Senate Estimates - Community Affairs Committee - ADHA Testimony - February 20, 2019

The session ran for about 1 hour from 2:30pm to 3:30pm

Those there for the ADHA were  Mr Kelsey, Ms Edwards, Ms McMahon and  Mr O’Connor.

Begin Transcript -----

Senator WATT: All right. I'll leave it at that. Should we get on to My Health Record?

Senator GRIFF: There are a couple of things I'd like to check off. I just want to first clarify: I understand practices have been provided with an incentive of up to $12,000 per quarter or $50,000 a year to sign patients up to My Health Record. Is that correct, not correct?

Ms Edwards : Senator, take a step back. I think what you're referring is we have an incentive. We call it the PIP, which is payments to practices to encourage and reward them for becoming more technology literate. That has included over the years being ready to connect with My Health Record. There's a number of various criteria that practices have to meet in order to be eligible for the incentive. I think that's what you're talking about.

Senator GRIFF: To be ready for My Health Record, are you saying they have the systems to actually—

Ms Edwards : There's a number of criteria. I can tell you what they are in just a moment.

Senator GRIFF: This doesn't relate to them signing people up in the system?

Ms Edwards : No.

Senator GRIFF: Okay.

Ms Edwards : Signing people up in the system is not an element of the requirement. There are five requirements, and signing people up to My Health Record is not one of them.

Senator GRIFF: It appears, from responses to my previous estimates question 1122, that nearly 300,000 people cancelled an existing My Health Record before the legislation was changed to allow the records to be permanently deleted. Have the records of all people who cancelled prior to commencement of the new legislation also been permanently deleted?

Mr O'Connor : In relation to the permanent delete functionality, that was put into the system on 24 January. At the same time, we put into the system the ability to delete all records retrospectively. That process has commenced and we are expecting that to last up to 90 days.

Senator GRIFF: If a provider incorrectly uploads one person's record to another person's record, what are the consequences for the provider? Are there any consequences?

Mr Kelsey : Fiscal consequences or clinical consequences?

Senator GRIFF: Are there any consequences if incorrect data has been put into somebody's record?

Mr Kelsey : Yes. Obviously clinicians operate under a clinical professional protocol to ensure a level of accuracy in the data that they record on patients. For example, if they make a mistake by accidentally uploading to a record and that is brought to their attention, they would then amend that record. Indeed, if it was brought to our attention we would take action to ensure the record was corrected.

Senator GRIFF: Okay. Referring to the 42 data breaches of My Health Record in the year to June 2018, were all of these investigated by ADHA?

Ms McMahon : In terms of notifiable data breaches, the Office of the Australian Information Commissioner provides regulatory oversight to the agency as system operator. I'm not familiar with the numbers you were quoting. They were much lower numbers, in the terms of the agency's notifiable data breaches.

Senator GRIFF: I'm referring to a newspaper report that states there were 42 data breaches in the year to June 2018.

Ms McMahon : The source of truth we relate to is—the OAIC releases a report. They released one in October last year which has the correct figures for us as a system operator, and the Department of Human Services in operating Medicare also lodges notifiable data breaches. We can provide an excerpt from that report on notice if that would help.

Senator GRIFF: If you can provide a breakdown of the sources and causes of those breaches as well on notice.

Ms McMahon : I can provide those now, if you like.

Senator GRIFF: Yes.

Ms McMahon : In terms of the notifiable data breaches we reported, we had two in relation to an incorrect registration of a My Health Record and three in relation to fraudulent activity against a Medicare program. That basically was fraud through the Medicare program which led to a potential access to the My Health Record and met the criteria for a notifiable report from us to the OAIC.

Senator GRIFF: Did they result in penalties or prosecutions?

Ms McMahon : No, there wasn't any actual harm or viewing of information. We need to report to the OAIC where there's a potential breach, and in those instances there was a potential breach but no evidence that anyone's privacy was actually breached.

Senator GRIFF: Okay. Thank you.

Senator DI NATALE: I don't have much on this, so I'll be reasonably quick. I want to refer back to a technical problem that I think existed with the My Health Record system. This was a long-standing problem that I think you had previously said was resolved: a software bug which began affecting the system in early 2016 and prevented some of the clinical systems from uploading clinical documents to the My Health Record system. Are you aware of what I'm referring to?

Mr Kelsey : Yes.

Senator DI NATALE: Is it right that the glitch was caused by part of the digital signatures used to help secure and authenticate the clinical records?

Ms McMahon : The glitch, as you described, was caused by a change in Microsoft's systems that they released in 2016. It had a flow-on effect to the digital signatures and the way they were working from clinical information systems to the My Health Record.

Senator DI NATALE: Okay. Is there any more technical information you can provide about that? You said it relates to a problem with Microsoft or a change from Microsoft?

Ms McMahon : I can provide you information on what was done to fix that problem. Is that what you're interested in, or is it the source of the problem?

Senator DI NATALE: Firstly, the specific nature of the problem and, secondly, what was done to address it.

Ms McMahon : We don't have much information on the nature of the problem at the time, because it occurred before the agency existed in early 2016. The agency came into operation on 1 July 2016. We have continued work on the rectification of the problem, so the information I can provide you is around the resolution of that problem.

Senator DI NATALE: Okay. You're saying the problem was resolved, but I understand there was an FOI request made by an academic at Deakin University called Joshua Badge and it revealed 95 documents with over 4,000 pages relevant to the request. That sounds like an awfully large number of documents. I'm interested in why it was such a large number, particularly given that it was resolved and dealt with in 2016.

Ms McMahon : The request was for digital signatures relating to the My Health Record. Our process in addressing FOI requests starts with a key word search—we basically do a broad search across the agency and our documents and records. That search with digital signatures in My Health Record identified, I think, as you said, 95 documents that met that criteria. The next step in the process is that we contact the applicant and we suggest that they might want to refine the search. In that instance the applicant declined, so we provided a fee notice in relation to that.

Senator DI NATALE: A what?

Ms McMahon : A fee notice. Then he came back and agreed to refine the search. We iterated a couple of times with him until he refined the search to a point where there was no longer any fee being charged and we are processing the FOI application without any fee being charged.

Mr Kelsey : To step in there, the My Health Record operates on digital signatures—it is a state. The specific request for information related to the specific Microsoft patch which was caused by a global fault in Microsoft operating systems across all software—not just related to My Health Record—so that did bring back a large number of searches. Once we understood that his interest was in the narrow instance relating to the Microsoft patch we were able to bring it down to a smaller number of documents.

Senator DI NATALE: My understanding is that the FOI was then narrowed down between mid-December 2018 and mid-February 2019—so we are talking two months, and recently; well after the issue was resolved—and it still turned up 35 documents and 260 pages. Is that right?

Ms McMahon : I know that the agreed refined scope has only thrown up four or five documents.

Senator DI NATALE: I've got information here that there was one between mid-December 2018 and mid-February 2019 that revealed 35 documents and 259 pages. Can you take that on notice and come back to me to see if that is correct?

Ms McMahon : Yes.

Senator DI NATALE: This is part of a broader question about when you escalate issues up to relevant bodies: what's the threshold that's applied for doing that? I'm interested in hearing your thoughts on that.

Ms McMahon : So, the threshold for FOI?

Senator DI NATALE: In this situation there are questions about who gets notified and when about a potential glitch like this. I suppose it is case-by-case, but I'm interested in knowing at what point you decide you're going to escalate it and what your threshold for doing that is.

Ms McMahon : We describe it as a malformed reference check. That is the technical term we use for this problem. It currently affects one-third of 1 per cent of documents attempting to be uploaded.

Senator DI NATALE: That is still a pretty significant number.

Ms McMahon : It could potentially affect that many. Of that many, it only possibly affects 65 per cent. In each of those instances we contact the healthcare provider involved to advise them that they are having problems with their system. They would be getting error messages at their end, but we have a step to contact them to advise them to upgrade their software. Is that the sort of escalation you are referring to?

Senator DI NATALE: That's right. I'm interested in that.

Ms McMahon : That's why we've put a tool in place, because we are aware that those practices, the 0.3 per cent, are getting error messages but they're persisting. So we contact them. We ring them and say, 'Look, we can see that you're getting these error messages. What you need to do is upgrade your software.' This is an additional step we're taking to address this tail end of the problem that occurred in 2016.

Senator DI NATALE: So if you haven't upgraded your software since that issue in 2016, you may be getting this error message?

Ms McMahon : Correct. The vast majority of practices have done that.

Senator DI NATALE: How do you know when there is a problem?

Ms McMahon : It's because the clinical information system sends the document to the My Health Record system, and it's the validation at our end that fails. We know when it is failing for that purpose.

Senator DI NATALE: You proactively reach out to each and every one of those companies?

Ms McMahon : That's right. We put some monitoring in place in December to be able to get that information in a weekly report, and then we contact those healthcare providers to try to get them to address the problem at their end.

Senator DI NATALE: Do you proactively contact all practices with something like this?

Ms McMahon : There are a number of things that we monitor in that weekly report. I don't have the details of all of those criteria, but there are routine checks that we run, things like making sure the correct data formats are in the fields; making sure that there aren't any malformed reference checks like this; there are a range of things that we check. I will be happy to provide on notice the full set of compliance checks that we run weekly. Then we do contact—it could be the software vendors who have an issue to resolve, or it could be the practices if it is their environment.

Senator DI NATALE: Has that 0.3 per cent been consistent, or is it coming down over time?

Ms McMahon : On that issue it's been coming down significantly.

Senator DI NATALE: One would assume that if you're contacting practices you are getting fewer of those. What are some of the other issues that have come up?

Ms McMahon : I'll need to take that on notice. I'm sorry, I don't have all of the checks with me.

Senator WATT: Just sticking with My Health Record, the last time we inquired about this at estimates, we heard that 1.147 million people had opted out of the My Health Record. What is the final opt-out number as at the end of January?

Ms Edwards : You will recall that the minister indicated in July that he was looking for a 90 per cent participation record. That's pretty much where we've landed. Ninety per cent of active Medicare users in Australia have not opted out. We'll have My Health Records for 90 per cent of people with Medicare.

Senator WATT: What's the actual number of people who opted out?

Mr Kelsey : The total number is 2,517,921.

Senator WATT: 2½ million people have opted out?

Mr Kelsey : Out of a total of people eligible for Medicare, which is the most conservative denominator available to us. That total number as at 31 January is 25,459,544.

Senator WATT: As you've said, that is roughly about 90 per cent of people.

Mr Kelsey : It's 90.1 and 9.9. 9.9 per cent have opted out on that denominator.

Senator WATT: There was obviously quite a big jump towards the end. That 1.147 million figure, that would have been at about October-November last year?

Mr Kelsey : From memory the actual figure was dated to September.

Senator WATT: So as the opt-out period was extended, there was obviously pretty much double the number of people that opted out. How does that 9.9 per cent opt-out rate compare to other countries with similar systems?

Mr Kelsey : We work very closely with international partners through the agency of something called the Global Digital Health Partnership, which has 28 countries involved in it. There are many countries that offer services where individuals are able to access health information, but none in the way that Australia does, where people have legislated control over who sees that data and when, personally controlled electronic health systems of this kind. There really isn't a comparison for a similar kind of opt-out rate in a similar scheme. There's a lot of international interest in My Health Record amongst those nations but, to be honest, Australia is leading the field in development of access to mobile information services for citizens.

Senator Scullion: For completeness, I understand that there are also a number of people who are opting back in. Some people opt out because they want to make sure they are making the right decision, but they can opt back in. I'm not sure of that number.

Mr Kelsey : That number is taken account of. We had a large number of people opting in during the period of opt-out. That is taken account of in this aggregate figure. We will obviously be reporting to the Senate on continuing levels of opt-in as the process continues. I would note that after opt-out people are able to permanently delete their My Health Record at any point in their life, or opt back in, as the Senator just suggested, so the sense in which this is an evolving permanent choice of people is very important.

Senator WATT: How many people have permanently cancelled their accounts since that became possible?

Mr Kelsey : That again is taken account of in these figures. I would have to take that on notice, because it depends on at what point in time you would be determining the start of that cancellation period. I can give you the figures on notice for the period from the beginning of opt-out to the end of opt-out, of those who have cancelled. I can give you the period from before opt-out started, going back to the origins of the agency in July 2016.

Senator WATT: You obviously have a few options. Have you got the figures there?

Mr Kelsey : I have no figures here.

Senator WATT: I might come back to you on what is the best way of framing that for my purposes.

Mr Kelsey : Of course.

Senator WATT: You probably saw this week the tech website ZDNet reported that nearly 300,000 people had cancelled their accounts. Does that sound accurate?

Mr Kelsey : I haven't seen that article, but the answer is yes, in broad terms, during the period of opt-out.

Mr O'Connor : I haven't got that figure. It depends on the time period as well.

Mr Kelsey : We could take that on notice. We weren't approached by that publication, so I don't know what the source of that data was.

Senator WATT: I was about to ask that. But you think that during the opt-out period—so up until the end of January—probably roughly 300,000 people cancelled their accounts?

Mr Kelsey : I must defer to Mr O'Connor. I'd prefer to give the figure accurately on notice. I also note that there were a large number of people that opted in during the same period. So there were cancellations on the one hand, opt-ins on the other.

Senator WATT: If you could get someone working on that for us, that would be great. If that 300,000 figure isn't right—let's just get the current figure.

Mr Kelsey : Yes.

Senator WATT: I take it then that the number of cancellations is entirely separate to the number who opt out? There is no crossover there.

Mr Kelsey : Yes. Cancellation would apply when you had a record prior to the beginning of the opt-out period, or you opted in during that period and then cancelled.

Senator WATT: Once we get the cancellation number, we can work out the full number that opted out or cancelled. So the people who cancelled their records before the amendments passed parliament—you will remember there were some amendments made to address some of the issues raised in the Senate inquiry.

Mr Kelsey : Yes, of course.

Senator WATT: Those people who had cancelled their records before the amendments were past, have their records been permanently deleted, or are they still in what has been called the locked box?

Mr Kelsey : To go back to Mr O'Connor's previous response, the process to initiate permanent deletion of those records has started and will be completed within 90 days.

Senator WATT: The deletions? They will be deleted?

Mr Kelsey : Yes. The permanent delete function was introduced into My Health Record on 24 January, and from that point onwards people who were prospectively opting in could have their record instantly permanently deleted. For those who had previously had a record and indicated they wanted that record to be cancelled, under the new legislation we respect that preference and that preference will be respected within 90 days of the date on which permanent delete was introduced.

Senator WATT: Does that mean there's effectively a two-tier system: those who cancelled before the amendments were put in a locked box, and they are progressively being deleted?

Mr Kelsey : For 90 days.

Senator WATT: Within 90 days. But those who cancel after the legislation, there's an automatic deletion?

Mr Kelsey : Essentially, yes.

Senator WATT: Do you understand what I mean by a suspended account? Is there an option for people—

Mr Kelsey : The agency is able to suspend a record when there's a concern raised by a consumer or a professional about it, if that is what you are referring to.

Senator WATT: What do people who have a suspended account need to do to get their accounts permanently deleted?

Mr Kelsey : They would just need to go online and indicate they want to delete it. That would supersede suspension.

Ms McMahon : Typically, we as system operator suspend an account where there's a dispute, perhaps where there are children involved in a marriage which has broken down and there are two parents who don't agree on what should happen with the record. It's often because two people are discussing what should happen to a record rather than wanting to delete it. If a consumer has authority to delete a record, they are able to do that at any time and there is no challenge to take it out of suspension. Suspension is a state that we put it in while we are working through an administrative process to determine authority for control of the record.

Senator MARTIN: I wonder if you could tell me the primary benefits of the My Health Record, specifically the opt-out rule adopted by the government?

Mr Kelsey : We have put in place a benefits realisation program to evaluate benefits of My Health Record both currently, before opt-out had finished, and obviously subsequently. We are already beginning to see significant evidence of those benefits. If I may take advantage of a recent report from the Townsville floods, where pharmacists have been working with emergency services to ensure that people have contingency of medicine during what has been a very difficult period for those communities. I would like to read out a quote from the Australian Journal of Pharmacy from a pharmacist reporting on some of the challenges they have had following the floods. 'The biggest problem for pharmacists is people being cut off from their home pharmacies, so they're presenting at whatever pharmacies are open without much knowledge of their medicines and without their prescriptions. At the moment, My Health Record is absolutely shining. The doctors are loving it, the nurses are loving it. The traditional relationships between GPs and patients don't really exist at the moment, so everyone is trying to help each other, and My Health Record is able to provide a consistent medication profile.'

Townsville is obviously one of the original opt-out areas, so professionals in that area are used to using My Health Record and on the whole most people have a My Health Record. I give that as an instance of My Health Record in action currently supporting those local communities. It may be worth passing over to my colleague Ms McMahon on the broader benefits work we have been doing to update the Senate on that as well.

Ms McMahon : We have a number of qualitative and quantitative studies and other research projects in place. We are already seeing benefits being realised around improved medication management, improved decision-making, reduction in adverse events and savings in time in collecting medical information at the point of care.

Senator MARTIN: Thank you. You mentioned the view of some of the stakeholders. Can you expand a bit more in regard to the views of the stakeholders to pursue the opt-out approach?

Mr Kelsey : To remind the Senate, the key clinical leadership peak bodies of Australia and consumer peak bodies supported opt-out because the evidence from the Northern Territory, where electronic records are ubiquitously used in treatment of local communities, was that if most people had one and that was the assumption the clinician made, they would build that into the workflow and in that way benefit would be realised. On that basis the clinical peak bodies, including the Australian Medical Association and the Royal Australian College of General Practitioners, as well as the Pharmacy Guild, the Pharmaceutical Society of Australia and the Consumers Health Forum, asked government to consider moving to opt-out registration so those benefits could be realised for all Australians, and day remain very supportive of that method of public registration.

Senator WATT: So just sticking with the Digital Health Agency, how does the agency typically deliver workplace health and safety training or training around appropriate workplace behaviour? Do you do that sort of thing online normally or face to face?

Ms McMahon : It's a mixture. We have an induction program when staff join the organisation, and that involves training in our values. We have a set of values which cover off some of those matters. We also have OH&S training face to face. We have periodic OH&S audits, which we conduct in each of our offices, and, where staff get flexible working arrangements agreed, there'll be an OH&S assessment done on their workplace at home, for example. We also have a reporting system in place, and people are trained in what to report if there's an OH&S incident at the time.

Senator WATT: I suppose, being a Digital Health Agency, you'd try where possible to use online mechanisms to deliver these sorts of things?

Mr Kelsey : We do.

Senator WATT: You do?

Mr Kelsey : We do have online modules.

Ms McMahon : It's a mixture of all of those things. But it's not purely digital. We also provide—

Senator WATT: Sure. How many staff members does the Digital Health Agency have?

Ms McMahon : We do have that figure to hand.

Mr Kelsey : Whilst we're waiting, I'll just say that we have an average staffing level cap of 250, so that's the maximum average staffing level we can employ as permanent staff. In addition, we have a number of contractor staff, and we will get you the total number of that now.

Senator WATT: So you've got roughly 250 direct employees?

Mr Kelsey : Yes, on average.

Senator WATT: On average? Is that month to month? While you are looking, those—

Mr Kelsey : Sorry; I can give you the data. The average staffing level cap is 250. At the point in time this report was compiled, the agency headcount, excluding contractors, was 226: 204 full-time employees and 21 part-time employees. Of the 226 employees, 47 are APS employees and 179 are non-APS.

Senator WATT: Does that mean they're contractors?

Mr Kelsey : No, they're staff within the cap. The number of contractors was 198.

Senator WATT: Wow! So nearly half your staff are contractors.

Mr Kelsey : Yes.

Senator WATT: Is that higher than—

Ms McMahon : That's consistent with the expansion program being a terminating measure. In terms of rolling out opt-out and scaling the system, that's a level of activity that was higher in the last two years than it would be going forward, so we haven't employed a permanent workforce on that basis.

Senator WATT: So you're expecting that number of contractors to come down over time?

Ms McMahon : Yes, we are, consistent with the budget as well.

Senator WATT: And is it coming down?

Ms McMahon : It will after 30 June, at the completion of the program.

Senator WATT: Okay. So you've got about 226 direct employees?

Mr Kelsey : Correct.

Senator WATT: When was that?

Mr Kelsey : That was at the end of December.

Senator WATT: And then about 198 contractors at around the same time?

Mr Kelsey : Which obviously is a more variable number, but yes.

Ms McMahon : Yes.

Senator WATT: Okay. So there are about 424 all up, between contractors and direct?

Mr Kelsey : Yes.

Senator WATT: Are those people spread across Canberra, Melbourne, Sydney and Brisbane?

Ms McMahon : No; Brisbane, Canberra and Sydney. There's no Melbourne office.

Senator WATT: Brisbane, Canberra and Sydney?

Ms McMahon : That's right.

Senator WATT: Okay.

Ms McMahon : In roughly even numbers across the three offices.

Senator WATT: That was my next thing. So it's roughly a third in each?

Ms McMahon : Yes.

Senator WATT: So there are about 140 or so in each. Do you often have all-staff meetings?

Mr Kelsey : Actually, we haven't had an all-staff meeting since the agency started. We have all-staff virtual meetings, as you would expect we'd do as a digital agency. We do have office based meetings, but we are concerned about the costs of bringing staff together, so, at this point, we have not had an all-staff briefing. I'm just mindful of the public—the taxpayer—interest.

Senator WATT: Sure. But you have had virtual all-staff meetings, like videoconferencing.

Mr Kelsey : We have those quite regularly.

Ms McMahon : Regularly.

Senator WATT: Are you planning an all-staff meeting for 15 and 16 May?

Mr Kelsey : There've been conversations about that in order, basically, to provide people with more insight. Something that the staff have been telling us is that they want to understand more about the nature of the work plan for the whole agency and to be able to connect their roles to that broader work plan, but also, crucially, to provide training and security, and in other areas, which would be much cheaper for us to do if we brought people together. That's currently under consideration and a decision has not been made as to whether we proceed with that.

Senator WATT: That training and security, is that workplace-health-and-safety-type training?

Mr Kelsey : That kind of thing, yes?

Senator WATT: And appropriate workplace behaviour—that kind of thing?

Mr Kelsey : Yes.

Senator WATT: Why couldn't that be delivered in a virtual manner?

Mr Kelsey : That's exactly the review that's happening at the moment.

Senator WATT: That's exactly?

Mr Kelsey : That's what we're reviewing at the moment—whether we can deliver that training virtually and effectively, or whether it is actually going to be cheaper for us to do that by bringing people together. I'm very happy to share the data on the budgets, when we've compared them, with the committee.

Senator WATT: Would this all-staff meeting include the contractors as well as the directly employed staff?

Mr Kelsey : It would, yes.

Senator WATT: So it would be about 424 people, roughly.

Mr Kelsey : Yes.

Senator WATT: And where would that be held?

Mr Kelsey : Again, we haven't made any decision to go ahead with this meeting yet. It entirely depends on the relative costs of the training budget. That's where we've got to with it.

Senator WATT: So there's been no decision about Canberra, Brisbane, Sydney or somewhere else?

Mr Kelsey : I know that colleagues have looked, I think, at the Hellenic centre, which is next to the Department of Health headquarters in Woden, but no final decision has been made and no final budget has been developed.

Senator WATT: So no venue has been booked?

Mr Kelsey : Not as far as I know.

Senator WATT: But there has been some thought about the Hellenic Club near Woden.

Mr Kelsey : I believe so.

Senator WATT: Have your officers considered holding that at any venues in Sydney?

Mr Kelsey : I'd have to take that on notice.

Senator WATT: Have you considered specifically the Sydney Cricket Ground as a venue?

Mr Kelsey : I'd have to take that on notice. I just don't know the details.

Senator WATT: Who's involved in organising this? Is there someone here who's across this?

Senator SINGH: You must have done some scoping options of venues.

Mr Kelsey : Whilst we are in this conversation, I will ask my colleagues to check whether or not we have been in touch with that venue. The person responsible for scoping this, and, as I repeat, this has not been agreed or had a budget prepared, is a relatively junior member of staff who's actually in the Sydney office. So we can ask her whether she's spoken to any venues, if that helps.

Senator WATT: Yes. Could you just find out whether there has been any contact with the Sydney Cricket Ground and, if so, what the cost of hiring it would be? If you were to hold this meeting in a venue, whether it be the Hellenic Club, the cricket ground or anywhere else, would that involve hospitality such as alcohol?

Senator Scullion: It is very much a hypothetical question.

Senator WATT: They're clearly considering—

Senator Scullion: No. The officers have indicated that this is not a decision. They're still vacillating between the options and that of a virtual meeting, so it may well be the case that this doesn't happen. I understand you want to go to some detail, but I just want to put on the record this: all of these things may not happen and this is usually hypothetical, but I won't resist any further. I just want to make that clear.

Mr Kelsey : Again, to provide reassurance, the agency has operated an extremely firm policy on expenses and travel. There would be no question of alcohol being funded through such an event. As I say, the decision about whether or not to go ahead with a physical meeting where staff would come is entirely down to the relative costs of the training that we would be providing, and that's got nothing to do with the venue or catering or anything else. That is the decision, and that decision has not been taken yet.

Senator WATT: Okay. Has any amount been budgeted for this all-staff meeting?

Mr Kelsey : No.

Senator WATT: What budget would the money come from for this kind of activity?

Ms McMahon : We have a training budget available.

Mr Kelsey : The training budget.

Senator WATT: So it would come out of your training budget. How much is in your training budget?

Ms McMahon : I'd have to take that on notice.

Senator WATT: Okay.

Senator SINGH: Is it a large budget?

Ms McMahon : No, it's not a very large budget.

Senator WATT: Why don't we see what comes back once you've made those inquiries, and we might have a few more questions from there.

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Mr Kelsey : I have a clarification for Senator Watt in relation to the staffing levels you asked about earlier. The numbers are correct. I said we have three officers, which is true. We also, I've just been reminded, have small numbers of staff in local Primary Health Network offices across the country.

Senator WATT: Are they included in those numbers?

Mr Kelsey : They're included.

Senator WATT: While you have the floor there, I understand that those figures I was quoting to you about the number of cancellations—300,000 or so, which was in an article—came from a question on notice that was answered by the department. I know you're checking that out, but maybe go back to that as a starting point.

Mr Kelsey : We'll certainly provide that. Absolutely.

Senator WATT: Thanks.

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The whole thing is worth a read as it reveals both the knowledge and lack of knowledge within the ADHA on a number of topics.

David.