Justine Elliot (Richmond, Australian Labor Party) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (eHealth) Bill 2015, which is aimed at streamlining the eHealth system within Australia. As the previous speaker said in summing up, it is important that we embrace the technology available to us, particularly to improve, in this instance, our health systems. There are major opportunities for the expansion of e-health to improve so many health outcomes. So I certainly agree with many of the points that he did make, particularly in terms of embracing the benefits of such technological advances as we do have. Indeed, we have said on this side of the House that we certainly support the intent of this bill.

We have mentioned how we would like to see some further scrutiny, but we certainly do support the intent because, of course, eHealth was a Labor initiative and it does have great potential to enhance our health system. The primary purpose of the bill is to modify the Personally Controlled Electronic Health Records system. This system contains an electronic summary of a person's health records, which allows individuals and healthcare providers to access all that vital health information all in one place. The information is available online, so it is fantastic that it can be accessed where and when it is actually needed. Under health situations which at many times may be urgent that information can be accessed. So the opportunities available with e-health are tremendous. Under the bill, the personally controlled electronic health record will be renamed the myHealth record.

These changes are proposed in response to recommendations made by the review in December 2013. The bill will additionally implement recommendations of the 2013 review of the Healthcare Identifiers Service, which is a foundation for these e-health measures. Further to this, it will make several amendments to the legislation in order to improve the operation and cohesiveness of these very important health systems. This bill will also change the governance arrangements and the system's usability.

What is important about this bill is that it will enable opt-out trials to be undertaken but with the same patient controls as contained in the Personally Controlled Electronic Health Record system, and it importantly allows opt-out to be adopted nationally if the trials are proven to be successful. In the meantime, the existing opt-in system will remain in place when these trials start. The bill will allow the government to make regulations to authorise new entities to handle healthcare identifiers and other protected information. It also increases the range of enforcement and penalty options available for intentional or deliberate misuse, introduces criminal penalties and amends the privacy framework. The government has stated that individuals in opt-out trials will automatically have a myHealth record created for them unless they opt out, and I understand they will have a number of ways to do that.

I was pleased to see that the government has undertaken that extensive communication will be undertaken in the trials before the trials actually begin to allow individuals to make informed decisions about whether or not to opt out. It is especially important, I think, for everyone to be aware of the benefits of e-health, particularly for our older Australians, obviously, who often have more complex and complicated health needs and who, I think, would be perhaps some of the greatest beneficiaries of the eHealth record. So it is important that extensive communication occur so that they can fully understand the benefits of such changes to the system.

I understand that the trials are expected to commence in 2016, and it is understood that they will take place in three locations. One location is most likely to be in northern New South Wales. I think my electorate of Richmond would certainly welcome a trial such as this, particularly, as I say, with the higher number of older Australians there. Another location, I understand, is metropolitan Queensland, and a further, third, site is yet to be determined at this stage.

This eHealth system has been so successful—and, of course, it is a Labor reform that was brought in by us in government. It was initially brought in through an opt-in-model. Labor introduced the Personally Controlled Electronic Health Record system in July 2012 to move the paper based health system to a far more efficient digital system. The main reason was to improve the level of health care for all Australians, especially those with complex and chronic health conditions. There are so many benefits for them. This change was needed due to the complex and often inefficient paper based system. Having such paper based systems can ultimately lead to poorer health systems and poorer health outcomes as well. There is so much potential with e-health.

This change, initiated by Labor, represents an ongoing commitment to improving our health systems which, of course, began with the introduction of the Medicare system of universal health care, and so distinguishes us on this side of the House. Labor is always looking for ways to improve the health system for all Australians and is very committed to making sure those improvements are in place.

When last in office, Labor achieved substantial milestones in the progress of e-health. We encouraged over a million Australians to sign up for the online system, and this growth has continued to expand to almost 2.5 million Australians today. That is a huge increase. Since Labor introduced these reforms, I understand over 3,000 specialists' letters have been uploaded, over 5,000 general practices have registered for e-health and a massive amount of more than 1.6 million prescription documents have been uploaded. So there certainly has been a lot of interest and involvement in e-health so far.

When we look at some of the history and evolution of e-health, there was more than a decade of debate in which, really, little action did happen. It took the Labor party to actually create the change to e-health. As stated by the member for Sydney when she was the health minister, eHealth is merely an extension of Labor's universal healthcare system, Medicare. I think it reinforces Labor's commitment to the principles of a universal national healthcare system, which is the basis of a strong Medicare system. A system which has, of course, been under threat generally from this current government. We have seen a number of versions of their GP tax, which would potentially have devastating results across the country, especially in rural areas, as well as $50 billion in cuts to hospitals. The impact of that has been very harmful, particularly in regional and rural areas such as my electorate of Richmond. Australians are gravely concerned about the extent of this government's harsh cuts, and some of those harmful health outcomes.

When we are talking about the history and the evolution of eHealth, having undertaken such significant health changes in the past, designing and implementing such an e-health system proved to be a challenge that only a Labor government would truly commit to and undertake. In 2010, the then minister for health, Nicola Roxon, announced Labor's two-year $467 million investment in developing the National Health and Hospital System. This funding was directed in several key areas to serve, essentially, as a building block for the growth of our health system. Specifically, funding was allocated to a range of areas relating to e-health, including providing summaries of patients' health information, including medications, immunisations and medical test results. A key area of funding was also the establishment of secure access for patients and healthcare providers to the online records. An investment priority was to also provide rigorous governance and oversight in order to maintain privacy and to ensure that healthcare providers had access to national standards, planning and core national infrastructure required to use the e-health system. Labor understand the health needs of a modern Australia, and we do see eHealth as a critical piece of infrastructure in any healthcare system, which is why we have said we certainly support the intent of this bill.

The potential for e-health records to reduce duplications and allow for a more efficient healthcare system cannot ever be underestimated. If we look to the extensive record in terms of what e-health can hold, there can be a summary of the patient's important medical history, the lists of medications prescribed and dispensed, allergy information, childhood immunisation records, child health and development information, hospital discharge reports, organ donor status, advanced care planning details, summaries of individual patient health events, Medicare and PBS claims data, and even private notes made by patients about their own health. All of that is vitally important to have there. In 2013 Labor made an additional investment, which enabled even pathology and diagnostic imaging results to be included in a patient's e-health record. So it is absolutely wonderful to have that all contained in one particular area and easily accessed, often urgently, so that all of that information is available to a healthcare provider, which is very important.

Unfortunately, the inaction of the Liberal-National government in their two years of government has certainly been disappointing when it comes to the lack of progress with e-health so far. We certainly saw last year that there may have been $700 million allocated for investment into the development of eHealth, but the government's so-called rescue package only served to cut this essential program back by $215 million. Compounding this situation is the fact that the government has not allocated a single dollar to the program for the entire 2018-19 financial year. That is disappointing because it has already been established that this system is vital in improving the efficiency and effectiveness of the healthcare program, and it means that this program will become increasingly cost-effective for the health system over time, so it is vitally important that it is implemented properly and funded effectively and efficiently. The government's lack of action raises serious concerns about their long-term commitment to reform and, more importantly, the health care of this nation.

These reforms are very important, and there is very strong proof as to why they are important. When Labor first introduced these measures about two per cent to three per cent of hospital admissions in Australia were linked to medication errors, which equates to 190,000 admissions each year and costs the health system $660 million, and about eight per cent of medical errors are because of inadequate patient information. When we look at those figures, there is a huge potential under this system to make sure there are major improvements in healthcare outcomes and also major savings due to all of those errors that did occur with ineffective and inefficient patient information.

In an electorate like mine, Richmond, on the New South Wales North Coast, where there is an ageing population, e-health measures are vitally important. The potential that an e-health record has in improving patients' care, especially the elderly, can never ever be underestimated—as I said, because of the often complex health concerns that older Australians do have. When we look overall at some of the benefits of e-health, it has been estimated that the benefits from this program will reach $11.5 billion over the 15 years from 2010 to 2025. That is a major achievement.

Labor supports the majority of changes the government proposes to make through this bill. Our concerns do lie with the length of time the government has taken to do anything in relation to e-health and to act on it. We do accept that a number of the changes they have made are very sensible, such as allowing service providers that might not meet the definition of a healthcare provider under the existing act, such as a palliative care or aged-care service provider, to now have access to it. So it is very good, and I certainly commend the government in terms of those changes. It is also of the utmost importance that patients' privacy be given the highest regard possible, and it is for that reason that Labor believes some of these provisions do require further scrutiny. We have stated that we believe that further scrutiny should occur when it is in the other house, in the Senate. We would like to see some more detail and get some greater reassurances around those privacy provisions that are contained. We do think that is vitally important.

In conclusion, we certainly do support the intent of this bill. We know the benefits of e-health as we initiated it, and we would certainly like to see it expanded properly. These new systems do seem to be very effective, and we look forward to the further expansion of e-health to improve the health outcomes for all Australians.

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