Thursday, 12 November 2015
Health Legislation Amendment (eHealth) Bill 2015; Second Reading
I rise to speak on the Health Legislation Amendment (eHealth) Bill 2015. The Labor Party strongly supports e-health and, in this instance, electronic health records. We recognise the many benefits that can flow from a well-implemented e-health agenda, including delivering efficiencies, empowering consumers, reducing the opportunity for errors, modernising and streamlining processes and reducing duplication. The opportunity for e-health to help drive an improved patient experience and better health outcomes are well known.
Australia's health system has been built largely around paper based systems. This is changing across the country as system administrators identify safer, cheaper and quicker ways to deliver health care, reduce the opportunity for mistakes and allow for improved information sharing across the health system.
There have been too many examples, which we would all be aware of, where mistakes were made in the health system which could have been avoided. Incorrect medication write-ups or incorrect or inadequate patient information can be devastating for both patients and health professionals. E-health systems will not eliminate all of these errors but they can significantly reduce the opportunity for them to occur, improving the quality of care for patients, protecting health professionals and saving an already resource-strapped system from the significant cost of these mistakes.
One of the challenges with the implementation of e-health initiatives has been the slow progress of reform, particularly in the last couple of years. Labor in government saw the many benefits that could flow from a well-thought-through e-health agenda and pursued this during our administration. But, unfortunately, we have not seen the same approach from this government, who initially—unconvinced of the push to innovate and reform in health—chose to review and slow down progress of the electronic health record. The bill we are debating today is late acknowledgement from the government that Labor was right to pursue the program, that it will bring many benefits to Australians accessing health care and that it does provide the opportunity for savings and efficiencies across the health system.
This bill changes the name of Labor's Personally Controlled Electronic Health Record to the My Health Record, following a recommendation from the Royle review. According to the explanatory memorandum, the bill also includes a number of changes to improve the useability of the system and the clinical content available in the system for individuals and healthcare providers. These appear to be sensible changes that Labor does not oppose, so long as these measures ensure the protection of patients' personal information.
In addition to these changes, the bill makes a number of changes to the governance arrangements and the system's useability. The bill also increases the range of enforcement and penalty provisions available for intentional or deliberate misuse, and introduces criminal penalties.
A significant change in this bill is the move to increase the number of eHealth records by moving to an opt-out system where all Australians will be given an eHealth record unless they specifically choose not to have one. The opposition welcomes the fact that the government has accepted the recommendation to begin this process through trials. The minister has confirmed that there will be extensive consultation in areas where opt-out trials are to be run. We support this approach, as it will support informed decision making by people about how they wish to control their personal health information. It is critical to the success of electronic health records over the long term that the community trusts this program, and education, information and informed decision making are all essential if this is to occur. The bill does allow for the government to extend opt-out arrangements nationally, in consultation with the states and territories, if the trials show that this is the preferred approach for improving participation in the My Health Record system. Whilst Labor will support the approach by the government taken in this bill, we do believe that adequately resourcing the eHealth record system and providing the proper incentives will be more important to the overall success of MyHealth records than whether the system is opt-in or opt-out. Labor looks forward to the government publically releasing the evaluation and other relevant information, following the trials, to ensure that trust in the transparency of the program implementation is encouraged.
An important element of eHealth implementation is to adequately deal with the appropriate use of, access to and protection of people's personal health information. The bill also makes changes to the Copyright Act. Specifically, the government is making changes to the Copyright Act that will specify that work will not be infringed where it is done for the following purposes: where the collection, use or disclosure of information is required or authorised under the My Health Records Act; where it is unreasonable or impracticable to obtain the individual's consent to the collection, use or disclosure; and, the entity reasonably believes that the collection, use or disclosure is necessary to lessen or prevent a serious threat to the life, health or safety of any individual, or to public health or safety; where a permitted health situation exists in relation to the collection of health information about an individual; and, where prescribed by the regulations, provided the purpose relates to health care, or the communication or management of health information.
The bill also make a number of technical changes to the Healthcare Identifiers Act. Other changes cover access to information, including allowing healthcare providers that are not currently registered under the national law—that is, the 14 professions covered by the Australian Health Practitioner Regulation Agency—to access personally controlled electronic health records.
The new division 2 clarifies when the recipient of a health service's healthcare identifier, or other information, can be collected, used or disclosed to another party. Division 2 provides that it can be collected, used or disclosed to another party for: assigning a healthcare identifier to a healthcare recipient; keeping a record of healthcare identifiers and related information; providing healthcare to a healthcare recipient, for the purposes of the MyHealth record system; aged care purposes; adopting a healthcare recipient's healthcare identifier; disclosing a healthcare recipient's healthcare identifier; disclosing information about a healthcare recipient's healthcare identifier; and, additional purposes that will be specified in the regulations.
Further changes to the Healthcare Identifiers Act allow the Healthcare Identifiers Service operator to disclose to a healthcare provider information about a healthcare recipient for the purpose of determining the recipient's healthcare identifier. This new section, section 20, broadens the power to allow for future regulations to be made allowing prescribed entities to collect, use, disclose and adopt identifying information and healthcare identifiers. According to the explanatory memorandum, this is only for very limited purposes that relate to the provision of health care or to assist people who, because of health issues, require support. This would mean entities like the National Disability Insurance Agency and cancer registers, and these changes are ones that make sense to the opposition. It is clear that entities and individuals may benefit from the entity being able to associate disability or health-related records with an individual's healthcare identifier.
The bill also allows for the viewing of certain disability or cancer registry records as part of an individual's MyHealth record. This differs from the current situation where entities such as the National Disability Insurance Agency and cancer registers are not authorised to handle healthcare identifiers or identifying information as they are not healthcare providers within the meaning of the Healthcare Identifiers Act. This will allow for the collection of information by entities like the NDIA, as stated in the explanatory memorandum, 'within tight limits related to providing healthcare and assisting individuals who require support because of health issues, without having to amend the Act each time a new entity needs to be authorised'.
I will conclude my remarks by reinforcing Labor's strong support of e-health being pursued as an increasingly important part of a modern, efficient and effective health care system. The opposition is pleased to see that the government has shown some movement to follow in the Labor Party's footsteps in this area of policy. Labor believes that if we are to improve the quality of healthcare provision, improve transparency and control by consumers, protect and support the work of health professionals, and at the same time drive efficiencies across the health system, e-health initiatives are an essential driver to achieving those ends.
There is much more to be done in this area, to learn, and there will be significant changes year after year as advancements in technologies are rolled out. But this bill is a positive step to build on the reforms that Labor introduced while in government just a few years ago.
As a trivia buff I appreciate the irony of a leader of a party in one jurisdiction presiding over the contribution in this chamber of the leader of the opposing party in another jurisdiction! It is probably the first time it has happened.
I thank all senators for their contribution. I would also particularly like to thank the Community Affairs Committee for their work. I ask the Senate to note that the Minister for Health has agreed to look at the Office of the Australian Information Commissioner's recommendations and to use them to inform our public awareness campaign about the opt-out trial. I commend the bill to the Senate.
Question agreed to.
Bill read a second time.