Final Comment on HI Service Legislation.

My final view on all this is that it has been a busy and confusing day. Sorry to those who read earlier posts when it seemed the legislation had been delayed. It has now passed close to the dying bell!

You can read some other commentary here:

http://www.ehealthcentral.com.au/2010/06/an-historic-day-for-ehealth-too/

The issue is now if we can see delivery of a useful working service. If they manage it they will deserve congratulations - but that will be a challenge. The reasons why one would use the service, as either a provider or a consumer, and how much trust can be put in it - to say nothing of all the issues about being able to 'opt-out' if one chooses are still there.

This was a rushed and I fear less than ideal outcome. Time will tell. If you naively believe sticking a number on the back of 22 million Australians will suddenly make a difference to the quality of care in Australia you are dreaming. This is a complex program that will take years to get right and years to show any real benefits - if ever. It may indeed work but success is by no means assured. Pity other options were never really examined.

I wish NEHTA luck, but with their track record of implementation to date one must reserve judgment for now.

David.

Oh - and this does expose the risks of live blogging as stuff happens. Looking back it was still a good way to go as it reflects the nonsense that went on behind the scenes I suspect!

D.

HI Service Apparently Passed By House of Reps. Approx 8.30pm

See previous comments and posts. Looks like it is done.

Issues will now be successful delivery of the service and the value it adds!

It was the very last thing done before the House rose!

We shall all see how well it works out!

David.

Final News on HI Service Bill - Needs House of Reps to Confirm Amendments

The House of Reps has now risen. So as I follow it the amendments having been made there needs to be passage through the Reps of the changes.

Hence it will take till end August or so for Final Passage.

David.

Senate Passes HI Service Legislation - With Considerable Concerns - 6.46pm 24 June, 2010

Dynamic times are happening in the Senate at 6:15pm today.

Senator Siewart is very nervous but wants to let it scrape through!  Very keen on an 'opt-out' approach to having an identifier.

Senator Boyce has now pointed out the system apparently won't start until October 1, since House of Reps have not agreed to amendments.

She is deeply critical of NEHTA and accuses them of not having their 'act together'.

Senator Boyce is very unhappy about NEHTA's competence.

Senator Mason has fundamental concerns about privacy balance struck. He is very worried about citizens being 'numbered'. Very worried about the incompleteness of the law and 'function creep'.

He is concerned about the risk of creating a 'national identification scheme'.

After a lot of discussion the Bills passed at 6.46pm

David.

Flash - HI Service Legislation Suddenly Brought Back

It seems with some arm twisting, and ignoring some angry Greens, it is now being debated!

Looks like it will pass at this point.

David.

Flash - HI Service Legislation Deferred Until August 24, 2010 At Least

As best I can tell the legislation has now been deleted from the Senate Agenda.

See here for the current agenda.

http://www.aph.gov.au/Senate/DynamicRed/Index.html?x=1995

The Senate rises no later than 8:40pm for the Winter Break.

Now we get the 'blame game' I guess, with NEHTA saying its it not their fault! Let us be clear it is, as they should have started the legislative / consultative process long before they did. Just poor project management!

David.

E-Health Cited as Failing Element in Major Mental Health Committee Resignation.

The following report appeared a day or so ago.

It is written by he who resigned ‘in disgust’.

John Mendoza resigned as chairman of the National Advisory Council on Mental Health last week. He is adjunct professor of health science at the University of the Sunshine Coast and adjunct associate professor of medicine at the University of Sydney.

Mental health lacks cash

• John Mendoza
• From: The Australian
• June 22, 2010 12:00AM

RUDD could make a huge difference with relatively modest funding, says John Mendoza.

LAST Friday the Prime Minister again restated his commitment to do more on mental health, calling it the "next cab off the rank".

While some more argue that there are a lot of cabs parked at the Rudd government's rank, we in mental health have yet to see any cab at all yet, let alone a driver with any idea of where we are going.

On December 7 last year, aptly while speaking at the John Curtin School of Medicine in Canberra, Kevin Rudd provided the first detailed response to the National Health and Hospitals Reform Commission report, what the government termed the Bennett commission because it was chaired by Christine Bennett.

The Prime Minister said that "a lack of early identification and intervention forces people suffering from acute mental illness to turn to hospitals . . . as their only option for help".

He was correct in identifying that systemic problem.

He went on to ask: "Why is it that mental health problems are so often picked up by police and drug workers, not our health services? This is the problem today, but it will become a greater problem in the future."

The reality is that mental health services across Australia remain in crisis.

.....

But, across Australia, lifesaving suicide prevention services are starved for funds.

About $100m would expand these crucial services and we should concentrate on suicide hot spots such as The Gap in Sydney, where just last week the NSW government passed on an opportunity to fund suicide prevention.

Fourth, $20m would fund effective e-health programs. For high-prevalence disorders such as anxiety, there's solid evidence that e-health programs reach a huge number of people in a very cost effective way.

Australia was a world leader in this a decade ago, and the internet is only going to become more important as a source of information and support - but now we're backsliding.

Fifth, 60 per cent of our homeless have severe mental health problems. That's about 63,000 people, and they need housing and support services.

These people are not lost causes. With help they can regain employment and their lives.

There are some great programs across the country, including the Housing and Accommodation Support Initiative in NSW, but your chances of getting a place are about the same as those of winning the lottery.

.....

So, what's stopping the Rudd government?

The Prime Minister has told us that fixing mental health care in Australia will be the "next cab off the rank".

But we're still not sure what that cab looks like: is it a rickshaw or a Commodore? Mr Rudd, we've got the cab, tell us when it's going to take off.

Full article here:

http://www.theaustralian.com.au/news/opinion/mental-health-lacks-cash/story-e6frg6zo-1225882476297

It is really pretty bad that someone in this situation becomes so frustrated that he feels he has to resign.

It is good for him to remind Government how little would be needed to provide a mental e-health program – which is known to really help very cost effectively.

See here for example.

http://aushealthit.blogspot.com/2008/01/mental-illness-and-web-canadian-view.html

David.

HI Service Legislation - Progress Upate 1:30pm June 24, 2010

Looking at the program on the Senate Dynamic 'Red' it seems unlikely the Senate will get to the HI Service Bill until after Question Time.

We can all come back again about 3:30pm to see where we are up to!

Follow the progress here if desired.

http://www.aph.gov.au/Senate/DynamicRed/Index.html

David.