Thursday, 16 February 2012
Personally Controlled Electronic Health Records Bill 2011, Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011; Second Reading
Andrew Leigh (Fraser, Australian Labor Party) Share this | Link to this | Hansard source
On 14 December last year, I had the honour of assisting Pat Douglass to sign up to Calvary eHealth as the first patient in the ACT and southern New South Wales. It was a delight to meet Pat Douglass. She is 80, still living independently, a bright person and a wonderful contributor to the north Canberra community. Mrs Douglass had a fall in the street near her home and acquired a brain injury. Her experience of her care and her health records demonstrate why e-health is such an important development. Mrs Douglass was confined to hospital for 10 weeks. After undergoing rehabilitation she returned home, but none of her regular doctors knew that she had been in hospital. None of her doctors knew about her injury or how she had been progressing. Similarly, the hospital was unaware of Mrs Douglass' regular health requirements. Any information on normal medicines or routine check-ups that Mrs Douglass might have required during her time in hospital was not available to the doctors at Calvary.
Mrs Douglass told me that she thought it was a bit ridiculous that none of her doctors could share information about her previous conditions or about her current conditions. It all seemed, to her, to be unnecessarily complex. I could not but agree. Mrs Douglass wanted all of her doctors who look after different aspects of her health to be fully informed. They can be fully informed by being connected to one another through e-health records. I am delighted to host in my electorate of Fraser one of the 12 national projects that are pretesting elements of the personally controlled electronic health record system. I personally was so impressed with the set-up that I became the third person to sign up for Calvary eHealth, just after Mrs Douglass and Calvary CEO, Ray Dennis, who also took the opportunity to sign up at the launch in December. I am a great fan of technology. For the time it was in existence I signed up to the Google Health electronic health system. In principle, that was a great idea. But, as Google learned, you need a consistent system and one which is common across patients and doctors. I am excited by e-health and I am also, in general, excited by the possibilities of technology for our healthcare system. The National Broadband Network will improve access to medical specialists, particularly in rural and regional Australia. That will mean people will get better quicker. It will mean that rural and remote communities will have access to better medical care than they did before the NBN. That is a productivity benefit. That is people getting healthier and getting back to work or whatever they were doing before they fell ill.
E-health records are a great example of how technology can improve health care. It is an easy way for people to be on top of all their health requirements and an easy way for patients to enable their doctors and allied health professionals to share information. Your GP will be able to know what your dietician has recommended. Your chiropractor and physiotherapist will understand the different types of treatments you are undertaking. You will not need to explain your allergies, medicines and immunisations every time you see a different doctor.
E-health records will not contain every single detail but they will contain information people need to be shared between their health providers. A Calvary eHealth record contains the following: a shared health summary, including basic information such as name, date of birth, address, contact details, allergies, immunisations and the medicines the patient is currently taking; a summary of each consultation; medical conditions; referrals; specialist letters; discharge summaries following hospital admissions; diagnostic reports, such as X-ray results; and shared care plans agreed between GPs and participating healthcare professionals.
Looking after the wellbeing of Australians through a terrific health system is what the Labor Party does. This is, after all, the party that created Medicare. Because this government cares about the issues that matter most to Australian families we are implementing e-health. That means that when a member of a family becomes ill they can get the help they need from their local hospital, irrespective of their circumstances or location. It is not going to matter anymore if you are out travelling when you fall ill; your e-health record will be there with you. We are continuing today to make health care more accessible and more affordable, ensuring our modern healthcare system upholds the great Labor traditions of equity, fairness and dignity. The Labor Party is the party of reform, and this is as true in the area of health care as anywhere.
E-health records are particularly important for a number of disadvantaged groups. They are important for young adults who have moved away from home and are finding a new GP. They are important for older Australians, because we tend to have more complex health needs the older we get. They are important to people with lower levels of literacy, who might have more difficulty relaying information provided by one health provider to another.
My electorate is younger than the average Australian electorate. The median age in my electorate is just 33. That is because, in large part, many young people move to Canberra to take advantage of the excellent educational and career opportunities this city has to offer. That also means that many of those young people have moved away from their normal health provider. E-health records will enable them to have their previous GP share the information with their new GP.
Older Australians, as was so well illustrated by the case of Mrs Pat Douglass, might be seeing a gerontologist as well as a GP and a chiropractor or other allied health professionals. They might have a fall and end up in hospital. E-health records will help older Australians to better manage the flow of information between their existing health providers to ensure that nothing gets missed. It will also mean that health professionals are aware of exactly what medications people are taking and will mean there is no mistake in prescriptions where a patient is mistakenly prescribed medications that cannot be taken together.
For Australians who struggle with literacy, there will be less of a need to fill in complex and confusing forms every time they see a new health professional. Instead, they will be able to let their health professionals see the information in their health record and share their medical history without needing to recall complex details. In fact, e-health records will be of benefit right across the Australian community.
I have two young and energetic boys. They always seem to be either catching lurgies or falling off things, so I have spent far too much time over recent years sitting in hospital emergency departments or paediatric wards. If it happens interstate, it is enormously frustrating to have to retell a child's medical history, fill out the same forms again and go back through the same family history that you have gone through with another doctor.
Economists know that sometimes the simplest reforms are the most effective. I have spoken before in this place about the reforms to encourage doctors to wash their hands and the many lives that saved in public hospitals. Similarly, the simple answer of sharing information between medical practitioners will lead to better health care.
I am told that 190,000 hospital admissions each year are due to medication errors. Better sharing of information about current medicines will reduce these sorts of unnecessary admissions, freeing up doctors and emergency rooms for other life-threatening occurrences. Better information sharing can also lead to reduced time and cost spent addressing avoidable medical errors or avoidable degradation of chronic conditions. As demonstrated by the example of Mrs Pat Douglass earlier, Calvary hospital was unaware that Mrs Douglass was taking additional medications and needed to see her specialist during that time. If Mrs Douglass had had an e-health record, all that information would have been available to her doctors. Economists hate waste and duplication. If our health system is sharing more information, we are reducing the amount of time and money spent on unnecessary and duplicated procedures such as diagnostic testing. Put simply, patients will spend less time explaining and more time getting the care they need from their health professionals.
E-health records are also a great development for patients as consumers. It is an opt-in system—I repeat that for the member for Paterson: it is an opt-in system—and that means no-one will be forced to have an e-health record. Opt-in is important for privacy and important for making sure patients understand what they are signing up for.
By making the health records personally controlled and managed by the patients, we are giving power to consumers. Consumers are the ones who will be able to take better management of their own health and will be able to decide whether they show their information to family members and friends and what they do to reduce avoidable adverse events.
We are getting patients to make better informed decisions about their health care and the access to their health records. Patients can also give family members permission to access and share their health records as necessary. Going back to Mrs Douglass: she might have allowed her children to share her information in the event of an adverse health occurrence such as her fall.
This is a great development, but it is a reform that only the Labor Party is brave enough to commit to. The Labor Party is the party of reform and development. We are the party of health reform. We are also the party of equity, making sure that the most disadvantaged in our community are able to access all of the developments technology has to offer. That is true in our rolling out of the National Broadband Network to all Australians and it is true in our providing all Australians with the opportunity to have an electronic health record. This reform is proudly in the Labor tradition.
I would like to take the opportunity here to make a point on a related issue on health. On ABC TV's Q&A program last week, the member for North Sydney mentioned the employees of the Department of Health and Ageing as an example of some of the 12,000 public servants he would like to make redundant if Tony Abbott were to become Prime Minister. The concept of e-health records, and the legislation we are debating now, would not be possible without the hard work of public servants from the Department of Health and Ageing using their knowledge and expertise to come up with a system that is appropriate for the Australian context. Making sure the right privacy controls are in place is the responsibility of those public servants. Monitoring the testing sites and seeing where we can make improvements is the responsibility of those public servants.
Those opposite have said they are going to support this legislation, but apparently they think you can have e-health without a department of health. It does not make much sense to me. The member for North Sydney thinks that, just because there might be no patients taken care of by the department of health directly, the people in the department of health are not performing important work. But it is only through their expertise and their willingness to drive reform that we are able to get health reforms that will save money, save time and produce better health care.
Important health reform and agreements between the Commonwealth, the states and the territories are only possible thanks to the highly experienced public servants who administer these programs and this funding. Many of the public servants performing this work live in my great electorate of Fraser, and I know how hard they work and how devastating it would be for the broader Canberra economy if the coalition were to come to office and make 12,000 Canberra public servants redundant. We saw in 1996 and 1997 what happened when the Howard government came to office, when the Public Service was slashed and burnt to a much greater extent than had been anticipated by John Howard when he was Leader of the Opposition.
I commend the legislation to the House. E-health is an important reform for Australia's future, and maintaining a strong Public Service will ensure that e-health becomes a reality.
Nola Marino (Forrest, Liberal Party) Share this | Link to this | Hansard source
I rise to speak on the Personally Controlled Electronic Health Records Bill 2011. As a member from a rural and regional area, I certainly understand, as members on this side do, the benefits and opportunities provided by e-health. But the issue facing the government is whether it can actually deliver a workable framework for e-health. A timely warning for the government is the UK experience—£12 billion spent on their e-health system since 2005, and it has since been scrapped.
I believe that security, accountability, reliability and transparency are the most important issues we should be considering in relation to this legislation. Both patients and health organisations are dependent on getting the technology and framework right. I know that the health IT industry has expressed concerns about the government's ability to deliver this program by the 1 July target date, as is evidenced by the submissions to the Senate inquiry. For example, the Medical Software Industry Association told the inquiry:
There is evidence of a lack of probity, ineffective governance and an inability to deliver targeted programs.
It also suggested:
The program risks falling into disuse from the very first day of live operation.
I believe the risk to the security of patients' information arises from two avenues: firstly, access by unauthorised persons, and, secondly, the broader cybersecurity risk. The government has to guarantee that this system will under no circumstances give other people access to individual or collective—I think that is a real issue—medical records. I am aware that computer experts have said that the technology needed to guarantee security does not actually exist. I note the measures mentioned in the bill focus on managing the process after the records have been accessed and place this responsibility on healthcare bodies. Well, the damage will have already occurred for the patient at that point.
I am sure everyone in this place is aware of how important the doctor-patient relationship is and how important the issue of confidentiality is. The AMA's submission to the Senate inquiry said:
Confidentiality is regarded as one of the most important aspects of good medical practice.
… … …
The integrity of the confidentiality of the patient medical record is absolutely essential to developing, enhancing, and underpinning the therapeutic relationship between medical practitioners and their patients. This confidentiality secures the necessary trust and openness that characterises the ongoing communication between doctors and their patients to optimise patient care.
There is no doubt that this trust between doctor and patient fundamentally underpins the integrity of our health system. People have to have complete confidence that the personal information they share with their doctor will always remain private.
Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source
The debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour.