Michael Roff, APHA Chief Executive Officer

In my report last year, I said that 2011 had been a “politically dramatic” year where proposals to means-test private health insurance rebates dominated the policy scene for APHA.  I mentioned the sensational events

of the last sitting day where the change in Speaker altered the numbers on the floor of the house.

History now shows these events were critical in the Government securing the passage of its means-testing legislation in March this year with the support of the independent MP, Rob Oakeshott, who gave the Government the one-vote margin they needed.

The speaker at the time, Peter Slipper, actually sent a letter of apology to his electorate, explaining that he did not support the policy of means-testing but was precluded from voting as he was presiding as speaker at the time the vote was taken.

Ironically, Mr Slipper was forced to step aside as Speaker a matter of weeks after the final vote was taken (he subsequently resigned the post in October), meaning the Government had luckily exploited a very narrow window when they actually had the number to pass this legislation.

Although means-testing commenced on 1 July this year, a loophole in the legislation allowed people to pre-pay premiums for 12 months or more and retain the full rebate.  APHA was instrumental in helping to publicise this loophole, which has resulted in the full impact of means-testing being deferred until the middle of 2013.

The federal Opposition has committed to repeal means-testing of the rebate should they win the next election.  However, they are yet to put a timeframe on this undertaking, which remains a topic of discussion.

In further desperate attempts to find savings to achieve a Budget surplus which appears unlikely to materialise, the Government launched further attacks on the rebate in the Mid-Year Economic and Fiscal Outlook (MYEFO) released in October. The measures change the indexation arrangements for the rebate, so that its value erodes cumulatively over time.  Unlike means-testing, these changes will hit every health fund member, regardless of their income.

And of course, any savings from this exercise are illusory, as these measures do not make healthcare costs disappear. In reality they just shift the cost from one bucket to another. If private care becomes unaffordable, healthcare costs transfer back to the public system and it is instead paid for by the taxpayers.

Initial discussions indicate this measure would not pass the current Parliament. However, as the measure is not due to start until 2014, in theory the Government could delay legislation until after the next election.

Speaking of which, the one certainty is that there will be a federal election held at some stage next year, and this will involve significant activity for APHA on the policy and advocacy front.

In 2012 we continued to work within the new structures created by health reform process.

Following the establishment of the Australian Commission for Safety and Quality in Healthcare as a permanent statutory body, APHA Director Christine Gee was appointed to its new Board.  We engaged closely with the Commission on the implementation of the new National Safety & Quality Health Service Standards, which come into effect from 1 January 2013.  In the middle of the year we raised concerns about a lack of clear communications in relation to the new Standards, which led to the Commission establishing a Standards Advice Centre to  help ensure health services have a consistent and shared understanding of the NSQHS Standards.

On a related issue, we have also been working with the Department of Health and Ageing to revise 2nd tier arrangements to harmonise accreditation requirements with the NSQHS Standards.

We provided submissions to the Independent Hospital Pricing Authority (IHPA) on Activity Based Funding. IHPA published its “National Efficient Price” which is the first stage in a transition to activity based funding for public hospitals that is planned to take until 2017. There is a growing view that this process will remove incentives for public hospitals to engage in the pernicious practice of chasing private patient revenue.

The National Health Performance Authority (NHPA) was established to monitor and report on the comparable performance of Local Hospital Networks, public and private hospitals, and primary health care organisations.

In 2012, APHA entered a series of discussions around key issues including developing a reporting framework for private hospitals, identifying appropriate indicators to be reported by private hospitals, ensuring NHPA processes do not impose any additional burden on private hospitals and seeking a rationalisation of existing reporting requirements.

The Association enjoyed another strong financial result due both to growing membership and control of expenditures.  An Extraordinary General Meeting in April approved amendments to our Constitution which provide for APHA to utilise available technology in attending to statutory communications with Members.  This allowed us to use online voting for the first time in the Council elections conducted in August.

There were a number of changes in the Association’s staff in 2012. We farewelled Dr Barbara Carney, who has made a significant contribution to the sector as APHA’s Director, Policy and Research. Barbara was replaced in June by Lucy Cheetham, who has quickly proved to a key intellectual asset.  Our Communications Officer, Rebecca Angove left to find fame and fortune in London and her successor is Lyndal Bailey. Other changes saw Andrea Versteegen, Saba Khan and Jodie Bremer join the admin team.

I would like to thank all of the staff in the secretariat for the support they provide to me on a daily basis and their dedication to providing the best possible representation for our members.

Details of changes in the Board and Council are contained in the President’s report.  I join Chris in thanking our Directors, Councillors and Taskforce members who unselfishly volunteer their time for the greater good of the private hospitals sector.