I rise today to speak on the Health Legislation Amendment (Information Sharing) Bill 2023. Before getting too deep into the contents of the bill, I would like to take this opportunity to thank the amazing healthcare staff across my electorate and in fact the entire state. They do an incredible job, often under immense pressure in under-resourced environments. We have great local hospitals, from Kilmore, where I previously served as a community representative, to Seymour and Benalla. We also have Euroa Health, whose need for public funding I will continue to raise with the Minister for Health. Whether it be in a hospital, general practice, allied health or anything in between, everyone in our health system locally deserves a heartfelt thankyou for the work they have carried out through the pandemic and the work they continue to do every single day.
This bill is not one without controversy, but it is great to be able to speak on a bill that draws debate. As has already been mentioned, we will be seeking to amend this bill to provide an opt-out clause to Victorians – something in line with the standards set by My Health Record at a federal level. I do acknowledge the importance of streamlining communications and updating record keeping systems to provide better outcomes for Victorian patients. The main purpose of this bill is to amend the Health Services Act 1988 to establish a centralised electronic health information sharing system for participating health services to share certain health information, which consequently requires the authorisation to collect and disclose this information. The establishment of a centralised data-sharing system was a recommendation of the independent report commissioned by the government in 2015 following a series of seven avoidable baby deaths at Djerriwarrh Health Services at Bacchus Marsh hospital. My heart goes out to the families who continue to grieve the loss of these babies.
While I may be a relative newcomer in this chamber, the bill before us now is not. The original 2021 version of this bill lapsed in the last Parliament. The Law Institute of Victoria has again asked for this bill to be withdrawn, just like it did in 2021, for greater consultation to occur with industry over privacy concerns and the inability of patients to control their recorded medical history. The Law Institute of Victoria’s objections to proposed legislation are nothing new to this government in the health sector, and I hope those that are sitting in the crossbench in the other place in the 60th Parliament have a stronger commitment to the transparency and accountability.
The bill nonetheless does aim to achieve something our health system desperately needs, and that is better outcomes for patients. Our health system simply is not working the way it should, and nowhere is this being felt more acutely than in regional Victoria. This government came to power in 2014 with a Premier who said he would save the minutes that save lives across our 000 system. I think they are actually 3 minutes later than they were when we were last in government. The average ambulance in a code 1 emergency now arrives more than 3 minutes slower than it did when the Nationals were last in government – some facts.
I want to make it very clear: we are certainly not opposed to creating a more fair and equitable health system for Victorians, particularly not while more than 80,000 Victorians are waiting for elective surgery – and that is a number the AMA suggests is a gross underestimate. Not only that, we are seeing one-quarter of patients not receiving the surgery they need on time and 10 per cent of patients waiting for more than a year. In our health system we certainly do need to be using technology to our advantage. This is especially true when our emergency departments see patients on time at a rate below the national average. Greater use of technology is crucial to ensure we are being as efficient as possible with the paltry resources provided. Outside of South Australia, we have the lowest number of full-time equivalent healthcare staff and public hospital beds in the nation.
There are several areas of concern with the bill and a number of key provisions I would like to outline. The bill provides power to the Secretary of the Department of Health to specify in the Government Gazette that health information must be given to the secretary to establish the patient health information sharing system. In the explanatory memorandum the scope of the information to be specified could include information such as medicines, allergies, alerts, admissions, discharge summaries, outpatient consults and laboratory and imaging results. In addition to this, the secretary can direct health services to provide prescribed information and disclose specified patient health information for the purposes of the new system without requiring the consent of patients to whom the information relates. The bill also ensures that the collection of the patient data is continuous and ongoing and information must be provided within five days. Access to this electronic system will be provided to someone who is employed or engaged by a participating service and who is authorised by a health service to access the system, with penalties in place of up to two years imprisonment for unauthorised access to the system. Finally, the Freedom of Information Act 1982 does not apply to the electronic patient health system, with this decision stated as being due to the participating health service holding more detailed information and being the primary source for the specified health data.
As a newly elected MP, I have found the vast majority of constituents are not watching Parliament live or overly concerned by the inner workings of the house – instead they come here. However, on this bill I have received a much higher level of correspondence from the community than I would expect. Given the record this government has, its reputation for secrecy and sometimes questionable motives, I can certainly empathise with these concerns. There are some very genuine areas of concern with this bill, ones that have been identified by the Law Institute of Victoria and ones that have not been addressed by the latest instalment.
Like the previous bill, the sharing of patient information will not involve the consent or knowledge of patients, with no opt-out option available. While the aim of the bill is to strive to improve medical outcomes, this does need to be balanced with and give thought to patient autonomy. As we have heard earlier, one in 10 Australians opted out of My Health Record. There is no doubt a significant percentage of the population would prefer an opt-out option or believe in the concept of patient choice and autonomy. Given not all health services have to comply with these new regulations, it seems interesting patients do not have the option to opt out of sharing their personal information.
Concern around data security and safely storing deeply personal medical information is something we must take seriously. While there are penalties in place for unauthorised access to the system, I have concern over how these breaches will be identified and how we can design a system that is hack proof and secure to ensure information is kept in the hands of medical professionals who are authorised to access data to improve medical outcomes. As has also been raised earlier, there are some concerns around IT and cybersecurity. While there is a delay in the implementation of the bill to allow the department to put systems in place, I hope consideration is given to compatibility with interstate IT platforms. This is of particular concern in my electorate, where a significant percentage of residents in towns like Benalla access health care on both sides of the border. The lack of safeguards for the disclosure of sensitive information, such as mental health, family violence, sexual assault, sexual history, termination of pregnancy and drug use, is something that needs to be considered.
The exemption from the FOI act will place a large burden on existing health services. With no opt-out clause, it is only natural there will be an increase in individuals seeking to understand what level of information is being held by the government. Again, given this government’s passion for secrecy and the continual decline in the rate of documents released through FOIs under its watch, it is understandable the people of Victoria are sceptical about any move to make a data system that holds their personal information FOI-proof.
The Nationals support amending this bill and ensuring it is reworked to provide individuals with the ability to opt out of this centralised health-sharing system. This is the first bill I have had the honour of debating in this chamber, and the amendment we are moving is one that could not illustrate more clearly the respective values of the Labor Party and the National–Liberal parties. I have come to this place as someone determined to fight for my community. While I have the freedom of choice to disagree with my party on principle, those opposite do not. I believe in the values of choice and personal responsibility. Sadly, those opposite must follow the leader and put their communities behind the party’s wishes day after day.
I think Victorians should have the ability to have a choice when sharing their private health information, and I support amending this bill to provide that right. What I have stated above is why we have moved a reasoned amendment in this place on the basis the government should redraft the bill with an opt-out clause.