Patients are being lost under paperwork: report

The health sector is one of the most highly regulated in the Australian economy, a new report claims.

Red tape is slowly strangling the ability of health professionals to provide patient care, according to a new report released last month.

There are also unnecessary disparities in regulation for health care providers between states which cause confusion and increase the barriers to establishing new health care facilities, it found.

The report, ‘The Impact and Cost of Health Sector Regulation’ shows that “regulations, interference and bureaucratic and ministerial discretion had developed beyond a sensible benchmark”.

“The health sector is one of the most highly regulated in the Australian economy and we believe it’s helpful to bring to the attention of governments regulatory impositions that are excessive and add needlessly to costs that are already growing too quickly,” said Neil Batt, executive director of the Australian Centre for Health Research, which commissioned the report.

According to the report, health care providers labour under more than 300 different Acts of Parliament containing 22,6000 pages of combined state and federal legislation.

“We don’t want to weaken regulation of matters critical to standards and safety. However, as the report identifies, regulation in Australia appears to have blown out to include everything that was, at one time or another, a good idea with a raft of unpredicted, undesirable outcomes,” Batt said.

The cost of regulation is also rising, said Julie Novak, one of the reports authors and research fellow with the Institute of Public Affairs.

For example, she said, the total cost of labour for general practice compliance in the area of enhanced primary care has grown by nearly 900 per cent between 2001-02 and 2007-08.

In a submission to the Productivity Commission in 2009, the AMA suggested GPs spend up to nine hours a week complying with red tape obligations. Nursing bodies have also reported nurses spending more time on paperwork than on patient care.

“Bureaucratic burdens feed directly into the three major causes of stress in general practice – excessive workload, the economic factors necessary to run a business, and medico-political factors, that is, the political and regulatory environment within which practices operate,” Novak said.

The increasingly blurred line of responsibility for the funding and service delivery of health between the states and federal government has resulted in health care service providers “grappling with duplicate and overlapping regulation,” the report states.

“NSW alone has 37 different Acts of Parliament, Victoria has 27. The Commonwealth, with no constitutional responsibility for health care service delivery has 59 Acts,” Novak said.

Further, the number of health care regulators interpreting and implementing this legislation is on the rise.

“Each state has between 15 and 20 different health care regulatory agencies and there are also nearly 80 at a Commonwealth level,” Novak said.

The result is that a single health care facility in only one state faces the prospect of having to work with up to nearly 100 different regulating entities, the report said.

As a consequence, it said, health care providers are required to invest significant resources toward regulatory compliance, and often duplicating the same material for state and commonwealth regulators.

“Health regulation in Australia has become a nightmare,” Novak said.

From health practitioners there is little argument about the need to alleviate red-tape burdens.

“Many of the regulations that exist in health serve very little identifiable benefit beyond giving a broad sense of confidence to the public. But, in the process, costs are raised, impinging on the quality or degree of access of health care services,” Novak said.
According to the authors, regulatory reform in health care cannot be instigated soon enough.

“Cutting regulation will be crucial to ensure private providers can ease demand strain on health services by an ageing population,” Novak said.

The ACHR is calling on governments to reduce the burden of excessive health care regulation. Not regulation which protects quality and standards, but regulation that is unnecessary.

“Every dollar spent on needless compliance or paperwork for doctors and nurses results in less money or time spent on improving or extending the lives of Australians,” Novak said.

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