NICOLA ROXON SPEECH HEALTH e NATION 19 AUGUST 2009

Ms Roxon gave the following speech earlier today – reactions welcome.

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The Hon Nicola Roxon MP

Health e Nation Conference

Wednesday 19 August 2009

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Acknowledgements

Ms Sally Glass, Managing Director, Chik Services;

Dr Andrew Pesce, AMA President;

Mr Peter Fleming, Chief Executive, NEHTA;

Mr Mark Cormack, Chief Executive, ACT Health

Dr Mukesh Haikerwal, NHHRC Commissioner; and

Ladies and gentlemen.

Introduction

Thank you for having me this morning.

I wanted to take time from proceedings in parliament to join you today because it is an important time for e-health in this country – and not just because it gives me a breather from the shenanigans of the House.

It has certainly been an exciting time in the health portfolio. Parliament has actually given me a chance to be in the same city for more than a day at a time.

As almost all of you would be aware by now, on July 27 the Prime Minister and I released the final report of the Health and Hospitals Reform Commission.

Reform Commission context

The Government set up the Commission because we knew there were serious, systemic issues in our health system that need addressing and action.

We asked for a comprehensive, independent forensic analysis of our health system – and we got it. The report represents an opportunity for the most important reform of our health system for decades, certainly since the introduction of Medicare.

The report paints a picture of a good health system, but one that is struggling to adapt to the needs of an ageing population, and a community which is becoming more prone to chronic disease.

We have a health system that is focused on hospitals and on treating people when they get sick. It patches up and treats patients very well, but it is finding it harder to do so as demand continues to increase.

The report describes the system as at a “tipping point”, and says the time for ‘business as usual’ has passed. The time to act is now.

We simply won’t have the resources to keep doing things the way we are doing them in the future. Our health and aged care costs will grow from around 9 per cent now to 12.4 per cent of GDP – or $246 billion – a little over two decades from now if we don’t change.

Our ‘frontline troops’ in primary care are our first line of defence against some of the health care problems that are set to cripple our population and our health care system – like obesity and diabetes. If we do that better our hospitals will have more capacity to treat those acute illnesses we cannot prevent.

There are plenty of other things we can also do better.

The Commission has provided the Government with 123 recommendations to address these challenges, which can be broadly broken down to three key goals:

- tackling major access and equity issues that affect health outcomes for people now;

- redesigning our health system so that it is better positioned to respond to emerging challenges, including the boom in chronic disease; and

- creating an agile and self-improving system for long term sustainability.

Reform Commission & e-Health

A key theme that emerges from the Report, that is of particular interest to this audience, is the revolutionary potential of e-Health to drive many of the transformative changes needed to meet these goals.

Fast forward 50 years.

Can you imagine our health system without instant access to our medical records? Where you have to carry your x-rays to each appointment, or have test results posted to you, or more commonly your doctor? Where a simple click could deliver so much information – but doesn’t, because we didn’t take action when we should have?

It’s unthinkable.

I want our future health system to be connected, secure and efficient.

It is frustrating that in a sector where technology and research drive continual innovation in patient care, paper is still king. After a decade of doing our banking – and almost everything else – online, we’re still carrying our x-rays under our arm, a script to the pharmacy, and the hospital can’t send a discharge summary to the family GP.

If any of you were to present to Canberra Hospital tonight unconscious, the staff in the ED would have no idea what your health history was – if you were diabetic, your vaccination history, or your allergies for example. That’s just the worst case scenario, but the same idea applies if you need care on holidays anywhere in Australia. And that is for an infrequent visitor to hospital – imagine the stress for frequent user – the elderly, those with chronic disease.

The NHHRC Report recommends:

- a person-controlled electronic health record for all Australians by 1 July 2012, with unique personal, professional and organization identifiers by 1 July 2010;

- legislative and policy controls to protect patient privacy; and

- encouraging the take up of e-health by making payments to public and private health professionals dependent on e-health compatibility by 2013, starting with hospitals and pathology and diagnostic imaging providers by 1 July 2012.

We are already moving to implement a new, unique healthcare identifier number, which I shall return to shortly.

The UHI number is important as once they are in place, we can get on with building the vault of information – the medical records – for our health professionals to access, via that unique key.

We are building an e-health system now, because a future without it is unthinkable.

E-health really does have the potential to revolutionise how we deliver health care services. Think of the patient suffering from the chronic disease diabetes, who over the course of 12 months of his or her treatment, may see multiple GPs across the country, practice nurses, podiatrists, pharmacists, dieticians and psychologists – at the moment none of these health professionals can access and share this patient history.

It is estimated that 30 to 50 per cent of patients with chronic disease are hospitalised because of inadequate care management.

It is examples such as this which highlight why this debate is so important.

The decisions we take now on e-health will be felt for generations. We want to get it right.

We want babies born in the next decade to have an electronic health record that stays with them for their whole lives.

An Electronic Health Record would mean patients will be able to present for health service treatment anywhere in the country, and with patient approval, the treating health professional will be able to access a summary of the patient’s treatment and medication history at the touch of a button.

For health professionals, this will mean that less valuable time is lost, expensive tests are not being re-ordered or duplicated at a cost to the taxpayer, and knowledge is shared.

In fact, it has been estimated that up to 18 per cent of medical errors are attributed to inadequate availability of patient information, and between 9 and 17 per cent of pathology and diagnostic tests are unnecessary duplicates. When we spend $14.8 billion a year on the MBS, there are clearly some major savings to be made.

Better information means better and safer health treatments for patients.

Our reform plans, including those on e-health, will not come cheap.

The Reform Commission has put the price tag of an Individual Electronic Health Record at between $1.1 and 1.8 billion. That’s serious money, and it will require serious consideration on how it could be funded.

Coincidently, you may have noticed that this week in the Senate that the Government is attempting to pass its changes to the private health insurance rebate.

We are trying to change the rebate provided to high income earners with private health insurance – for example couples who earn over a quarter of a million dollars – which is estimated to save the Government $1.9 billion.

So as you can see, the E- health reforms are an example of what we could pay for if the private health insurance measure is passed

You might consider placing a call to your local Coalition or Independent Senator to point this out.

E-health does however also have the potential to deliver significant savings. The AIHW supplementary report to the Reform Commission, puts them in the order of $430 million in 2022/23 and $627 million in 2032/33.

The government has committed to a series of public consultations on the Report.

We want to road-test the recommendations and options with the community, who are all stakeholders in the future shape of our health system. We have so far had a number of forums in Sydney, Adelaide, Melbourne and North Queensland, with more to come. I urge you to come to a forum, and if you can’t do that, get online at www.yourhealth.gov.au and give us your views on the recommendations.

So far at our consultations there has been vigorous nodding and lots of supportive comments and questions when e-Health has been mentioned.

I can’t announce our position on this key recommendation of the Commission’s today – much as I’m sure you’d all be delighted if I did.

What I can do, is confirm that I, and the Government, are well aware of the potential benefits and importance of e-health and we’ve already taken action in this area – this work will not be halted.

NEHTA & e-Health strategy

Like our broader reforms in healthcare funding, elective surgery and infrastructure projects, the Government has not been sitting on its hands when it comes to e-Health.

In December last year, Health Ministers endorsed the National e-Health Strategy, which will help drive future e-Health activity for the next decade. The Rudd Government is determined that the Commonwealth has a major role to play in driving the roll-out of e-Health.

With the states and territories, we have already committed to funding of $218 million over the next three years to fund the work of the National e-Health Transition Authority.

Since being established, NEHTA has developed and commenced the roll-out of the Australian Medicines Terminology and the National Product Catalogue, two initiatives which introduce common standards for how medicines and health products are defined in this country. The fact that this situation did not exist before demonstrates the scale of the task ahead as we try to build common foundations for e-Health in Australia.

Mr Peter Fleming, the Chief Executive of NEHTA, will be discussing NEHTA’s work a little later today. My department continues to work with NEHTA on implementation packages for e-Prescribing, e-Pathology, e-Referral and e-Discharge.

Unique Patient Identifiers and privacy

Regardless of our success with technical aspects of e-Health, it will not realise its potential without ensuring the privacy and security of personal information. That’s why our number one priority is the privacy and security of information.

The Commonwealth, together with the states and territories, is developing national legislation for a consistent approach to privacy across Australia and the roll-out of unique healthcare identifiers. NEHTA is spending $50 million on this project this year alone.

Public consultation on the legislative framework for these was undertaken jointly by all jurisdictions and NEHTA during July and August. The results of this process will be reported to COAG and feed into the legislation to be introduced early next year.

By the middle of next year, all Australians will have been allocated a 16 digit Unique Healthcare Identifier.

This 16 digit unique number is the first step in building a secure e-Health system. It will not replace your Medicare card – it will be a totally new, unique number. It will be the key that unlocks the information on your medical record – an e-Health record.

You will be the owner of the key, and you will decide who gets access to your records.

So whilst progress may seem slow at times, there is still a lot of work being done outside the arena of the reform process, but complementary to it.

Conclusion

We stand at the cusp of an era of significant changes in health in this country. The decisions the government makes over the coming months will help build a health system to meet the needs of the current, and future generations. E-health is a clear symbol and practical example of this.

The Prime Minister and I are absolutely determined to get the reform of our health system right. We have blueprint for the most significant reform of the health system since the introduction of Medicare 25 years ago.

I welcome the contributions and ideas of everyone here today to our consultation process.

And I am pleased to officially declare today’s conference open for business.

ENDS

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Passed on without comment for now – other than to note giving yourself 50 years to develop e-Health seems pretty cautious!

David.