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Health Legislation Amendment
HEALTH LEGISLATION AMENDMENT
BILL (No. 2) 1996
EXPLANATORY NOTES
GENERAL OUTLINE
Policy Objectives of the Bill
The primary objective of this Bill is to change the organisational
arrangements for the delivery of public sector health services in Queensland.
This entails the abolition of Regional Health Authorities and the
incorporation of all health service delivery functions into the Department of
Health under the Chief Executive of the Department. The Bill provides for
the employment, by the Chief Executive, of employees in the Department to
deliver public sector health services.
The Bill provides for community participation in the planning and
delivery of public sector health services in the State, through the
establishment of District Health Councils.
Other policy objectives of the Bill are:-
· to provide for the control of traffic and conduct on health service
property,
· to allow specially appointed auditors to access patient records to
verify data provided under funding arrangements such as the
casemix funding system and the funding arrangements under the
Medicare Agreement,
· to permit the passing of patient-identifying information to the
Commonwealth or a State Government agency to meet reporting
obligations under agreements such as the Medicare Agreement,
· to reconstitute the membership of the Queensland Institute of
Medical Research Council,
· to make consequential amendments to other Acts that are affected
by the abolition of Regional Health Authorities,
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· to amend the Hospitals Foundations Act 1982 to remove
inconsistencies between that Act and the Financial Administration
and Audit Act 1977, and
· to make minor amendments to other Acts.
How the Policy Objectives will be Achieved
The changed organisational arrangements for the delivery of public sector
health services require substantial amendments to the Health Services Act.
These changes include the repeal of Part 3 of the Act which provide for the
constitution of health service regions, the establishment of Regional Health
Authorities and the appointment of Regional Directors. The functions
previously performed by Regional Health Authorities will be assumed by
the Chief Executive of the Department of Health on the commencement of
this Bill. Transitional arrangements in the Bill provide for the transfer of all
assets and liabilities from Regional Health Authorities to the State.
As a consequence of the abolition of Regional Health Authorities, Part 4
of the Act dealing with Regional Health Authority personnel will also be
repealed. On the commencement of the Act, existing staff employed by
Regional Health Authorities will be employed by the Chief Executive under
this Act on the same conditions as their employment as Regional Health
Authority employees. A new Part in the Act will provide for the
employment of health service employees on a tenured, contract, temporary
or casual basis.
The Bill provides for the establishment of health service districts and
District Health Councils and outlines the functions that the Councils are to
perform. Councils will not be involved in day-to-day management of health
services. but will have a monitoring role with respect to district health
services.
The Council's functions include:
· identifying and assessing health service needs of people living in
the council's district,
· participating in the development of strategic plans for the district,
· monitoring compliance with strategic plans, health services
agreements and budgets by the Manager for the district, and the
quality of public sector health services delivered in the district,
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· deciding priorities for minor capital works, and monitoring
programs for the works and asset management, for the district,
· advising and making recommendations to the Manager for the
district about the above matters,
· advising the Manager in the development of health services
agreements for the district, and
· reporting to the Minister on the performance of the Council's
functions under the Act.
At the Council's discretion, the Chairperson or the Chairperson's
nominee is to be a member of a selection panel for senior executives in the
district, including the Manager for the district.
The Bill also outlines how Councils are to be appointed and how they are
to perform their functions.
The Bill establishes the positions of. Managers for districts and outlines
their functions.
The Bill includes a comprehensive set of provisions dealing with the
control of traffic and conduct on health services land. These provisions are
modelled on the existing provisions of Part 7 of. the Sunshine Coast
University College Act 1994. The Bill provides for the appointment of
authorised persons (to deal with traffic) and security officers (to deal with
conduct) on health services land. The Bill allows penalties to be imposed for
breaching speed limits or parking in restricted or prohibited places. The Bill
also allows security officers to direct a person causing a public nuisance to
leave health services land. These amendments will enable the Hospital
By-laws, enacted under the repealed Hospitals Act 1936, to be repealed by
this Bill.
The Bill enables the appointment of auditors under the Act to verify
patient and statistical data reported under a funding arrangement, such as the
casemix funding system and the Medicare Agreement. These provisions are
necessary to allow auditors to access patient identifying information, which
would otherwise be prohibited under Section 62 of the Act. Confidentiality
requirements are placed on auditors by the Bill. The provisions dealing with
auditors have been combined with the existing provisions in the Act dealing
with inspectors and authorised officers (renamed `investigators') under the
Bill.
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The confidentiality provisions of the Act (Section 62) are amended under
the Bill to allow information to be provided to the Commonwealth or a State
under an agreement between Queensland and the Commonwealth or State
concerned. For the information to be provided the agreement must be
prescribed by regulation. This provision has been included to enable
Queensland to meet its obligations under agreements such as the Medicare
Agreement, the National Health Information Agreement and the Cross
Border Agreement (under the Medicare arrangements), which require
potentially identifying patient information to be provided to the
Commonwealth or State. The Bill places confidentiality obligations on the
Commonwealth or State Government agency receiving this information.
The constitution of the Queensland Institute of Medical Research Council
under the Queensland Institute of Medical Research Act 1945 is amended
by this Bill. The amended provisions allow for a wider cross-section of
membership on the Council to better enable the Council to perform its
functions under the Act.
The amendments to the Hospitals Foundations Act 1982 repeal various
provisions which are redundant as a result of the Financial Administration
and Audit Act 1977.
Estimated Cost for Government Implementation
The re-organisation of Queensland Health will result in annual savings of
$10M commencing in the 1996-97 financial year. This will enable a
significant re-allocation of resources from administration to service delivery
as a result of--
· dissolution of Regional Health Authorities and restructuring of
Queensland Health Corporate Office
· rationalisation of administrative staffing levels
· reduction in accommodation rentals
· reduction in outlays on utilities, and
· redeployment of assets (eg from Regional Health Authorities to
District Health Services).
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Consistency with Fundamental Legislative Principles
The Bill does not breach any fundamental legislative principles as stated
in the Legislative Standards Act 1992.
Consultation
The dissolution of Regional Health Authorities is consistent with
announced Government policy.
Consultation has been undertaken with the Office of the Public Service,
the Department of Training and Industrial Relations and the Crown Solicitor
in relation to the amendments to the Health Services Act 1991 concerning
employment matters.
All other Departments and agencies administering those Acts to which
minor and consequential amendments are necessary have been consulted.
Other stakeholders consulted include:
Queensland Institute of Medical Research Act 1945--Queensland
Institute of Medical Research Council and all bodies which have nominees
on the Council
Hospitals Foundations Act 1982--Treasury Department, Queensland
Audit Office and all Hospital Foundations
NOTES ON PROVISIONS
PART 1--PRELIMINARY
Clause 1 sets out the short title of the Act.
Clause 2 provides that the Act commences on a day fixed by
proclamation.
PART 2--AMENDMENT OF HEALTH SERVICES
ACT 1991
Clause 3 identifies this Part as amending the Health Services Act 1991.
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Clause 4 repeals and amends a number of definitions consequential to
other amendments to the Act, and incorporates a range of additional
definitions.
Clause 5 inserts a revised definition of `health service' This definition is a
simplified wording of the existing definition of `health service'. The revised
definition also amends "any administrative or other service related to a
health service" to "any administrative or other support service directly
related to a health service". When read in conjunction with the definition of
`public sector health service', this clarifies that the `corporate office `support
services of the Department (primarily the Division of Planning and
Systems), are not a `public sector health service'. This has important
implications, for example, for the employment provisions under this Bill.
Clause 6 replaces the existing objects of the Act with new objects, ie "to
help prevent illness and provide for the treatment of the sick".
Clause 6. also inserts a new section 3A, which clarifies that the Act binds
the Crown. This is of relevance, for example, in relation to the
confidentiality provisions of the Act.
Clause 6 also inserts a new Part in the Act--`Health Service Districts and
District Health Councils' (sections 4 to 4Q)--
· section 4 allows the Governor in Council to declare an area of the
State to be a health service district and to assign a name to that
district. This provision also allows public sector hospitals and/or
other public sector health facilities to be declared a district. This
will allow, for example, metropolitan hospitals such as the Royal
Brisbane Hospital (and associated facilities) to be declared a health
service district under the Act.
· section 4A requires a District Health Council ("Council") to be
established for each district.
· section 4B specifies the functions of Councils (refer summary of
functions in `General Outline' section of this Explanatory Note).
The Bill provides that a Council's functions relate to the public
sector health services delivered in the district as outlined in the
health services agreement for the district. A health services
agreement for a district is made between the Chief Executive and
the Manager for the district and deals with the services to be
delivered in the district and the funds for their delivery.
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· section 4C entitles the chairperson of a Council, or another
Council member nominated by the chairperson, to be on a
selection panel for the appointment of the Manager, or other
senior executive, in the district. Participation in such selection
panels is at the discretion of the Council.
· section 4D outlines the membership structure of Councils.
· section 4E provides for the appointment of the chairperson of the
Council.
· section 4F provides that the term of appointment of members is
to be not more than four years.
· section 4G provides for the disqualification from membership of.
Councils. The section disqualifies a person employed in the
delivery of a public sector health service in the Council's district
from being a member of a Council. However, the Minister may
waive this restriction if the Minister determines that it is not
otherwise possible to get appropriate members for a Council.
· section 4H provides for the vacation of office of members.
· section 4I provides for the Governor in Council to determine
remuneration for Council members, with the proviso that a
member may waive payment in whole or part.
· sections 4J to 4N provide for the business and meetings of
Councils, including the time and places of meetings, quorum and
voting at meetings, the requirement for the Manager for the
district to attend Council meetings, and the keeping of minutes of
meetings.
· section 4O requires members to disclose interests in any matter to
be considered by the Council which could conflict with the proper
performance of the members' duties.
section 4P provides for the appointment of managers for each
district and outlines the Manager's functions as managing the
delivery of public sector health services in the district in
accordance with the health services agreement and consulting and
liaising with the district's Council. Under this section, the
Manager is also required to provide the administrative support.
reasonably required by the Council to carry out its functions.
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· section 4Q enables Councils to establish consultative committees
to. enable members of the public to express their views about
public sector health services in the district. Members of such
committees are not to be paid any fees or allowances.
Clause 6 also inserts sections 5 to 9 dealing with the employment of
persons in the Department of Health for the delivery of public sector health
services--
· section 5 allows the Chief Executive to appoint a person as a
health service employee in the department for the delivery of
public sector health services. Under the current organisational
arrangements in the Department, this will allow the Chief
Executive to appoint a health service employee in the Health
Services Division of the Department. However, in addition to this
requirement, the Bill provides that a regulation may prescribe
parts of the department which are excluded for the purposes of
this section. These parts of the department will continued to
staffed by public service employees. The purpose of these
provisions is to clearly outline which parts of the Department are
to be staffed by employees under this Act and which parts of the
Department are to be staffed by employees under. the Public
Service Act 1996. These provisions, and a regulation under these
provisions, will result in staff currently employed by Regional
Health Authorities being employed under this Act. Section 5 also
provides that health service employees are to be employed on
tenure, on. contract for a fixed term, on a temporary basis or on a
casual basis.
· section 6 states that employees under this Act are not public
service employees under the Public Service Act 1996.
· section 7 allows for full-time and part-time employment and
requires a contract employee to enter into a written employment
contract with the Chief Executive.
· ·section 8 empowers the Governor in Council to issue directives
for health service employees. This provision complements section
34 of. the Public Service Act 1996 and is necessary as directives
issued under that Act may not be suitable for application to health
service employees.
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· sectiplied provisions of the Public Service Act 1996, an award,
inon 9 provides that an employee's conditions of employment are
governed by any apdustrial agreement or directive (and if an
employee is a contract employee, the employee's contract). The
section also empowers the Chief Executive to determine
conditions of employment for health service employees.
However, such determinations are subject to any applied
provisions of the Public Service Act, directives, relevant awards
and industrial agreements.
Clauses 7 and 8 of the Bill omit Part 2, Division 1 and Parts 3 and 4 of
the Act.
Clause 8 also inserts a new Part (sections 20 to 32) which provides for
the control of traffic and conduct on health services land--
· section 20 enables the Chief Executive to appoint authorised
officers and security officers under this Act--with authorised
officers being responsible for traffic control and security officers
for conduct on health services land.
· section 21 outlines the terms of appointment for authorised
persons and security officers.
· section 22 requires the Chief Executive to issue identity cards to
each authorised officer and security officer and outlines the form
of the identity card.
· section 23 requires an authorised officer or security officer to
produce or display the identity card.
· section 24 empowers an authorised officer to give directions to
persons on health services land for the purpose of controlling
traffic. It is an offence under the Act for a person to fail to comply
with such a direction.
· section 25 enables the Chief Executive to display regulatory
notices on health services land, regulating the driving, parking or
standing of vehicles on the land. It is an offence for a person to
not comply with such a notice. A regulatory notice under this
section may state that a contravention of the notice is an offence
against the Act.
· section 26 requires the Chief Executive to display an information
notice near the entrance to the health services land if the regulatory
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notice does not include a statement that a failure to comply with
the notice constitutes an offence. The information notice must
state a contravention of a requirement of a regulatory notice is an
offence under the Act.
· section 27 authorises an authorised officer to seize a vehicle that is
parked in contravention of a regulatory notice (under
circumstances set out in the section), or is abandoned. The section
outlines procedures to be followed to advise the owner of how the
vehicle may be recovered.
· sections 28 and 29 enable an unclaimed vehicle to be disposed of
if it is not claimed by the owner and outlines how the proceeds of
sale of a seized vehicle are to be applied.
· section 30 establishes an offence for behaving disorderly or
creating a disturbance on health services land. (`Health services
land' is defined as land and buildings from which public sector
health services are delivered).
· section 31 empowers a security officer to direct a person to leave
health services land where a person is believed to be, or has been,
creating a public nuisance; may pose a threat to the safety of
anyone else on the land; or where the security officer believes a
person is on the land without lawful excuse. It is an offence for a
person to fail to comply with a direction given under this section.
· section 32 provides that a person is not to smoke on health
services land, other than in a designated smoking area. The Act
permits an authorised person or security person who finds a
person smoking in contravention of this section to direct the
person to stop smoking, leave health services land, or smoke only
in a designated smoking area. It is an offence to fail to comply
with such a direction.
Clause 8 also inserts sections 33 to 38 of the Act which deals with the
appointment and functions of officials, who are defined as auditors and
investigators--
· section 33 enables the Chief Executive to appoint a person as an
auditor or investigator.
· section 34 outlines the terms of appointment for auditors or
investigators.
· section 35 provides for the functions of an auditor under this Act.
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Health Legislation Amendment
· section 36 outlines the functions of investigators. These functions
are a re-statement of the existing functions of `inspectors' and
`authorised officers' appointed under section 8 of the Health
Services Act 1991.
· section 37 empowers an auditor or investigator to require an
officer or employee of the Department to give to the official any
document relevant to the official's functions. Such a document
may include confidential information, which is any. information
about a person who is receiving or has received a public sector
health service from which the person can be identified. These
provisions re-state the existing provisions for. `inspectors' and
`authorised officers' (now combined as `investigators'), and
extend their application to auditors to enable auditors to access
health records if this is necessary to verify patient or statistical
data reported under funding arrangements such as casemix or the
Medicare Agreement.
· Section 38 places confidentiality requirements on the officials
receiving such information.
Clause 8 also--
· inserts a new section 39 of the Act which enables the Minister to
establish Ministerial Advisory Committees and pay members of
such Committees fees and allowances;
· inserts a new section 40 of the Act which provides that the Chief
Executive, subject to the Minister, has the overall responsibility
for the management, administration and delivery of public sector
health services in the State; and
· relocates the heading of the Part of the Act dealing with the
`Provision of Facilities For Food And Other Services'
(Amendment 12 to the Act in the Schedule to the Bill relocates the
relevant sections in this Part).
Clause 9 makes minor and consequential amendments to section 62 of
the Act, establishes additional exemptions from the confidentiality
provisions of Section 62 of the Act, and places additional confidentiality
obligations on persons who receive patient-identifying information--
· a new paragraph 62(2)(f) provides an exemption to the giving of
information to an official (refer sections 33 to 38).
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Health Legislation Amendment
· a new paragraph 62(2)(g) enables patient-identifying information
to be given to the Commonwealth or a State, or an agency of the
Commonwealth or a State,. where the information is required, or
may. be given, under an agreement between Queensland and the
Commonwealth or State. For the information to be given, the
agreement must be prescribed by regulation and the Chief
Executive must determine the giving of the information is in the
public interest.
· paragraph 62(2)(h) allows a person within the Department to
provide patient-identifying information to another person in the
Department. where such information is to be given to the
Commonwealth or a State under Section 62(2)(g). This allows
such information to be collated at a single point in the department
before being forwarded on. This provision also allows
patient-identifying information to be provided to a single point in
the Department where such information is required under a
funding system such as the current casemix arrangements.
· sub-section 62(2A) places confidentiality obligations on the
Commonwealth or State Government agency who receives
information under this section.
· the amendments also place an on-going obligation on
Departmental employees to maintain the confidentiality of
information received while Regional Health Authority employees.
Clause 10 of the Bill requires that the provisions of the Act be numbered
and renumbered as permitted by the Reprints Act 1992. This will enable the
sections in this Bill to be numbered sequentially when reprinted.
Clause 10 also inserts a new Part in the Act dealing with repeals, savings
and transitional matters--
· section 79 of the Bill repeals 24 sets of Hospital Board By-laws
which were made under the Hospitals Act 1936. These by-laws
can now be repealed. as the control of traffic and conduct on
health services land will be dealt with under the Act.
· sections 80 to 89 provide for the savings and transitional
provisions relating to Regional Health Authorities. These
provisions provide for--
-- the dissolution of all Regional Health Authorities;
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-- the transfer to all assets, liabilities, contracts, agreements,
undertakings and property held in trust from Regional Health
Authorities to the State;
-- the continuation of any proceedings by or against an
Authority in the name of the State;
-- the transfer of employees from being Regional Health
Authority employees to health service employees under this
Act on the same basis (ie tenured, temporary, contract,
casual) and on the same conditions, which that person was
previously employed;
-- -the retention of all accrued rights, leave entitlements and
superannuation entitlements that such employees had at the
time of the dissolution of the Regional Health Authorities;
-- the saving of directions issued by the Chief Executive under
section 58 of the Act as determinations under the new
section 9 of the Act;
-- -the continuation of any disciplinary action; and
-- -the requirement for the Registrar of Titles to record the
vesting of. property in the State under this Part.
PART 3--AMENDMENT OF QUEENSLAND
INSTITUTE OF MEDICAL RESEARCH ACT 1945
Clause 11. identifies this Part as amending the Queensland Institute of
Medical Research Act 1945.
Clause 12 omits Section 5 of the Act and inserts new Sections 5 to 5C--
· section 5 outlines the new membership structure for the Council
of the Queensland Institute of Medical Research. These
amendments were necessary due to the abolition of Regional
Health Authorities and to expand the membership of the Council.
The members. under paragraphs (e), (k) and (l) were not
previously provided for in the Act.
· section 5A outlines the procedures for the nomination of Council
members.
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· section 5B provides for the term of appointment of Council
members.
· section 5C provides for the appointment of a chairperson and
deputy chairperson of the Council.
Clause 13 inserts a new section 6A in the Act requiring casual vacancies
to be filled using the applicable nomination procedures.
Clause 14 provides for the appointment of the chairperson of the
Queensland Institute of Medical Research Trust. This amendment is
necessary as the Act currently provides that the Trust chair is one of the
specified members of the Council--a provision which is to be repealed and
replaced by this Act.
PART 4--MINOR AND CONSEQUENTIAL
AMENDMENTS
Clause 15, through a Schedule to the Bill, makes a range of minor and
consequential amendments to Acts, including further amendments to the.
Health Services Act 1991. These amendments are primarily necessary as a
result of the dissolution of Regional Health Authorities, but also make
minor amendments to Acts unrelated to the changed organisational
arrangements.
The amendment to the Ambulance Services Act 1991 is necessary due to
the abolition of Regional Health Authorities.
The amendment to section 7 of the Dental Technicians and Dental
Prosthetists Act 1991 replaces a reference to a Board member who is to be
an Regional Health Authority employed dentist, to a dentist who is an
employee of the Department. The amendments provide that this does not
affect the current membership of the Board.
The amendments to section 43A of the Drugs Misuse Act 1986 are
necessary due to the abolition of Regional Health Authorities.
The amendments to the Food Act 1981 are necessary due to the abolition
of Regional Health Authorities. Provisions requiring delegations to be
made. to `appropriately qualified' officers or employees (as defined) have
been included.
The amendments to the Health Act 1937 are. necessary due to the
abolition of Regional Health Authorities.
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The amendments to the Health Rights Commission Act 1991 are.
necessary due to the abolition of Regional Health Authorities.
Amendment 1 to the Health Services Act 1991 replaces the reference to
Regional Health Authorities in the long title with `District Health Councils'
Amendment 2 inserts a new heading for Part 2 of the Act. Amendments 3
to 6, and 15 to 18 are necessary due to the abolition of Regional Health
Authorities. Amendment 7 inserts a new heading in Part 5 of the Act.
Amendment 12 relocates the sections of the Act dealing with provision of
facilities for food and other services to Part 4A of the Act. All other
amendments to this Act are to repeal provisions which are now redundant.
Amendment 1 to the Hospitals Foundations Act 1982 repeals redundant
definitions. Amendment 2 inserts definitions of. 'associated district health
council `and `district health council' These terms are used in lieu of
'regional health authorities' in sections 18 and 19 of the Act, which deal
with the membership of Hospital Foundations and the method of
nomination for membership--refer amendments 4, 8 to 10 and 12 to 15.
(Amendment 23 provides that this does not affect the current membership
of persons holding office under section 18(3)(c)). Amendment 11 removes
the requirement to nominate six persons to be members of a Foundation
which has proved to be administratively unnecessary. Amendments 16 to
19 are necessary due to the abolition of Regional Health Authorities.
Amendments 20 to 22 repeal provisions in the Act which duplicate
provisions in the Financial Administration and Audit Act 1977. A cross
referencing provision has also been included to state that a body corporate
(ie a Hospital Foundation) established under the Act is a statutory body for
the purposes of the Financial Administration and Audit Act 1977.
The amendments to the Medical Act 1939 require the Medical Board, as
well as a Committee of Assessors appointed by the Board, to give the
relevant practitioner 14 days notice of an Inquiry.
Amendments 1 and 4 to 7 to the Mental Health Act 1974 replace
references to the Director-General, Health and Medical Services with the
Chief Health Officer of the Department. (Note--the Director-General of
Health and Medical Services was the former title for the Chief Health
Officer). Amendment 13 repeals provisions redundant due to the Trusts Act
1973. All other amendments are necessary due to the abolition of Regional
Health Authorities. (These amendments also simplify the provisions dealing
with administrative responsibility for hospitals under the Act).
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Health Legislation Amendment
The amendments to the Penalties and Sentences Act 1992 are necessary
due to the abolition of Regional Health Authorities.
The amendment to the Public Service Superannuation Act 1958 is
necessary. due to the abolition of Regional Health Authorities.
The amendment to the Public Trustee Act 1978 is necessary due to the
abolition of Regional Health Authorities.
The further amendments to the Queensland Institute of Medical Research
Act 1945 are necessary due to the abolition of Regional Health Authorities.
and to amend definitions in the Act. Amendment 11 provides that the
current members of the Council cease to hold office on the commencement
of the section.
The amendment to the State Service Superannuation Act 1972 is
necessary due to the abolition of Regional Health Authorities.
The amendment to the Whistleblowers Protection Act 1990 is necessary
due to the abolition of Regional Health Authorities.
The amendments to the Workers `Compensation Act 1990 are necessary
due to the abolition of Regional Health Authorities.
© The State of Queensland 1996