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Monday, 23 November 2009
Page: 8593


Senator LUDWIG (Special Minister of State and Cabinet Secretary) (6:00 PM) —Perhaps the Greens can understand, partly, the predicament the government is in, in dealing with a bill that it did not want to deal with today at this particular hour. If I frame my comments in that way it may assist a little bit, but it will not assist us to support the Greens amendments, unfortunately.

We have, in the short time available, had a look at the issue. We think we are grappling with two matters. One is that the opposition are seeking to ensure that we provide sufficient and meaningful consultation around the changes—and we accept that—and the second matter is the Greens issues of privacy. The issue of privacy was one of the critical and fundamental issues that were developed. I can say this with some experience in this portfolio, because when this area was first mooted as being in need of compliance measures the Privacy Commissioner came on board very early in the piece to deal with how the process would actually work in the legislation.

Medicare Australia deals with a range of information about providers and medical services. It deals with that in a sensitive way and it ensures that its protections around privacy are of the highest standard—so much so that last year they won an award from the Privacy Commissioner for the way they dealt with privacy in handling a range of issues.

If you look at Medicare Australia you will find that when people put in for an item number it provides for a particular service. On occasion, sufficient information is able to be gained from that to identify what that service might be. That may have clinical implications. Medicare Australia has always recognised the sensitivity of the material and has maintained all of the matters that you would expect in order to ensure privacy and confidentiality for patients. And of course the onus is on providers as well to ensure that when they deal with medical records and when they store their medical records at the practices—or through whatever process they put in place—they similarly meet high standards. I think there is an expectation from the population more broadly that that is done.

This bill has been drafted so that a provider can provide documents in the easiest and most convenient way but the bill does protect patient privacy. If you turn your mind to how the process works, submitting a claim will sometimes require documents about a medical service. The government believes that the bill provides a sensible way of dealing with sensitive information. You could imagine the enormous amount of information that Medicare Australia maintains when it pays a bill. It does not simply pay a bill; it provides information on a particular item number that the provider then seeks to get a rebate claim for. The person who is dispensed the particular service by the medical provider will then claim that particular item number from Medicare—or alternatively it will be bulk billed. But Medicare Australia does understand that in all that information there is a significant requirement to maintain the confidentiality and privacy of the patients and the providers. It has demonstrated, time and time again, that it does this in the most sensitive way possible.

What we cannot do in this area is prescribe a particular way that this should be transacted. Particularly with regard to compliance this will depend on the nature of the audit and the type of information that is sought in order to substantiate a particular claim. I am sure, Senator Siewert, that you sat on the committee and heard from Medicare Australia. Unfortunately I did not, but I can assume that they would have explained to you that they only seek the minimum amount of information necessary to substantiate the particular claim. If the providers can provide that without going to clinical records that is fantastic. They can maintain a whole range of information that can be provided to Medicare Australia. On occasion, depending on the particular item number, and depending on the type of records that the provider maintains, it will switch to the private provider to meet the requisite audit by saying: ‘Yes, we provided this item number. We provided it to this patient. Here is our record’—whatever that record or document might be—’to substantiate that claim.’

On occasion it will be sensitive, but Medicare has demonstrated time and time again that it will maintain that information with a full understanding of the privacy requirements. That is why the Privacy Commissioner was involved throughout the whole process. I hope that goes some way to providing some explanation as to why this government takes this issue very seriously and understands the position that you are advancing. We agree with the principle completely—that privacy for patients is one of those areas that we have to deal with. It is a Privacy Act requirement but it is more than that for Medicare Australia. I think that Medicare has demonstrated that they want to ensure that patients and providers have confidence in providing that information, knowing that Medicare Australia will keep it confidential.

But keep in mind that this is about compliance and an audit process for the particular provider that is being audited. That is why, as I have indicated, we cannot agree with your amendments as put. I have gone on a little bit longer than I should have to explain that it is a principle that we can all agree with.

Question negatived.