Brett Mason (Queensland, Liberal Party, Shadow Minister for Universities and Research) Share this | Hansard source

The coalition opposition supports the Personally Controlled Electronic Health Records Bill 2011 and the Personally Controlled Electronic Health Records (Consequential Amendments) Bill 2011. A personally controlled electronic health record system is, let us face it, a very good idea. Any improvement to mankind's armoury against the empire of disease is a very good thing as well. Senators in this debate this afternoon have spoken about the advantages of such a system, and indeed it does have advantages. I accept that this system will assist in effective, efficient and timely patient care. I accept that this system will save time and allow medical practitioners to rely on information noted by other doctors rather than forcing patients to relay their medical history. I accept that the system could dramatically reduce the number of hospital visits each year. I accept that the system could also help prevent thousands of deaths annually when the system is fully operational, another significant advantage provided by e-health.

We also should not forget about the dollars. It is very important in these times of fiscal stringency to save taxpayer dollars. This system may well save billions of dollars over the next 10 to 15 years, by reducing duplication and errors, improving productivity and encouraging stricter adherence to world's best practice. These are all good things. I know that coalition senators and members such as Senator Fierravanti-Wells, Dr Southcott in the other place and Senator Sue Boyce have done a lot of work on this particular issue, and I want to congratulate all of them.

But the opposition does have some reservations. Once again we encounter the standard problem with this government. They come up with some very good ideas now and then, but that is often marred by lack of attention to detail and poor implementation. You will recall that it was the coalition that initiated the focus on shared electronic health records. But again this is a program that the Labor government has not fully developed. I listened before to Senator Di Natale and I loved his use of the words 'soft launch'. We now know that even though the system is being launched on 1 July this year, it is being 'soft launched', which I think means it will be quite some time before the system is ubiquitous. I think that is probably right. But I liked the language—slightly Orwellian, but it never gets by the opposition. We are not quite sure about the costs. The government has not been too forthcoming about the long-term costs of this technology. We know it is expensive, but that does not mean it is not worth it. Already it has been raised in debate that the United Kingdom spent about $12 billion on e-health records and that money has now largely been scrapped. It would not be a good thing for this government to go the same way. I am hoping the Australian Labor Party is not like the British Labour Party in this context—I am in a generous mood and so I will not assume it is.

An opposition senator: You always are.

Yes, I always am! Some of my colleagues have raised the issue of stakeholder use and how some will see it as a make-work scheme for medical practitioners with little incentive to create the shared health summaries. That is a potential problem and of course there is a reliance on general practitioners to drive the uptake. Some have already asked this afternoon why would they bother doing that. It will take time, and they will see little or no reward for their efforts. Over time, perhaps, that will change, but, initially, I think it is fair to say, it will be an issue. My colleagues have raised—Senator Fierravanti-Wells raised it well and eloquently—the lack of stakeholder consultation. Reports from a number of key stakeholders indicate there was not thorough consultation and they had difficulty communicating with the National E-Health Transition Authority.

They are all important points, and I know that the Senate has discussed them well this afternoon. I congratulate all my colleagues for their contributions in this debate. But I want to concentrate on one particular issue, if I might. As Senator Polley just recognised—and I agree with her—health records are among the most sensitive records citizens give to a doctor, but governments potentially have access too. They hold potentially the most personal, sensitive information. So, of course, there are significant privacy concerns about these e-health records—about access, about their security, about their veracity, about the control over contents, the use and the potential use of these e-health records. All those issues are legitimate and they are all live in this debate.

This is one of those absolutely classic Senate debates because this debate reflects that most fundamental tension in regulating a liberal democracy—that is, the quest for individual autonomy and individual privacy on the part of every citizen versus the impulse of a community and social responsibility. That tension between the two—it is not a dichotomy; it is a tension—is being played out in this debate. While the government does have a moral responsibility to look after their citizens—and e-health is a very good example of that—citizens do not want the state to intrude excessively upon their autonomy in extracting that information. Somewhere in that tension lies the answer and lies the balance. Exactly where those boundaries should be drawn will always be widely contested and hence the privacy concerns raised by citizens about these bills.

The government is quite right to suggest, as they have this afternoon, that the government's decision to have an opt-in scheme—I remember discussing an opt-in or opt-out scheme a long time ago, Acting Deputy President Boyce, with you and others. But the government having chosen that—that is, people have to choose to register to have a personally-controlled electronic health record—it does raise the question of privacy protections. Privacy remains a concern, but with an opt-in scheme they are strengthened, and I acknowledge that. In my view the government should be congratulated for that.

Last week I happened to watch the 7.30 on the ABC—even though I am in the opposition, I do watch the ABC—with Professor Chris Puplick, the former New South Wales Privacy Commissioner, and he was asked about this legislation.