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Thursday, 11 March 2010
Page: 2222


Mr CIOBO (9:29 AM) —I rise to speak on the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010, which are before the House this morning. There can be no doubt that for the Australian community health is one of the key national policy priorities for government. We have seen a shift in our aged population. In the early 1990s, around 12 per cent of the population were aged 65 and over. Based on demographics, we anticipate, with the affliction of time and the ageing of the population, that those Australians aged 65 and over will become roughly one in three—nearly 30 per cent of Australia’s population—in the next couple of decades. We have a landmark change happening across the Australian community in the number of older Australians.

The increasing number of older Australians, predominantly driven by the baby boomers, who were born after the Second World War, has meant a number of things. The first is that, where you have a large socialised health compact, as we have in Australia, there will be an increasing demand upon the services provided by the Commonwealth. Coupled with that is the fact that with the ageing of a large proportion of the population there will be fewer people actually contributing to Australia’s tax system. Indeed, with a large number we will be in the situation of having a net drawdown, so to speak, by taxpayers of consolidated revenue for services such as health.

It is crucially important that we continue to identify measures that can be taken to increase efficiency. We need to consistently utilise new technology to ensure that we develop maximum bang for our buck. That is crucial because, with a decline in the number of taxpayers paying tax and an increase in the number of taxpayers drawing on those services, we need to make our dollar stretch further. This is a problem that besets all governments. It is not something that is unique to the Labor Party and it is not something unique to the coalition; it is a common policy challenge, something that as a nation we must address.

The bill that is before the parliament today to some extent addresses this issue. It effectively provides a resource for government to ensure that we are able to gain greater efficiencies and improve productivity when it comes to the administration of the health system. The Healthcare Identifiers Bill will provide for a 16-digit identifier for every Australian and every healthcare provider. This will provide greater efficiencies when it comes to the administration of this scheme. If I look back over the past several years I am conscious of the fact that it was the previous coalition government that took perhaps some very bold steps—I would argue too bold—with respect to advocating for an access card. The access card, which some may consider a forerunner to or a super-duper version of a healthcare identifier card, on the plus side would have provided for greater efficiencies with respect to the administration not only of health but more broadly of the social welfare system in this country.

The concern that I had at the time, albeit it was a coalition initiative—and I certainly spoke quite strongly within my own party room about the access card—was that a situation might arise where, with the passage of time and function creep, the access card would have become a national identity card. For Liberals like me the notion that we would hand up to government the power to have something like a national identity card was one step too far. We saw around the world other governments moving down that pathway. Indeed, the United Kingdom has moved down that pathway, forcing all citizens and residents in the United Kingdom to have a national identity card.

The parallel between that and the bill today means that those of us who are concerned about the relationship between the individual and the state must remain vigilant about where exactly we go with this legislation. On the face of it, the bill that is before the House is not, I believe, of significant concern. It is about efficiencies. It is about ensuring that government can utilise technology that will enable it to stretch its health dollar further, that will enable it to ensure that the administrative arrangements that are in place are utilised most efficiently and productively so that all Australians benefit from a more efficient system. Let’s be frank: there are not too many Australians who would argue that when it comes to government administration we are among the most efficient in the world. That notwithstanding, we need to be conscious of unintended consequences and function creep. These remain for me very serious considerations which I believe all members of this parliament should be concerned with.

The introduction of a healthcare identifier, which provides a 16-digit number for every single Australian, means that there will be, for the first time, a great ability for governments to have, through the use of that single identifier, access to a raft of health information on every single Australian. As I said, on the face of it I am comfortable with that insofar as it provides greater opportunity for efficiency and, perhaps even more importantly, the opportunity to ensure that, when it comes to the administration of health and linking patient records with patients, there is less room for error. That has to be a positive.

I certainly do not believe this legislation is bad. I think it has taken a long time to come about. We have had a vacuum for a couple of years now while this government has been ambivalent about which way to move. Nonetheless, it is in broad terms a logical and solid step forward in the administration of Australia’s health system.

I want to state on the record that I will continue to watch closely the development of policy around this bill and associated bills that deal with the labelling of each individual Australian with a single number which provides government greater access to records all administered through one number. I believe that we will see with the passage of time increasing pressure to utilise this number as successive governments say: ‘Look, we are only seeking to add on this particular function. We are only seeking to ensure that when it comes to your unique health identifier number we are only adding on this one particular aspect.’ Who knows what that will be? Perhaps it will be combined with passports in the future. Perhaps it will be combined with drivers licences in the future. Perhaps it will be combined with tax records in the future. Perhaps it will be combined with welfare records or family tax benefits in the future. There is a whole raft of different things that successive governments could say, ‘This will stop duplication and mix-ups.’

Each argument individually will make sense. Each time a government stands up and says, ‘Look, when it comes to making government more efficient we believe this is a step in the right direction.’ I concede that I would agree with each one of those arguments if they were taken in isolation. But the problem we have as policymakers is that it is actually not that far of a journey between starting with a system like this and ending up with a situation that I foresee down the track: where each and every Australian has a 16-digit number identifier which links them back through all government records about them in all government agencies and departments. It would also seem logical to conclude that it would not be very long before criminal records, police investigations and all such matters are all linked as well to those unique 16-digit identifiers.

Some Australians, I concede, would have no problem with that. Some Australians would be very comfortable with government agencies being able to access all of those records at the push of one or several buttons. But we must remain vigilant about the abuse of power by governments. It is well and good for the population to say: ‘Well, we’ve got nothing to be concerned about. Governments have, over time in this country, proven that they don’t abuse powers.’ Other Australians would say there have been many examples of abuse of government power in the nation’s history. It all depends on your perspective. But I can say with authority that when you look around the globe you see many examples of governments misusing power as a direct result of the adoption of technology which enables all of that information to come to one particular person.

Over the past several weeks I was concerned when I saw numerous media reports talking in particular about the unauthorised access by bureaucrats of people’s private information in health records. When audited, there were thousands of examples of unauthorised personnel within Australian government agencies and departments that were accessing other people’s private information with no authority and—it would appear on the face of it—with no proper motive.

This has been a concern that the tax office has dealt with for some time. Occasionally we do see, unfortunately, from the tax office the personal tax records of high-profile individuals and celebrities being accessed without authorisation, and, on occasion, if memory serves me correctly, some of that information has spilled into the public arena. If I was one of those Australians, I would be saying, ‘Whose business is it that my private tax records should be out there in the public domain because a bureaucrat somewhere has taken it upon themselves to access my information and put it out there?’ That is just one single agency’s record. Can you imagine what the potential could be for the abuse of information if every single government record or piece of information about an individual was accessible from all departments through one unique identifier?

We might say, ‘Well, they’re celebrities and they can deal with it.’ The reality is, as recent media reports have demonstrated, there are many examples where people have misused and accessed information on other Australians. Perhaps it is a friend of the bureaucrat or someone who happens to be in the newspaper or the Woman’s Day that particular day, and their interest is piqued and they have a little squiz at what they have in their health or tax records. I would like to pretend that that is never going to happen but the truth is, as we have seen in recent weeks, it happens thousands and thousands of times every single year. It is for that reason that I think as Australians we need to remain vigilant about where these particular initiatives go—certainly I will as a policymaker.

But that is part of the broader fabric of the debate about when successive political parties take the reins of government and help to move Australia’s health system forward, and the administration of Australia’s health, welfare and other systems when governments seek greater efficiencies. I am not a troglodyte. It is not that I believe that all technology is bad, but we must recognise that with this new technology in particular there is a greater ability to misuse the information that is contained within the 16-digit identifier.

I will touch upon some other health related issues which are more pertinent and perhaps more germane to the aspects of this bill. I noted previously that the member for Petrie and others in this debate have railed against the coalition recently blocking the private health insurance legislation. The first point I would make is that the coalition is unable to block anything. We hear the Labor Party talking about how the coalition blocks this, that and the other, but it is simply untrue, because Labor members know that the coalition cannot block anything in the Senate. The coalition can be opposed to something but it requires other senators to support the coalition in order to block legislation.

It is simply convenient for the Labor Party to make out that their legislative agenda is frustrated, when in reality they have not been able to advocate a reason strongly enough for why other senators should support their legislation. We on this side of the House know bad legislation when we see it, and that is why we stand opposed to it. And do you know what? It seems that there are other non-major political party senators who also recognise bad legislation when they see it. I say good on them for standing up to this government and good on them for ensuring that this government does not have the freedom to reign all over the place when it comes to policy and when it comes to introducing policies that would be damaging to Australia’s national interest. If the Labor Party cannot come up with policies that garner enough support; so be it. It is the Labor Party’s problem to ensure that they get the support of crossbench senators to get their legislative agenda through.

In addition to that, you have really got to scratch your head when the Australian Labor Party stands up in this chamber and says, ‘How unfortunate and how dare the coalition block our attempts to make private health insurance less attractive to the Australian people.’ This is from the government whose Prime Minister, before the last election, hand on heart, said: ‘We will not touch private health insurance. Trust us. The Australian Labor Party has no ideological war with private health insurance. You can trust us. We won’t touch it; we won’t do anything to it.’ That is basically what the Prime Minister said. Lo and behold, less than two years later the original moves to gut private health insurance were made by the Labor Party. They have the audacity to come into this chamber and say, ‘How dare the coalition block it.’ I would say the Australian people recognise when a government is breaking a promise. How absolutely absurd for a member of the Australian Labor Party to come into the chamber and say, ‘How dare the coalition block our attempts to gut private health insurance.’ You know what? My response to the Australian Labor Party is: honour your election promises. How dare the Prime Minister walk into this House and seek to make a change to private health insurance after he promised that he would not.

Government members interjecting—


Mr CIOBO —I see the sensitivity of Labor members now.


Dr Emerson —Mr Deputy Speaker, I draw your attention to the departure by the member for Moncrieff—


The DEPUTY SPEAKER (Hon. BC Scott)—What is your point of order?


Dr Emerson —It is on relevance. He is being irrelevant, and we are seeking to honour election promises and they are being blocked.


The DEPUTY SPEAKER —The minister has no point of order. The member for Moncrieff will continue.


Mr CIOBO —We see the sensitivity of Labor members in this chamber. I notice that the minister at the table, the honourable member for Rankin, did not jump up when the member for Petrie was talking about this exact same issue. I notice the Labor members were nowhere to be seen when it came to the member for Petrie talking about the injustices of the coalition trying to force the Labor Party to honour their election promises. But now, when the truth comes out, we see them springing up trying to take points of order.

Let us look at the health system in this country, because we all know that one of the other promises made by the Prime Minister was that the buck would stop with him when it came to Australia’s health system. Now, two years later, we have the absolute debacle of administration of health in this country as the Prime Minister desperately tries to get state governments to stitch together and sign up to his particular initiative, if you want to call it that, on health. We saw the Labor Premier In Victoria, John Brumby, absolutely tear apart this Prime Minister and this government’s latest proposal when it comes to health and ask how it is possible that the Labor Party, which signed up to the most recent GST arrangements, would now seek to rip those apart and leave state governments in a situation where they have far less money to run their own states and their own health systems and instead try to siphon off 30 per cent of that money to the federal government. Little wonder that Colin Barnett, John Brumby and, I predict, probably Kristina Keneally and others will rail against this government’s myopic approach to health administration in this country.

On a final point when it comes to health, I would like to touch upon Labor’s much vaunted proposal, which I believe should be much maligned, to deal with health through GP superclinics. In my own electorate of Moncrieff on the Gold Coast, the fastest growing region in this country, the coalition introduced a number of initiatives when we were in power to help provide Gold Coasters with greater access to health. One of those was funding for doctors to be able to treat patients after hours. The Labor Party said that that was not necessary because they would introduce a GP superclinic, which would facilitate access to doctors by the general public. In my seat they axed funding for after-hours medical treatment. What did they do? It would be logical to conclude they would have built a GP superclinic. But, no, here we are two years later, the sixth largest city in the country, and we have no GP superclinic. This is a government that ignores the sixth largest city in this country and expects to get the support of its citizens. They can forget about it, absolutely forget about it. I turn my back on their failed policies and I know my constituents will as well.