HEALTH LEGISLATION AMENDMENT BILL
Second Reading
Debate resumed from 28 May.
Mrs SKINNER (North Shore) [8.00 p.m.]: This bill will amend the Dental Technicians Registration Act 1975 to put it beyond doubt that dental prosthetists may make and fit mouthguards and give related advice. Whilst this is current practice, it is somewhat ambiguous in the Act and has been interpreted differently by different people. The amendments will bring New South Wales into line with other States. The Australian Dental Association is concerned that because mouthguards are more sophisticated these days as a result of new technology, care needs to be taken to ensure that those fitting them or providing advice about them are sufficiently trained and have appropriate skills. Having made those comments and noted the concerns of the Australian Dental Association, the Opposition has no problem with the amending legislation.
The bill will amend the Drug Misuse and Trafficking Act 1985 and the Poisons and Therapeutic Goods Act 1966 to make it clear that those who are caring for others may possess lawfully prescribed drugs for the purpose of caring for them. This amendment applies in particular to schools. I have one child still at school and I am aware of the difficulty experienced by schools in that regard. The amendment is a sensible attempt to overcome the problems, and the coalition will support the amendment.
The bill will also amend the New South Wales Institute of Psychiatry Act 1964 to reduce and alter the constitution of the membership of the institute to better reflect its changing roles and activities. It will broaden the membership, reduce the term of office of members, and establish new committees. The coalition wishes to make a number of points in the light of recent activities in regard to the New South Wales Cancer Council. It is necessary that the Minister guarantees that the institute, whose members are appointed by the Minister, will not be politicised; that the members will be a genuine representation of the community with a particular interest in psychiatry; and that there will be no ministerial or Department of Health directions as to their attitudes and roles.
Mr Watkins: That’s a disgrace.
Mrs SKINNER: It will be discussed further when the New South Wales Cancer Council Bill is debated tomorrow. As the honourable member for Gladesville knows, the Cancer Council has been in the headlines recently because of the Minister’s interference in the appointment of members of that board, including one of his colleagues from the upper House who stirred the pot. The Cancer Council’s reputation was damaged internationally by political interference, with disturbing results, such as the fall off in donations and the risk to the funding base of the Cancer Council, which has done a lot of good work in New South Wales. There is every reason to elicit a guarantee from the Minister that there will be no such interference in the membership of the New South Wales Institute of Psychiatry.
With that guarantee the Opposition will not oppose the amendments. The Opposition also supports the final amendment, which relates to the Private Hospitals and Day Procedure Centres Act 1988. That amendment will clarify definitions to cover diagnostic procedures, amongst other things. I have consulted a number of organisations which are affected by the legislation. Some of those organisations, including the Association of Dental Prosthetists, have expressed concern that they were not consulted about the amendments. I am surprised that the association was not consulted, because its members will stand to gain by the amendment to the Act. Such bodies should have been consulted. I am also concerned that the Medical Services Committee was not aware of amendments to the Dental Technicians Registration Act, the Drug Misuse and Trafficking Act or the Poisons and Therapeutics Goods Act. I seek an assurance from the Minister that those bodies will be consulted in the future.
Ms FICARRA (Georges River) [8.06 p.m.]: This bill covers amendments to the Dental Technicians Registration Act, the Drug Misuse and Trafficking Act, the Poisons and Therapeutic Goods Act, the New South Wales Institute of Psychiatry Act and the Private Hospitals and Day Procedure Centres Act. Dealing first with dental technicians, although the current legislation does not prohibit dental prosthetists from making and fitting mouthguards, unfortunately in New South Wales many dental practitioners believe otherwise. The bill includes an express provision to enable dental
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prosthetists who have the ability to make and fit dentures to also make and fit mouthguards. Such a right is legislated for in Victoria, Queensland, Tasmania, South Australia and Western Australia. The legislation will bring some national uniformity to the delivery of dental health care. The Australian Dental Association is opposed to the provision, and I therefore ask the Minister in his reply to give an assurance that adequate training will be required and monitored by the Department of Health to allay the fears of the association.
In regard to those who provide care or assist in the care of others as part of their employment or voluntary activities, it is proposed to amend the Poisons and Therapeutic Goods Act and to make associated amendments to the Drug Misuse and Trafficking Act. Schoolteachers, community service workers, volunteers and child-care workers have at times been placed in invidious positions by the necessary administration and possession of medication required by their students or clients. It is clearly sensible to alleviate any anxiety in regard to the legal position of carers by eliminating any possible breach of the Acts in relation to the possession or supply of medication lawfully prescribed for a person in their care, administering it directly or assisting in self-administration.
A major part of the bill deals with amendments to the New South Wales Institute of Psychology Act to reduce and alter the constitution of the membership of the institute to better reflect current-day objectives and practices, to reduce the term of office of members of the institute, to provide for regular turnover of input and experience, and to establish four new committees. In the past Institute of Psychiatry membership has been weighted with psychiatrists, reflecting the past need to encourage psychiatric research and the development of significant undergraduate and postgraduate psychiatric medical education. Such strong academic representation is not as important in current times, when the focus is being broadened to encompass multidisciplinary training and increased emphasis on community education in mental health. Community consultation leading up to the introduction of the bill saw 22 different community organisations and interest groups represented in the consultative committee process, due to the great interest in the institute’s role and operations. The New South Wales Institute of Psychiatry supports the bill.
It has been agreed with the institute to reduce membership by two, to 10 members, with the Minister nominating the chairperson. The Minister will also appoint a member of the business community; a person who has demonstrated consumer interest in mental health; a psychiatrist selected from a panel of three persons, nominated by the New South Wales branch of the Royal Australian and New Zealand College of Psychiatrists; a health professional selected from two nominees from the New South Wales branch of each of the Australian Psychological Society, the Australian Association of Social Workers and the Australian Association of Occupational Therapists. I am disappointed that there could not be a representative from each of those three worthwhile bodies, rather than one member from six nominations. I believe that their separate input and experience of views with respect to health care delivery would have benefited the institute.
Other ministerial appointments will be a mental health nurse nominated by the Australian and New Zealand College of Mental Health Nurses; two academic psychiatrists selected from a panel consisting of nominees from the University of Sydney, the University of New South Wales and the University of Newcastle; and a senior officer of the Department of Health or a chief executive officer of an area health board. As the honourable member for North Shore indicated, the Minister would be aware of the medical and paramedical and research communities’ anger at his interference with the New South Wales Cancer Council. That issue has attracted a great deal of general public awareness of the political centralised control and cronyism that often goes with government appointments on boards such as this. This bill would allow potential manipulation of the New South Wales Institute of Psychiatry. I call on the Minister to give his necessary guarantee of non-interference and future reliance on professional recommendations in making the required institute appointments.
The institute will be required to establish within three months of royal assent to the bill a psychiatrists training committee, a research committee, a multidisciplinary program committee and a community education and outreach committee. This broad-based structure will better reflect current health care needs and community attitudes. Three-year terms of office, with a limit of two consecutive terms, will be in line with most other professional and government bodies and committees. A wider range of professional groups will have input to the Institute of Psychiatry. The institute will be requested to consult widely and regularly with relevant community organisations with a special interest in mental health, along with both public and private health care providers. I turn now to amendments to the Private Hospitals and Day Procedure Centres Act. The amendments are mainly
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ones of definition and result from feedback relating to licensing provisions of private hospitals and day procedure centres throughout the State.
Diagnostic services should not be isolated or exempt from licensing requirements, as they can involve sedation of the patient or the administration of an anaesthetic. Thus, such diagnostic services have been included under proposed new section 3(1A). The bill also defines private hospital situations in which only one patient is covered, instead of the current reference to the plural "patients". All procedures are included; not just those for fee, gain or reward. This amendment is supported. The bill covers a variety of necessary health care amendments. What is disappointing is that the Australian Medical Association and its medical services committee were not aware of many of the amendments, as the honourable member for North Shore has said, and had little opportunity to investigate them or consult members about them. They did not know about many of the amendments before the honourable member for North Shore contacted them. I hope that the Minister, in his rush to have legislation passed through the House, will improve his departmental legislative consultative processes. The Opposition does not oppose the bill.
Dr REFSHAUGE (Marrickville - Deputy Premier, Minister for Health, and Minister for Aboriginal Affairs) [8.15 p.m.], in reply: I welcome the support of the Opposition, or, rather, its lack of rejection.
Mrs Skinner: A lack of support?
Dr REFSHAUGE: The Opposition has not supported anything, but it has said that it has no problem with the bill. Opposition members apparently have to be oppositionists; supporting is not in their lexicon. Some mention has been made of boards. My involvement with boards is based on the precedents of the Leader of the Opposition and the Deputy Leader of the Opposition, former Ministers for health. In no way do I do anything with boards for which those honourable members have not set precedents. That will not change. If the honourable member for North Shore and the honourable member for Georges River do not like what I do, they must have severe problems with the leaders of their own party. Although the legislation does not make major changes to some Acts, it is important. The honourable member for Georges River should realise that the bill makes amendments to the Institute of Psychiatry, not the Institute of Psychology.
Motion agreed to.
Bill read a second time and passed through remaining stages.