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Legislative Council - Fifty-Fourth Parliament, First Session (54-1)
2018-11-13 Daily Xml
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Health and Community Services Complaints (Miscellaneous) Amendment Bill

Second Reading

Adjourned debate on second reading.

(Continued from 6 November 2018.)

The Hon. K.J. MAHER (Leader of the Opposition) (16:49): I indicate that I will be the lead speaker for the opposition on this bill and that the opposition intends to support it. Although AHPRA looks after most health practitioners, the Health and Community Services Complaints Act covers the oversight of those remaining unregistered practitioners AHPRA does not cover. Between 2007 and 2009, the Social Development Committee undertook an inquiry into bogus, deregistered and unregistered health practitioners.

This committee was established in response to complaints about the treatment of South Australians suffering from terminal cancer from unregistered practitioners. Amongst other things, the committee recommended that the government legislate to regulate unregistered health practitioners and to establish a code of conduct based on the New South Wales model. This recommendation was enacted, with a legislated code of conduct established in 2013.

In 2015, the COAG Health Council committed to standardising the codes of practice for unregistered health practitioners based on the South Australia and New South Wales models to facilitate information sharing between jurisdictions and to stop the practice of jurisdiction shopping. The bill legislates for this national code to apply in South Australia and essentially aligns other jurisdictions with South Australia's best practice model. The bill also allows orders to apply across jurisdictions and introduces a fine where orders made interstate are breached in South Australia.

The bill contains updates to the language of the act, including changing the language of 'user' to 'consumer' upon recommendation from the Health and Community Services Complaints Commissioner. As the minister touched upon during his second reading, the bill is about preventing harm where a health practitioner, regardless of whether they practice in mainstream or complementary alternative forms of medicine, is presenting a risk to the community.

We understand the bill will come into the other place next year, should it successfully pass this parliament. The opposition has been advised that the updated national code of conduct will be introduced later by regulation and this will not contain any fundamental changes and will primarily seek to present the code in more accessible and easier to understand language. The opposition supports the bill and looks forward to running through a few remaining queries we have during the committee stage.

The Hon. S.G. WADE (Minister for Health and Wellbeing) (16:51): I thank the Leader of the Opposition for his comments and the indication of support of the opposition. I think he appropriately highlighted the role that the Social Development Committee played more than a decade ago. I think at that stage it was chaired by the Hon. Ian Hunter of this chamber. It is another example where, together with New South Wales, South Australia has provided national leadership. I thank the honourable member for his comments and look forward to further consideration of the bill in the committee stage.

Bill read a second time.

Committee Stage

In committee.

Clause 1.

The Hon. K.J. MAHER: Can the minister confirm when it is intended that the bill will be enacted?

The Hon. S.G. WADE: I am advised that the government will proclaim the legislation as soon as the regulations have been finalised and that is likely to be in the first or second quarter of next year.

The Hon. K.J. MAHER: Is the minister able to outline what consultation was undertaken on the bill prior to its introduction?

The Hon. S.G. WADE: The government regards the bill as enabling. There was consultation nationally on the code of conduct, but we did not undertake a state-based consultation other than with the commissioner himself.

The Hon. K.J. MAHER: I thank the minister for his answer. What is the status of each other jurisdiction in terms of legislating to a national standard as agreed at the 2015 COAG Health Council?

The Hon. S.G. WADE: I am advised that four jurisdictions, namely Queensland, New South Wales, Victoria and Tasmania, have legislated and their amendments are operational.

The Hon. K.J. MAHER: I understand that the ANMF in their feedback on this bill put the case for assistants in nursing to be included under AHPRA's remit and therefore under the jurisdiction of the Nursing and Midwifery Board. Given that they perform nursing work as a fundamental aspect of this role, is this something that the minister is willing to further investigate and raise federally?

The Hon. S.G. WADE: I thank the honourable member for his question. There is constant debate as to what health professions should be covered by AHPRA and, in contrast, what professions should be covered by the unregistered health professional framework that we are referring to here. For example, I have been approached by speech pathologists who believe that they should be under AHPRA, and there is also currently a debate in relation to social workers.

The COAG Health Council has developed a set of criteria as to whether or not a profession will be recognised going forward. I think from 1 December this year we will have our next health profession joining the AHPRA framework, that being the profession of paramedic. Of course, assistants in nursing are somewhat different because there is already a Nursing and Midwifery Board. My understanding is that AHPRA is moving towards recognising nursing and midwifery as separate professions, and I presume it would be open to the Nursing and Midwifery Board to progress a role of assistant—I think the term was 'assistant in nursing'—but I am not aware of COAG having actively considered that.

The Hon. K.J. MAHER: I understand the ANMF has further suggested, and I quote:

It is possible that a Nurse may have had their ability to practice withdrawn by the Nursing and Midwifery Board but might still be able to practice as an Assistant in Nursing, unless they are also specifically barred from engaging in that activity, which may not be identified by AHPRA or the Health and Community Services Commissioner until it is too late.

My question is: how do we respond to those concerns and would this situation be prevented under a new national code?

The Hon. S.G. WADE: My understanding is that, if a person has been a registered nurse and loses their registration, they are by definition an unregistered health worker or health professional and they would therefore be covered by the code that is the subject of this act.

The Hon. K.J. MAHER: Could they practise as an assistant in nursing if that was not covered by the code?

The Hon. S.G. WADE: The member might ask further questions if I am missing the point, but I am not aware of assistant in nursing being a protected title. AHPRA protects titles and, through that, protects professions.

The Hon. K.J. MAHER: This might be one that the minister takes on notice. How many prohibition orders and how many undertakings against unregistered health practitioners have been issued since the 2013 code of conduct came into effect?

The Hon. S.G. WADE: Having been the subject of a dare by the Leader of the Opposition, I might give him more than he asked for.

The Hon. K.J. Maher: I have a couple more questions so you might—

The Hon. S.G. WADE: Why don't I get them in before you—I will save you the time. It might be of interest to the chamber to know that I am advised that the total of complaints relating to unregistered health workers received by the Health and Community Services Complaints Commissioner from 1 July 2015 to 24 October 2018 were 264. The number of complaints relating to unregistered providers was 253—

The Hon. K.J. Maher interjecting:

The Hon. S.G. WADE: No, I am happy to take guidance.

The Hon. K.J. MAHER: It might assist just in the flow; that was going to be my next question. Of the complaints about unregistered health practitioners, I think the minister said 264 since a particular date in 2015?

The Hon. S.G. WADE: Yes.

The Hon. K.J. MAHER: How many of those cases are now closed, if the minister has that information?

The Hon. S.G. WADE: The total number of complaints is 264; the number closed is 253.

The Hon. K.J. MAHER: And how many complaints against unregistered health practitioners have been made since the 2013 code came into effect, and how many of those are closed?

The Hon. S.G. WADE: You caught me out there; I will have to take that on notice.

The Hon. K.J. MAHER: How will this information be shared across jurisdictions in the new national scheme?

The Hon. S.G. WADE: It is an interesting point, because I think it is worthy to note that AHPRA, the Australian Health Practitioner Regulation Agency, is a joint state agency. It is supported by a network of state and territory legislation, and it of course has its own database. Each of the jurisdictions has their own form of a health and community services complaints commissioner, obviously by different names, but I am advised that, whilst they are separate bodies, they will be working together to share a common portal to share such data.

The Hon. K.J. MAHER: I guess this question then goes one further than that: is the minister currently aware, and under the new system is there a way for the minister to be made aware, of how many unregistered practitioners are residing in SA who have orders in place from other states?

The Hon. S.G. WADE: I am advised that each of the commissioners—or whatever title they may go by—will be able to interrogate the portal and identify which individuals are subject to orders, whether or not they are resident in their state.

The Hon. K.J. MAHER: I think I understand what the minister is saying: each state will be able to check the national database, so if there is a practitioner in a certain area who has some sort of order from WA, Tasmania or the NT, the South Australian authorities can check the national database and say, 'Ah, they have an order or a ban for something from that other state.'

The Hon. S.G. WADE: I am advised that the Leader of the Opposition has accurately described situation.

The Hon. K.J. MAHER: We will come back full circle, and I think it was the original question that sparked the further ones: how many prohibition orders and undertakings have been issued against unregistered health practitioners since 2013?

The Hon. S.G. WADE: To clarify, I am only talking about 1 July 2015. In relation to 2013, I am happy to take it on notice—

The Hon. K.J. MAHER: Yes, if you can take that on notice.

The Hon. S.G. WADE: Do you want the data as of—

The Hon. K.J. MAHER: Yes.

The Hon. S.G. WADE: I am advised that, from 1 July 2015 to 24 October 2018, the number of prohibition orders imposed, whether that be interim or final, was six.

The Hon. K.J. MAHER: And then, if you could take on notice the—

The ACTING CHAIR (Hon. D.G.E. Hood): Through the Chair, please, members.

The Hon. S.G. WADE: Yes, I will, sir.

The Hon. K.J. MAHER: I ask the minister if he will take on notice the total since the 2013 code came into effect, through the Chair.

The Hon. S.G. WADE: I still will, sir.

Clause passed.

Remaining clauses (2 to 19) and title passed.

Bill reported without amendment.

Third Reading

The Hon. S.G. WADE (Minister for Health and Wellbeing) (17:06): I move:

That this bill be now read a third time.

Bill read a third time and passed.

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