Private Health Insurance (National Joint Replacement Register Levy) Amendment Bill 2026

Ms ROBERTS (Pearce) (17:39): The incorporated speech read as follows— The National Joint Replacement Registry is one of Australia's quiet success stories in health care. Administered by the Australian Orthopaedic Association, it collects information from virtually all relevant hospitals across the country to define, improve and maintain the quality of care for people receiving joint replacement surgery.

Its value is not abstract. The registry improves clinical effectiveness by tracking long-term outcomes, identifying which prostheses and surgical approaches perform best and giving clinicians the evidence they need to make better choices for patients. It has collected data on more than two million procedures since 1999, with coverage exceeding 99 per cent of 'primary' and 'revision' joint replacements in Australia.

That depth and continuity of data allows us to see, over years and decades, which implants last, which fail, and why. This is real-world evidence that saves patients from unnecessary pain, additional surgery and lost time with family and at work. It also saves the health system money.

Independent analysis finds the registry delivers around $10 in benefits for every dollar spent, with net benefits of roughly $390 million to 2022. The Australian Orthopaedic Association is provided funding to operate the registry through a Commonwealth grant agreement which is efficiently cost recovered through the imposition of a levy authorised by the Private Health Insurance (National Joint Replacement Register Levy) Act 2009.

That levy falls on sponsors of joint replacement devices listed on the Prescribed List of Medical Devices and Human Tissue Products—in other words, the companies that supply these devices into the Australian market. This design is intentional. Those who benefit from the registry's work, including manufacturers whose products are monitored and compared, contribute to its ongoing operation.

At the same time, the cost recovery model ensures that the registry remains independent, clinically led and focused on patient outcomes, rather than commercial interests. The purpose of the Private Health Insurance (National Joint Replacement Register Levy) Amendment Bill 2026 is straightforward: to remove the $5,000 levy cap per device per financial year. Under the current law, no matter how many units of a particular device a company supplies in a year, the levy payable for that device type is capped at $5,000.

That cap was designed with good intentions—to avoid excessive burdens on industry—but, in practice, it has produced an inequitable outcome. The existing levy cap has resulted in smaller and medium sized medical device companies bearing a disproportionate share of the financial burden, while companies that supply large volumes of devices pay comparatively less per unit.

A company that supplies a modest number of implants can quickly hit the cap and then pay no further levy on additional units, whereas a very high-volume supplier effectively pays a much lower levy per device once the cap is reached. This distorts the market. It means the levy is not allocated in proportion to the actual volume of devices supplied.

It also means that the companies doing the most business in joint replacement devices are not contributing proportionately to the system that monitors the safety and performance of those same devices. By eliminating the cap, the amendment ensures the levy is allocated in proportion to the actual volume of devices supplied by the medical device companies. Removing the cap will create a fairer and more equitable distribution of the levy across the industry.

This is important because, as demand for joint replacement grows with an ageing population and increasing rates of chronic disease and obesity, the registry will become even more important to maintaining safe, effective and high-quality orthopaedic care. Australia already sees tens of thousands of hip and knee replacements each year, and those numbers are rising.

Every additional procedure adds to the data that keeps the registry robust, but it also increases the stakes. We must be confident that the implants being used are the best available and that emerging problems are identified early. A well-funded, independent registry is central to that confidence.

It allows the Therapeutic Goods Administration, clinicians, hospitals and patients to see which implant combinations have higher-than-expected revision rates and to act on that information. It supports continuous quality improvement, not just at the level of individual surgeons and hospitals but across the entire national system. The government's continued support for the registry reflects its commitment to evidence based health care, patient safety, clinical quality and the responsible use of private health insurance contributions.

Australians who hold private hospital insurance expect their premiums to be used wisely. They expect that the devices implanted in their bodies are monitored, that poor performers are identified quickly and that clinicians have access to the best possible information when making decisions. The National Joint Replacement Registry delivers exactly that.

It turns routine clinical data into actionable intelligence. It has already influenced practice—for example, by highlighting higher revision rates for certain implant designs and bearing surfaces and by showing where particular patient groups face greater risks. It has supported the expansion of data collection beyond hips and knees to shoulders, elbows, wrists, ankles and spinal disc replacements, reflecting the evolving needs of patients and clinicians.

Ensuring the levy is fairly distributed strengthens the financial base for this work. It means the registry can continue to invest in data quality, timely reporting and the integration of new measures such as patient reported outcomes, which are increasingly important in understanding how people actually feel and function after surgery. This bill is targeted and proportionate.

It does not create a new tax. It does not expand the scope of the levy. It simply removes an arbitrary cap that has produced unintended and inequitable results.

Medical device companies will continue to pay the levy only on devices that fall within the prescribed list. The rate structure remains unchanged. What changes is the total levy payable, which will now reflect the true volume of devices supplied so that larger suppliers contribute in line with their market presence.

For smaller and medium sized companies, this reform levels the playing field. For larger companies, it ensures their contribution matches the scale of their activity in the Australian market. And, for patients, it reinforces the principle that the system that watches over implant safety is funded fairly by those who participate in that market.

In the electorate of Pearce, we see the importance of this work every day. Our community includes many older Australians who have benefited from hip and knee replacements to regain mobility and independence as well as younger patients seeking to return to work and active lives after injury or arthritis. Families in Pearce rely on our public and private hospitals to deliver safe, high-quality orthopaedic care, and they trust that the implants used in those hospitals are monitored rigorously for safety and performance.

Strengthening the funding model for the National Joint Replacement Registry is, in practical terms, a way of standing with those patients and their surgeons and ensuring that the data that protects them remains robust, independent and sustainable. Joint replacement surgery transforms lives. It restores mobility, reduces pain and allows people to return to work, sport and family life.

But, like any surgical intervention, it carries risks, and the quality of implants and techniques matters enormously to long-term outcomes. The National Joint Replacement Registry is a cornerstone of Australia's approach to managing those risks. It is clinically led, nationally comprehensive and internationally respected.

Ensuring its funding model is fair and sustainable is a basic responsibility of this parliament. The Private Health Insurance (National Joint Replacement Register Levy) Amendment Bill 2026 does exactly that. It removes the $5,000 cap so that the levy is allocated in proportion to the actual volume of devices supplied, creating a fairer and more equitable distribution of the levy across the industry.

In doing so, it strengthens the foundation for a registry that will be even more critical as our population ages and demand for joint replacement continues to grow. I commend the bill to the House.