For those who still have an appetite for health reform reading (are there any of you still standing??), here is some more…

The Parliamentary Library has just published this digest of the bill that is curiously named National Health and Hospitals Network Bill 2010 but is really about establishing the Australian Commission on Safety and Quality in Health Care as a Commonwealth statutory body.

The paper (see more from it at the bottom of the post) raises questions about whether the Commission will have the power to implement system wide improvements in health care and says the legislation is also silent on the proposed linkages between the various governance authorities to be established under the National Health and Hospitals Network (NHHN).

“This combined with the lack of power of the Commission could potentially hamper the Commission’s important role in improving in improving the safety and quality of Australia’s healthcare system,” the paper says.

For more reading about the Commission, here is the report recently tabled by a Senate committee. (The Opposition has signalled its intention to oppose the Bill in the House and the Senate, arguing that it creates additional bureaucracy without real reform.)

Meanwhile, this bill may be called Federal Financial Relations Amendment (National Health and Hospitals Network) Bill 2010 but it is really about establishing the nuts and bolts of the NHHN.

The Parliamentary Library paper on the Australian Commission on Safety and Quality in Health Care notes that the limitations of the establishing the Commission without regulatory power is illustrated by the history of sentinel event reporting.

The paper says:

A national list of core sentinel events was agreed with all jurisdictions at the Australian Health Ministers Conference (AHMC) in 2003. Jurisdictions also agreed that sentinel events would be publicly reported by the end of 2005. A report about sentinel events in Australia during 2004/05 was published by the Australian Institute of Health and Welfare (in conjunction with the Safety and Quality Council) in 2007.

To date, there have been no subsequent publications of this report and information about sentinel events are not included the ‘Australia’s hospitals’ statistical series published by the Australian Institute of Health and Welfare.

A review of jurisdictions health department’s websites reveals that there is no national consistency when reporting sentinel events. The timeliness of reporting also varies as does the inclusion of data from private hospitals.

This is despite agreement on the public reporting of sentinel events by Health Ministers at AHMC in 2003. Questions could be asked about the accountability for decisions made by Health Ministers through the AHMC.

Further questions could also be asked about the appropriate framework to ensure consistency. The proposed legislation does not appear to address these concerns or establish a framework that might facilitate greater accountability. This perhaps is a lost opportunity to ensure a national approach to quality and safety in health care.

Let’s hope not…