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Wednesday, 10 March 2010
Page: 2177


Ms HALL (6:41 PM) —I am a trifle confused after hearing the contribution of the previous speaker, the member for Boothby, on the Healthcare Identifiers Bill 2010 and the cognate bill. On the one hand, he said that the opposition will not oppose this legislation; on the other hand, he said it is being referred to the Senate Standing Committee on Community Affairs. Then he said that, when the committee reports back, the opposition reserve their right to make amendments, to oppose or to actually change their position. We on this side of the House know the one thing that those on the other side of the House are good at doing is obstructing, blocking and opposing any piece of legislation.

Despite the opposition saying they will support the legislation, I would not be surprised to come into this House and see the opposition voting against it. That is the one thing that they do—oppose, oppose and oppose. They are never constructive. They never look at things in a constructive way. They are not about improving health, health outcomes and access to health for Australians; rather, they are about opposing any change. Whilst the Rudd government is undertaking the most important overhaul of our health system, since the introduction of Medicare 25 years ago, the opposition are thinking of opposing any proposal that is put forward. This is vital legislation. Its roots were actually in the Howard era. At that particular time the opposition were very gung ho in supporting the introduction of healthcare identifiers. Unlike the Rudd government, they were prepared to race in without proper consultation, without looking at all the aspects and without looking at what the implication might be of the introduction of health identifiers.

The Healthcare Identifiers Bill 2010 will establish a national Healthcare Identifiers Service and set out arrangements for its operation and its function, which will be to assign, issue and maintain healthcare identifiers for individuals, healthcare providers and organisations. It is very vital. If we want to introduce a strong e-health system in Australia that caters for the needs of all Australians and all health professionals and ensures that all Australians get the kind of healthcare they deserve, then e-health is important. And to have a strong e-health system we need to have healthcare identifiers.

The key objective of the Healthcare Identifiers Service will be to provide a national capability to accurately and uniquely identify individuals and healthcare providers, enabling reliable healthcare-related communications between individuals, those people seeking medical treatment, those providing the treatment and the organisations that those providers are associated with. All Australians will be issued with the 16-digit number which will follow them throughout their lives. There are safeguards in place that I will discuss a little later that ensure the privacy of individuals.

A national approach to healthcare identifiers was agreed at COAG in February 2006. I want to emphasis the fact that the Howard government was in power in 2006. At that time, it was 100 per cent supportive of healthcare identifiers and could see the benefit. Now we have an opposition that has serious concerns about it. It may support the legislation but—as I have already indicated—I will not be surprised to see the Abbott opposition come back into this House and do what it always does: oppose, oppose, oppose. It is never constructive. COAG agreed to the universal assignment of identifiers to individuals and to provide $218 million in funding for the e-health work program. It was also agreed that public consultation on the national health privacy process should be conducted. That consultation happened and the outcome was reported to COAG in December last year. This legislation before us today makes minor amendments to the Privacy Act 1998 and the Health Insurance Act 1973 to enable the functions under the Healthcare Identifiers Bill 2010.

As I mentioned earlier, there has been widespread consultation. I will just mention some of the agencies that have been consulted in drawing up this legislation: the Department of the Prime Minister and Cabinet; the Office of the Privacy Commissioner, which should allay the fears that anyone has about privacy; the Department of Human Services; Medicare Australia, who will play a vital role in the administration of this; the Department of Veterans’ Affairs; the Attorney-General’s Department; the Australian Government Solicitor; the Department of Defence; the Department of Broadband, Communications and the Digital Economy; the Department of Families, Housing, Community Services and Indigenous Affairs; the Department of Finance and Deregulation; the Department of Infrastructure, Transport, Regional Development and Local Government; the Department of Innovation, Industry, Science and Research; and the Department of the Treasury. In addition, there has been widespread community consultation and consultation with interest groups outside of government.

When I was first elected to this parliament I was a member of the House of Representatives Standing Committee on Family and Community Affairs and at that time they were doing an inquiry into Indigenous health. A report was brought down following the conclusion of that inquiry titled, Health is life. One of the issues that was apparent to the members of that committee was the fact that e-health was of vital importance if we were to provide an excellent service to people living in rural and remote areas, particularly Indigenous Australians. Here we are, 10 years after that report was tabled in the parliament, and we are gradually moving towards a stage where e-health will be up and operational.

I thought I would just quickly summarise what the Healthcare Identifiers Bill 2010 will do. The bill will establish a Healthcare Identifiers Service to assign and issue unique identifiers to individuals and, as I have said, to all the providers and their organisations. The bill will authorise the chief executive officer of Medicare Australia to be the initial HI Service operator. It will also authorise the CEO of Medicare Australia to use personal demographic information collected for the purpose of administering Medicare Australia’s healthcare benefits program to generate identifiers for the purpose of the HI Service or to disclose the information to any subsequent HI Service operator for the same purpose.

That enables all Australians to be issued with a HI number, and that is going to be the core feature of our e-health system. That must be in place before we can have an e-health system that we can be sure will operate effectively and so we can be sure that the information will not be able to be questioned and the service will be streamlined. The bill will authorise the HI Service operator to collect and use information provided from other sources, such as the Department of Veterans’ Affairs, and to share that information for professional registration and accreditation purposes.

The bill will enable appropriately authorised individual healthcare providers to retrieve an individual identifier or individual healthcare provider identifier. It will enable appropriately authorised individual healthcare providers and provider organisations to disclose certain information to the HI Service operator. It will limit the adoption, use and disclosure of healthcare identifiers and establish penalties for the misuse of healthcare identifiers. In saying that, there are in place appropriate systems to ensure that misuse does not take place.

The bill will provide for the federal Privacy Commissioner to oversee the HI Service, use of identifiers and complaints handling in relation to Commonwealth agencies and the private sector. I am a person who always worries about privacy issues. With the federal Privacy Commissioner being involved and with the safeguards that will be in place, I feel that this system will work and the privacy of individuals will be protected.

The bill will provide for review of the role of the CEO of Medicare as service operator after two years and reporting within three years of the HI Service commencing operation. It will support the arrangements for healthcare organisations to participate in the HI Service. Going back to the point I was just talking about, the HI Service will be supported by robust privacy legislation to ensure protection of individual personal and health information that will continue to underpin quality health care. Ensuring that privacy of individuals is absolutely paramount.

Another important aspect is that a national partnership agreement has been signed by COAG setting out cooperative jurisdictional arrangements for e-health, including for the HI Service. This is the states and the Commonwealth working together to ensure that all Australians have access to e-health services. Underpinning this is the fact that people will be issued with healthcare identifiers.

This is a leap forward. This is moving into the future. This is ensuring that Australia is at the cutting edge of medicine. We have been a lot slower in getting to this stage than other countries have. A Personal Demographic Service, or PDS, with information on over 48 million health consumers has been in the process of implementation in the United Kingdom since July 2004. It will replace a number of locally held databases and put in place a unified scheme. Each person’s PDS card record will comprise demographic information very similar to the type of information that will be attached to the health identifiers as set out in this legislation.

There are a number of benefits in having a national e-health system. It will improve safety and quality of health care and increase involvement of consumers in their own health care. It will improve access for healthcare providers to reliable health information when and where it is needed. It will enhance shared care of complex medical problems and chronic diseases. I will just pause there and refer back to the Health is life report, which I mentioned earlier, brought down after an inquiry conducted by the House of Representatives Standing Committee on Family and Community Affairs. During that inquiry, we visited a number of remote Indigenous communities where many community members had complex medical problems and chronic diseases, and their access to on-the-ground services was limited. It was recognised that being able to use e-health and link into services elsewhere would really improve the health outcomes of people living in those communities. So it will be a real benefit to people living in remote areas.

An e-health system will reduce the burden on Australia’s health sector through better health management. I do not think there is anyone who works within any health system in Australia that would argue against e-health and the need for e-health. It will be a streamlined process that creates efficiencies and ensures that all Australians can get the best health care in the most efficient way. It will also ensure that the organisations providing the health care can share information. It is an innovative way to improve health sector productivity, and we are always looking to improve health productivity.

As has already been noted, the third Intergenerational report and the final report of the National Health and Hospitals Reform Commission have recently been brought down. Both those reports state that we need to prepare our health system for the needs of the coming decades. There will be more people with complex medical needs. We cannot go on as we have in the past. It cannot be business as usual. We need to ensure that our health system is up to the task of caring for all Australians into the 21st century. We need to make sure that we are at the cutting edge. We need to make sure that we cut down on the duplications. We need to make sure that health care and health services are delivered efficiently, and that can only be done if we utilise e-health.

With the improved health care that e-health enables and by ensuring that resources are directed to where they are most needed, which will happen through the utilisation of e-health, we will get better outcomes. Lives will be saved through better decisions, better support, increased access to information and a reduction in adverse events. This is a win-win situation.

As I mentioned earlier, the only concern I had initially was about privacy. Having read the details and having been assured that there will be a proper framework in place to ensure the privacy of all Australians and penalties if anyone looks to breach those privacy requirements, I am quite comfortable with the legislation that we have before us. Putting in place the health identifier service is the starting point for an e-health system that is uniform throughout Australia. It is vitally important for the health of all Australians. I encourage the opposition not to change their position but to get behind the legislation and support it and not oppose it just so they can oppose legislation.