All AUSTRALIANS would be automatically enrolled for an e-Health record and have to opt out to protect their health privacy under sweeping changes to the $1 billion white elephant.
And doctors could get paid to upload patient health summaries onto the record to get more clinicians involved in using it.
Launched in July 2012 the Personally Controlled Electronic Health Record was meant to bring medical records into the digital age and contain an electronic patient health summary, a list of allergies and medications and eventually X-rays and test results.
Seventeen months after it was launched only a million people have signed up for the record and only one per cent of these records has a clinical summary uploaded by a doctor.
A government inquiry into the record headed by Uniting Care Health chief Richard Royle has been charged with overhauling the struggling policy.
The intention of his panel is “not to kill it but build on the foundation base”, he says.
“If there is one consistent theme it is that the industry wants to see it work,” says the man who will next year launch Australia’s first digitally integrated hospital.
Voluntary sign-ups for e-health records have been slow and the Consumer’s Health Forum which previously backed an opt-in record has told the inquiry it now wants an opt-out system.
“Australia should bite the bullet and make joining the national e-Health records system automatic for everyone unless they actively choose to opt out,” CHF spokesman Mark Metherell says.
“An opt out model is one of the issues we’re looking at,” says Mr Doyle.
Doctors have told the inquiry they won’t trust the record unless patients are prevented from changing or withholding any clinical data such as an abortion or mental illness from the record.
They say they need this information so they have a proper understanding of all the medications and health conditions the person has to get a correct diagnosis and ensure there are no medication mix-ups.
Mr Royle says the inquiry is considering the personal control issue but “don’t assume the AMA position is the prevailing view,” he said.
The Consumer’s Health Forum says “if there is to be opt out full personal control of the health record must be central to the system and if possible strengthened”.
Consumers who had health procedures such as an abortion or a mental illness they may want to hide would be worried if they lost control over the record.
The changes would completely change the nature of the Personally Controlled e-Health Record which the previous Labor government promised would be voluntary and controlled by the patient.
The review set up by incoming Health Minister Peter Dutton has received over 82 submissions and the inquiry has been told the record won’t be useful until a critical mass of patients and doctors begin using it.
Health Minister Peter Dutton has ridiculed the slow progress with the record and doctors have argued they are unlikely to quickly embrace the record until they get paid to upload patient health summaries.
The review is also looking at whether involving private information technology providers who run private e-health records could improve the system.
A draft report is due to go to Health Minister Peter Dutton before Christmas.
In a series of interviews yesterday throughout Australia The Prime Minister Tony Abbott, Warren Mundine Chair of the new Indigenous advisory council and the new Health Minister Peter Dutton have made a series significant annoucements including;
PRIME Minister Tony Abbott’s new indigenous advisory council will complete a review of indigenous spending by early next year.
Mr Abbott has begun recruiting people for the council, which will oversee a shake up of indigenous affairs. (see email contact below)
HEALTH Minister Peter Dutton supports raising tobacco taxes but won’t raise taxes on alcohol because he says it doesn’t cut consumption.
The new minister says boosting community-based mental health services will be one of his priorities in government.
The Abbott Government will do more to stop indigenous Australians taking up smoking.
Warren Mundine on Wednesday officially signed on to be the council’s chairman.
He said his preference was for the council to have seven or eight members.
The membership will be finalised before the end of October.
And finally todays rumour “There are some OATSIH program areas being considered for transfer but there will be 3 month consultation”
Mr Mundine spoke to Lisa Martin from AAP
“It’s not a representative committee … it’s a council of experts, indigenous and non-indigenous, who will be working in this space to get the socio-economic outcomes for indigenous people,” Mr Mundine told AAP.
“It will be based on expertise, but the majority will be indigenous people on the council.”
Mr Mundine confirmed former Department of the Prime Minister and Cabinet boss Peter Shergold will be on the council.
In the early 90s Dr Shergold headed the now defunct Aboriginal and Torres Strait Island Commission.
The council will meet Mr Abbott and senior ministers three times a year.
Mr Mundine, a former Labor national president, will meet with Mr Abbott and Indigenous Affairs Minister Nigel Scullion on a monthly basis.
Mr Mundine flagged that some meetings would be held in indigenous communities.
“We want to get out and about,” he said.
The council’s first task is to conduct a review of indigenous spending and how to get value for money.
Mr Mundine has stressed the review is not about budget cuts.
He expects the review to be finalised by February or March 2014.
* People can register their interest to be on the council by emailing
HEALTH Minister Peter Dutton supports raising tobacco taxes but won’t raise taxes on alcohol because he says it doesn’t cut consumption.
The new minister says boosting community-based mental health services will be one of his priorities in government.
And he’s warned bureaucrats working in 18 health agencies they could be axed or merged into the department.
The government’s Mental Health Commission will be absorbed back into the Health Department, where it will outline how to fix a fragmented system of service delivery, he said.
And the Australian Institute of Health and Welfare and the National Health Performance Authority – which both collect health data – can expect to be merged.
“There are several bodies collecting data and we’ve got to make sure we’re doing it in the most efficient way possible,” Mr Dutton told ABC Radio National.
“We want to make sure we’re getting the most efficient spend possible for taxpayers money so that we can get as much money as we can to frontline services,” he said.
The minister refused to comment on reports that he also has the National Preventive Health Agency in his sights.
In Opposition, Peter Dutton says he proposed a hike in the tobacco tax to cut smoking rates that was finally supported by the Rudd Government.
“I think wherever we can discourage the take up of tobacco we should because we know of the health outcomes and we should do whatever we can,” he said.
However, he says increasing alcohol taxes to combat Australia’s binge drinking culture won’t work.
“The (previous) government imposed the so-called alcopops tax and, in actual fact, the consumption of spirits has gone up since the introduction of that tax,” he said.
“It didn’t work,” he said.
The Abbott Government will do more to stop indigenous Australians taking up smoking, he said.
Mr Dutton says he wants to boost community-based services for the mentally ill and break down the stigma around mental illness that prevents 65 per cent of those with a problem seeking help.
NACCHO JOB Opportunities:
Are you interested in working in Aboriginal health?
NACCHO as the national authority in comprenhesive Aboriginal primary health care currently has a wide range of job oppportunities in the pipeline.
The speech is provided to NACCHO members for information only and is not NACCHO Policy
Please note: NACCHO will be responding next week
As Health Minister, it’s always such a privilege to meet with some of the brightest minds and passionate advocates in the Australian health system. So thank you for the opportunity to do that again today.
And congratulations on playing such an important part in reshaping the Australian health system.
The establishment of Medicare Locals is emblematic of how this Government has acted to shift the gravity in the health system towards primary healthcare.
Medicare Locals are part our Government’s National Health Reform agenda. An agenda that’s changing the landscape of Australian healthcare – from a system focussed on the best treatments for people who are sick in hospital, to one that keeps people well too.
It’s change based on the best evidence about what works to give patients quality healthcare when they need it, where they need it.
As we all know, the evidence is clear. Health systems centred on primary healthcare have better outcomes.
As I’ve said before, but it’s important to reinforce, we just have to look at the findings of the World Health Report in 2008. The Report found that where countries at the
same level of economic development are compared, those that were organised around the tenets of primary healthcare produced better health outcomes for the same investment.
Today I wanted to speak with you about three things:
Firstly, how Medicare Locals are transitioning from the establishment to the delivery phase;
Secondly, about engaging with Australians on what their Medicare Local is doing for them; and
Thirdly, why the devolution of decision making and responsibility to Medicare Locals is so important, and how that flexibility supports innovation.
Medicare locals transitioning from establishment to delivery
Since 2009, we have worked to set up the architecture for Medicare Locals, so each organisation can operate with the confidence of strong governance and support.
But as important as that architecture is, we’re now on to the exciting stuff – the transition of Medicare Locals from establishment to the delivery phase.
That is, health professionals on the ground delivering services to people – across the nation.
I find it extremely disappointing to hear some describe Medicare Locals as just another layer of red tape.
I’ve spoken to health professionals and the people they help in Medicare Locals throughout Australia – and nothing could be further from the truth.
You know, as I know, that Medicare Locals are health services, not health bureaucracies. And those who suggest otherwise do so in spite of the facts.
The truth is that around seven out of ten Medicare local staff work directly with patients -More than 1740 workers across Australia
I fail to see which doctor, which nurse, which psychologist, or which patient would be helped by cutting the $1.2 billion for Medicare Locals out of the system.
The word Medicare in the name ‘Medicare Local’ reminds us all what an integral part Medicare Locals play in Australia’s world-class universal health system.
Any assault on Medicare Locals is an assault on Medicare and our system of universal healthcare. And it’s an insult to those health professionals who work so hard to help so many.
Make no mistake – to me, and to this Government, Medicare Locals are no optional extra. Although much newer, Medicare Locals are as important to our healthcare system as the MBS or the PBS.
They are also the vital link between community health and hospitals – the other three out of ten Medicare Local workers are helping to ensure patients are cared for properly whether in their own home, a community setting, or going into or coming out of hospital.
Engaging with australians on what their medicare local is doing for them
Because Medicare Locals are in their infancy, it is critical we work together to engage with Australians about what Medicare Locals mean for them.
As I visit Medicare Locals throughout the country, I see first-hand the incredible work going on – and the difference that work is making to people’s lives.
And they are the stories we must share.
Only last Thursday I visited the Footprints program at Newstead in Brisbane which is supported by Metro North Brisbane Medicare Local through its flexible fund.
Footprints uses the money to provide an active outreach service targeting the homeless community in their region to access primary healthcare services, and to help them with advanced care planning.
Or the new after-hours service that’s just opened at the Nepean Hospital – helping families in Penrith and the Blue Mountains access a GP instead of having to turn up at an emergency room.
And there are many many other examples of fine work happening across Australia.
But for the public and for healthcare professionals to grow confident in Medicare Locals, they must hear about what it is you are doing, and they must be a part of it.
That is why this forum is so important.
I understand the purpose of you all being here together in Canberra is to clearly articulate a shared strategy for Medicare Locals …
…what is your common story and how do you tell it?
…here are you going as a network of Medicare Locals and how are you going to get there?
…ow do you continue building trust and respect amongst the people you serve?
…ow do you not only perform and succeed, but share that performance and success with your communities, and with each other?
…how do you build capacity and capability to take on increasingly sophisticated and complicated roles and responsibilities within the health system?
These are important questions and it is timely for you to be planning together about how you respond to them.
The importance of devolving decision making and responsibility to medicare locals – flexibility to support innovation
As a Government, we have given Medicare Locals the opportunity to play a central leadership role in reform of primary healthcare and consequently of the Australian health system more broadly.
This is both a great privilege and responsibility.
The devolution of decision making to a local level and more flexible funding allows Medicare Locals to be innovative and responsive to the unique health needs of their communities.
But it’s important to remember that the investments you are making in your communities are with the nation’s health dollar. And it’s critical that you get bang for our buck.
Your achievements so far have been impressive.
In recognition of that, I continue to look for other Commonwealth funded programs that can be devolved to the Medicare Local level.
Already, about 30 major health programs are being delivered through Medicare Locals.
And today, another program will be added to that list.
I am very pleased to announce that the Government’s
More Doctors for Outer Metropolitan Areas Relocation Incentive Grants will be devolved to the Medicare Local level.
As you probably know, this program has been supporting doctors to relocate from inner to outer metropolitan areas.
This is helping even out medical care services in our communities and is reducing some of the geographical inequities that persist.
The transfer means 30 outer-metro Medicare Locals will be funded to administer the grant – which is backed by a $15 million Government investment over the next four years.
Responding to emerging community needs
In recent years, our Government has invested record amounts for more hospital beds, more clinics, more equipment for high-tech procedures and better health infrastructure.
We’ve also opened the door for thousands more doctors, nurses and allied health professionals.
But, at the primary healthcare end of the spectrum, what confronts today’s patients?
Will they share in the full benefits of the health resources of an advanced, developed nation?
Do people, especially the disadvantaged, see a clear pathway to wellbeing?
We know that lower-SES Australians still find it harder to access health services compared to their higher-SES counterparts.
Medicare Locals are instrumental in helping to address that inequality.
A great example – just a few days ago in Perth a new StreetDoctor Truck was launched at the headquarters of the Perth Central and East Metro Medicare Local.
This will provide healthcare services in inner Perth and the surrounding area for homeless and disadvantaged people.
The service provides general health checks, wound dressings, immunisations, harm minimisation and other counselling, and links patients to mainstream services.
This service launches with 2,500 active patients, four in every ten are under-25-year-olds, 30 per cent are Aboriginal and Torres Strait Islander people, and the vast majority have mental health issues.
The service has important partnerships with Passages, Red Cross’ soup kitchens, Pharmacy Ashfield, The Town of Bassendean, Catholic volunteer friendship, and support workers.
Recognising this important community need, the Medicare Local has built the StreetDoctor up so that it now provides 40 hours of service a week – an incredible example of a collaborative response to a local health need.
And Medicare Locals are there in times of crisis.
Like in Queensland after the recent floods, the Sunshine Coast Medicare Local offered free mental health counselling to support the well-being of residents in Sunshine Coast and Gympie. And the Wide Bay Medicare Local was also very active in supporting Aboriginal and Torres Strait Islander people who were hit particularly hard.
Conclusion
It’s examples like those that really do speak volumes about the importance of Medicare Locals.
Local control and local solutions are seeing Medicare Locals delivering for communities across Australia.
Medicare Locals are an essential part of our universal healthcare system.
Our Government stands shoulder to shoulder with you all as you continue your fantastic work delivering healthcare to Australians when they need it, where they need it.
