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Wednesday, 10 March 2010
Page: 2182

Mrs D’ATH (7:15 PM) —19:14:59 I rise to speak in support of the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010. The purpose of the Healthcare Identifiers Bill 2010 is to establish a national Healthcare Identifiers—HI—Service and set out arrangements for the operation of the service and its functions, which will be to assign, issue and maintain unique healthcare identifiers for individuals, healthcare providers and healthcare provider organisations. This bill will ensure establishing arrangements for their management. The bill will establish arrangements for operating and maintaining the Healthcare Identifiers Service, including the conferral of functions on the Chief Executive Officer of Medicare Australia. These functions include assigning, collecting and maintaining identifiers for individuals, individual healthcare providers and organisations by using information already held by Medicare Australia for its existing functions; collecting information from individuals and other data sources; developing and maintaining mechanisms for users to access their own records and to correct or update details; using and disclosing healthcare identifiers and associated personal information for the purposes of operating the Healthcare Identifiers Service; and disclosing healthcare identifiers for other purposes set out in the bills.

Importantly, the Federal Privacy Commissioner will provide independent regulation of how healthcare identifiers are handled and the operation of the Healthcare Identifiers Service. This will include handling complaints against Medicare Australia, as a service operator, and private sector healthcare providers. The Healthcare Identifiers (Consequential Amendments) Bill 2010 will ensure the Healthcare Identifiers Bill 2010 once enacted operates appropriately and effectively. This will be achieved by making minor amendments to the Health Insurance Act 1973 to authorise the Chief Executive Officer of Medicare Australia to delegate functions to officers to support the day-to-day running of the Healthcare Identifiers Service. In addition, minor amendments to the Privacy Act 1988 will provide for the Privacy Commissioner’s role as the independent regulator of the Healthcare Identifiers Service.

The establishment of the HI Service through these bills is an important step forward in health reform throughout Australia. The Rudd government has consistently argued that a national approach is needed to ensure the frameworks and key infrastructure components are coordinated and aligned across Australia. It is hoped that those on the other side of this chamber will support these bills and recognise the importance of this move towards e-health. I am pleased to hear that some of the speakers from the other side have already stated that they will support these bills. To do otherwise would fail their commitment made in February 2006 through COAG when funding was agreed towards the foundations for a national electronic health record system to allow for safe and secure communication between healthcare providers regarding their patients’ health information.

On 28 November 2008 COAG reaffirmed the earlier decision and agreed to universally allocate the individual healthcare identifier and to provide $218 million in funding to the e-health work program. In the National Partnership Agreement on E-Health it was agreed between the Commonwealth, states and territories that the key objective of the national Healthcare Identifiers Service, to be known as the HI Service, is to provide a national capability to accurately and uniquely identify individuals and healthcare providers to enable reliable, healthcare related communication between individual providers and provider organisations. The HI Service will underpin the development of a nationally consistent electronic health system by removing technological and organisational impediments to the effective sharing of health information resulting from poor patient and provider identification.

The identifiers are a fundamental key building block for a national e-health system. These bills not only will ensure the ability to meet the objective laid out in the National Partnership Agreement on E-Health but also start the process of adopting some of the key recommendations made in the final report of the National Health and Hospitals Reform Commission. In that report the commission identified actions that can be taken by governments to reform the health system under three reform goals: firstly, tackling major access and equity issues that affect health outcomes for people now; secondly, redesigning our health system so that it is better positioned to respond to emerging challenges; and, thirdly, creating an agile and self-improving health system for long-term sustainability. In achieving the third goal, the commission grouped the recommendations under five levers of reform to support a system adaptive and responsive to changing needs. The third lever to support an agile, self-improving system is a smart use of data, information and communication. The final report recommended a transforming e-health agenda to drive improved quality, safety and efficiency of health care. The report also stated that the introduction of a person controlled electronic health record for each Australian is one of the most important systematic opportunities to improve the quality and safety of health care, reduce waste and inefficiency and improve continuity and health outcomes for patients.

In fact, the final report of the National Health and Hospitals Reform Commission recommended the introduction of identifiers by July 2010. That is what this bill seeks to establish. E-health has the potential to improve patient safety and health outcomes. Such outcomes should be paramount in any consideration of health reform. If there was any doubt in this parliament or in the community about the necessity for this move, we need only look at the facts. It is estimated that 30 to 50 per cent of patients with chronic diseases are hospitalised because of inadequate care management. It is estimated that up to 18 per cent of medical errors are attributed to inadequate availability of patient information. Between nine and 17 per cent of pathology and diagnostic tests are unnecessary duplicates.

Putting aside the politics, the facts speak for themselves. COAG, both under the previous government and the Rudd Labor government, recognised the importance of a move to e-health. The National Health and Hospitals Reform Commission recognise the need for the implementation of e-health. The final report of the commission showed the stark reality if no action is taken to change the way health and hospitals are funded and administered throughout Australia. The report states that, if we continue to provide health services on the basis of ‘business as usual’ with no policy change, our health and aged-care costs are forecast to rise sharply from around nine per cent of GDP now to 12.4 per cent of GDP a little over two decades from now. In dollar terms, we are talking about a shift from $84 billion in 2003 to $246 billion in 2033.

The need to address the strain on the current health and hospital system in Australia and the future demand of the system was further emphasised in the Intergenerational report: Australia to 2050 - Future Challenges. This report highlighted the important issues of an ageing population, escalating pressures on the health system, and the environmental and economic challenges of climate change. The report noted that the proportion of Australia’s population aged 65 and over is projected to almost double over the next 40 years. The report stated that today there are five working-age people for every person aged 65 and over but by 2050 this will be almost cut in half—down to only 2.7 people. With a large ageing population within the electorate of Petrie, it is clear to many in my communities, including the health professionals, that we need to act. I am certainly pleased that the many health professionals in my electorate that I have spoken to recognise the need for and support the transition to e-health.

Kevin Rudd as leader of the Labor Party in 2007 and as the Prime Minister since the Rudd Labor government came into office has acknowledged the need for health reform and has committed to such reform. The member for Herbert was saying how he is disappointed, stating that he believes the government has taken 28 months to do nothing. Upon coming into office, the Rudd government immediately set to work on its commitment to the Australian people to reform the health and hospital system across Australia. In the very month that the first parliament of the new Rudd government was formed, February 2008, the Prime Minister and the Minister for Health and Ageing announced the establishment of the National Health and Hospitals Reform Commission. The commission was established to develop a long-term health reform plan for a modern Australia. Dr Christine Bennett, Chief Medical Officer at MBF Australia Ltd, was appointed as the chair of the commission, with nine other commissioners being appointed to assist Dr Bennett.

The commission undertook 16 months of intense discussions, debate, consultation, research and deliberation in their dedication to the cause of strengthening and improving our health system for this and future generations of Australians. On 30 June 2009, the commission presented the Minister for Health and Ageing, the Hon. Nicola Roxon, with more than 100 recommendations to transform the Australian health system. As Dr Christine Bennett noted in her letter to the minister in delivering the report:

Health reform does not happen overnight. It takes time and patience, commitment and goodwill from all of us. But we also believe that there is a pressing need for action, and health reform must begin now.

In September 2009, the government, including the Prime Minister and the Minister for Health and Ageing, set about consulting widely through health and hospitals reform roundtables across the country to gauge the opinions of doctors, nurses and allied health professionals on the recommendations with the final report. In all, over approximately four months, the government held 103 consultations.

On 3 March 2010, the Rudd government announced major structural reforms to Australia’s health and hospital system. The government announced that we would deliver better health services and better hospitals by establishing a National Health and Hospitals Network. This new national network will be funded nationally and run locally. These reforms represent the biggest changes to Australia’s health and hospital system since the introduction of Medicare, and one of the most significant reforms to the federation in its history.

There will be a national network, to bring together eight disparate state run systems with one set of tough national standards to drive and deliver better hospital services. It will be funded nationally, and by taking over the dominant funding role in the entire public hospital system the Australian government will end the blame game, eliminate waste and shoulder the burden of funding to meet rapidly rising health costs. Systems will be run locally, through local hospital networks bringing together small groups of hospitals, where local professionals with local knowledge are given the necessary powers to deliver hospital services to their community.

The Commonwealth will achieve these changes through the following actions: taking 60 per cent of funding responsibility for public hospitals by investing one-third of GST revenue—currently paid to the states and territories—directly in health and hospitals; taking over responsibility for all GP and primary healthcare services; establishing local hospital networks run by health and financial professionals which will be responsible for running their local hospitals, rather than central bureaucracies; paying local hospital networks directly for each hospital service they deliver, rather than just handing over block funding grants to the states; and bringing fragmented health and hospital services together under a single National Health and Hospitals Network, through strong transparent national reporting.

These reforms will be put to the states and territories at the COAG meeting to be held in Canberra on 11 April. The Commonwealth wishes to work with the states and territories to reach agreement on these reforms. However, if agreement cannot be reached the Prime Minister has stated that the government will take this reform plan to the people at the next election—along with a referendum by or at that same election to give the Australian government the power it needs to reform the health system.

The new National Health and Hospitals Network will end blame shifting and cost shifting, and provide national leadership on health and hospitals with increased local control. Yet, the member for Herbert says we have been doing nothing for 28 months. Sweeping changes to the way hospitals are funded and run will also lead to less waste and duplication and a health system which is sustainable into the future. On the basis of these reforms, over the coming weeks and months the government will announce critical additional investments to train more doctors and nurses; increase the availability of hospital beds; improve GP services; and introduce personally-controlled electronic health records. The establishment of the National Health and Hospitals Network builds on record investments in health and hospitals made by the Rudd government over the last two years.

Already underway under the Federal Labor government in just two years is an agreement for health and hospitals funding over the next five years—a 50 per cent increase on funding under the Howard government—including training more doctors and nurses. This is the largest ever investment in the health workforce. This government has increased GP training places to over 800—a 35 per cent increase on the Abbott cap—and increased the number of places for junior doctors to experience working in a general practice setting by 10 per cent this year. We are also upgrading the emergency departments of 37 hospitals around the country. The Rudd government has already delivered more than 62,000 extra elective surgery procedures—64 per cent more than the target of 25,000 procedures.

The government is delivering new elective surgery equipment and operating theatres for 125 hospitals, and 36 GP superclinics are to be built across Australia, including a new superclinic in Redcliffe in my electorate. The government is already investing in our rural and remote workforce—an extra 500 communities and around 2,400 doctors in rural Australia will become eligible for financial support for the first time—and there will be 35 health infrastructure projects including improving 18 hospitals around the country and upgrading 12 medical research and clinical training facilities. Already underway are more residential aged-care places through providing low real interest rate loans.

In contrast the Liberals in government, under the stewardship of the Leader of the Opposition, as then health minister, slashed $1 billion from public hospitals, and they caused a national shortage in the medical workforce by freezing medical student places and capping GP training places, leading to a critical doctor shortage affecting 60 per cent of the population.

Debate interrupted.