Ken Wyatt (Hasluck, Liberal Party) Share this | Hansard source

I rise today to support the Personally Controlled Electronic Health Records Bill 2011 and the Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011. I believe that this legislation will improve the level of connectivity between the points of access to health services and health care that people use. The Personally Controlled Electronic Health Records Bill 2011 will establish the framework for a national personally controlled electronic health record. It will establish the regulatory framework under which the system will operate and the privacy regime that will govern it. This system will operate in tandem with federal, state and territory privacy laws.

E-health is fundamentally the use of modern information and communication technologies to meet the needs of citizens, patients, healthcare professionals, healthcare providers and policy makers. The coalition will not be opposing either of the bills because it has always supported the concept of a shared electronic health record. The coalition has a strong record on investing and delivering in e-health. For example, under the coalition government computerisation of general practice increased from 17 per cent in 1997 to 94 per cent in 2007. This was achieved through a $740 million investment over those years. I am aware that the Howard coalition government in 1999 initiated steps towards the implementation of a national e-health policy with the establishment of the National Health Information Management Advisory Council. This body, in collaboration with government and relevant health stakeholders, conceived a plan for e-health. The Australian Health Ministers Council, in a media release and communiqué issued by Dr Wooldridge's office, stated:

Electronic medical records a boon for consumer safety—Health Ministers

Australian Health Ministers today considered and agreed to lend their support to a proposal to develop a system of electronic medication records.

Speaking at the Australian Health Ministers' Conference in Wellington, New Zealand, Federal Health Minister, Dr Michael Wooldridge, said today's show of support for the proposal in-principle could lead to significant and genuine improvements in health outcomes in a relatively short time.

"The Better Medication Management System (BMMS) is a way to bring together currently fragmented medication record systems by using information technology to link patients, doctors, pharmacists and hospitals," Dr Wooldridge said.

The new system would be entirely voluntary for all parties—consumers, prescribers and dispensers. The BMMS offers consumers access to their own medication record for the first time.

"This affords consumers the opportunity to become active participants in their medication management. It also enables doctors and pharmacists—with patient consent—to make prescribing and dispensing decisions based on knowledge of what has been prescribed for a patient before and what other current medications a patient is taking."

It is important to note that there have been two bills that have been discussed in this House which address both these issues. It continues:

"An area of potentially great gains will be at the interface with public hospitals, where quick access to a patient's medication record could be life saving."

In terms of the broader health IT agenda being discussed at the conference, Health Ministers agreed that the BMMS provides a unique opportunity to apply the principles for HealthConnect in a confined and manageable area of the wider health sector.

At that time I worked in health and it was interesting to read one of the reports that was commissioned for the health ministers at the time. Some salient points were made. Our healthcare system is one of Australia's largest and most complex industry sectors, with over 21 million customers, over 750,000 employees, tens of thousands of geographically dispersed and largely autonomous care providers and hundreds of millions of service transactions each year. We face a set of challenges in delivering that, including the increasing incidence of chronic disease, significant discrepancies between health outcomes for advantaged and disadvantaged Australians, an ageing population, increasing consumer demand for more costly and complex procedures and a shortage in the health sector workforce.

The information challenges that this bill addresses—and it has to be acknowledged that the sector has invested significantly less than other comparable sectors in information technology over a sustained period of time—include that health information management still being heavily reliant on pen, paper and human memory; the Australian health system containing many thousands of discrete islands of information; consumers not being to access their own health information; significant amounts of health system errors and inefficiencies occurring; and poor support for population health surveillance, service planning and operational-clinical decision making.

So there is widespread recognition within the Australian health sector of the importance of e-health in addressing healthcare challenges and that it requires a significant investment in e-health as well as a large and growing number of e-health projects being delivered in Australia across the health sector. There is an urgency to move forward in the way in which information is gathered, managed and is available to the consumer. I acknowledge that this has been an ongoing agenda, as mentioned by a previous speaker.

The Australian Health Ministers Advisory Council on 4 October 2007, following a discussion on e-health policy and strategic planning, agreed to the development of a national e-health strategy. All Australian jurisdictions undertook to work towards the establishment of a national integrated e-health system. Since the early 1990s governments have collaborated to develop national information management and technology governance arrangements and common standards to enable interoperability. More recently, they committed significant funding towards accelerating national efforts to identify and develop better ways to electronically collect and securely exchange health information.

It is interesting that within the tri-state regions of the Northern Territory, South Australia and Western Australia Aboriginal controlled health services some three or four years ago established an e-health records system so that the movement of Aboriginal people between communities and within those jurisdictions would not prevent access to information relevant to their health needs. That was at the forefront of some of the early work done in the private sector by non-government organisations.

The AHMAC e-health strategy said that all jurisdictions were committed to the establishment of the National Electronic Health Transition Authority to undertake work to establish and operate a unique health identifier service, and to work on a business case for a shared electronic health record. The council said it had identified a range of policy and operational issues that required examination and resolution by governments to ensure further development of e-health in accordance with government requirements but, more importantly, community aspirations and the needs of health consumers.

It was interesting that on 31 January 2008 at the Melbourne meeting the Australian Health Ministers Conference in their deliberations on this very issue noted the current context and progress towards the development of national e-health infrastructure and envisaged the contribution of e-health to improving health outcomes and health system efficiency, which is important if we are going to provide the quality of health care that is needed in this country. They noted that health ministers were expected to report back to COAG in 2008 on the next steps in the development of a national e-health records system and endorsed development of a national e-health strategy by the National E-Health and Information Principal Committee for consideration by AHMC and as an input to deliberations on health reform by the National Health and Hospital Reform Commission, the COAG Working Group on Health and Ageing and the Commonwealth, state and territory health agreement, which occurred at a time when there was a series of alignments occurring. In each of those I had the privilege of contributing to much of the debate. Again, it was about the consumer and the efficiency of health systems in the provision of services and connectivity, which meant that you did not have to continually repeat the story of your treatment and enabled people to get the type of treatment they had been having. So when they connected with the system there was that flow-through effect. They also noted progress in relation to a business case for a national shared electronic health records service for consideration by COAG.

I come to the new national entity to drive e-health. In a joint communiqué, Australian health ministers committed to looking forward to what was achievable, but that would require resources and all jurisdictions transcending their borders and looking at a system that would better serve all Australians. The ministers agreed to establish a new entity as a company limited by a guarantee, governed by a board of directors made up of CEOs from health departments across Australia. So NEHTA became, in effect, a body that drove work on the concept.

The ministers noted the need for further cooperation on significant national projects over the coming years. Those included clinical data standards and terminologies, and it is interesting to note the variations in those terminologies within the various sectors; patient, provider and product/services standards and directories/indexes; consent models; secure messaging and information transfer; and user authentication processes. One of the challenges there is the confidentiality of the information. In some of the submissions that were put forward during the work of the Senate committee, people expressed the view that they had not been engaged and that stakeholder engagement had not been comprehensive. As I said earlier, I know from having worked in this area that there was substantial consultation with some key stakeholders who were at the forefront of the delivery of these services and who also reflected their position, as an organisation or a representative body, on all matters that were being progressed within the bill.

I think the other serious element that highlights the commitment of government to this whole process was the allocation made in the 2010-11 budget of $466.7 million specifically for the purpose of creating a personally controlled electronic record for Australians who choose to opt into the system. In one sense it is a pity that it is an opt-in. I think that in this day and age records and access to information by medical providers and health providers will ensure that we do not have some of those adverse events that do occur within hospitals and clinics. The history and detailed records of a patient's treatment, regimes and types of investigations that have occurred tell a story. Nothing is worse than having only pieces of the information and all of us as human beings have incredibly selective memories as to what we recall about some of the treatments that we have had. Males in particular are probably worse than anybody else—and this would certainly serve males well.

I think the consumer perspective has been gleaned through the consultation processes, and I think we will see a tremendous take-up by Australians as the program is implemented. Certainly after their discussions with medical practitioners and health service providers, we will see more and more Australians setting aside their reservations about the way in which electronic records are kept, given the way in which they will be able to easily access their records regardless of their location. Hopefully, considering the increasing areas of chronic disease and some of those debilitating illnesses that people have, this system will enable them—and also grey nomads and many of us who travel in the course of our work—to move around Australia knowing that should anything happen then there will be different points at which the person treating them will have access to their medical records. I commend the bills to the House.

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