Penny Wong (SA, Australian Labor Party, Minister for Climate Change and Water) Share this | Hansard source

I move:

That these bills be now read a second time.

I seek leave to have the second reading speeches incorporated in Hansard.

Leave granted.

The speeches read as follows—

Healthcare Identifiers Bill 2010

This Bill 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.

The development of a national e-health system will improve safety and quality and patient convenience by ensuring that the right people have access to the right information at the right time.

As noted recently by the third Intergenerational Report and the final report of the National Health and Hospitals Reform Commission, we need to prepare the health system to meet the needs of the coming decades.

An ageing population, technological change, a rise in the prevalence of chronic disease and increasing consumer expectations mean we cannot continue with a ‘business as usual’ approach.

The Government is currently undertaking the most important overhaul of our health system since the introduction of Medicare twenty five years ago. An important part of this work will be ensuring that as a nation, we are well positioned to take full advantage of the opportunities presented by information and communication technology. The Reform Commission was clear in identifying the importance of e-health in driving and enabling reform to healthcare delivery. Among the 123 recommendations of the final report is a recommendation to introduce healthcare identifiers by July 2010 and individual electronic health records by 2012.

This Bill establishes the healthcare identifiers, without which, there cannot be an integrated, consistent, e-health system in Australia.

One of the major barriers currently limiting the progress of national e-health initiatives is the lack of a single process to accurately and consistently identify patients and healthcare providers.

For example, when a patient visits their GP for a check up, the identifying number on their health record is different to the number at the pharmacy where they have their prescription filled or the pathology laboratory where they have their blood tests done.

Healthcare providers face a similar problem with professional or registration bodies, Medicare Australia, and their employers all identifying them through a variety of different methods.

This fragmented approach to identification does not provide the accuracy or consistency needed to confidently share health information in an electronic environment. Nor does it adequately support the safe delivery of healthcare with providers regularly required to match patients and patient information to their records, increasing the risk of mismatching records and tests needing to be re-ordered.

Studies in hospital environments have indicated that between 9% and 17% of tests are unnecessary duplicates. Up to 18% of medical errors are attributed to inadequate availability of patient information, which indicate the scope of the potential efficiency and productivity benefits possible with accurate patient information. Healthcare Identifiers help progress our goal to utilise health resources in a smarter, more targeted and sustainable way.

In 2006, the Council of Australian Governments (COAG) agreed to a national approach to identification for patients and providers, as part of accelerating work on a national e-health records system. This decision was affirmed in November 2008 when COAG agreed to universally allocate healthcare identifiers to all healthcare recipients in Australia.

A national approach to establishing healthcare identifiers has been adopted to avoid duplicating development costs and efforts and in recognition that identifiers are part of the core infrastructure needed to support secure electronic communication across the various elements of Australia’s healthcare system.

In consultation with the healthcare sector and the Australian community over the past three years, NEHTA in conjunction with Medicare Australia has designed and developed an identifiers system for patients, healthcare providers and healthcare provider organisations.

The Healthcare Identifiers Service has been designed to include appropriate safeguards to ensure that:

• minimal demographic information will be required to assign and obtain healthcare identifiers;
• no clinical information will be held by the service operator;
• only authorised healthcare providers will be able to access the Healthcare Identifiers Service and obtain healthcare identifiers for their existing patients; and
• the Medicare card and Department of Veterans’ Affairs treatment card are used as a token to obtain an individual’s healthcare identifier.

The Service has been designed to ensure that mechanisms currently available through Medicare Australia to protect the identities of vulnerable individuals (such as those in the witness protection program) will be catered for.

An IHI will not alter the way in which anonymous healthcare services are currently provided. Where it is lawful and practical, individuals can seek treatment and services on an anonymous basis. In these instances, an IHI would not be used by the healthcare service.

The design of the Service has been subject to three independent privacy impact assessments to ensure significant privacy impacts were identified and where necessary, addressed. This ensures the design of Service appropriately protects the privacy of those participating in it.

The design of the Healthcare Identifiers Service, combined with a national authentication system, an appropriate governance framework and the regulatory support this Bill seeks to establish, healthcare identifiers will deliver the access and identity requirements critical to ensuring confidence in the way a patient’s health information is handled in an electronic environment.

While attention is often given to the potential benefits of the eventual adoption of electronic health records, there are immediate benefits associated with the implementation of a national healthcare identifiers system. These benefits will improve the safety and quality of healthcare in Australia and include:

• Minimising the likelihood of information being sent to the wrong healthcare provider or being assigned to the wrong patient;
• Reducing the likelihood of adverse events and inefficiencies associated with mismatching of patient information;
• Establishing a Provider Directory Service to enable, for example, GPs to locate specialists in a timely manner and provide a greater confidence in electronic communications; and
• Improving productivity for healthcare providers and increasing patient convenience by helping to automate some of the more routine interactions between providers such as referrals, prescriptions and image processing.

For example, when eight year old Amy injures her arm roller-skating, her Mum takes her to the emergency room at the local hospital. Using their family Medicare card as a token, the hospital collects Amy’s healthcare identifier from the Healthcare Identifier Service and adopts it as an identifier in its own system.

Using Amy’s healthcare identifier the treating doctor orders an X-ray, the results of which are sent electronically from the radiology department to the doctor. This allows the doctor to quickly diagnose Amy’s fracture, treat her and prescribe any medication to assist with the management of her pain.

When Amy is discharged from hospital, the doctor sends an electronic discharge summary to her regular GP with information about her condition, treatment and the medication prescribed. From this information, Amy’s GP knows when follow-up treatment is needed, reducing the likelihood of needing to go back to the hospital for further care.

At each step in this scenario, Amy’s healthcare identifier is used to uniquely identify her in a variety of different healthcare settings and support the electronic communication of information relevant to her healthcare.

The scenario I have described can only become a reality if there is widespread use of healthcare identifiers system by both patients and healthcare providers. To achieve this, the system must be easy to use, provide benefits to clinical care and be one that people can trust.

The Bill seeks to establish appropriate limitations and protections for healthcare identifiers, including a robust complaints handling framework which will be managed by independent regulators. This will give patients and healthcare providers the necessary confidence in the safety of the system to encourage widespread participation.

The protections will be achieved by:

Limiting the use of healthcare identifiers to:

• health information management and communications activities undertaken as part of delivering health-care; and
• other related purposes including health service management, research and emergency situations.

Working to develop uniform health information regulation and privacy arrangements, for both the public and private healthcare sectors;

Supporting appropriate authorisation and authentication processes for access to the healthcare identifiers system;

Establishing strong inquiry and complaint handling arrangements with oversight conducted by the Federal Privacy Commissioner and penalties for misuse; and

Providing for a review of the role of Medicare Australia as the service operator after a two year period.

While all individuals receiving healthcare in Australia will be issued with an identifier, the Bill does not impose a requirement that healthcare providers use healthcare identifiers when providing healthcare services, nor will identifiers be required for claiming healthcare benefits.

On 7 December 2009, COAG signed a National Partnership Agreement setting out its commitment to implementing the governance, legislative and administrative arrangements necessary to implement e-health, starting with the healthcare identifiers system.

This Agreement recognises the need for strong collaborative governance arrangements between jurisdictions, allocating responsibility for oversight of the Healthcare Identifiers Service, including the consideration of any proposed legislative changes and decisions regarding ongoing funding of the Service to a Ministerial Council made up of representatives from each jurisdiction.

Two rounds of public consultation on the legislative proposals to support the Healthcare Identifiers Service have been undertaken. While there is strong support for the implementation of healthcare identifiers as a foundation for the development of e-health, patient and healthcare provider confidence in the regulatory support outlined in the Bill is only one part of the story when it comes to ensuring widespread participation.

Getting a broad range of healthcare providers to actively participate in the system is going to be critical to achieving widespread use of healthcare identifiers in the healthcare system.

It is our aim to get as close to full participation in the healthcare identifier system as possible.

Engaging with and educating healthcare providers is the best way of ensuring widespread uptake of the identifiers. While most of the benefits associated with improving safety and quality and increasing patient convenience and productivity are obvious, the Government will be strongly encouraging healthcare providers to participate in the system.

This is an exciting time for health reform and specifically, for e-health development. Every Australian has a stake in our health system and e-health provides us with great opportunities to improve the way in which healthcare is delivered.

The implementation of a healthcare identifiers system for patients and healthcare providers is an important step towards building an effective national e-health system.

Healthcare Identifiers (Consequential Amendments) Bill 2010

The Healthcare Identifiers (Consequential Amendments) Bill 2010 (‘the Bill’) seeks to make a number of minor consequential amendments to existing acts to support the introduction of the Healthcare Identifiers Bill 2010.

The Healthcare Identifiers Bill 2010 seeks to establish a single national healthcare identifier system for patients, healthcare providers and healthcare provider organisations.

This 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 system.

The development of a national e-health system will improve safety and quality and patient convenience by ensuring that the right people have access to the right information at the right time.

The fragmented approach to identification that currently exists does not provide the accuracy or consistency needed to confidently share health information in an electronic environment.

The Healthcare Identifiers Bill 2010 seeks to overcome this issue by establishing a national healthcare identifiers system for patients, healthcare providers and healthcare organisations. 

To ensure the Healthcare Identifiers Bill 2010 operates appropriately and effectively, minor amendments to the Health Insurance Act 1973 and the Privacy Act 1988 are required.

For example, the Healthcare Identifiers Bill 2010 seeks to allocate functions relevant to the operation of the Healthcare Identifiers Service to the CEO of Medicare Australia. This includes functions relevant to the day-to-day operation of the Service.

To support the day-to-day running of the Service, it is necessary to provide the CEO of Medicare Australia with the authority to delegate functions allocated to his or her office. To enable this to occur, minor amendments to the Health Insurance Act 1973 are required.

Minor amendments to the Privacy Act 1988 are also required to ensure that an act or practice that breaches the Healthcare Identifiers Bill 2010 is classified as an interference with the privacy of an individual, subject to investigation by the Federal Privacy Commissioner. Any such investigation will be undertaken in accordance with the Privacy Commissioner’s existing functions and the specific functions established to support healthcare identifiers.

Inclusion of the provision in the Privacy Act 1988 supports the strong privacy framework which has been established for the Healthcare Identifiers Service and provides patients and healthcare providers with confidence in the compliance and enforcement arrangements.

Other minor technical changes to the Privacy Act are also required to ensure the Privacy Act 1988 and the Healthcare Identifiers Bill 2010 operate appropriately together and to take account of changes to the Privacy Act that will come into effect with the commencement of the Personal Property Securities (Consequential Amendments) Act.

This Bill seeks to make these changes to ensure the Healthcare Identifiers Service operates effectively and as intended.

Offshore Petroleum and Greenhouse Gas Storage Legislation Amendment (Miscellaneous Measures) Bill 2010

This bill amends the Offshore Petroleum and Greenhouse Gas Storage Act 2006 (the Act). This is a relatively small bill making a number of minor policy and technical amendments.

It is nevertheless an important bill as it progresses the Government’s intention to establish a new National Offshore Petroleum Regulator commencing on 1 January 2012.

To this end, the Bill introduces a measure by which the Commonwealth, will retain the industry fees raised under the Offshore Petroleum and Greenhouse Gas Storage (Registration Fees) Act 2006 in order to use this money for the establishment of a National Offshore Petroleum Regulator.

Until now the registration fees have been re-distributed to the States and Northern Territory. The industry fees raised under the Offshore Petroleum and Greenhouse Gas Storage Act 2006 and the Offshore Petroleum and Greenhouse Gas Storage (Annual Fees) Act 2006 will continue to be re-distributed to the States and the Northern Territory. I will review the fees to be re-distributed to the States and the Northern Territory to ensure that they continue to recover their costs of administering petroleum activities in Commonwealth offshore areas pending the establishment of the new regulator. If necessary, I will amend the level of the fees by regulation to ensure this outcome.

I do not expect to introduce legislation amendments for the establishment of a National Offshore Petroleum Regulator until next year as discussions regarding the exact arrangements are ongoing within the Ministerial Council on Mineral and Petroleum Resources, however I would like to emphasise that this initiative is a key development in the ongoing improvements and streamlining of the national regime for the regulation of petroleum and greenhouse gas activities in Commonwealth waters.

Also of significance in this Bill is the augmentation of the existing functions of the National Offshore Petroleum Safety Authority (NOPSA) to include non-occupational health and safety (non-OHS) aspects of structural integrity for facilities, wells and well-related equipment in Commonwealth waters.

Since its establishment on 1 January 2005, NOPSA has had structural integrity functions relevant to occupational health and safety for petroleum facilities, including for pipelines, and associated wells.

The amendments introduced in this Bill clarify NOPSA’s role and strengthen their ability to fully carry out their functions in relation to all facilities, wells and well-related equipment – including during the drilling and construction of wells and whether or not wells are associated with a facility.

The augmentation of NOPSA’s functions to include non-OHS aspects of structural integrity is not to extend NOPSA’s responsibilities into environmental management or resource management regulation but to allow NOPSA to more effectively carry out its responsibilities as an occupational health and safety regulator.

This is particularly the case where a structure used in petroleum operations such as a well or a pipeline is on the sea floor and contact between people and the structure is only occasional.

To a large extent, the structural integrity of a pipeline or a well is an OHS matter, as it is central to the safety of operational or maintenance crews whenever they are required to do work on the structure. There will always be some aspects of structural integrity that fall outside this category, however, and it is these that the present amendments seek to address. The amendments will enable NOPSA to take a comprehensive and integrated approach to the integrity of structures, without any question as to the scope of their functional responsibilities.

The Government will work with industry and other stakeholders to determine in regulations which matters relating to the structural integrity of pipelines and wells are also resource security or resource management matters. These will continue to be the responsibility of the Designated Authorities under proposed regulations relating to resource management. There will therefore be an element of overlap between the responsibilities of NOPSA and those of the Designated Authorities, although they will be performing different functions.

Other minor policy amendments proposed in this Bill seek to:

• Provide a streamlined process for the submission of applications, nominations, requests or notices in relation to a title when that title is jointly owned by 2 or more titleholders (known as multiple titleholders);
• Make clear that when the Act imposes obligations on a titleholder and where a title is owned by multiple holders, while the obligation is imposed on each and every titleholder that the obligation may be discharged by any one of the titleholders; and
• Correct a technical problem with the authority of responsible State and Northern Territory ministers to participate in the performance of Joint Authority functions, and to perform Designated Authority functions, under the Commonwealth regulations.

On this last matter, existing State and Northern Territory legislation, which corresponds to the Act, provides the Designated Authority (the relevant State or Northern Territory minister) with authority to perform functions and powers under the Act, but this does not include the regulations in force under the Act. This amendment therefore closes the gap, as many important functions and powers of Designated Authorities are conferred by the regulations. For consistency, corresponding amendments have also been made to Joint Authority provisions.

A further small but important amendment clarifies the duties of titleholders under the occupational health and safety provisions of this Act. This amendment narrows the titleholder’s duties in the current clause 13A of Schedule 3 of the Act from facilities generally to wells and well-related equipment, specifically in new clauses 13A and 13B.

As it stands the clause can be read as imposing a duty of care on a titleholder in relation to the design of facilities, such as drilling rigs, which the titleholder could not reasonably be expected to have any control over.

Therefore this duty of care has been recast so that it applies to all aspects of wells from design through to operation and closing off. Consequential amendments have been made to allow OHS inspectors to monitor compliance and investigate possible contraventions.

Technical amendments in this Bill include changes to offence provisions that relate to titleholders, where the offence consists only of a physical element. These amendments provide that offences under these provisions are made provisions of strict liability, which removes the need to prove intent.

Given the geographically remote nature of offshore petroleum and greenhouse gas activities it is not possible for regulatory staff to be constantly monitoring titleholder activities, so they are reliant on accurate reporting by titleholders to inform them that directions and requirements in the Act have been complied with.

Where the offences relate to doing or not doing an act, proving the intent of a titleholder is very difficult. In these circumstances making the offences ones of strict liability is justified.

This application of strict liability is consistent with Government policy on the application of strict liability and is to provide a regulatory regime that is effective and enforceable. These amendments do not increase any penalties on titleholders, in fact in some instances removes imprisonment as a penalty and instead replaces with penalty units.

Further technical amendments in the Bill correct a referencing error and update the listed OHS laws set out in the Act to take into account recent changes to safety regulations.

In summary, through a range of measures including:

• retaining some of the money raised through industry fees to fund the establishment of a National Offshore Petroleum Regulator;
• strengthening the functions of NOPSA;
• increasing the effectiveness of compliance through the application of strict liability to appropriate offences;
• clarifying the application of titleholder provisions in the Act in relation to multiple titleholders; and
• setting out that a titleholder’s duty of care under OHS provisions of the Act relates specifically to wells;
• this Bill underscores the Government’s commitment to the maintenance and continuing improvement of a strong, effective framework for the regulation of offshore petroleum and greenhouse gas activities.

Offshore Petroleum and Greenhouse Gas Storage (Safety Levies) Amendment Bill 2010

This bill amends the Offshore Petroleum and Greenhouse Gas Storage (Safety Levies) Act 2003 to provide transitional arrangements in relation to the phasing out of the pipeline safety management plan levy.

These arrangements provide time for the States and the Northern Territory to amend their jurisdictional regulations to reflect recent changes in this, the parent Act, and in Commonwealth regulations which have replaced the pipeline safety management plan levy with a safety case levy covering pipelines. These changes were applied to pipelines in both Commonwealth waters and designated coastal waters.

The amendments in this Bill specifically relate to the safety regime for pipelines in designated coastal waters. This amendment provides that from 1 January 2010, when amendments to this Act and related regulations came into force, until 31 December 2012 – that a pipeline safety management plan in force is treated, for the purposes of this Act, as if a safety case for the pipeline is in force. These amendments ensure that safety levies relating to pipelines in designated coastal waters can continue to be collected.

The amendments also include similar transitional amendments to reflect minor changes in relation to a safety case in designated coastal waters, understood to be within the meaning of regulations of a State or Northern Territory that have not yet been amended to reflect Commonwealth changes made on 1 January 2010.

Ordered that further consideration of the second reading of these bills be adjourned to the first sitting day of the next period of sittings, in accordance with standing order 111.

Ordered that the Healthcare Identifiers Bill 2010 and the Healthcare Identifiers (Consequential Amendments) Bill 2010 be listed on the Notice Paper as one order of the day and the Offshore Petroleum and Greenhouse Gas Storage Legislation Amendment (Miscellaneous Measures) Bill 2010 and the Offshore Petroleum and Greenhouse Gas Storage (Safety Levies) Amendment Bill 2010 as one order of the day.