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Health Services Amendment Bill 2006
Health Services Amendment Bill 2006
Explanatory Notes
Title of the Bill
Health Services Amendment Bill 2006
Objectives of the Bill
The main objective of the Bill is to amend the Health Services Act 1991 to
support the continued implementation of the current health reform agenda.
Achievement of the Objectives
· The Bill amends the Health Services Act 1991 to:
· expand the objects of the Act to include health promotion and
protection;
· insert a set of guiding principles into the Act which reflect the key
elements of the current health reform agenda;
· align the Act's organisational provisions to align with Queensland
Health's new structure including clearly articulating the respective
roles of the chief executive (state-wide strategic direction and
leadership), area general managers (leadership within their respective
health service areas) and district managers (managing public sector
health services within their respective districts);
· authorise area general managers to employ health service employees
in their health service areas, in addition to the Director-General as is
currently the case;
· enable the creation of state-wide health services by Executive Council
approval, to operate across districts and areas.
· Replace district health councils with health community councils.
Health community councils will focus on community and consumer
engagement, and monitoring quality and safety in hospitals; and
· create a health executive service, incorporating area general managers,
district managers, and other senior health executives who are not a
part of the public service.
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Health Services Amendment Bill 2006
Alternative Ways of Achieving Policy Objectives
Alternative ways of achieving the policy objects were considered.
However, each of the policy objectives dealt with in the Bill is required to
be effected by legislation.
Estimated Cost for Government Implementation
There will be no administrative or operational costs under the Bill for the
State Government.
Consistency with Fundamental Legislative Principles
An aspect of the Bill which raises possible fundamental legislative
principles issues is outlined below.
Clause 17 contains a new section 28H (Exclusion of certain matters from
review under other Acts) which excludes a decision to appoint, or not to
appoint, a person as a health executive or the contract of employment of a
health executive from review under the Industrial Relations Act 1999 and
the Judicial Review Act 1991.
The inclusion of this new section 28I as part of clause 17 raises the issue
whether this new section has sufficient regard to the rights and liberties of
individuals by making individual rights and liberties, or obligations,
dependent on administrative power only if the power is sufficiently defined
and subject to appropriate review (section 4 (3)(a) of the Legislative
Standards Act 1992).
The inclusion of this section is essential as it provides certainty in relation to
appointment decisions concerning health executives and it makes clear that
the terms and conditions of the health executives' contracts shall govern their
employment arrangements. This section is defensible as it is the same
standard that applies to senior executives under the Public Service Act
1996.
Consultation
Community
As this Bill focuses on the organisational arrangements for Queensland
Health, there has been no consultation with the community in relation to
the Bill.
However the guiding principles, demarcation of the respective role of the
chief executive, area general managers and district managers, as well as the
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Health Services Amendment Bill 2006
new Health Community Council provisions in the Bill draw upon
directions and structure set out in the Queensland Health Systems Review,
which involved extensive community consultation.
Government
The following government agencies and statutory bodies have been
consulted about, and support the introduction of, the Bill:
Department of the Premier and Cabinet
Office of the Public Service Commissioner
Health Quality and Complaints Commission
Notes On Provisions
Clause 1 sets out the short title of the Bill.
Clause 2 sets out the arrangements for the commencement of the Bill.
Clause 3 specifies that the Bill amends the Health Services Act 1991.
Clause 4 amends the long title of the Act to reflect the fact that district
health councils are being replaced by health community councils.
Clause 5 amends and inserts definitions contained in the Health Services
Act 1991.
Clause 6 expands the meaning of a health service to include a service
dealing with the protection and promotion of health. The amendment is
consistent with the inclusion of the protection and promotion of health in
the objects of the Act.
Clause 7 inserts a new section 3A which defines the meaning of a "user",
which is a term used to describe the functions of community health
councils and the function of district managers in relation to managing
complaints from user. The definition with the definition in the Health
Quality and Complaints Commission Act 2006.
Clause 8 amends section 4 to expand the objects of the Act to include the
protection and promotion of health, and also to update the description of
the means through which the Act achieves those objects, such as
establishing health community councils and requiring the chief executive to
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Health Services Amendment Bill 2006
prepare and give the Minister reports about the performance of certain
public sector hospitals
Clause 9 inserts a new section 4A that creates a set of principles intended to
guide the achievement of the objects of the Health Services Act 1991. The
guiding principles include:
· making the best interests of users of public sector health services
the main consideration of for decision-making;
· a commitment to quality and safety;
· being responsive to the needs of users of public sector health
services and service delivery;
· being open and transparent in the provision of information to the
community in relation to public sector health services;
· a commitment to creating workplaces that are free from bullying,
harassment and discrimination and in which staff are respected
and diversity embraced;
· openness to complaints;
· collaborating with clinicians in the planning, developing and
delivering public sector health services;
· promoting research and develop relevant to the delivery of public
sector health services; and
· promoting opportunities for training and development relevant to
the delivery of public sector health services.
These principles are derived from the Queensland Health Systems Review,
the Queensland Public Hospitals Commission of Inquiry and the Action
Plan Building a better health service for Queensland.
Clause 10 amends the heading of Part 2 Health Services Act 1991 by
omitting the reference to district health councils.
Clause 11 omits the heading of Division 1 in Part 2 of the Health Services
Act 1991.
Clause 12 inserts a new Part 2A (Chief executive's responsibility and
functions) and a new heading of Part 2B (General managers).
Part 2A outlines a range of functions for the chief executive including:
· providing strategic leadership and direction in relation to the
delivery of public sector health services so as to promote, protect
and maintain the health of Queensland residents,
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Health Services Amendment Bill 2006
· ensuring the development of a State-wide health services plan,
· ensuring available resources for the delivery of public sector
health services are used effectively and efficiently, and
· entering into performance agreements with general managers and
members of the health executive service.
The description of the chief executive functions includes any other
functions given to the chief executive under the Act. The description of the
chief executive's functions is not intended to displace the description of the
chief executive's functions under another Act, such as the Public Service
Act 1996.
The Bill also provides that in performing the functions the chief executive
must have regard to the objects and guiding principles for the Act.
Clause 13 includes the amendment of the heading for section 21A.
Clause 14 inserts a new section 21B (General manager's functions) and a
new heading for Part 2C.
Section 21B outlines a range of functions for the general manager
including:
· leading the delivery of public sector health services in their
health service area to ensure the provision of quality, safe and
cost-effective public sector health services,
· leading the delivery of particular public sector health services,
within and outside the health service area, as directed by the
chief executive,
· developing a health service area plan that complements the State-
wide health services plan,
· allocating available resources to public sector health services
within the health service area in accordance with the health
service area plan and any funding arrangement for public sector
health services,
· developing health service agreements for each district within the
health service area,
· entering into performance agreements with district managers,
and
· performing other functions as directed by the chief executive.
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Health Services Amendment Bill 2006
In performing the functions the general manager is subject to the chief
executive and must have regard to the objects and guiding principles for the
Act.
Clause 15 amends section 22.
Clause 16 replaces sections 23 and 23A with a new section 23 which
outlines the functions of a manager for a district.
These functions include:
· managing the delivery of public sector health services in the
district in accordance with the health service agreement,
· implementing the health service area plan,
· effectively and efficiently applying available resources for the
performance of the manager's functions,
· enuring there is a system to deal with any complaints from users
of public sector health services delivered in the district,
· ensuring health community councils for the district have
administrative support services reasonably required to carry out
the councils' functions effectively and efficiently,
· giving each health community council for a district written
reports about the quality and safety of, and access to, public
sector health services delivered in the district, and
· performing other functions as directed by the chief executive or
relevant general manager.
In performing the functions the manager for a district is subject to the chief
executive and must have regard to the objects and guiding principles for the
Act.
Clause 17 amends section 24 by enabling general managers, as well as the
chief executive, to appoint a person as a health service employee. This
devolution of responsibility through legislation is consistent with the
Queensland Health Systems Review and the Action Plan Building a better
health service for Queensland.
Clause 18 amends section 26 so that a contracted health service employee
may enter into a contract with the chief executive or a general manager.
Clause 19 amends section 27 to provide the directives issued by the
governor in council about health services employees do not apply to a
health executive.
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Health Services Amendment Bill 2006
Clause 20 amends section 28 to provide that the matters which govern a
health service employee's condition of employment do not apply to a
health executive.
Clause 21 inserts three new parts into the Health Services Act 1991, namely
Part 3A Health Executive Service, Part 3B Health community councils, and
Part 3C State-wide health services.
Part 3A Health Executive Service
The new sections within this part have been modelled on relevant sections
within the Public Service Act 1996. The new sections include:
· section 28A which establishes the health executive service;
· section 28C which outlines the purpose of the health executive
service;
· section 28C which outlines the principles of health executive
service employment;
· section 28D which describes the composition of the health
executive service;
· section 28E which provides for appointment of persons to the
health executive service;
· section 28F which outlines the basis of employment for health
executives, namely a contract of employment with the chief
executive;
· section 28G which requires the undertaking of an annual
performance review of members of the health executive service;
· section 28H which excludes certain matters from review under
the Industrial Relations Act 1999, the Judicial Review Act 1991
and awards and industrial agreements,
· section 28I which enables the chief executive to fix the
remuneration packages and classification levels for health
executives. In exercising these powers, the chief executive must
have regard to a number of considerations including any relevant
directives issued by the Governor in council under section 27,
· section 28J which enables the chief executive to transfer health
executives, and
· section 28K which provides for the health executive to refuse
transfer on reasonable grounds.
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Health Services Amendment Bill 2006
Part 3B Health community councils
· The new sections within this part include:
· section 28L which empowers the Minister to establish as many
health community councils for a district as the Minister considers
appropriate for the administration of the Act. Each district must
have at least 1 health community council,
· section 28M which sets out the functions of a council, including
that it is an advisory body with a range of functions including:
-- undertaking community engagement activities;
-- monitoring the quality, safety and effectiveness of public
sector health services;
-- considering and evaluating reports about the delivery of
public sector health services;
-- enhancing community education about the delivery of
public sector health services;
-- advising and making recommendations to the manager of
the relevant district about the above matters;
-- providing the Minister, within 3 months after the end of
each year, a written report on the performance of its
functions during the year; and
-- performing other functions as directed by the Minister;
· section 28N which provides for the appointment of a council of
not more than 8 members by the Minister. The Minister may only
appoint persons nominated as suitable by the Health Quality and
Complaints Commission. If practicable, a council should include
at least 1 general practitioner as a member. A council must not
include more than 1 member who is engaged in the delivery of
public sector health services;
· section 28O which provides for the appointment of a
chairperson;
· section 28P which provides that a member's term of appointment
shall not be more than 4 years;
· section 28Q which outlines the conditions for disqualification
from membership. It also provides for the Minister to ask the
commissioner of the police service for written report about a
person's criminal history;
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Health Services Amendment Bill 2006
· section 28R which deals with vacation of office by members;
· section 28S which provides for when notice of resignation takes
effect;
· section 28T which concerns the remuneration of members;
· section 28U which enables councils to conduct their business in
the way it considers appropriate;
· section 28V which provides for the times and places of meetings,
· section 28W which requires the manager of a district to attend
community health council meetings;
· section 28X which requires councils to keep minutes of its
meetings;
· section 28Y which provides for disclosure of interests;
· section 28Z which provides for the issuance of Ministerial
Guidelines about a matter relating to a function of the health
community council; and
· section 28ZA provides for the tabling of a council's report for a
year in the Legislative Assembly within one month of receipt of
the report by the Minister.
Part 3C State-wide health services
The new sections within this part enable the creation of a State-wide health
service. The sections include:
· section 28ZB which defines the meaning of a State-wide health
service;
· section 28ZC which provides for the establishment of a state-
wide health service by Governor in Council by gazette notice;
· section 28ZD which provides for the appointment of a manager
for each state-wide health service. The manager's functions
include:
-- managing the delivery of the State-wide health service in
accordance with the State-wide health service agreement,
-- implementing the State-wide health services plan in relation
to the delivery of the State-wide health service,
-- ensuring available resources for the delivery of the State-
wide health service are used effectively and efficiently, and
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Health Services Amendment Bill 2006
-- performing other functions as directed by the chief
executive.
In performing the functions the manager for a district is subject to the chief
executive and must have regard to the objects and guiding principles for the
Act.
Clause 22 amends section 57C to remove mental health from the
responsibilities of the Chief Health Officer in pursuance of machinery of
government changes announced following the 2006 State Government
Election. Section 57C is also amended to insert a range of areas that are
now the responsibility of the chief health officer due to structural changes
as a result of the Queensland Health Systems Review and the Action Plan
Building a better health service for Queensland.
Clause 23 relocates and renumbers section 59 which concerns the
responsibility of the chief executive to Part 2A as inserted by the Bill.
Clause 24 inserts a new Part 9, Division 6 that outlines the transitional
arrangements for the transition of district health councils to community
health councils.
To effect the transition immediately following commencement of the
amending Act, the clause continues the district health councils immediately
in existence before commencement of this Bill as health community
councils for the transition period, which continues from the
commencement of the amending Act to 30 June 2007. The transition period
has been established to enable the Health Quality and Complaints
Commission sufficient time to perform its function of nominating to the
Minster persons it considers suitable for appointment as members of health
community councils.
Additionally, section 86 has been included in the Bill to cater for the
situation where the Governor in Council revokes the declaration of a
district. Such a revocation may arise when the publicly announced
consolidation of 37 districts which existed at the time that the amending
Act commenced into 20 new districts occurs. If that situation arises, the
council for a former district is taken to also be a council for the new district
which includes the area of the old district.
Clause 25 inserts a schedule to make consequential amendments to the
Health Quality and Complaints Commission Act 2006 and the Hospital
Foundations Act 1982 in relation to health community councils.
The Health Quality and Complaints Commission Act 2006 removes the
reference to district health councils in the Act and replaces them with
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Health Services Amendment Bill 2006
references to health community councils. The Commission retains
responsibility for recruiting membership for councils and making
suggested nominations to the minister.
The Hospital Foundations Act 1982 provides that the chair of the district
health council is an exofficio member of the associated hospital foundation.
Section 4 of the Act is amends the definitions to reflect health community
councils.
As there may be more than one council in the district, a new section
18(3)(a) is inserted in the Act to enable the minister to proclaim which
council is to be the associated council for the purposes of the Act.
© State of Queensland 2006