Quote Of The Year

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

or

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

Tuesday, October 23, 2018

Commentators and Journalists Weigh In On The MyHR Debate And Related Matters. Lots Of Interesting Perspectives - Week 14.

Note: I have excluded (or marked out) any commentary taking significant  funding from the Agency or the Department of Health on all this to avoid what amounts to paid propaganda. (e.g. CHF, RACGP, AMA, National Rural Health Alliance etc. where they were simply putting the ADHA line – viz. that the myHR is a wonderfully useful clinical development that will save huge numbers of lives at no risk to anyone – which is plainly untrue) (This signifies probable ADHA Propaganda)
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Australians made over 19K privacy principle enquiries in 2017-18

2,947 privacy complaints were also received by the Office of the Australian Information Commissioner.
By Asha McLean | October 19, 2018 -- 05:34 GMT (16:34 AEDT) | Topic: Security
The Office of the Australian Information Commissioner (OAIC) responded to a total of 19,407 privacy enquiries in 2017-18, with the most common query over the use and disclosure of an individual's personal information.
Of the total privacy principle enquiries, 14,928 were made via phone, 4,452 were received in writing, and 27 were made in person, the OAIC's Annual Report [PDF] has revealed.
1,560 enquiries were made regarding the use or disclosure of personal information; 1,351 related to the access to personal information; 991 on the general collection of personal information; and 882 on the security of personal information obtained.
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Committee recommends better teen privacy for MHR following calls by RACGP

Doug Hendrie 19/10/2018 2:27:06 PM
The Senate committee investigating My Health Record has recommended greater privacy protection for teenagers aged between 14 and 17.
Can teens’ health data privacy be better protected?
Dr Nathan Pinskier has been clear on the issue of teenagers’ data.
Last month, the immediate past Chair of the RACGP Expert Committee – Practice Technology and Management told the Community Affairs References Committee that changes should be made to prevent parents automatically having access to their teenager’s sensitive health data.
A key recommendation in the committee report released yesterday is that the privacy of teenagers aged 14–17 be protected by default unless they expressly request that a parent can view their data.
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Senate inquiry recommends locking down My Health Record by default

A comprehensive review of Australia's centralised digital health record has recommended extending the opt-out period by another 12 months while privacy controls are significantly tightened.
By Stilgherrian | October 18, 2018 -- 06:10 GMT (17:10 AEDT) | Topic: Security
The Senate inquiry into the My Health Record system has called for access controls to be applied by default, with individuals having to choose to remove access codes themselves, and for the current opt-out period to be extended for a further 12 months.
It has also called for stronger restrictions on using My Health Record data for secondary uses, commercial purposes, for employment or insurance purposes, or to enable the government to recoup revenue.
The report by the Senate Community Affairs References Committee was tabled in the Senate on Thursday by the committee chair, Senator Rachel Siewert of the Australian Greens. The inquiry received 118 public submissions.
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Children need more My Health Record privacy, says inquiry

It has called for parent access to be revoked by default when children turn 14
19th October 2018
Allowing parents to access their children’s My Health Record even after the child turns 14 may be putting the safety of young patients at risk, a Senate inquiry has concluded.
The inquiry has spent two months examining the billion-dollar system as it moves to a compulsory opt-in model.
More than two million children and adolescents already have records and the number will increase dramatically as files are uploaded next month.
Doctors have been concerned that youngsters will be bamboozled by the process for banning their parents from accessing their files, which requires them to go through the My Gov website.
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19 October 2018

Senate MHR report echoes doctors’ concerns

Posted by Julie Lambert
A Senate committee has called for the My Health Record roll-out to be put on ice for 12 months, to fix security concerns, tighten access controls and ensure patients properly understand their options.
The Senate Community Affairs References Committee’s report criticised the Australian Digital Health Agency’s information strategy, saying it had failed to give people enough information to make informed choices about the planned opt-out system.
The committee’s recommendations chime with many doctors’ concerns over the current MHR design regarding security and patient awareness.
RACGP President Dr Harry Nespolon said the problems had arisen due to the shift from an opt-in system to opt-out without adequate attention to safeguards.
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Opt out of My Health Record before 15 November

18 October 2018
You only have until 15 November 2018 to opt out of My Health Record.
My Health Record is an online summary of your key health information. This year, you will automatically get a My Health Record unless you opt-out.
When you have a My Health Record, your health information can be viewed securely online, from anywhere, at any time – even if you move or travel interstate. You can access your health information from any computer or device that’s connected to the internet.
Up until recently, the opt-out portal was not accessible for people who are blind or have low vision. The accessibility has now been improved including the removal of CAPTCHA.
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Thu 18th Oct 2018

My Health Record: Time for Government to Opt Out

The report released today of the Senate Inquiry into My Health Record (MHR) reveals a Government intent on collecting data on patients without their knowledge, without knowing how or how well the data will be used including for commercial purposes, and without telling Australians about the many problems that this Record has. We welcome the recommendation that the Opt Out policy (which forces an MHR on people without telling them) be deferred for a further twelve months whilst the many issues raised are addressed.
These are some of those issues which the Government has failed to address.
  • At least a third of Australians are not aware of the scheme and will therefore have their private data uploaded without their consent
  • Most health care providers have not signed up to MHR which means most patients cannot benefit from their involvement with these providers
  • Most specialists are not part of the scheme and there has been no direct attempt by Government to involve them personally
  • The Government has not addressed the problems relating to many vulnerable groups including
    • Adolescents
    • Victims of family violence
    • Sex workers
    • Those with mental illnesses
    • Those who cannot themselves control their own record because of lack of skills, language and cultural barriers, lack of money, lack of good relationship with a regular supportive GP
With all of the above issues to address, the suggestion that the security of the data is ‘world class’ is dubious at best. The Government has not yet implemented its framework for use of the data for ‘research’ and other purposes. For three weeks the Government rejected calls for better controls over data access by police and welfare departments until accepting better legislation was required. This is a clear indication the Government cannot be trusted to do the right thing.
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Greg Hunt sticks to timing on My Health

  • 11:00PM October 18, 2018
Health Minister Greg Hunt will not extend the opt-out ­period for the My Health Rec­ord scheme despite a Senate committee yesterday declaring more time was needed to ­address privacy and security concerns.
Mr Hunt has already extended the opt-out period by a month, to November 15, and introduced legislative amendments to enforce the policy surrounding law enforcement access to medical records.
But the committee — whose inquiry Mr Hunt has previously labelled a stunt — yesterday made a series of recommendations for refinement and proposed the opt-out ­period be extended by another 12 months.
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myGov portal can be used by abusive partners to track down victims, Government warns

Updated 18 October, 2018  at 8:01am
Parents fleeing domestic violence are being urged to deactivate their children's myGov accounts, amid concerns abusive partners can use the portal to discover where spouses and children are living.
An email circulated by staff at the Queensland Department of Child Safety, Youth and Women has warned that a group of doctors had raised concerns about abusive partners being able to access the updated address details of their child through the Federal Government's myGov portal.

Family violence support services:

  • 1800 Respect national helpline 1800 737 732
  • Women's Crisis Line 1800 811 811
  • Men's Referral Service 1300 766 491
  • Lifeline (24 hour crisis line) 131 114
  • Relationships Australia 1300 364 277
"With this platform there is no way to protect addresses at this stage," the email said.
"It is encouraged for parents fleeing violence to deactivate their account to reduce the ability to track their new address."
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My Health Record inquiry backs away from return to opt-in

By Julian Bajkowski on Oct 18, 2018 10:43PM

But has a slew of security improvements.

Australia’s grinding, decade-long and always controversial journey towards national adoption of electronic health and medical records is set to maintain its current ‘opt-out’ stance after a key parliamentary committee backed away from a return to voluntary adoption.
The Senate’s Community Affairs References Committee on Thursday delivered its final report into the My Health Record system, recommending a slew of improvements but pulling up short of flipping the roll-out back to the previous opt-in model.
The report represents a crucial truce in the ongoing political and social debate surrounding privacy and access elements of the troubled scheme because it stipulates far tougher default access controls over the presumption that citizens should only get an eHealth record if they proactively ask for one.
Medical and care sector stakeholders had feared that recommendations to flip the national eHealth scheme back to opt-in would again derail the potential for vital critical mass to be garnered to make the system feasible at a mainstream level.
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Major changes to My Health Record laws needed to safeguard Australians, Senate inquiry finds

By Dana McCauley
18 October 2018 — 10:00pm
The deadline to opt-out of the federal government's controversial My Health Record system should be extended by 12 months and legislation substantially rewritten to safeguard patients' safety and privacy, a Senate inquiry has found.
The Labor-led inquiry, which released its findings on Thursday, found that Health Minister Greg Hunt's implementation of an opt-out model had meant that “an unreasonable compromise may have been struck" between the system's utility and patient rights.
Opposition health spokeswoman Catherine King renewed Labor's call for the government to suspend the My Health Record rollout and "commission an independent review of privacy provisions".
Labor has already promised to extend the opt-out period by a year beyond the November 15 deadline if the party wins government.
But Health Minister Hunt refused to further extend the opt-out following the Senate report's release.
“The opt-out date has already been extended and the opt-outs are travelling at a significantly lower rate than expected," a spokesperson for Minister Hunt said. "We will not be extending it further as it would not be appropriate to delay the benefits to patients."
The spokesperson added that the government would "review and respond to other items in the report".
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Delay roll out of My Health Record for 12 months while privacy and safety flaws are fixed: Senate

Sue Dunlevy, National Health Reporter, News Corp Australia Network
18 October, 2018
HEALTH Minister Greg Hunt has refused a Senate Committee’s call to extend the opt-out period for the controversial $2 billion My Health Record by 12 months while major new privacy protections are included.
The Senate committee has expressed grave concerns the record in its current state could allow violent partners to track down domestic violence victims in hiding and wants default open access settings changed.
However, Health Minister Greg Hunt said he would not extend the opt out period.
“The opt-out date has already been extended and the opt-outs are travelling at a significantly lower rate than expected,” a spokeswoman for Mr Hunt said.
“We will not be extending it further as it would not be appropriate to delay the benefits to patients.
“The Government will review and respond to other items in the report”.
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Teenagers, E-Health and Privacy

Here at Manly Village Medical we respect and support our teenage patients’ right to privacy. We want to ensure teenagers are empowered to make choices about privacy around their healthcare. As GPs, we have a duty of care to ensure you have access to information which will inform you about choices relating to My Health Record.
My Health Record is an Australia-wide Electronic Health Record. The key idea around the record is that it enables your health information to be shared with all health professionals who are directly involved in your healthcare. https://www.myhealthrecord.gov.au/for-you-your-family
The Australian Federal government will automatically create and activate an My Health Record for you from 18 November 2018. For teenagers and young adults, it is important to know, if you are on your mum or dad’s, guardian’s or sibling’s medicare card, information uploaded to your My Health Record will be visible to whoever signs onto the medicare account. In other words, other family members have the potential to read information uploaded to your record.
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Australians could end up in a Big Brother system under new online identity program

Tory Shepherd, State Editor, The Advertiser
October 18, 2018 12:30am
AUSTRALIANS are in danger of ending up in a Chinese-style “social credit” scheme thanks to new Government online identities, a report out today warns.
The Federal Government is set to roll out trials of the IDs – which have been likened to the ill-fated Australia Card – this month.
Through the $92.4 million GovPass scheme, people can opt to set up myGovID accounts.
The accounts, which will rely on facial recognition technology, will provide people access to services including Centrelink, car registration and the Australian Taxation Office.
……
The Australian scheme is intended to save the Government money and make it faster and easier to access services.
But today’s Australian Strategic Policy Institute report says the public is “largely unaware” of the controversial scheme, and that it could face bigger opposition than the MyHealth record, which sparked fears of private information being exposed.
There are not enough safeguards in the scheme, author Fergus Hanson writes in his report, Preventing Another Australia Card Fail .
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DTA attacks China-style social credit claims about Govpass digital identity

By Julian Bajkowski on Oct 18, 2018 7:03PM

Rubbishes report from defence thinktank ASPI.

The Digital Transformation Agency is at public loggerheads with one of Australia’s most influential national security policy think tanks, the Australian Strategic Policy Institute, over claims its digital identity rollout needs strict legislation to stop a Chinese-style social credit system.
Yep, you read that right.
The DTA on Thursday hit back hard at an analysis brief penned by the head of ASPI’s international cyber policy centre, Fergus Hanson, which also bleakly warned the government risks a repeat of the Australia Card and Access Card flops because of poor public education and understanding of the schemes.
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Time running out to decide on My Health Record

17 Oct 2018, 1:29 p.m.
AUSTRALIANS have less than a month to decide who can access their health records.
MY HEALTH RECORD: Opt-out period expires on November 15.
The opt-out period for My Health Record will expire on November 15.
Those who do not opt out will automatically have a digital record created for them on a national data base accessible by health professionals including GPs, specialists and pharmacists.
While various health experts say the database could save lives, many Australians have fears about the security of data while others believe the system should have remained as opt-in.
Australian Patients Association executive director strategy, Michael Riley, said it was important that patients and their families did not get caught up in the emotive arguments being put forward by groups and individuals that were either for or against Australians maintaining their My Health Record.
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My Health Record: Opt Out or Stay In?

Chris Kelly  ADHA Propaganda

A quick internet search will reveal that My Health Record is a contentious issue right now. Various objections are spurted out while others praise the idea – with no proper debate between either side.

To combat the current media mishmash, here’s our comprehensive neutral overview of the viability of My Health Record:

Privacy

According to Timothy Pilgrim PSM, former Australian Information and Privacy Commissioner at the Office of the Australian Information Commissioner (OAIC), “even organisations with great information security can fall victim to a data breach, due to the rapid evolution of data security threats and the difficulty of removing the risk of human error in large and complex organisations.” Which means, if you don’t want to risk your personal information being hacked, you should remove yourself from the internet altogether – because that’s the only surefire way to fully protect your personal information. In all seriousness, reverting to the age before the internet is not going to happen. So, the next best option is to minimise the risks and follow proper procedures for when breaches occur. My Health Record does this in various ways.
According to My Health Records Act 2012, only “healthcare providers” – who are registered with the system and are involved in your care – can gain access to your health records. This may include health care providers such as your General Practitioner (GP), pharmacies, pathology labs, hospitals, specialists, and allied health professionals. You can also allow – to your discretion – spouses, friends or family members to access your records.
Note: The authors are part of a lifestyle promotion company….
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How to corrode your social licence in nine easy steps

October 17, 2018, Anna Johnston
A lesson from the Australian Government.
Privacy missteps are eroding the public’s trust in the Government’s ability to achieve ambitious digital projects, and risking trust in the very notion of government itself.
The corrosive effects of privacy debacles are cumulative, with hashtag-worthy government disasters like #Censusfail colliding in public consciousness with the re-identification of MBS/PBS data, bumping up against the cruelty of #Robodebt and the stupidity of declaring a war on maths, and flaring into outrage at a Minister’s unpunished disclosure of a welfare recipient’s personal information to a journalist.
Each privacy catastrophe eats away at the public’s trust in successive government projects, before they even get off the ground. Reasons people have given for opting out of the My Health Record system have included fear of misuse by the government of the day, citing both Robodebt and the weaponisation of Centrelink records by Minister Tudge.  And then in turn, mistrust in My Health Record has been referenced in multiple submissions to PM&C’s Issues Paper on the proposed Data Sharing & Release Bill, as a way of illustrating the dangers of proceeding without caution and due respect for privacy and security.
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Why seniors are encouraged to be connected online

17th Oct 2018 9:00 AM | Updated: 10:11 AM
A GOVERNMENT-funded initiative called Be Connected is being rolled out nationally for the first time to help "digitally excluded" individuals get online.
The program is being administered with the help of 1800 volunteer partners across Australia, including the Gladstone City Library, not-for-profit organisation Welcoming Intercultural Neighbours, and National Seniors Gladstone.
Welcoming Intercultural Neighbours executive officer Natalia Muszkat said Be Connected was aimed at allowing older-generation people to become competent online users.
"Think about My Health Record or Centrelink - everything is online and then you have a big group of people who don't know how to do it," Ms Muszkat said.
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Game changer: Creator of FHIR writes about approaching critical mass and a growing data sharing revolution

Grahame Grieve | 17 Oct 2018
HL7 is close to publishing the fourth milestone release of the FHIR standard at a time of increasing uptake that the US Office of the National Coordinator for Health IT recently said could soon approach critical mass. These are exciting times.
In a blog post, ONC's Steven Posnack and Wes Barker wrote that the US "might be at a turning point when it comes to the adoption and implementation" of HL7's FHIR standard, supercharged no doubt by the integration of the standard by mammoth companies such as Apple.
But there is still much to be done both here and internationally to get health systems sharing patient information and fuelling quality care – which is what our work is all about.
FHIR contains the foundation content for exchanging data about all parts of the healthcare process. It supports exchanging patient clinical summary, care plan management, medication management, diagnostic reporting, as well as clinical decision support, administration, financial management, and even clinical trial administration.
From the beginning, the mission of the FHIR community – which I am privileged to lead – has been to change the way healthcare is practiced by providing the technical infrastructure that allows applications to connect in new ways, ways that erode the barriers to improved care. We’ve seen other industries disrupted by the combination of technologies and scalability that the web offers, and we want to bring that to health.
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My Health Record privacy amendments 'woefully inadequate': Labor

An Australian senate committee has recommended passing the My Health Records Amendment (Strengthening Privacy) Bill 2018, but Labor senators have lashed out at the government's "stubborn refusal" to fix further problems.
By Stilgherrian | October 14, 2018 -- 23:08 GMT (10:08 AEDT) | Topic: Security
After carefully reading and considering 31 public submissions on the My Health Record privacy amendments, as well as three further documents from community health organisations, the Senate Community Affairs Legislation Committee's report on its inquiry has made just one solitary recommendation.
"The committee recommends the Bill be passed," it reads.
The committee didn't come up with a single suggested improvement to the hastily written Bill, at least according to the majority view. Solid effort, although to be fair there's a second, more comprehensive inquiry under way.
The Bill in question is the My Health Records Amendment (Strengthening Privacy) Bill 2018, which is intended to allay the privacy concerns which have lead to 900,000 Australians opting out of the centralised digital health records system.
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Australians’ information privacy is protected by Claytons policing

  • By Michael Connory
  • 11:00PM October 15, 2018
Treasurer Paul Keating’s floating of the dollar in the 1980s symbolised Australia’s willingness to embrace globalisation.
It was also the decade when iconic winery Orlando Wines distributed its non-alcoholic beverage Claytons.
Today the term “Claytons” is commonly used to describe something masquerading as legitimate when it isn’t, which begs the question, is the Office of the Australian Information Commissioner (OAIC) a Claytons regulatory body?
As confronting as the question may seem, the stark reality remains, we continue to establish regulatory bodies that are toothless tigers, and are ineffective at executing what they are mandated to do.
The OAIC’s key objective is to prosecute serial offending corporates who repeatedly show no regard to the codes of practice and regulations required as custodians of our personal information.
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With one month left to opt out of My Health Record privacy concerns remain

From today Australians have 31 days to opt out of the controversial ehealth scheme, My Health Record (MHR). As the deadline approaches the chorus of criticism for MHR has not subsided and the Senate committee investigating the scheme has been granted another extension.
There are two Senate Inquiries into My Health Record – one looking at the overall system and a second investigating whether the underlying legislation should be further strengthened.
The broader inquiry into MHR was scheduled to release its report last Friday, but a second extension was granted and a report is now expected on Wednesday, less than one month before the November 15th opt out deadline.
The second inquiry released its report on Friday, recommending the legislation proposed by Greg Hunt to strengthen MHR be passed. Despite supporting the changes overall, committee senators from Labour and The Greens argued the proposed changes did not go far enough to ensure privacy and security.
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15 October 2018

Tighter privacy measures agreed for MHR

MyHealthRecord Technology TheHill
Posted by Julie Lambert
A senate committee has given a tick of approval to proposed added privacy measures for the My Health Record, but the wrangling is far from over.
The My Health Records Amendment (Strengthening Privacy) Bill 2018 was drafted amid an outcry over privacy issues, such as whether police would be able to demand access to patients’ health information.
In one key amendment, the bill removes the ability of the system operator (the Australian Digital Health Agency) to disclose a patient’s information to a law enforcement or other government agency without a court order or the patient’s consent.
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Comments welcome!
David.

Monday, October 22, 2018

Weekly Australian Health IT Links – 22nd October, 2018.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

It has mostly been about the release of the Senate Inquiry into the myHR and the shocking audit report on the NSCR as not really delivered by Telstra Health.
Other bits and pieces as well.
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Government should consider tearing up Telstra cancer contract: Inquiry

Still no go-live date for bowel cancer screening register
Rohan Pearce (Computerworld) 18 October, 2018 14:03
The Department of Health should consider terminating its contract with Telstra Health to operate two cancer screening registries, a parliamentary committee has concluded.
Telstra’s health arm in May 2016 was awarded a five-year, $220 million contract to establish and operate the National Cancer Screening Register (NCSR).
In the wake of the announcement there was controversy over having a for-profit entity operating the new service.
When the project was first announced in 2015, the then health minister Sussan Ley said that it would replace eight separate state and territory cervical screening registers and “an outdated, paper-based, bowel screening register which has created a fragmented system”.
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Audit committee suggests Telstra Health contract termination over cancer screening register delay

The Department of Health should consider terminating its AU$220 million contract with Telstra Health over delivering the long-delayed national cancer screening registers, the joint audit committee has recommended.
By Corinne Reichert | October 18, 2018 -- 03:04 GMT (14:04 AEDT) | Topic: Mobility
A joint audit committee has suggested that delays in delivering cervical and bowel cancer screening registers by Telstra Health could result in a termination of the AU$220 million contract, or with penalties to be paid by the provider.
In Report 472: Commonwealth Procurement -- Second Report Inquiry based on Auditor-General's reports 9 and 12 (2017-18) and 61 (2016-17) [PDF], published on Thursday, the Joint Committee of Public Accounts and Audit made several recommendations to the Department of Health.
These included reporting to the committee on whether due to the "serious underperformance by Telstra Health" the Commonwealth should terminate the contract and "pursue other options for either or both registers", which were meant to be delivered by May 1, 2017, and March 20, 2017.
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Government should consider tearing up Telstra cancer contract: Inquiry

Still no go-live date for bowel cancer screening register
Rohan Pearce (Computerworld) 18 October, 2018 14:03
The Department of Health should consider terminating its contract with Telstra Health to operate two cancer screening registries, a parliamentary committee has concluded.
Telstra’s health arm in May 2016 was awarded a five-year, $220 million contract to establish and operate the National Cancer Screening Register (NCSR).
In the wake of the announcement there was controversy over having a for-profit entity operating the new service.
When the project was first announced in 2015, the then health minister Sussan Ley said that it would replace eight separate state and territory cervical screening registers and “an outdated, paper-based, bowel screening register which has created a fragmented system”.
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Telstra Health: Cancer screening register rollout delay could have put women at risk

Sue Dunlevy, National health correspondent, News Corp Australia Network
October 18, 2018 6:31pm
THE extended delay in rolling out a new cervical cancer register has seen a Senate committee raise questions about whether up to 80 cancer cases may have gone undetected.
A unanimous Senate inquiry into the scandal has slammed the performance of cancer screening register Telstra Health, and asked the government to consider cancelling its $220 million contract with the company citing serious under performance in delivering the vital scheme.
It comes after an Auditor General’s investigation found evidence senior health department officials involved in the decision to award the contract failed to declare their Telstra shares as a potential conflict of interest.
The Senate inquiry found the tender evaluation process was so flawed the department could not rule out the possibility that Telstra Health may not have even won the contract if the department had followed its own tender evaluation plan.
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Telstra could lose $220m cancer register contract

By Ry Crozier on Oct 18, 2018 3:07PM

Joint committee asks Health to examine its options.

The Department of Health has been asked to consider terminating Telstra’s $220 million contract for the late-running national cancer register.
The Joint Committee of Public Accounts and Audit also suggested Health could consider pursuing damages against the telco “given the significant extra costs incurred” as a result of delays.
“The committee recommends that the Department of Health give consideration and report back to the committee on whether, in the circumstances of such serious underperformance by Telstra Health, it may be in the Commonwealth’s interests to terminate the contract and pursue other options” for the register’s build, it said. [pdf]
The committee also asked Health to provide any advice it had sought or received on either contract termination or the pursuit of damages.
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ADHA's non-process for releasing My Health Record data revealed

Australian Digital Health Agency documents obtained under Freedom of Information show that a 'feelpinion from the board' now counts as a policy, according to Future Wise's Dr Trent Yarwood.
By Stilgherrian | October 19, 2018 -- 05:26 GMT (16:26 AEDT) | Topic: Security
As of July 2018, the Australian Digital Health Agency (ADHA) appears to have no detailed policy or process for releasing My Health Record data to support regulatory and legal requests.
The only internal policy guidance appears to have been the agency's commitment, stated publicly, not to release data except "where the agency has no discretion", such as when responding to a court order.
This state of affairs was revealed in documents released on Friday under a Freedom of Information request made on July 25 by infectious diseases physician Dr Trent Yarwood, who represents Future Wise on e-health and privacy matters.
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  • Updated Oct 19 2018 at 11:00 PM

Before artificial intelligence we need to understand human intelligence

by Cade Metz
In the global race to build artificial intelligence, it was a missed opportunity. Jeff Hawkins, a Silicon Valley veteran who spent the last decade exploring the mysteries of the human brain, arranged a meeting with DeepMind, the world's leading AI lab.
Scientists at DeepMind, which is owned by Google's parent company, Alphabet, want to build machines that can do anything the brain can do. Hawkins runs a little company with one goal: figure out how the brain works and then reverse engineer it.
The meeting, which had been set for April at DeepMind's offices in London, never happened. DeepMind employs hundreds of AI researchers along with a team of seasoned neuroscientists. But when Hawkins chatted with Demis Hassabis, one of the founders of DeepMind, before his visit, they agreed that almost no one at the London lab would understand his work.
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SafeScript proves its worth in real-world pharmacy

It has taken less than two weeks to identify patients in need of help
15th October 2018
It took less than two weeks for pharmacist Jarrod McMaugh to gather proof that Victoria’s new real-time monitoring system will improve patient safety.
His use of the SafeScript program revealed that a long-term patient had stock-piled 700 tablets of oxazepam in 90 days.
The patient, who has been attending Mr McMaugh’s pharmacy for several years, had seen four different doctors and visited seven pharmacies.
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Tech can help mental health

  • By Sam Duncan
  • 11:00PM October 15, 2018
 “Overconnectedness” and “too much technology” are often cited as the cause of more stress, anxiety and isolation in our lives. The lesser-told story is the potential for technology to detect and help manage mental health conditions.
The emphasis of current research is on new ways of using technology to detect mental health conditions, says director and chief scientist at the Black Dog Institute, Helen Christensen. It’s very much “blue skies”, she says, but it’s also where the exciting science comes in.
Companies around the globe, including Google and Verily, are looking at whether you can detect anything about a person being at risk by what they do with their mobile phone, Christensen says.
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Small pharmacies claim MedAdvisor is steering patients away from them

They say the app favours the branded chains
17th October 2018
Small pharmacies say they are being disadvantaged by deals between chains such as Discount Drug Stores and MedAdvisor that appear to direct patients away from them towards bigger businesses.
For months, Small Pharmacies Group (SPG) members have raised concerns with MedAdvisor that its app gives preferential treatment to Discount Drug Stores (DDS).
The problem is patients who sign up for MedAdvisor through a DDS pharmacy or select a DDS pharmacy as their favourite are only ever directed to DDS pharmacies when they search for pharmacies in a new area.
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Chemist Warehouse could create an internet of medicine

By Ry Crozier on Oct 18, 2018 11:57AM

'Considering' large-scale sensor deployment in retail stores.

Chemist Warehouse is "considering" installing thousands of sensors in each of its stores to understand consumer foot traffic and what products they are most interested in buying.
AMS solutions architect Antoine Sammut - who has spent five years at the retailer - told VMWare’s vForum in Sydney that the pharmacy chain was interested in both IoT and augmented reality.
“The opportunity that IoT gives us is tremendous,” Sammut said.
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Tech trends for the next 10 years

  • By Jane Nicholls
  • The Deal
  • 11:00PM October 18, 2018
The coming decade “will see significant advances in sensory systems, machine learning, predictive analytics and artificial intelligence generally”. That’s the pronouncement in the latest Digital Megatrends report from CSIRO’s Data61. These innovations – a mix of now, soon and blue-sky – offer a glimpse of how these talked-about technologies will be deployed in our daily lives. People who watched The Jetsons as kids are now seeing the cartoon come to life around them. Solving the myriad legal, ethical and social challenges as the AI-enabled world advances remains a human endeavour (at least for now), but innovations that successfully tap into human nature and somehow make life better will inevitably shape our future.
Additive manufacturing
The industrial cousin of consumer 3D printing, additive manufacturing is changing factories from the ground up. The old process of making things by removing material is flipped, along with the economics of production lines: additive manufacturing builds a piece rather than carving it out. There’s little waste, and the process affords endless design iterations, customisation, much lighter end products and the ability to vastly reduce the number of parts needed. GE Aviation is creating additive manufacturing production lines for aircraft engine parts. GM Holden in Melbourne is 3D-printing parts for old cars. They’ve also revved up their engineering department to work on autonomous and electric vehicles.
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Medibank boss warns lack of transparency is breeding suspicion among consumers

  • 4:12PM October 19, 2018
Medibank chief Craig Drummond has warned that the lack of transparency on outcomes in the healthcare system is breeding suspicion and driving value concerns among consumers.
Mr Drummond, who previously worked in the financial sector, said the healthcare industry was unlike any industry he had seen because of the lack of disclosure and transparency.
He added that Medibank (MPL) would soon publish patient reported experience measures based on around 30,000 customer surveys that had been completed since 2016.
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Dr Google in the ED: searching for online health information by adult emergency department patients

Anthony M Cocco, Rachel Zordan, David McD Taylor, Tracey J Weiland, Stuart J Dilley, Joyce Kant, Mahesha Dombagolla, Andreas Hendarto, Fiona Lai and Jennie Hutton
Med J Aust 2018; 209 (8): 342-347. || doi: 10.5694/mja17.00889
Published online: 20 August 2018

Abstract

Objective: To determine the prevalence, predictors, and characteristics of health-related internet searches by adult emergency department (ED) patients; to examine the effect of searching on the doctor–patient relationship and treatment compliance.
Design: A multi-centre, observational, cross-sectional study; a purpose-designed 51-item survey, including tools for assessing e-health literacy (eHEALS) and the effects of internet searching on the doctor–patient relationship (ISMII).
Setting, participants: 400 adult patients presenting to two large tertiary referral centre emergency departments in Melbourne, February–May 2017.
Outcome measures: Descriptive statistics for searching prevalence and characteristics, doctor–patient interaction, and treatment compliance; predictors of searching; effect of searching on doctor–patient interaction.
Results: 400 of 1056 patients screened for eligibility were enrolled; their mean age was 47.1 years (SD, 21.1 years); 51.8% were men. 196 (49.0%) regularly searched the internet for health information; 139 (34.8%) had searched regarding their current problem before presenting to the ED. The mean ISMII score was 30.3 (95% CI, 29.6–31.0); searching improved the doctor–patient interaction for 150 respondents (77.3%). Younger age (per 10-year higher age band: odds ratio [OR], 0.74; 95% CI, 0.61–0.91) and greater e-health literacy (per one-point eHEALS increase: OR, 1.11; 95% CI, 1.06–1.17) predicted searching the current problem prior to presentation; e-health literacy predicted ISMII score (estimate, 0.39; 95% CI, 0.20–0.39). Most patients would never or rarely doubt their diagnosis (79%) or change their treatment plan (91%) because of conflicting online information.
Conclusion: Online health care information was frequently sought before presenting to an ED, especially by younger and e-health literate patients. Searching had a positive impact on the doctor–patient interaction and was unlikely to reduce adherence to treatment.
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Digital Health Update - October 2018

October 15, 2018

West Moreton Health is now uploading pathology results to the My Health Record system

West Moreton Health is now sending finalised pathology results to patients’ My Health Records. Healthcare providers registered with the My Health Record system can access this information as soon as it is uploaded to a patient’s My Health Record.
With an increase in Queensland Health documents being sent to the My Health Record system, GPs can expect to receive an increase in patient enquiries. 
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Farewell: Outgoing RACGP president reflects on his 'humbling' tenure

Dr Bastian Seidel has written a farewell letter to college members
17th October 2018
The departing head of the RACGP has cited the “exponential growth” in media coverage for the college and the re-indexation of Medicare as two of his biggest achievements in the role.
Tasmanian GP Dr Bastian Seidel, who officially stepped down as RACGP president last week after two turbulent years in the top job, has written to college members to thank them for their “humbling” support during his tenure.
He also reflected on his record as president, which he said had seen the college transformed from a side-player to one of the country’s most trusted sources of health policy development.
“In the last two years, we’ve moved from the periphery of reacting to health policies to the centre of actively shaping them,” he said.
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AI in health raises privacy concerns

Friday, 12 October 2018  
eHealthNews.nz editor Rebecca McBeth
Health providers and consumers need to consider questions of privacy and confidentiality before using artificial intelligence to assist in healthcare, an Otago law expert says.
Associate professor of law Colin Gavaghan is part of a three-year multi-disciplinary project funded by the Law Foundation looking at applications of AI in New Zealand that raise legal, ethical and social questions.
AI has big implications for medicine, as tasks that are currently done by a human doctor or nurse could be done by a machine.
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New Zealand ready to reap benefits of full end-to-end EMRs

October 19, 2018
eHealthNews.nz editor Rebecca McBeth
New Zealand health providers have the skills and digital maturity to reap the benefits of full end-to-end electronic medical record systems, says Phillips chief medical officer – EMR Dr Luiz Arnoldo Haertel.
Haertel  is a keynote speaker at the HiNZ Conference 2018 in Wellington from November 21–23 on EMR: The processing agent of the healthcare industry revolution.
He tells eHealthNews.nz that New Zealand has so far taken a “best-of-breed” (BoB) approach to EMR adoption rather than “best-of-suite” (BoS).
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Apple says decryption should 'alarm every Australian'

By Ry Crozier on Oct 13, 2018 10:49PM

The security weaknesses and spying it could be forced to do.

Apple has laid out some of the ways it could be forced to spy on its customers if the decryption bill before Australian parliament passes into law.
The bill “could allow the government to order the makers of smart home speakers to install persistent eavesdropping capabilities into a person’s home, require a provider to monitor the health data of its customers for indications of drug use, or require the development of a tool that can unlock a particular user’s device regardless of whether such tool could be used to unlock every other user’s device as well," Apple said in a parliamentary submission [pdf].
In addition, Apple said it was “deeply concerned that the government may seek to force providers to provide real-time interception of messages or internet-based audio or video calls should the law pass in its current form.”
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Encryption bill will cause 'significant risk' to Internet: Mozilla

Any measure that permits a government to lay down specifications for the design of Internet systems would cause significant risk to the security, stability and trust of such systems, the Mozilla Foundation has said in a submission about Australia's proposed encryption bill.
The Foundation, which serves as an umbrella group for development of the open-source Web browser Firefox among other well-known projects, said in its submission to the Parliamentary Joint Committee on Intelligence and Security that the technical capability notices that were part of the Bill, along with other notices that could be used to demand changes in software, would "significantly weaken the security of the Internet".
The organisation's comments focused on the three new powers for investigative and intelligence agencies in the Bill:
  • a “technical assistance request” that allows voluntary help by a company. The staff of the company will be given civil immunity from prosecution.
  • a “technical assistance notice” to make a communications provider offer assistance; and
  • a “technical capability notice” that can be issued by the Attorney-General at the request of an interception agency. This will force a company to help law enforcement, by building functionality.
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Australia's encryption-busting bill also after PINs, passwords

By Ry Crozier on Oct 19, 2018 11:09AM

Home Affairs proposes simpler mechanism to get at data.

The government has raised the prospect of using so-called decryption laws to simply get a provider to turn over a user’s PIN or password to get access to a target’s encrypted communications.
While much of the debate on the Assistance and Access Bill so far has concentrated on the prospect of encryption being weakened, the Department of Home Affairs indicated today encryption may not even be its primary target.
At a joint parliamentary committee hearing, shadow Attorney-General Mark Dreyfus QC noted the bill contained just one reference to encryption in its 171 pages, preferring instead to use an umbrella term “electronic protection”.
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  • Updated Oct 16 2018 at 10:25 PM

Cochlear's next big breakthrough: 24/7 hearing for the profoundly deaf

New technologies and new ways of doing things in healthcare are not limited to start-ups. In some cases, incumbents are continuing to re-invent themselves and, in turn, improving the lives of patients.
When Melbourne surgeon Graeme Clark implanted the first hearing device in a patient with profound hearing loss 40 years ago, it was a big breakthrough. The device was the forerunner to the Cochlear implant, and Cochlear – a $10.7 billion ASX darling today – was launched four years later in 1982.
Prior to Clark's landmark operation at the Royal Victorian Eye and Ear Hospital in Melbourne, "it was not understood that you could restore hearing" in patients with profound hearing loss, surgeon Robert Briggs says. Now Cochlear and Briggs reckon they're ready for the next big breakthrough – 24/7 hearing for such patients via a fully implantable Cochlear.
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Australian e-health company G Medical Innovations eyes Nasdaq listing

11:58 15 Oct 2018
G Medical Innovations Holdings Ltd (ASX:GMV) CEO Yacov Geva sits down with Proactive Investors' Christine Corrado in New York to update investors on the mobile and e-health company's move to list on the Nasdaq.
Geva says the company, which specializes in software and devices that aim to reduce inefficiencies in health care delivery, will remain listed on the Australian Stock Exchange, but will begin trading on the major US exchange in early 2019.
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18 Oct 2018 12:55 PM AEST -         

 App Diagnoses Snore Danger While You Sleep

 Want to know if your snoring is damaging your health? Perhaps just ask your smartphone!
 Exciting new research to be presented at an Australasian sleep congress in Brisbane on Saturday shows smartphone technology can potentially diagnose a serious disorder, obstructive sleep apnoea (OSA), in snorers.
The technology, not yet commercially available, might allow the thousands of Australians living with the common but concerning condition to get a diagnosis quickly and cheaply from the comfort of their own bed for the first time.
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Telstra CEO demands $20 a month NBN price cut

By Ry Crozier on Oct 16, 2018 10:40AM

Renews criticism of wholesale charges.

Telstra CEO Andy Penn has called for a “more than $20” a month cut to NBN Co’s wholesale charges because reseller margins are “rapidly falling to zero”.
Penn used the telco’s annual general meeting to renew his criticism of NBN charges, which he first raised back in April.
He had been hoping for regulatory intervention on the wholesale pricing and had set an arbitrary deadline of July for that to occur, however that deadline passed without action.
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Talk of NBN sale to Telstra highlights the network’s failings

  • By David Forman
  • 11:00PM October 10, 2018
That some people in the communications industry are seriously suggesting the NBN will be “flipped” to Telstra any time soon speaks to two things: how badly the project execution has been botched to date, and how uninformed some industry players continue to be.
To the second point first — the NBN was carefully wrapped up in legislation from the day it was conceived to prevent certain things ever happening.
It cannot sell retail services.
It cannot favour one of its wholesale customers (retail service providers such as Macquarie Telecom, Telstra and Optus) over any other one.
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Writedown an option as Labor vows to repair NBN

  • 11:00PM October 14, 2018
Fixing the broken business model of the National Broadband Network will be Labor’s key priority if it comes to power at the next election, with a potential multi-billion- dollar writedown a live option, according to the opposition communications spokeswoman Michelle Rowland.
“The Coalition has ruled out a writedown but we are keeping all of our options open,” she told The Australian.
“There’s little wriggle room for either government, whoever wins the next election. There is no way NBN Co is going to meet its average revenue per user forecast [$51 by 2021-22] and there are alternative players popping up everywhere.”
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Enjoy!
David.

Sunday, October 21, 2018

At Least One Acknowledged Global Expert Thinks The #myHealthRecord Is Going In The Wrong Direction.

This appeared late last week:

Game changer: Creator of FHIR writes about approaching critical mass and a growing data sharing revolution

Grahame Grieve | 17 Oct 2018
HL7 is close to publishing the fourth milestone release of the FHIR standard at a time of increasing uptake that the US Office of the National Coordinator for Health IT recently said could soon approach critical mass. These are exciting times.
In a blog post, ONC's Steven Posnack and Wes Barker wrote that the US "might be at a turning point when it comes to the adoption and implementation" of HL7's FHIR standard, supercharged no doubt by the integration of the standard by mammoth companies such as Apple.
But there is still much to be done both here and internationally to get health systems sharing patient information and fuelling quality care – which is what our work is all about.
FHIR contains the foundation content for exchanging data about all parts of the healthcare process. It supports exchanging patient clinical summary, care plan management, medication management, diagnostic reporting, as well as clinical decision support, administration, financial management, and even clinical trial administration.
From the beginning, the mission of the FHIR community – which I am privileged to lead – has been to change the way healthcare is practiced by providing the technical infrastructure that allows applications to connect in new ways, ways that erode the barriers to improved care. We’ve seen other industries disrupted by the combination of technologies and scalability that the web offers, and we want to bring that to health.
I should be clear, at this point, that many of the barriers to improved care are not technical – there’s massive cultural, political, legal and financial barriers to improving healthcare. FHIR isn’t solving those – it’s part of a wider movement to change the way healthcare works. But we, the FHIR community, think that what we have to offer is a game changer.
……
There is a window of opportunity here in Australia to leverage all this into something useful.
As I write this, the Senate inquiry in My Health Record is due to report back on the direction of the platform. The MyHR – and the National Digital Health Strategy generally – intends to make good on the vision I outlined above. But our current reality is very different – the system we have is based on an architecture that largely predates the emergence of the current web, and the gap between vision and reality is driving the current political challenges.
We’re about to reinvest in a new technical infrastructure for the national system – still based, for the moment, on the same central document repository architecture. That doesn’t make sense – if we’re going to invest, it needs to be in a solution that care providers and receivers want and demand so they can get improved health care and outcomes. Also, it should be an infrastructure that vendors want to leverage because its benefits are obvious and systemic. Let’s take this opportunity to pivot to a different architecture, one that can break down our silos instead of building new ones.
Real change, however, is bottom up. We don’t have to wait for the senate to decide the future of healthcare in Australia. The world is full of highly motived patients who want to get care differently – see Mike Morris’ story. We’re all patients and we all need better care. Since there’s many barriers to improving care, there’s many opportunities to develop solutions to our challenges. FHIR is just one small part of that picture.
So, today, don’t wait. Ask yourself: how can I make a difference today?
Grahame Grieve is the creator and global project lead of HL7’s FHIR, and the Principal of Health Intersections.
Others have made the same point with the technology being a decade old or so.
If you read Grahame’s Mike Morris story you will realise that the current myHR has a snowflakes chance in hell of enabling such care.
What do you think of the message Grahame is sending and how can we have it actioned.
David.

AusHealthIT Poll Number 445 – Results – 21st October, 2018.

Here are the results of the poll.

Are The Current Senate Inquiries Sufficiently Informed and Competent To Properly Determine The Correct Future For The #myHealthRecord?

Yes 46% (73)

No 53% (84)

I Have No Idea 2% (3)

Total votes: 160

This is the most split poll in a while. Overall readers were pretty split as to whether the Senate could handle this health / technical problem well.

If you have not already, don’t forget to come to grips with what we are really facing…..

https://www.youtube.com/watch?v=XlUQMH19BkQ (78,816 views so far!)

This one is also from the same team is also fun!

https://youtu.be/eW-OMR-iWOE (114,976 views so far!)

This time on the planned encryption laws

Any insights on the poll welcome as a comment, as usual.

A really, great turnout of votes!

It must have been an easy question as 3/160 readers were not sure what the appropriate answer was.

Again, many, many thanks to all those that voted!

David.

Saturday, October 20, 2018

Senate Estimates Hearing - ADHA - Wed 24 October, 2018

Here is the announcement.

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Community Affairs

2018–19 Supplementary Budget estimates

Wednesday, 24 October 2018
Health

Thursday, 25 October 2018
Social Services
Human Services

Program for 24 - 25 October 2018 (PDF 137KB)


Questions on notice

Search the database for questions placed on notice during estimates hearings, and the answers provided. The database contains information for the Community Affairs Legislation Committee from the 2018–19 budget estimates hearings.
To view answers to questions on notice from Budget estimates 2017-18 or later estimates rounds, please use the questions on notice search function on the Senate estimates webpage. To view answers to questions on notice from estimates rounds prior to Budget estimates 2017-18, please see the links to estimates rounds below.

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Download the program from the link.

Vision will be available from the aph.gov.au page.

https://www.aph.gov.au/Watch_Read_Listen


David