Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Link to this | Hansard source

I rise to speak on the National Cancer Screening Register Bill 2016 and the National Cancer Screening Register (Consequential and Transitional Provisions) Bill 2016. From the outset, I want to make it clear that Labor strongly supports the establishment of a national cancer screening register, and, in particular, the improvements to cancer screening programs that the new register will support.

Addressing the specifics of these two bills, they will first and foremost establish the national cancer screening register and authorise collection, use and disclosure of information for the designated cancers of cervical cancer and bowel cancer. These bills authorise the migration of existing bowel cancer screening and state and territory cervical screening data to the register, ensuring existing screening information is retained in the new register. The bills also mandate reporting of screening information to the register.

It should be noted that the creation of this register will enable improvements to several cancer screening programs. The National Cervical Screening Program will move from a two-yearly pap test to a five-yearly cervical screening test—the recommendation of the independent Medical Services Advisory Committee. Incorporating this change in the national cancer screening register is expected to stop an additional 140 incidences of cervical cancer a year. In addition, this legislation will see the National Bowel Cancer Screening Program accelerate its transition to biennial screening, with Australians aged 50 to 70 to be screened every two years by 2020 instead of 2034. Clinical trials have shown that biennial screening can prevent 300 to 500 deaths a year. Labor strongly welcomes these improvements, which will arise from the creation of a national register.

When you look at the information the register will hold—some of the most sensitive health data of Australians—you quickly realise the importance of getting it right, and yet the government has approached this important legislation in the most shambolic way. On the eve of the election, the Turnbull government signed a $220 million contract to outsource the register to Telstra before parliament even saw the legislation. Now in a rush to pass the bill retrospectively, the government has completely bungled the bills.

When Labor and the crossbench referred the government's bill to an inquiry, the member for Farrer accused Labor of a 'hysterical tirade'. But in an embarrassing rebuke of the government their own privacy and information commissioner made six recommendations to the Senate inquiry to fix the legislation. Some of the loopholes identified by the commissioner were alarming. For example, the government's bill, as drafted, may allow the register operator to collect all the Medicare information of people who are on the register. Under the government's plan this would allow Telstra to see all health services that a person has received, including sensitive areas like mental health and sexual health.

The new national register is designed to hold extremely sensitive information about every Australian who is eligible for cancer screening programs. The register is not opt in, and an individual will only be able to opt out of the register once it is implemented. At the most basic level, it will hold an individual's personal details, such as their name, address, contact details, date of birth, gender and sex. It will also hold an individual's Medicare number, Medicare claims and preferred GP or other health providers. The register will also contain extremely private and intimate health data that is usually only disclosed between a person and their GP. The register will record human papillomavirus vaccination status, screening test results and cancer diagnosis.

Further to this, as the government's own explanatory memorandum says, Telstra will know if a person has cervical or bowel cancer, a person has a precursor to cancer or genetic markers that may lead to cancer, a woman has had a hysterectomy or a part hysterectomy, a person is transgender—for example, biologically a woman and has a cervix. Certainly, this is not information that most Australians would be comfortable disclosing to a telecommunications provider. Labor accepts that this information is necessary for the operation of the register, but we do not accept that Telstra, with a questionable record of privacy breaches, should have Australia's most private and sensitive health information. We know that many Australians would question the rationale behind giving a for-profit company access to this health data.

The scope of these bills also makes clear that the minister can give Telstra even more information and the register may be expanded to other cancer screening programs in the future. As the explanatory memorandum notes:

With rapidly advancing technology or changes in screening tests, the range of information that needs to be collected may also change and is difficult to predict. This provision allows rules to prescribe additional classes of data to form part of the contents of the Register that is considered necessary to be included in the Register for the purposes of the Register.

It isn't only Labor that is concerned about the government's decision. The Royal Australian College of General Practitioners, which represents 33,000 GPs, has said of the government's decision:

[The] RACGP would be far more comfortable with [the Register] being operated by a government, tertiary institution or a not-for-profit entity that has little interest in how the data in the registry might otherwise be used for pecuniary reasons.

The Australian Medical Association expressed similar views, saying:

Given the potential commercial value of the data contained in the register, the AMA would be more comfortable with it being operated by government, a tertiary institution, or not-for-profit entity that has little interest in how the data in the register might otherwise be used. This would go a long way to allaying concerns about the secondary use of data for commercial reasons.

These concerns are shared by many others across the health sector, because they know how important it is to get this register right.

Last week, Labor proposed nine amendments to improve the government's legislation. Labor has now dragged the government, kicking and screaming, into accepting many of those amendments. We understand the government will move a series of amendments that meet many of our demands. Remember, this is the same government that said the Senate inquiry was a hysterical tirade and that is now having to amend its own legislation.

And yet the government still cannot get it right. Its legislation is still full of holes. In addition to the Labor amendments that the government is accepting, we will move amendments that it refused to accept. Labor's amendments will ensure that Australians' personal information is collected and used appropriately and that appropriate penalties are in place to protect all Australians.

First, Labor will proceed with its amendments to limit the operation of the register to a not-for-profit organisation or government agency. Telstra has never operated a register such as this. In fact, as the Senate inquiry heard, no for-profit corporation operates a cancer screening register anywhere in the world. The register is far too sensitive to be used as a guinea pig for Telstra's foray into health. It will contain extremely private health information that has never been handed over to a for-profit company before. This information includes a person's Medicare number, Medicare claims information, preferred GP or other health provider, human papillomavirus vaccination status, screening test results and cancer diagnoses. So Telstra will know things like whether a person has cervical or bowel cancer or has a precursor to cancer or genetic markers that may lead to cancer, whether a woman has had a hysterectomy or partial hysterectomy or whether a person who identifies as a man is biologically a woman and has a cervix.

The Senate inquiry revealed that the Australian Medical Association, the Royal Australian College of General Practitioners and other experts share Labor's concern about outsourcing the register to a for-profit corporation, so Labor's amendment provides that the new National Cancer Screening Register can only be operated by a government or not-for-profit organisation. This amendment would still allow the register to be operated by one of the government agencies or not-for-profit organisations that have successfully managed the existing registers: the Commonwealth Department of Human Services, which operates the National Bowel Cancer Screening Program register; a state or territory agency, like those that operate most of the existing registers for the National Cervical Screening Program; or a not-for-profit organisation like the Victorian Cytology Service, which operates the Victorian and South Australian registers for the Cervical Screening Program. The Senate inquiry heard evidence that one of these organisations could deliver the register on time, from 1 May 2017.

Second, Labor will move an amendment to ensure that individuals are notified when their most sensitive health data is breached. Under the government's draft legislation, if and when there are data breaches Telstra only has to tell the Department of Health. We understand the government will now accept Labor's amendment to ensure that the Privacy Commissioner is notified of breaches—another improvement to the legislation that resulted from our 'hysterical tirade'.

But that is not good enough. Individuals deserve to be told if their most private health information is accessed inappropriately. So Labor's amendment will mandate disclosure of data breaches to affected individuals. The government will argue that the Privacy Commissioner can notify individuals if he chooses. But, again, that is not good enough. Individuals must be told. This is consistent with Labor's position across all portfolios. The government says it agrees but is dragging its feet on the mandatory disclosure legislation. Recently, when sensitive Medicare and PBS data was breached, the government took weeks to come clean.

Third, Labor will propose an amendment to increase the penalty for unauthorised use or disclosure of information. Under these bills, the penalty for recording, using or disclosing information without authority is only $21,600. That is a drop in the ocean for an organisation like Telstra, which reported profits of almost $2.1 billion in the six months to 31 December 2015.

A former secretary of the health department, Stephen Duckett, has said:

The automatic consequences of release of data – inadvertent or not – must be made so great that any risk-management matrix will ensure the organisation and its managers always have patient privacy at the forefront of their mind.

Even stakeholders that are generally supportive of the government's legislation, such as Pathology Australia, have called for a review of the fines for offences to ensure that they are appropriate deterrents.

Labor's amendments would increase the penalty for unauthorised use or disclosure of the information, from 120 penalty units—about $21,600—to 600 penalty units, which would be $108,000. Under the Criminal Act 1914, a court can impose a penalty of up to five times that amount on a corporation. So if Telstra is the registered operator, it could be fined up to $540,000 for breaching the legislation. Again, the government will argue that the privacy commissioner can seek tougher penalties. But this should not be discretionary; if individuals or organisations inappropriately use Australians' most sensitive health data, they should be punished severely and automatically. Labor will also propose an amendment to ensure the Commonwealth will continue to be the custodian of data in the register. The explanatory memorandum states:

Although the Bill does not address issues of ownership or custodianship of information, the Commonwealth will be the custodian of data in the Register.

There should be no question about explicitly outlining this in the bill as well—and yet the government is refusing to include it. This raises questions about why the government does not want to clearly state that the Commonwealth is the custodian of the data. This is a crucial point in relation to the security of Australians' sensitive information.

The fact is that this legislation reflects the government's overall approach to health and their desire to increase the role of the private sector in our health system. This bill is just another example of the government's determination to privatise our health system. At least 27 times during the election campaign, Malcolm Turnbull said that he would 'never outsource Medicare'. But that is exactly what these bills do. They put Australians' Medicare numbers and Medicare claims information in the hands of a multinational telecommunications corporation. This is a government which spent $5 million trying to privatise the Medicare payments system. Now they want to pay Telstra to store Australians' most sensitive health data. The government have proven time and time again that they cannot be trusted when it comes to health. They have delivered nothing but a track record of cuts and cost shifting from Medicare to patients—privatisation by stealth. The government remain committed to the following: the six-year freeze on Medicare rebates; cuts to Medicare bulk-billing incentives for vital tests and scans; hiking up the price of vital medicines by up to $5, even for concessional patients; and slashing the Medicare safety nets. The government have continued to put profit over patients, and this is exactly why they cannot be trusted. It is why this parliament should be sceptical of their decision to hand over the sensitive information of millions of Australians to a for-profit company.

The government insisted that the parliament had to pass these bills without scrutiny in the last sitting week. Now we know why—the legislation was a mess. Labor and the Senate inquiry have uncovered serious flaws in the government's bills. We are glad that the government will follow Labor's lead and fix some of those flaws. But, to truly protect Australians' most sensitive health information, the parliament needs to pass the remainder of Labor's amendments.

Catryna Bilyk (Tasmania, Australian Labor Party) Share this | Link to this | Hansard source

I also rise today to speak on the National Cancer Screening Register Bill 2016 and the related National Cancer Screening Register (Consequential and Transitional Provisions) Bill 2016. As Senator Polley has said, these bills together seek to establish a national cancer screening register which will replace the national register for the Bowel Cancer Screening Program and eight state and territory registers for the National Cervical Screening Program.

In principle, Labor supports this initiative. As someone who has been very active in raising funds and awareness for cancer prevention, I am an enthusiastic supporter of any initiative that may help to save the lives of cancer sufferers. While my fundraising and advocacy has been mainly focused on brain cancer—a cause that I think most people in this place realise I am particularly passionate about—I understand the importance of cancer screening to detect and treat cancers early, and even prevent them when possible. While this register will currently hold data relating to two forms of cancer, I recognise the potential for it to be expanded to other forms of cancer. To me, it makes sense to have a national approach to keeping cancer screening records, removing the duplication caused by having separate state and territory registers and allowing GPs to see a patient's entire cancer screening history, even if the patient has moved states. I have read in the minister's second reading speech that the bowel screening registry is paper based, which is clearly outdated and not suitable for the 21st century.

Not only is this a unified national approach but the new national register will enable improvements to cancer screening programs. For example, the National Cervical Screening Program will move from a two-yearly Pap test to a five-yearly cervical screening test and the Bowel Cancer Screening Program will be increased to two-yearly screening for Australians aged 50 to 74. The increased screening is expected to prevent an additional 140 cervical cancers a year, and also to prevent 300 to 500 deaths a year from bowel cancer. Essentially, this is about better access to information. It is surprising the impact that improved access to health information can have on the prevention of illness and, ultimately, saving lives.

As a general principle, investment in the early detection of disease and the secure sharing of information amongst treating professionals can lead to better outcomes in treatment and prevention. And I have argued in this place before for an expanded screening program for haemochromatosis, a disease which can be expensive and debilitating if left untreated, but which could potentially be easily detected and treated if we invested just a little bit of money. I am in no doubt that these improved cancer screening programs will save many lives and prevent a great deal of suffering. I am also hopeful that, at the same time, they will take pressure off our acute care system, as earlier detection can lead to cheaper and less invasive treatments.

But while Labor support these bills in principle, we do not support outsourcing the register to Telstra. In an election campaign where the privatisation of Medicare was front and centre as an issue—and it was no doubt an issue on which the government lost a fair bit of skin—I am surprised that those opposite still have not learnt their lesson. Prior to the election we heard the Prime Minister say at least 27 times that his government would never outsource Medicare. Yet this is exactly what these bills do—they put Australians' Medicare numbers and Medicare records in the hands of a for-profit multinational corporation.

Members of this government complained bitterly after the 2016 federal election about Labor's claims that they had plans to privatise Medicare. This government doth protest too much, because what they were really upset about was being found out. Despite their protestations about Labor's campaign—despite their Federal Director Tony Nutt's dummy spit at the National Press Club and their frontbench's confected cries of foul play after the election—the Abbott-Turnbull government's actions confirm time and time again what Labor has been saying about their privatisation agenda. After all, actions speak louder than words.

The government's decision to award the contract for the National Cancer Screening Register to Telstra adds to a string of evidence that they cannot be trusted to keep Medicare in public hands. We know that this government established a 20-person $5 million Medicare privatisation task force. We also know that this government told the Productivity Commission to investigate privatising all human services, including Medicare. On Monday, in the House, we had another show of the government's true colours when it comes to the issue of Medicare privatisation. They were called on to support Labor's motion for a guarantee that Medicare be kept in public hands as a universal health insurance scheme. Given the opportunity to demonstrate a commitment to public health care—to keep Medicare in public hands—not a single Liberal MP supported the Labor motion. In addition to voting against the privatisation of Medicare, Liberal MPs in the House of Representatives also voted against a guarantee: to protect bulk billing; to reverse their harmful cuts to Medicare by unfreezing the indexation of the Medicare Benefits Schedule; to reverse their cuts to pathology and diagnostic imaging that will mean Australians will pay more for tests and scans; to abandon their plans to make Australians pay more for vital medicines; and to develop a long-term agreement to properly fund our public hospitals to reduce emergency department and elective surgery waiting lists. The Liberals' failure to support our motion just goes to show that they cannot be trusted with health care, and they cannot be trusted to keep Medicare in public hands.

Our opposition to the privatisation of Medicare is based on concerns about extremely sensitive health information being handed over to a private, for-profit provider. But if the government presses ahead with its plans to award the contract to manage the national register to Telstra, this is what will happen. This is an extraordinary move. The existing registers that this new national register will replace are all managed either by government agencies, or, in the case of Victoria and South Australia, the Victorian Cytology Service—a not-for-profit organisation set up specifically to operate such registers. The information the government proposes to hand over to Telstra includes an individual's Medicare number; their Medicare claims information; the name of their preferred GP or health provider; whether they have been vaccinated for human papillomavirus, or HPV, as we know it; their cancer screening test results; and their diagnosis for bowel or cervical cancer. The explanatory memorandum to this bill reveals that Telstra will also know whether a person has a precursor to cancer, or genetic markers that may lead to cancer. They will also know whether a woman has had a hysterectomy and whether a person who identifies as a man is a biological woman and has a cervix.

If this arrangement goes ahead, it would be the first time that a for-profit corporation has been given responsibility for managing a sensitive cancer screening register. Not only does Telstra not have prior experience in managing such sensitive information, but their record when it comes to protecting customers' privacy with the information they do manage is, to say the least, questionable. As recently as 2013, Telstra had to issue a formal apology to customers after phone numbers, names and home addresses were found online during a Google search. While Telstra said that the privacy breach was 'not acceptable' they had actually been investigated by the Privacy Commissioner for two data breaches in the three years prior. In a 2011 breach, the details of almost 800,000 Telstra customers were left online for eight months, available to anyone via Google. Several stakeholders, such as the Australian Healthcare and Hospitals Association, have expressed concerns about Telstra being awarded the contract. The Australian Medical Association, in their submission to the Senate inquiry, expressed concern about 'the risks associated with awarding a contract of this magnitude to a company that has no direct previous experience in undertaking such a task'.

Given the bills open up the possibility for other cancer screening programs to be included in the register in the future, could this provide an opening for the government to sign more contracts with Telstra and allow them to take on more data—adding to the privacy risk? To quote David Vaile, the Executive Director of the Cyberspace Law and Policy Centre at the University of New South Wales:

Telstra ... is a strong proponent of big data, of open data.

They're obviously a commercial operation—they're often seeking to use personal information for uses beyond what it was originally collected for and to push the limits of privacy and data protection law.

I find it rather outrageous that, prior to the last election, the government would sign a $220 million contract with Telstra to operate the register, despite not having passed the necessary legislation. Now the government is scrambling to pass this legislation retrospectively, having already bound Australian taxpayers to this contract, without public scrutiny or consultation.

Having not seen the contract with Telstra, it leads the parliament and the Australian public to wonder what implications it has for the way the register will operate. A number of people and organisations in the health industry and in the medical profession have expressed concern about the lack of consultation with doctors, patients and other stakeholders about the development of the national register. The secretive manner in which the government awarded the contract to Telstra, without having the enabling legislation in place, raises serious questions about whether this government can be trusted to manage this process or protect the privacy of patients.

When Labor and the crossbenches referred these bills to a Senate inquiry, do you know what the Minister for Health and Aged Care said? She accused Labor of a 'hysterical tirade', but the inquiry has revealed some very real concerns about the privacy issues raised by these bills. Even the government's own privacy and information commissioner has raised six concerns about the bills and made recommendations to fix them.

One of the most embarrassing loopholes in the legislation is that it allows the register to collect all Medicare claims information for people who are on the register, not just the claims information that is relevant to bowel and cervical cancer screening. This is one of the worst examples of the kind of rushed, sloppy drafting that has exposed the government's failure to take proper care to protect and safeguard the privacy of patients.

Last week, Labor proposed nine amendments to improve the legislation. Consistent with the recommendations of the privacy and information commissioner, Labor's amendments would: limit the Medicare claims information that may be collected by the register to information that is relevant to bowel and cervical cancer screening; require the register operator to report data breaches to affected individuals and the commissioner, similar to the My Health Records Act 2012; require compliance with the framework for research that is established by the Privacy Act; provide that a breach of the national cancer screening register bills is also a breach of the Privacy Act, so that individuals have recourse to the privacy commissioner; limit the purpose of the register to anything that is directly related, not incidental, to the other purposes; and use the terminology 'opt out' rather than 'opt off', for consistency with the My Health Record system.

We also proposed three amendments to strengthen the penalties for data breaches. Various stakeholders have called for a review of the fine for offences to ensure they provide an appropriate deterrent, including those who are generally supportive of these bills. For example, the former secretary of the Department of Health, Stephen Duckett, said:

The automatic consequences of release of data—inadvertent or not—must be made so great that any risk-management matrix will ensure the organisation and its managers always have patient privacy at the forefront of their mind.

Labor proposed to increase the penalty for unauthorised use or disclosure of information from 120 penalty units, or $21,600, to 600 penalty units, which is currently $108,000.

Under the Crimes Act 1914, a court can impose a penalty up to five times this amount on a corporation. As such, if Telstra are the register operator they could be fined up to $540,000 for a data breach. We are talking here, after all, about a company which—let us not forget—made a $2.1 billion profit last financial year. Another amendment would clarify that these penalties apply to the unauthorised use or disclosure of key information as well as protected information. Key information includes details such as a person's name, address, contact details, date of birth, Medicare number and HPV vaccination statement, which are not explicitly protected by the penalties in the government's bills as they are currently drafted. A third amendment would make it explicit that the Commonwealth is the custodian of the data in the register.

Despite accusing Labor of a hysterical tirade when we moved to address the legitimate privacy concerns, I understand that the government now proposes to move a series of amendments that meet many of our demands. However, in their rush to get this legislation through the parliament, the government still cannot get it right and their legislation is full of holes. As such, Labor will be moving three amendments that the government has refused to accept. These are: our amendment to limit the operation of the register to a government agency or not-for-profit organisation, an amendment to require individuals to be notified when their sensitive health data is breached and an amendment to increase the penalty for unauthorised use or disclosure of information on the register.

With regard to the second of these amendments, we understand that the government has at least accepted Labor's amendment to ensure that the privacy commissioner is notified of breaches. The way the bills are currently drafted, Telstra is only required to tell the Department of Health if there is a breach of their private health data. But that is not good enough. Individuals deserve to be notified if their sensitive personal information is breached. It should not be up to the Department of Health or the privacy commissioner to have to tell them.

Once again, I reiterate that Labor supports the principle of these bills. It makes sense to have a national cancer screening register, and I am looking forward to the improvements that this will bring to cancer screening—particularly as it will result in saving lives. But, once again, this process has been rushed, and it has fallen to Labor to clean up the mess that has been left by the government's shoddy drafting of these bills.

Despite the government insisting that the legislation had to be passed in the last sitting week without scrutiny, Labor and a Senate inquiry have exposed serious flaws in the way the bills were drafted. This has been the consequence of the government's desperate rush to get this legislation through the parliament. Labor understands that the contract with Telstra is for five years, with an option for a 10-year extension, so if parliament gets it wrong, we may not be able to revisit our decision until 2031. The government would not be in such a rush to pass this legislation if they had not—in their arrogance—stitched up a deal with Telstra behind closed doors four days before calling an election. An exposure of serious flaws in these bills shows that the referral of the bills to a Senate inquiry was indeed necessary to make sure it had proper scrutiny. If it was not for that inquiry, the government would not be scrambling to fix their drafting errors.

In addition to their amendments, we call on the government to also accept the opposition's amendments. Through our proposed amendments Labor are standing up for Australians and the protection of their sensitive personal health information, and we are standing up to this government's move to privatise Medicare. On Monday the Turnbull government had an opportunity to demonstrate their commitment to keep Medicare in public hands. We know they have failed that dismally. Today, they have another opportunity: they can abandon their contract with Telstra; they can support Labor's amendments to these bills; and they can ensure that the sensitive personal information of patients listed on the national cancer screening register is not handed over to a multinational for-profit corporation. If they fail to do any of that, they will be thumbing their noses at another opportunity to oppose the further privatisation of Medicare for the second time in as many days.

Murray Watt (Queensland, Australian Labor Party) Share this | Link to this | Hansard source

I also rise to speak on this bill. I do so as a member of the community affairs committee, which conducted a hearing into this legislation in Sydney a week or two ago. As my Labor colleagues have said, and as I want to say at the outset: Labor strongly supports the establishment of a national cancer screening register. As a member of the committee, I was apprised of the benefits of this register, particularly to improve procedures around screening to make sure that we keep people alive longer—that is essentially what this comes down to. Labor also supports the improvements to cancer-screening programs that the new register will support.

But we do have concerns about the government's legislation. This register will hold Australians' most sensitive health data, like the results of cervical and bowel cancer screening, and we need to get such a sensitive matter right. So Labor does have serious concerns about the government's shambolic approach to this important legislation. On the eve of the election, the Turnbull government signed a $220 million contract to outsource this register to Telstra before parliament even saw the legislation. So we had a government that had not put through the legislation that was required to facilitate this register, and yet the very same government were hell-bent on rushing through and signing a contract to get this register up and running—mysteriously, on the eve of the election. You can only assume that they did so in order to have a great little campaign announcement without actually having done their homework in getting the necessary legislation in place.

Now, as we are becoming used to from the Turnbull government, we see another stuff-up. The government have bungled the bills to establish the register in their rush to pass this legislation retrospectively. When Labor and the crossbench first referred the government's bills to a Senate inquiry, the Minister for Health and Aged Care, Sussan Ley, accused Labor of a hysterical tirade. But, in an embarrassing rebuke of the government, their own Information Commissioner made six recommendations to the Senate inquiry to fix the legislation. So their very own commissioner raised concerns about matters in this legislation that were very basic privacy and data restriction matters that the government had not taken into account in drafting the legislation. At the committee hearing, even government senators, on hearing the evidence of the privacy and information commissioner, indicated that there did seem to be some benefits in considering the amendments that the commissioner proposed. Some of the loopholes identified by the commissioner were incredibly alarming. For example, the government's bills as drafted may allow the register operator to collect all Medicare claims information on people who are on the register. I well remember during the federal election that we had a bit of a debate about Medicare. Do you remember that, Senator Polley?

Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Link to this | Hansard source

I do remember that.

Murray Watt (Queensland, Australian Labor Party) Share this | Link to this | Hansard source

You do remember that—and I think Australians remember that. We continue to hear the horrified claims from the government that Labor perpetrated a lie in saying that Medicare was going to be privatised, and here we have a very good example of the government's determination to outsource and privatise aspects of our health services by giving the contract to run this register to a private, for-profit corporation. Not only that; the way the bill is drafted has left it very unclear. It would appear that the register operator, who will be a private, for-profit corporation—that is the government's desire—will be allowed to collect all Medicare claims information on people who are on the register. I remember the Prime Minister claiming very loudly, 'This is just terrible. We're not privatising Medicare. Nothing to do with Medicare will ever go to the private sector,' and here, in the third sitting week of the new parliament, we have the government putting through legislation which will, apparently, allow private access to Medicare claims information. Under the government's plan, this would allow Telstra to see all health services that a person has received, including in sensitive areas like mental health and sexual health. The more Australians hear about this, the more horrified they will be to think that their personal health information—really something that is just between them and their doctor—will now potentially fall into private hands. That is something that I think most Australians would not want to see.

So, last week, Labor proposed nine amendments to improve the government's legislation, and we have now dragged the government, kicking and screaming, into accepting many of those amendments. We understand the government has accepted some amendments that meet many of our demands—very practical, sensible demands. Remember, this is the same government which said that the Senate inquiry was a hysterical tirade, and it is now admitting that it has to amend its own legislation.

Unfortunately, despite the amendments that have been taken on board by the government, this legislation remains full of holes. In addition to the Labor amendments that the government is accepting, we are going to continue on and move three amendments that it refused to accept. Labor's amendments will ensure that Australians' personal information is collected appropriately and used appropriately and that appropriate penalties are in place to protect all Australians. The first batch of amendments concerns this attempt by the government to privatise Medicare and privatise health services. First, Labor will proceed with its amendment to limit the operation of the register to a not-for-profit organisation or a government agency. I do not have a problem particularly with Telstra—they have done a great job; they are a great corporation; they provide a lot of services to Australians—but the problem is that Telstra have never operated a register like this. We took evidence to that effect in the hearing. In fact, at the hearing it was made very clear to us by a number of witnesses that nowhere in the world has a for-profit corporation operated a cancer-screening register like this. So this would be a world-first privatisation of health services in this way committed to by the Turnbull government—which, of course, is the government that is not going to privatise health services. We remain very concerned about that and the prospect of people's private health information being handed to a for-profit company.

The Senate inquiry revealed that the Australian Medical Association, the Royal Australian College of General Practitioners and other experts share Labor's concern about outsourcing the register to a for-profit corporation. So this cannot be dismissed as some ideological pursuit by the Labor Party; this is being backed up by some of the most respected voices in the health community around Australia. They share our concern and also believe that this register should be operated by a government or not-for-profit organisation.

The second set of amendments concerns mandatory disclosures. We will move an amendment to ensure that individuals are notified when their most sensitive health data is breached. I am conscious of the time, so I will not say too much more. We will be moving amendments to increase the penalties for unauthorised use or disclosure of information. One of the really great concerns is that the government continues to refuse to say that the government will remain the data custodian. The government says this in its explanatory memorandum to the bill but is not prepared to do so in the bill, which really raises some concerns. In the interests of time, I might wrap up my speech there, but I do want to move an amendment to this bill. I move:

At the end of the motion, add:

  ", but the Senate condemns the Government for outsourcing Australians' most sensitive health information to Telstra before the Parliament even saw the necessary legislation.".

Debate interrupted.