Julian Hill (Bruce, Australian Labor Party) Share this | Hansard source

By any measure the implementation of My Health Record is a debacle. It's a big call to say at the outset, but it is worse than the usual IT stuff-ups we've seen under this government. The ATO outage inconvenienced business and cost the economy millions. The census fail not only inconvenienced the whole of Australia and risked the integrity of the enormously important and expensive endeavour of the five-yearly census but also, relevant to this point, further undermined public trust in data, privacy and the government's IT ability. The NDIA IT stuff-up and robo-debt picking on older Australians were bad enough, but this is a critically important project to get right. It will save lives.

Labor strongly supports e-health and the concept of My Health Record. When it's done properly we hope to see not only tangible healthcare improvements in coordination between practitioners, access to records and saving lives in emergency settings but also money saved in the health system that we can use more productively in other areas to meet growing demand: fewer tests, better and quicker diagnoses, multidisciplinary practice enabled in a much lower-cost environment and fewer prescription errors. It is good if it's done right, but part of doing it right means public confidence. You cannot have a universal system like this without the public being confident in the security of the data, in terms of who can access it, their right to withdraw and all the other safeguards around it. On any reasonable measure the government has failed and continues to fail, because they are not hearing the community concern, and this bill covers only a few of the issues that need to be fixed to restore public confidence.

It is a surprise, member for Batman, that the health minister has not been promoted for this incompetence, because the current Prime Minister was promoted for his incompetence with the company tax cuts and the current Treasurer was promoted for his incompetence with the energy policy—they don't have an energy policy. It is a surprise that the health minister didn't run away from the health portfolio and become the deputy leader and the foreign minister, as Australia knows he wanted to, and nick off overseas. Alas, poor Yorick!

Labor began to deliver a health system when we were in government and that system was opt in. The government changed it to opt out. I understand there are sensible arguments that've been put by the profession for opting out. Fair enough; that's fine. They arrogantly and naively failed when making that decision to make the case to the people, and explain to the public and build confidence about why they were doing that. All of a sudden people woke up, because they hadn't made the case, and said: 'What, all my private medical data is going to be stored in a database? I didn't consent to that. Who can access it?' The minister had no ability to answer the questions. He hadn't thought it through.

The legislative and the regulatory foundation on which this opt-out system rests was the previous design done by Labor for a completely different system. It should not be a surprise to the government, even the minister—arrogant and out of touch that he is, no topic that he couldn't politicise, as we learn in question time every day—given the degradation of public trust in government, in institutions, in data and in privacy that people have opted out. They've botched the rollout.

I say to the House that I opted out in the first few days for three key reasons. The first reason is that I take this stuff seriously. The minister was completely unable to explain the safeguards and the access. To be unkind, he blatantly misled the public. If I were kinder I would say that he had no idea about the detail and just got it wrong—one or the other. He misled the public by pretending that some of the privacy safeguards were in legislation when they were not. They are in regulation that can be changed. The second reason was the issue of availability of information. The controls on the system to insurers were entirely unclear. If I change my mind at some point, like any other Australian, they wouldn't delete my data. The third reason is that I have a presumption, which I'll touch on in a moment, that the data will leak. I believe the data will leak. It will be hacked. That is inevitable in the current era, and there is no clarity on what rights people will have then.

In Singapore the Prime Minister's data was hacked, only a couple of months ago, in a hack to their system. It was a pointed and targeted attack, as he admitted. Singapore is known as having the best-performing public service in the entire world, and that's no exaggeration. The Singaporean public service—their data, their integrity, their systems and their policy development—is absolutely topnotch. People go from all over the world to study how they run their government there. I don't agree with all their policies. Our political systems may have some differences but they are a great partner overall. They are renowned for their public administration and even their system was hacked.

I took a conservative approach, as we've now learnt a million other Australians have, and that figure is climbing. We did offer to work with the government; bipartisanship is entirely desirable. But the minister didn't take that offer up—he knows best. It was public outcry, media pressure and stakeholders that forced this change. But his heart is not in the fix. I had a look at his second reading speech. He still doesn't get it. When introducing this bill, the minister was still claiming that there's nothing wrong. He said: 'There is actually no problem. The system is fine, but I'm going to introduce this bill that we don't even need.' He is doing it because apparently a million Australians were wrong, the doctors were wrong, the nurses were wrong, the lawyers were wrong, the consumer health forum was wrong and the media was wrong—even the member for Goldstein was wrong. Everyone was wrong except the minister.

The minister has decided to legislate to stop a nonproblem that will never happen, according to him. Despite this bill wasting our time, he remains true to his word and loyal to the old scheme. I think it's fair to say that this year the only thing he has been more loyal to than this scheme is Malcolm. I wonder, given that he actually doesn't believe the bill is needed as he told us, whether he'll even vote for his bill. We will find out.

Labor does believe that this bill is necessary, but it's premature. We've said clearly we have to build public confidence in this system. The benefits are enormous—for individuals' health care, to save lives and to save money—but it can only happen if we get it right. We have said we need a pause. We want to work with the government in a bipartisan way. We started this. The government is in charge now. We should do this together and get it right. But to do that, we have to pause it, suspend the rollout and work together. This bill has come before us before the Senate inquiry has even concluded. We haven't even heard what the stakeholders have said. It is not enough and it does not allay community concerns regarding privacy.

Let me quote Kerryn Phelps. If the polls are right, we are going to be hearing a lot more from Professor Kerryn Phelps in this place. She said the government's changes are 'woefully inadequate'. She is the former head of the Australian Medical Association. She said they are just 'minor concessions'.

The shadow minister raised a number of concerns, which have been touched on by other speakers. These are concerns that the bill does not address the real, legitimate issues around family violence. Unless the custodial parent decides to change it and convinces the Digital Health Agency—who apparently are now going to be experts in family violence disputes; good luck with that—to remove access for the non-custodial parent, the non-custodial parent can access the My Health Record. Otherwise, in family violence cases, where usually a woman—sometimes a man, but usually a woman—has fled a violent situation with the kids, the non-custodial parent can access the My Health Record to track down where they are. The government says, 'Oh, that's okay. She can remember to ring up the health agency,' because, of course, you're going to have that on your mind. You will get through on the number, fill out the right forms and press the right buttons when you're fleeing domestic violence. You can ring up and get the access removed, but it might be reinstated—but it might not.

We've heard about the issues of parental access to teenage records. They are sensitive issues. They need to be thought about carefully. The bill completely fails to address these issues. The previous speaker also spoke eloquently on the issue of concerns for workers. People going to a job want a basic health check to check if their back is okay, but all of a sudden the doctor might get other stuff from the medical record and tell the prospective employer. Where are the safeguards around that? This is bill does not address that. This is bad legislative process.

Again, I make the point that if the government is serious about fixing this, we extended the olive branch. I know we did, because I spoke to the shadow minister. I was really concerned about this, because I had constituent emails. I rang her. I said, 'This is a debacle. I'm going to opt out. What are we doing about this?' The shadow minister said, 'We've reached out to the minister. We want to work on this, but he is not up for it.' It is because he is too arrogant.

Let's hear more from Kerryn Phelps. We are going to hear more from Kerryn Phelps, no doubt. She said that we also need to guard against the future monetisation and privatisation of this system. The government, when you say the word 'privatisation', say, 'You're all making it up. It's terrible! We weren't going to privatise Medicare.' We know you were, because we saw the documents. We scared you off for now with the Australian people at the last election. But we are seeing the wholesale privatisation of Australia's visa system. That was all over the front page of the paper today. This is an ideological agenda. Whenever you can get their hands on a public service or something that is clearly in the public interest, to be done in the public sector by the Commonwealth, you try to privatise it. You push it out and think, 'Who can monetise this and make a profit out of it?' That's what you do; it's in your DNA. It's as clear as day that that's what will happen with this system at some point, under one of you in the future, if we don't put in these safeguards now. I agree with Professor Phelps on that point. We also need to think about what access the private health insurers might have. That's not dealt with clearly in this bill.

I will finish on the point I touched on earlier: it is my belief that the data will leak or be hacked. The minister's assures are naive at best. They are suggesting to people that there is no risk, this system is ironclad, it's completely foolproof and no-one is ever going to get into it. I don't think anyone in the community would believe that in the modern era. What happens then? It's not just an issue about politicians; it's an issue for ordinary Australians, not the celebrity sports star embarrassed in the paper routine. When stuff is leaked or hacked, in relation to ordinary Australians, can newspapers report on it? Can people's private medical records, if they're put on the internet, be circulated? Apparently, yes. There has been no consideration of what actually happens in the inevitable situation where this stuff occurs.

I understand the nothing-is-private world view. You do get that, particularly from younger people, who say, 'There's nothing interesting about me. I share everything on social media.' Fair enough; that's a world view. But in the real world there are many people in our community, in the Australian community, for whom real harm and real stigma are caused through the revelation of their private medical records. Mental health issues can stigmatise people and deny them employment, cause extreme embarrassment and further compound their mental health problems. Abortions, terminations, are deeply private matters. Before I opted in to this, I would want to be assured that these things had been thought about and that there were safeguards in place and that people in Australia knew that these things couldn't be reported for individuals in the media if they were leaked. The government has just denied this as a problem. There are diseases and chronic conditions that still carry stigma. They may have nothing to do with your ability to function in the workplace, in the community or in your family, but they carry enormous stigma. I used to watch Embarrassing Bodies on Foxtel, so I know that people do all sorts of things to their bodies that they'd rather remain private. Then there is plastic surgery and botox addiction. They grow or shrink certain bits of themselves. Have a look around the parliament—you never know! What about weekly sexual health checks, as one wag volunteering in the office said: Is that too often? Is that embarrassing? And then there's the case of the man in the Blue Mountains this week and certain surgery. These things are deeply private. When they get hacked, when they're leaked, they do not belong in a newspaper. They should not be able to be circulated. These safeguards should be put in place. The government should take seriously that we're not just standing here being politicians; we're speaking up for genuine views in the community while they're carrying on with their muppet show over there. Sitting here listening to them, there's a quote from The Muppet Show that seems rather apt:

Why do we always come here

I guess we'll never know

It's like a kind of torture

To have to watch the show

You're not taking this seriously. I believe that these things have to be looked at now, before this legislation passes the House or the parliament and before the rollout continues. It's critical if we're going to have real public confidence in this system, which we should all be seeking and which is so important. If we can get it right, we can build trust with the Australian people in the rollout of this system.

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