Ms Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

As I was saying last night, the government in this bill is making changes to the Copyright Act that will specify that work will not be infringed where it is done for the following purposes: where the collection, use or disclosure of information is required or authorised under the My Health Records Act; where it is unreasonable or impracticable to obtain the individual's consent to the collection, use or disclosure, and the entity reasonably believes that the collection, use or disclosure is necessary to lessen or prevent a serious threat to the life, health or safety of any individual, or to public health or safety; where a permitted health situation exists in relation to the collection of health information about an individual; and where prescribed by the regulations, provided the purpose relates to health care, or the communication or management of health information.

The bill also makes a number of changes to the Health Identifiers Act, many of which are technical in nature. Others include allowing healthcare providers that are not registered under the national law—that is the 14 professions covered by the Australian Health Practitioner Regulation Agency—to access personally controlled electronic health records. This could include, for example, paramedics or social workers.

The new division clarifies when the recipient of a health service's healthcare identifier or other information can be collected, used or disclosed to another party. Division 2 provides that it can be collected, used or disclosed to another party for: assigning a healthcare identifier to a healthcare patient; keeping a record of healthcare identifiers and related information; providing healthcare to a healthcare recipient; for the purposes of the My Health record system; aged-care purposes; adopting a healthcare recipient's healthcare identifier; disclosing a healthcare recipient's healthcare identifier; disclosing information about a healthcare recipient's healthcare identifier; and additional purposes that will be specified in the regulations. Further changes to the Healthcare Identifiers Act allow the Healthcare Identifier Service Operator to disclose to a healthcare provider information about a healthcare recipient for the purpose of determining the recipient's healthcare identifier.

The new section 20 broadens the power to allow for future regulations to be made allowing prescribed entities to collect, use, disclose and adopt identifying information and healthcare identifiers. According to the explanatory memorandum, this is only for very limited purposes that relate to the provision of healthcare or to assist people who, because of health issues, require support. I appreciate that this could include entities such as the National Disability Insurance Agency and cancer registers, and these changes certainly make sense to the opposition. It is clear, as the explanatory memorandum states, that entities and individuals may benefit from the entity being able to associate disability or health related records with an individual's healthcare identifier.

The bill also allows for the viewing of certain disability or cancer registry records as part of an individual's MyHealth Record. This differs from the current situation where entities such as National Disability Insurance Agency and cancer registers are not authorised to handle healthcare identifiers or identifying information as they are not healthcare providers within the meaning of the Healthcare Identifiers Act. This will certainly allow for the collection of information by entities such as the NDIA and cancer registers, according to the explanatory memorandum, 'within tight limits related to providing healthcare and assisting individuals who require support because of health issues, without having to amend the act each time a new entity needs to be authorised'.

Because this is a somewhat significant change, as I said, whilst Labor does not oppose these measures—in fact, we think they are sensible measures—we think the change requires some scrutiny in the other place to ensure that people's privacy is protected. As I stated well at the outset, Labor does not oppose the intent of this bill. However, we do believe there are elements—especially those that relate to changing the way information can be collected and shared—that do require further scrutiny. As I said, it is not that Labor opposes the principles—many of them do at face value appear to be very common-sense and necessary changes to meet the policy intent—but, given the extent of the changes, stakeholders with direct experience and responsibility in delivering health care and working with personally controlled electronic health records should have an opportunity to provide feedback on the bill.

More generally, however, I again want to put on record Labor's strong support for an electronic health records system. It is, after all, our initiative. The reason we are here having this debate is that Labor, as part of its health and hospitals reform agenda, drove this change and built the architecture for an electronic health records system. Again, I add some words of caution to the government: it is an incredibly complex area and it will take time to get it right. It is important to not rush decisions just for the sake of being seen to be doing something in this space, particularly after the government has done very little for the last two years. It requires an approach that makes sure it has the effect intended. In particular, you want to make sure that you address the very issue that we are trying to grapple with: how to get health professionals engaged in uploading data and then utilising that data in an integrated system. How do you embed it in the everyday practice of general practitioners, specialists, our hospital system, our residential aged care, disability support, and, eventually, allied health professionals? How do you embed it as a normal tool of their trade. That is a really challenging prospect, and it takes time and effort to do that. It is not something, unfortunately, that there is any magic bullet to or any easy or swift answer to. It is a difficult area. So, I reiterate, don't rush to a solution in that area, because you are going to find yourself in a bit of strife if you do.

It was the Labor that introduced this reform, and we continue to see it as a vital component of Australia's health system. It is vital when it comes to improving the quality of care patients receive. It has enormous potential to improve the efficiency of the health system, especially in terms of reducing duplication, and it will ensure that a patient's medical record stays with them throughout their whole life. These reforms, once embedded as normal practice within our health system, will provide a platform for future technologies, many of which we will not even have thought of today, that have applications well beyond our imagination.

I will now move the second reading amendment that appears in my name. I move:

That all the words after "That" be omitted with a view to substituting the following words:

"while not declining to give the Bill a second reading, the House notes the Government's inaction on eHealth over more than two years and the inadequacy of this Bill in making real improvements to a national electronic health record system".

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