Quote Of The Year

Quotes Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"


H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, July 25, 2012

Well COAG Has Just Not Done Anything With Funding E-Health. I Wonder What That Means?

Here is the communique.

Council of Australian Governments Meeting–Communiqué
Canberra, 25 July 2012

The Council of Australian Governments (COAG) held its 33rd meeting in Canberra today.  The Prime Minister, Premiers, Chief Ministers and the President of the Australian Local Government Association (ALGA) attended.  The Leaders acknowledged this was the final COAG meeting for Councillor Genia McCaffery, President of ALGA, and thanked her for her contribution.

National Disability Insurance Scheme

COAG noted progress in establishing the first stage of a National Disability Insurance Scheme (NDIS) from July 2013, and that the Commonwealth has reached in-principle agreement with South Australia, Tasmania and the Australian Capital Territory for a launch to commence from July 2013.  These jurisdictions agreed to engage closely in the implementation of the first stage, noting this will inform the move to a national insurance-based approach to disability care and support.
These jurisdictions agreed to work together on the development of Commonwealth legislation to establish both the scheme and a national launch agency to administer the scheme during the launch phase.  The agency will be responsible for managing Commonwealth and State funds in a single national pool, and undertaking planning, assessment and approval of individual support packages.
The Commonwealth, South Australia, Tasmania and the Australian Capital Territory welcomed the opportunity to establish launch sites so that, from July next year, governments will start the first stage of an NDIS and improve the quality of support for people with a disability and their carers.  These jurisdictions agreed that participants in the launch sites will receive ongoing support until a decision is taken to move to a full NDIS.  All governments also agreed that the funding and governance arrangements agreed for launch do not create a precedent for the full scheme.
COAG welcomed a report from the Select Council on Disability Reform on progress with establishing an NDIS.  First Ministers discussed funding and governance options for an NDIS and agreed to consider these issues further at their next meeting in 2012.
As part of its report, the Select Council has proposed an approach to defining eligibility and reasonable and necessary support under an NDIS, building on the work of the Productivity Commission. COAG agreed that, as a first step to settling the design of an NDIS, consultation with people with a disability, their families and carers, the workforce and disability sector and peak bodies would commence from late August on this approach.  These consultations would occur through Commonwealth and State Advisory Groups that have been established to support government consideration of an NDIS.  The consultations will inform the final approach to eligibility and reasonable and necessary support to be agreed by COAG, as well as further work on how these definitions would work in practice, and how they would be reflected in legislation, regulations or guidelines.

Future Competition and Regulatory Reform

COAG noted the progress report from its inter-jurisdictional Taskforce which was set up to advise COAG following the successful Business Advisory Forum meeting in April.  The Taskforce has been consulting with peak business bodies and other organisations interested in specific reforms, including conservation groups which have an interest in environmental regulation reforms.
COAG reiterated its commitment to reducing duplication and double-handling of environmental assessment and approval processes while maintaining high environmental standards that are risk- and outcomes-based. In line with the timing agreed at the COAG meeting in April, consultations are underway and negotiations for bilateral agreements are about to commence.
The Taskforce has worked with the Select Council on Climate Change to examine options to expand and expedite planned reviews into the complementarity of climate change measures with a carbon price.  Significant progress has been made in establishing the scope for reform and in identifying measures for review. This process will be largely completed by late 2012.
On energy market reform, considerable work is already in train through the Standing Council on Energy and Resources.  COAG expressed concern over the recent substantial electricity price increases arising from factors including increases in transmission and distribution charges and requested energy ministers to focus current reviews of market regulation in the interconnected market on achieving efficient future investment which does not result in undue price pressures on consumers and business. COAG noted the Taskforce’s advice that the current program of work is consistent with its original vision for an interconnected national electricity market. Nonetheless, noting the interest of governments, business and consumers in competitive markets, COAG asked the Taskforce to undertake further work and advise COAG in late 2012 on any additional action required to deliver a regulatory framework that promotes a competitive retail electricity market, including appropriate support for vulnerable customers, and efficient investment. 
Work to develop best-practice approaches to lift regulatory performance and policy initiatives to meet the red tape challenge is also being advanced. 
COAG noted that a report would be provided to the next meeting of the Business Advisory Forum and recommendations to COAG in late 2012.

Progress on Seamless National Economy Reforms

COAG has released two report cards on the implementation of its deregulation priorities and competition reforms under the National Partnership Agreement to Deliver a Seamless National Economy.
COAG welcomed completion of the business names reform and noted that 17 of the 27 deregulation priority reforms are now operational and three of the eight competition reforms are complete.
In relation to directors’ liability reform, to ensure the operation of directors’ liability is applied in a nationally consistent and principle-based manner in future legislation, COAG agreed to a set of Principles and Guidelines, noting that this reform is still under consideration by the Queensland Government.
COAG welcomed the release last week for consultation of the Regulation Impact Statement (RIS) for electrical occupations, under the National Occupational Licensing Scheme reform, and noted the three remaining RISs are about to be released for consultation.
COAG welcomed the progress on infrastructure reform, the National Construction Code, chemicals and plastics reform, e-conveyancing reform, legal professions reform and trades licensing.

Construction Industry Costs and Productivity

COAG agreed to establish an independent review panel to conduct a broad ranging investigation into cost, competitiveness and productivity challenges in the commercial, civil and large scale residential construction industry.  COAG will appoint three eminent persons with relevant expertise to conduct the review over the next 12 months and report back to COAG.  A secretariat within the Department of the Prime Minister and Cabinet, comprising Commonwealth and State representatives, will support and report directly to the review panel.  The panel will undertake analysis and consider reforms that could be pursued nationally or by individual Commonwealth, State, Territory and Local governments. Terms of reference are attached.

Expiring National Partnerships

COAG noted that a number of programs under National Partnerships have supported increased service levels. COAG recognised the importance of a coordinated approach to the consideration of ongoing funding for National Partnerships.  It endorsed the criteria developed by Heads of Treasuries to determine the treatment of expiring National Partnerships. COAG also agreed to establish a working group to report back to COAG in September, to provide early identification of those agreements expiring on or before 30 June 2013 that have led to increased service levels, and options for their treatment if they were continued, noting that any Commonwealth funding decisions are contingent on Commonwealth Budget processes.

Improving Funding Arrangements

COAG discussed ongoing concerns about the proliferation of National Agreements, National Partnership Agreements and Project Agreements. COAG is committed to ensuring that only matters of truly national significance will be progressed as new multilateral National Partnership Agreements, with consideration of existing or alternative funding mechanisms before any new funding agreements are entered into. To support this, the working group which will consider expiring agreements will also consider and recommend measures to streamline the development and administration of selected funding agreements, for reporting to COAG at its December 2012 meeting.

National Response to Organised Crime and Firearms

COAG acknowledged that organised crime and firearms-related issues are of considerable concern to all governments and the community, and noted the initiatives agreed through the Standing Council of Police and Emergency Management (SCPEM). COAG agreed that the Commonwealth will continue to work with the States on a coordinated approach to organised crime, and firearms-related crime, in line with the work agreed by SCPEM.

Not-for-Profit Reform

COAG reconfirmed the objective of minimising regulatory compliance costs to the
not-for-profit sector and requested further advice from Senior Officials on any legislative and regulatory changes required to achieve this objective. This includes legislative impacts of the proposed Australian Charities and Not-for-profits Commission Bill.  Senior Officials will finalise this work within a month and before the Bill is settled for introduction to the Commonwealth Parliament in August 2012.
COAG agreed to consider before the end of 2012, the results of a regulatory impact assessment on governance and reporting standards in the not-for-profit sector, in light of the proposed Bill.

Royal Succession

Leaders confirmed Australia’s support for changes to the rules for Royal Succession agreed by leaders of the Realms on 28 October 2011 which would: allow for succession regardless of gender; and, remove the bar on succession for an heir and successor of the monarch who marries a Catholic.

New Zealand Engagement in COAG Fora

COAG welcomed New Zealand’s move from long-term observer to a member of the National Counter-Terrorism Committee and the National Emergency Management Committee to ensure the closest possible coordination and cooperation on counter-terrorism and emergency management issues.
25 July 2012
----- End Extract.
The section that matters is the part on Expiring National Partnerships - of which NEHTA / E-Health is one.
What do you read into this?
“It endorsed the criteria developed by Heads of Treasuries to determine the treatment of expiring National Partnerships. COAG also agreed to establish a working group to report back to COAG in September, to provide early identification of those agreements expiring on or before 30 June 2013 that have led to increased service levels, and options for their treatment if they were continued, noting that any Commonwealth funding decisions are contingent on Commonwealth Budget processes.”
This may cause some real heartburn in NEHTA I would imagine.
Here is the page where you can see the old funding agreements - under e-Health.
I wonder what happens next?


Anonymous said...

those last two comments on Ms Halton are completely inappropriate and lower the tone of this blog. I find them offensive and less than ordinary.

You may have let them slip through inadvertently, but can I ask that you remove them immediately.

Dr David More MB PhD FACHI said...

Removed - but see blog for comment on removal. I agree with the sentiment if not the mode of expression.


Dr David More MB PhD FACHI said...

To add to that I think Ms Halton has been a total policy incompetent in the e-Health domain and all the commenters were doing was suggesting they had similar views.

Pity about the mode of expression however - they had a serious point to make!


Anonymous said...

Were the removed comments seriously this offensive? As I cannot now see them, I cannot now judge for myself.

If they were truly in poor taste and offensive, then discretion means censorship "may" be unfortunately required. If on the other hand they were only potentially offensive to those targeted and their advocates, then maybe "thicker skins" is what's required from our policy wonks and their supporters.

Regardless, the heated sentiment, whatever it was, is only the symptom and expression of substantial latent frustration with our public service bureaucrats that are more “self-serving” than "public serving" through their behaviours, language, decisions, actions and at times where it is the most important, complete "inaction" and outright "lack of accountability", and no quantity of weasel words, overt obfuscation and bureaucratic double-speak will quash or placate this growing unrest and distrust of our "public servants" and elected representatives.

If "one person" finds posted comments offensive, they can always choose either to not read the blog or ignore offensive comments that reside on this blog.

David, you have mediated and exercised your editorial judgement in removing germane comments but this really must be the last resort as censorship of a blog like this is a dangerous and slippery path to venture down. Removing or screening (!@#% ) out offensive language may be a lesser evil to allow posted comments to be shared in their greatest fidelity amongst the "voluntary" readership of this blog!

I am often "deeply offended" by the drivel Ms Halton spiels out that is completely inappropriate and lowers the tone of discourse around ehealth in her public appearances and senates estimates hearings regularly, but I am certainly not going to ask for her to be censored, and as a previous free speech poster has suggested, will only wait and wish for her inevitable and justified (IMHO) "sacking".

David, any chance of reinstating the comments, maybe in some redacted form so the sentiment and serious points can be shared amongst this blog's "voluntary" readership? And those potentially offended can remove this blog’s URL from their bookmarks.

I suspect Ms Halton has thick enough skin to wear and have rub off any degree of potentially "offensive" commentary from any lowly peon and great unwashed anonymous bloggers she lords over and scrapes off the bottom of her very expensive shoes.

To her fans in the public service, that says more about the wimps who the run the navy than Jane Halton. To them, she's bright, conscientious, a straight shooter and, yes, very tough. You have to be to get to the top of the public service at 42 - the youngest department head in the federal public service and a woman to boot, only the second to make department secretary. She's famous for shocking dithering blokes round a meeting table with: "Haven't any of you got balls!"


Anonymous said...

I think one of the removed comments might have had a too smart by half reference to the parable of the little boy who shouts “The Emperor Has No Clothes" – which while not seeking to personalize the matter, is very apt commentary.

Notwithstanding this, it is also a matter of fact, as numerous commentators on this blog have previously mentioned; if there is a point of overlap between NEHTA and DOHA and a single point of failure of leadership, governance and accountability it lies with the Secretary of DOHA.

Furthermore, she may well have been burnt the first time with Healthconnect, and this may explain some personal and professional shyness the second time round. But no amount of gilding the lily/spin can erase the truth of the matter – that there is truth in what the little boy speaks. And in such matters it is the truth that many fear most.

I also agree with another post that we see with recent articles by Karen Dearne of the Australian an inevitable zeroing in and mainstreaming of key concerns by someone who creditably knows the subject matter. This can only add gravitas – two of the most recent articles are actually quite extraordinary when one thinks about it.

Cris Kerr said...

' ... The (Canberra Hospital) Emergency Department’s management information system, which is used to prepare the performance information, has very poor system access and user controls. There is a lack of governance and administrative accountability for this system, which means that there is no identifiable system owner with responsibility for ensuring the integrity of the system and the appropriateness of its access and user controls. The very poor system access and user controls over the Canberra Hospital’s Emergency Department management information system has wider implications beyond the inaccurate reporting of timeliness performance. There are risks to the privacy and confidentiality of patient information. The very poor systems and practices also mean that there is a risk that the Health Directorate does not meet the requirements of Principle 4.1 of the Health Records (Privacy and Access) Act 1997 relating to the safekeeping of personal health information. ... '

What gets measured gets done.

Quality on-mission strategic and operational plans target both qualitative and quantitative (clearly defined/detailed) objectives and outcome measures, not quantitative measures alone.

Qualitative measures clarify quantitative measures and vice versa. They complement each other, add greater depth of meaning, improve the clarity of outcomes, and importantly, are also sentinel tools that can aid early detection when managing the risk of data corruption.

When targeting improvement, they enhance the reliability of each data set in isolation, but also in combination... and that in turn leads to more meaningful and reliable analyses which better inform future priorities, plans and budgets.

Effective governance frameworks (quality management policies, systems and processes) play a supporting role. They ensure a common language and understanding, transparency and integrity in all directives, actions and activities... including data collection and reporting.

The point is... if every measure recorded is accurate and reliable, then every measure after that also has a much higher degree of reliability... and that's critical when it comes to reporting and analyses (data you can take to the bank).

Falsified or manipulated data is corrupt data (i.e. data without integrity).

A single corrupt data measure, whether falsely entered or later manipulated will, like a domino, corrupt and invalidate every data measure that follows.

Dr David More MB PhD FACHI said...

All, the comments were offensive - and put the point that thought Ms Halton was a less than quality custodian of Australian e-Health. I agree. The comments are gone - but they live on in spirit!


Anonymous said...

I suspect the irony is that the bloggers words are more direct and possibly offensive than any that were deleted - describing a Departmental Secretary as “a total policy incompetent” strikes at the heart of such a role and an incumbents professional competence.

Anonymous said...

David, perhaps you should get into the Olympic spirit in the coming week and do some ambush marketing - perhaps a label badge or a series of T-shirts emblazoned with “I read David More’s Blog” at HIC. That indeed might be truly offensive (to some)!
Perhaps you can give a prize for the best suggestion.

Dr David More MB PhD FACHI said...

That is a wicked and very amusing idea I must say!

It might unsettle a few - but remember even those who violently disagree tend to read - just so they know what the rest of the well informed world thinks of their efforts.


B said...



Is the Department of Health and Ageing a policy agency or a service delivery agency?

I thought it was a policy agency. Maybe that's why it is making such a mess of implementing the PCEHR.

It could be that Jane H is suffering from the Jeremy Clarkson syndrome "how hard can it be?".

Anonymous said...

It could be that Jane H is suffering from the Jeremy Clarkson syndrome "how hard can it be?"

As hard as she wants to make it. It takes a great deal of skill and a high IQ to set others up to fail and in the process transfer the blame.

Anonymous said...

I have to say that I am really disappointed by the personal attacks above. I saw, and am glad that David removed, the earlier posts which were unprofessional, insensitive and did the cause of e-health no favours.

I post here often, am critical of national e-health often, but playing the man not the ball is a sure strategy to lose the game.

If we have specific and valid arguments to make we should make them. It is the case that one never can walk in the shoes of others, nor understand how things come to pass. All one can do is focus on the issue and make your voice heard.

This 'going negative' on the individual only makes impartial observers shake their heads, when they want to hear facts.

We have a real and critical debate to have about where e-health is going in this country. Lets not derail it folks with this sort of stuff - the stakes are too high.

Anonymous said...

While the Sun may not always exactly shine on the righteous

"but playing the man not the ball is a sure strategy to lose the game"

Sometimes the situation and the context disables the ability to separate and differentiate between the two.

Just ask Maradona and the '86 defeated English World Cup team.

She tough, she's a big girl, and there's no doubt as we've seen time and again she can serve up and dish out just as well as she can take it.