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  • SKM ECONOMICS RE02006: Draft Final - NCP REPORT HEALTH ACT

    1937 (HAIRDRESSING & SKIN

    PENETRATION).DOC

    i

    Contents

    Executive Summary i

    1. Introduction 1

    2. The Public Benefit Test Process 3

    3. The Existing Legislation 6

    4. Market Structure 10

    5. Public Health Risk Assessment 23

    6. Public Health Costs 39

    7. Assessment of the Existing Legislation (Base Case) 48

    8. Assessment of Reform Options 62

    9. Experience in Other Jurisdictions 95

    10. Conclusions 97

    Appendix A - Summary of Submissions A-1

    Appendix B - Legislative Extracts B-1

    Appendix C - Impact Statement Matrix C-1

    Appendix D - Experience in Other States D-1

    Appendix E - Disease Costing Calculations E-1

  • SKM ECONOMICS RE02006: Draft Final - NCP REPORT HEALTH ACT

    1937 (HAIRDRESSING & SKIN

    PENETRATION).DOC

    ii

    Document History and Status

    Issue Rev. Issued To Qty Date Reviewed Approved

    Printed: 2 September 1999 6:50

    Last Saved: 20 November 2009 1:28 PM

    File Name: \\SKM-BRIS1\VOL1\Plen\WP\Reed\ECON Jobs\Re02006\Finals\RE02006 Final Health Approved.doc

    Project Manager: Alain Pillay

    Name of

    Organisation:

    Queensland Health

    Name of Project: Review of the Hairdressing, Beauty Therapy and Skin Penetration Legislation

    Name of Document: Public Benefit Test Report

    Document Version:

    Job Number: RE02006

  • SKM ECONOMICS RE02006: Draft Final - NCP REPORT HEALTH ACT

    1937 (HAIRDRESSING & SKIN

    PENETRATION).DOC

    i

    Executive Summary

    Introduction

    No modern society is wealthy enough to eliminate the

    societal risk arising from all infectious conditions

    and/or communicable diseases. As a result, all governments

    across the world have made judgements (either explicitly

    or implicitly) regarding the acceptable level of risk to

    the public arising from various activities and the degree

    to which legislation can minimise those risks.

    In the case of hairdressing, beauty therapy and skin

    penetrating activities, societal health risk management is

    implemented through Parts 5 and 15 of the Health

    Regulation 1996.

    The purpose of this report is to set out the findings of

    the public benefit test assessment into the restrictions

    imposed on participants undertaking activities within the

    hairdressing, beauty therapy and skin penetration

    industries (e.g. tattooing, body piercing and

    acupuncture).

    The identification of the causal factors influencing the

    transmission of diseases has proven that regulatory

    measures based on broad industry classifications are

    unwieldy and inappropriate. Mechanisms to minimise

    infectious conditions or communicable disease transmission

    from hairdressing, beauty therapy and skin penetration

    services should focus on the individual activities in

    question.

    Definitions

    The following definitions were used to assist in the

    identification and classification of activities during the

    risk assessment process and have been formed through a

    consensus opinion of what should be captured by any

    legislation seeking to minimise the risks associated with

    these types of activities.

    Skin Penetrating Activities - Any activity involving the

    piercing, cutting, puncturing, tearing or shaving of the

    skin, mucous membrane or conjunctiva of the eye.

    Non Skin Penetrating Activities - Any activity that does

    not fall into the category of skin penetrating activities.

    For the purposes of this study, risk has been defined as

    the potential exposure of the community to the possibility

  • SKM ECONOMICS RE02006: Draft Final - NCP REPORT HEALTH ACT

    1937 (HAIRDRESSING & SKIN

    PENETRATION).DOC

    ii

    of harm arising from infectious conditions/communicable

    diseases.

    Higher Risk Activities - Any risk activity that causes

    blood or other body fluid to be released as a consequence

    of its operation.

  • SKM ECONOMICS RE02006: Draft Final - NCP REPORT HEALTH ACT

    1937 (HAIRDRESSING & SKIN

    PENETRATION).DOC

    iii

    Moderate Risk Activities -

    Any Activity that:

    Has the potential to cause blood or other body fluid to

    be released accidentally; or

    Results in such small quantities of blood or body fluid

    being released that a lower to moderate risk exists; or

    As a result of the equipment being used, mitigates the

    risk of contamination arising from the activity being

    undertaken.

    Lower Risk Activities - Any activity that does not cause

    blood or other body fluid to be released as a result of

    its execution but may still create the opportunity for the

    transmission of infectious conditions or communicable

    diseases through inappropriate infection control

    practices.

    No Risk Activities - Any activity that effectively

    generates no material1 risk of infectious conditions or

    communicable disease transmission.

    The following definitions of non-skin penetrating

    activities were utilised to define the scope of the

    project:

    Hairdressing - The cutting, styling or undertaking of any

    similar activity involving facial or scalp hair for the

    purposes of maintaining or enhancing a persons

    appearance.

    Beauty Therapy - The provision of any non-skin penetrating

    service (excluding hairdressing) for the purpose of

    enhancing a persons appearance (e.g. use of cosmetics).

    It should be noted that the activity based approach to the

    study makes the definitions of particular industries

    redundant for the purposes of establishing a new

    legislative model. This approach was designed to

    facilitate the identification of services provided by

    existing participants. This was done by adopting non-

    prescriptive definitions based on specific tasks or

    functions which enables demarcation based on activity. It

    is recognised that, in practice, some participants in

    these industries undertake activities that span across

    these definitions.

    1 For the purposes of this study, materiality was deemed to mean the risk of any

    activity causing the transmission of those diseases which could in all

    likelihood be transmitted through blood and result in severe sickness or death.

  • SKM ECONOMICS RE02006: Draft Final - NCP REPORT HEALTH ACT

    1937 (HAIRDRESSING & SKIN

    PENETRATION).DOC

    iv

    The Public Benefit Test Process

    The governing principle underlying any legislative review

    is that any legislative restrictions on competitive

    behaviour shall be removed unless it can be shown that:

    the benefits of the restriction to the community as a

    whole, outweigh the costs of the restriction; and

    the objectives of the legislation can only be achieved

    by restricting competition.

    In order to answer these questions, a Public Benefit Test

    (PBT) was undertaken to assess the cost-effectiveness of

    the hairdressing, beauty therapy and skin penetration

    regulations of the Health Act 1937.

    In undertaking a PBT, Queensland Treasury Guidelines2

    stipulate a number of key tasks that should be completed.

    These are:

    clarify the objectives of the legislation;

    identify the nature of the restriction;

    analyse the likely effect of the restriction on

    competition and on the economy generally;

    assess and balance the costs and benefits of the

    restriction; and

    consider any alternative means for achieving the same

    result, including non-legislative approaches.

    The projects methodology embodies these fundamental

    requirements and extended the analysis to incorporate an

    assessment of risk to clients, operators and the broader

    community. This was undertaken in order to identify the

    relative effectiveness of the alternative models under

    consideration.

    The project was completed in two primary stages:

    Risk Assessment; and

    The Public Benefit Test Process.

    The risk assessment stage resulted in the production of a

    separate risk assessment report which forms the foundation

    for the analysis contained in this report. A copy of the

    risk assessment report is provided under a separate cover.

    2 Queensland Treasury - Public Benefit Test Guidelines, 1994

  • SKM ECONOMICS RE02006: Draft Final - NCP REPORT HEALTH ACT

    1937 (HAIRDRESSING & SKIN

    PENETRATION).DOC

    v

    The Existing Legislation

    The current legislation administered by Queensland Health

    consists of:

    Health Act 1937; and

    Health Regulation 1996.

    Sections 33 and 100A of the Health Act 1937 enables Parts

    5 and 15 of the Health Regulation 1996 respectively. These

    parts of the Health Regulation 1996 have the following

    effect on participants within the hairdressing, beauty

    therapy and skin penetration industries:

    requires the licensing/registration of premises at

    which hairdressing, beauty therapy and skin penetration

    activities are conducted, as well as the licensing of

    mobile hairdressing operators;

    prescribes the means of cleaning, disinfecting and

    sterilising equipment and items used in the conduct of

    these businesses;

    prescribe