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Thursday, 11 March 2010
Page: 2241


Mr ZAPPIA (10:59 AM) —I rise to speak in support of the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010. Since coming to office in November 2007, the Rudd government has embarked on a major reform of the Australian health system, a reform needed in response to both the immediate health needs of today and the changing health needs and growing health costs of the future. Treasury estimates have concluded that by 2045 health spending will consume the entire budget of the state governments. That is something that we certainly need to be aware of and plan for accordingly.

Health needs have weighed down the health services in Australia for over a decade, and I have to say that in that respect the previous government largely ignored the reforms that were needed. We have a national health system that is financially inefficient and which does not deliver the best possible care to the Australian people. The Rudd government has made it a priority to address the inefficiencies in Australia’s health system and to ensure Australians have access to better health services. To date, the Rudd government has increased health and hospital funding by 50 per cent to $64 billion over the next five years. That funding includes: $1.1 billion to train more doctors, nurses and allied health workers, in the largest ever investment in the health workforce; $750 million to take pressure off emergency departments; upgrades of 37 hospitals around the country; $500 million for subacute facilities, including rehabilitation, palliative care, geriatric evaluation and psychogeriatric services; $600 million in an elective surgery waiting list reduction plan that has delivered more than 62,000 procedures, and new elective surgery equipment and operating theatres for 125 hospitals across the country; and $275 million for 36 GP superclinics around Australia. I am pleased to say that one of those GP superclinics is in the electorate of Makin, and if time permits I will talk a little bit more about that later on.

There has been an $872 million investment in preventive health programs to be rolled out in schools, workplaces and local communities with a high incidence of chronic disease; $1.6 billion allocated to close the life-expectancy gap between Indigenous and non-Indigenous Australians; $134 million invested in the rural and remote workforce; and $3.2 billion invested in health infrastructure projects, including $1.5 billion to upgrade 18 hospitals around the country, $1.3 billion over six years to modernise Australia’s cancer infrastructure, $430 million to upgrade 12 medical research and clinical training facilities and $293 million allocated for 2,000 transition care places.

Last week the Prime Minister announced the Rudd government’s national health reform proposal. It is a proposal that brings together the work of the Bennett health review and the subsequent widespread consultation by the government with health service providers and the community around the country as part of that review. Under the Rudd government’s national health reform proposal, the federal government will replace eight separate health systems with a single national health and hospitals network, combining all public hospitals and all GP services and related services; dedicate one-third of GST revenue directly to health and hospitals; and put local hospital networks in charge.

To deliver this system, the federal government will take 60 per cent of funding responsibility for public hospitals, take over full responsibility for GP and related services provided outside of hospitals and pay local hospital networks directly for each hospital service they deliver, rather than just handing over block funding grants to the states.

The measures in this bill are another important step in modernising Australia’s health system. It is a proposal that benefits the patient, the health professionals and the Australian taxpayers. As the Minister for Health and Ageing, Nicola Roxon, stated in her second reading speech:

This new identifier system will facilitate reliable healthcare related communications, support the management of patient information in an electronic environment and provide the foundations necessary to support the development of a national e-health record system.

I note that this system is being implemented after agreement with all the Australian states and territories. In fact it was an agreement reached, if I recall correctly, in November 2008.

The existing system of medical data is outdated, inadequate and wasteful. As other members have pointed out, including the member for Corangamite, who has just spoken, it is estimated that between nine per cent and 17 per cent of medical tests are unnecessary duplicates, wasting both patient time and tens of millions of dollars. I agree with the member for Corangamite, who quite rightly asked the question: wouldn’t those tens of millions of dollars that are being wasted be better spent on services which the community is screaming out for but for which funds are not available? That is a stark example of how our health services across the country could be improved.

Looking at this from a patient’s perspective, we see that up to 18 per cent of medical errors are attributed to inadequate availability of patient information. One wonders about that figure not simply as a percentage but because of the emotional cost that patients incur as a result of medical errors, which in turn occur because the system could be working much better—and making it work much better is exactly what this proposal aims to do.

I am aware that there have been some concerns expressed about this proposal, particularly concerns relating to the privacy of medical information not being properly protected and that wrong medical diagnoses may form part of a patient’s record. I was pleased to hear the member for Moore make a contribution to this debate because as a practicing GP he knows only too well the system that GPs currently operate under. In response to both of those matters, though, it is my view that both of those concerns are valid under today’s management of the health system. The privacy of medical information and wrong medical diagnosis are already issues under the existing system. Whilst it might have been an issue that was raised as part of the response to this proposal, it is my view that it is no greater issue than exists under the current arrangements.

On the issues of privacy and wrong medical diagnosis, the minister has stated that no clinical information will be held by the service operator. Only authorised healthcare providers will be able to access the Healthcare Identifiers Service and obtain healthcare identifiers for their existing patients. The Medicare card and the Department of Veterans’ Affairs treatment card are used as a token to obtain an individual’s healthcare identifier. In fact, the legislation was considered by the Office of the Privacy Commissioner, the Attorney-General’s Department and the Solicitor-General, amongst others. I also note that the issues of privacy are specifically dealt with by the consequential amendments that are attached to this bill.

Australians want the government to deliver a better health system. This message could not have been made clearer than in that which we are seeing in the lead-up to the South Australian state election, where health has become a dominant election issue, as it was in the last state election in 2006 and in the 2007 federal election. There has been a range of commitments made in the lead-up to the state election in South Australia. I am pleased to see that the South Australian Rann government is committing to building a brand new Royal Adelaide Hospital if it is re-elected—a brand new hospital that would deliver after many years the kinds of services that are required by the people of Adelaide; a brand new Royal Adelaide Hospital that has the support of much of the medical community in South Australia. Again, that was made abundantly clear last week when a number of key senior medical people from South Australia openly stated that we needed a new hospital in South Australia. It is a huge investment but it is required to ensure that the health services in South Australia in the future will be able to provide the level of services that the people quite rightly expect.

I am also pleased to see that only yesterday the Premier of South Australia, Mike Rann, committed an additional $44 million to the upgrade of the Modbury Hospital in my electorate of Makin. This $44 million is in addition to a $25 million commitment to establish a GP superclinic almost adjacent to the hospital. It is a $25 million commitment made up of $12.5 million of federal government funds and $12.5 million of state government funds. It will be a service that will complement the services provided by the Modbury Hospital. I reiterate something I said in this House only a couple of weeks ago about the Modbury Hospital. The hospital services the north eastern parts of Adelaide and has done so since 1973, when it was established by the Dunstan Labor government of the time. In 1993 the Liberals came to office in South Australia and immediately privatised the Modbury Hospital. As a result of privatising the Modbury Hospital, the services from that hospital began to deteriorate—so much so that by the time the Labor government was re-elected in 2002 the local community was screaming out for the state government to take back control of the Modbury Hospital. At the expiration of the agreement with Healthscope, which was the private operator that had been managing the Modbury Hospital, in 2007 the state government did exactly that and took back ownership and control of the hospital in every sense of the word.

Since 2002 the Rann Labor government has committed $39 million in additional funding to begin to restore the services that the local community quite properly expect from that hospital. To see an additional commitment now of $44 million towards that hospital is something I certainly welcome. The $44 million includes the development of 25 purpose-built emergency cubicles and the redevelopment of levels 5 and 6 to provide 36 single rooms in those two levels. Those are two levels of the hospital that have been largely unused for several years now. The emergency services are the critical aspects of the hospital that the community wants to see upgraded. Again, as someone who represents the people out there and who has called for the upgrade of the emergency services department, it is something I certainly welcome.

I also welcome, and I have very much supported, the $25 million investment in the GP superclinic. One of the issues that was clearly raised with me when I visited the hospital in the lead-up to the 2007 election was that the hospital emergency department was dealing with an overwhelming number of people who were coming into the hospital but who could, and should, have otherwise gone to their local GP. But because they did not have access to their local GP for a range of services they were using the hospital, thereby draining not only the financial resources of the hospital but also the staff time needed to attend to them. The establishment of a $25 million GP superclinic in close proximity to the hospital will take that kind of pressure off the hospital and allow the hospital to get on with the services which hospitals are built for.

As part of health reform in this country, when the state Labor government came to office it embarked on a similar program to that which I am now seeing the Rudd Labor government do at a national level. I am pleased to see that the South Australian Minister for Health has come out in support of the Rudd government’s national health reform proposals. But the state Labor government at the time also embarked on a proposal of its own where it was going to reform the health system after a lengthy inquiry by Mr John Menadue, who is considered to be an authority on the provision of health services in this country.

Part of that reform meant that there was some restructuring of the Modbury Hospital. But I make it absolutely clear that the Modbury Hospital was built by a Labor government, it was privatised by a Liberal government—demonstrating their lack of interest in the services being provided by the hospital—and it took a state Labor government to bring it back into the public fold and make real commitments to ensuring that the hospital is able to deliver the services that are required. I also point out that, in the years that the hospital was privatised, over the last decade, hospital funding in this country was cut by over $1 billion by the current Leader of the Opposition. It is no wonder that hospitals around the country, including the Modbury Hospital, saw a deterioration in the services they provide. Again, it has taken the Rudd government to reinstate that funding—and in fact increase it by 50 per cent.

These bills, as I said earlier on, are part of a range of reform measures that are required to ensure that into the future we have a health system that people around the country will benefit from, a health system that will be efficient for the Australian people and efficient for Australian taxpayers in that it is not wasteful. It is one of a number of measures. I understand that this is the first step to establishing an e-health records system around the country—again, something that is absolutely necessary in today’s modern society. We have said on many occasions in this place, in respect of a whole range of matters, that we have moved on since Federation. People in this country move around, from one state to another, on a regular basis. Their employment takes them from one place to another. Whether they are on vacation or whether they are studying, Australians move frequently. If people move frequently the best care we can give them is to ensure that the doctors who are treating them at the time have the most up-to-date and accurate records in respect of the health of those people—and that is exactly what this proposal begins to do. I commend the bills to the House.