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Thursday, 24 June 2010
Page: 4418


Senator MASON (6:17 PM) —This debate is perhaps more important than many honourable senators appreciate. It has long-term implications for our community. Senators more eloquent than I have pointed out the importance of e-health. It will assist in the diagnosis and treatment of illness and it will help patients in rural areas particularly, and it is true that services will be cheaper and, perhaps, more efficient. But there are implications for privacy, and they are fundamental concerns in any liberal democracy. The balance to be struck between the efficient delivery of government services and medical services on the one hand and the right of individuals to keep intimate information private on the other is a difficult one. One of the best examples of this the most intimate of all information: the health record. For example, we have a public figure, a politician, who suffers from depression. We now know that there will be hundreds of thousands of people who will potentially have access to those records. If those records are not absolutely confidential it could, for example, not only destroy the parliamentarian’s career but also potentially influence national security.

These are weighty, difficult and important issues. Whenever a state or government seeks to number its citizens, it bears the heavy onus of showing why that is necessary. As Senator Siewert mentioned, the fear amongst some members of the community is that this bill could provide the architecture for a national surveillance system. All of us would agree that we should never meet the needs of government and administrative convenience and meekly surrender to perpetual surveillance. No government efficiency is ever worth some sort of Orwellian dystopia. Mr Rudd was never quite Big Brother and I am sure the new Prime Minister, Ms Gillard, is no big sister, but all democrats should share a scepticism of enhancing the capacity of the state to monitor and survey its citizens. All of us should share that scepticism, and government bears the heavy onus of showing why it is absolutely necessary.

The purpose of these bills is to establish an individual health identification number for every Australian. Whilst the coalition supports the uptake of important advances in the delivery of contemporary medicine such as e-health, the fundamental problem with these bills is that it is so hard to determine where we are going to go from here. The bills are essentially incomplete. They cover only a small but essential element of a much broader health identification and surveillance system, including future personal e-health records. They leave so much detail to be worked out later on by parliament and administratively, and that is the difficulty. It is very hard to know where the government will go next.

Any data-matching scheme, and these bills contemplate a data-matching scheme, must look at two essential elements. First, who has control over the access to the data, the information or the unique number? Second, what data is linked to that unique number, to that individual health identifier? Both those aspects must be controlled and very closely monitored by the Commonwealth parliament. We must never abdicate our responsibility to another parliament, to a minister or to administrators. That is why I strongly argue that any extension of the use of information or a unique number should be explicitly authorised by the Commonwealth parliament.

Function creep, as Senator Siewert mentioned, is the most significant issue not addressed by government and not sufficiently appreciated in this debate. Under these bills, health information may be disclosed for other purposes not detailed in the bill where that disclosure is authorised under another law. This means that it might be authorised by other Commonwealth, state or territory legislation or regulation. I believe that, where other agencies seek access to a unique identifying number or any information attached to it, access to such information should not be granted automatically by virtue of other Commonwealth legislation or, more importantly, by regulations or legislation passed by a territory or state parliament. This will ensure that the Commonwealth parliament retains direct oversight and responsibility for any extension of the entitlement to access information by government agencies.

The individual health identifier, that number, is a creature of the Commonwealth parliament. No other parliament should be entitled to legislate access for their own instrumentalities. For example, why should the Queensland parliament, the parliament of my home state, be able to legislate access for the Queensland Police Service? Why should they be able to do that? In my view they should not. No-one should be able to legislate for access to this unique identifying number except the Commonwealth parliament. So should access to this unique number be at the mercy of state parliaments or even regulations made by state parliaments? No, it should not. I accept that this number might facilitate administration but this parliament and this parliament alone should decide who has access to this information—not a state and not a territory and not their parliaments. It is as simple as that.

The second issue, and there is progress on this, in any data-matching scheme is that the Commonwealth parliament should explicitly authorise what information or what data is linked to the individual’s unique number. The parliament should explicitly authorise the data that is linked to this number. It has critical implications for privacy. The responsibility for that can never go anywhere other than to the Commonwealth parliament—not to a minister by regulation and not to other parliaments. We have had progress on this issue and I hope that the government will move an amendment to address this issue. I understand they will and I look forward to it.

My friend Senator Fierravanti-Wells has spoken about the appointment of a service operator. To save time I will not go into that. I understand that is being addressed. Guaranteeing the right of appeal I understand is also being addressed and I will not address that either. I understand those issues have been catered for by the government.

The compulsory nature of the scheme means it is compulsory to have a number. Every Australian will have to have a number. I am not happy about that. Ideally, citizens should be able to opt out if they do not want it. But I understand that you will not need to provide a number to supply or to obtain medical services, so this is something that is at least better than it was. I thank the government at least for that.

I conclude with a few remarks which I make somewhat pointedly. With the passage of this bill we have the first essential element of a national identification scheme. For the first time since World War II we will have a unique identification number for every Australian, and we have never had that before. Neither the Medicare number nor the tax file number is universal and none of them is compulsory. My point is that this is a unique identifying number for every Australian. If it is the intention of the government to use these bills and this number as a legislative subterfuge for the introduction of a national ID card, they have got it wrong. I raise it for this reason. The previous government tried to use the argument that to facilitate the access to welfare with a smart card was a good idea.


Senator Ludwig —We cancelled that.


Senator MASON —Yes. In fact, I chaired the committee that, without dissent, recommended against the adoption of that scheme. You may remember that, Acting Deputy President Trood. Why? Because that would have led to a de facto national identification scheme and an ID card.

The critical issue for this parliament over the next few months when this debate is fully ventilated will be this: what form will the use of this number take? Will it be a number on a card with a photo? If it is, let me put this on the record. It will become a de facto national identification number. The critical part of this debate that has not been caught today is how the government is going to use this number and how individual Australians will carry it. This is a critical issue for the citizens of this country. If the government is trying to use this to camouflage a broader intention to bring in an ID card or some such thing, they should think again. If there is an attempt by any government to extend access to this unique number beyond health professionals, or to expand the data to be collected beyond patient records and health matters, or to use the unique number as part of a de facto ID card, this debate will erupt. It will not be like a nice calm debate on the last Thursday before eight weeks without sittings; this debate will erupt. To any public servant, any doctor, any lobbyist or any politician who thinks that these bills are the first step towards greater surveillance of our citizens, I say they should think again. Like Big Brother, all of us will be watching.