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Wednesday, 29 February 2012
Page: 2253


Mr MATHESON (Macarthur) (10:25): Today I rise to speak about the Personally Controlled Electronic Health Records Bill 2011 and the Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011. The coalition will not oppose either of these bills but we do recognise a number of concerns that have been raised about this legislation and the government's implementation of the personally controlled electronic health records rollout. My main concern with these bills, like any other concerns I have raised in this House, is the effect they will have on residents in Macarthur. I do, however, believe that if managed and implemented correctly the electronic health records system will be a positive thing for my community, especially our most vulnerable residents.

I am proud to say that the coalition has a strong track record of investing in e-health. Under the coalition government, computerisation of general practice increased from 17 per cent in 1997 to 94 per cent in 2007, as we have heard a number of members mention today. This was achieved through a $740 million investment over those years. We originally started the focus on a shared electronic health record and have always supported the concept. Unfortunately, despite the Howard government's focus and direction towards e-health, Labor's implementation of the system since taking government in 2007 has received much criticism from the industry for their poor management of the program's development.

The bills before the House today provide the legislative framework required for the management of the personally controlled electronic health records system. The new e-system will allow for the health information of a patient to be easily transferred between the patient's health practitioners, including GPs and specialists. As it stands now, a patient has to repeat their medical history and information to a doctor each time they visit a different clinician. We all know what it is like trying to relay our own medical history to a new doctor or specialist. It can be extremely difficult for sick or elderly people, who may have a long list of past illnesses, allergies, hospital stays and treatments to remember. Repeating this medical history to each new doctor can result in poor information flow, extra or duplicated testing, delays and potential errors.

The electronic health records are designed to be a secure electronic record of a patient's important health information. The record will contain a great deal of patient information, including past and current medical conditions, medications, allergies, discharge summaries from hospitals and Medicare information, as well as any information the consumer would like to add themselves. Each patient will have the ability to determine who has access to their record and how much information is visible. I believe this is a positive step forward for patients, practitioners and our health system. It has been forecast that by 2020 electronic health records could save up to 5,000 lives and $7.6 billion each year by reducing the duplication of testing across Australia.

I am, however, aware that several concerns over privacy issues in relation to health records were raised during public hearings of the Senate inquiry into the bills. It is important that we make clear to the public that this system is a purely opt-in system, which means that a person will need to actively apply for an electronic health record. They can then de-activate and reactivate their record at any point in time. Also, the electronic health records will not be in a centralised data collection. The program is designed to link up the data sources around the country that already exist in GP practices, chemists, pathology groups and hospitals. Those who register for an electronic health record will be able to choose their own settings, including which practitioners can access their record and how much of their electronic health record they can access.

The system has been designed to ensure that the patient will be in full control of who sees what information and when they are allowed to see it. I am concerned, however, that this is not the case in either of the trials currently under way, and it remains to be seen whether this will be the case after 1 July this year. Patient's data will also be protected by the provisions of the 1988 Privacy Act, and the Information Commissioner will have the powers to investigate any complaints or potential breaches of privacy. But, while this is the case, there is an issue with overlapping and confusing jurisdictions based on the federal/state control of privacy provisions. This is something that must be rectified before the rollout of the system in July this year. This also brings me to my next concern. Why are we debating these bills before the Senate inquiry has publicly reported on its findings? We have seen this situation so many times: Labor announces a major project and then scrambles to meet its own deadline. This legislation was only introduced to the House on the last sitting day of 2011. Now it is up for debate, before the Senate inquiry into these bills concludes on 29 February. In its public hearings on 6 February the Senate inquiry heard testimony highlighting a number of stakeholder concerns with these bills. I would think that it would be important for the Minister for Health and the government to defer debate on these bills until the Senate inquiry has publicly reported on its findings. However, we know that this government is famous for rushing through legislation without proper scrutiny, and these bills are no different.

A number of concerns have also been raised over the future costs of the system and the ongoing funding for the National E-Health Transition Authority. The government needs to come clean on the future long-term costs of managing and operating the program and the future funding contribution through the Council of Australian Governments to the transition authority. I believe the taxpayers in Macarthur and all over Australia have the right to know what the future long-term costs of this system will be.

The government has only allocated $35 million per year over the next three years for e-health implementation. Like any computer network or IT system, technology dates very, very quickly, so there needs to be some forecast of the future costs of these issues. There has been no comment on or discussion of the long-term costs relating to ongoing maintenance of the system, upgrades to the system or the provision of a help desk or support staff for the system, so you can see there are a few holes there. We only need to look at the situation in the United Kingdom, where they have spent £12 billion on their e-health record equivalent, which was scrapped in late 2011. This is not a scenario we can afford to impose on the Australian taxpayer.

Another primary concern that has been raised is the lack of encouragement or incentives for general practitioners to create the shared health summaries as part of the system. The summary is a collection of the patient's medical history and will make up one part of the patient's electronic health record. It is expected that a patient's general practitioner will spend additional time and effort creating and maintaining these shared health summaries, but they have been given no incentive to do so. We need widespread support from our general practitioners because they primarily will be the driving force behind the system's success.

While there are many concerns which need to be addressed before the rollout of this system on 1 July, there are a number of perceived benefits of an electronic health record system for this country. It has been forecast that by 2020 e-health capabilities could save up to $7.6 billion each year by reducing duplications and errors, improving productivity and better adherence to best practice. These figures are for all facets of e-health, not just electronic health records. The government's own numbers suggest that the benefits of e-health records alone in Australia would be $11.5 billion to 2025.

In addition, the same report suggests that a full e-health program could help avoid up to 5,000 deaths annually once the system is in full operation. It goes on further to state that a fully implemented e-health system could avoid up to two million primary care and outpatient visits, 500,000 emergency department visits and 310,000 hospital admissions annually. Importantly, it will also mean that patients have their entire medical history available to them anywhere they travel. How many times have we seen Australian people become injured or sick overseas? If a patient with their own personal electronic health record becomes sick whilst travelling, their full medical history will be available for the doctor or emergency department that they visit.

I do believe the positives of this system outweigh the negatives. This is why the coalition do not oppose this legislation, but we reserve the right to move amendments following the outcome of the Senate inquiry. I know that there are many people in Macarthur who will benefit from having their own electronic health record, but like all Australian taxpayers they deserve the right to know how much this system will cost them in the long term. This is why I support all of the positive features of this e-health system but cannot fully support this legislation until the findings of the Senate inquiry, released later this week, are dealt with appropriately. What is wrong with constructive criticism and deliberate scrutiny to deliver good policy? I think that is exactly what we should be doing in relation to this legislation.