Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Link to this | Hansard source

I ask leave of the House to make a ministerial statement relating to e-health reform.

Warren Truss (Wide Bay, National Party, Leader of the Nationals) Share this | Link to this | Hansard source

Mr Speaker, normally we would grant leave, but this is not a ministerial statement; it is a tirade of political abuse. It is an abuse of the ministerial statement process, so leave is not granted.

Anthony Albanese (Grayndler, Australian Labor Party, Leader of the House) Share this | Link to this | Hansard source

I move:

That so much of the standing and sessional orders be suspended as would  prevent Ms Roxon speaking for 10 minutes.

Kevin Andrews (Menzies, Liberal Party, Shadow Minister for Families, Housing and Human Services) Share this | Link to this | Hansard source

The opposition oppose this motion, just as we opposed the giving of leave in the first place. This is an abuse of the parliamentary processes by the Minister for Health and Ageing and now by the Leader of the House. They think they can come in here every day in the way we have seen from the Leader of the House and just abuse the parliamentary process, and the opposition are not going to stand for it. We had it today in this sectarian attack by the minister for health, repeating what she said a week ago, and this was passing somehow as parliamentary debate. It is disgusting.

Anthony Albanese (Grayndler, Australian Labor Party, Leader of the House) Share this | Link to this | Hansard source

Mr Speaker, this is a suspension so as to allow the minister to speak for 10 minutes. They are taking more time in debating the procedures than in debating the substance, which says it all.

Harry Jenkins (Speaker) Share this | Link to this | Hansard source

There is no point of order. The Leader of the House will resume his seat. The member for Menzies has the call.

Kevin Andrews (Menzies, Liberal Party, Shadow Minister for Families, Housing and Human Services) Share this | Link to this | Hansard source

I am speaking against the motion that was moved by the Leader of the House. I put to the House that this is an abuse of the processes of the House, given the attitude that has been taken by this minister in relation to these matters. What we have had from this minister today is an attempt to engage in a tirade of abuse against the opposition rather than debate matters of significance and importance to the people of Australia. It is for that reason that we opposed giving leave to the minister in the first place and it is for that reason we are opposed to this motion by the Leader of the House.

This is a matter which is still before the parliament in other realms. It is a matter which could be debated in a proper setting within this House. But we do not get that. We simply have the minister coming in here at question time with the attitude that she has taken. Now she is being backed up by the Leader of the House, who says, ‘We’ll just waltz this through; we’ll just push it through.’ They are using the usual thuggery that we get from the Leader of the House in this place towards all matters of parliamentary procedure.

As far as we on this side of this House are concerned, we are going to make a stance for proper parliamentary performance and we are going to make a stance against the abuse of the processes and the procedures of this parliament which is so typically engaged in by the Leader of the House.

The Leader of the National Party did not give leave for the reasons that he gave. For those reasons, we are not going to allow this parliament to be used for a tirade of personal abuse from the minister for health, which we have seen her engage in before. She simply wants to bring up a personal attack against the Leader of the Opposition. She did it at the end of a question today and she did it last week in question time. There was nothing of substance; nothing about this government’s proposals for health.

And when she gets a serious question asked about health by the shadow minister—for example, about why Dr John Mendoza resigned saying that he was disgusted with the attitude of the minister in relation to this minister—there is no answer from her and no answer from the Prime Minister, who simply waffles on for minute after minute as per usual in question time. He could not even name Professor Mendoza yesterday—one of the most significant medical advisers, the Chairman of the National Advisory Council on Mental Health. He sent a letter to the government saying that he was stepping down. Why was he stepping down? He said that it was because the whole approach of this government to mental health was a disgrace and had no vision whatsoever.

Worse than that, he said that what the government was doing—as we know is typical—was claiming for itself the programs and the policy expenditure that had been put into place by the previous government. And the Prime Minister could not even mention Professor Mendoza when he was asked in here why such an illustrious leader in the mental health field in Australia had resigned. It was because of the shabby treatment of mental health policy and programs under this minister.

What do we get from this minister? She comes in here thinking that it is great for her. She thought, ‘I will make a personal attack on the Leader of the Opposition.’ That is what she is about. She cannot come in here and defend her failure to provide adequate funding for mental health programs in Australia; she cannot come in here and say, ‘This is the way in which we’re going forward so far as health is concerned in Australia.’ All she can do is come in here and engage in a foul sectarian attack on the person and the character of the Leader of the Opposition. That is what we have had.

It is for that reason that the opposition did not give leave to this minister and it is for that reason that we will vote against this thuggish motion from the Leader of the House, who thinks that ministers should be able to waltz in here and engage in personal tirades against the Leader of the Opposition and the shadow health minister, which is what they seek to do day after day rather than doing anything substantially so far as healthcare funding in Australia is concerned. If there is any greater example of that, it is composed in this letter from Professor John Mendoza, one of the most illustrious leaders in mental health in this country. He said that there has been a shabby approach from this minister and this government so far as mental health is concerned.

This is what he said today:

On Friday I resigned my position as the head advisor to the Rudd Government on mental health. And it’s because of stories like Mary’s and my frustration over the Government’s failure to do more to prevent them.

So, today I’m taking the unusual step of writing to you through GetUp—

GetUp—do you remember them on the other side?—

to ask you to sign this petition, because I’ve come to the regrettable conclusion that my advice was not getting through—only public pressure will spur politicians into action.

This is Professor Mendoza.

Daryl Melham (Banks, Australian Labor Party) Share this | Link to this | Hansard source

Mr Melham interjecting

Kevin Andrews (Menzies, Liberal Party, Shadow Minister for Families, Housing and Human Services) Share this | Link to this | Hansard source

Are you seeking to deny his reputation, member for Banks? This is Professor Mendoza, a person chosen by this government for his ability, knowledge and expertise so far as mental health is concerned. He has been reduced to resigning, and the Prime Minister dare not mention his name in this parliamentary chamber. In order to get his concerns and the concerns of thousands and millions of Australians through to this thick headed government, Professor Mendoza is asking people on GetUp to start protesting and petitioning this government because of their absolutely disgusting failure of performance so far as mental health in this country is concerned.

If you want to have a debate about these issues, we will have a debate about these issues—and not using the sorts of personal tirades that we get question time after question time from the minister for health. They are why we are saying no. Do not abuse this chamber; do not abuse this parliament. Let us deal with your failures so far as mental health and the health system in Australia are concerned.

This is a motion to allow Roxon, the minister for health, to speak for 10 minutes only, to come in here and thuggishly say that we are going to have another tirade against the government. We have said: ‘No, we object to that. We object your personal approach to these things, Minister.’

Harry Jenkins (Speaker) Share this | Link to this | Hansard source

Order! The shadow minister will refer his remarks through the chair.

Kevin Andrews (Menzies, Liberal Party, Shadow Minister for Families, Housing and Human Services) Share this | Link to this | Hansard source

Mr Speaker, I refer them through the chair out of deference to you. What I am saying through you, Mr Speaker, is that we object to this approach by this minister. This is a disgusting approach by this minister. It is a regrettable approach by this minister. It is another opportunity for this government simply to engage in a tirade of personal abuse. We have had enough of the personal abuse from the Leader of the House and others in this government. So far as we are concerned, your abject failure so far as mental health in Australia is concerned is an indication of the total incompetence of this government that cannot deliver a program and that engages in overblown rhetoric day in, day out—and yet the people of Australia are waking up every day and finding out that promises which have been made are simply not capable of being delivered by this government. The reality is that this motion should be opposed.

Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Link to this | Hansard source

I speak against the comments made by the member for Menzies, who has finally lost it in this House. He has absolutely no recollection that the process for ministerial statements is to provide them, as was done, at 12 o’clock to the opposition. It is a statement about e-health, an important part of the future reform of our health system. The reason they want to talk about anything other than this topic is that they are cutting half a billion dollars out of e-health and they are looking for every other distraction they can possibly find rather than actually having a debate—with the minister standing here and the shadow minister replying—on an issue of substance. The shadow minister for health does not have anything he can say when it comes to the Liberal Party’s view on e-health because they are slashing half a billion dollars out of this system. So they are looking for every other diversion. They are pretending that the processes have not been followed. They are letting the member for Menzies off his leash to go absolutely barking in here, when he is talking about something that is nothing to do with the topic that is here for the ministerial statement.

Just minutes before we came into the chamber for question time I was in discussions with the shadow minister, with the shadow minister wanting to know if we would accept amendments on this so that the bills could be passed in the Senate. So this is a substantive health reform question. It is appropriate for it to be able to be debated here in the House. It is appropriate for there to be discussions about what is happening in the other place. And it is a complete distraction for the member for Menzies to get up and have a rant and rave about sectarianism—nothing at all to do with e-health and the significant reforms that are being introduced by this government. That is why we are seeking to suspend standing orders—in order to have this significant debate and in order to encourage the Liberal Party to actually put on the record their view about e-health.

Anthony Albanese (Grayndler, Australian Labor Party, Leader of the House) Share this | Link to this | Hansard source

I move:

That the question be now put.

Nicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | Link to this | Hansard source

We are at a crucial point for the future of electronic health development in Australia.

Given the key role that e-health will play in reforming Australia’s health system, progressing e-health is vital for the future direction of the health reform agenda.

For more than three months the government have wanted the Senate to consider the Healthcare Identifiers Bill 2010. We want to get on with implementing e-health, but these attempts have been blocked by the Liberal Party, by their delay and their dithering.

The bill sitting in the Senate as I speak today seeks to establish a single national healthcare identifier system for patients, healthcare providers and healthcare provider organisations.

This new identifier system will facilitate reliable healthcare related communications, support the management of patient information in an electronic environment and provide the foundations necessary to support the development of a national e-health record system.

Put simply, this is like building Highway 1, the main backbone of the new e-health system. Without unique healthcare identifiers there cannot be an integrated, consistent, national e-health system in Australia. We have to build the highway which will allow each and every healthcare provider and consumer to connect to a national system.

Electronic health records will help revolutionise the delivery of health care in Australia. That is why last month’s budget included almost $467 million to roll out personally controlled electronic health records for all Australians from 2012-13.

This investment will establish a secure, personally controlled electronic health record system that will provide:

• summaries of patients’ health information—including medication and immunisation summaries, and results of diagnostic tests;
• secure access for patients and healthcare providers to their e-health records via the internet;
• rigorous governance and oversight to maintain privacy; and
• the national standards, planning and core national infrastructure required to use the national system.

Patients will, for the first time, be able to access their key health information when and where they need it. Patients will no longer have to remember every detail of their care history, medications or test results and have to retell it to every health professional that they see.

It is estimated that two to three per cent of hospital admissions in Australia are linked to medication errors, which equates to 190,000 admissions each year and costs our health system $660 million per annum. And about eight per cent of medical errors are because of inadequate patient information.

E-health will save lives, reduce medical errors, keep people out of hospital and save money for the taxpayer.

Nine of the National Health and Hospitals Reform Commission’s 123 recommendations deal with the need to progress e-health, including a recommendation to introduce healthcare identifiers by July 2010—that is just next week—and individual electronic health records by 2012.

The government has worked hard to progress these reforms as a priority and to progress the legislation.

We referred the bill to the Senate Standing Committee on Community Affairs to allow for more community consultation on the bill after two rounds of consultation last year.

Stakeholders including the Australian Medical Association, the Australian Nursing Federation, the Royal Australian College of General Practitioners, the Royal College of Pathologists of Australasia, industry and the Consumer Health Forum of Australia all outlined the critical need for this legislation to be passed.

The committee recommended the passage of the bills without amendment.

However, following further consultation on the draft regulations and the recommendations proposed by the coalition in its minority report, the government has been prepared to propose amendments to the bill and regulations to respond to some of the issues raised.

Despite this, the coalition are still yet to commit to supporting the legislation and have announced that they would cut the budget funding to roll out e-health records—defying the almost unanimous support in the health sector for e-health.

The coalition have abandoned, unfortunately, more than a decade of bipartisan support for e-health reform and once again embraced the health funding cuts agenda they pursued when they were last in government.

This contradicts three specific speeches that Mr Abbott, the Leader of the Opposition, gave as Minister for Health and Ageing calling for e-health records.

Indeed, he based his first speech as the new health minister in 2003 on the need for e-health records. He gave his government five years to implement a national scheme or it would be an ‘indictment against everyone in the system, including the government’.

The member for Dickson, sitting at the table today, is also on the record as offering bipartisan support for e-health. Last September he stated the lack of e-health was a ‘very poor reflection on the last decade of discussion’.

The shadow Treasurer told parliament in 2008 that ‘there was a very bipartisan agreement’ on e-health.

After the Liberal decision to cut the next tranche of funding announced in this year’s budget was widely condemned by the AMA, the ANF, the AGPN and other stakeholders, Andrew Robb, the opposition finance spokesperson, declared they would not support e-health as there was no ‘individual identifier’ in place.

Today is the opportunity to change that. I say to the Leader of the Opposition, the shadow Treasurer, the member for Dickson and the member for Goldstein: here is the chance to right the wrongs of the last decade. Here is the chance to demonstrate that the Liberal Party is serious about health reform.

The decision to introduce a national approach to identification for patients and providers was made as far back as 2006 by COAG—under the Howard government. The decision was then affirmed in November 2008 when COAG agreed to universally allocate healthcare identifiers to all healthcare recipients in Australia.

Now it is crunch time for the Liberal Party. This is an opportunity to stop standing in the way of this building block for e-health in Australia. Clinicians, patients, industry and business all see this legislation as vital to improving patient care and efficiency in the health system.

There is much at stake with this legislation. Building a national e-health system depends upon having a secure, consistent foundation to correctly identify all records. Allocating healthcare identifiers for all Australians provides that foundation.

Personally controlled electronic health records will require specific safeguards, in separate legislation and governance arrangements.

The Liberal Party must think carefully about whether they want to risk consigning our health system to languishing under a paper based system or whether they want to support taking a big leap into the 21st century with this legislation.

The government has consulted often and widely on this legislation—with two rounds of public consultation, three independent privacy impact assessments, and the Senate committee all examining the design and operation of the identifiers service and legislation.

It is time for the Liberal Party to stop playing politics with patients and either support this legislation or step aside and allow the Rudd government to get on with the job it was elected to do.

So today I call on the Liberal Party and the shadow minister here at the table to state on the record if they will stand with the patients who want this, with the clinicians who want this and with the healthcare stakeholders who want this, or if they will continue to consign our health system to the paper records of the last century.

This is the choice that the Liberal Party face, and this is why this is a matter of such importance to be discussed in the chamber today.

We can consign e-health to the last century. We can leave it there, languishing with paper records. That may be where the Liberal Party’s health policies belong, but they should not stand in the way of such fundamental reform to our health system any longer.

We want the Liberal Party to stop playing games with this piece of legislation, acknowledge the government’s genuine attempts to address the issues raised during the consultation and allow the bills to pass the Senate this week.

I ask the shadow minister to please indicate today and advise the House in his reply if the Liberal Party will allow this legislation to pass in the Senate in the remaining few days before the winter recess and before the all-important 1 July start date.

Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Link to this | Hansard source

by leave—It is widely recognised and acknowledged that the introduction of a unique individual healthcare identifier is one of the important pieces of architecture in e-health in our country. The opposition understands this. We support e-health. We supported it in government. For example, the widespread computerisation of general practice was an initiative of the Howard government almost a decade ago. We support the introduction of a unique individual healthcare identifier; however, as many submissions to the Senate inquiry identified, the healthcare identifier legislation is too broad. That is why the opposition has drafted a number of sensible amendments to prevent function creep and to see that there is greater parliamentary scrutiny of the laws that will underpin the healthcare identifying service.

E-health is an area where substantial amounts can be wasted. According to Deloitte’s 2008 National e-health strategy report, $5 billion has been spent by the Australian state and territory governments over the past 10 years alone. This minister is proposing $467 million for electronic health records before they even have an identifier in place. At the COAG meeting in December 2009, $218 million was allocated from 30 June 2012 for the introduction of a health identifier, so the crocodile tears from the minister today really need to be exposed for what they are. There is money in the system. We propose sensible working amendments to the Healthcare Identifiers Bill 2010. We want to encourage the government to support them so that we can have a healthcare identifier.

To put this debate in perspective, I was first contacted by the Minister for Health and Ageing in relation to this bill at one o’clock today to say that she was going to provide this ministerial statement. A draft text of the ministerial statement was sent through to my office. We perused that information and it does not reflect the speech that was given by the minister only a few minutes ago. A page magically disappeared from the text of the speech that the minister provided—the page which included the tirade of personal abuse that we have become used to from this minister. It was not what was delivered to our office and it shows that this minister knows nothing else but personal abuse. She probably took that decision to modify her speech on the advice of the Leader of the House.

Why are we debating this bill today, at a time when this opposition has said that we will support sensible legislation? We are having this debate today because the government want to distract from their major failings, particularly in relation to mental health but also in relation to health more broadly. This is a government who have sat on their hands for the last 2½ years in the health arena. We have seen great frustration from health providers and indeed from patients right around the country, and that really came to a peak in the last 48 hours when Professor John Mendoza resigned his position as chief advisor in relation to mental health. For that the government should stand condemned. That is what we are doing here today.

This is a government that are trying to distract. They cannot say that they have a good record in health. They cannot say that they have a good record full stop. There are a number of reasons why people should not vote for this government at the next election and they have been well detailed—the insulation program, the billions of dollars being wasted in the school halls rip-off and the way in which GP superclinics have not been delivered. This government promised 31 GP superclinics at the last election and have three fully operational 2½ years later. Now they want us to believe that they can take over Australia’s 762 public hospitals and somehow competently run them when they cannot manage money and they cannot manage the health system.

We are here today as part of a massive distraction. If this minister were sincere about getting this legislation through, why would she approach me only a couple of hours before question time today? Why would that be the case when the shadow parliamentary secretary for health has been negotiating with the minister’s office in relation to this matter for some time and we said before question time, in a meeting which I urgently convened with the minister, that we would be prepared to look at a sensible halfway mark? We should be able to sensibly negotiate an outcome because we as an opposition want to see this bill passed, but we have some serious considerations that the government has ignored. They are not just our considerations; they are considerations that have also been raised during the Senate process by people who have an expert knowledge in relation to these matters.

We have raised those concerns on behalf of some of those stakeholders because we want this bill to be legitimate. We want to address some of the concerns so that, as we go forward in what is a contentious debate, particularly around the privacy issues, we do not have function creep and this government cannot just introduce by way of regulation some further function under the guise of this legislation when it should be a legislative change passed by both houses of this parliament. In essence, that is all we are asking for. We are asking for a sensible outcome and a debated outcome with this minister, but that is not the approach of this government. This government have been sitting for months on recommendations. It took them about two months to reply to the Senate committee’s recommendations. They want to come in here at the eleventh hour, only a week before 30 June, with this legislation due to start on 1 July this year, yet this minister cannot get her act together. This is not the first example of the way in which this minister has been completely negligent in the way in which she has managed her portfolio. She is completely incapable—with all due respect to the minister—of negotiating sensible outcomes.

We see it in relation to a number of issues, not the least of which is cataract surgery where announcements are made with no consultation and there is an expectation from the government that the opposition should just meekly roll over and agree to what is a failed process. All we have said as part of this debate is that we should have sensible amendments agreed to. Dr Southcott, our shadow parliamentary secretary, has put forward those arrangements and negotiations are now ongoing between the government and the opposition. I expect we will get a reasonable resolution to this, but do not come in here as a government trying to take some sort of high road and make some political issue of the fact that we want sensible amendments supported.

The Australian people should know that Mr Rudd is a complete failure as our Prime Minister. There are countless examples of that and I detailed some of them before. The real reason, as I said in my opening remarks, is that the government want to deflect from their other failings, not just in other policy areas but specifically today in relation to the ongoing criticism which they are receiving for their failure in mental health.

Professor John Mendoza is one of the most respected mental health professionals we have seen in a generation. He has great respect from both sides of parliament. This man says he took up the position as the chair of the National Advisory Council on Mental Health as ‘perhaps the most important public service responsibility of my life’. They were his words. This man is passionate about mental health and he reflects the passion that is in the mental health sector right around the country. This is a government which, at budget time, tried to rip money out of mental health, while having said over the last couple of years that they really want to put money into mental health. That is not the case. Do not look at what the Rudd government say; look at what they do. Do not take our word for it; take the word of an independent expert who was chosen by the Prime Minister himself to chair the Advisory Council on Mental Health. This man is highly respected in the Australian community and he said in his letter to the Minister for Health and Ageing of 18 June:

... it is now abundantly clear that there is no vision or commitment from the Rudd Government to mental health. While significant improvements have been made in disability employment policy and to a lesser extent in housing ... there is no evidence of a change in policy or investment in mental health.

This is a person also who claimed quite rightly that the Rudd government was trying to rip off the policies which had been implemented by the Howard government, by our commitment to mental health. It just shows why we are in this chamber today. We will accept sensible negotiations and I think we will provide a resolution, but we will not be bullied and harangued into supporting what is otherwise a flawed bill—not just identified by us but identified by others as well. This is clearly a government that has sought to distract from the main business. The main business that this government has shirked its responsibility on is trying to implement the reform they promised at the last election. The Australian public should not forget at this election that an amazing amount was promised by Kevin Rudd in 2007 but this Prime Minister clearly is all talk and no action and there is no clearer example than in the area of health. (Time expired)