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Thursday, 11 March 2010
Page: 2238


Mr CHEESEMAN (10:44 AM) —I would like to recognise the contribution made by the member for Moore. He has had a long history in health care. As a doctor in this place, he has helped quite a number of members of parliament from time to time.

I take this opportunity to make my contribution in the debate on the Healthcare Identifiers Bill 2010 and cognate bill. This legislation is another example of why Australia’s healthcare system—and of course Labor’s Medicare system is at the heart of our country’s health system—is one of the best systems in the world. This legislation and Labor’s proposed healthcare reform program, as announced by the Prime Minister last week, show a pathway towards maintaining our mantle as having the best system in the world.

This legislation shows a core quality that is one of the primary reasons we have such a fantastic system that is the envy of the world. This quality is the quality of continual improvement. We know we have a fantastic system, but we do need to continue to work on it and refine it to ensure that it delivers for all Australians. We have to be vigilant and keep reviewing and improving our healthcare system. This legislation is about building the best healthcare system for the future—future-proofing our system.

The Healthcare Identifiers Bill will establish a national Healthcare Identifiers Service and sets out arrangements for its operation and its functions which will assign, issue and maintain healthcare identifiers for individuals, healthcare providers and organisations. This bill will provide a national capability to accurately and uniquely identify individuals and healthcare providers to enable reliable healthcare communication between individuals, providers and provider organisations. This approach to healthcare identifiers was agreed by COAG, the Council of Australian Governments, in February 2006 as part of accelerated work on electronic health records to improve patient safety and increase efficiency for healthcare providers.

We know this issue has some risks. The importance of confidentiality and security of information is paramount. So we know there is risk, but we also know that that risk can be managed. We also know we have to take this step for the sake of providing better healthcare services and for the efficiency that electronic health records provide. We also know from similar types of projects in other institutions in our society that we will be able to do it well.

I believe that this is a very big step in developing a future health system that is more efficient, more flexible, more reliable and safer for those involved. This legislation establishes the Healthcare Identifiers Service and allocates functions to Medicare Australia as the initial service operator. Medicare Australia’s existing information and service infrastructure is to be used to establish the individual and provider 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 to enable reliable healthcare related communication between individuals, providers and provider organisations. The identifiers are a fundamental building block for the national e-health system.

E-health has the potential to improve patient safety and of course health outcomes for all of us. We should consider these facts as key drivers. It is estimated that between 30 and 50 per cent of patients with chronic diseases are hospitalised because of inadequate care management. Up to 18 per cent of medical errors are attributed to inadequate availability of patient information and between nine and 17 per cent of pathology and diagnostic tests are unnecessary duplicates. Think of the waste when these statistics are translated into dollars across the system. If we could just halve these error rates—and e-health records hold out real promise in this regard—we would save our country billions of dollars over the decades to come. This money of course could be reinvested into other new and emerging technologies. Think of the many ways this money could be spent to further improve the treatment that patients receive. E-health has the capability to radically improve the amount of waste and, therefore, make our fantastic health system even better at delivering for all of us.

In my electorate of Corangamite, I recently released a four-point plan to improve the health of the region. It is about creating better health solutions in my region. The last federal health minister in the Howard government, Mr Abbott, did tremendous damage by ripping more than a billion dollars out of our health system and capping the number of GP training places. This is having a real impact in regions like Corangamite where there are skill shortages today. The key parts of the plan that I announced strongly support the Rudd government’s health reforms, which will establish local hospital networks to be run by health and financial professionals—who will be responsible for running local hospitals rather than central bureaucracies.

We will work with local councils and sports clubs to apply for one of the Australian government’s Healthy Communities comprehensive five-year intervention trials, whereby sports clubs and officials will be funded to significantly raise the level of participation of young people in sport. This will particularly relate to the Colac Otway region. Sport is fundamental in securing better health outcomes in the long term.

We will work with Deakin University medical school to ensure that nursing training continues to be rolled out across the region as well as the training of new GPs who will be coming out of the Deakin University medical school over the next few years so that they can take up the opportunity to practise medicine in regional communities such as Corangamite.

Better e-health and better data are critical in making and developing the case in each of these areas. If we are able to integrate information and share that information where appropriate amongst healthcare providers and individuals, it will lead to much stronger outcomes for the patients.

The Colac Otway region, which is a very important part of my electorate, has high health needs in different areas and, due to the nature of the region, hospitals are not often that close. The federal government is attempting to undertake a massive shift in our health spending based on preventative health. I think that an e-health record is very important in terms of setting up strong, well thought through, individually tailored, preventative health strategies. Good e-health services are central to that policy shift, in my view.

One of the local proposals I have put forward in the area of preventative health in our region is to secure the opportunity of being part of the five-year preventative health trials, and having strong e-health records will assist with that. I want to see our local shire councils combine with our sports clubs and other health stakeholders to drive participation in sport, and an e-health platform is very much an enabler of that.

The most important organisations in our shire and our region, in terms of keeping young people active, are the sports clubs. Good e-health capabilities will, in my view, enable us to design systems to analyse the impacts that sporting activities might have over a significant period of time.

The federal government’s preventative health strategy has a vision for Australia to be the healthiest country by 2020. The strategy provides the road map for a series of strategic and practical actions to be implemented across all sectors between now and 2020. The preventative health strategy is being driven by projected future costs in our healthcare system, which are experiencing significant pressure particularly because of our ageing population. In light of this projection, in 2006 the Council of Australian Governments, COAG, established the Australian Better Health Initiative with the aim of refocusing the health system towards promoting good health and reducing the burden of chronic disease. Good e-health systems go hand in hand with these initiatives.

These bills are about taking a national approach to ensure that the frameworks and the key infrastructure components are coordinated and aligned across Australia. The Commonwealth portion of funding for the costs of operating the Healthcare Identifiers Service, which totals $52 million over the next couple of years, was agreed through the Strategic Priorities and Budget Committee on 26 November 2008 as part of the total amount of $218 million to provide this e-health framework. The Commmonwealth share will be $26.01 million, which is 50 per cent of those costs. I believe that spending this money is one of the best things we can do to invest in a modern healthcare system for the future.

I should also note that the identifiers will not hold any clinical information. They are not electronic health records but they are a key step in building the infrastructure for an electronic health record into the future. They are the building blocks for a thoroughly modern future health system. Individual health identifiers, IHIs, will be allocated to all individuals who receive health care in Australia, but consumers will not be refused health care if their identifier is not available for some reason. The IHI will be generated as a temporary number in situations where an individual cannot be identified at the point of care—such as in emergency situations such as traffic accidents—or where a person is not entitled to Medicare provisions, such as tourists who have come to Australia.

In conclusion, this legislation has very lengthy origins and was developed as part of a COAG process. I will not go through all of the steps, but, most recently, on 7 December 2009, COAG considered a report on the outcomes of the public consideration on healthcare identifiers and privacy and signed a national partnership agreement setting out cooperation between jurisdictions and arrangements for e-health, including the Healthcare Identifiers Service.

The government has committed to work and consult closely with government agencies, state and territory governments and clinical, community and consumer stakeholders in the rollout of the Health Identifiers Service. The Minister for Health and Ageing is required to have a report prepared on the operation of the IHI service and the legislation, which will be tabled in both houses of parliament. This legislation has all the checks and balances that ought to be required in legislation of this nature. It is legislation that is on the cutting edge of a modern healthcare system in Australia. It is legislation that will be good for Australia, will save billions of dollars into the future and will provide better health outcomes for all of us. I commend these bills to the House.