Health Transparency Bill 2019
Plain English Summary
Overview
This bill creates a new framework for publicly reporting quality, safety and staffing information about Queensland hospitals and aged care facilities. It also sets minimum staffing levels in public aged care homes and reforms the health complaints system to improve coordination between the Health Ombudsman and the national health practitioner regulator, AHPRA.
Who it affects
Patients and families choosing hospitals or aged care facilities will gain access to comparative data. Aged care residents in public facilities benefit from mandated minimum staffing. People making health complaints will experience a more streamlined process.
Hospital and aged care transparency reporting
Creates a new Health Transparency Act requiring public and private hospitals and aged care facilities to report quality, safety and staffing information for publication on a new public website. Private aged care facilities may opt out of reporting, but their refusal will be publicly noted.
- New website will publish quality and safety data for all public and private hospitals
- Aged care facilities must report average daily resident care hours (staffing levels)
- Private aged care facilities can opt out of reporting but this will be publicly disclosed
- Penalties of up to 100 penalty units for failing to provide requested information or providing false data
Aged care staffing ratios in public facilities
Introduces minimum nurse and support worker skill mix ratios and minimum average daily resident care hours in public residential aged care facilities, to be set by regulation. This does not impose penalties for non-compliance but compliance will be publicly reported.
- Minimum staffing ratios for registered nurses, enrolled nurses and support workers in public aged care homes
- Minimum average daily resident care hours set by regulation
- Minister may grant temporary exemptions of up to 3 months (maximum 6 months total)
- Estimated cost of approximately $10 million annually for implementation
Health complaints system reform
Reforms how the Health Ombudsman and AHPRA handle complaints about health practitioners. Introduces a joint consideration process, reduces the splitting of complaints between the two bodies, and gives the Health Ombudsman power to issue final prohibition orders against unregistered practitioners.
- New joint consideration process where AHPRA has 5 business days to give its view on complaints about registered practitioners
- Health Ombudsman can now decline complaints not first raised with the health provider or better handled by another body
- Health Ombudsman can issue final prohibition orders for unregistered practitioners (previously only QCAT could do this)
- QCAT no longer required to have a judicial member for certain health practitioner matters, reducing delays
- Timeframes in the Health Ombudsman Act changed from calendar days to business days for consistency
Bill Story
The journey of this bill through Parliament, including debate and recorded votes.
▸Committee4 Sept 2019View Hansard
Referred to Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee
The Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee examined the Health Transparency Bill 2019 over six weeks, receiving 17 submissions and holding a public hearing. The committee recommended the bill be passed, finding widespread support for the transparency measures covering public and private health facilities and aged care. The committee made seven recommendations, including the establishment of an advisory committee of stakeholders and measures to avoid duplicating reporting burdens with Commonwealth requirements. LNP members filed a Statement of Reservation supporting the bill but questioning the evidence base for the 3.65-hour minimum daily care standard.
Key findings (5)
- Stakeholders broadly supported the bill's goal of making health facility and aged care information publicly available, with Health Consumers Queensland and the Queensland Nurses and Midwives' Union among strong supporters
- The Royal Australian College of Surgeons and the Surgical Advisory Committee raised concerns about the accuracy of data sources, emphasising the need for facilities to verify reports before publication
- Leading Age Services Australia opposed the bill, with over 95 per cent of surveyed aged care providers reporting they did not support it and citing additional reporting burdens with no clear benefit
- The Commonwealth Department of Health criticised the bill as creating a reporting burden on providers with no clear benefits to consumers, a view the committee chair publicly rejected
- The bill also amended the Health Ombudsman Act 2013 to improve the health complaints system, implementing three of four recommendations from a previous committee review
Recommendations (7)
- The committee recommends the Health Transparency Bill 2019 be passed.
- The committee recommends that Queensland Health establish an Advisory Committee of external and internal stakeholders to provide feedback on existing reporting data and any proposed changes to the data to be published on the website.
- The committee recommends that Queensland Health provide opportunity for facilities to publish contextual information on care facilities that will assist consumers understand the information reported on the website.
- The committee recommends that Queensland Health, in consultation with a representative Advisory Committee, consider expanding residential aged care information to be reported to include skill mix data for aged care facilities in Queensland.
- The committee recommends that Queensland Health give consideration to avoiding duplication of reporting burdens where possible, by aligning the format of reported information with the requirements of other reporting regimes.
- The committee recommends that the Minister for Health and Minister for Ambulance Services, in the second reading speech, indicate how Queensland reporting requirements will align with possible future Commonwealth requirements, to minimise potential overlap in reporting obligations for facilities.
- The committee recommends that the results of the research project as acknowledged by the Director-General, Queensland Health, on page 7 of the transcript of the public briefing of 9 October 2019, be made publicly available upon completion.
Committee report tabled
▸Second Reading27 Nov 2019View Hansard
Vote on a motion
Vote on the second reading of the Health Transparency Bill 2019, to advance the bill to the consideration in detail stage. The bill creates a transparency framework for health facilities and aged care, introduces minimum staffing ratios in public aged-care facilities, and reforms the health complaints system.
The motion was agreed to.
A formal vote on whether to accept a proposal — this could be the bill itself, an amendment, or another motion.
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Ayes (49)
Noes (34)
Vote on a motion
Procedural motion during the sitting day, unrelated to the bill's second reading vote. The Health Transparency Bill debate was adjourned and continued the following sitting day.
The motion was rejected.
A formal vote on whether to accept a proposal — this could be the bill itself, an amendment, or another motion.
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Ayes (43)
Noes (46)
▸21 members spoke14 support7 mixed
Spoke in strong support of the bill, citing personal experience with her grandmother's dementia care and the need for transparency and minimum staffing in aged-care facilities.
“This will be the fourth time I have spoken in this House about the need to ensure a safe level of staffing in our aged-care facilities, so I am proud to stand here today supporting a bill that does just that.”— 2019-11-28View Hansard
As Minister for Health, moved the second reading and defended the bill as necessary to address the lack of transparency in the aged-care sector, citing the Royal Commission into Aged Care Quality and Safety's interim report.
“The Palaszczuk government cannot and will not wait for the Commonwealth government to act.”— 2019-11-27View Hansard
Supported the bill's transparency measures, noting it will help families choose aged-care facilities, though raised concerns about attracting nurses to regional areas to meet ratios.
“We hope that everyone in this House will support the bill. The KAP will be supporting the bill.”— 2019-11-28View Hansard
As shadow health minister, criticised the government's health transparency record and questioned the evidence base for the 3.65-hour minimum care standard, but did not oppose the bill's passage.
“Only the LNP will put patient care ahead of politics. Patient care will always be our No. 1 priority.”— 2019-11-27View Hansard
As a former nurse, spoke strongly in support of the bill's staffing ratios, transparency measures and the need for good information to enable consumer decision-making about aged-care facilities.
“I am proud to be part of the Palaszczuk Labor government. It is a nursing government. It is the government that introduced ratios. It is the government that introduced nurse navigators. A nursing government is a government for patients.”— 2019-11-28View Hansard
As committee chair, strongly supported the bill's transparency measures and aged-care staffing ratios, criticising the Commonwealth Department of Health for failing to engage with the committee's inquiry.
“This government is sickened by the findings of the royal commission. The lack of humanity shown towards Queenslanders in their old age and lack of transparency for loved ones and their families is utterly appalling.”— 2019-11-27View Hansard
Acknowledged the bill's reasonable intentions but raised concerns about lack of evidence for the 3.65-hour minimum care benchmark, the $10 million annual cost, the two-year phase-in period, and the exclusion of multipurpose health service facilities in regional areas.
“Although the bill appears to have reasonable intentions, the LNP has some concerns which I will outline. The lack of evidence to determine the level at which minimum care hours are set is concerning.”— 2019-11-28View Hansard
Supported the bill in principle but raised concerns about the lack of evidence base for the 3.65-hour minimum care standard, the exclusion of multipurpose health services and transitional healthcare programs from the ratios, and the way care hours are calculated as averages rather than guaranteed minimums.
“The bill should be supported, but a lot more work needs to be done.”— 2019-11-27View Hansard
Supported the bill as a step towards ensuring elderly residents and families can make informed decisions about aged-care services, and criticised the federal LNP government for cutting aged-care funding.
“We are sick of dodgy contractors and greedy owners exploiting vulnerable Queenslanders for profit. Even though the federal government is responsible for the sector's regulation, this is one way we can make them more accountable.”— 2019-11-28View Hansard
Spoke in support of the bill, highlighting the Moreton Bay Nursing Care Unit closure under the previous LNP government and arguing for stronger transparency and staffing standards in aged care.
“It is time and it is timely that this bill is before the House.”— 2019-11-27View Hansard
Raised concerns about lack of evidence for minimum care levels, the $10 million annual cost from existing health resources, and used the transparency theme to question the handling of the Wide Bay health service chief executive's dismissal.
“Queenslanders want to see world-class aged-care facilities. No-one in this place would argue against that. Queenslanders who have worked hard all their lives deserve to be treated with dignity and respect.”— 2019-11-28View Hansard
Stated the LNP would not oppose the bill but criticised the arbitrary basis for the 3.65-hour care ratio, noting it was not evidence based and that the ratio would not apply to 33 multipurpose health services and 11 transitional healthcare programs also operated by Queensland Health.
“Whilst the LNP will not be opposing the bill, we acknowledge that this particular bill was part of a Palaszczuk Labor government commitment to the union.”— 2019-11-27View Hansard
Spoke in support of the bill's framework for transparency in health and aged-care facilities and supported the introduction of nurse-to-resident ratios, citing international evidence linking staffing levels to care failures.
“I rise to speak in support of the Health Transparency Bill 2019. My dear mother, who turned 80 last year, spent 14 years of her life working night shift looking after the elderly.”— 2019-11-28View Hansard
Spoke in support of the bill based on committee visits to aged-care facilities, recounting stories of residents waiting extended periods for assistance due to inadequate staffing levels.
“Our ageing Queenslanders need to be looked after and provided with high-quality aged care in a timely way.”— 2019-11-27View Hansard
Supported the bill as delivering on the government's commitment to implement safe staffing levels in state-run aged-care facilities, and noted the bill also includes important changes for the care of children in court cells.
“Whether we are talking about young people in youth justice or our elderly Queenslanders in residential facilities, we will never shy away from doing everything that we can to make sure that Queenslanders in our care are safe.”— 2019-11-28View Hansard
Supported the bill and its staffing ratios, arguing that aged care should be treated as an essential service and that the fundamental conflict between profit and universal high-quality care must be acknowledged.
“Aged care has to be treated now as an essential service.”— 2019-11-27View Hansard
Argued passionately for transparency in health information to empower consumer decisions, citing harrowing evidence from Dr Richard Kidd about the consequences of inadequate nurse-to-patient ratios in aged care.
“Any member in this place who votes against transparency votes against the stark, harrowing and direct evidence of nurses and doctors such as Dr Kidd. Before you vote, you must read Dr Kidd's evidence in full.”— 2019-11-28View Hansard
Spoke in support of the bill, highlighting visits to aged-care facilities in her electorate and arguing that nurse-to-patient ratios in aged care are overdue, just as they exist in hospitals, childcare and schools.
“This bill is about making sure that our parents, our grandparents, the ones we love and members of our community are treated with respect, with dignity, and are provided with the appropriate level of care.”— 2019-11-27View Hansard
Supported the bill's transparency framework and staffing ratios, sharing a constituent's story of her mother's dramatic improvement after moving from a poorly staffed aged-care facility to a well-staffed one.
“The first photo showed an elderly woman who looked sad and lost. The second photo was transformative. The same elderly woman was smiling and looking healthier and certainly happier. The difference was clear and it was all due to the increased care and support received in the new facility.”— 2019-11-28View Hansard
As shadow minister for communities, stated the LNP would not oppose the bill but questioned the two-year implementation delay and criticised the government for politicising aged care rather than working collaboratively with the federal government.
“From the outset I wish to note that the Liberal National Party opposition will not be opposing this bill.”— 2019-11-27View Hansard
Spoke about the importance of transparency in health reporting but defended the many well-run nursing homes in Hervey Bay, arguing it is unfair to denigrate all facilities because of a few bad actors.
“It is a little upsetting when the good work carried out by a lot of retirement villages and nursing homes is denigrated. Just because one facility does the wrong thing does not mean that every other facility has.”— 2019-11-28View Hansard
▸In Detail4 Sept 2019 – 28 Nov 2019View Hansard
Government amendments Nos 1 to 4: Technical amendments including renaming Part 6, inserting provisions about Hospital and Health Services prescription revocation and transitional regulation-making power, and adding new Part 7 amending the Corrective Services Act 2006, Police Powers and Responsibilities Act 2000, and Youth Justice Act 1992 to establish a child-focused framework for managing children in court cells.
Government amendments Nos 5 to 7: Consequential amendments to the long title of the bill to include the Corrective Services Act 2006, Police Powers and Responsibilities Act 2000, Youth Justice Act 1992 and Youth Justice Regulation 2016.