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HEALTH PROFESSIONALS (SPECIAL EVENTS EXEMPTION) BILL 1999

Introduction and First Reading

Bill introduced, on motion by Mr Day(Minister for Health), and read a first time.

Second Reading

MR DAY (Darling Range - Minister for Health) [10.04 am]: I move -

That the Bill be now read a second time.

I am pleased to introduce this Bill, the purpose of which is to facilitate the provision of health care services by health professionals who accompany overseas teams to major sporting, cultural and other events in Western Australia. The Bill addresses the consequences for overseas health professionals of legislation which regulates health professionals in Western Australia.

The State's health practitioner registration legislation generally makes it an offence for persons who are not registered with the relevant health registration board to practise a regulated health profession; or hold themselves out as being entitled or qualified to do so; for example, by using certain titles which may be lawfully used only by registered health professionals in Western Australia.

These provisions are intended to protect the public of Western Australia from harm that may result from the provision of health care services to them by persons who do not have the qualifications, experience or skill to provide such services safely and competently. The public is protected by requiring health registration boards to be satisfied that persons who wish to become registered under one of a number of health registration Acts meet certain requirements for registration. One

The granting of registration in these circumstances can be problematic. For example, a visiting health professional may not have a qualification which is required for registration in Western Australia. Or he or she may not be able to satisfy requirements relating to English language competency which are found in health practitioner legislation. Such requirements are relevant in the Western Australian context. But they are of little or no value in determining the competence of a non-English speaking doctor, for example, to provide health care to the members of a team from a non-English speaking country.

In short, there is little - if indeed any - benefit gained for the public of Western Australia from the involvement of the State's health registration boards in processing applications to register overseas health professionals who only intend to provide health care to the members of visiting teams. Moreover, registration requirements established to determine who may practise a regulated health profession in Western Australia may be neither relevant for, nor capable of being satisfied by, visiting health professionals.

To address this situation, the Bill proposes to exempt visiting health professionals from Western Australian health practitioner registration requirements. This exemption is achieved by the Bill authorising visiting health professionals to provide health care services in connection with special events which are declared by the minister. This authorisation applies to the provision of health care services only to members of the visiting teams to which visiting health professionals are attached. If a visiting health professional were to attempt to provide a health care service to a member of the general public, he or she would be practising outside the scope of the authorisation provided by the Bill. As a consequence, if this situation were to occur, the visiting health professional would still be liable to prosecution under the relevant health registration Act for the offence of practising the profession or holding himself or herself out as being entitled to do so while not being registered.

The Bill is modelled on comparable legislation which has been passed in New South Wales as part of the preparations for the Sydney 2000 Olympic Games. Passage of the Bill at this time will facilitate Western Australia's contribution to the Sydney games. It will do so by enabling overseas health professionals to accompany teams which are expected to come to Western Australia to prepare and acclimatise during the lead up to the games. For example, the Minister for Sport and Recreation has announced that the Greek Olympic team has decided to base itself in Western Australia during August 2000 to prepare for its participation in the games. Similar legislation has been passed in Queensland and Tasmania, and other States and Territories are intending to do likewise.

The House may recall that legislation with a similar intent was passed in Western Australia in 1985 to facilitate the staging of the America's Cup defence. However, that legislation was specific to that event and lapsed when the event finished. The approach taken in this Bill has been to frame generic legislation that can be applied to all such events in the future.

Health registration boards in Western Australia have been consulted about the Bill and have indicated their support for it.
I turn now to the main provisions of the Bill. Clause 4 defines who is a visitor for the purposes of the Bill. This definition determines who may be provided with health care services by visiting health professionals. The definition encompasses residents of another country who are in the State for the purposes of officially participating, or preparing for official participation, in a special event. It also includes persons who are appointed to assist participants in special events, such as trainers, coaches and other team officials. Clause 4 also acknowledges that a resident of Australia may be involved in an overseas team, either as a team participant or in a supporting role. It includes Australian residents who are in this situation within the definition of "visitor", so as to enable them to receive health care from visiting health professionals who are attached to their team.

Clause 5 defines who is a "visiting health professional" for the purposes of the Bill, and hence who is authorised by the Bill to provide health care services to visitors. A person is a visiting health professional if the person is a resident of another country, has been appointed to provide health care services to a visitor, and is not registered as a health practitioner under Western Australian law. In addition, notice of the person's intention to provide health care services to visitors must be provided in accordance with a procedure identified in the minister's order declaring the special event. The notification procedure is intended to enable relevant authorities to know who will be providing health care services as visiting health professionals during the special event. It also links to clause 14 which enables the minister to determine that the provisions of the Bill do not apply to individuals or classes of persons who seek to provide services as visiting health professionals.

Clause 6 deals with the declaration of special events by the minister. Any sporting, cultural or other event being held in the State may be declared to be a special event if the minister considers that the event will attract a significant number of participants from other countries. Special events declared in other States and Territories of Australia may also be declared to be special events in Western Australia if the minister considers that the event will attract visitors to the State. This provision recognises that there will be situations - such as the Olympic Games - in which Western Australia may not be hosting the event, but will nonetheless have an involvement which will result in visitors and visiting health professionals spending time in the State. The minister's order declaring a special event will be published in the Government Gazette. The order is to specify the period or periods during which the Bill's exemptions from committing offences under various state laws will apply. The minister's order is also to identify the procedure to be followed by a person who wishes to provide health care services as a visiting health professional.

Clause 7 authorises the provision of health care services to visitors by visiting health professionals. As indicated previously, a visiting health professional who attempts to operate outside the scope of this authorisation remains liable to prosecution

Clause 8 provides for conditions to be placed on the practice of a visiting health professional. A number of conditions are applied to all visiting health professionals by subclauses 8(1) and 8(2). These conditions provide that a visiting health professional may provide only health care services of a kind that may be lawfully provided by a registered health professional of the like profession in Western Australia; and a visiting health professional cannot possess, use or supply a therapeutic substance unless the substance can be lawfully possessed, used or supplied by a registered health professional of the like profession in Western Australia. This latter condition limits who may possess, use, or supply therapeutic substances to visiting doctors, dentists and pharmacists. In the interests of retaining some flexibility to deal with exceptional situations, clause 8 also provides that the minister may exempt a visiting health professional from either or both of the conditions in subclauses 8(1) and 8(2). Clause 8 also provides for other conditions to be placed on the practice of visiting health professionals, either by the minister's special events order under clause 6 or by regulations made under clause 16.

Clause 9 deals with access to therapeutic substances for use in providing health care services authorised by the Bill. The ability to administer therapeutic substances is an integral part of health care delivery for a number of health professions, most notably the medical profession. This is recognised by the Poisons Act 1964 which authorises the possession, use and supply of therapeutic substances by registered medical practitioners, dentists and pharmacists. Clause 9 acknowledges that certain visiting health professionals may similarly need to administer therapeutic substances to visitors, while also recognising the need for appropriate controls to be applied in this situation. Accordingly, the clause enables the minister to authorise visiting health professionals, either individually or as a class, to issue prescriptions for restricted substances and drugs of addiction; and to be sold by wholesale any substance which is scheduled under the Poisons Act 1964. The terms "restricted substance" and "drug of addiction" are defined by reference to the Poisons Act 1964. Essentially, they refer to therapeutic substances which can be accessed by a member of the public in Western Australia only by a prescription issued by a registered medical practitioner or dentist.

I make it clear that it is not the intention to make frequent use of the ability to authorise visiting health professionals to issue prescriptions for restricted substances and drugs of addiction. An authorisation of this kind would be the exception rather than the rule. However, where, for example, a visiting team or the organisers of a special event can show good cause why visiting doctors should be able to prescribe restricted substances or drugs of addiction for use by visitors, such an authorisation could be contemplated. In this situation, subclause 9(3) provides that the minister could grant the authorisation only if satisfied that adequate arrangements are in place to ensure that substances prescribed under the authorisation will be prescribed for, sold or supplied to, and used only by visitors. Such arrangements would most likely take the form of requiring special prescription pads to be used, nominating the pharmacies through which prescribed substances could be obtained, and requiring records to be maintained to account for all substances which are prescribed under the authorisation.

The Bill allows the granting of the authorisation to be made subject to conditions. This provision would be used to specify that these and other control arrangements considered desirable should be attached to any authorisation granted by the minister enabling prescriptions to be issued by visiting health professionals. The ability to authorise visiting health professionals to obtain substances by wholesale is likely to be more frequently used. For example, such an authorisation could be used to enable visiting doctors to replenish their supplies of therapeutic substances which are readily available to members of the public over the counter at any pharmacy.

An authorisation made by the minister under clause 9 will be able to specify the range of substances that could be prescribed, or obtained by wholesale, by a visiting health professional who is the subject of the authorisation. This would enable substances about which there may be a particular concern to be excluded from the scope of the authorisation. Finally, subclause 9(4) effectively limits who may be authorised to issue written prescriptions for restricted substances and drugs of addiction to visiting doctors and dentists.

Clause 10 enables the minister to authorise visiting health professionals to refer visitors for diagnosis and therapy by a person who is licensed to use irradiating equipment under the Radiation Safety Act 1975. Facilitating such referrals is particularly relevant in the context of major sporting events.

Clause 11 sets out a number of exemptions from committing offences under certain Western Australian laws. These exemptions are consequential on the authorisations granted by, or under, the Bill to visiting health professionals and others. Relevantly, the clause provides that a visiting health professional does not commit an offence against a health registration Act for providing health care services as authorised by the Bill. Exemptions from committing offences under the Poisons Act 1964 and the Misuse of Drugs Act 1981 are also provided for certain visiting health professionals who possess, use, or supply therapeutic substances in the course of providing health care services to visitors. Effectively, this exemption applies to the possession, use and supply of substances by visiting doctors, dentists and pharmacists, but only if the substances can be lawfully possessed, used and supplied by a registered medical practitioner, dentist or pharmacist in Western Australia; and the possession, use and supply of substances which are either lawfully imported into Australia or are lawfully obtained while in Australia. The reference to the lawful importation of substances accommodates the importation of therapeutic substances by teams participating in major sporting events in Australia, which is permitted under the Commonwealth's therapeutic goods regulations. Certain drugs to which the Misuse of Drugs Act applies are accessible by registered medical practitioners for therapeutic use in Western Australia.

Access to these substances by visiting doctors could be authorised by the minister under clause 9. The clause 11 exemption

As I indicated earlier, clause 12 limits the operation of authorisations under the Bill to periods of time notified in the minister's special events order under clause 6. It also makes clear that authorisations do not have effect if a visiting health professional fails to comply with the provisions of the Bill, regulations made under the Bill, or any conditions imposed by, or under, the Bill.

Clause 13 provides that a complaint may not be made about a visiting health professional to the relevant health registration board, nor can the board take disciplinary action against a visiting health professional. As visiting health professionals are not registered with the relevant health registration board, it is inappropriate for boards to have a role in dealing with complaints about them. However, the clause also makes clear that this does not prevent proceedings being brought against a visiting health professional for an offence against a health registration Act. This is to ensure that a visiting health professional can be prosecuted if he or she attempts to provide health care services outside the scope of the authorisation provided by the Bill - that is, to anyone other than a visitor.

Clause 14 enables the minister to determine that the provisions of the Bill do not apply to a specified person or class of person. Such a determination could be made if there is serious concern about the possible consequences of allowing an individual or particular group to provide health care services in Western Australia.

Clause 15 makes it clear that the Bill does not affect the lawful practice of a health professional who is registered as such under Western Australian law. A registered health professional could be engaged to provide health care services to visiting teams. Where this happens, the health professional concerned would provide health care services in accordance with the requirements of the health registration Act under which he or she is registered, and not as a visiting health professional under the Bill.

Clause 16 provides for the making of regulations under the Bill. Clause 17 requires the minister to conduct a review of the legislation after five years and to report the results to Parliament.

The Bill is a modest but important measure which should facilitate attempts to attract major events to Western Australia, and thus help to raise the State's profile around the world. Indeed, competition policy review of the Bill has concluded that Western Australia could be at a competitive disadvantage relative to other jurisdictions in seeking to attract major events if the Bill is not progressed.

As I indicated previously, Western Australian health practitioner registration boards have been consulted about the Bill, and are supportive of it. They recognise that the Bill should have no impact on their core responsibility, which is to protect the public of Western Australia. I commend the Bill to the House and for the information of members, table an explanatory memorandum for the Bill.

[See paper No 250.]

Debate adjourned, on motion by Mr Cunningham.