Wednesday, June 23, 2010
Ms Roxon and Mr Dutton speak On E-Health in the Reps – 22 June, 2010.
Ms Roxon and Mr Dutton Spoke in the House of Representatives yesterday on the HI Service Bills and E-Health.
Here is what she said. (It does not seem to have been much reported)
I would not say it is looking very hopeful at this point. This starts at page 15 of the Draft Hansard.
There are a few fun pages before this with lots of argy bargy!
The full transcript is here:
Take it away you politicians!
Ms ROXON (Gellibrand—Minister for Health and Ageing) (3.58 pm)—We are at a crucial point for the future of electronic health development in Australia. Given the key role that e-health will play in reforming Australia’s health system, progressing e-health is vital for the future direction of the health reform agenda.
For more than three months the government have wanted the Senate to consider the Healthcare Identifiers Bill 2010. We want to get on with implementing ehealth, but these attempts have been blocked by the Liberal Party, by their delay and their dithering.
The bill sitting in the Senate as I speak today 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.
Put simply, this is like building Highway 1, the main backbone of the new e-health system. Without unique healthcare identifiers there cannot be an integrated, consistent, national e-health system in Australia. We have to build the highway which will allow each and every healthcare provider and consumer to connect to a national system.
Electronic health records will help revolutionise the delivery of health care in Australia. That is why last month’s budget included almost $467 million to roll out personally controlled electronic health records for all Australians from 2012-13.
This investment will establish a secure, personally controlled electronic health record system that will provide:
• summaries of patients’ health information— including medication and immunisation summaries, and results of diagnostic tests;
• secure access for patients and healthcare providers to their e-health records via the internet;
• rigorous governance and oversight to maintain privacy; and
• the national standards, planning and core national infrastructure required to use the national system.
Patients will, for the first time, be able to access their key health information when and where they need it. Patients will no longer have to remember every detail of their care history, medications or test results and have to retell it to every health professional that they see.
It is estimated that two to three per cent of hospital admissions in Australia are linked to medication errors, which equates to 190,000 admissions each year and costs our health system $660 million per annum. And about eight per cent of medical errors are because of inadequate patient information.
E-health will save lives, reduce medical errors, keep people out of hospital and save money for the taxpayer.
Nine of the National Health and Hospitals Reform Commission’s 123 recommendations deal with the need to progress e-health, including a recommendation to introduce healthcare identifiers by July 2010—that is just next week—and individual electronic health records by 2012.
The government has worked hard to progress these reforms as a priority and to progress the legislation.
We referred the bill to the Senate Standing Committee on Community Affairs to allow for more community consultation on the bill after two rounds of consultation last year.
Stakeholders including the Australian Medical Association, the Australian Nursing Federation, the Royal Australian College of General Practitioners, the Royal College of Pathologists of Australasia, industry and the Consumer Health Forum of Australia all outlined the critical need for this legislation to be passed.
The committee recommended the passage of the bills without amendment.
However, following further consultation on the draft regulations and the recommendations proposed by the coalition in its minority report, the government has been prepared to propose amendments to the bill and regulations to respond to some of the issues raised.
Despite this, the coalition are still yet to commit to supporting the legislation and have announced that they would cut the budget funding to roll out e-health records—defying the almost unanimous support in the health sector for e-health.
The coalition have abandoned, unfortunately, more than a decade of bipartisan support for e-health reform and once again embraced the health funding cuts agenda they pursued when they were last in government. This contradicts three specific speeches that Mr Abbott, the Leader of the Opposition, gave as Minister for Health and Ageing calling for e-health records.
Indeed, he based his first speech as the new health minister in 2003 on the need for e-health records. He gave his government five years to implement a national scheme or it would be an ‘indictment against everyone in the system, including the government’.
The member for Dickson, sitting at the table today, is also on the record as offering bipartisan support for e-health. Last September he stated the lack of e-health was a ‘very poor reflection on the last decade of discussion’.
The shadow Treasurer told parliament in 2008 that ‘there was a very bipartisan agreement’ on e-health. After the Liberal decision to cut the next tranche of funding announced in this year’s budget was widely condemned by the AMA, the ANF, the AGPN and other stakeholders, Andrew Robb, the opposition finance spokesperson, declared they would not support e-health as there was no ‘individual identifier’ in place.
Today is the opportunity to change that. I say to the Leader of the Opposition, the shadow Treasurer, the member for Dickson and the member for Goldstein: here is the chance to right the wrongs of the last decade.
Here is the chance to demonstrate that the Liberal Party is serious about health reform. The decision to introduce a national approach to identification for patients and providers was made as far back as 2006 by COAG—under the Howard government.
The decision was then affirmed in November 2008 when COAG agreed to universally allocate healthcare identifiers to all healthcare recipients in Australia.
Now it is crunch time for the Liberal Party. This is an opportunity to stop standing in the way of this building block for e-health in Australia. Clinicians, patients, industry and business all see this legislation as vital to improving patient care and efficiency in the health system.
There is much at stake with this legislation. Building a national e-health system depends upon having a secure, consistent foundation to correctly identify all records.
Allocating healthcare identifiers for all Australians provides that foundation.
Personally controlled electronic health records will require specific safeguards, in separate legislation and governance arrangements.
The Liberal Party must think carefully about whether they want to risk consigning our health system to languishing under a paper based system or whether they want to support taking a big leap into the 21st century with this legislation.
The government has consulted often and widely on this legislation—with two rounds of public consultation, three independent privacy impact assessments, and the Senate committee all examining the design and operation of the identifiers service and legislation.
It is time for the Liberal Party to stop playing politics with patients and either support this legislation or step aside and allow the Rudd government to get on with the job it was elected to do.
So today I call on the Liberal Party and the shadow minister here at the table to state on the record if they will stand with the patients who want this, with the clinicians who want this and with the healthcare stakeholders who want this, or if they will continue to consign our health system to the paper records of the last century.
This is the choice that the Liberal Party face, and this is why this is a matter of such importance to be discussed in the chamber today.
We can consign e-health to the last century. We can leave it there, languishing with paper records. That may be where the Liberal Party’s health policies belong, but they should not stand in the way of such fundamental reform to our health system any longer.
We want the Liberal Party to stop playing games with this piece of legislation, acknowledge the government’s genuine attempts to address the issues raised during the consultation and allow the bills to pass the Senate this week.
I ask the shadow minister to please indicate today and advise the House in his reply if the Liberal Party will allow this legislation to pass in the Senate in the remaining few days before the winter recess and before the all-important 1 July start date.
And here is what the Opposition said.
Mr DUTTON (Dickson) (4.08 pm)—by leave—It is widely recognised and acknowledged that the introduction of a unique individual healthcare identifier is one of the important pieces of architecture in e-health in our country. The opposition understands this. We support e-health. We supported it in government. For example, the widespread computerisation of general practice was an initiative of the Howard government almost a decade ago. We support the introduction of a unique individual healthcare identifier; however, as many submissions to the Senate inquiry identified, the healthcare identifier legislation is too broad. That is why the opposition has drafted a number of sensible amendments to prevent function creep and to see that there is greater parliamentary scrutiny of the laws that will underpin the healthcare identifying service.
E-health is an area where substantial amounts can be wasted. According to Deloitte’s 2008 National e-health strategy report, $5 billion has been spent by the Australian state and territory governments over the past 10 years alone. This minister is proposing $467 million for electronic health records before they even have an identifier in place. At the COAG meeting in December 2009, $218 million was allocated from 30 June 2012 for the introduction of a health identifier, so the crocodile tears from the minister today really need to be exposed for what they are. There is money in the system.
We propose sensible working amendments to the Healthcare Identifiers Bill 2010. We want to encourage the government to support them so that we can have a healthcare identifier.
To put this debate in perspective, I was first contacted by the Minister for Health and Ageing in relation to this bill at one o’clock today to say that she was going to provide this ministerial statement. A draft text of the ministerial statement was sent through to my office.
We perused that information and it does not reflect the speech that was given by the minister only a few minutes ago. A page magically disappeared from the text of the speech that the minister provided—the page which included the tirade of personal abuse that we have become used to from this minister. It was not what was delivered to our office and it shows that this minister knows nothing else but personal abuse. She probably took that decision to modify her speech on the advice of the Leader of the House.
Why are we debating this bill today, at a time when this opposition has said that we will support sensible legislation? We are having this debate today because the government want to distract from their major failings, particularly in relation to mental health but also in relation to health more broadly. This is a government who have sat on their hands for the last 2½ years in the health arena. We have seen great frustration from health providers and indeed from patients right around the country, and that really came to a peak in the last 48 hours when Professor John Mendoza resigned his position as chief advisor in relation to mental health.
For that the government should stand condemned. That is what we are doing here today.
This is a government that are trying to distract. They cannot say that they have a good record in health. They cannot say that they have a good record full stop. There are a number of reasons why people should not vote for this government at the next election and they have been well detailed—the insulation program, the billions of dollars being wasted in the school halls rip-off and the way in which GP superclinics have not been delivered. This government promised 31 GP superclinics at the last election and have three fully operational 2½ years later. Now they want us to believe that they can take over Australia’s 762 public hospitals and somehow competently run them when they cannot manage money and they cannot manage the health system.
We are here today as part of a massive distraction. If this minister were sincere about getting this legislation through, why would she approach me only a couple of hours before question time today? Why would that be the case when the shadow parliamentary secretary for health has been negotiating with the minister’s office in relation to this matter for some time and we said before question time, in a meeting which I urgently convened with the minister, that we would be prepared to look at a sensible halfway mark? We should be able to sensibly negotiate an outcome because we as an opposition want to see this bill passed, but we have some serious considerations that the government has ignored. They are not just our considerations; they are considerations that have also been raised during the Senate process by people who have an expert knowledge in relation to these matters.
We have raised those concerns on behalf of some of those stakeholders because we want this bill to be legitimate.
We want to address some of the concerns so that, as we go forward in what is a contentious debate, particularly around the privacy issues, we do not have function creep and this government cannot just introduce by way of regulation some further function under the guise of this legislation when it should be a legislative change passed by both houses of this parliament.
In essence, that is all we are asking for. We are asking for a sensible outcome and a debated outcome with this minister, but that is not the approach of this government. This government have been sitting for months on recommendations. It took them about two months to reply to the Senate committee’s recommendations.
They want to come in here at the eleventh hour, only a week before 30 June, with this legislation due to start on 1 July this year, yet this minister cannot get her act together. This is not the first example of the way in which this minister has been completely negligent in the way in which she has managed her portfolio. She is completely incapable—with all due respect to the minister— of negotiating sensible outcomes.
We see it in relation to a number of issues, not the least of which is cataract surgery where announcements are made with no consultation and there is an expectation from the government that the opposition should just meekly roll over and agree to what is a failed process. All we have said as part of this debate is that we should have sensible amendments agreed to. Dr Southcott, our shadow parliamentary secretary, has put forward those arrangements and negotiations are now ongoing between the government and the opposition. I expect we will get a reasonable resolution to this, but do not come in here as a government trying to take some sort of high road and make some political issue of the fact that we want sensible amendments supported.
The Australian people should know that Mr Rudd is a complete failure as our Prime Minister. There are countless examples of that and I detailed some of them before. The real reason, as I said in my opening remarks, is that the government want to deflect from their other failings, not just in other policy areas but specifically today in relation to the ongoing criticism which they are receiving for their failure in mental health.
Professor John Mendoza is one of the most respected mental health professionals we have seen in a generation. He has great respect from both sides of parliament. This man says he took up the position as the chair of the National Advisory Council on Mental Health as ‘perhaps the most important public service responsibility of my life’. They were his words. This man is passionate about mental health and he reflects the passion that is in the mental health sector right around the country. This is a government which, at budget time, tried to rip money out of mental health, while having said over the last couple of years that they really want to put money into mental health. That is not the case. Do not look at what the Rudd government say; look at what they do. Do not take our word for it; take the word of an independent expert who was chosen by the Prime Minister himself to chair the Advisory Council on Mental Health. This man is highly respected in the Australian community and he said in his letter to the Minister for Health and Ageing of 18 June:
... it is now abundantly clear that there is no vision or commitment from the Rudd Government to mental health. While significant improvements have been made in disability employment policy and to a lesser extent in housing ... there is no evidence of a change in policy or investment in mental health.
This is a person also who claimed quite rightly that the Rudd government was trying to rip off the policies which had been implemented by the Howard government by our commitment to mental health. It just shows why we are in this chamber today. We will accept sensible negotiations and I think we will provide a resolution, but we will not be bullied and harangued into supporting what is otherwise a flawed bill—not just identified by us but identified by others as well.
This is clearly a government that has sought to distract from the main business. The main business that this government has shirked its responsibility on is trying to implement the reform they promised at the last election. The Australian public should not forget at this election that an amazing amount was promised by Kevin Rudd in 2007 but this Prime Minister clearly is all talk and no action and there is no clearer example than in the area of health. (Time expired)
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All I can say it is not looking good – or was not yesterday afternoon!
Posted by Dr David G More MB PhD at Wednesday, June 23, 2010