Mrs Armitage (Launceston) to ask the Honourable the Leader of the Government -

With regard the Government’s policy of purchasing services from private hospitals, including from Victoria –

(1) Can the Government advise what quality indicators will be used?

Answer from the Leader of Government, Dr Vanessa Goodwin:

1 The Request for Tender provides rigorous quality requirements. All providers must demonstrate compliance with respect to mandatory requirements such as accreditation requirements under: - National Safety and Quality Health Service Standards; - International Society for Quality in Health Care Inc; or - Australian Council on Healthcare Standards.

All tenderers must also demonstrated compliance with respect to:

- provision of a copy of the current registration certificate (registration as a private hospital or day procedure centre) issued by the relevant state Department of Health; - demonstrated compliance with respect to the requirements for the Specialist Medical Practitioner(s) including: - appropriate qualification for the Nominated Surgical Procedures; - valid medical credentialing for the Nominated Surgical Procedures; There are specific qualitative requirements that cannot be outlined until completion of the tender.

(2) (a) How will the clinical risk of treating a patient who may have complications from surgery undertaken elsewhere be addressed, e.g. access to medical records etc;

Answer:

The contract will require the tenderer to be responsible for any related readmission or presentation to an emergency department within 14 days of discharge of the procedure undertaken. The Department will fund the THO/THS any costs arising from adverse events not recovered through the monitoring of the 14 day threshold and consequential treatment liability.

The provider under the terms of the contract must ensure that a summary of treatment is sent electronically to the referring THS Administration Manager, referring surgeon, and the patient’s general practitioner (GP) prior to or on the day of patient separation.

and (b) what measures are being considered in the case of elderly patients who will require postoperative care?

Answer:

The provider is responsible for providing rehabilitation services to admitted patients as deemed necessary by the Contractor and agreed by the THO/THS. Unless previously agreed with the THO/THS the patient will be referred back to the THS for allied and other health professionals to ensure complete and, if necessary, continued medical treatment. It should be noted that many elderly patients are expected to require less post-operative care when compared with the level of primary health care delivered to patients who have waited far too long for their surgery.

(3) Will this tender require these providers to provide pre and post-operative care and follow up services such as rehabilitation, noting these services, like John L Grove are either under resourced or at risk of closing, and cannot deal with a big increase in workload?

Answer:

For all referred patients the Contractor must conduct an initial consultation and assessment of the patient for the purposes of diagnosing their condition and determining the required treatment. In addition contractors will provide any associated pathology, medical imaging; other diagnostic testing; and inclusive of post-operative review by the Nominated Health Practitioner. Again, it should be noted that it is anticipated that the level of care following surgery will in many cases be less than they would otherwise have required while waiting, in many cases, many years for their surgery.

(4) (a) What will be the likely impact on the LGH and its capacity to reopen theatres; and (b) have required reductions in FTE numbers reduced the capacity for the public hospital system to undertake its work?

Answer to 4a

There is no impact on the LGH and its ability to open theatres. Given the time limited nature of this funding it was recognised by the LGH that they could not use these funds to open additional capacity. Instead, the LGH applied for funding under the State Government Rebuilding Health Services to open an additional theatre given the four year funding envelope of this programme.

Answer to 4b

No theatres have been closed as a result of FTE reductions. In fact the Tasmanian Government has contributed $16 million in new money towards elective surgery under our Rebuilding Health Services.

(5) (a) Will people be moved off the waiting list by time on the list as opposed to clinical need; and (b) is reducing the waiting list number, irrespective of procedure preferable to less reduction in the list, but greater clinical need; and (c) what will be the criteria for surgery?

Answer to 5a

Yes. This programme is expressly intended to purchase long waiting patients who have waited well beyond their clinically recommended time to get their treatment. This programme will enable more urgent patients to receive their surgery within our public hospitals with less urgent patients now having the option to wait or accept alternative options to have their surgery.

(Questions 1-5a answered April 30, 2015)

(6) (a) Can the Government advise whether there has been consultation with private health insurers regarding this policy; and (b) if so, what have been their comments; and (c) do private health insurers have any concerns?

(7) What advice has been received from insurers regarding the effect of the policy on the rates of private insurance?