Brett Whiteley (Braddon, Liberal Party) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (eHealth) Bill 2015. This bill is a part of the coalition government's responsible and effective approach to the health system in this country. I do want to just say that I come to this debate today in this place having been the shadow minister for health and human services in the state of Tasmania for four years. As a previous contributor said, this issue has been part of public policy discussion for many years and, in my view, for far too long.

Our health system is an extremely important part of the fabric of our society. It consumes enormous amounts of financial resources, as taxpayers would expect it to, but there are ways in which we can now use technology to ensure that efficiencies are in place and that double dipping, duplication and doctor shopping are not issues. We need to be looking at all of these issues to ensure that the hardworking taxpayer money that is invested into the area of health in this country is working at its best and we are extracting every opportunity from every dollar spent.

This government acknowledges the difficulties facing Australians today in seeking medical assistance from multiple doctors, sometimes in different cities, areas and even states. The e-health system will greatly improve patient health outcomes as doctors are able to access patient records quickly. This government is cognisant of the need to make our comprehensive healthcare system more efficient and more effective. This bill is part of that process and specifically seeks to amend the Personally Controlled Electronic Health Records Act 2012—the PCEHR Act—in order to better facilitate positive outcomes for all Australian systems when it comes to health.

Under the previous government, the Healthcare Identifiers Service came into being, which is the foundational service of the PCEHR. The Healthcare Identifiers Service is a national system for consistently identifying individuals, individual healthcare providers and healthcare provider organisations for healthcare communication purposes. Both the HI service and the PCEHR are helping to facilitate a more efficient and effective healthcare system. This government is seeking to build on and improve the current service in a number of significant ways.

First, however, I believe it is important to understand the reforms that this government is enacting within the context of this electronic framework. This national electronic system commenced in July 2010 and was the result of a joint initiative of all Australian governments as part of accelerating work on a national electronic health record system to improve patient safety, to support safe and efficient sharing and storage of person health information and to increase efficiency for healthcare providers. It is jointly funded by the Commonwealth, state and territory governments.

Under the previous government, a review in 2012-13 found that the core functionality of the HI service was operating effectively; but given the PCEHR system is now impacting directly on clinical workflows, there are emerging issues that needed to be addressed. The HI review made 24 recommendations to improve the HI service. In response to some of those recommendations, the PCEHR system was implemented in July 2012. Its aim was to overcome significant issues facing health care that were arising from the fragmentation of health information across a vast number of different locations and different systems. In many situations, quick access to key health information about an individual is not always possible but is often necessary for the patient.

A review of the PCEHR system was undertaken in 2013. It found that there was overwhelming support for continuing implementation of a consistent electronic health record system for all Australians, but that a change in approach was needed to correct early implementation issues. The PCEHR review made 38 recommendations aimed at making the system more useable and able to deliver the expected benefits in a shorter period of time. The recommendations include establishing new governance arrangements, moving to an opt-out system for individual participation and improving system usability and the clinical content of records.

The government strongly believes in the benefits of an effective and efficient electronic record system. Such a system rectifies many issues facing our healthcare practitioners and delivers better results for our citizens. The coalition government's response to the recommendations of the PCEHR review was announced in the 2015-16 budget. We committed to strengthening e-health governance and operations by establishing an Australian commission for e-health to manage governance operation and the ongoing delivery of e-health. We also are committed to trialling new participation arrangements, including an opt-out system; we are committed to improving system usability and the clinical content of records; we are revising incentives; and we are delivering education and training to all healthcare providers.

The government is also renaming PCEHR—thank goodness for that—to My Health Record. What do you think? Do you agree? Whilst this government is committed to lower, simpler taxes, we are also committed to simpler and more efficient language. As I said, thank goodness for that. We have made significant commitment in the eHealth space and are today delivering on those commitments.

As a sideline, you do often wonder how on earth some of these acronyms ever get into operation. Sometimes you read one and you go, 'Didn't someone put those letters in a row to see what they actually spell?' But, obviously, some do not. Either that, or they have a very good sense of humour.

To get back to the main point, whilst we are delivering on recommendations made through extensive reviews, we are also staying very proactive in this space. Trials of participation arrangements—including the important opt-out trials—are intended to inform future strategies for increasing uptake and meaningful use of the myHealth Record.

This government appreciates that limited access to health information at the point of care can result in a greater risk to patient safety, can deliver less than optimal health outcomes and assist in the avoidance of adverse events of treatment. We remain committed to decreasing costs of care and time wasted, and we know that this can be delivered through providing a more effective mechanism for collecting or finding information.

This bill will deliver on our commitment to making health care more efficient through avoiding unnecessary or duplicated investigations; reducing additional pressure on the health workforce; and increasing participation by individuals in their own healthcare management. Our obligation to provide a comprehensive healthcare system is a priority of the government but we are also vigilant in ensuring our healthcare system is as efficient as it can be, thus maintaining our commitment to the taxpayer by ensuring the long-term sustainability of what is a very under-pressure health system.

The coalition government will continue to lead the national rollout of eHealth technology and services, and work with the states positively to support eHealth foundations and to finalise a national eHealth strategy, which will identify the priorities for future Commonwealth and jurisdictional investment in eHealth.

Productivity improvements such as those that can be delivered by eHealth are needed—they are really needed—to help counter the expected increase in the unit costs associated with the delivery of health care. Leveraging eHealth is one of the few strategies available to drive microeconomic reform to reduce Commonwealth health outlays.

I remind this chamber that the annual Commonwealth costs of health care are forecast to increase by $27 billion to $86 billion by 2025 and over $250 billion by 2050.This is an enormous cost burden and is the consequence of maintaining a comprehensive, world-class healthcare system. Yet whilst our broad healthcare system is important and integral in delivering quality of life to all our citizens, it is now what we would commonly call a very sacred cow.

We should not be afraid to reform our healthcare system and ensure its efficiency into the future, and to ensure that hardworking taxpayers' money—for a service that they obviously expect for them and their families—is actually sustainable into the future, and, as I said earlier, that we are getting the best bang for the hard-earned buck. Rather than being uncompassionate, it is irresponsible to maintain a view that our healthcare system is beyond reform. Any scare language around the fact that any reform is bad for the health system is not helping the public policy debate in any way, shape or form. It is irresponsible to refuse to make our tax dollars work harder in our expansive healthcare system. That is why reforms enacted under this government are so essential.

It is only a coalition government which can deliver an effective, efficient and economically sustainable healthcare system today and for future generations. Whilst the previous government implemented the PCEHR system as a first step, today this government is making, I believe, meaningful progress in overcoming serious issues facing health care arising from the fragmentation of health information. We understand the opportunities that technology provides us with, and that is why we have embraced eHealth and are developing a more efficient system.

We acknowledge that health information is spread across a vast number of different locations and systems, especially as more Australians are constantly moving between various state and territory health systems. It is estimated that 2.5 per cent of hospital admissions are due to adverse drug events due to incomplete medication histories. This is not an acceptable state of affairs in any first world country—it is not acceptable anywhere. I know that my state of Tasmania and the electorate of Braddon are not the only state and constituency facing hospital shortages. That is why this government is making every effort and taking every opportunity to leverage better healthcare outcomes for all.

Thirty-six per cent of visits involve the clinician spending at least five minutes or more locating information. Just think about that: 36 per cent, in over a third of all visits to any clinician five minutes of it is spent just locating information. In any language, whether it concerns the health system or the education system, time is money. In year 2009-2010, 83 per cent of Australians visited a GP with a total of 116.8 million general practice services paid for by the taxpayer through Medicare. The collective waste of time and energy over these huge volumes of patients is staggering, and that is only looking at the opportunity costs associated with GP visits. When you take into account that this waste of time is constant among all healthcare practitioners it is astounding and it is a significant cost to the taxpayer.

Currently, 10 per cent of laboratory tests are avoidable through electronic health records—that is right: one in ten very expensive laboratory tests are unnecessary. Due to duplicated investigations, these tests occur not only wasting time but taking up time and resources that could be directed to more necessary testing. We do not have to have an ideological debate in this place about the left, the centre-right or the right view of health. This just makes sense. If we can improve the circumstances of all Australians and get a better return on hard-earned taxpayers' money, it has to be a good result irrespective of what side of politics we may be on. Currently, when a person attends a new provider and their previous test results are not available, this leads to huge, unnecessary duplication—especially as Australian citizens are more fluid, as I said, in their living arrangements.

These are just some of the areas this bill seeks to address. This bill will change the name, as I said, and will enable opt-out trials to be undertaken for individuals in a manner that retains the same patient controls as were provided. But while these trials are operating in defined areas, the existing opt-in system will continue to operate everywhere else in Australia. If the trials are successful, and I suspect they will be, the government will decide to implement opt-out nationally. This bill enables that to occur if and when that is the case.

To make way for new governance arrangements that will be established, this bill will abolish the existing PCEHR Jurisdictional Advisory Committee.

In order to better protect the sensitive information that can be contained in a myHealth record and to provide a more graduated framework for responding to inappropriate behaviour that is proportional to the severity of a breach of either the HI or myHealth system, the bill will introduce new civil and criminal penalties and provide that enforceable undertaking. This government is delivering a more comprehensive and effective system and it also strongly believes in the consequences of breaching the integrity of that system.

In the short time that I have left, I just make a plea to all members of parliament that, as one, we should all be committed to efficiencies within our health system. We should not be scared of that technology that is now available to us. Every man, woman and child now knows that, with all online purchases and online records, much of our lives is exposed basically to the world. I would encourage everyone to understand that it is very much in the best interests of the health system of this country to move to a fully implemented myHealth Record system. I thank the House.

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