This paper provides information for local health districts, hospitals, professional associations and other prescribed establishments wishing to obtain qualified privilege for their quality assurance committee under Division 6B of the Health Administration Act 1982 and the Health Administration Regulation 2015.
The following information is not designed to replace the information set out in Division 6B of the Health Administration Act 1982 and the Health Administration Regulation 2015. It provides a brief summary to assist in understanding the key points of the legislation. You should refer to the Act and the Regulation for precise requirements.
In health care, quality assurance (more commonly known as quality improvement) refers to activities and programs intended to assure or improve the quality of care in a health service.
Quality assurance is a continuous cycle of evaluating clinical care. To achieve this, the quality assurance committee should:
Quality assurance embraces a wide range of activities such as audits of surgical or perinatal mortality rates and reviews of adverse events.
More information on quality improvement and quality improvement methodology can be found in a range of publications.
Quality assurance does not involve:
There is support amongst health care professionals and consumers for open and positive participation in quality assurance activities. Some people however, may be discouraged from participating in quality assurance activities because of the fear that:
The underlying aim of the quality assurance legislation is to provide an atmosphere of confidence and security that will encourage clinicians, managers and others to communicate openly and honestly in assessing themanagement, processes and outcomes of health services.
The provision of qualified privilege for quality assurance committees is designed to encourage health care professionals to participate in quality assurance activities by providing for:
The legislation grants qualified privilege to the documents and proceedings created by or solely for an approved quality assurance committee. This means that documents such as patient medical records and databases that are created for use outside of the Committee are not covered by qualified privilege.
Present and past Committee members must not divulge information acquired as a committee member or the content of discussions of the Committee. Past and present members cannot be forced to give evidence on these matters in legal proceedings.
The grant of qualified privilege does not apply beyond the Committee.
It is not mandatory for a Committee undertaking quality assurance activities to seek qualified privilege under the Act.
Committees considering applying for qualified privilege should consider the need for qualified privilege and be convinced that it is required before making an application.
The role of the Committee is to assess and evaluate services, to report and make recommendations about those services and to monitor the implementation of the recommendations.
The Committee is required to prepare three reports as outlined in the table on page 2.
The Committee must not conduct an investigation about the competence of a clinician nor reveal the identity of a clinician or a patient unless he/she has consented in writing to their identity being revealed.
At all times the Committee must operate under the principles of natural justice.
The training and experience of the members of the Committee must be relevant to the service/s being examined. As members of a Committee may change for various reasons details need only be provided of the criteria for Committee membership such as a specialist medical practitioner in pediatrics or a registered nurse with at least five years experience in nuclear medicine.
There is clearly a strong public interest in ensuring that the health system provides high quality health care. If reviews of health services are impeded by the lack of participation by health care professionals then there is a public interest need to remove the known barriers to their participation. This is the basis for arguing that there is a public interest in maintaining the confidentiality of information generated by quality assurance committees, if that confidentiality is essential to the participation by health care professionals.
This public interest should however, be balanced against the community's interest in accessing information about health services.
Committees seeking qualified privilege must be able to show that:
Quality Assurance Committees
Of the members of a Committee, one is to be elected as chairperson by a majority of those members
A decision supported by a majority of the votes cast at a meeting of a Committee at which a quorum is present is the decision of the Committee.
The procedure for the calling of meetings of a Committee and for the conduct of business at those meetings is, subject to the Act, this Regulation and any rules of the prescribed establishment that established the Committee, to be as determined by that Committee.
In this Division:
Committee means a Committee declared to be an approved quality assurance Committee under section 20E.
Prescribed Establishment means:
Service means a health service, and includes any administrative or other service related to a health service.
A person who is or was a member of a Committee must not make a record of, or divulge or communicate to any person, any information acquired by the person as such a member, except:
Maximum penalty: 50 penalty units.
A finding or recommendation by a Committee as to the need for changes or improvements in relation to a procedure or practice is not admissible as evidence in any proceedings that the procedure or practice is or was careless or inadequate.
The regulations may make provision for or with respect to: