Health and Other Legislation Amendment Bill 2021
Plain English Summary
Overview
This bill makes wide-ranging amendments to Queensland's health legislation, with the most significant reforms to the Mental Health Act 2016. It strengthens the rights of people receiving mental health treatment by replacing 'best interests' tests with a rights-based approach, improves safeguards around electroconvulsive therapy (ECT), enables international patient transfers, and aligns confidentiality provisions across health agencies.
Who it affects
People receiving mental health treatment in Queensland gain stronger rights and protections. Allied health professionals gain access to patient records to improve community care. Victims of unlawful acts by forensic patients receive better information and ongoing support.
Mental health rights and treatment safeguards
Reforms the Mental Health Act to adopt a stronger rights-based approach. ECT approval now requires the MHRT to consider patients' views, wishes and preferences, and all patients on involuntary orders need MHRT approval for ECT even if they consent. The Mental Health Court gains flexibility to convert between forensic orders and treatment support orders.
- ECT approval replaces 'best interests' test with clinical merit and appropriateness criteria that prioritise the patient's views
- All patients on involuntary orders now need MHRT approval for ECT, even if they consent, to provide independent oversight
- Mental Health Court can return matters to criminal courts when expert opinions rely on disputed facts
- Court can convert between forensic orders and treatment support orders while preserving forensic history and victim notifications
Patient transfers (interstate and international)
Enables the MHRT to approve international transfers of forensic patients for the first time. Removes legislative compatibility barriers for interstate transfers, replacing them with clinical suitability and community safety criteria. Patient transfers now require consideration of the person's views, wishes and preferences.
- International transfers of forensic patients now possible through the MHRT for the first time
- Interstate transfers simplified by removing requirement for matching legislation between states
- All transfer decisions must now consider patients' views, wishes and preferences
- Broader range of authorised persons (not just police) can apprehend people absent from interstate mental health services
Confidentiality and information sharing
Aligns confidentiality provisions across the Ambulance Service Act, Hospital and Health Boards Act, and Mental Health Act. Increases penalties for breaches and expands authorised disclosure circumstances to support better information sharing between health services.
- Penalties for unauthorised disclosure of confidential information increased from 50 to 100 penalty units across health Acts
- QAS Commissioner can now authorise officers to disclose confidential information in the public interest
- Confidentiality obligations extended to the Director of Forensic Disability and expert practitioners
- Disclosure for child protection, safety and wellbeing now explicitly authorised
Allied health access to patient records
Expands access to The Viewer, Queensland Health's patient information system, to allied health professionals who are not registered under the National Law. This enables better continuity of care when patients move from hospital to community care settings.
- Audiologists, social workers, dietitians, speech pathologists and other allied health professionals can access The Viewer
- Unauthorised access to The Viewer remains an offence carrying up to 600 penalty units
- Strict identity verification, monitoring and auditing safeguards continue to apply
Victim support and information notices
Reforms information notice provisions for victims of unlawful acts committed by forensic patients. Provides clearer rules about when notices end, requires written reasons, and enables ongoing information sharing for victim support services.
- Victims receive written notice within 7 days explaining why their information notice has ended
- Information notices reinstated if a transferred patient returns to Queensland
- Personal information can now be used on an ongoing basis to provide victim support, not just for initial identification
Other health operational amendments
Makes operational improvements to several health-related Acts including allowing health students to assist in terminations of pregnancy, excluding human milk from tissue trading restrictions, removing the age limit for the QAS Commissioner, and simplifying licensing for personal appearance services.
- Health students on clinical placements can assist in terminations of pregnancy under supervision, with conscientious objection rights
- Human milk explicitly excluded from tissue trading prohibition, ensuring hospitals can provide it to sick and pre-term infants
- Age-65 limit for the QAS Commissioner removed
- Tattoo and piercing businesses get longer licence renewal windows (60 days) and a new 30-day licence restoration process
Bill Story
The journey of this bill through Parliament, including debate and recorded votes.
▸Committee1 Dec 2021View Hansard
Referred to Health and Environment Committee
The State Development and Regional Industries Committee examined the Health and Other Legislation Amendment Bill 2021 and recommended it be passed. The committee made five recommendations covering amendments to the Ambulance Service Act, Environmental Protection Act, Hospital and Health Boards Act, and Termination of Pregnancy Act. The government supported all recommendations, which addressed environmental nuisance regulation under infrastructure designations, enhanced patient control over health information in The Viewer, a community engagement campaign about The Viewer, and protections for students exercising conscientious objection to assisting with terminations of pregnancy.
Key findings (5)
- The bill is an omnibus amendment covering the Ambulance Service Act 1991, Environmental Protection Act 1994, Hospital and Health Boards Act 2011, and Termination of Pregnancy Act 2018
- The committee raised concerns about how environmental nuisance would be investigated and regulated under Ministerial infrastructure designations exempt from the Environmental Protection Act
- Stakeholders sought greater patient control over who can access specific health information on The Viewer, Queensland Health's digital health record system
- The committee sought assurances that health students would not be compelled to assist with or observe terminations of pregnancy to complete their qualifications
- The government supported all four substantive recommendations made by the committee
Recommendations (5)
- The committee recommends the Health and Other Legislation Amendment Bill 2021 be passed.
- The committee recommends that the Minister, during the second reading debate, provide detail on how instances of environmental nuisance relating to a Ministerial infrastructure designation as exempted by the amendment, would be investigated and regulated.
- The committee recommends that Queensland Health examine enhancing the functionality of The Viewer, in consultation with key stakeholders, so that an individual may have greater control over who can access specific information or categories of information.
- The committee recommends that Queensland Health, in consultation with relevant providers, deliver a comprehensive and accessible engagement campaign to inform the community about what health information is available on The Viewer, who can access their health information, and what options they have to control it.
- The committee recommends that for the avoidance of any doubt, the Minister make clear in the second reading speech: that it will not be compulsory for students to assist with or observe terminations of pregnancy in order to complete their qualifications; information on alternative study options for students who express a conscientious objection to assist in a termination of pregnancy; and what measures will exist to ensure students feel supported in exercising a conscientious objection.
Committee report tabled
▸Second Reading
▸35 members spoke30 support3 oppose2 mixed
Supported the bill as an important part of the government's commitment to delivering the best health care for Queenslanders, praising the extension of the Viewer to allied health professionals and the consultative approach to the Mental Health Act amendments.
“This is a bill that will see allied health professionals able to access the Viewer. It will lead to better outcomes for Queensland patients, while safeguarding their privacy.”— 2022-02-24View Hansard
As Minister for Health, moved the second reading and outlined the bill's amendments to mental health, ECT approvals, the Viewer, termination of pregnancy, and environmental protection provisions.
“This bill is about ensuring Queensland's health legislation is keeping up with best practice so Queenslanders continue to receive efficient, world-class health care.”— 2022-02-23View Hansard
Supported the bill, acknowledging the work of health workers during COVID-19 and praising the government's approach to addressing areas that need improvement in the health system.
“This bill is the sort of thing that good governments do. We go through and look at things that need to be fixed and need to be attended to, unlike those opposite.”— 2022-02-24View Hansard
As LNP shadow health minister, confirmed the LNP would not oppose the bill. Supported expanded Viewer access and conscientious objection protections for students but warned about the government's record on health IT projects.
“For the most part the bill is largely uncontroversial and some of the changes within are straightforward and are common sense. It is for this reason that the LNP will not be opposing this bill.”— 2022-02-23View Hansard
Supported the bill as being about improving the health system and supporting health services in Queensland, highlighting increased staffing in Central Queensland and local hospital investments.
“This bill is about improving the health system and will support the health services provided in Queensland.”— 2022-02-24View Hansard
As committee chair, spoke in favour of the bill, highlighting the committee's examination of the Viewer, ECT reforms, and privacy protections.
“When examining the bill we found it heartening that the issue of the rights of Queenslanders was always close to the surface of the bill and the amendments contained within it.”— 2022-02-23View Hansard
Acknowledged the bill is largely uncontroversial and supported initiatives improving patient access to health care, but criticised the government's track record on IT projects and argued the bill is a missed opportunity to fix the broader Queensland health crisis including mental health services and ambulance ramping.
“This bill is a missed opportunity to fix the Queensland health crisis. It is clear that our dedicated doctors, nurses, paramedics and allied health professionals are the ones holding our hospitals together while the state government fails to properly resource them.”— 2022-02-24View Hansard
Confirmed the opposition would not oppose the bill but raised concerns about the ministerial infrastructure designation powers, the Viewer's opt-out model, and the government's record on health IT.
“Of course we will not oppose the bill, but those articulated points she made I will reinforce in terms of our concerns.”— 2022-02-23View Hansard
Supported the bill, highlighting government investment in the Townsville University Hospital and praising the amendments to the Public Health (Infection Control for Personal Appearance Services) Act as common sense reforms that reduce stress on small businesses.
“This alone takes a lot of stress off those who must adapt to a new operating environment during a time when the business and working environment has changed dramatically due to COVID-19.”— 2022-02-24View Hansard
As Deputy Premier and Planning Minister, spoke in support of the environmental protection amendments, explaining how ministerial infrastructure designations work and the safeguards in place.
“Ministerial infrastructure designations are an important tool under the Planning Act 2016 to facilitate the development of critical infrastructure.”— 2022-02-23View Hansard
Supported the bill, addressing the donated breastmilk provisions, ECT safeguards, expansion of the Viewer to allied health professionals, and the amendments enabling students to assist with terminations of pregnancy, condemning KAP claims about conscientious objection as reckless and untrue.
“The claims by the member for Hill and others that students might be required to provide abortion care as part of their training or that these provisions constitute any kind of watering down of conscientious objection provisions are reckless, they are untrue and I absolutely condemn them.”— 2022-02-24View Hansard
KAP opposed the bill primarily due to the termination of pregnancy amendments allowing students to assist. Expressed zero trust that adequate conscientious objection protections would be provided. Supported other parts of the bill.
“There is zero trust from our end on there being enough latitude provided to students who want to choose to not participate in this sort of activity. That is a strong point for us and we will be seeking to vote against it in the passage of the bill.”— 2022-02-23View Hansard
Supported the bill, highlighting the streamlined planning processes enabling satellite hospitals in the Redland City area and the removal of photo ID requirements for radiographers.
“Labor governments support our health workers; we do not sack them. We recognise the hard work that they have put in to get these qualifications and licences and the work that they do every single day in our hospitals.”— 2022-02-24View Hansard
Supported the bill as a committee member, methodically outlined each amendment and committee recommendation, and commended the government's reformist legislative agenda.
“Since being elected to state parliament in 2015 I have been pleased to see the Palaszczuk government introduce a wide range of reformist and groundbreaking legislation.”— 2022-02-23View Hansard
As Minister for Health, delivered the reply speech defending the bill's provisions on the Viewer expansion, termination of pregnancy amendments, ECT safeguards, and the urgent amendment to allow transfer of involuntary mental health patients from Norfolk Island.
“This bill introduces practical and workable health reforms to improve the efficiency of our health system. The amendments in the bill help to support responsive ambulance services, allied health services, local community services and mental health services.”— 2022-02-24View Hansard
Supported the bill as a committee member but raised concerns about extending the Viewer through regulation rather than legislation, and criticised the government's practice of introducing last-minute amendments.
“Knock me down with a feather, but the Minister for Health fully explained that and I am completely satisfied with her explanation again.”— 2022-02-23View Hansard
Supported the bill, providing detailed analysis of ECT reforms and rights-based approach, the termination of pregnancy amendments including conscientious objection provisions, and forensic patient protections.
“This is the great ethical debate that has brought about the amendment.”— 2022-02-23View Hansard
Supported mental health reforms and breastmilk provisions but criticised environmental protection amendments allowing MIDs to bypass local planning rules, and called for greater health system funding.
“This bill does not really touch funding for our healthcare system to take care of Queenslanders.”— 2022-02-23View Hansard
Supported the bill, highlighting the Viewer's benefits for patient care, mental health amendments, and the Mackay community mental health facility refurbishment.
“We know how important information sharing is across many sectors, not just in health care. When information is not shared efficiently, opportunities are lost.”— 2022-02-23View Hansard
Did not oppose the bill, supported ECT reforms and digital health initiatives, but warned about Labor's track record on health IT projects and called for greater attention to patient privacy safeguards.
“Any move that the state Labor government makes to expand this e-health initiative, the Viewer, must proceed with absolute care and due diligence and with increased attention given to the protection of patient privacy.”— 2022-02-23View Hansard
Supported the bill as a former paramedic, focusing on amendments to the Ambulance Service Act aligning confidentiality provisions and removing the age restriction on the QAS Commissioner.
“The bill amends the Ambulance Service Act to ensure the framework for the management of confidential information by the Queensland Ambulance Service is robust and clear.”— 2022-02-23View Hansard
Did not oppose the bill but protested the use of omnibus bills. Supported expanding the Viewer with privacy caveats, and called for a new hospital in Blackwater.
“Patients should be able to opt out at any point or exercise control over parts of their record they want to keep private.”— 2022-02-23View Hansard
Supported the bill, focusing on ambulance service confidentiality amendments, the removal of age restrictions on the QAS Commissioner, and the Viewer expansion.
“Ultimately this bill is going to support the continued world-class healthcare delivery for all Queenslanders.”— 2022-02-23View Hansard
Did not oppose the bill but raised concerns about the environmental protection amendments being introduced without local government consultation, and warned against cost-shifting investigations to councils.
“I do urge caution with this amendment, because tucked away on page 29 of the explanatory notes are the details regarding the lack of consultation.”— 2022-02-23View Hansard
Supported the bill, highlighting the Viewer expansion, mental health reforms, and the government's record health investment including the Springfield hospital and Ripley satellite hospital.
“I am very pleased to see expansion of the Viewer, Queensland Health's read-only application, which displays a consolidated view of patients' clinical and demographic information.”— 2022-02-23View Hansard
Opposed aspects of the bill, particularly ECT being performed on minors without consent and the wholesale expansion of third-party access to patient information via the Viewer without express consent.
“I am against the unwarranted expansion of the third-party access to people's sensitive medical information without their express knowledge or consent.”— 2022-02-23View Hansard
Strongly supported the bill as a former nurse, rebutting criticism of ECT by drawing on clinical experience, and defending the breastmilk provisions and the government's health record.
“I have literally seen people who were completely and utterly catatonic, completely and utterly unable to move their legs, arms or get out of bed, go through one session of ECT and regain full use of their bodies.”— 2022-02-23View Hansard
Supported the bill, sharing a powerful testimony from a family before the Mental Health Select Committee about ECT, and advocated for greater information sharing between public and private health sectors.
“Right across the board, apart from the many other issues that are raised in this House from time to time, there certainly is a need for greater information sharing between the public health sector and the private health sector.”— 2022-02-23View Hansard
Supported the bill, highlighting the Ipswich Hospital expansion, ambulance service amendments, Viewer expansion and mental health reforms including ECT safeguards.
“The amendments in this bill reflect our ongoing commitment to quality public health care for all Queenslanders and they deliver health legislation that meets their needs.”— 2022-02-23View Hansard
Opposed the bill due to the termination of pregnancy amendments, viewing them as watering down protections despite the government's assurances on conscientious objection. Supported some other amendments.
“Despite the government stating that they had checks and balances in place when the abortion bill was passed in this parliament, here we see the start of the watering down process.”— 2022-02-23View Hansard
Supported the bill, sharing a personal case about the Viewer's importance when a constituent's daughter died interstate due to a drug interaction, and defended ECT as a necessary treatment.
“An elderly gentleman lost his daughter because she was in an accident interstate. She was given a drug that conflicted with a drug she was already on for another condition and it caused her death.”— 2022-02-23View Hansard
Did not oppose the bill but used his contribution to highlight the rural doctor crisis in his electorate, with communities like Clermont going four years without a permanent doctor.
“Just because you live in the bush, it should not mean that you are subjected to a lack of health services when you need them.”— 2022-02-23View Hansard
Supported the bill, particularly the termination of pregnancy amendments to build regional capacity, but expressed concerns about the conscientious objection recommendation potentially undermining patient focus.
“I am determined to ensure that termination of pregnancy services in regional Queensland are restored and improved for regional women and children.”— 2022-02-23View Hansard
Supported the bill, praising the Health Minister's leadership during COVID and commending health workers, testing centres, and local businesses for their efforts.
“The message to me from seeing such a diverse range of amendments was just how much hard work has been happening in the health system on top of, and in spite of, the enormous burden which has been placed on it by COVID in the last two years.”— 2022-02-23View Hansard
Did not oppose the bill but sought assurances on conscientious objection protections for students, patient privacy rights regarding the Viewer, and advocated for a new hospital in Toowoomba.
“I do not think anybody should be compelled to be involved in a medical procedure that goes against their conscience under any circumstances.”— 2022-02-23View Hansard
▸In Detail
Inserts new provisions to treat the Territory of Norfolk Island as a State for the purposes of the Mental Health Act 2016, enabling the transfer of involuntary mental health patients from Norfolk Island to Queensland when there is a clinical need.
Amends the Mental Health Regulation 2017 to prescribe the Norfolk Island Mental Health Act 1996 as a corresponding law for the purposes of patient transfers, forensic orders and interstate transfer requirements.
Consequential amendment to clause 51 to include a cross-reference to the new division 3A inserting the Norfolk Island provisions.
Amends the long title of the bill to include a reference to the Mental Health Regulation 2017.
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