I am in this place.

The Attorney-General's comment is reinforced by law academic, Professor Gerard Carney, who in his book The Constitutional Systems of the Australian States and Territories states:

A risk of many commonwealth and state cooperative schemes is executive federalism, that is, the executive branches formulate and manage these schemes to the exclusion of the legislatures. While many schemes require legislative approval, the opportunity for adequate legislative scrutiny is often lacking, with considerable executive pressure to merely ratify the scheme without question.

That is what we are seeing this afternoon. We are expected to ratify this within hours this afternoon. Professor Carney goes on to say:

Thereafter, in an extreme case, the power to amend the scheme may even rest entirely with a joint executive authority.

That is what we have here: the ministerial council. Professor Carney continues:

Other instances of concern include, for example, where a government lacks the authority to respond to or the capacity to distance itself from the actions of a joint commonwealth and state regulatory authority. Public scrutiny is also hampered when the details of such schemes are not made publicly available.

That is the other issue today. As I have already said, we need to have this legislation not only tabled in here but also it needs to be made part of the legislation. The Western Australians have done it, and I will talk about that a bit more, but we need to make sure that it is publicly available. Professor Carney continues:

For these reasons, a recurring criticism (at least since the report of the Coombs royal commission in 1997) is the tendency of cooperative arrangements to undermine the principles of responsible government.

That is the issue for the opposition. We would love this legislation to be able to proceed and for the national scheme to come in but not the way in which it is presented. Today we have this legislation and we will deal with it as the government sees fit, because it has the numbers in this place. When it goes to the other place it will be interesting to see what happens.

The devolution of power of parliaments is not unique to Australia. In his book, The Story of Parliament, a story of Westminster, John Field discusses the changing roles of parliament and the increasing load of parliamentary legislation. In this book—and he is telling the story of the UK parliament—Field first emphasises the usefulness of an upper house, which Queensland does not have and which this government would love to get rid of. When this piece of legislation goes to the upper house, I hope that members read my second reading contribution and know that we do love them up there, that we do appreciate their input into the legislative process in South Australia.

Field first emphasises the usefulness of an upper house, the house of review, and then goes on to talk about the devolution of the power and authority of sovereign parliaments. I will read a couple of short passages from John Field's book, The Story of Parliament in the Palace of Westminster. His book states:

The volume of legislation passing through parliament has more than doubled in recent years from 1,175 pages a year in 1971 to 2,581 pages in 1989, and still rising, as governments try to push through ever more ambitious programs. Statutory instruments and government orders that are scrutinised only in an abbreviated form of the legislative process, if at all, have increased in the same period from about 70 a year to over 1,200. Even if it worked 24 hours a day, the Commons would not give adequate scrutiny to such a volume of legislative business, and up until now it has had to leave it to the House of Lords to do so. Never has it been more necessary for the Lords not to be the poodle of any government.

Field then continues on about the function of parliament:

The function of parliament has also been undermined and its clear legitimacy muddled by the devolution in its many forms. The European Union Commission and the parliament, the International Monetary Fund and other multinational organisations (public and commercial) have limited the remit of Westminster's authority.

And that is what we cannot allow to happen here in South Australia. The whole problem with this bill, as I have said, is clause 4, and I will repeat it because it is so important. In clause 4 we have 308 pages of legislation with 305 clauses and seven schedules of a further 108 clauses, also known as 'bill B' or the 'national law', reduced to one clause of eight lines—eight lines. This is the guts of this piece of legislation. It is the nuts and bolts of the national scheme and this is where the detail is. But we do not get to see it; we have to trust the executive of this government; we have to trust the ministerial council.

As I said, the opposition can live with and support the rest of the bill with the changes to pharmacy practice and optometry practice, but it will not support the bill as presented. I ask the minister either to withdraw the bill and bring it back as it should be (that is, as corresponding legislation) or to justify his position on presenting it this way. We cannot see justification for this parliament being a rubber stamp to the ministerial council.

This bill should have 'bill B' as part of it. There is no excuse. As I said, Queensland has incorporated it into its legislation (as one would expect) and New South Wales has done it, but then it does not solve the fundamental problem that other states have not done it. I realise that the Northern Territory, the ACT and Victoria have not included it in their pieces of legislation and they have got away with it. Their oppositions, for some reason, have not insisted on the inclusion of bill B as a more open and transparent piece of legislation.

South Australians cannot be expected to obey laws made by an unelected group with political agendas. This legislation will only be acceptable to the opposition if it is brought back to the parliament as corresponding legislation. The Western Australians have done it; we can do it. We need to be able to do that and make sure that the legislation is not only acceptable to the IMC—which it is, as corresponding legislation—but also acceptable to the people of South Australia through their elected representatives in this parliament, not just the executive of the government.

The minister in his second reading speech acknowledges that this legislation could be introduced as corresponding legislation, and it is a very weak argument to say that parliaments will take time to pass amendments and so cause confusion. Even if there were delays then this could already happen, as we have seen, because Western Australia has introduced corresponding legislation.

It is up to each jurisdiction to make sure that the amendments are scrutinised, and the ability to do that with corresponding legislation is going to be easier for this parliament. It will be put through as quickly as possible by this parliament if the amendments are good amendments and the government is sitting more frequently, or is able to schedule the amendments at appropriate times. As I said, we could have looked at this legislation before and we could have had it examined in detail before, because we've had plenty of time, but, no, today we are expected to do it in a very short time frame.

I should point out that the ministerial council agreements to decide to proceed or not proceed with any particular issue is not something that South Australians can have any faith in. Our minister cannot have faith in his ability to have input into that with any degree of significance, because he can be sidelined. So South Australia and our minister could become totally irrelevant if the majority of ministers have their way, because the intergovernmental ministerial council in its own agreement document talks about agreement by consensus or, in the bill, talking about regulations, by the majority of ministers at the ministerial council. There is no unanimous decision that needs to be made, so our minister could actually be sidelined, this government could be sidelined and this parliament could be sidelined by the ministerial council. That is a completely unacceptable position for the opposition to live with.

Let me just talk a bit more about this legislation that we have before us, because it is important that people who are reading Hansard and people who are listening to the debate do understand that the opposition does support the intent of this legislation. We do understand and, as I said, personally I have a real desire to see national legislation brought in for veterinary surgeons as well, or the veterinary profession generally, and allied veterinary practitioners, as well as, in this particular case, medical practitioners or health practitioners.

I will talk a bit about this and I will also refer to a parliamentary research paper in a few moments. The National Registration and Accreditation Scheme, known as NRAS, will replace the current system of state-based registration and accreditation to create a single national scheme for 10 different health professions, which are: chiropractors; dentists, including dental hygienists, dental prosthetists and dental therapists, not including dental technicians—and I will talk about that a bit later; medical practitioners; nurses and midwives; optometrists; osteopaths; pharmacists; physiotherapists; podiatrists and psychologists.

The scheme is scheduled to commence on 1 July 2010. The NRAS is the result of a Council of Australian Governments (COAG) intergovernmental agreement signed on 26 March 2008 to implement the national scheme.

The current status of the legislation in other states throughout Australia is as follows: in Queensland, the bill was passed on 29 October 2009 and will commence on 1 July 2010; in New South Wales, the bill was passed on 11 November 2009 and will commence on 1 July 2010; in Victoria the bill was passed on 8 December 2009 and will commence on 1 July 2010; in the Northern Territory the bill was passed in the Legislative Assembly in February this year and will commence on 1 July 2010; the ACT passed the bill and that will also commence on 1 July 2010; in Western Australia, the bill was introduced into parliament on Tuesday 4 May, has been passed and will commence on 1 July 2010.

The reason I keep saying that it will commence on 1 July 2010 is that the national scheme will commence on 1 July 2010, with or without South Australia. As the chair of the Psychology Board of Australia said, it will go ahead, but South Australia will not be included unless we get the legislation through this state.

A very good summary of the history and objects of the current position has been prepared for members at my request by the Parliament Research Library, and I would like to thank Dr Susan Errington for all her work. That excellent report reads, in part:

The legislative process, in the implementation of the national registration and accreditation scheme, was a three-stage process:—

and that is why today we are calling this bill C; we have had bill A and bill B through the Queensland parliament, and now we are being asked to adopt bill C here. The report continues:

The first stage was the passage of the Health Practitioner Regulation (Administrative Arrangements) National Law Act 2008 of Queensland, which enabled the legal and governance arrangements to be established to assist implementation of the national scheme from 1 July 2010. The Health Practitioner Regulation (Administrative Arrangements) National Law Act 2008 was passed by the Queensland parliament and received royal assent on 25 November 2008. This act established the interim administrative arrangements for the scheme such as the establishment of the Australian Health Workforce Ministerial Council, the national agency, and the profession specific national boards.

The second stage was the passage of the Health Practitioner Regulation National Law Act 2009 of Queensland, which will repeal the 2008 act from 1 July 2010, and cover the substantial elements of the national scheme including registration and accreditation arrangements, complaints, conduct, health and performance arrangements, privacy and information sharing arrangements, and transitional arrangements.

The third stage is the introduction of adopting or corresponding legislation by other jurisdictions to apply the national law as a law of that jurisdiction—

That is what we are talking about today; that is the piece of legislation that is before us today—

or, in the case of Western Australia, the introduction of corresponding laws to achieve the same effect. The South Australian bill fulfils this third stage in that process [by adopting the legislation.]

Why introduce a national scheme of regulation for health professionals? The primary objectives of the national scheme are to:

provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered;

facilitate workforce mobility across Australia by reducing the administrative burden for health practitioners wishing to move between jurisdictions or to practise in more than one jurisdiction;

facilitate the provision of high quality education and training of health practitioners;

facilitate the rigorous and responsive assessment of overseas-trained health practitioners;

facilitate access to services provided by health practitioners in accordance with the public interest; and

enable the continuous development of a flexible, responsive and sustainable Australian health workforce and to enable innovation in the education of, and service delivery by, health practitioners.

The background to the bill, as is so clearly laid out in the parliamentary library's research paper is:

In 2005, the Productivity Commission was asked by COAG—

and I acknowledge that this was a federal Liberal government at the time but, as I understand it, this particular arrangement was not the one intended at the time—

to undertake a research study of Australia's health workforce. The purpose of the study was to 'examine issues impacting on the health workforce including the supply of, and demand for, health workforce professionals, and propose solutions to ensure continued delivery of quality health care over the next 10 years.'

The Productivity Commission's report concluded that despite Australia's growing reliance on overseas-trained health professionals, the Australian health workforce continues to experience shortages (particularly in rural and remote areas and in special-needs sectors).

That is an area that we shall talk about later on, because I do not see in this legislation any assistance or incentives for people to go bush; it is great to move interstate or into the territories but not to go bush. The report continues:

The commission further concluded that the demand for the health workforce continues to grow due to a combination of developing technology, increasing community expectations and population ageing, and expenditure on health care already accounts for 9.7 per cent of Australia's GDP and is continuing to increase.

As a key component of its recommendations, the Productivity Commission suggested that factors decreasing the productivity and effectiveness of the available health workforce should be addressed in order to increase the amount and quality of workforce services available for any given levels of expenditure. The extraordinarily complex and interdependent nature of Australia's health workforce arrangements was identified as a significant factor detracting from the productivity of the health workforce.

Amongst its proposed actions, the Productivity Commission recommended the establishment of a national accreditation board as well as a national registration board for health professions. The Commission saw the accreditation of health professionals as encompassing the assessment and evaluation of education and training courses and institutions to ensure that course standards are consistent and of appropriate quality. The registration of health professionals referred to the assessment of an individual person's qualifications, experience and character to practice their chosen profession.

Following the Productivity Commission's recommendations, COAG signed an Intergovernmental Agreement on 26 March 2008 for a National Registration and Accreditation Scheme for the Health Professions. The IGA outlined the perceived benefits:

The new arrangements will help health professionals move around the country more easily;

Reduce red tape;

Provide greater safeguards for the public;

Promote a more feasible, responsive and sustainable health workforce.

As the power to regulate the health professions lies with the states and territories rather than the commonwealth—

and this is why we are seeing national legislation and not commonwealth legislation—

the legislative framework for the bill could not be enacted through a single piece of commonwealth legislation. Instead, legislation to improve the national scheme is required to pass through the individual state and territory legislatures.

The Queensland parliament was chosen to host the legislation to create and support the scheme because it has a unicameral Parliament. As there is only one House in Queensland there is a certainty that the bill will be passed without being further amended in the second chamber.

I think that is a very telling point about why Queensland was the host in this particular piece of legislation. South Australia has been the host in a number of other pieces of legislation where there have been intergovernmental agreements and ministerial councils and, quite honestly, we could probably have lived with that as the host legislators but not as, here, tail-end Charlie. The report continues:

On 19 March 2009, the design of the proposed national scheme was referred to the Senate Community Affairs Legislation Committee for reporting by 6 August 2009. Among the findings of the Inquiry, it concluded that there was general support among health professions for a national registration and accreditation scheme. The inquiry made three recommendations.

It recommended that the Ministerial Council consider amendments to clauses relating to the Ministerial Council's power to approve or amend accreditation standards for a health profession because of a perceived substantive and negative impact on the recruitment or supply of health practitioners to the workforce. Stakeholders considered that such influence could potentially lead to a lowering of accreditation standards in favour of increasing health practitioner recruitment and/or supply.

There are still significant concerns around Australia that the ministerial council can still influence the accreditation standards and supply of health practitioners, not to the extent that they initially wanted to but certainly I know that the AMA in Western Australia, when that bill was going through that place, was lobbying very hard to amend the bill to strengthen even further the need to maintain accreditation standards for health practitioners. The second recommendation states:

In instances where the ministerial council did give a direction about an accreditation standard, the reasons for such a direction should be made public.

It needs to be very clear that any direction from the ministerial council needs to be made public, and made public in a way that is not hidden away on a website somewhere or in a piece of legislation or a newspaper advert. It should be made open and transparent and public. The third recommendation states:

The scheme should contain sufficient flexibility in the composition of national boards to allow them to accurately reflect the characteristics and needs of the different professions.

On 12 June 2009, the Exposure Draft of the Health Practitioner Regulation National Law was released for public consultation.

That is in Queensland. It continues:

In total, 550 written submissions were received and a total of 950 people attended consultation forums held in each capital city.

On 27 August 2009, the Australian Health Workforce Ministerial Council released a communiqué outlining their responses to issues raised both through the public consultation on the draft legislation and the Senate Committee's report. With regard to the stakeholders' concerns about the independence of the accreditation function, the Council stated—

and these are the ministers who—

agreed to amend the Bill so that when the Ministerial Council proposes to give a direction in relation to a new or amended accreditation standard where the Council considers that the standard will have a substantive and negative impact on the recruitment and supply of health practitioners, Ministers must first consider the potential impact on quality and safety of health care.

That does not completely negate any dumbing down of accreditation. I sincerely hope that I am not being alarmist there, but that is another reason why we are insisting that this legislation be more accessible to this parliament and the people of South Australia as corresponding legislation.

In response to the other two recommendations of the Senate committee, the ministerial council agreed that any direction issued by them on an accreditation standard should be made public. They also agreed to expand some national boards from nine members to 12 members to allow a practitioner representative from each state and territory in the larger professions.

The Health Practitioner Regulation National Law Bill 2009 was introduced into the Queensland parliament by the Queensland health minister, the Hon. Paul Lucas, on 6 October 2009. The law was passed without amendment on 29 October 2009, nearly 6 months ago. I would like to thank Dr Susan Errington from the Parliamentary Library for putting that research together for me and for other members in this place.

I have also taken some advice on how this legislation is going to be handled and how it will impact on the parliament and the people of South Australia by speaking to our attorney-general and he has, like the Attorney-General, the Hon. John Rau, significant concerns about the power of ministerial councils. The Hon. Stephen Wade, our shadow attorney-general—

The Hon. J.D. Hill interjecting:

Dr McFETRIDGE: Our shadow attorney-general made some significant comments.

The Hon. M.J. Atkinson: Who is that now?

Dr McFETRIDGE: He made sure that—it is interesting that they are starting to interject now because they know that we are not going to get this legislation through this place as they wanted it—rammed through in a matter of hours. So, I will continue on. I will take as long as the house forces me to take with this legislation. I am happy to read all 308 pages of the legislation into Hansard if that is what it takes to make it open and transparent for the people of South Australia.

The Hon. Stephen Wade, the shadow attorney-general, shares the concerns of the Attorney-General, the Hon. John Rau, about the influence of ministerial councils, and I will quote from Hansard again from October last year, if the house wants me to, to reinforce what he said. They can read what I said in my second reading speech earlier. As to the ministerial council's decisions—and, as I said before, I mentioned it with the Hon. Stephen Wade from the other place, the shadow attorney-general, who backs this up—contrary to advice that the government gave us that the decisions by the ministerial council were only by unanimous agreement, the IGA states that agreements by the ministerial councils for the purpose of decisions relating to the national scheme will be by consensus. Then if you read the Queensland legislation bill B, the national law on regulations, it is by a majority of members of the ministerial council.

The national law adopted in each jurisdiction is also amended without the need for any action by respective parliaments, and that is something that is a concern for us: that the Queensland parliament can amend its legislation with its one house. Sure, we can reject any amendments but then that means we pull out of the scheme. I had a call from one of the health workforce unions this morning urging me to support the bill as it is. I pointed out to that representative that we support the intent of the legislation; we support the need for a national registration scheme, but what we do not support is the way this is being presented to us. We want to make sure that the legislation is going to be a piece of legislation that we can all have respect for and that the legislation respects this parliament.

As I said, Western Australia has done what we are asking—no more, no less. The minister has already acknowledged it in his second reading explanation. The ministerial council acknowledges that it can happen. We just ask that this legislation be presented to us as a corresponding law model.

There are a number of opinions that have been raised, and the Hon. Stephen Wade refers to these in advice given to me about the constitutional validity of the regulation-making powers. We are able to live with those. That is not a die in a ditch issue for us, so the minister can relax. What we do have concerns about is that part of the government's position (in introducing this by adopting the legislation) that it will make a nationally consistent scheme unlikely. Parliaments would consider the proposed amendments on their merits, including their relative impact on the national consistency. That is the thing that the parliament should be doing, not subject to the ministerial council's direction. It is the parliament, not the executive, that should be driving this legislation. If it is good legislation, I am sure the parliament will support it, and we will pass it and any subsequent amendments.

The government also said that if the corresponding law was introduced it would be extremely burdensome on the national scheme. The burden on the national scheme is clearly bearable, as Western Australia is already using the corresponding legislation approach. The government says it will create lengthy delays that will in many cases be completely unacceptable to the public and the professions. The answer to that is easy: the length of delay is determined primarily by the efficiency of the government in bringing matters to the parliament. Also, professional groups and boards consulted support a corresponding law model.

A corresponding law model, the government says, would compromise the national registration of South Australian practitioners while waiting for the South Australian parliament to pass the required amendments. I do not understand that, because, as the chair of the Psychology Board of Australia said, 'It won't matter, we can continue. The world won't stop.' As I have said before, with all the other corresponding legislation that has been passed, the national scheme will be implemented and we will just have to follow on. There will be some inconvenience—I accept that—but it will be for the greater good.

The minister may or may not accept our position; it is up to him. It will be a long committee process. There will be a long discussion about this. There are a number of speakers on this side, and I have a lot more to say about this. As we take the national tour of what has happened around Australia with this bill, it is not all sweetness and light. There are lots of issues, not only raised by opposition members of parliament in the various jurisdictions but also by the various ministers. There are some wonderful quotes coming out of New South Wales, in particular, about this legislation, and I will quote the various health ministers. We have had a number of briefings on this, and I thank the minister and the staff for those opportunities, but we still have not been able to overcome this one particular major concern, that is, the presentation of the legislation.

The AMA has written to the government expressing concerns about the way this legislation was presented. It was concerned about preserving the sovereignty of the South Australian parliament. My advice is that this legislation does not affect sovereignty per se. We still have the power to intervene, to amend legislation. We can still do that, but the consequences of doing that are what causes concern for me and those I have spoken to as well as other members of the opposition. We do not want to have to try to unscramble the egg; we want to make sure that the cake, with all the ingredients in it, will end up perfect and properly cooked, not half-baked, such as we are seeing at the moment.

The AMA has given me some amendments that it would like to have introduced into this bill. We will not consider introducing those amendments in this chamber. I will read in those amendments at some later stage, probably during the committee stage, but we will be maintaining our position that this bill needs to be re-presented as a piece of corresponding legislation.

Some information given to me by the Australian Doctors Fund has been described as 'quite bullish' by a senior legal counsel. The Australian Doctors Fund's legal advice from eminent QCs did question the constitutional validity of the regulation making powers. There were three recommendations given at the end of the legal advice. Some were really quite hopeful, I suppose. Others are more confident in the legal challenges to this legislation.

I have read that legal opinion. I have spoken to Stephen Milgate, the executive officer of the Australian Doctors Fund, about their position. I have also spoken to legal professionals here in South Australia to just check that where we are going with this is along the right path. There are some issues that we are going to need to compromise on. As I have said, with the regulation-making powers, we are willing to live with that at the moment, provided we get the rest of the legislation presented in an acceptable fashion to this parliament, not to the executive.

Once again I thank the minister's staffers and departmental officers for their assistance in this briefing paper. The issues that were raised in the briefing session on 11 May were about the legislative model. The position was put that this model is the most appropriate and efficient way for the national scheme. I think I have already said that the advice from the Hon. Stephen Wade is that that is not right.

The advice that was given at that briefing was that this is not the first piece of legislation of this type that has gone through here, and that if we try and change it then we will be setting a precedent. That is fine, I can live with that. There are other national laws that have been through here—the national gas law and the national electricity law. South Australia was the host legislature. So we accept that there are other examples of it. In fact, I was just checking whether there were other examples around Australia where governments have acquiesced, and we have national laws other than the few that were given to me—the national gas law, national electricity law, consumer credit laws and corporations law.

In an address by Andrew Parkin to Flinders University on executive federalism, there is a list of 30 ministerial councils, starting with the Ministerial Council for Aboriginal and Torres Strait Islander Affairs and continuing on: the Ministerial Council on the Administration of Justice, the Australasian Police Ministers' Council, the Intergovernmental Committee on Australian Crime Commission—and it goes on.

There is the Cultural Ministers' Council, the Ministerial Council on Drug Strategy, the Ministerial Council on Energy, the Australian and New Zealand Food Regulation Ministerial Council, the Housing Ministers' Conference, the National Resource Management Ministerial Council, the Online and Communications Council, the Primary Industries Ministerial Council, the Regional Development Council, the Small Business Ministerial Council, the Tourism Ministers' Council, the Australian Transport Council, the Ministerial Council on Vocations and Technical Education and the Workplace Relations Ministers' Council.

So we are seeing more and more ministerial councils being formed and more and more the state and territory parliaments are being asked to accept the will, the desires, the wants of those ministerial councils as pieces of legislation that should be rubber-stamped. I do hope that the Attorney-General comes in and makes some comment on the roles of ministerial councils, because what he has said in the past is quite interesting. I would have thought that that may have affected the way this legislation is being presented to this place here.

I just remind the house that ministerial councils are not elected. They are executive members of the various jurisdictions and they come together. They are not elected by the professions, they are not elected by the constituents of the various states. They really become almost a law unto themselves. They are not answerable to any parliament in particular. Sure, we can allow and disallow amendments to go through, but you can really mess up the national schemes if the ministerial councils are not made aware of the fact that legislatures are watching what they are doing.

Ministerial councils are very powerful. Clause 26(2) of this bill provides for the ministerial council to direct the national agency and the national board if they do not agree on various things. The national agency management committee sets policy, subject to the ministerial council. The ministerial council is a very powerful body in this legislation, as well as in many other pieces of legislation and policy forming areas. I am further inclined to lock in on our position. It is important that we ensure that this parliament, rather than a ministerial council, is the final arbiter of its fate.

In the briefing on bill C on 11 May we talked about the Western Australian model. Comments were made that the original model was for all jurisdictions to adopt a national law, but Western Australia does have a history of digging in. We saw it with the GST, with health and other issues, and we are seeing it with the super tax on mining. They stick up for states' rights over there. I lived in Western Australia for seven years and it was always 'them and us'—'us' being the eastern states, everything east of South Australia. I understand their parochialism, but it is time South Australia became more parochial and ensured that legislation presented to us is genuinely in the interests of the state.

I did ask at the briefing about the role of the Health and Community Services Complaints Commissioner, because the national law provides that the national board and the commissioner must notify each other about the receipt of complaints. That is fine. Most of the intent of this legislation, the clauses and the way in which they are presented, is fine. There are some issues about the relationships between the various states and the national bodies, and one of those concerns is the relationship between the Health and Community Services Complaints Commissioner and the national board, the national agency. That has been sorted out.

There is an issue about the assets of the various boards. I do know that one particular professional board in South Australia has accumulated through good management—not because of any avarice or other desire to acquire wealth—over $1 million in liquid assets in the bank. They also have their own buildings.

Those assets will be transferred from the state boards to the national board—and that is happening all over Australia. I understand that the total amount being transferred is in the tens of millions of dollars. I will be asking in committee about the transfer of those assets and whether there will be stamp duty on the transfer of those assets. Western Australia has exempted the transfer of assets from stamp duty.

Why is that not in this legislation? Will we see a continuation by this government of a grab for stamp duty? We know we are a high taxing state, so I would like that matter cleared up. I would like to see the transfer of those assets—if they are to transfer in whole, and that is another issue—exempt from stamp duty. Obviously, there is no stamp duty on the transfer of money, but we will talk about the transfer of money later.

We should take a tour around the nation to see how this law is being constituted. We will start with sunny Queensland. The draft release was out in June last year. The legislation that was passed by its one house of parliament on 29 October last year set up this scheme. Queensland is retaining a separate register for dental technicians. I spoke earlier about various professions being included in this bill. Dental technicians are not included: dental therapists, prosthetists and hygienists are included. All 229 dental technicians in South Australia will be left out in the cold. A couple of dental technicians in my electorate have a thriving business which will be put in jeopardy by this legislation. We are working through that, and I know the minister is working through that, and I thank him for his assistance in that area.

However, it has been put to me by one of the members of the national authorities that have already been put in place (although in a temporary fashion, you might say) that dental technicians in South Australia could go and register in Queensland, get a Medicare provider number in Queensland and come back and work here. The registration of dental technicians is not included because the government is saying that dental technicians do not have contact with the public generally.

Dental technicians are having their livelihood taken away in many cases not only by legislation but also by upgrades in technologies; and also, unfortunately, by the fact that dentists (being the frugal professionals that they are) are looking at overseas sources for a lot of their materials and particularly dentures. Dental technicians are being sidelined, not only by this legislation but also by the dental profession. That is understandable in some ways but there are issues with that. It was raised with me that, because of the importation of overseas-produced prostheses and dentures, quality control (while it comes under totally different acts) is of concern. Will dental technicians in South Australia register in Queensland? We don't know. There are 229 dental technicians in South Australia, so that is an issue.

In New South Wales the legislation was introduced on 28 October last year and passed shortly afterwards. The 230 pages of the national law is attached to the bill as a note for all to see. There are some significant differences in every state and territory. They all have amendments, and I will talk about those as we go through. For example, in New South Wales, the legislation has a five-year review. I have read this legislation and I am fairly confident in what I am saying. I am happy to be corrected by the minister if I am wrong about any of this, because it is a complex piece of legislation, but that reinforces my whole point that we need to have this legislation laid before the whole of the house as a piece of legislation that we can all look at, understand and accept as being owned by this parliament.

New South Wales has a serious concern with the handling of health care complaints under the national law, so much so that in her second reading speech the then deputy premier, the Hon. Carmel Tebbutt—is she the deputy premier, still? I don't know, because they change their premiers over there—

The Hon. M.J. Atkinson: Yes, I think she is.

Dr McFETRIDGE: —a bit like some other parliaments.

Members interjecting:

Dr McFETRIDGE: We won't go there at the moment, will we? Let me read what the Hon. Carmel Tebbutt said of the health system in New South Wales. She said:

...the government considers this is a sensible and appropriate solution to ensure cooperative approach on these issues...compromises are necessary...There are...areas where compromise is not possible where the protection of the public is the paramount consideration. For this reason this government has consistently argued there can be no compromise in ensuring the maintenance of a strong, accountable and transparent disciplinary and complaints system in New South Wales.

Members will be aware that the health care complaints system in New South Wales is...unique in Australia. It divides the complaints and disciplinary roles between the health professional boards and independent Health Care Complaints Commission.

This structure has evolved over many years. Starting in response to the Chelmsford Hospital scandals in the 1980s, to the establishment of Australia's first fully independent health complaints investigator in 1993, the changes made to the New South Wales system over the last 20 years have consistently focused on...enhancing the public accountability of health service providers and...improving the capacity of the complaints system to protect the public.

She continues:

As members may be aware, the national law's complaints model adopts processes similar to those which currently apply in most other states and territories. It is markedly different from the current New South Wales model, as it relies primarily on the health professional boards to undertake disciplinary functions and does not provide for an independent investigator and prosecutor such as the Health Care Complaints Commission.

This government remains committed to the Health Care Complaints Commission as an integral element in complaints management in New South Wales.

For this reason I am pleased to advise the house that the government has brokered an agreement with the other states and territories which will enable New South Wales to maintain the current...health complaints system and retain the New South Wales Health Care Complaints Commission.

New South Wales will now participate in national registration as a 'co-regulatory jurisdiction'. As a result, the bill I bring before the house specifically provides that New South Wales will not adopt the national law complaints model...

Already we are starting to see holes in this national law. The quote continues:

Under the proposed New South Wales approach, the national registration boards will be—

and this is the really good bit, this bit here. Listen and tell me how this is going to work, because I have some real questions and queries about this national system—

expressly precluded from dealing with complaints about matters occurring in New South Wales and those matters must be referred to the New South Wales authorities, including the Health Care Complaints Commission, to be managed.

But this is the good bit I wanted to get to:

Practitioners in New South Wales will not be called on to fund the complaints system established under the national law. In most cases, if not all cases, registration fees payable for practitioners based in New South Wales will continue to be lower than those in the rest of the nation.

Not only are they having a separate complaints system but they are also having lower registration fees. I thought that this was a national system whereby you paid one registration fee to a national authority and you could move smoothly and seamlessly between states and territories. But the health minister in New South Wales has dug in on this one and she has stuck up for her health practitioners. She has kept her state's complaints commission and she is returning that in spades. In most, if not all, cases registration fees payable for practitioners based in New South Wales will continue to be lower than those in the rest of the nation.

I need to get an answer on that because it is a real issue. I will just quote some of the fee changes that are going on a little later. There are some absolute doozies out there. Under the New South Wales law not only do we see different complaint systems and different registration fees but also a number of definitions have been left out. 'National law' is amended to remove large sections of mandatory reporting and rights of appeal. Part 2, section 6 (and that is page 3 of the New South Wales legislation) makes significant changes. The New South Wales Deputy Premier sums up this legislation and the process used to get it up in her contribution; and, as I said, that was by a system of negotiation and consensus, but consensus was not always achievable. The Hon. Carmel Tebbutt states:

Members will be aware that all national systems are necessarily the result of negotiation and compromise to reach outcomes acceptable to all jurisdictions. The national law to be adopted by this bill is no different, and practitioners and regulators in New South Wales will find some differences in how registration and accreditation and other processes will be managed under the national scheme.

You can go to New South Wales and you can register more cheaply there. You get pinged under a different system there, and it does work slightly differently. That is not coming from me, that is coming from the Minister for Health, the Deputy Premier in New South Wales, the Hon. Carmel Tebbutt, in her contribution on 28 October 2009.

That bit about why they can register more cheaply there is one that concerns me, because I can see all the health practitioners rushing to New South Wales to register because, once they are registered there, they can then practise all over Australia, because why would you not?

The Hon. J.D. Hill interjecting:

Dr McFETRIDGE: Well, they can do it now but they have to pay other fees. The minister says that they can do that now: they can register in New South Wales and practise in other states, but they must re-register in other states. That is the whole point of this legislation. We need to make sure that we pay one registration fee nationally. That registration fee—and it may be less than New South Wales—for the Medical Board of Australia is $650. The Australian Doctor magazine, which talks about the hike in registration fees, states:

The spike in Medical Board complaints expected under the controversial mandatory reporting laws has been blamed for the $650 Medical Board of Australia fee.

I will talk about mandatory reporting later. I do not think that is the case, but I think there is a real issue with the size of bureaucracies. I am not sure whether I brought the list of the sizes of the bureaucracies that have already been created and the executive positions that are already out there, both in the Melbourne head office and in every state.

This article states that the $650 fee is more than four times the $150 paid by doctors in the Northern Territory, and is a sharp rise on the $415 paid in Victoria, the $385 paid in Western Australia, and the $430 paid in Queensland. I could not find the South Australian fee but, in talking to doctors at the AMA dinner at the Botanic Gardens on Saturday night—a very good dinner, which the minister and I attended; and congratulations to Professor Michael Rice for receiving an AMA award for life service—some expressed concern about the increase in their fee.

This article states that doctors in New South Wales, who currently pay $270, will pay slightly less due to the New South Wales government subsidising their registration fee. So, I think that if I were living somewhere else I might put my address down as a mate's place in New South Wales; I think that would be a quite legitimate thing to do.

The article in the Australian Doctor of 28 April this year, just a few weeks ago, states that the Medical Board of Australia expects to raise more than $52 million from this year's registration fees. In the past registration fees have not only been used to fund the functions of the board but also accumulated to allow any funds not required for continued cash flow to be put aside to provide for any litigation expenses or other concerns the board may have, as well as to provide support for continuing education and professional development and things like that, but that is an issue I will talk about when dealing with the transfer of assets. So, there will be $52 million from registration fees, and they are going up considerably, except in New South Wales, where they will be subsidised in this national scheme.

I did not count them, but a number of definitions have been left out of the New South Wales legislation. Certainly the definitions of health assessment, performance assessment, professional misconduct, unprofessional conduct, and unsatisfactory professional conduct are omitted from the national law. Divisions 3 to 12 of part 8 of the law are omitted, as well as section 199(1)(h) to (k). So we are getting a bit of a variation on a theme.

Some other acts have been omitted that we do not see in our act: the Privacy and Personal Information Protection Act (I suppose that may be similar to some of our acts), the Public Finance and Audit Act and the Subordinate Legislation Act. One which is not in the New South Wales legislation but which is in ours and others is the Acts Interpretation Act, and I will be interested to see how that effects the Governor's ability (not the ability of this parliament or the executive) to make regulations. I may be wrong on the process, but I understand that the regulations are put together by the parliament but that the Governor, by signing off on them, makes the regulations. So, I will be interested to see whether or not it influences his ability to perform his duties as the Governor of this state.

Continuing down the eastern seaboard: Queensland was different; New South Wales was quite different; and Victoria has gone down what I would almost call the shortcut path, a little like we are, simply by applying the Queensland legislation to its own legislation. During the debate in Victoria my veterinary colleague in the Victorian parliament, Dr Denis Napthine, pointed out that registration fees for many professions would increase significantly, as I showed just a moment ago.

Dr Napthine also raised the issue of the transfer of assets. It was a concern for them, and I know it is a concern for boards in most states in terms of where that money will go. Dr Napthine raised the very valid issue of what happens when an overseas-trained doctor becomes a citizen of this country. Will they take a month-long enforced holiday while the board sorts out their changes of visa? We do not know, but it is an issue that we need to answer: what will happen with overseas-trained doctors who want to work in South Australia? Dr Napthine also points out: where are the incentives for nurses and doctors and other health professionals to go bush in this legislation? You can move around from state to state, but where are the incentives to go bush?

Sticking with the eastern seaboard and just coming inland a bit, let us look at the ACT. The ACT introduced the legislation in December last year. The Deputy Chief Minister and Minister for Health, in her second reading speech, points out that the ACT legislation will be different. So much for national consistent legislation: Queensland is different; New South Wales is considerably different; Victoria has gone down the shortcut. I do not know what the opposition is doing there, but I hope it gets its act together before the election which is—this year?

Mr Marshall: This year.

Dr McFETRIDGE: This year. I am sure they will. With people of the calibre of Dr Denis Napthine there I am sure they will. Coming across to the ACT, they are different again. The ACT has come up with not a national complaints handling mechanism or the New South Wales style state model but its own hybrid style. I will read what the ACT health minister had to say in her second reading speech. This is the Deputy Chief Minister, Treasurer, Minister for Health and Minister for Industrial Relations, Ms Gallagher, the member for Mongolo in the ACT—

The Hon. M.J. Atkinson: Molonglo.

Dr McFETRIDGE: Molonglo. I am happy to be corrected by the member for—

The Hon. M.J. Atkinson: Croydon.

Dr McFETRIDGE: —Croydon. I do miss his corrections from the front bench there, correcting our grammar. On 10 December last year, when this was before the ACT parliament, the ACT health minister stated:

While the ACT is committed to the national scheme—

There is always that preface: we love you, but—

we currently have a complaints handling model which closely links the health professions board with the ACT Health Services Commissioner. This arrangement is similar to the public interest assessor model which is strongly based on the current ACT laws proposed in exposure draft bill B.

As the public interest assessor role was removed from bill B, the ACT has modified its complaints-handling process to retain a joint consideration model between the national boards with the ACT Health Services Commissioner.

So, it is a bit different again. I forgot to mention that there is a five year review in New South Wales as well. We in South Australia will have a three year review, and Queensland has a three year review. The ACT is looking at a 12 month review, so they have a lot of faith in this national scheme. It is five years in New South Wales, three years here and three years in Queensland. I think it is three years in Western Australia, as well, but I will refresh my memory on that fairly shortly.

Mr Jeremy Hanson, the ACT opposition leader, in his speech, made some very telling comments. Mr Hanson is a very honourable member of the ACT parliament and he is talking about the complaints handling system again. They call it a hybrid model over there. We have a different one in New South Wales and we have a hybrid model in the ACT. In Hansard, Mr Hanson states:

Where the ACT bill deviates substantially from the national model is in relation to the complaints handling process...Effectively, what is being proposed by the government is to give the health complaints entity in the ACT—that being the ACT Health Services Commission—additional powers, more than what the commissioner's counterparts in other states will be given.

So, it will be a more powerful complaints authority there, according to this contribution. Mr Hanson continues:

The bill, as presented, provides for instances where the ACT Health Services Commissioner will be permitted to participate in various stages of an investigation by a panel of a national board into the conduct of a health practitioner and will be given the power to be involved in the deliberations stage of an investigation.

This is at odds with what the other jurisdictions will be implementing or, in the case of Queensland and Victoria, already have implemented. Even New South Wales, which has completely departed from the national agenda on this issue, at least have made a clear and unambiguous distinction between the role of their Health Complaints Commission and the national boards.

Importantly, however, the New South Wales model will not have any impact on the workings of a national board, because the national boards will not have to deal at all with complaints made against New South Wales based practitioners, as this will remain the responsibility of the New South Wales Health Care Complaints Commission...What the government—

I remind members that this is the ACT government—

is proposing here, however, is a hybrid complaints handling system for the ACT which differs vastly from every other jurisdiction and which severely undermines the nationally consistent model that was negotiated and agreed to.

Mr Hanson is so concerned about this that he said he will be introducing amendments to change the way the complaints handling system is being used in the ACT. In the ACT they have a human rights act, as I understand it, and Mr Hanson said that he would be introducing amendments to remove the proposed new section 35A relating to a national board consideration of criminal history. He said:

This modification to bill B is simply impractical and, as outlined in the explanatory statement, requires a national board to apply a specific set of criteria, including case law precedents, when considering an applicant's criminal history. One possible result of this will be that practitioners will apply for registration as ACT-based practitioners because of a perceived leniency in the application criteria...This is hardly in the national interest.

This is hardly consistent across Australia.

Mr Hanson also has some concerns with their new section 150(4A) and that was the public interest model that the minister outlined in her speech. A number of amendments were made in the ACT bill. In fact, when you look at their legislation, there are 25 amendments listed in the introductory part of their legislation; that is 25 amendments to the national law. So, we are already seeing that this is not consistent.

The ACT is different with their hybrid model, New South Wales has its separate model, Queensland and Victoria seem to be hanging in there together, and South Australia will look at the model we will be using here. But let's go and have a look at what comrade Vatskalis said in the Northern Territory. It is a Labor government up there by 92 votes, I think; I know how they feel. The territorians will get a similar model to the rest of Australia because the territorians quite tamely followed along the intergovernmental ministerial council, and the legislation will go through.

I am intrigued by the Northern Territory health minister's comments in his second reading explanation. This is something the minister might want to listen to because I do not know whether or not we are in for the same dollars. This is what Mr Vatskalis, the Minister for Health in the Northern Territory, said on 24 February 2010:

The National Partnership Agreement to Deliver a Seamless National Economy also commits jurisdictions to achieve key milestones in relation to the COAG agreement for the national scheme.

He is talking about the national health practitioners regulation scheme.

To be eligible to receive its share of reward payments under the national partnership agreement, the Northern Territory must enact this legislation to effect implementation of the national scheme by 1 July 2010.

I would like to know whether, if the national scheme that we are introducing here is not introduced by 1 July 2010, we will lose these reward payments that Mr Vatskalis talked about in his second reading speech on the Health Practitioner (National Uniform Legislation) Implementation Bill 2010 back in February, because I have not found that anywhere else. There is no mention in the second reading explanation of any financial penalties. I have not read it anywhere in any submissions or on AHPRA websites. It is one of those things that just pop up here. I would be interested to see whether it is something to do with just the territories or whether the states are in for some money as well.

The question that needs to be asked is whether South Australia is at risk of not getting its reward of share of payments. If there are penalties, then this government has only itself to blame because, as I said, in September last year I wrote to the minister.

Let us go across to Western Australia. I do not think Tasmania has even got a health minister yet, so we will not be talking about its legislation. They are still in a bit of a bind down there, as I understand. There is a classic case where you cannot trust Labor. If you expected the Labor government to give up power I think you would have to be pretty naive for a start anyway, but it is just one of those things.

In Western Australia the law is presented in the manner acceptable to the intergovernmental ministerial council and acknowledged by our minister in his second reading speech, which is as corresponding legislation. The difference is between adopting it in eight lines in our bill to cover 308 pages of the national law or to do what the Western Australians have done, and that is enact it as corresponding legislation, where it is there for all Western Australians—all Western Australian health practitioners and all members of the public—to see, and to see very clearly.

The Western Australian government has enacted this legislation. It did it just recently, in early May, so South Australia really is tail-end Charlie on this, and I am disappointed that that is the case. The Western Australian law is good law. Clause 6(4) of the Intergovernmental Agreement for a National Registration and Accreditation Scheme for the Health Professions deals with implementation. It provides:

The state of Western Australia will, as soon as reasonably practicable, enact corresponding legislation, substantially similar to the agreed model, so as to permit the scheme to be established on 1 July 2010. The States of New South Wales, Victoria, South Australia and Tasmania and the Australian Capital Territory and the Northern Territory will, as soon as reasonably practicable following passage of the Queensland legislation, use their best endeavours to enact legislation in their jurisdictions applying the Queensland legislation as a law of those jurisdictions...

Just looking at that, we see in that clause that it is quite okay to have the corresponding model. The minister has acknowledged that, and the Western Australian government has done it. It is all through, done and dusted. There are some issues over there with it, but at least they own the legislation. Just as importantly, this clause provides that, after the Queensland legislation has been passed, the other states and territories will do it 'as soon as reasonably practicable following the passage of the Queensland legislation'.

Just to remind the house again, my office contacted the minister in September last year to ask about when this legislation was going to be introduced—eight months ago. We are expected to rush it through now, when even the ministerial council said that it should be enacted after the Queensland legislation has gone through—and that should have started late last year. We could have sat in December or February to pass this legislation. We did not need to rush it through now. We should not have had it out for only four weeks' consultation in January and February.

The ministerial agreement says that we should have done it. It has not happened, so anybody who wants to blame the opposition for holding up this legislation, for holding the government to ransom, for trying to get our own way, as one person put it to me, well, no, it is not about the opposition; it is about the parliament. This is about parliamentary process, this is about executive federalism, and this is about presenting well-intended legislation in an acceptable manner to the people of South Australia and the Parliament of South Australia.

The Western Australian law is good law. The intergovernmental agreement talks about the law being transparent, accountable, efficient, effective and fair. Adopting it in this way, it certainly is not transparent, it certainly is not accountable, and it certainly is not efficient. I think it is very unfair, not only to have it presented this way, where 308 pages of legislation are reduced to eight lines in our bill, but also to expect it to be rammed through this parliament in a matter of hours. It is not fair to this parliament, it is not fair to the people of South Australia, and it is not fair to the health practitioners of South Australia.

It is certainly not fair to all those people who have put in many hours of work, who have made personal arrangements to change their lifestyle, to change their abode, to move around, interstate, in some cases. It is not fair to put all that at risk, because this legislation has been presented in a way that the executive of this government expects this parliament to be a rubber stamp. We know that the Attorney-General does not agree with that; he has said so in the past in this place. I just hope he has some influence on the Minister for Health and brings this legislation back in the way that it should be presented, that is, as corresponding legislation.

The Western Australian legislation has some significant differences, though, from other legislation, but, in my opinion, they are common-sense differences, differences that we should enact in this place. One of those is to exempt the transfer of assets of boards from stamp duty. In his second reading speech the health minister in Western Australia talks about their complaints handling procedures. He states:

Under national law serious complaints in Western Australia, those relating to matters that could amount to professional misconduct, will continue to be dealt with by the Western Australian State Administrative Tribunal. The national boards, on the other hand, will deal with matters that relate to unsatisfactory professional performance and unprofessional conduct as well as matters that are regarded as health issues.

To me, that is a reasonable thing to do.

Another thing that the Western Australians have done is adopt a different attitude to criminal checks. I think it is a fair thing that, if your criminal history has no bearing on your ability to perform your job as a health practitioner, it really should not be the final arbiter of the decision of any board to register or not register you, or to give you accreditation to operate in the way that you are qualified to do so. So, the Western Australians are a little bit different. Like New South Wales, Western Australia—guess what?—has a five-year review, not a three-year review.

I see that the Attorney-General is in the house. I welcome him to the house and ask him to read my second reading contribution in relation to comments he made in October last year about ministerial councils. I am not trying to embarrass him in any way, shape or form because I think he is a fine member of this parliament and a worthy replacement of the former attorney-general. I look forward to watching him progress legislation through this place with his acute mind, because I know he is one of the most intellectual thinkers in this place. Right from my early days in this parliament I have enjoyed sparring with him in private members' time over various bills which were of some significance but which were not of a lot of consequence. I look forward to what he has to say in the future about ministerial councils.

Western Australia has a five-year review. There is a one-year review in the ACT and a five-year review in New South Wales where you can get cheap registration. There is a three-year review in Queensland, Victoria, Northern Territory and South Australia. It is a bit all over the shop. It has been said frequently that this will be consistent legislation and, so far, we are seeing it is not consistent legislation. There are lots of issues. The devil is in the detail with this bill.

We do not have a problem with the majority of the provisions and clauses. I do not understand why the government cannot be more conciliatory on this matter, why it must dig in and give the shortcut, abbreviated version. We would rather have the whole encyclopaedia and the index, not just an abstract from the front to say how good the encyclopaedia really is.

The AMA has asked us to move amendments—which we will be doing in the other place. We will talk about them in the committee stage. Last year the Social Development Committee of this parliament reported on bogus and unregistered health practitioners. In this legislation we see no hint of further broadening registration requirements for health professionals, other than for small groups. Chinese medical practitioners and Aboriginal and Torres Strait health workers are coming in later. Other groups can come in, and I am sure there is nothing to limit the range of health practitioners who can be included in this legislation.

At the moment there are 90 different organisations across Australia, registering something like 400,000 health practitioners. We are dealing with a significant number of people and that is why we feel we need to get the legislation right and have it presented to us in a way that is acceptable.

The South Australian Salaried Medical Officers Association has written to us with its concerns about the way in which the legislation in South Australia has been put together. A letter of 17 May states:

Dear Dr McFetridge—

and I will talk about the title 'Dr' later because there is protection of titles in here. As far as I am concerned, just don't call me late for dinner. The letter (from SASMOA's president Dr David Pope) continues:

I write regarding the Health Practitioners Regulation National Law (Bill C) as the president of the South Australian Salaried Medical Officers Association. SASMOA council notes that the SA version of Bill C has now been introduced into House of Assembly on 11/5/2010.

It is of concern to SASMOA members that the bill establishes a different tribunal structure to apply to medical practitioners to what currently now exists. This is despite submissions by SASMOA and other bodies (AMA-SA) indicating that the existing tribunal structure which is established under the District Court should be continued for medical practitioners. This was drafting option 3 which went out for consultation where a separate medical practitioners tribunal was established along the existing arrangements.

The concern is because almost all cases of medical officers referred to a tribunal with adverse findings made (only a few cases a year) end up using all appeal options. If, as now, the tribunal is under the District Court then appeals go directly to the Supreme Court which reduces overall costs and results in a final determination for the medical practitioner in a reasonable time frame. The new bill before the house has the tribunal for medical practitioners being below the District Court, with appeals to the District Court. Therefore, appeals will need to go to the District Court and then, inevitably, to the Supreme Court, increasing costs and delaying final determinations.

We are asked here to consider moving amendments, and it may be the case that if we are not able to proceed down the path we want to proceed down, it may be that amendments will be introduced in the other place to improve the legislation.

The questions coming out of our bill are: will there be stamp duty on the transfer of assets; will the tribunal judgments act on state precedents; and what precedents will the national agency use? Of course, sections 245 to 247 of the national law will have implications for this parliament's ability to make and disallow regulations under this legislation. While there has been a lot of discussion and legal opinion about that, we can live with it if the bill is presented as corresponding legislation.

There are many more questions and answers in the bill, and to expect this parliament to accept this legislation as it is presented is unacceptable. I will now look at our legislation, and then we will start going through the national law, because we need to do that. I will not read the national law into Hansard at this stage, but I will make sure that the points I have concerns about are included and, if necessary, I will read it in.

Our legislation, as presented to us, as I said when I started my contribution some time ago now, is 68 pages with 85 clauses, the vast majority of which we have no issues with. It is all at page 7, lines 26 to 34, which is eight lines of legislation. To me, that is not acceptable.

The legislation before us provides that bills are being excluded from our parliament, different from other jurisdictions. I am not a legal eagle or parliamentary counsel. I know the Leader of the Opposition (Hon. Isobel Redmond) is vastly experienced in this area, and I should have sought her counsel before coming in here but I did not get time, unfortunately. My understanding is that the Acts Interpretation Act 1915 concerns the way regulations are made, and I will be interested to be educated on the effect, or otherwise, of the Governor's ability to make regulations.

The Freedom of Information Act is excluded, and I can understand that. I have spoken to people about why that is so. The Ombudsman Act 1972 is excluded, as is the Public Finance and Audit Act 1987. The Public Sector Act 2009, the Public Sector (Honesty and Accountability) Act 1995 and the Subordinate Legislation Act 1978 are also excluded.

The AMA has asked for amendments to be moved here that would improve the outcomes of this legislation, in its opinion. It wants more emphasis on each decision being made in the public interest. The first amendment it wants moved is to clause 4, where it wants to ensure that, if this bill were to go through in its current form, any amendments in Queensland do not automatically apply to our parliament here.

What is laid out in detail in our bill (other than all the changes to the pharmacy and optometry practice legislation), is the setting up of the South Australian health practitioners tribunal. I did go before the Veterinary Surgeons Board once for handing out my business cards before we were allowed to advertise, way back, years ago, but I have never been prosecuted by the professional board, and I am proud of that fact. The need for these boards is a sad fact, and the need to have tribunals set up to investigate and to prosecute (if necessary) practitioners who are not doing the right thing is necessary, as well as to protect the public good and to protect the professions.

The changes in attitudes need to be reflected in the way in which cases are being dealt with, and, certainly, we have a change here, moving away from the Medical Board of South Australia setting up its own investigation systems, which have worked quite well in the past and which have kept South Australians safe. There have been occasions where doctors have been exposed as not being fit to exercise their profession, but we are not just dealing here with doctors, of course, we are dealing with many health professions, and that is why the intent of this legislation is good and needs to be supported, but not the way in which it is presented today.

The South Australian Health Practitioners Tribunal will consist of the president and one or more deputy presidents appointed by the Governor. The president or deputy president is a legal practitioner of not less than seven years standing. We should remember that this is replacing the—and I will ask the member for Bragg, who is a lawyer, when she makes her contribution perhaps to go into this in a little more detail—the District Court system that has been working for many years in this state.

The appointment of various members of the tribunal is laid out in the legislation. There is no retirement age stipulated, so I will be interested to see whether there is a retirement age. They can continue to be reappointed for life, is my understanding. Mind you, if they are very good at what they are doing, not being ageist at all, I do not see why they should not stay there. If there is a retirement age then, perhaps, it should be in the legislation.

The tribunal can set up panels. The Governor may, for the purpose of the tribunal, establish a panel consisting of persons from the health professions. I cannot find anything in here about how many members will be on those panels. The panel will be appointed for a period not exceeding three years. The allowances and expenses of the panel are not laid out in here. I would not expect them to be, but I would like to see what it will cost to run this panel because, when the Industrial Relations Commission had some of its responsibilities handed over to the commonwealth government, I think that some of the pressures on its time were reduced.

One issue that has been raised with me is: instead of establishing a new tribunal, why could not some of the commissioners from the Industrial Relations Commission take over that role rather than having to recreate a new panel with its ongoing bureaucracy and costs? The constitution of the tribunal is raised in the legislation. It all looks pretty straightforward. I declare that my wife is a dental therapist, but she is not practising any more. Clause 15(2)(b), 'Constitution of Tribunal', provides:

In a case where the matter relates to a person who is (or has been) a dental therapist, dental hygienist, dental prosthetist or oral therapist—select one person who is a dentist and one person who is a member of the same division of the health profession as the person in relation to whom the relevant matter relates.

That is a good thing that we are reflecting the professions. It is not Caesar judging Caesar but peer review. There is nothing wrong with peer review. I know that the Veterinary Surgeons Board, with its very well-credentialed and experienced veterinary surgeons, conducts itself in a way that it can be proud of. I expect that this tribunal will be able to do that if this legislation gets through, as we all hope, but not in this form, as the opposition hopes. There are a few other issues in here, but most of them can be answered in the committee stage. There is one—I am trying to give people a bit of notice so that they can answer them in the committee stage—regarding provisions as to proceedings before the tribunal:

the tribunal may, if it thinks it appropriate to do so, give a lesser period of written notice under subsection (1);

They are talking about suspensions of practitioners here. They can be suspended before the hearing has made its determination, and I would like some examples of where that may happen. One could probably understand if there were an example where patients were put in extreme danger because a doctor was not qualified, or was not able to perform procedures he claimed he was able to perform—the Dr Patels of this world—but it would be interesting to know what has been the record here in South Australia, because I think the various boards in this state have been doing a very good job of keeping the people of South Australia safe.

As I understand it, the tribunal can override the national board. If there is a conflict between the national board and the tribunal, whichever of those two entities has the most severe penalty is the organisation which conducts the investigation. The tribunal is 'not bound by the rules of evidence'; as a layperson I find that a bit disconcerting, and I would like it explained. The tribunal must also 'act according to equity, good conscience and the substantial merits of the case without regard to technicalities and legal forms.' Who sets all these parameters, what are the precedents, how will this tribunal conduct itself and know that it is going in the right direction?

The interaction with privacy legislation is also a question. Under section 19, relating to powers of the tribunal, the bill provides:

the tribunal may—

(a) by summons…require the production of any relevant documents, records or equipment…

I suppose privacy legislation is a concern there but, like a lot of tribunals and investigative authorities, I would imagine they are able to handle these matters in such a way that the information can be used to make a determination but also remain private.

As I said, the concern from SASMOA was that it goes from the tribunal to the District Court to the Supreme Court now, with the rights of appeal. Division 6, clause 23, provides:

An appeal lies to the District Court against a decision made by the Tribunal...

I would like to know how many appeals there were in the past, what was the average cost of those appeals, and the time taken to deal with the appeals. The practitioners involved are, in many cases, being suspended, but in other cases they are being allowed to continue to practise while they being investigated. In either case it seems an unsatisfactory way to conduct their business. I may be wrong there, but I would like to see the evidence to assure both this house and the public that this tribunal will operate in a manner that is effective in its aims, outcomes and procedures as well as in its timelines. The last thing we want is dodgy doctors and health practitioners continuing to practise whilst they are under investigation.

Clause 24, page 16, really ends with where we are at with the guts of this bill—that is, the national law, the national registration, the Health Practitioner Regulation National Law (South Australia) Bill 2010. Tacked on to this, we have the subsections amending the pharmacy practice acts and optometry practice in South Australia. There are no real difficulties with those, but we do need to make sure that the public of South Australia is given the protections that it requires.

I think that protecting the eyes of citizens is a worthy thing and so, it is a good thing to control people who want to sell plastic cosmetic contact lenses to unsuspecting people at the Royal Show. We should not be allowing people to be exposed to that risk, because I could think of nothing worse than being blind.

Under the schedules of this bill, there is the transfer of assets and liabilities and under Ministerial Orders, the bill states:

(1) The Minister may...transfer:

(a) specified assets or liabilities of a prescribed body to the National Agency or the Minister;

(b) specified classes of assets or liabilities of a prescribed body to the National Agency or the Minister;

(c) all assets and liabilities of a prescribed body...

It is a pretty powerful thing to be able to go and grab the assets of the state boards and then transfer them to the national boards.

As I said before, one particular board that has contacted me has $1 million that has been put aside over the years, not by shortcutting services to its members but by making sure that its members' interests are protected by being able to thoroughly carry out any legal investigations. That is what that money has been used for in the past, and also to enable the board to support any professional development, particular areas of interest to its members, to provide constant feedback to its members on various health legislation issues and to allow the board to conduct its business the way it wants to and should be able to. That is right across the board.

In Western Australia, the medical board is losing $2 million. I would like to know what some of the bigger boards in the other states are losing if this particular board in South Australia—and I will not name it—is losing $1 million and the Western Australian board is losing $2 million. I understand why the Western Australians have introduced an amendment to this legislation so that transfer of assets to the national boards, such as buildings, is not going to be subject to stamp duty. It would be interesting to know how much is being transferred. We know that the national board will accumulate $52 million in registration fees. The transfer of assets to the national board, including the liquid assets, will be many millions of dollars as well.

The concern for me, the opposition, members of the boards in South Australia that exist already and the many health practitioners is that there was very little consultation in the process of transferring these assets. The boards wanted these assets that they have accumulated over many years through good management to be used for continuing professional development. I know that, in the case of the dental board, it had already entered into discussions with the University of Adelaide to set up a continuing professional development program for dentists in South Australia.

We should understand that continuing professional development is a part of this national legislation. It becomes an integral part of this legislation that you do have to undertake professional development. It is compulsory professional development, and I have no argument with that. Just a few weeks ago, I attended a conference put on by the Australian Veterinary Association's South Australian branch on the latest trends in diabetes in animals in South Australia.

I was able to update my knowledge on that and, while I have not been practising extensively as a vet, I do want to exercise that part of my brain that I have used for many years as a vet, and I also want to be able to continue to have dialogue with my daughter who is a vet. My daughter Sahra is practising up in the member for Frome's electorate at Port Pirie now and enjoying herself very much up there. She and I attended this function the other night. Continuing professional development is very important. The Dental Board wanted to put some of this money towards that continuing professional development.

I would like to know from the minister what arrangements and what discussions were entered into with the various boards and what consultation there was to say, 'This is what we are going to do; this is why we are going to do it and these are the benefits that are going to be seen from this move' so that it is not just a wholesale shift of the bank balance from the South Australian boards to the national board with no real benefit to the members of those various professions that have been served so well by those boards in the past.

As to the transfer of the assets, let's find out about the stamp duty, but I will not keep repeating myself on that one. The transfer of staff of the boards is another issue and that is brought up in division 3, clause 37 which provides:

A qualifying member of the staff of a prescribed body who, on the commencement of this subclause, has not gained employment with the National Agency...will be incorporated into the Department as a redeployee by force of this clause.

That is a good thing that people are not going to be thrown out of jobs because of this legislation. None of us want that. Some issues have been raised by the Australian Nursing and Midwifery Association here in South Australia (the old ANF) as to what will happen with members of these boards when they are superfluous to requirements of the national agency or national boards. Will they be able to move backwards and forwards between the departments and the boards if opportunities arise? There are some issues there. They want to be able to opt in, opt out. Will they get continuity of employment benefits? Will the members of the boards be protected and will their lives not be disrupted by being sidelined in the lounge of the Public Service?

It is an important issue. That really is the nub of this legislation that is before the house. What we do not have before this house, though, is the national law. I have said this before a number of times and I will say it again because it is so important to me, as the shadow minister for health, to the opposition in this place, to many others both in this place and the other place, and it is certainly very important to health practitioners: the health practitioner regulation national law that was put through the unicameral parliament of Queensland back in October last year (this piece of legislation that we are adopting in eight lines) consists of 308 pages of legislation with 305 clauses in the bill with 138 clauses, an additional 138 clauses, and seven schedules.

It is important that we examine that and do not just gloss over it. I am quite prepared to read it into Hansard if that is the will of the house, but in the meantime I will continue to go through and have a look at the way this bill is going to change life as we know it for health practitioners in Australia. The intent of the legislation is good, the content of the legislation is good, it is just the way it is being presented in this place that we have this fundamental disagreement with at the moment, and we look forward to seeing the government's response on that and not just a blanket no.


[Sitting suspended from 18:00 to 19:30]


Dr McFETRIDGE: Before the dinner break, I had made some contribution on the Health Practitioners Regulation National Law (South Australia) Bill that we are seeing introduced in this place and I will continue on to examine this legislation. We will do it in detail. I think that is what this sort of legislation requires. What I will do just before I go into the actual 300 pages of the national law—and I am not going to read it, you can take a deep breath—

Mr Piccolo interjecting:

Dr McFETRIDGE: No, that will not take very long, actually, the way I read, Tony. What I do want to do is quickly go back to the Western Australian act and read their amendment to exempt dutiable properties and transactions from the stamp duty on the transfer of property from the local boards to the national board. What they have done over in the West is they have introduced what is known as Clause 8. It is under Part 3, 'Provisions specific to this jurisdiction'. We have Clause 8, 'Transfer of certain property exempt from duty'.

Clause 8(1) provides that the meanings given to dutiable property transactions have the same meanings as defined in Section 3 of the Duties Act 2008. Clause 8(2) provides that:

a dutiable transaction relating to the transfer of dutiable property from a local health practitioner registration board—

say, for example, the South Australian Medical Board or the South Australian Dental Board or the Nursing and Midwifery Board, one of those if it were in South Australia—

to the national agency under the Health Practitioner Regulation National Law (Western Australia) Act is exempt from duty under the Duties Act 2008.

This means it would not add another cost to the implementation of the national scheme. I would like to have an assurance from the minister that that is the case here in South Australia, that there is not going to be a tax grab in the transfer of either dutiable property or dutiable transactions. That is a good amendment in Western Australia and I look forward to the South Australian government doing a similar thing.

During the dinner break, I received an email from the Australian Nursing and Midwifery Federation just reiterating points that I had had in previous discussions with them. The ANMF is urging us to support legislation and they outline their two remaining concerns. I will just read from the email. It says:

Consistent with our discussions we note that there are only two remaining concerns, neither of which should delay or inhibit the passage of the bill.

None of us wants to delay or inhibit the passage of this bill when it is presented in a form that is acceptable to this side of the house. Their first concern is the failure to endorse mental health nurses. It says here:

It is critical to point out that this is not a failure of the bill/proposed law itself, but is a matter for the National Nursing and Midwifery Board of Australia to determine. As a result, the ANMF will continue to lobby the national board on the issue and has sought a policy commitment from the state government that supports the employment of mental health nurses in the provision and supervision of nursing care to those with mental health illnesses. We would be pleased if you would consider adopting a similar policy position.

We certainly would support that because I think that is a very good position to propose and one that we can quite happily support on this side.

Regarding the second concern, I have made some comment about this and perhaps I was not as clear as I would like to have been, so I will read the email from the ANMF to make sure that we do understand exactly what their concerns are. This relates to employment arrangements. It states:

We refer to subclauses 37(2)(b) and 38(2)(b), which provide that a staff surplus can be returned to the public sector and have continuity recognised. We have asked the state government to extend these provisions in order that staff can also elect at their own option to transfer back to the public service within two years of transition and have continuity of service recognised. We consider this is necessary given that one third of the staff of the NMBSA have elected not to transfer to the new scheme.

This is adverse to the intents of the staff who have had a difficult choice to make in an environment of uncertainty; the scheme which requires skilled staff to give effect to transition; and to the public service which will need to redeploy workers who might have otherwise comfortably integrated into the new scheme.

This can be achieved through administrative decision and action by the state and does not require amendment to bill B, so I am glad that I was able to clarify that concern there, and I thank the ANMF for its dialogue on this. We do have a good relationship. I once described the ANMF as an association. It calls itself a federation, and one of the senior members described it as a union. I said calling the ANMF a union is like saying that USS Midway is a boat. I think it is a much more powerful organisation than that, and I do not just mean as a union. I think that the professional development and training programs it undertakes are very commendable, and I look forward to a fruitful relationship with it in the future.

The Hon. S.W. Key interjecting:

Dr McFETRIDGE: No; they will still remain, the member for Ashford; I understand it has not actually changed its identity. It was the Royal—I digress. I have a few more pages to go through here that we need to discuss.

The ANMF does urge that we support this legislation and, while it wants it through in its current form, I think I have made it quite clear already that we do support the intent of this legislation. I do not agree with the claim that is being made that it is critical that this legislation is passed in its current form because, as members may recall, early in my contribution I read out that letter from the chair of the Psychology Board of Australia stating that life will continue, the sky will not fall in and the medical practitioners and health practitioners will continue to practise quite lawfully.

There is another part to the email that I need to refer to quickly. At the bottom of the email, the ANMF states:

In addition to the above, the ANMF...has sought and received commitments from the State Government to ensure assets of the NMBSA [Nursing Midwifery Board of South Australia] are used for the good purpose and betterment for the professions in this State—

which we would all agree with. The email continues:

It is understood that whilst the law provides for the transfer of assets to the national body, any residual assets will be dealt with accordingly.

That is the first time I have heard about residual assets. I thought I had been through this legislation reasonably well with my limited resources, not being a legal eagle, but I would like the minister at some stage to tell us what is the deal here. What is going on? What residual assets? Will all the assets of all the boards be transferred to the national boards?

Another point that I made earlier—and I was unable to find the document at that time—was about the number of positions being created to get this national scheme up, because there has been some concern about the size of the bureaucracy that is going to be created by this scheme. As we will see when we go through the national law, a number of national bodies and state versions or state representatives of those national bodies will be created, admittedly to replace state-based organisations, but there are some significant increases in numbers from my understanding of the situation.

An announcement made just recently by the Australian Health Practitioner Regulation Agency (AHPRA) about state and territory senior appointments, and it goes through the various states. There are eight new appointments in Victoria, and I think these are the state appointments, and this is separate from the national body that will oversee these, because there will be state representatives, state directors and state managers. In Victoria (I will not name the people individually) there are a number of positions, and these are senior appointments. What level of wages and conditions they are on as a senior administrator, I am not sure.

We have the Director of Registration, the Director of Notifications, the Director of Corporate Services, the Manager of the Health Practitioner Registration, the Manager of Nursing and Midwifery Registration, the Legal Adviser, the Manager of Finance and Administration and the Manager of Conduct. There are eight positions there. So far, in New South Wales, four positions have been appointed. In Queensland, nine positions have been appointed. There is a Manager of Assessment and Investigations, a Manager for Performance and Health, as well as the others mentioned before.

In the ACT, there are three appointments so far, two in the Northern Territory and seven appointed so far in South Australia, which is interesting. We have the Director of Registration, the Director of Notifications, the Manager Health Practitioners Registration, the Manager of Medical Registration, the Manager of Nursing and Midwifery Registration, the Manager of Conduct and the Manager of Performance and Health. In Tasmania, there are three, seven in Western Australia, and I should note that all the above appointments will commence when the National Registration and Accreditation Scheme comes into effect, pending the passing of legislation in the relevant states and territories.

So, there is a significant number of senior appointments being made. Looking at the website today, a lot more are being advertised. I do not know what the conditions of employment are, but it will be interesting to watch what happens. We should all remember that, in the past, all our boards have managed to be self-funding. They have done an excellent job of being self-funding. They have also been able to accrue significant funds that they have been able to put to other use, such as professional development, legal advice and the like.

I will now go to the national law, because there are a number of areas here that can be discussed in the second reading, and we need to flesh them out in committee. We do need to discuss this bill in committee, and it is my understanding that we can. We do not have to limit ourselves to the bill that has been put before this house, because this is an integral part of that bill. If we have to have that discussion, that is something we will have once the committee stage starts.

The Queensland Health Practitioner Regulation National Law Bill was attached as a schedule to their bill, which is a nice way of getting it up. As I have said, it is 308 pages in length. It has in here provisions specific to this jurisdiction, so we are already talking about Queensland even in this bill.

Then we come to Part 4, which is preliminary to all the legislation that has been put in by the various jurisdictions. That is the amendment of Health Practitioner Regulation (Administrative Arrangements) National Law Act. This is bill A, as I understand it. This was the set up for bill B. It talks about the way the ministerial council will be set up. It talks about the recruitment and supply of health practitioners and the aims of that. It talks about how the ministerial council may give a national board a direction under subsection 3(d), which is about accreditation. There has been a lot of discussion over many months about the ministerial council's ability to influence accreditation and registration, and there are still a lot of concerns.

I see that the AMA in Western Australia still feels very strongly that this legislation will not stop changes to the accreditation and registration standards. I think the head of the AMA in Western Australia—and I am just paraphrasing here—said that this legislation will put the public at risk. The AMA in Western Australia put in a 20-page submission on this to the Western Australian parliament. I have had a quick look at that. Its concerns have been expressed in the past by other branches of the AMA and other health practitioner groups, where they do not want the ministerial council to interfere in the standards of accreditation and registration.

There may still be some issues in this bill. The areas of need—limited registration, the public interest—are subjective areas which can be looked at from a political or economic point of view; so, there may be some areas that need to be watched very carefully. Once again, another reason that this should be in here as corresponding legislation is so that we can make sure that if there is any need to tighten it up quickly we can do so.

As we have seen and as I have shown, there is ample evidence right across this nation that both states and territories have been amending this to suit their own outcomes, whether it is periods of review—one year, three years or five years—or whether it is the way complaints are being handled, and that not each state or territory is completely happy with this legislation. The intent and the objects are there.

Page 26 of the national law discusses the objects and guidelines, and this is what it is all about: the object of this is to establish a national registration and accreditation scheme for the regulation of health practitioners and the registration of students undertaking programs. A lot of that is new. A lot of students have not been forced to register in the past.

I declare an interest here. My son Lachlan is a first-year medical student at Flinders University, doing a postgraduate course. He has a PhD in robotics, and he left a very good job to go back to study medicine. I congratulate him on that, because you must always do what you want to do in life and put your mind to it if you want. I welcome the fact that he and his wife and our two grandchildren are living at home with us at the moment. It is all a bit squeezy, but we are enjoying the pleasure of their company until they move into their own home fairly shortly.

Lachlan is studying medicine. The other night I asked him about registering, and he understood that, because he is doing a postgraduate course, he is being exposed to clinical experiences right from the word go. It is a very good course at Flinders. He will need to be registered, and that is the case. I am not quite sure, quite honestly, of the current situation, but I would imagine it would be the case.

I am having discussions with the new veterinary school at Roseworthy about any changes necessary to legislation in South Australia. It has enabled veterinary students to undertake veterinary surgery or work in veterinary practices where they are dealing with the public. It is a good move to bring students in on that.

The objects continue: to facilitate workforce mobility across Australia. As I said, in my case that was a real issue when I was working for the airline and acting as a veterinary surgeon. We want that in Australia. We want to be able to make sure that the workforce can move around and is not subjected to more and more red tape and increased costs.

My own experience with the airline was also reinforced during the equine influenza outbreak, when I had the opportunity to work in New South Wales. As it was, my obligations to this parliament precluded me from doing so at that particular time, but I was already checking out the need to register myself over there. Nobody can say that I am not right behind the intent of this legislation. I understand passionately that we need to do this, but I am just as passionate about the rights of this parliament as a sovereign parliament of this nation, and its right to not be dictated to by the executive government.

There are a number of continuing objects in the legislation: to facilitate the provision of high quality education and training of health practitioners and to facilitate the rigorous and responsive assessment of overseas-trained health practitioners. That has always been an issue, not just the fact that they need to pass English language tests. I have seen recently that the English language assessors, who have been used exclusively in the past, are now being opened up to competition, so there will be a number of organisations that can assess overseas-trained medical practitioners on their English language skills.

There is nothing more important than a health practitioner being able to communicate with their patients. You need to be a good clinician, you need to be a good diagnostician, you need to have excellent clinical skills, excellent surgical skills, but you also need to be able to speak to and understand your patients. Also, in Australia we should be able to understand the idiosyncrasies and colloquialisms that we encounter.

I do not envy people who come from overseas to Australia and have to learn English because it is an extremely difficult language. My wife is Dutch and came here as an eight year old girl. She reminds me quite frequently, when we are talking about the training of overseas health practitioners, how difficult it is to learn the English language. It is good that this bill is going to facilitate the rigorous and responsive assessment of overseas trained health practitioners.

Developing a flexible, responsive and sustainable Australian health workforce sounds good. As my veterinary colleague in Victoria Dr Denis Napthine said, 'Yes, this is good. We'll be flexible. We can move around the states and territories, but where are the incentives to go bush? Where are the incentives for the nurses and doctors to go bush?' It is so important that we have people working out in the regional and rural areas.

On Saturday night, I was given an example of a case where one of the AMA staff was visiting her mother on a station property north of Wentworth. Her husband has kidney stones, and he had a painful attack. Anyone who knows someone with kidney stones, or has had them themselves, knows how excruciatingly painful they are. He was able to go to the nearby RFDS clinic, where the nurse was able to get on the phone to the RFDS doctor, who was able to give her instructions on giving medication.

That is another issue we will talk about later in this bill—the right to prescribe scheduled medications, and it is a good move. There was a successful outcome, and the patient was treated well by the nurse working out in the bush. We certainly admire and owe a great deal of debt to our health practitioners, whether it be the RFDS, the RDNS (Royal District Nursing Society) or any others who have gone bush in the past and made this country what it is. I read the story of John Flynn a few weeks ago, and it was quite amazing what the pioneers of this country put up with in getting the RFDS going and in giving us the country we have.

We do want health practitioners to be encouraged to go bush and not just across the border. It must be difficult for people in South Australia working down in the South-East or around the Broken Hill area with doctors swapping backwards and forwards across state borders all the time, as it would be for others who require registration of their various professions, whether it be the medical profession or other professions.

The definitions under the national law fill page after page. As I have said, particularly in New South Wales, they excluded many of the definitions in relation to professional misconduct and professional standards, and one can refer to what I said about that in my second reading speech. The definitions are another example of this bill not becoming a piece of mirror legislation; it is a piece of national legislation, and it is certainly a very important piece of legislation. The definition of criminal history is one with which I have some concerns. It provides:

criminal history of a person means the following—

(a) every conviction of the person for an offence, in a participating jurisdiction or elsewhere, and whether before or after the commencement of this Law…

That is okay but then, as in New South Wales, Western Australian and also the ACT, there has to be consideration as to whether that conviction is pertinent to the person's ability to conduct themselves as a medical practitioner. It also provides:

…every plea of guilty or finding of guilt by a court…whether or not a conviction is recorded for the offence;

That is important but, once again, it has to be taken in context. I have a concern with paragraph (c), which provides:

…every charge made against a person for an offence in a participating jurisdiction or elsewhere, and whether before or after the commencement of this Law—

Whether the charge was proceeded with or not, I am not so sure.

I assume that is all part of reporting police reports nowadays, but it concerns me whether that is in this legislation or in every other legislation because a charge may have been laid against you but it was then dropped. That does not always mean that you were not guilty; it might have been that there was not enough evidence. I can accept there might be circumstances, but I think it is a real concern.

I mentioned earlier that New South Wales has exempted some definitions, and the definition of health assessment is not in the New South Wales collection of definitions. The definition of health professions is good in that there is a comprehensive list of 14 professions. For example, dental professions includes dental therapists—and, as I said earlier, my wife is a dental therapist so I declare an interest there—dental hygienists, dental prosthetists and oral therapists. Dental technicians can still register in Queensland, but not here in South Australia.

The health services definition includes services provided by registered health practitioners, hospital services and mental health services. It also provides for services provided by dietitians, masseurs, naturopaths, social workers, speech pathologists, audiologists and audiometrists.

We recently saw a backdown by the federal government. It was going to exclude occupational therapists and social workers from the ability to claim medical benefits. I am not sure of the exact relationship, but I assume they were able to get provider numbers. They were doing an excellent job in providing frontline services to assist with the burgeoning mental health problems in this state—and don't we know about that!

The need for more mental health workers was talked about by the minister in question time, and I just hope that we see a significant improvement in the provision of mental health practitioners and allied health practitioners in the mental health area, including social workers and occupational therapists.

The definition of ministerial council means 'the Australian Health Workforce Ministerial Council comprising ministers of the governments of the participating jurisdictions and the commonwealth with portfolio responsibilities for health'. We have this parliament being subject to the will of not only the ministerial council of other state and territory ministers but also the commonwealth minister. I remind members that the intergovernmental agreement does not require a unanimous decision by the ministerial council but, rather, a decision by consensus or the majority, so the commonwealth minister could have the final say, if the numbers fell his or her way.

The definition of performance assessment is important. It is an assessment of the knowledge, skills or judgment possessed or care exercised by a registered health practitioner. That is not included in New South Wales; they think they have a better definition. I have not looked at the New South Wales definition, but it is certainly an area to watch because, if there are various definitions across jurisdictions and various meanings and interpretations, surely we will get various interpretations about whether a person has committed an offence under the national legislation that is then being interpreted by their state tribunal or state court system because that is what happens in that state. It may completely different in another state.

Professional misconduct is not in the New South Wales legislation; they have their own definition. For those who do not know, professional misconduct is considered to be unprofessional conduct by the practitioner that amounts to conduct that is substantially below the standard reasonably expected of a registered health practitioner or an equivalent level of training or expertise. Also, it talks about the conduct of the practitioner, whether or not occurring in connection with the practice of the health practitioner's profession. That is inconsistent with the practitioner being a fit and proper person to hold registration in that profession. Being a fit and proper person is a subjective assessment of whether someone is guilty or not guilty of professional misconduct, and having different definitions further clouds the issue across the states.

We will talk about scheduled medicines when we come to the clause that provides the ability to prescribe scheduled medicines. There is a regulation concerning S3 medicines—which are pharmacy-only medicines—across the states. It is not a big deal in this particular case but, certainly, in relation to S4 medicines, which are prescription-based medicines, it will be good to see the ability to prescribe those medicines being given to professions that are currently unable to prescribe those medications.

I have had approaches from both the podiatrists association and some of the nursing federation representatives around the role of nurse practitioners. There is a need to look at that provision. As I said, the lady spoke to me on Saturday night about her husband who, when they went bush, would have access to a nurse able to give a scheduled medicine under the direction of a medical practitioner, and that is a good thing.

There are definitions about specialist health practitioners. There are concerns about the registration or inclusion of various specialities in this legislation. I know of two straight away. One is specialist physiotherapists, and I had a letter from a doctor from Queensland urging us to support the registration of cosmetic surgeons as a speciality in Australia. I understand the Victorian medical board is looking at it. There is an American association, but there is an American association for many areas of expertise. They are just examples that need to be recognised as specialities.

It is not only very important under this legislation that we get it right for the general practitioners, the general nurses, general dentists and the general practitioners of all the other health professions, but also it is very important that we get it right for the specialists. To profess to have a speciality, an expertise, in a particular area and then be unable to perform to the level you profess to have is a despicable thing, and it is very important that we safeguard the use of the specialist title.

The definition of 'unprofessional conduct', which has eight subclauses in it, is not in the New South Wales legislation. Unprofessional conduct, I would have thought, would be one of those areas where there could be some preliminary discussion between the members of the ministerial council so that professions transferring between the various states have a crystal clear—absolutely transparent—understanding of what is unprofessional conduct. If you have subjective assessments or if there are particular codes of practice that are being interpreted in different ways, that could really stuff things up for people who, in their mind, act in a responsible and professional way that may be acceptable in other jurisdictions but not in New South Wales, and they could be caught out.

In relation to the interpretation of this legislation, it points out in the national law in clause 7 that it is a single entity—the aim is a single national entity—but, as I say, we have several variations. We have had trans-Tasman recognition of the legislation in the past, and that will continue; but, again, anyone who wants to register in Australia obviously will be subject to this piece of legislation.

Clause 10 says that this law binds this state. That, again, emphasises our whole issue: this law binds this state. It binds this parliament and this state. Sure, we can come in and move amendments and stand here and say that this is not right and this is not fair but, if we are not careful, this is another case where we will be sidelined. The ministerial council is incorporating subclause (2). Clause 11(4) provides:

...the ministerial council may give a national board a direction under subsection (3)(d) only if—

(a) in the council's opinion, the proposed accreditation—

and this particular part is talking about accreditation—

standard or amendment will have a substantive and negative impact on the recruitment or supply of health medical practitioners;

I have some concerns about that, because if you want to bump up the supply of health practitioners then, sure, subparagraph (b) provides:

...the council has first given consideration to the potential impact of the council's direction on the quality and safety of health care.

Heaven forbid if the ministerial council is willing to put people in urgent need in places that will not be able to offer the levels of expertise that we would expect. That may be as simple as not being able to comprehend and speak English as well as we would expect. It may be that people who are of various training backgrounds are given limited or special accreditation to work in areas where there is a need for extra health professionals.

I hope that does not happen, but that is a problem where we need to have more control. We do not want dumbed-down accreditation. There has been a lot of argy-bargy over that. We do not want that and we must not allow that to creep in here. As I said, there has been a lot of discussion over the approval of registration standards. The federal government's Senate inquiry went into that. It made sure that the practitioner groups—the stakeholders—were communicated with, matters were discussed, their opinions were listened to and they were consulted. That is something new for this government; they were consulted.

What we are seeing here is that, while it is a significant improvement, there are still some concerns. There are some safeguards on the accreditation registration standard, but there is wriggle room. That is why we need to make sure that this legislation is tighter than watertight wherever we can possibly make it, and having it as corresponding legislation is one significant step. With respect to the approval of registration standards, clause 12(3) provides:

...the ministerial council may, at any time, ask a national board to review an approved or proposed registration standard for the health profession for which the national board is established.

One would expect each time that to be improving, increasing and being more demanding of the registration standard that was expected of that health profession. I sincerely hope that the ministerial council would never ask the national board to review those standards with a political or economic agenda behind it. We hope that that would not happen, because it would be a despicable thing to do.

The approval of endorsement in relation to scheduled medicines I mentioned briefly before, under clause 14. For nurses in country areas it is a great move, and podiatrists are keen to have some extra prescribing powers. A number of professions are looking forward to being able to put their case that they should be able to prescribe scheduled medicines. I understand that, if that is the case, state legislation has to be amended to permit this to happen. I cannot give a guarantee, minister, because I am always at the will of the joint party room, but I would be more than happy to look at that in a favourable light.

Clause 16(1) talks about how the ministerial council exercises its functions in accordance with procedures determined by the council, and those procedures were agreements made by consensus. When we reach clauses 244 to 247, the ministerial council may make regulations for the purpose of this law, but the regulation disallowed under this subclause does not cease to have effect in the participating jurisdiction or any other jurisdiction unless the regulation is disallowed by a majority of the participating jurisdictions. For 'jurisdictions' read the minister responsible and the ministerial council. Once again, the way the ministerial council works is an issue.

The ministerial council can give a direction to the national board and that has to be published on the board's website. It is something that I would hope most people who are interested in this area will be able to find, but I would also perhaps suggest that the good old hard copy in a newspaper is something that would be a small cost but a worthwhile thing to do. The ministerial board will also have an advisory council. We were talking previously about the numbers of bureaucrats involved in this system. The functions of the advisory council have been established under this legislation to assist the ministerial council. My questions are: will the advice that that advisory council gives to the ministerial council be released in full? Will the consultations be released? We do know it will be made public, but we want all the advice released, even if it is contrary to the will of the ministerial council.

We need to make sure that this legislation is as the intergovernmental agreement states; that is, it is fair, open and transparent. We need to ensure the intent is there and that the outcomes match the intent. We have seen it so many times with politicians, particularly with the current federal government. We have seen expectations which have risen to the moon but which have failed to be delivered. That cannot be allowed to happen in this case.

The members of the advisory council will be advising the ministerial council. There will be seven members on the advisory council. At least three of the members of the advisory council are to be persons who have expertise in health or education and training. I assume, quite rightly I hope, that that expertise in education is health education: it is not woodwork and metal work. That it is in health training, not personal fitness training—which is a good thing; it is part of your health. That is, it is about the structuring of courses, the content of courses and that sort of thing.

The overarching body is under part 4 of this legislation and that is the Australian Health Practitioner Regulation Agency (AHPRA). In many cases, you will hear it referred to as the national agency. They have an excellent website with lots of information. You are able to download frequently asked questions and look at who is doing what at the moment. I could not find the scale of fees, but that may be because I was not looking in the right spot. However, the website will continue to be developed.

The national agency is the overarching agency that will drive this legislation. The functions of the national agency are to provide administrative assistance and support to the national boards and the boards' committees. Do not forget that, under this legislation, all the boards—medical board, nursing midwifery board, dental board, physiotherapists board and chiropractic board—in existence at the moment in South Australia will all become part of the national boards that are set up under this legislation. The national agency will provide administrative assistance and support to the national boards and the boards' committees. They will also establish procedures for the development of accreditation standards, registration standards, and codes and guidelines approved by the national boards for the purpose of ensuring the national registration and accreditation scheme operates in accordance with good regulatory practice. Clause 25(i) provides that the national agency will:

...establish an efficient procedure for receiving and dealing with notifications against persons...

They are not actually going to handle the notifications. At the moment those notifications are handled by the various boards. The medical board here is notified of any issues by other medical practitioners, and also patients and nurses, and then an investigation is held. If an investigation is proceeded with, then it goes down that path. The national agency is not going to do that; it will receive some notifications and I assume it will then pass them on to the relevant national board, which will then proceed down the path of either rejecting or investigating the allegations. Clause 26 provides:

(1) The national agency must enter into an agreement...with a national board that makes provision for the following—

(a) the fees that will be payable under this law by health practitioners...refunds of fees, waivers of fees and additional fees for late payment).

The national agency is making agreements with the national boards on fees. That is why I do not understand why the New South Wales practitioners can have a different fee. I cannot see why there is not going to be an influx of people living in New South Wales who want to practise under this legislation, be it in reality or, not by deceit but certainly by legitimate reasons as far as notification of addresses go, but not where you actually do live.

It is of concern to me that, while there is supposed to be a national fee, we are already seeing, in the case of New South Wales, that there is going to be a discrepancy. We have certainly seen a variation in fees across the board. The increase in the Northern Territory from $175 to $650, I think, is a pretty steep rise for anybody. The punters out there would say, 'These bloody doctors, they earn a lot of money, they can afford it anyway,' and it may be the case that it is not going to be a huge impost, but it is a significant addition to running any business and it is a significant overhead that is necessary in running a registered and highly regulated business where you need to have significant accreditation and registration in place.

This is the interesting part, and we see it on a few occasions, that the national agency will be able to direct the national board, but then if the national board and the national agency are unable to agree on a matter, clause 26(2) provides:

If the national agency and a national board are unable to agree on a matter relating to a health profession agreement or a proposed health profession agreement, the ministerial council may give directions to the national agency and national board about how the dispute is to be resolved.

You have a national board and a national agency, which are made up of people well experienced in the health professions, being directed what to do by people who are teachers and lawyers and well-meaning people, but they are politicians. I have some serious concerns about the ministerial council's ability to direct the national agency and the national board about how the dispute is to be resolved. I would be interested to see what the get-out clause is there. The other issue is where a national agency is able to exert its power not just over the national boards. Clause 27—'Cooperation with participating jurisdictions'—provides:

The national agency may exercise any of its functions in cooperation with or with the assistance of a participating jurisdiction or the commonwealth...

So, the commonwealth comes in again. It continues:

...with or with the assistance of any of the following—

(a) a government agency...

(d) a health complaints entity...

So, can the national agency exercise its functions in the participating jurisdictions with or without the assistance of the government agency or health complaints entity? I would have thought this would be a cooperative arrangement you would be entering into here.

If they were not cooperating, you would want to ask yourself, 'Why aren't they cooperating? What's going on here?' There are some issues there. Can they override the tribunal? I do not know about that. I would be very surprised if that were the case, but I am here to be educated as well as to express my points of view. I have certainly learnt a lot in this place and been puzzled by a lot, and I have a lot of questions and sometimes not a lot of answers.

The office of the national agency is being set up in Melbourne. That is the main game there. The regulations, which are to be proposed by the ministerial council, are interesting. As I understand, it will be put through the Queensland legislation—if I am wrong please correct me—then they are going to be printed by the Victorian Government Printer. Why? I do not know. We are a mouse click away from the rest of the world, so why would you have the Victorian Government Printer being responsible for that? I do not know. I would have thought it would be the Queensland Government Printer.

The national agency is to establish a national office, as I said, in Melbourne. Our South Australian representative has been appointed, and I have had some discussions with her. I congratulate that lady (and I will not name her) on the entirely professional relationship she has had with me in our discussions. She has given me some significant confidence in the fact that South Australia is going to be well represented in this new arrangement.

The chairperson of the national agency management committee (once again, here come some more bureaucrats) is a person to be appointed again by the ministerial council. He or she is not a registered health practitioner. There will be two others who have expertise in health or education and training. As I have said before, I hope that is medical education, medical training, not just in education and training, because I think it needs to relate back in a comprehensive way; it cannot just be an esoteric connection.

There are also two others who have business or administrative expertise, because we all know that running a business is very important and maintaining a bureaucracy that does not go broke is even better. This is another concern—and again the ministerial council raises its head:

The functions of the Agency Management Committee are as follows—

(a) subject to any directions of the Ministerial Council, to determine policies of the National Agency.

What does 'subject to the directions of the ministerial council to decide policies of the national agency' mean? Does it mean that the ministerial council can implement its policies onto the national agency? I hope not.

As I have said, the national agency is there to oversee the national boards—our medical board, the dental board and all those others going to the national boards. There will be 14 national boards established, some of which will not come into place straightaway—the Aboriginal and Torres Strait Islander Health Practice Board of Australia, the Chinese Medicine Board of Australia, the Chiropractic Board of Australia and another one, which I cannot think of at this moment—and a number of others will come into practice on 1 July this year whether or not South Australia is ready to go. I hope we are, because I think it is something we should try to do, but it has to be done in a way that will make sure that this parliament is comfortable with it. The commonwealth does have a bit of a dip into the national board, as follows:

The National Agency may exercise any of its functions in cooperation with or with the assistance of a participating jurisdiction or the Commonwealth...

I still have some concerns about the commonwealth having influence on what were our state boards. We would not accept that, but now they are coming in on this national board, which will have state versions or state agencies working on their behalf.

The national boards have been increased from nine to twelve. There were originally nine which left out some jurisdictions in some areas of representation. The national boards will have members appointed as practitioner members or community members. Interestingly, they will have at least one member from each large participating jurisdiction and one member from a small participating jurisdiction and at least two community members. The large participating jurisdictions are New South Wales, Queensland, South Australia, Victoria and Western Australia. The small participating jurisdictions are the Australian Capital Territory, the Northern Territory and Tasmania.

The functions of the national boards are obviously to register suitably qualified and competent persons, to develop registration standards for approval by the ministerial council. I do not see why the ministerial council has to improve registration standards other than just to say it has been through the right procedures. We do not understand it because we are only politicians. There may be a doctor or two here and there, that would be a good start, or a health practitioner, not necessarily a doctor. What we need to do is make sure that the ministerial council is not going to dictate to anybody on registration standards.

The national boards will oversee the assessment and knowledge of clinical skills of overseas trained applicants. This is something which we cannot overemphasise. It appears several times in this legislation and we cannot overemphasise it.

The national boards can establish panels to conduct hearings and refer matters about health practitioners who are registered under this law or a corresponding law to responsible tribunals. They can make recommendations to the ministerial council about the operation of specialist recognition. As I said, the state and territory boards are going to be established. A national board may establish a committee, a state or a territory board for a participating jurisdiction to enable the board to exercise its function in a way that provides an effective and timely local response to health practitioners and other persons in the jurisdiction.

So we have the SA board, the national board, the national authority, the national agency, and all of the advisory committees. We have quite a lot of people going up and down the line and it has been put to me already by those working in the health area that it will take a long time for things to react, so we need to be assured that this system is able to be streamlined as it should be, not burdened down by bureaucracy. This is an area where the state needs to have some say and we need to be able to keep people well and truly on the ball.

The national boards must develop registration standards. Under the national boards registration standards—this has been an area of contention with midwives particularly—there are requirements for professional indemnity insurance arrangements. Twenty-six years ago, a quarter of a century ago, when I first registered as a veterinary practitioner in South Australia, you had to have professional indemnity insurance. Doctors did not have to have it, but as a vet you had to have professional indemnity insurance. You had to show evidence of it, it had to be of a certain value and there were recommendations for you to have other types of insurance as well. It is good to see that requirements for professional indemnity insurance are being put in place for all professions.

There is a requirement for continuing professional development. This is compulsory, but it is not an offence if you do not undertake it, as I read this legislation. Continuing professional development is something that all doctors do and I know that some of the medical, dental and other boards that are losing their assets wanted to put those assets to use to assist in the professional development of the various professions they have been serving over many years.

It is good to see that continuing professional development is in here and that the national board must develop registration standards with requirements about English language skills, because we all hear anecdotal evidence about doctors and nurses who are difficult to understand, through no fault of their own. They are intelligent and well trained, but difficult to understand because of their strong accents; some people say that it is difficult to understand me! However, the need to enforce registration and accreditation standards is very important.

The consultation about registration standards and codes is contained in clause 40, which provides:

(1) If a national board develops a registration standard or a code or guideline, it must ensure there is a wide-ranging consultation about its content.

(2) A contravention of subsection (1) does not invalidate a registration standard, code or guideline.

Now, there is an issue there. If a national board develops a registration standard, code or guideline it must ensure that there is wide-ranging consultation about its content; however, if there is a contravention of that, if you do not consult, it does not matter. There is an issue there, and this is why this parliament needs to know what is in this legislation. We need to know what is going on and we need to be able to make sure that this legislation will do the job it is intended to do. We support the intent of it but, again, this is an issue for us to be aware of, and the only way we can be aware of it is if the legislation is not reduced down to eight lines in the bill before this house.

Part 6 of this legislation talks about accreditation and accreditation function, it talks about the assessing authorities in other countries. That is very important; not only that we check the bona fides of the individuals trying to register but also that they did not get their medical, nursing or dental degree out of a Cornflakes box. Years ago when I was at vet school I heard a story about one of the guys who failed a number of times. He paid to go to a vet school in Italy, and at that school they never touched an animal throughout the whole five years of the degree. I would not think he would be a competent person to be practising as a veterinary surgeon in Australia. I hope there are no similar examples with health practitioners for humans.

We need to make sure that these overseas authorities—the universities, the training organisations—have a curriculum that is acceptable to us, with a range of subjects and standards that are acceptable to us. That is a good thing to see in this legislation, and hopefully it will safeguard us from the Dr Patels, the dodgy doctors, who are coming here and causing untold grief.

I talked earlier about registering an accreditation, and I was concerned that the ministerial council could influence the national boards and agencies in terms of the registration and accreditation standards if there were an area of need. Clause 67 provides:

An individual may apply for limited registration to enable the individual to practise a health profession in an area of need decided by the responsible Minister under subsection (5).

I hope that the minister, the ministerial council, who declares these areas of need, does not then apply pressure for limited registration to be given to health practitioners who, under normal circumstances, would not be looked at in any way, shape or form. This cannot be an avenue for the dumbing down of standards. I am not accusing anyone of that or saying that it will happen, but we need to be aware that this is an area to watch, to keep an observant eye upon, to see how it works. We do not need a political agenda being used to influence the provision of health services in Australia. That is also referred to in clause 67(5).

The limited registration in the cause of public interest is a similar case. An individual may apply for limited registration to enable the individual to practise a health profession for a limited time or a limited scope in the public interest. 'In the public interest' is a subjective assessment. We all need to ensure that there are standards and codes of conduct that guide this and that it is not just a political agenda. I do not care whether it is Liberal, Labor or a coalition, we need to make sure the public interest is well and truly protected.

The usual procedures take place with applying for registration, and that is making sure you fill in the forms, which I do every year, to re-register as a vet. We need to fill in the boxes for where to pay. We have filled out the forms and applied for registration. We have heard about the fees, and we have proof of identity. Once again, we need in this legislation to make sure there is no fraud, no dodgy or bogus doctors or dodgy documents. Having had a good look at the legislation, I am comforted by other clauses in it, but I need to emphasise that it is not the be all and end all and will need to be improved.

There is a lot more in this bill, and I will quickly skip through to the title and practice protections. People refer to me—it is on my name tag there—as Dr Duncan McFetridge. It is a courtesy title. My son has a PhD in robotics and artificial intelligence: I call him a real doctor. He is studying medicine now, so we say he will be 'doctor doctor'. We see nurses with PhDs who are doctors now, so the use of the title 'doctor' is very widespread. I honestly have no professional or egotistical hang-up about the use of that title, but the AMA has concerns about protecting the use of various titles, such as physician, medical practitioner and surgeon. You get tree surgeons and variations on the theme. So, I have concerns about that.

There are significant fines in place—for an individual, $30,000 or a body corporate, $60,000—if you abuse the regulated use of a title. The professional titles that have been approved are listed in the bill, and the ANMF has concerns about accreditation of mental health nurses and I support it in its push. Physios and cosmetic surgeons also have some concerns there.

I will finish on a big area—and members will be pleased to hear that I am going to finish at this hour. There are a couple of areas I need to discuss or go into. The one causing real concern is the area of mandatory notification. In the Australian Doctor magazine the article I quoted blamed the increase in handling mandatory notifications for the increase in fees. In division 2, mandatory notifications, clause 140 provides that 'notifiable conduct' means that a practitioner has practised the practitioner's profession while intoxicated by alcohol or drugs, engaged in sexual misconduct, placed the public at risk, has an impairment or has departed from accepted professional standards. I assume that that last one there means that you have put in dodgy documents, so I would have thought that that would be notifiable, but it is not.

Under division 3, section 144, the grounds for voluntary notification (and I do not understand why this is not a mandatory notification) are as follows:

(a) that the practitioner's professional conduct is, or may be, of a lesser standard than that which might reasonably be expected of the practitioner by the public or the practitioner's professional peers;

If you had a bloke out there who is a butcher, you should be duty-bound to dob the bloke in straight away. I say 'bloke', but it could be him or her. The other one that is voluntary notification but should be mandatory is:

(g) that the practitioner's registration was, or may have been, improperly obtained because the practitioner or someone else gave the National Board information or a document that was false or misleading in a material particular.

You do not have to dob them in if you know that; you can let them continue practising out there. That should be mandatory notification, but it is not.

Mandatory notification includes intoxicated, sexual misconduct, substantial risk of harm, and that is fine, but who is subject to the mandatory notifications? Under this legislation, if there are two doctors who are married or living together in a relationship, the spouse could be compelled to dob in their partner. I am not a lawyer but I understand that that does not happen anywhere else.

Also, if a doctor or a health professional is seeking treatment from a psychiatrist or another doctor, and that doctor is aware that there is an impairment or that there have been some issues there, they are compelled under the mandatory notification to notify that doctor. There are some significant issues there.

Whether we have a one-year review as in the ACT, or a three-year review as in Queensland, Victoria or the Northern Territory or a five-year review as in Western Australia and New South Wales, this needs to be looked at and, in this particular case, it needs to be looked at now. Certainly, waiting three years or five years is not something that I think is worth while. I will finish with—

Mr Pengilly: No!

Dr McFETRIDGE: Okay, I will continue with regulations, and this is the thing that really sparked a lot of my interest regarding this parliament being sidelined. That is why we have come around to this position where we are demanding—not only demanding, but expecting—that the executive respect this parliament. We are expecting that this executive will say, 'Yes, this parliament should be shown its due.' It should be able to have this legislation not as adopting legislation, not 308 pages jammed into eight lines of one piece of legislation. This legislation should be presented as corresponding legislation because when it comes to the regulations, as I mentioned briefly before, the act provides:

(1) A regulation made under this Law may be disallowed in a participating jurisdiction by a House of the Parliament of that jurisdiction—

and that sounds great—

(a) in the same way that a regulation made under an Act of that jurisdiction may be disallowed;

but—

(2) A regulation disallowed under subsection (1) does not cease to have effect in the participating jurisdiction, or any other participating jurisdiction, unless the regulation is disallowed in a majority of the participating jurisdictions.

In that majority, our health minister could be sidelined completely, so the government is sidelined and the parliament is sidelined. It is not a good position to be in. As I read out before, there are 30 ministerial councils at the moment (and probably more) that are participating out there. There are numerous pieces of legislation that have similar clauses in them which we have been able to accept.

In some of those, we have been the lead legislator, which makes it a lot more acceptable but here, not only have we not been the lead legislator, we have not been able to get this as corresponding legislation. It has been adopted, so there will be some very close scrutiny of the way national regulations are drawn up, made and disallowed because it will be a significant issue. As I have said at the start of my contribution, this whole legislation needs to be scrutinised by this parliament. It needs to be looked at, and it should be open and transparent.

I think I know the answer already and we do not have the numbers in this place, but I ask the minister to reconsider his position on this, because he does have the time. I asked him back in September when we were going to see this legislation. I support the intent of this legislation, but I want it to be presented in a way that will be good for this parliament, the nation and, in particular, the people of South Australia.

As it has been presented to us, this is not good legislation, with the national law being presented in one clause. It is so important, and I am told that we are setting a precedent for this parliament if we go down this path. I am not so sure about that. If we look back at all the legislation that has been through this place, I am sure that corresponding legislation has been through this place before. It is not difficult.

An intergovernmental ministerial council has allowed Western Australia to do it. Why is that state so peculiar, so particular or so special? Are South Australians not as special as Western Australians? I think we are more important. We are South Australians, and we are a very proud state. We need to be proud of our parliament and not allow a ministerial council—an unelected group—to dictate to this place. Give us the legislation so that this parliament can be the final arbiter of its destination.

Ms CHAPMAN (Bragg) (20:47): I rise to indicate that I will be opposing the Health Practitioners Regulation National Law (South Australia) Bill, a bill introduced by the Minister for Health on 29 April 2010. As the minister informed the parliament, this bill follows other state jurisdictions around the country considering similar legislation, largely with approval.

There are a number of reasons for my opposition to this bill, but essentially it is important to place on the record that this bill attempts to bring in uniformity for registration purposes for a whole lot of health professionals, particularly 10 different professions in the health area, to come into effect on 1 July 2010, those professions being medicine, nursing, pharmacy, physiotherapy, dentistry, psychology, optometry, osteopathy, chiropractic and podiatry; and a further four professions to come into effect by 1 July 2012, being medical radiation practitioners, occupational therapists, Chinese medicine practitioners, and Aboriginal and Torres Strait Islander clinical health practitioners.

The professions to be covered are currently dealt with in each individual jurisdiction within each state or territory by their own regime of legislation, boards, tribunals and/or courts. It essentially works on the principle that, in the area of health service, the way in which to monitor the standard of a health professional, in order to ensure the protection and safety of members of the public, who are the consumers of these services, is to have a registration system. The system is not unique to the health professions, but it is one that works on the principle that someone has to be registered to be able to practise the particular profession. They have to demonstrate a number of things to qualify for that registration, not least of which is to pay the fee; essentially be a fit and proper person, usually not have some history of felonies and the like; and, most importantly, I suspect, have a certain standard of qualification, education and training and professional experience before they are let loose on the public through this registration procedure.

When the registration is withdrawn or suspended or someone is disqualified from holding or obtaining it, it is with the view of preventing them from imposing on the public an inadequate standard of service at the very least. That is the way in which it works—that is the principle—and we manage it through state administrations.

In the eight years I have been in the parliament, the position in South Australia is that we have, under various bills introduced, progressively upgraded or really brought into contemporary form the standards of the registration and qualification procedure. Here is my great friend. You must be contributing to this debate, are you, Treasurer? I am sure you will make a valuable contribution—not.

The state administration is one that will allow for the new contemporary regime of legislation, and there are a number of those bills which I stood in this house and supported the minister on: those on individual professions, on upgrading the standards they had to achieve and on the boards of management, with contemporary powers and really better disqualification procedures, allowing for suspensions rather than full disqualifications—all those things to make things contemporary.

I thought that we had brought South Australia to a standard that was one of the best in Australia. In addition, the government established the Health and Community Services Commissioner (and we supported it, although we felt that it should be part of the Ombudsman's office) not only to deal with public complaints of health maladministration or mistake—whether inadvertent or due to neglect, but harmful if you are the victim—but also to cover the public. Why then would we support a system that goes into a national scheme if it were in any way to diminish the high standard of structure that we currently have in this state? That is the first reason.

The second reason is: is the structure that is being presented by the minister one that will actually employ and operate a standard nationally from which the state will benefit and within which we have the capacity to be flexible and to amend in the event that it is in the interest of South Australians? The answer to that question, in my view, is no, and that is the second reason I oppose it. The third reason is fundamentally that, as usual, the government is going to introduce a further tribunal process which in my view will be inadequate and which will isolate both practitioners and the public from an accessible and just resolution of these issues, including the potential disqualification of a practitioner.

On the first matter, the current regime speaks for itself. I think it is of a high standard and we should maintain it. On the second issue—that is, what we are about to receive—essentially, the minister announced that, in following the footsteps of the Hon. Tony Abbott as a former federal health minister, this was really just the extension of what the previous federal government had initiated under a national registration scheme. I say to the parliament: that is utter rubbish.

In fact, the proposal by the former federal health minister was for a national registration scheme and for a separate qualification regime for the standards to be imposed for professional development and training and qualification, but it was nothing like what is being presented to us today. I want to dispel that as being absolutely mythical. It must be some kind of invention in the mind of the minister because nothing could be further from the truth.

The national scheme is one which resulted in the ministers of health getting together and deciding, through both Liberal and Labor governments, that they would look to work on a restructured scheme for registration. There was a complete balls-up, if I could say, on the qualification side of it. There were clearly attempts by the new federal Labor government and minister Roxon and, I think, these ministers to have a system where there would be potentially political interference with the quality control of the standards of training of medical practitioners.

That was utterly rejected by the stakeholders, and over the last couple of years it is fair to say that the state ministers have gone back and actually said, 'Okay, we'll back off from that. We want some abbreviated structure of that, but we accept that we are not going to get that through.' It did not stop them trying after they bulldozed the initial part of this procedure through the Queensland parliament, and I will come back to that in just a moment. Having reached an agreement that they wanted a national scheme, that this was going to be cheaper, quicker, more accessible, better—all that other nonsense we usually hear with these things and which sound good on the face of it—they then decided at their ministerial councils that they would create a new structure.

The way that we have historically dealt with these things is to say, 'All right, if something can be dealt with better at a national level, one option is that we transfer our powers to the federal parliament, and they can deal with it and they can sort it out.' The alternative, which has been historically the way we deal with it, is for the states to introduce legislation, which is what we call the applied laws model of having each of the jurisdictions following the lead on a standard precedent, a bill that is introduced and passed in the first jurisdiction. We have been the host state under that model a number of times. It has been very workable, I think it has been fair, and it has been important in ensuring that, if there are changes, they are unanimous, rather than this new consensus nonsense, and that we have some protection.

What the minister says, under this new model, is that it does not matter, because South Australia can just pull out if it feels like it. That is easier said than done. The truth is, when you dismantle all your own structure and you transfer into a federal structure, and something goes wrong and you realise it is not adequate, it is all or nothing. You have to pull out and start it all again yourself. So of course that is a disincentive to do that. It is very difficult, I suggest, to actually get out of the system.

It is a bit like talking about the national commonwealth corporate legislation. Often I hear it said, 'Look, states can pull out if they want to,' but to re-establish that structure at the state level is very expensive and is not in all practical means a way out. So, that is the first objection I have to this new proposal, to this new hybrid way we are going to deal with this.

There are questions raised about the sovereignty of parliament. I do not think that they have been fully answered. I am disappointed that the government, in an instance where they want to introduce novel and, I think, novice structures, has come along to the parliament and said, 'Look, just believe us, we've got crown law advice on this, this is fine, everything will be sweet and it will all be okay.' It is almost indecent of the government to say that. Why not show us the legal advice in that regard? Why not be honest and come clean on that, and say that this is the basis upon which we are relying? That is especially so when we hear not only that New South Wales is working towards a claim against the constitutional validity of this model in legislation but, during the briefings kindly provided by the minister on this matter, it was acknowledged by officers that the ACT has a fund ready to challenge this.

So why are we going to enter into a model that is novel, and I think is already showing fractures of inadequacy for us, and not stick to the proven model that has worked in the past? I simply do not believe that we should accept this legislation and rely on the minister to say everything will be fine. We heard that on the bikie legislation; what happened? We are still in the High Court. We heard it on the historic agreement on the River Murray. We are in the High Court on that, too.

We cannot rely on this government to do the proper investigation, and to make that assessment accurately so that we are not wasting our time in here, and moreover that we are not duped into transferring powers to an unelected body, which is a ministerial council, to deal with this important issue in the future. It is too important. We can have a nationally consistent scheme without this model. This national scheme is, I think, burdensome and clumsy, and will create delay and further expense. It creates a whole new group of people who have to come together, who will change from time to time—namely different ministers—and is quite unworkable. There will be delays because it will always rely on ministers either to get along to their ministerial meetings or, alternatively, to make sure that they bring on promptly and diligently amendments necessary to this legislation.

The other matter I want to briefly address is the proposed tribunal process. The government says that, apart from the board process, there is an avenue of appeal: it is going to introduce a new federal tribunal to deal with the appeals that we would normally take to court. The minister outlined in his second reading contribution that this would be cheaper and that our court system—this was an astonishing revelation, I thought—is already overloaded. He claimed that the benefit here is that, instead of going into a court system that already has a huge delay, there would be a more timely resolution of these matters if we had a separate tribunal. He also claimed that it would be less threatening and friendlier, thereby minimising anxiety for both complainants and practitioners. What utter rot!

We have, as do other jurisdictions, a district court that is ready, willing and able to take up the jurisdiction as transferred by this parliament. It has a proper accessible process to ensure the best interests and protection of people; where practitioners in these cases would usually go to fight for a person's livelihood to be retained. That is all we are really talking about here: practitioners having the right to go to court and saying, 'I think that the board was wrong and I want my registration entitlement back,' or, 'I want the suspension lifted,' or otherwise. These people are fighting for their livelihood.

If a midwife makes a mistake and she is deemed by the board to be struck off, if she wants to go back and fight for her livelihood, she will get legal representation. It does not matter whether the minister wants to gloss this up as some kind of Mickey Mouse tribunal that is going to be cheaper, etc. The truth is that she is going to get counsel and she will make sure that she is properly represented and that she has access to a proper and legitimate process of appeal and remedy—and she is entitled to it.

The minister's government has transferred industrial laws to the federal arena, so we only have the Public Service left here. We have half the industrial court sitting in their chambers with nothing to do any more so, if there is a concern about what the minister is going to do for the resources for this, why not appoint them. We can simply transfer them to the district court, establish that portion of it so they do not have to go on a waiting list behind criminal cases or civil disputes and let them start on day one, giving them something to do. If they are being paid, why not give them something to do. We can have a proper court system and not some Mickey Mouse thing, a further jurisdiction that I do not think will be anything like the minister has implied. I have never known a tribunal to be cheap. I have never known a tribunal to be fair in its administration—

Mr Kenyon interjecting:

Ms CHAPMAN: We can have an ICAC as well, of course.

An honourable member: We'd like an ICAC. We've been calling for one.

Ms CHAPMAN: He wants an ICAC. We would love an ICAC. In the meantime, we want a system that is accessible and fair and ensures that the rights of practitioners are protected when they get into difficulty in relation to the professional standards which they are administering.

A further matter I would like to raise is that the model proposes that we adopt what has gone through Queensland. We all know why this legislation was pushed through Queensland. Let's be honest—it was because they do not have a house of review; they have never had a house of review. Queensland has always been difficult. They were the last to come into Federation. We had a big dustup about our sugar cane, as I recall. WelI, I recall reading it—I'm pretty old, but not quite that old! But sugar cane held that up.

Western Australia is always spitting the dummy. The reality is that I think Queensland has a different law from the rest of Australia in just about every jurisdiction you can think of. They have never complied. For us to whiz into Queensland, use their system without an upper house to shove this through the parliament without adequate scrutiny, is an insult to our own bicameral system of parliament.

It is certainly an insult to South Australians, who have demonstrated their commitment to keeping an upper house in this state and the need for it, and to shove it through Queensland is an insult to South Australians. If ever there was an example of the standard they have, just think of Dr Patel. Wasn't he a purler? He was practising in Queensland, allegedly causing the death of a number of people—

Mr Marshall interjecting:

Ms CHAPMAN: —and we are going to adopt the Queensland standard. After spending eight years here, former shadow minister Brown and I put through this legislation, raised standards in South Australia and introduced extra things, such as plano lens protection by requiring prescriptions to be issued for the girls to have cats' eyes and so on, because of the importance of protecting against blindness—all important things to do—and we want to go to a standard that Queensland has set? You've got to be kidding me.

This legislation is deceptively simple; it promises the world. I think it is utterly dangerous in the end and it will not serve South Australians well. It is important that the government does not come in here, introduce legislation at the end of April, and say, 'We are in a hurry to get this through; we need to deal with it straight away.' We could have sat in February, of course; we could have sat in December, or we could have sat well and truly before the first sitting in April, but, oh no, this government wanted to shove it through at the end. Tasmania has not even done it yet. I am not even sure whether they have a minister or a shadow minister for health there. The important thing is that we do this properly. We have the opportunity to do it; go back and write it again.

Mr PENGILLY (Finniss) (21:07): I also rise to indicate that I will be opposing the Health Practitioners Regulation National Law (South Australia) Bill 2010. I suspect that the contribution made by the member for Morphett in just over three hours and the compact 20 minute contribution made by the member for Bragg probably covered everything that needs to be said about this.

However, my view has been and always will be that I want to know how any legislation in this place relates to the people in my electorate. That is what it is all about. If it is not going to do anything to improve the health and welfare of the people of Finniss and, indeed, the people in the rest of South Australia, I really do not want to know anything about it.

I also indicate that I have grave concerns about some ministerial council closeted away in Canberra, Darwin, or wherever it chooses to sit, making decisions that are not in the best interests of the people of South Australia, which I think the member for Morphett referred to on several occasions during the course of his remarks. I listened intently for just over three hours, and I was rapt with the honourable member's performance. I thought he did an amazing job.

The reality in South Australia is that few, if any (apart from the odd member of parliament who may not be in the chamber or the odd government officer in the Department of Health or in far-flung regions of the state), will read or hear anything of what we have talked about tonight or, indeed, anything the Minister for Health said in his second reading speech. That is the great concern.

People simply do not understand that this is a lot of bureaucratic gobbledygook and they would not have a clue what it is all about. So, when their health services are reduced; when, for example, the threat of not having obstetrics or elective surgery on Kangaroo Island, at Ceduna or wherever you would like to go, the government will have to ask itself whether this bill, prior to its going to the other house where, I suggest, it might not get quite as far quite so quickly, is in our best interest, and I do not think it is.

The member for Bragg, interestingly enough, raised the example of Dr Patel in Queensland. What an absolute blighter he proved to be; what a disaster he perpetrated on the good people of Queensland. The ongoing debacle and family traumas resulting from that particular person's actions have to be read about to be believed. We never ever want to see that sort of thing happen in South Australia.

I talked about the Kangaroo Island issues but I also talk about issues relating to the other major health service in my electorate, the South Coast Health Service. What is in this bill that is going to directly assist, aid and help the people on the Fleurieu Peninsula and the South Coast? I suspect very little. All it is going to do is cost a heap more money; it is going to result in a lot more bureaucracy and it is going to result in fewer services to the community across the electorate of Finniss. In the long term, I do not think it is going to stand for much at all.

It always worries me when Canberra thinks something is a wonderful idea. You can think what you like and you can say what you like about John Howard when he was prime minister but he always believed in the Federation—he was a federalist. As for this nincompoop we have as the Prime Minister now, quite frankly, the man is an outrageous disgrace and the sooner he is consigned to the annals of history the better. He is ruining this nation and as this sort of thing goes on, which is being pushed through the state parliaments like it is being pushed here tonight, I fear for everyday Australians and what is going to happen the next decade, the next 15 or 20 years. That really worries me.

I do not want to prolong this debate; other members have spoken at length about it but I do indicate that I fiercely reject this legislation. I realise that when it goes into committee in this chamber it could be somewhat of a battle for this side of the house. However, you can rest assured that we will take it up to the government. Coming in here and trying to jam through legislation that is going to have an enormous impact on the people of South Australia in two minutes flat is not the way to go. It is not good business, and I continue to oppose this legislation.

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for Mental Health and Substance Abuse, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (21:12): It is always a joy to hear members of the opposition unburden themselves of their feelings about matters that the government has put before the house. It is an education to us all and my colleagues in the visitors' gallery are better people for having sat through the last four hours of commentary from the opposition.

I thank the members opposite for their contributions. May I just say that the implementation of a national registration and accreditation scheme has been discussed since the Productivity Commission report was released in 2006. In fact, this was an initiative of the Howard government, and I recall Tony Abbott raising it at health ministers' meetings when he was the responsible minister. So, largely, this reform has enjoyed bipartisan support around Australia.

From that time, registration boards have been operating with a degree of uncertainty about when the scheme would commence. I have to say there has been some anxiety among those who work for the boards particularly and those who have been on the boards about when the scheme will come into play. I guess there is a sense of relief now that the matter is about to be resolved and the new boards will be in place by 1 July. Of course, it is important that this parliament passes legislation to allow that to occur.

The legislative model has been applied—and this, I suppose, is the significant point raised by the shadow minister for health who was the lead speaker for the opposition and who said he supported national registration, and I thank him for that and I think he is sincere in that. I was not sure whether or not the member for Bragg supported national registration; I could not tell from her commentary, but the member for Morphett certainly supports it. He asked questions and raised with me the possibility of our introducing what is known as complementary legislation. The model we have chosen to use has been chosen for very particular reasons. It has been applied to a number of national law schemes that have been considered by the parliament in a number of areas including agriculture and veterinary chemicals, electricity, gas, consumer credit and corporations, to name a few.

In fact, when John Olsen was the minister responsible for electricity legislation, according to my colleague the Minister for Energy, he moved similar provisions through the South Australian parliament which were then adopted by other jurisdictions in Australia in order to create a national scheme for the management of electricity. It was done in a similar way to the legislation we are now considering.

For the purposes of the Health Practitioner Regulation National Law, the Western Australia parliament introduced it on a corresponding law model—and the opposition here, of course, is proposing a similar approach. There are problems with that. These are real problems. They are not debating points but, rather, real and significant problems.

I will give an example of where the corresponding law has been used for other national schemes. A corresponding law requires jurisdictions to pass corresponding or mirroring legislation so that identical legislation is passed through each parliament. The major problem with this model is that it is unlikely that a nationally consistent scheme would be established if amendments were required to be passed through every parliament around Australia. If national consistency was able to be achieved it would not be in a timely manner.

For example, in the year 2000 the commonwealth government passed the Gene Technology Act. The purpose of this act is to protect the environment and the health and safety of the public by identifying risks posed as a result of gene technology, and to manage these risks through regulating genetically modified organisms. All jurisdictions were required to pass corresponding laws to achieve national consistency. Corresponding laws for the last jurisdiction occurred in 2006—so it took six years for this process to go through. It took six years for the scheme to be put in place.

Each jurisdiction then needs to amend its legislation each time there is a change in the national scheme, so that means all the states and territories have to pass the exact same amendments at the same time in order for the national scheme to occur. I am advised that we now have the situation where two jurisdictions' legislation has been declared 'not corresponding' and other jurisdictions have legislation that is out of step because of different election cycles and parliamentary sitting schedules.

In other words, if we adopt the model the member for Morphett is proposing, we create a risk that in future South Australia's legislation will be out of sync with legislation in other states. Under the model I am proposing, if a change is made then it will automatically apply in South Australia and will apply immediately to those covered by the regulations in South Australia—those who are registered under the scheme. If our system is changed in the way the member for Morphett would suggest, practitioners in South Australia would have a period of time when they are not covered by the national law; and that could be for a matter of months if an election were to be held or the parliament is of a view that things should be delayed in a particular way, for example a select committee is established. There could be a period of months when the national law is not applied in this state.

I will give an example that explains what happens. Under the codes that are to be established, particular professions will be able to create rules about how they behave, and systems will be put in place about what various professions can and cannot do. Let us say that there is an amendment that affects how midwives, for example, do their work. At the moment midwives are able to provide services to mothers. A set of rules or guidelines apply to them about when, how and under what circumstances they can assist mothers give birth.

If those rules were to change on a national basis based on good evidence, that change came into place in Australia as a result of procedures in place in other states and did not come into place in South Australia, what would happen if a South Australian midwife continued to practise in a way which was outside the rules in other states but still technically able to be done in this state and something happened, for example a baby died or a mother was injured in some way? Who would be responsible? How would the system deal with this?

This would create imponderable legal problems for the system and for the individuals. If you are serious about wanting a national scheme, then you have to adopt the mechanism we are proposing because the consequences of not doing so mean that, over time, you have a breakdown in that national scheme.

In particular, I would say to the house that the purpose of the national registration accreditation and health practitioners scheme is to, first, provide for the protection of the public by ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered and, secondly, facilitate workforce mobility across Australia by reducing the administrative burden for health practitioners wishing to move between jurisdictions and to practise in more than one jurisdiction.

The infamous Dr Patel was mentioned. I understand that he is before the courts in Queensland, and I am not sure what the rules of sub judice are in relation to a matter before another jurisdiction's court. Let us say that a doctor at the moment, once registered in any jurisdiction in Australia through mutual recognition rules, can then apply to be registered in any other jurisdiction. That means we are vulnerable to the weakest link in the national scheme so, in order to protect the public, we want a very robust national scheme with a very high standard. All states and all jurisdictions have strongly supported that, and all the professions, as I understand it, have strongly supported that. This is a way of protecting the public.

There are also benefits for the practitioners as well, in that, once registered in the scheme, the registrant pays one fee, and that entitles them to work and practise in any jurisdiction in Australia. At the moment, you have to be registered in each jurisdiction, so there are anomalies. For example, in emergencies, if doctors and nurses and other health practitioners want to go from South Australia to another state to assist in, say, a bushfire or flood, they would have to get registration in that jurisdiction in order to provide services.

So, the Productivity Commission recommended a national registration and accreditation scheme to overcome the variations in registration and accreditation standards across jurisdictions and to eliminate the red tape for health practitioners. Using a corresponding law model has the high probability of returning back to the current system, where registration standards vary across jurisdictions as they take time to pass laws through their parliaments.

There is nothing in this model used for this bill that undermines the sovereignty of the South Australian parliament. Let me make that plain to this house and to the other place when members up there maybe read these words. There is nothing to stop this parliament, if it chooses, to overturn, dismantle or alter any of the provisions in this. The consequence of the parliament doing that, of course, is that we will not have a national scheme, but we still have the authority and power to do any of these things.

I can assure members that the legislation has been a long time in the planning, and there has been extensive consultation. I have had numerous meetings with representatives of the various professions—the boards and the organisations that represent them—and individuals who have had views about this; equally, of course, departmental officers (both nationally and at a state level) have been through very extensive consultation processes. The intergovernmental agreement was first developed under the Howard government, as I said earlier, with the preferred legislative model being for jurisdictions to apply the Queensland law as the law of their jurisdiction.

The intent of the agreement was picked up under the current federal government (the Rudd government) and signed by all the premiers at COAG in March 2008, given the benefits of using this model compared with that of corresponding laws. It is extremely important in this area of regulatory reform where consistent legislation is essential to protect the health and safety of the public.

The planning for the implementation of the national scheme has now been ongoing for the past 18 months, and it is very important, I believe, for this legislation to now pass our parliament by the end of this financial year. There are a number of consequences should we not join the national scheme on 1 July. The current state health practitioner regulation legislation will continue until such time as South Australia joins the national scheme. The current registration boards have based their planning and preparation on the expectation that they will not exist after 30 June. On this basis, lease or hire agreements for equipment and accommodation have been set to end around that time. Some boards have sold their properties to cover their liabilities, and these properties may not be available after 30 June.

The staff of the boards have been working under an uncertain employment future. Some boards have paid staff retention payments in order to hold on to them; this has been particularly important to ensure continuity of businesses. For those staff from the registration boards that are ineligible to transition to the national agency (that is, contract staff, temporary staff and staff earning more than $120,000), many have now found alternative employment. Some eligible staff have accepted positions interstate. The net effect of this is a loss of staff from the boards.

If we do not get this new structure through, the machinery of the current boards will have run down and we will have a very wobbly system in place, and that, of course, threatens the safety of our community. Also, a number of board positions fall vacant after 1 July, and, under the state legislation, of course, they need to be filled by elections. The cost of holding elections is expensive, depending on the size of the board, and all those expenses would be incurred if this legislation were not to pass.

The current registration boards are also waiting on the passage of the bill to determine which entity will be responsible for the renewal of registrations for practitioners. This renewal process usually commences three months prior to the expiry of the registration period. The next lot of professions in South Australia for which registration falls due are psychology, nursing and midwifery at the end of August this year, and medical at the end of September 2010.

At the moment the registration boards are working on the assumption that the renewal process for these professions will be the responsibility of the national agency. However, a decision needs to be made shortly to ensure that the 1,269 psychologists, the 31,485 nurses and midwives and the 7,381 doctors can continue to practise in this state. The state registration boards may be limited in their ability to process these registrations with reduced staffing complements and, in some cases, experienced staff to vet the registrations.

Whilst we have stressed to registration boards that it is business as usual under this bill as passed by parliament, I am aware that their ability to do so is becoming increasingly compromised as staff leave. Health practitioners registered with South Australian boards have already received a package from the national board detailing the information that is included on the national register about their registration and asking them to be aware of the new standards and codes that will be applicable from 1 July 2010.

If South Australia is not part of the national scheme, all practitioners will still need to be registered locally in order to practise in this state. Should any of these practitioners wish to practise in another jurisdiction, they will need to go through the registration process in that jurisdiction and pay a separate registration fee. For example, a nurse practising in this state will pay a registration fee of $115, and if that individual wishes to practise in other jurisdictions they will have to pay registrations in those states as well. Any practitioner from another jurisdiction wishing to practise in this state, of course, will also have to pay a separate fee.

We will break down the national scheme; we will cause problems for the boards and, of course, place burdens on the individuals. I recognise that we are close to the end of this financial year and that the parliament has not sat for many days in this six month period. I recognise that that has put some pressure on opposition and other members of parliament, so I understand that there may be some feeling that they have not had adequate time to consult and discuss this.

I would simply appeal to them that it is in the best interests of this state, and it is certainly in the best interests of the public and the individual professionals who are covered by these registration standards, that this goes through. However, if the parliament chooses not to pass this legislation, of course that is the will of the parliament, and then the processes that I have detailed will have to be put in place. Those processes would be very inconvenient, rather expensive and create risks, but that would be the burden that this parliament would have to wear.

I conclude at that point. I take this opportunity to thank all the officers who have assisted on the development of this legislation: Richard Dennis, the parliamentary counsel in particular; and from the health department, David Filby, who is now partly retired, Tahnya Donaghy, Andrew Stanley and Kathy Ahwan, three of whom are in the chamber today to assist me. I commend the legislation to the house.

The house divided on the second reading:

AYES (19)
Atkinson, M.J. Bedford, F.E. Bignell, L.W.
Caica, P. Conlon, P.F. Foley, K.O.
Fox, C.C. Hill, J.D. (teller) Kenyon, T.R.
Key, S.W. O'Brien, M.F. Odenwalder, L.K.
Piccolo, T. Portolesi, G. Rau, J.R.
Sibbons, A.L. Thompson, M.G. Vlahos, L.A.
Weatherill, J.W.
NOES (13)
Chapman, V.A. Evans, I.F. Gardner, J.A.W.
Goldsworthy, M.R. Griffiths, S.P. Marshall, S.S.
McFetridge, D. (teller) Pederick, A.S. Pengilly, M.
Sanderson, R. Treloar, P.A. van Holst Pellekaan, D.C.
Whetstone, T.J.
PAIRS (10)
Rann, M.D. Hamilton-Smith, M.L.J.
Koutsantonis, A. Pisoni, D.G.
Geraghty, R.K. Redmond, I.M.
Wright, M.J. Venning, I.H.
Snelling, J.J. Williams, M.R.

Majority of 6 for the ayes.

Second reading thus carried.

Committee Stage

In committee.

Clauses 1 to 3 passed.

Clause 4.

Dr McFETRIDGE: Thank you, Madam Chair, and welcome to our committee. You should be at home with Theo. Thank you for giving up your valuable time with your son.

The CHAIR: I always have time for you, member for Morphett.

Dr McFETRIDGE: I hope he is in good hands. Clause 4 of this bill is the crux of our whole dilemma with this piece of legislation. As I said, we do support national registration. We do support the intent of this bill but we cannot support the adoption of this Queensland legislation as legislation of South Australia.

The intergovernmental ministerial council accepted that this legislation could be introduced as corresponding legislation. The minister, in his second reading explanation, acknowledged that it could be introduced as corresponding legislation. I acknowledge that there will be some difficulties if there are delays in presenting this legislation as corresponding legislation and we do not become part of a national scheme by 1 July, but as I read out in my second reading contribution from the chair of the new Psychology Board of Australia, the world will not end, the sky will not fall in, life will not change forever as we know it now.

What will happen is that there will be a delay, there will be some inconvenience, but what will also happen is that this house will have the opportunity to be in charge of its own destiny. Clause 4—Application of Health Practitioner Regulation National Law, provides:

The Health Practitioner Regulation National Law, as in force from time to time, set out in the schedule to the Health Practitioner Regulation National Law Act 2009 of Queensland—

not South Australia, Western Australia, Northern Territory, ACT, New South Wales, Victoria, Tasmania or any other place, but Queensland, where they have one house and where it has been rammed through—

(a) applies as a law of this jurisdiction; and

(b) as so applying may be referred to as the Health Practitioner Regulation National Law (South Australia); and

(c) so applies as if it were a part of this act.

We cannot accept that. It is completely wrong that this is being forced upon this house. I have listened to what the minister said in his summing up speech. I accept there will be issues and I am happy—I have broad shoulders—to accept the fact that there will be complaints. I will get the emails and the phone calls, and I will have some of the associations who want to get this legislation through—

An honourable member interjecting:

Dr McFETRIDGE: No, I can do it. Somebody said to me that I am putting on weight and I said, 'No, I'm just getting a thicker skin,' because that is what you need in this place. You cannot take things personally. You have to be prepared to stand up and get in there for your principles, and this is a very important principle: that we do not adopt this legislation.

Madam Chair, I would like your ruling on the fact that, as part of clause 4, this committee is able to examine the 308 pages and the 300-plus clauses of the national law, plus the seven schedules with the other 108 clauses in them, because it is very important that we do examine all of that legislation. I understand this will not be a precedent, that this has been done in the past, and I seek your ruling on our ability to proceed down that path.

The CHAIR: Sorry. It is true that I was trying to learn about the process and not listening exactly to your words as I should have.

Dr McFETRIDGE: I understand that you are trying to get things right here. What I am asking is for your ruling on whether, under clause 4—because this parliament is being asked to adopt the Health Practitioners Regulation National Law Act 2009 of Queensland as a law of this state—

The CHAIR: Yes, I got that bit.

Dr McFETRIDGE: I want to know whether we are able to examine the clauses of that legislation as part of this committee process.

The CHAIR: Are you asking me, member for Morphett, if you can have a number of speakers perhaps on this particular issue?

Dr McFETRIDGE: No, Madam Chair. I am asking you whether we are able to go through the clauses in the Queensland legislation that is being adopted as part of state law. It is going to become state law, so therefore we should be able to examine this law. It is a law of this state, and this parliament should be able to examine the laws of this state. It should be the right of this parliament to examine those laws, and I seek your ruling on that matter.

The CHAIR: Right. Meaty stuff! There seem to be quite a lot of clauses in the act to which you refer. Is there any way that you could perhaps squash them in, so to speak, and not take them one by one by one?

Dr McFETRIDGE: It is very important that any legislation that proceeds through this place is examined in detail.

The CHAIR: Yes.

Dr McFETRIDGE: That does not mean that every clause has to be examined in detail, but I can say that it will not be done by 10 o'clock.

The CHAIR: I am just seeking to ascertain—and forgive me for this also—whether you wish to go through clause by clause by clause, and you are telling me that you will not be discussing every clause within that act.

Dr McFETRIDGE: We will need to set a procedure here so that, just as in any legislation where we have to itemise every clause—just as we have passed clauses 1 to 3 without any debate—

The CHAIR: Yes, I understand that.

Dr McFETRIDGE: —there are many clauses in this Queensland legislation that will not be debated, but there are clauses in there that need to be discussed and teased out, and we need assurances that they will be acceptable to South Australia.

The CHAIR: One further question: which clause would you be wanting to begin on within that act?

Dr McFETRIDGE: Pick a number.

The CHAIR: So just a random number or—

The Hon. J.D. HILL: Madam Chair, can I indicate, to be helpful—

The CHAIR: Yes, indeed, minister.

The Hon. J.D. HILL: I have no objection to what the member for Morphett wishes to do and I will not object to any move that you make to allow him to do it.

The CHAIR: Okay.

Dr McFETRIDGE: Just to be clear, the law we are being expected to adopt as part of state law starts on page 23 of the Queensland legislation at part 4. It is from clause 11 of that part that we would be asking the committee to look at those clauses. As I have said, not every clause needs to be debated, but there are a number of clauses in there that we would like to ask questions on and have explained so that the people of South Australia and the members of this place are clear on the intent of this legislation.

The CHAIR: Thank you for your elucidation of that matter, member for Morphett, and in that case, yes. Is your first question pertaining to clause 11, as you said previously?

Dr McFETRIDGE: No, the examination of the whole act starts at clause 11, but the first clause that I actually want to ask questions about is clause 12.

The CHAIR: Member for Morphett, I am advised that I will only be putting one question and that is the question relating to clause 4 in its entirety. Obviously I am not going to go through the actual act itself and put those questions in relation to the clauses. You can question the minister about each of those clauses but we will not be putting them.

Dr McFETRIDGE: Thank you, Madam, for clarifying that procedure. In that case, I refer to clause 4 which refers to the Queensland act. I am referring in the Queensland act to page 23, clause 12—Amendment of schedules—Policy directions. Part 4 provides:

(a) in the Council's opinion, the proposed accreditation standard or amendment will have a substantive and negative impact on the recruitment or supply of health practitioners;

I would like the minister's advice on the meaning of that clause. The house needs to know that the ministerial council will not apply political or economic agendas to the recruitment or supply of health practitioners that—God forbid—would result in the dumbing down of accreditation standards that were implemented to enable the recruitment and supply of health practitioners.

The Hon. J.D. HILL: I thank the member for the question. Before I answer, can I just indicate to him and to the house that the Liberal Party's position in relation to this legislation, I gather, is one of principle; that is, the Liberal Party is opposed to bringing into this place legislation that has passed through the unicameral Parliament of Queensland and adopting it without debating the full extent of the legislation.

I draw to the members' attention that a very similar process was used in 1995 when the consumer credit legislation was passed by this place. In fact, it was based on legislation which was adopted by this parliament having been passed through the unicameral Parliament of Queensland in 1994. I am not sure which government was in power in Queensland in 1994 but I certainly remember which government was in power in South Australia in 1995.

Ms Chapman: Brown.

The Hon. J.D. HILL: Yes, one Dean Brown was the premier. I have no idea what the Labor Party said at the time because I was not here, but I do know that this parliament passed that legislation because it was the right thing to do. In relation to electricity legislation, of course, as the Minister for Energy informed me, a similar approach was taken by the then Liberal government—

An honourable member: So it is all right to be leading, but you can't follow.

Members interjecting:

The CHAIR: Order! I think it would be nice if the members could sit in their proper spots.

The Hon. J.D. HILL: Yes, that is a good idea, Madam Chair. I think I have made my point. Now to the question of the member for Morphett.

Under the arrangements that will be put in place—and I will get advice if I have not got this 100 per cent correct—the national boards, that is, the boards which are dominated by their professions, will determine the scope of practice and the requirements for practice of various practitioners. The board responsible for doctors will determine what doctors can do and the scope and practice of those doctors. The role of ministers will be to approve those standards. They cannot change those standards. If they do not like a standard, they can refer it back and ask for a review. That is similar to what we do now in South Australia. In Victoria, the minister—

Ms Chapman interjecting:

The Hon. J.D. HILL: Vickie, please—belt up, would you?

Members interjecting:

The Hon. J.D. HILL: I beg your pardon, that little Greek chorus in the back row there. If the—

Members interjecting:

The CHAIR: Minister, I think it best not to respond to the provocation of the wall of testosterone there.

The Hon. J.D. HILL: The wall of testosterone; it sounds like the name of a bad 1980s band. I understand that in the Victorian government, until this legislation comes into effect, the minister currently has the right to approve, disapprove and change standards.

In future, the critical role for ministers collectively will be where the areas of practice between the various professions overlap. For example, as I understand it, if one group of professionals wanted to extend or restrict the scope of practice in a way that would interfere with the scope of practice of another group of professionals, that is when ministers would have to take some action. I think that is the point the member was making. This does not allow ministers to overturn professional standards to satisfy some political exigency that might occur. The standards are absolutely determined by the professions.

Dr McFETRIDGE: On the same subclause (4)(b):

…the council has first given consideration to the potential impact of the council's direction on the quality and safety of health care.

Again, there appears to be room for political or economic concerns there. I heard what the minister said about legislation similar to this being introduced, but in some of those cases we were the lead legislators. Had we been the lead legislator here, we would not be having this conversation. We would have had this legislation as part of our state legislation, and that would have been completely acceptable to us. I can count, minister, but that does not stop me ensuring that this house, all the members on this side and on the government's side, are aware of each of the clauses in here and their impact.

I refer again to the wording of subclause (4)(b). How can the minister assure the committee that there will be no political or economic concerns overriding the ministerial council's decisions, particularly when we know that those ministerial council decisions do not have that safeguard of being unanimous, as they do in some other legislation that has been put through? They are by consensus or, in the case of regulations, by majority decision.

The Hon. J.D. HILL: The member raises two issues: whether it should be a majority or unanimous. I think it is important that it be by majority, because it would be possible for a jurisdiction that was not interested in improving standards to object to anything that might strengthen standards across Australia; to make it unanimous would give a veto right to the weakest jurisdiction, if you like. This provision is there to ensure that ministers collectively consider the impact any decision will have on standards. That is to make clear that this is about improving standards, protecting the public, if you like. I am not sure what the concern really is.

This is a new way of doing business, and the professions have certainly been consulted on it in great detail, and that is one of the reasons we are having a review. Inevitably, with any complex piece of legislation you need to have a review after a reasonable period of time to pick up any flaws in it. However, I can assure the member that nobody in the health system wants to create opportunities for rogue doctors or nurses to practise. This is about ensuring the safety of the public. At the moment, some jurisdictions in Australia—not this one—have measures in place that are not as rigorous as they ought to be.

Ms Chapman: Hear, hear!

The Hon. J.D. HILL: The member for Bragg interjects and says 'Hear, hear!', but the fact is that under the mutual recognition arrangements anybody can enter into that state that has weaker standards than our own, be registered there and then come and practise in South Australia if they pay the fee. This will ensure that there is a standard in place that is rigorous right across Australia, and it will be scrutinised by everybody—the professions, the ministers and the national bodies that have been created and all the political processes that go along with that.

Dr McFETRIDGE: Clause 6 provides that the national agency or national board must comply with a direction given to it by the minister or council under this section. I have some concerns there and I do not expect the minister to explain any further. I listened to his response, but I have some concerns about the ministerial council dictating to the national agency or national board which, after all, is suppose to be setting independent standards.

I move on to part 1; I am moving forward in the Queensland legislation. Under the definitions, I refer to 'criminal history'. Paragraph (c) states, 'every charge made against the person', and they are talking about reporting criminal history. Is this a standard thing? If the charge was dropped or not proceeded with, either because there was not enough evidence to proceed with it or some other circumstance, is this some sort of draconian legislation? Are there examples where this clause would be included elsewhere? There may be circumstances where one is charged with, for example, paedophilia—a very serious charge—but it is withdrawn or dropped because you were not guilty, you did not do it, but you were charged with it. Perhaps the lawyers in the place could tell us, but to me that would be a significant issue for a health practitioner.

Progress reported; committee to sit again.


At 22:00 the house adjourned until Wednesday 26 May 2010 at 11:00.


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