Schedule 1

Medicare principles and commitments

Current

Sections 3 and 5

Part 1 Medicare principles

The Commonwealth and the States are committed to the following principles in the provision of public hospital services:
Explanatory Note:	The Principles focus on the provision of public hospital services to eligible persons, but operate in an environment where eligible persons have the right to choose private health care in public and private hospitals supported by private health insurance.
Choices of services
Principle 1:	Eligible persons must be given the choice to receive public hospital services free of charge as public patients
Explanatory Note 1:	Hospital services include in-patient, out-patient, emergency services (including primary care where appropriate) and day patient services consistent with currently acceptable medical and health service standards.
Explanatory Note 2:	At the time of admission to a hospital, or as soon as practicable after that, an eligible person will be required to elect or confirm whether he or she wishes to be treated as a public or private patient.
Universality of services
Principle 2:	Access to public hospital services is to be on the basis of clinical need
Explanatory Note 1:	None of the following factors are to be a determinant of an eligible person's priority for receiving hospital services:
	- whether or not an eligible person has health insurance;
	- an eligible person's financial status or place of residence;
	- whether or not an eligible person intends to elect, or elects, to be treated as a public or private patient.
Explanatory Note 2:	This principle applies equally to waiting times for elective surgery.
Equity in service provision
Principle 3:	To the maximum practicable extent, a State will ensure the provision of public hospital services equitably to all eligible persons, regardless of their geographical location
Explanatory Note 1:	This principle does not require a local hospital to be equipped to provide eligible persons with every hospital service they may need.
Explanatory Note 2:	In rural and remote areas, a State should ensure provision of reasonable public access to a basic range of hospital services which are in accord with clinical practices.

Part 2 Commitments

In order to achieve principles 1 to 3, the Commonwealth and States make the following commitments regarding public hospital services for eligible persons:
Information about service provision
Commitment 1:	The Commonwealth and a State must make available information on the public hospital services eligible persons can expect to receive as public patients
Explanatory Note 1:	The joint Commonwealth/State development of a Public Patients' Hospital Charter for each State will be a vehicle for the public dissemination of this information.
Explanatory Note 2:	The Charter will set out the public hospital services available to public patients.
Efficiency and quality in service provision
Commitment 2:	The Commonwealth and the States are committed to making improvements in the efficiency, effectiveness and quality of hospital service delivery
Explanatory Note:	This includes a commitment to quality improvement, outcome measurement, management efficiency and effort to integrate the delivery of hospital and other health and community services.

This Act’s bill:Explanatory notes Second reading speech

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