Health Legislation Amendment Bill 2019
Plain English Summary
Overview
This bill makes wide-ranging amendments across Queensland's health laws to embed Aboriginal and Torres Strait Islander health equity, ban conversion therapy by health service providers, strengthen collaboration across the public health system, and update private hospital accreditation requirements. It also repeals the redundant Pap Smear Register and makes administrative changes to the Queensland Mental Health Commission.
Who it affects
Aboriginal and Torres Strait Islander Queenslanders gain legislated health equity commitments and board representation. LGBTIQ Queenslanders are protected from conversion therapy. Private hospital operators must meet national accreditation standards.
Aboriginal and Torres Strait Islander health equity
Embeds health equity for Aboriginal and Torres Strait Islander people as a guiding principle in the public health system. Requires each Hospital and Health Service to develop a health equity strategy and mandates Aboriginal and/or Torres Strait Islander representation on all Hospital and Health Boards.
- Health equity for Aboriginal and Torres Strait Islander people becomes a guiding principle of the Hospital and Health Boards Act
- Each Hospital and Health Service must develop and publish an Aboriginal and Torres Strait Islander health equity strategy
- All Hospital and Health Boards must include one or more Aboriginal and/or Torres Strait Islander members
- Aboriginal and Torres Strait Islander health expertise is recognised as relevant board skills
Conversion therapy ban
Makes it a criminal offence for health service providers to perform conversion therapy — any practice that attempts to change or suppress a person's sexual orientation or gender identity. Gender-affirming care and reasonable clinical decisions are expressly excluded.
- Health service providers face up to 100 penalty units or 12 months imprisonment for performing conversion therapy
- Penalties increase to 150 penalty units or 18 months imprisonment if the person is a child or vulnerable person
- Gender-affirming care, transition support and reasonable clinical decisions are expressly excluded from the ban
- The offence applies to all health service providers including registered and unregistered practitioners
Public health system governance
Strengthens the networked governance model by requiring Hospital and Health Services and Boards to consider statewide resource efficiency and patient interests. Recognises mutual collaboration obligations with the Queensland Ambulance Service and improves patient safety reporting.
- Hospital and Health Services must consider statewide resource efficiency and patient interests
- Mutual collaboration obligations between Hospital and Health Services and the Queensland Ambulance Service are legislated
- Root cause analysis reports can be shared with quality assurance committees to improve patient safety
Private health facilities and other changes
Aligns private health facility licensing with the national accreditation scheme, repeals the redundant Pap Smear Register following the introduction of the National Cancer Screening Register, fixes a drafting error in water safety requirements, and extends the Mental Health Commissioner's maximum term to five years.
- Private health facility licensing aligned with the national Australian Health Service Safety and Quality Accreditation Scheme
- Pap Smear Register repealed as screening is now handled by the National Cancer Screening Register
- Water risk management plans must address both monitoring failures and hazard test results
- Mental Health Commissioner can be appointed for up to five years instead of three
Bill Story
The journey of this bill through Parliament, including debate and recorded votes.
▸Committee28 Nov 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 Legislation Amendment Bill 2019 and tabled Report No. 32 in February 2020. The committee recommended the bill be passed with amendments, particularly seeking greater clarity around the conversion therapy ban provisions. The committee received broad support from stakeholders including the Queensland Human Rights Commission, Queensland Nurses' and Midwives' Union, and the Queensland Aboriginal and Islander Health Council, though it noted areas where the bill could be strengthened.
Key findings (5)
- Stakeholders broadly supported amendments to strengthen health equity commitments for Aboriginal and Torres Strait Islander people in the Hospital and Health Boards Act 2011.
- The committee identified a need for greater clarity in the conversion therapy ban provisions regarding what treatment and care would be covered and what would not.
- The committee supported repealing redundant Pap Smear Register provisions, as the Queensland register had been replaced by a national register.
- Submitters supported amendments to clarify the Mental Health Commissioner's staffing functions and extend the maximum appointment term to five years.
- The committee examined amendments to water risk management plans for hospitals and aged care facilities, noting a potentially lower threshold for offences carrying significant penalties.
Recommendations (3)
- The committee recommends the Health Legislation Amendment Bill 2019 be passed with the amendments proposed at Recommendation 2.
- The committee recommends that new section 213F in clause 28 of the Bill be amended to provide greater clarity and certainty as to what treatment and care provided by health service providers are to be covered and what services are not to be covered by the conversion therapy ban.
- The committee recommends that the Minister informs the House, if the Bill is passed, what education, training, or guidelines would be provided to health service providers to assist them to understand what care and treatment would be covered by the definition of conversion therapy and the offence provisions in clause 28 of the Bill.
Committee report tabled
▸Second Reading13 Aug 2020View Hansard
▸18 members spoke10 support1 oppose7 mixed
As Minister for Health, moved the second reading and outlined the bill's key reforms including strengthened networked governance, Aboriginal and Torres Strait Islander health equity provisions, and Australia's first ban on conversion therapy by health service providers.
“It is time to send a clear message that conversion therapy is unacceptable and has no place in Queensland's healthcare system. Being LGBTIQ is not an affliction or a disease that requires medical treatment.”— 2020-08-13View Hansard
As shadow health minister, supported most of the bill but strongly opposed clause 28 banning conversion therapy, arguing it would treat doctors like criminals and citing concerns from AMA Queensland, the National Association of Practising Psychiatrists, and the Queensland Law Society about the impact on gender dysphoria treatment.
“Labor's laws would have turned doctors into criminals, compromising medical treatment, and we will oppose that clause in the bill.”— 2020-08-13View Hansard
Supported the bill as committee chair, highlighting the key reforms including strengthened networked governance, Aboriginal and Torres Strait Islander health board representation, and the conversion therapy ban.
“The term 'conversion therapy' covers a raft of treatments that attempt to change or suppress a person's sexual orientation or gender identity.”— 2020-08-13View Hansard
Questioned why legislation was needed to force hospitals and ambulances to collaborate, arguing it reflects the minister's inability to manage his portfolio. Opposed clause 28, arguing the Health Ombudsman already has power to deal with conversion therapy and the criminal sanction is unnecessary.
“Why are we imposing a criminal sanction when authority exists with the ombudsman to deal with that?”— 2020-08-13View Hansard
Strongly supported the bill, particularly the conversion therapy ban, citing clinical evidence that conversion therapy does not work and causes harm. Shared personal experiences of changing his views on homosexuality and read a constituent's account of being sent overseas for conversion therapy.
“Given that there is no basis in evidence for a fully trained health professional to practise a therapy that is known to harm a patient, it should attack a criminal sanction.”— 2020-08-13View Hansard
Acknowledged most of the bill contains sound amendments but opposed clause 28 as a virtue signal that does not address the actual problem. Cited concerns from AMA Queensland and the National Association of Practising Psychiatrists that the legislation could constrain legitimate medical practice.
“This is a solution desperately seeking a problem to solve and, as the member for Greenslopes pointed out in his contribution, the problems lie historically or elsewhere.”— 2020-08-13View Hansard
Supported the bill, focusing on the amendments to the Hospital and Health Boards Act regarding health equity for Aboriginal and Torres Strait Islander people, citing life expectancy gaps and leading health conditions.
“Through these amendments, health and wellbeing for Aboriginal and Torres Strait Islander people will be at the forefront of the delivery of health services.”— 2020-08-13View Hansard
Supported the bill including the conversion therapy ban, but argued it should be extended to religious institutions. Noted a ban on conversion therapy has long been part of the Queensland Greens' platform and that the harm justifies a strong legislative response regardless of prevalence.
“Any health practitioner who exercises reasonable professional judgement in providing safe, appropriate health services has nothing to fear.”— 2020-08-13View Hansard
Supported the bill as a First Nation woman, emphasising the commitment to Aboriginal and Torres Strait Islander health equity and the prohibition of conversion therapy. Commended the Minister for Health for his leadership.
“As a First Nation woman and a member of the Palaszczuk government, this makes me feel extremely proud to represent a government committed to giving visibility to First Nation people.”— 2020-08-13View Hansard
Supported Aboriginal and Torres Strait Islander health equity amendments and mental health commission changes, but opposed clause 28 as originally drafted, citing lack of empirical evidence of conversion therapy in Queensland and concerns from medical professionals about unintended consequences for gender dysphoria treatment.
“There is absolutely no place for gay conversion therapy. There is no place for any health service provider or anyone else to provide gay conversion therapy.”— 2020-08-13View Hansard
Supported the bill, particularly the conversion therapy ban, arguing that evidence shows conversion therapy increases the risk of suicide and that no health practitioner will be required to provide treatment but will be prevented from dangerous practices.
“By introducing this legislation we have sent a very clear message to all members of the LGBTIQ community, particularly young people, that there is nothing wrong with you.”— 2020-08-13View Hansard
Supported the bill, particularly the conversion therapy provisions, arguing conversion therapy belongs in the Dark Ages and that the prohibition sends a strong message that being LGBTIQ is not a disorder requiring treatment.
“Conversion therapy belongs in the Dark Ages.”— 2020-08-13View Hansard
Stated the LNP will not oppose the bill overall but will oppose clause 28 on conversion therapy. Supported the Aboriginal and Torres Strait Islander health equity amendments and raised concerns about fly-in fly-out board appointments in regional areas.
“No-one disputes the importance of ensuring health treatment to Queenslanders who need support to understand their own sexual identity, but this bill goes a whole step further.”— 2020-08-13View Hansard
Supported the prohibition of conversion therapies, sharing the experience of a trans friend who was given religious counselling at school and denied proper medical information by GPs.
“He said that conversion therapy is very hurtful and the fact that it still exists is horrible. He said that it does not have a place in modern medicine and that you cannot change gender identity or sexuality by talking people down.”— 2020-08-13View Hansard
Called conversion therapy a disgraceful practice and said he stands with those who call it out, but raised concerns about whether the criminal sanctions in clause 28 could deter medical practitioners from offering legitimate therapies for gender dysphoria.
“I think there are very few people who would endorse the disgraceful practice of conversion therapy. Where people are subjected to pain, humiliation and denigration because of their sexuality, we should rightly call out those who are putting them through it.”— 2020-08-13View Hansard
Supported the bill as part of the government's commitment to delivering the best healthcare system, highlighting the strengthened governance and Aboriginal and Torres Strait Islander health equity provisions.
“The Palaszczuk government is committed to delivering the best healthcare system we can for Queenslanders and this legislation will work towards that commitment.”— 2020-08-13View Hansard
Opposed both the governance amendments, arguing they return Queensland to a centralised health system undoing Lawrence Springborg's reforms, and clause 28, arguing it risks driving mental health professionals from treating at-risk children due to fear of criminal prosecution.
“This one innocuous change will undo all the good work achieved to repair Queensland's hospital and health services. Eventually, it will return us to the worst of the bad old days but with an additional layer of bureaucracy.”— 2020-08-13View Hansard
Shared the LNP's concerns about clause 28 but his speech was cut short by the expiry of the time limit for this stage of the bill.
“I share the concerns expressed on behalf of the LNP by the shadow minister for health, the member for Mudgeeraba, in talking about clause 28 of the bill.”— 2020-08-13View Hansard
▸In Detail16 Oct 2019 – 13 Aug 2020View Hansard
Amendments to the Medicines and Poisons Act 2019 addressing minor drafting and technical issues identified after the act's passage, including corrections to pest management activity provisions, manufacturing licence definitions, and substance management plan requirements.
Amendments to clause 28 (conversion therapy ban) clarifying the definition of conversion therapy by adding examples, expanding the exclusions for legitimate clinical practices including assessment, diagnosis and treatment of gender dysphoria, and changing 'treatment' to 'service'.
That the amendments be agreed to
Vote on government amendments to clause 28 (conversion therapy ban) that clarified the definition of conversion therapy, added examples of excluded legitimate practices, and changed 'treatment' to 'service' to distinguish from genuine medical treatments.
The motion passed.
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Ayes (47)
Noes (41)
That clause 28, as amended, be agreed to
Vote on whether to include the amended clause 28 prohibiting conversion therapy by health service providers in the bill. The LNP, KAP, NQF and PHON voted against the clause while ALP, Greens and an Independent voted in favour.
The motion passed.
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Ayes (47)
Noes (41)
▸Third Reading13 Aug 2020View Hansard
That the bill, as amended, be now read a third time
Final passage vote on the Health Legislation Amendment Bill 2019, with the LNP, KAP, NQF and PHON voting against the bill primarily due to their opposition to the conversion therapy ban in clause 28.
The motion passed.
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Ayes (47)
Noes (41)
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