Andrew Southcott (Boothby, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services, Health and Wellbeing) Share this | Link to this | Hansard source

The Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010 allow for the introduction of 16-digit identifiers for every Australian, every healthcare provider and every healthcare organisation in Australia. The introduction of these identifiers is a key foundation for the establishment of a national e-health system. In order for an effective national e-health system to be implemented it is critical that we put in place a solid foundation. This is the legislation which will establish that solid foundation. Healthcare identifiers are the first step in establishing a system that will ultimately ensure a more cohesive, coordinated healthcare system for Australian patients.

Since the last election, we have heard the Clayton’s promises of the Rudd Labor government. The Prime Minister promised to fix the hospitals by June 2009. We are still waiting for him to fix hospitals. He promised 31 GP superclinics and, according to a Senate estimates hearing, only two of those are currently fully operational and only five are expected to be operational by the time of the next election.

We have a healthcare system which is increasingly under pressure. Rates of chronic disease are increasing, coupled with an ageing population. This places a massive burden on the healthcare system, both from a health management point of view and in terms of cost. The Australian Institute of Health and Welfare estimated that just over seven million Australians had at least one chronic condition in 2004-05. As people age, the likelihood of their having more than one chronic condition increases. Australian hospital statistics for 2007-08 indicate that more than half of the potentially preventable hospitalisations are from selected chronic conditions. Better management of these conditions and a more coordinated approach between healthcare providers could have a significant impact in decreasing these hospitalisations.

E-health offers an opportunity to improve health care in Australia but it is critical that it is introduced right from the outset. In contrast to countries like Great Britain, Germany and Canada, we lag well behind in the implementation of e-health measures. The systems that have been introduced in those countries allow for the sharing of diagnostic imagery between providers, e-prescription services and the ability to facilitate communications between providers—reducing the silo method of treating patients.

The Howard government took e-health seriously, and we had a commitment to providing leadership in e-health. The computerisation of GPs, which now sees very high rates of prescriptions prepared by general practitioners, was part of an incentive payments scheme introduced by the previous government to increase the uptake of these technologies and the use of them in general practice.

A national system will provide for greater consistency of health care for Australians. We need to ensure that accurate information is conveyed and that patients are not undergoing unnecessary procedures or unnecessary diagnostic tests as a result of duplicated services. We need to ensure that our medical practitioners are being provided with the best possible information about their patients, enabling them to make accurate diagnoses. E-health has benefits for rural and regional services. Particularly in Indigenous health care, where there is a significantly higher rate of chronic disease, coordinated health management would have a significant impact.

Studies in the United States have shown that a failure to utilise health IT has resulted in higher costs, medical errors, administrative inefficiencies and poor coordination, amongst other issues. This information is taken from the 2008 Booz & Company report into e-health. The Institute of Medicine estimated that between 44,000 and 98,000 Americans die each year as a result of medical error, and as much as $300 billion is spent each year on health care that does not improve patient outcomes.

When we deal with this legislation there are still a number of concerns that have not been addressed and, once again, the government appears intent on rolling out legislation without having done the appropriate groundwork. The National Health and Hospitals Reform Commission recommended a person-controlled electronic health record. That recommendation has not been taken up. This will not be a patient-controlled electronic health record. It is also not an opt-in system for patients. Anyone who has a Medicare number or a DVA number will be given the 16-digit number. It will be compulsory for patients to have an individual healthcare identifier. A number of stakeholders have rased concerns around the privacy controls. The opposition believe it is critical to address any concerns before the implementation of these identifiers. The government is yet to provide details of the regulatory framework to ensure security of individuals’ health information. The government has not provided the regulations which will govern the operation of this legislation. The National E-Health Transition Authority has admitted that it is yet to decide how access control would work.

One of the most serious allegations in the area of e-health is in an article in the Australian on 2 March, where allegations were raised against Medicare Australia staff, with a report showing that one in six staff have apparently looked at confidential patient records, without authority, in the past financial year. That is an alarming figure and it is a concerning figure, given that we are talking about Medicare Australia. It is subject of course to the privacy principles. But the issue here is that this legislation intends to give responsibility for the implementation and oversight of healthcare identifiers to Medicare. Medicare will be the identifier service for this e-health system. So it is absolutely critical that the safeguarding of private patient information is assured and it is absolutely critical that the chief executive officer of Medicare Australia, who will be responsible for operating and maintaining the healthcare identifier service, addresses these issues, which show that Medicare staff are inappropriately accessing confidential patient records.

I recognise that there has been a long consultation period, with a discussion paper in July last year, and release of the draft legislation in December. However, there was very limited time for stakeholders to respond to the draft legislation, with the one-month window of opportunity spanning the Christmas break. This matter was raised by a number of stakeholders who felt they did not have sufficient opportunity to voice their concerns. As a result, while the opposition do not oppose this legislation, we think it is important that stakeholders be given a further opportunity through the Senate Standing Committee on Community Affairs to examine this legislation. That committee has received a number of submissions and conducted hearings, both yesterday and today, and will be reporting back to the Senate next week.

Another concern that has been raised follows on from the lack of consultation time available to stakeholders. This system is due to commence on 1 July 2010. It defies belief that the government has delayed in providing software manufacturers and developers the specifications to enable them to design an appropriate IT framework or to integrate healthcare identifiers into existing software packages.

In its submission, the Law Council proposed to include a legislative declaration to ensure that the healthcare identifier number could be used only for the purpose of health management. I thought that was a sensible recommendation but it was not picked up by the government in moving from the draft legislation to the legislation that we currently have before us. The Minister for Health and Ageing has not adopted that recommendation.

Concerns have also been raised about the breadth of this legislation. As it currently stands, privacy laws are able to be overridden if the action is legal under any other law—that is, giving out a healthcare identifier number is not subject to privacy laws if that action is legal under any other law. That very broad definition is contained in this legislation.

As I said earlier, the coalition are not opposing this legislation but we have referred it to the Senate Standing Committee on Community Affairs. We do reserve the right to make any amendments, depending on the findings of that Senate committee. The committee provides a greater opportunity for stakeholders to raise their concerns, and I recognise that many have done that. As I said before, with the draft legislation very little time was afforded for stakeholders to submit their views and, to date, not all of their concerns have been addressed. For legislation as important as this, which is set to play such a crucial role in sharing very sensitive, very confidential healthcare information in the future, it is absolutely vital that we get this right and the Senate committee will afford us that opportunity.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I am a trifle confused after hearing the contribution of the previous speaker, the member for Boothby, on the Healthcare Identifiers Bill 2010 and the cognate bill. On the one hand, he said that the opposition will not oppose this legislation; on the other hand, he said it is being referred to the Senate Standing Committee on Community Affairs. Then he said that, when the committee reports back, the opposition reserve their right to make amendments, to oppose or to actually change their position. We on this side of the House know the one thing that those on the other side of the House are good at doing is obstructing, blocking and opposing any piece of legislation.

Despite the opposition saying they will support the legislation, I would not be surprised to come into this House and see the opposition voting against it. That is the one thing that they do—oppose, oppose and oppose. They are never constructive. They never look at things in a constructive way. They are not about improving health, health outcomes and access to health for Australians; rather, they are about opposing any change. Whilst the Rudd government is undertaking the most important overhaul of our health system, since the introduction of Medicare 25 years ago, the opposition are thinking of opposing any proposal that is put forward. This is vital legislation. Its roots were actually in the Howard era. At that particular time the opposition were very gung ho in supporting the introduction of healthcare identifiers. Unlike the Rudd government, they were prepared to race in without proper consultation, without looking at all the aspects and without looking at what the implication might be of the introduction of health identifiers.

The Healthcare Identifiers Bill 2010 will establish a national Healthcare Identifiers Service and set out arrangements for its operation and its function, which will be to assign, issue and maintain healthcare identifiers for individuals, healthcare providers and organisations. It is very vital. If we want to introduce a strong e-health system in Australia that caters for the needs of all Australians and all health professionals and ensures that all Australians get the kind of healthcare they deserve, then e-health is important. And to have a strong e-health system we need to have healthcare identifiers.

The key objective of the Healthcare Identifiers Service will be to provide a national capability to accurately and uniquely identify individuals and healthcare providers, enabling reliable healthcare-related communications between individuals, those people seeking medical treatment, those providing the treatment and the organisations that those providers are associated with. All Australians will be issued with the 16-digit number which will follow them throughout their lives. There are safeguards in place that I will discuss a little later that ensure the privacy of individuals.

A national approach to healthcare identifiers was agreed at COAG in February 2006. I want to emphasis the fact that the Howard government was in power in 2006. At that time, it was 100 per cent supportive of healthcare identifiers and could see the benefit. Now we have an opposition that has serious concerns about it. It may support the legislation but—as I have already indicated—I will not be surprised to see the Abbott opposition come back into this House and do what it always does: oppose, oppose, oppose. It is never constructive. COAG agreed to the universal assignment of identifiers to individuals and to provide $218 million in funding for the e-health work program. It was also agreed that public consultation on the national health privacy process should be conducted. That consultation happened and the outcome was reported to COAG in December last year. This legislation before us today makes minor amendments to the Privacy Act 1998 and the Health Insurance Act 1973 to enable the functions under the Healthcare Identifiers Bill 2010.

As I mentioned earlier, there has been widespread consultation. I will just mention some of the agencies that have been consulted in drawing up this legislation: the Department of the Prime Minister and Cabinet; the Office of the Privacy Commissioner, which should allay the fears that anyone has about privacy; the Department of Human Services; Medicare Australia, who will play a vital role in the administration of this; the Department of Veterans’ Affairs; the Attorney-General’s Department; the Australian Government Solicitor; the Department of Defence; the Department of Broadband, Communications and the Digital Economy; the Department of Families, Housing, Community Services and Indigenous Affairs; the Department of Finance and Deregulation; the Department of Infrastructure, Transport, Regional Development and Local Government; the Department of Innovation, Industry, Science and Research; and the Department of the Treasury. In addition, there has been widespread community consultation and consultation with interest groups outside of government.

When I was first elected to this parliament I was a member of the House of Representatives Standing Committee on Family and Community Affairs and at that time they were doing an inquiry into Indigenous health. A report was brought down following the conclusion of that inquiry titled, Health is life. One of the issues that was apparent to the members of that committee was the fact that e-health was of vital importance if we were to provide an excellent service to people living in rural and remote areas, particularly Indigenous Australians. Here we are, 10 years after that report was tabled in the parliament, and we are gradually moving towards a stage where e-health will be up and operational.

I thought I would just quickly summarise what the Healthcare Identifiers Bill 2010 will do. The bill will establish a Healthcare Identifiers Service to assign and issue unique identifiers to individuals and, as I have said, to all the providers and their organisations. The bill will authorise the chief executive officer of Medicare Australia to be the initial HI Service operator. It will also authorise the CEO of Medicare Australia to use personal demographic information collected for the purpose of administering Medicare Australia’s healthcare benefits program to generate identifiers for the purpose of the HI Service or to disclose the information to any subsequent HI Service operator for the same purpose.

That enables all Australians to be issued with a HI number, and that is going to be the core feature of our e-health system. That must be in place before we can have an e-health system that we can be sure will operate effectively and so we can be sure that the information will not be able to be questioned and the service will be streamlined. The bill will authorise the HI Service operator to collect and use information provided from other sources, such as the Department of Veterans’ Affairs, and to share that information for professional registration and accreditation purposes.

The bill will enable appropriately authorised individual healthcare providers to retrieve an individual identifier or individual healthcare provider identifier. It will enable appropriately authorised individual healthcare providers and provider organisations to disclose certain information to the HI Service operator. It will limit the adoption, use and disclosure of healthcare identifiers and establish penalties for the misuse of healthcare identifiers. In saying that, there are in place appropriate systems to ensure that misuse does not take place.

The bill will provide for the federal Privacy Commissioner to oversee the HI Service, use of identifiers and complaints handling in relation to Commonwealth agencies and the private sector. I am a person that always worries about privacy issues. With the federal Privacy Commissioner being involved and with the safeguards that will be in place, I feel that this system will work and the privacy of individuals will be protected.

The bill will provide for review of the role of the CEO of Medicare as service operator after two years and reporting within three years of the HI Service commencing operation. It will support the arrangements for healthcare organisations to participate in the HI Service. Going back to the point I was just talking about, the HI Service will be supported by robust privacy legislation to ensure protection of individual personal and health information that will continue to underpin quality health care. Ensuring that privacy of individuals is absolutely paramount.

Another important aspect is that a national partnership agreement has been signed by COAG setting out cooperative jurisdictional arrangements for e-health, including for the HI Service. This is the states and the Commonwealth working together to ensure that all Australians have access to e-health services. Underpinning this is the fact that people will be issued with healthcare identifiers.

This is a leap forward. This is moving into the future. This is ensuring that Australia is at the cutting edge of medicine. We have been a lot slower in getting to this stage than other countries have. A Personal Demographic Service, or PDS, with information on over 48 million health consumers has been in the process of implementation in the United Kingdom since July 2004. It will replace a number of locally held databases and put in place a unified scheme. Each person’s PDS card record will comprise demographic information very similar to the type of information that will be attached to the health identifiers as set out in this legislation.

There are a number of benefits in having a national e-health system. It will improve safety and quality of health care and increase involvement of consumers in their own health care. It will improve access for healthcare providers to reliable health information when and where it is needed. It will enhance shared care of complex medical problems and chronic diseases. I will just pause there and refer back to the Health is life report, which I mentioned earlier, brought down after an inquiry conducted by the House of Representatives Standing Committee on Family and Community Affairs. During that inquiry, we visited a number of remote Indigenous communities where many community members had complex medical problems and chronic diseases, and their access to on-the-ground services was limited. It was recognised that being able to use e-health and link into services elsewhere would really improve the health outcomes of people living in those communities. So it will be a real benefit to people living in remote areas.

An e-health system will reduce the burden on Australia’s health sector through better health management. I do not think there is anybody that works within any health system in Australia that would argue against e-health and the need for e-health. It will be a streamlined process that creates efficiencies and ensures that all Australians can get the best health care in the most efficient way. It will also ensure that the organisations providing the health care can share information. It is an innovative way to improve health sector productivity, and we are always looking to improve health productivity.

As has already been noted, the third Intergenerational report and the final report of the National Health and Hospitals Reform Commission have recently been brought down. Both those reports state that we need to prepare our health system for the needs of the coming decades. There will be more people with complex medical needs. We cannot go on as we have in the past. It cannot be business as usual. We need to ensure that our health system is up to the task of caring for all Australians into the 21st century. We need to make sure that we are at the cutting edge. We need to make sure that we cut down on the duplications. We need to make sure that health care and health services are delivered efficiently, and that can only be done if we utilise e-health.

With the improved health care that e-health enables and by ensuring that resources are directed to where they are most needed, which will happen through the utilisation of e-health, we will get better outcomes. Lives will be saved through better decisions, better support, increased access to information and a reduction in adverse events. This is a win-win situation.

As I mentioned earlier, the only concern I had initially was about privacy. Having read the details and having been assured that there will be a proper framework in place to ensure the privacy of all Australians and penalties if anyone looks to breach those privacy requirements, I am quite comfortable with the legislation that we have before us. Putting in place the health identifier service is the starting point for an e-health system that is uniform throughout Australia. It is vitally important for the health of all Australians. I encourage the opposition not to change their position but to get behind the legislation and support it and not oppose it just so they can oppose legislation.

Peter Lindsay (Herbert, Liberal Party) Share this | Link to this | Hansard source

Over in the United States, the Americans are paranoid about any move whatsoever to change gun laws. The Americans say, ‘It is our right to carry arms,’ and it is not unusual, if you travel on a bus somewhere in the United States, to find that every third person probably has a gun in their pocket. It results in some terrible outcomes and is something that should be changed. America should follow Australia’s lead in relation to gun laws.

Here in Australia we have our own peculiar phenomenon, which relates to national ID issues and the paranoia that Australians seem to have about having national ID cards and the like. Just as the gun law situation in the United States is wrong, the paranoia in Australia about having national identifiers is wrong. It is such a pity that, whenever there is a proposal to establish a common identifier, the public are very ill at ease and edgy, and often it is opposed. A government will put up a policy to have some kind of national identifier and the opposition will oppose it, building on the fear of Australians that Big Brother is watching.

That happened under the last government when the Labor Party opposed the notion of a national health card which rolled into one card a whole range of possibilities. The card had a smart chip which had all sorts of Centrelink information, health information, taxation information and so on, but it was extraordinarily well protected. The security that was proposed for the card was second to none. The card also had the potential to carry people’s personal information—bank details and so on—and would have produced a situation where you only needed to have one card to carry everything that you used in your normal, day-to-day life. But the Labor Party opposed it and it did not fly. That is such a pity, because it would have been so convenient to have it.

Of course, what we have now is the de facto national ID card, which is your drivers licence. How often is it that you have to present your drivers licence as a form of identification? Interestingly, I recently had to apply for a new ordinary passport. I went to the post office, as everybody does, and had to identify myself. I said: ‘Here is my current official passport. This is my identification.’ The people at the post office said, ‘No; you have to produce your drivers licence and your Medicare card.’ The official passport was not sufficient identification for me to get an ordinary passport. What a nonsense that is.

My point is that this legislation—the Healthcare Identifiers Bill 2010 and Healthcare Identifiers (Consequential Amendments) Bill 2010seeks to establish a 16-digit identifier for healthcare purposes, and I do not think it goes far enough. I certainly support the legislation. I certainly support the notion that this is a safe, secure mechanism and that there are no privacy issues, and we should implement it. I am just disappointed that it does not go far enough. My message to the parliament tonight is that we should extend this proposal. We should have a practical national ID number for everything.

Other countries have it. I will give you an example. A country that you would think would be opposed to a national ID number is Sweden. It is basically a socialist country. But everybody in Sweden accepts the need for a national ID number. It is used in everything. You cannot go anywhere without quoting your national ID number. It does not lead to any fraud or misuse of the number. People’s privacy is respected. It is even used for the electoral roll. Incidentally, when I was looking at this issue, I discovered that in Sweden you can have two votes. If you cast your vote in an election and then decide that you want to change it, you can then go back and change your vote. But you can only do that because of this national ID number. So I appeal to the government to think about expanding the concept—effectively this is a narrow form that is being presented to the parliament tonight—to a truly national identifying number that can be used everywhere you go across all federal, state and local departments and that is securely protected for the convenience of Australians. These days, with the wonderful technology that we have access to, surely it makes sense that we can produce such a system for the benefit of all Australians.

So this is a positive step by the government. I support it. There are clear benefits for the e-health program, and it does help create a more unified and coordinated national healthcare system. The key aspect of this is that there will be, through increased communication and availability of healthcare information for both patients and doctors, clear benefits. As Australians have a propensity these days to move around the Commonwealth—lots of Australians move from state to state and from district to district—it is just so sensible to be able to arrange for whoever is the local doctor you are going to see to have access to the information in the e-health system.

I guess I do have a word of disappointment, though, in that it has taken the Rudd government 28 months to do anything on health care. Inaction has been Labor’s only solution for too long. When it comes to an issue as important as health care, taking the first small step is only the beginning. I draw parliament’s attention to Townsville Hospital in my electorate. It is one of the many hospitals around the country that are struggling. Townsville Hospital is under serious pressure. A Queensland Health report in September 2009 showed that, for that quarter, patients in Townsville spent an average of eight hours waiting for a ward bed—that is the highest state wide—and, in just one day in February 2010, last month, there were 26 patients in the emergency department waiting to be admitted to a ward. Labor knows that Townsville Hospital is struggling. The state government knows that Townsville Hospital is struggling. The Queensland health department released a report in January 2010 which predicted that there would be an extra 40 per cent of overnight hospital stays by 2016-2017 and the need for an additional 179 beds. But the report did not address many of the real concerns or propose actual solutions. There is no solution for the chronic workforce shortages of the hospital and no plan to boost the number of doctors and nurses to provide care for these extra beds. Bed shortages are a big issue for Townsville Hospital. In June 2009, the hospital had over 21,000 people on a waiting list to get on a waiting list. That is an extraordinary situation. It is unacceptable for patients in Townsville. But it is just one of the problems in health care in North Queensland. The e-health initiative in this legislation before us tonight does help.

I come from regional Australia. Behind Townsville is the great north-west minerals province, where people work on a fly-in fly-out basis at the mines. As people come and go across the north-west minerals province, they may need to see a doctor in Townsville or Cloncurry or Mount Isa or Hughenden or Richmond and so on. So this e-health initiative helps with their medical records and this legislation provides an individual identifier which allows people to access their information and doctors to access this information no matter where they might be in this great land of ours. The Australian health system is facing increasing pressure. Can I just ask the member for Petrie: how much time do you want to use in your speech?

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

Twenty minutes.

Peter Lindsay (Herbert, Liberal Party) Share this | Link to this | Hansard source

So I can conclude.

Judi Moylan (Pearce, Liberal Party) Share this | Link to this | Hansard source

The member for Herbert, I think, should continue.

Peter Lindsay (Herbert, Liberal Party) Share this | Link to this | Hansard source

That is okay. I was just trying to assist the House. Thank you to the member for Petrie for assisting me. The whip asked me to talk on. Now I will not talk on —

Robert McClelland (Barton, Australian Labor Party, Attorney-General) Share this | Link to this | Hansard source

Mr McClelland interjecting

Peter Lindsay (Herbert, Liberal Party) Share this | Link to this | Hansard source

The Attorney-General loves that. So I will wrap up and say to the House that I do not think we have gone far enough in this legislation. I would like to see the parliament really seriously look at a proper national identifier that can be used for everything, not only for health but for all facets of our identification requirements across all levels of government, and indeed across the private sector as well. I will be supporting these bills, and I thank the House for its attention.

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

19:14:59 I rise to speak in support of the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010. The purpose of the Healthcare Identifiers Bill 2010 is to establish a national Healthcare Identifiers—HI—Service and set out arrangements for the operation of the service and its functions, which will be to assign, issue and maintain unique healthcare identifiers for individuals, healthcare providers and healthcare provider organisations. This bill will ensure establishing arrangements for their management. The bill will establish arrangements for operating and maintaining the Healthcare Identifiers Service, including the conferral of functions on the Chief Executive Officer of Medicare Australia. These functions include assigning, collecting and maintaining identifiers for individuals, individual healthcare providers and organisations by using information already held by Medicare Australia for its existing functions; collecting information from individuals and other data sources; developing and maintaining mechanisms for users to access their own records and to correct or update details; using and disclosing healthcare identifiers and associated personal information for the purposes of operating the Healthcare Identifiers Service; and disclosing healthcare identifiers for other purposes set out in the bills.

Importantly, the Federal Privacy Commissioner will provide independent regulation of how healthcare identifiers are handled and the operation of the Healthcare Identifiers Service. This will include handling complaints against Medicare Australia, as a service operator, and private sector healthcare providers. The Healthcare Identifiers (Consequential Amendments) Bill 2010 will ensure the Healthcare Identifiers Bill 2010 once enacted operates appropriately and effectively. This will be achieved by making minor amendments to the Health Insurance Act 1973 to authorise the Chief Executive Officer of Medicare Australia to delegate functions to officers to support the day-to-day running of the Healthcare Identifiers Service. In addition, minor amendments to the Privacy Act 1988 will provide for the Privacy Commissioner’s role as the independent regulator of the Healthcare Identifiers Service.

The establishment of the HI Service through these bills is an important step forward in health reform throughout Australia. The Rudd government has consistently argued that a national approach is needed to ensure the frameworks and key infrastructure components are coordinated and aligned across Australia. It is hoped that those on the other side of this chamber will support these bills and recognise the importance of this move towards e-health. I am pleased to hear that some of the speakers from the other side have already stated that they will support these bills. To do otherwise would fail their commitment made in February 2006 through COAG when funding was agreed towards the foundations for a national electronic health record system to allow for safe and secure communication between healthcare providers regarding their patients’ health information.

On 28 November 2008 COAG reaffirmed the earlier decision and agreed to universally allocate the individual healthcare identifier and to provide $218 million in funding to the e-health work program. In the National Partnership Agreement on E-Health it was agreed between the Commonwealth, states and territories that the key objective of the national Healthcare Identifiers Service, to be known as the HI Service, is to provide a national capability to accurately and uniquely identify individuals and healthcare providers to enable reliable, healthcare related communication between individual providers and provider organisations. The HI Service will underpin the development of a nationally consistent electronic health system by removing technological and organisational impediments to the effective sharing of health information resulting from poor patient and provider identification.

The identifiers are a fundamental key building block for a national e-health system. These bills not only will ensure the ability to meet the objective laid out in the National Partnership Agreement on E-Health but also start the process of adopting some of the key recommendations made in the final report of the National Health and Hospitals Reform Commission. In that report the commission identified actions that can be taken by governments to reform the health system under three reform goals: firstly, tackling major access and equity issues that affect health outcomes for people now; secondly, redesigning our health system so that it is better positioned to respond to emerging challenges; and, thirdly, creating an agile and self-improving health system for long-term sustainability. In achieving the third goal, the commission grouped the recommendations under five levers of reform to support a system adaptive and responsive to changing needs. The third lever to support an agile, self-improving system is a smart use of data, information and communication. The final report recommended a transforming e-health agenda to drive improved quality, safety and efficiency of health care. The report also stated that the introduction of a person controlled electronic health record for each Australian is one of the most important systematic opportunities to improve the quality and safety of health care, reduce waste and inefficiency and improve continuity and health outcomes for patients.

In fact, the final report of the National Health and Hospitals Reform Commission recommended the introduction of identifiers by July 2010. That is what this bill seeks to establish. E-health has the potential to improve patient safety and health outcomes. Such outcomes should be paramount in any consideration of health reform. If there was any doubt in this parliament or in the community about the necessity for this move, we need only look at the facts. It is estimated that 30 to 50 per cent of patients with chronic diseases are hospitalised because of inadequate care management. It is estimated that up to 18 per cent of medical errors are attributed to inadequate availability of patient information. Between nine and 17 per cent of pathology and diagnostic tests are unnecessary duplicates.

Putting aside the politics, the facts speak for themselves. COAG, both under the previous government and the Rudd Labor government, recognised the importance of a move to e-health. The National Health and Hospitals Reform Commission recognise the need for the implementation of e-health. The final report of the commission showed the stark reality if no action is taken to change the way health and hospitals are funded and administered throughout Australia. The report states that, if we continue to provide health services on the basis of ‘business as usual’ with no policy change, our health and aged-care costs are forecast to rise sharply from around nine per cent of GDP now to 12.4 per cent of GDP a little over two decades from now. In dollar terms, we are talking about a shift from $84 billion in 2003 to $246 billion in 2033.

The need to address the strain on the current health and hospital system in Australia and the future demand of the system was further emphasised in the Intergenerational report: Australia to 2050 - Future Challenges. This report highlighted the important issues of an ageing population, escalating pressures on the health system, and the environmental and economic challenges of climate change. The report noted that the proportion of Australia’s population aged 65 and over is projected to almost double over the next 40 years. The report stated that today there are five working-age people for every person aged 65 and over but by 2050 this will be almost cut in half—down to only 2.7 people. With a large ageing population within the electorate of Petrie, it is clear to many in my communities, including the health professionals, that we need to act. I am certainly pleased that the many health professionals in my electorate that I have spoken to recognise the need for and support the transition to e-health.

Kevin Rudd as leader of the Labor Party in 2007 and as the Prime Minister since the Rudd Labor government came into office has acknowledged the need for health reform and has committed to such reform. The member for Herbert was saying how he is disappointed, stating that he believes the government has taken 28 months to do nothing. Upon coming into office, the Rudd government immediately set to work on its commitment to the Australian people to reform the health and hospital system across Australia. In the very month that the first parliament of the new Rudd government was formed, February 2008, the Prime Minister and the Minister for Health and Ageing announced the establishment of the National Health and Hospitals Reform Commission. The commission was established to develop a long-term health reform plan for a modern Australia. Dr Christine Bennett, Chief Medical Officer at MBF Australia Ltd, was appointed as the chair of the commission, with nine other commissioners being appointed to assist Dr Bennett.

The commission undertook 16 months of intense discussions, debate, consultation, research and deliberation in their dedication to the cause of strengthening and improving our health system for this and future generations of Australians. On 30 June 2009, the commission presented the Minister for Health and Ageing, the Hon. Nicola Roxon, with more than 100 recommendations to transform the Australian health system. As Dr Christine Bennett noted in her letter to the minister in delivering the report:

Health reform does not happen overnight. It takes time and patience, commitment and goodwill from all of us. But we also believe that there is a pressing need for action, and health reform must begin now.

In September 2009, the government, including the Prime Minister and the Minister for Health and Ageing, set about consulting widely through health and hospitals reform roundtables across the country to gauge the opinions of doctors, nurses and allied health professionals on the recommendations with the final report. In all, over approximately four months, the government held 103 consultations.

On 3 March 2010, the Rudd government announced major structural reforms to Australia’s health and hospital system. The government announced that we would deliver better health services and better hospitals by establishing a National Health and Hospitals Network. This new national network will be funded nationally and run locally. These reforms represent the biggest changes to Australia’s health and hospital system since the introduction of Medicare, and one of the most significant reforms to the federation in its history.

There will be a national network, to bring together eight disparate state run systems with one set of tough national standards to drive and deliver better hospital services. It will be funded nationally, and by taking over the dominant funding role in the entire public hospital system the Australian government will end the blame game, eliminate waste and shoulder the burden of funding to meet rapidly rising health costs. Systems will be run locally, through local hospital networks bringing together small groups of hospitals, where local professionals with local knowledge are given the necessary powers to deliver hospital services to their community.

The Commonwealth will achieve these changes through the following actions: taking 60 per cent of funding responsibility for public hospitals by investing one-third of GST revenue—currently paid to the states and territories—directly in health and hospitals; taking over responsibility for all GP and primary healthcare services; establishing local hospital networks run by health and financial professionals which will be responsible for running their local hospitals, rather than central bureaucracies; paying local hospital networks directly for each hospital service they deliver, rather than just handing over block funding grants to the states; and bringing fragmented health and hospital services together under a single National Health and Hospitals Network, through strong transparent national reporting.

These reforms will be put to the states and territories at the COAG meeting to be held in Canberra on 11 April. The Commonwealth wishes to work with the states and territories to reach agreement on these reforms. However, if agreement cannot be reached the Prime Minister has stated that the government will take this reform plan to the people at the next election—along with a referendum by or at that same election to give the Australian government the power it needs to reform the health system.

The new National Health and Hospitals Network will end blame shifting and cost shifting, and provide national leadership on health and hospitals with increased local control. Yet, the member for Herbert says we have been doing nothing for 28 months. Sweeping changes to the way hospitals are funded and run will also lead to less waste and duplication and a health system which is sustainable into the future. On the basis of these reforms, over the coming weeks and months the government will announce critical additional investments to train more doctors and nurses; increase the availability of hospital beds; improve GP services; and introduce personally-controlled electronic health records. The establishment of the National Health and Hospitals Network builds on record investments in health and hospitals made by the Rudd government over the last two years.

Already underway under the Federal Labor government in just two years is an agreement for health and hospitals funding over the next five years—a 50 per cent increase on funding under the Howard government—including training more doctors and nurses. This is the largest ever investment in the health workforce. This government has increased GP training places to over 800—a 35 per cent increase on the Abbott cap—and increased the number of places for junior doctors to experience working in a general practice setting by 10 per cent this year. We are also upgrading the emergency departments of 37 hospitals around the country. The Rudd government has already delivered more than 62,000 extra elective surgery procedures—64 per cent more than the target of 25,000 procedures.

The government is delivering new elective surgery equipment and operating theatres for 125 hospitals, and 36 GP superclinics are to be built across Australia, including a new superclinic in Redcliffe in my electorate. The government is already investing in our rural and remote workforce—an extra 500 communities and around 2,400 doctors in rural Australia will become eligible for financial support for the first time—and there will be 35 health infrastructure projects including improving 18 hospitals around the country and upgrading 12 medical research and clinical training facilities. Already underway are more residential aged-care places through providing low real interest rate loans.

In contrast the Liberals in government, under the stewardship of the Leader of the Opposition, as then health minister, slashed $1 billion from public hospitals, and they caused a national shortage in the medical workforce by freezing medical student places and capping GP training places, leading to a critical doctor shortage affecting 60 per cent of the population.

Debate interrupted.