Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025

Ms WHITE (Lyons—Assistant Minister for Women, Assistant Minister for Health and Aged Care and Assistant Minister for Indigenous Health) (17:14): First, I thank all members for their contributions to the debate on this bill. The Health Legislation Amendment (Miscellaneous Measures No. 1) Bill 2025 does streamline Medicare provider number administrative processes so that health practitioners receive their Medicare provider number sooner.

Schedule 1 of this bill will amend the Health Insurance Act 1973 to enable the Chief Executive Medicare to approve the use of a computer program to make decisions to allow Medicare provider numbers, including validating Medicare provider numbers that were previously issued by a computer program. This will only apply to positive decisions to issue a Medicare provider number, and any decision requiring assessment of a discretionary factor will still be mainly processed by a service officer.

Schedule 1 also confirms that any Medicare provider numbers issued by automation remain valid so there is no impact on health practitioners or their patients for services previously provided. Our government is committed to ensuring that there is a sufficient and sustainable health workforce to meet the healthcare needs of Australians. The Australian government, together with state and territory governments, has committed to implementing all health related recommendations from the independent review of Australia's regulatory settings relating to overseas health practitioners.

This will help to ease the shortage in the health workforce by removing unnecessary barriers and improving and expediting regulatory processes for more overseas health practitioners to commence working in the Australian health system sooner. This bill supports a key recommendation from the review to automate the issuance of Medicare provider numbers. Schedule 1 also confirms the conditions that applicants must meet to be issued an MPN, ensuring the highest standards of healthcare provision are maintained.

I would like to let the House know that Services Australia, the Department of Social Services and the Department of Veterans' Affairs were consulted as part of the drafting of the bill and support this streamlining process. Schedule 2 of the bill amends the Private Health Insurance Act 2007. This is to support processes for claiming the private health insurance rebate upfront through the premium reduction scheme.

The self-assessment process will be supported by postpayment compliance activities. Schedule 3 of the bill makes changes to the Health Insurance Act 1973 and Health Insurance Legislation Amendment (Assignment of Medicare Benefits) Act 2024 to allow finalisation of regulations to modernise and digitise the assignment of Medicare benefits and to delay commencement of the new processes from 9 January 2026 to 1 July 2026 to provide industry more time to ensure the necessary software and system changes can be made.

For simplified billing, the bill enables any eligible person covered by a private health insurance policy to assign Medicare benefits and reduces the administrative burden on providers of privately insured services associated with mandatory notification, without reducing patient access to this information. For bulk-billing, the bill will enable the completion of regulations for enduring agreements to complement the government's primary care payment reforms, such as MyMedicare.

It also provides for a new legislative instrument to be delegated to the Minister for Health and Ageing and Minister for Disability and the National Disability Insurance Scheme to make service information simpler for patients and to inform an assignment decision. Amending the commencement date to 1 July 2026 will be welcomed by stakeholders, who will now have additional time to adopt modern and simplified assignments that benefit the processes, including through updating their software products which are used to manage clinical businesses.

Modernising, simplifying and making assignment of benefit easier for patients and providers will strengthen Medicare now and into the future. I think it's important to note some of those timelines included in this particular bill and the importance of progressing this legislation. Schedule 4 of the bill amends part VD of the Health Insurance Act 1973 to enhance elements of the Bonded Medical Program.

I would like to acknowledge the questions that were put by the member for Nicholls in his contribution, and I provide some answers to those questions that I hope will provide further information. The bill ensures consequences for breaching a condition or for withdrawing from the program and balances the personal circumstances of the bonded participant with the broader interests of the community.

There were questions around further clarification of what this means. We know that, due to the specialisation of some doctors, there is a risk they have breached and, as a consequence, have a ban of six years from billing under Medicare. This is bad not only for them but for patients who might be in need of services that they have been providing, so we are removing this consequence.

We also know that currently, if a medical student withdraws before the census date in their second year, they avoid any debt. What we intend to do, if this bill successfully passes, is to extend that grace period, which would mean that any withdrawal after this date—the census date in year 2 of their medical degree—up until they finish would be regarded as within the period where, if they incurred a debt, it could be waived.

We have circumstances where somebody hasn't completed their medical degree but, under this program, they have a debt raised against them, which could be between $100,000 and $140,000, that they've been asked to repay. This change recognises that, if a student hasn't completed their degree, they shouldn't be required to pay this debt, and this is due to the acknowledgement that personal circumstances change.

There might be a person who is 17 or 18 and commits to a medical degree. They might be embarking on a bonded medical program, thinking that they could continue to complete that degree at that placement, and circumstances change for them. I can update the House and let you know that the cohort is very small with regard to the types of medical students we're talking about here who don't complete their degrees.

However, the impact on them is enormous when they are faced with a student debt of $100,000 or more and they have no qualification to show for it. So we propose this amendment through this legislation to ensure this is fairer. There were questions raised by the member for Nicholls about concerns that doctors won't have to work for as long in rural areas under the changes proposed.

This amendment bill aims to simplify the Bonded Medical Program. The department administers, I understand, about 36 different contracts and different contract types due to the legacy schemes for bonded medical students across a range of different schemes over the last couple of decades. For example, there was a legacy scheme that ran between the years of 2016 and 2019 or thereabouts wherein there was only a need to do one year of a rural placement as part of the return-of-service obligation.

What we are doing here is acknowledging that there are different lengths of time. We are trying to simplify and also be consistent, with a three-year requirement for the return-of-service obligation for those medical students. The explanatory memorandum, in 'Part 3—Bonded Medical Program rules', does explain in detail the reason for this change, which is about more fairly recognising work completed by bonded participants, and I draw the member's attention to that section of the explanatory memorandum.

As the member for Macarthur spoke about in his contribution, these changes to the Bonded Medical Program will make it more flexible and aid any uptake of rural bonded scholarships as an option for medical students. We understand that there isn't as great an uptake as we would like of the rural bonded medical program because there is an inflexibility to the scheme, which we are seeking to address through making these changes which provide for greater consistency and simplification.

Our government is very committed to providing greater access to health services and health care for all Australians, no matter where they live. As a member who also represents a regional electorate, I can empathise with the concerns that were raised by the member for Nicholls and appreciate his interest in ensuring that we provide access to health care to Australians no matter where they live.

He will be very pleased to know that, alongside the good work of the Murray-Darling medical school that he spoke about, our government has also seen an increase in the number of medical students studying right around the country. Since 2022 the government has invested in over 140 new medical Commonwealth supported places, with a focus on training in rural communities.

In 2022 we had 3,095 commenced CSPs; we are looking to increase that to 3,450 by 2028. We've had 80 new commencing CSPs per year and funding for end-to-end rural medical training across six medical schools; 20 new commencing CSPs per year and funding for James Cook University's Cairns medical school; and 40 new commencing CSPs per year and $27.4 million in funding to establish the Charles Darwin University medical school.

And, in the 2025-26 budget, the Australian government committed a further $48.4 million for up to 150 new primary care focused medical student places as one element of our $606 million GP workforce package. There are also the 100 CSPs currently out for tender now that we heard the Minister for Health and Ageing speak about in question time today. They'll be distributed by a competitive process for universities with existing medical schools, and a further 50 new commencing CSPs per year will be on offer from 2028 and open to universities that do not currently possess a medical school.

We also made two commitments in the 2025 federal election to support up to 68 additional medical places at the University of Tasmania and Queensland University of Technology by converting some of their non-medical CSPs. The University of Tasmania will be allowed to provide 20 commencing medical places based in Launceston from 2026, and Queensland University of Technology will be allowed to provide 48 commencing places from 2027, subject to AMC accreditation of its proposed medical school.

We are training more doctors than we have ever before. There are record numbers this year compared to last year, and we are hopeful that next year we will see an intake that is even greater than the record numbers we've seen this year. Our government is very committed to training more health professionals, including more doctors; to providing more bulk-billing and more access to urgent care clinics; and, of course, to providing cheaper medicines to Australians.

I understand that the department has offered a briefing to members opposite to support them in getting more information about the Bonded Medical Program. I hope this provides them with further answers to the questions that were raised so that we can have the support of this parliament for this bill. There are some key dates that we need to address so that we can commence this to alleviate some of the pressure on medical students or those who have started a medical degree but haven't finished and have a debt raised against them, not only to streamline and simplify the processes for those who are in the Bonded Medical Program but also to deal with some of those other bulk-billing matters by the automation of some of our systems.

That will allow more time for our general practitioners to have the software in place so that they can commence appropriately from the middle of next year, rather than the start of next year, which is what the timeline currently allows for. This bill would give them more time, and I would expect and hope that all members of this parliament would be endeavouring to support our GPs and GP practices so that they can take full advantage of bulk-billing provisions to support patients across the country.

I thank everyone who made a contribution to this bill. It is clear how important affordable access to health care is right across this country, and it was reflected in all of the contributions on this bill. Our government is working very hard to deliver on our commitment to strengthen Medicare, and this bill is another step in that endeavour.

I thank members for their contributions. Question agreed to. Bill read a second time.

Message from the Governor-General recommending appropriation announced.