Tuesday, October 08, 2013
Will Mr Dutton Be A Health Minister We Can Have Some Confidence In? At Least He Talks The Talk!
It really is interesting times in the Federal Health sector. The only words to come from the Federal Minister in public seems to be an interview on ABC’s Life Matters.
Transcript of interview of Minister Dutton on Radio National by Natasha Mitchell on the Life Matters program.
Page last updated: 25 September 2013
25 September 2013
Topics: Mental Health, Priorities for Government
Natasha Mitchell: It's been a big first week for Australia's new Prime Minister, Tony Abbott, and the federal government. His new ministers were officially sworn in last week. Peter Dutton was the Shadow Minister for Health and Ageing for five years while in opposition. Now he takes the posts of both the Minister for Health and for Sport. This means that he's effectively responsible for what were three separate roles under the Rudd Government. You'll recall that mental health was a separate portfolio as well.
Now, health is always near the top of Australians' list of priorities. The minister certainly has a complex job ahead and a significant recent legacy of national health reform to pick up on, and so what are the minister's priorities for your health? What will stay, what will go, and what might be new? Peter Dutton joins us on the line from Canberra.
Thank you very much for joining us on Life Matters, Minister.
…… (Lots omitted).
Peter Dutton: Well let's again look at the facts Natasha. I mean the Government imposed the so called alcopops tax. In actual fact the consumption of spirits has gone up since the introduction of that tax. What we've said is that we're very keen to pursue evidence based policies and ideas that can work, but we don't think for argument sake that prohibition would work in terms of alcohol or tobacco. I think if we're starting with a clean slate and we're having a discussion about the federation today and we were starting fresh as a country I'm sure that we would approach things differently both in terms of the way in which regulation's imposed at a state and federal level, but also in relation to tobacco for argument sake. I mean I think wherever we can discourage the take up of tobacco we should because we know of the health outcomes, we should do whatever we can [indistinct].
Natasha Mitchell: [Talks over]Do you acknowledge though, Minister, that regulation has a place in targeting some of those powerful vested interests that contribute significantly to poor outcomes? So, the tobacco industry, the alcohol industry, the junk food industries, who are in our face with their products in a major way and target young people too?
Peter Dutton: Well let's again take, sort of, a factual case study into consideration. When Tony Abbott was the Health Minister, we introduced the graphic warnings onto cigarette packaging. Now, that has had the greatest impact in terms of the reduction of smoking rates in addition to the increase in excise. In Opposition, I proposed an increase in the tobacco excise, and the Rudd Government eventually took it up. They announced increase in tobacco excise, again during the course of the last couple of months we adopted that same policy.
So, we're happy to adopt measures that have proven to be successful and an increase pricing around tobacco has been part of the reason that we've been able to reduce smoking rates in this country to some of the lowest in the western world. Part of the tobacco problem, that I don't think we've concentrated on, to be frank, is in indigenous communities, or in the take up around young women and young men, for arguments sake. And I think that part of our focus going forward really needs to be about how we can reduce smoking rates in indigenous communities. I think that is a national shame, the smoking rates within indigenous communities at the moment. And I think we can start to target some effort in those areas and I think, frankly, that would be a great and positive outcome for our country if we could start to target more those indigenous smoking rates.
Natasha Mitchell: Okay.
Peter Dutton: So we're not opposed to evidence based, but the only point that I'd make here…
Natasha Mitchell: Good to hear.
The full transcript is here:
(Italics and emphasis is mine.)
So Mr Dutton says he wants to be evidence based in making policy. That is just great but what does it mean for e-Health?
To me the first thing he needs to do is access and release and evidence base on which the design and implementation of the NEHRS / PCEHR is based ad facilitate and expert review of the evidence to understand just how justifiable and evidence based the whole program is.
Without trying to prejudice the outcome of the review I have to say that at present I can find no publicly available evidence backing the architecture, design and implementation approach of the PCHER. This is especially true of one is looking for evidence of improved clinical outcomes based on such an implementation.
Indeed it is very hard to find good evidence supporting improved clinical outcomes from national Shared Electronic Health Records Systems - for example the UK NHS Shared Care Record Program.
There are a number of evaluation studies that have been conducted on the UK system.
Here are some links:
Full report on evaluation of summary care record - University College London
Do summary care records do more harm than good? - Ross Anderson
A defence of summary care records - Mark Walport [Wellcome Trust]
Clinicians may not access summary care records - IT Projects Blog
Summary of draft UCL report on summary care record - IT Projects Blog
These links are taken from an excellent article which is important reading.
So Mr Dutton’s challenge is really pretty simple. First to test the evidence that shows worthwhile clinical utility from the e-Health program as it presently is and then to reshape it based on what proper sound evidence actually shows.
We can all wait and watch!
Posted by Dr David More MB PhD FACHI at Tuesday, October 08, 2013