Hunt bows to pressure over MHR safeguards

4 minute read

MyHealthRecord TheHill

By

Julie Lambert

Minister Hunt agrees to tougher penalties for misuse of MHR data, and some other safeguards, but is holding firm on the November 15 opt-out deadline

After bowing to demands for tighter safeguards in the My Health Record legislation, Health Minister Greg Hunt still faces calls to postpone the opt-out deadline that falls due next week.

The minister said today he had agreed to make the safeguard changes – which include tougher penalties for misuse of MHR data – in response to a Senate inquiry and “sensible and reasonable requests from medical authorities”.

The announcement came after a rush of people attempting to opt out of the troubled system reportedly caused a meltdown at the My Health Record call centre yesterday.

The planned amendments include raising the maximum criminal penalty for a breach from two years to five years’ jail and increasing the fine from $126,000 to $315,000 for individuals.

There are also provisions to protect patients affected by domestic violence and to ban employers from requesting and using health information in a patient’s electronic health record.

AMA President Dr Tony Bartone  welcomed the announcement, especially the provisions around privacy, confidentiality, and access by insurers.

However, he acknowledged more work would need to be done.

“The My Health Record may not yet be perfect, but it will get there with the support of the public and the health professions,” he said.

“It is better than anything else out there now. Some doctors are still using their fax machines. We need to move into the 21st century,” Dr Bartone said.

Labor’s health spokesperson Catherine King said the government needed to extend the November 15 opt-out deadline to allow time to consider the new amendments.

“These changes have been made with only days left until the opt-out deadline closes,” she said.

“We once again call on Minister Hunt to heed Labor’s call for a further extension to the opt-out period.

“We also call on the government to commission a Privacy Commissioner review to address outstanding privacy concerns about system settings.”

Ms King took the opportunity to remind voters that when Labor proposed the Senate inquiry into the e-health record, Mr Hunt dismissed it as a “stunt”.

“Now – with just a week to go until the end of the opt-out period – Minister Hunt has realised we were right all along and is scrambling to implement our fixes.”

The Consumers Health Forum said bipartisan support was essential for the My Health Record to succeed, backing the call to put off the deadline.

It said more time was needed for debate and to settle “significant issues affecting public support” for  the new system.

CEO Leanne Wells welcomed “several key improvements” in the amendments but said it was vital that the start-up of My Health Record was not overshadowed by uncertainty and political disputation.

“We urge our political leaders to work towards an all-party settlement before the opt out deadline is implemented,” she said.

“If that is not possible before 15 November, that formal deadline should be extended.”

The forum said the deadline was too soon to completely examine the proposed amendments to legislation to ensure that law enforcement agencies could only access a record with a warrant or court order and to allow the permanent deletion of records of people opting out.

Former AMA president Dr Kerryn Phelps, the independent who won the blue-ribbon seat of Wentworth vacated by former prime minister Malcolm Turnbull, said Mr Hunt should act swiftly to extend the opt-out period.

“I welcome these proposed changes but it really does seem that Health Minister Greg Hunt has been dragged kicking and screaming to the table at five minutes to midnight,” Dr Phelps said.

“The simple reality is that the House of Representatives doesn’t sit again until November 26 and that is beyond the current opt-out date.

“Minister Hunt needs to urgently extend the opt-out period in order for the Parliament to do its job to negotiate and then pass appropriate amendments so that privacy and security concerns are properly addressed.”

The government has also promised to review MHR privacy provisions for 14- to 17-year-olds.

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Donald ROSE
Donald ROSE
6 years ago

Absolutely must delay else the Coalition will suffer the consequences at the ballot box. Patients regularly get angry when I explain what is happening. They are initially incredulous then ask why there isn’t more protest. The MHR in its current form is beyond repair and we need need a MHR Mark 2 with all the problems fixed.

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Lou Lewis
Lou Lewis
6 years ago

What is most disturbing in this article is the fact that these safeguards and privacy protections were not even addressed by the health minister in the past, despite his saying that they were, and despite all the flaws and lack of previous protections is the fact that the AMA president is still sucking up to the Minister. Surely a person of the President’s intellect can see that the Minister has been lying to people all long and only when pressed by the media did he decide to bring these protections.
I particularly love the one where he is not going to allow employers access to prospective employees my health record!! I had no idea that that loophole existed.
Rather than promoting this flawed and totalitarian system the AMA president should be advising the Minister and his health Department to immediately cancel the opt out system and spend money on advertising promoting the benefits of the MHR and leaving it up to people if they wish to opt in. Unfortunately this totalitarian government will do what this Totalitarian govt wants to, and stuff the people and their wishes.
And, Mr AMA president and Mr health Minister, can you please tell me the benefits of every citizen who does not opt-out being forced to have a medical record created for them? What is the benefit of the average patient? In my opinion sweet Fanny Adams, and the only people will benefit will be the health insurers and the marketers, despite some rubbish about “ if you are in an accident the hospital will have access to your records and will know how to treat you appropriately” , as if hospitals are not treating people appropriately at present.
And talking of advertising, maybe the RACGP can lend its bed-mate the government some of its tens of millions of dollars it has in its bank to help promote the MHR! They seem to be in bed with government on every other decision that adversely affects GPs and now will adversely affect patients and even the confidential relationship with the patient’s GP.
Like all politicians, the health Minister and our medical leaders are slinging us massive spin and we are expected to embrace it, even though they admit that is flawed.
This certainly is not the Australia that I have grown up in, rather like the old Communist countries most people fled from!
Cheers
Lou

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Jane Smith
Jane Smith
6 years ago

Want to know why the AMA and RACGP are supporting MHR? Read this: “My Health Record money trail: Questions raised over health lobby groups ‘on payroll’”
(The Daily Telegraph 28 Jul 2018)
By Sue Dunlevy

“In the wake of a growing public backlash and increasing scrutiny of the My Health Record, key health lobby groups backing it are declaring themselves to be on the payroll of the agency rolling it out.”

“We can reveal the Australian Digital Health Agency has spent millions of dollars of taxpayers money trying to co-opt the support of leading health and consumer groups for the government’s online My Health Record.”

“A News Corp investigation of government tender documents has found
* The Consumers Health Forum has received over $105,000;
* The Royal Australian College of General Practitioners nearly $2 million;
* The Australian Health and Hospitals Association $1.2 million;
* The Pharmacy Guild $194,000;
* Australian Council Of Social Service $32 500.”

“The Australian Medical Association and the Royal Australian College of General Practitioners both signed contracts with the government to promote the record to doctors in return for a $910 million increase in Medicare rebates.”

ps 76% of doctors think it wont improve clinical care and 80% are opting off themselves so the AMA support for MHR is completely unfounded. Maybe everyone should review whether they want to renew their memberships? The new RACGP president, Nespoleon, has publicly opted off MHR.

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Jane Smith
Jane Smith
6 years ago

You can join a protest petition to Greg Hunt to make MHR opt in at this site
https://www.change.org/p/greg-hunt-mp-make-my-health-record-opt-in
52,000 people has signed so far.

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Dr David Fong
Dr David Fong
6 years ago

Even as of last week when I carefully explain what the MyHealth record is, and how it can benefit patient care, almost all of my patients (many non-English speaking, and with whom I need to communicate with the aid of a booked ‘live’ interpreter) can recognize the benefits and are willing to enroll into MyHealth in the current opt-in system.

Just on Monday, when I was discussing MyHealth with an (English-speaking) patient, he both expressed enthusiasm and was also somewhat delighted to find out he had in fact already been registered (perhaps during previous appointments at the local oncology hospital).

Perhaps for those of us fantastic GPs who provide all the necessary care for the patient, make sure their patients never need to see the hospital, have taken care of the patient from the minute we delivered them in the local hospital, have provided 24-hour 7-day access such that the patient has never, ever had to see another GP, and will then provide care right up to palliation when they are in the nursing home then, in that case, those of us FANTASTIC GPs (which I am sure most of the people who post in this forum are) can happily advise their lucky patients that they won’t benefit from a MyHealth record.

For not-so-great GPs like myself

1. whose patients often attend the hospital
2. whose patients I have abysmally failed to teach how to communicate with other doctors in English
3. whose I seem to be not the only GP (or clinic) providing care to the patient, because my books are not so entirely full that I don’t see new patients who have seen other GPs in the past
4. whose patients, despite my communication attempts, patients still seem to be confused about my clinic’s medication instructions
5. I am so inefficient, that I waste considerable time actually finding out that the medicines the patients are taking don’t quite match up with what my clinic has prescribed (both less, and more!)
6. I am so inefficient, that I find out the patient has already had lots of blood tests, XRs, CT scans and immunizations at another clinic

…then I find anything which aids my communication with other health care providers useful.

by the way – I am not a great communicator. I happily concede that most GPs are much better at communicating than I am, and they can communicate to their patients why the their GP does not need any help to communicate with other health care providers

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Jane Smith
Jane Smith
6 years ago

David, your arguments are around connectivity between different providers. No one has any issue with that.

The issue is that MHR is not fit for purpose. To quote an IT expert…

“It’s simple. If you don’t establish baseline standards for physically securing computers (and networks) that can access the system, eg. In Doctors consulting rooms etc, then you have failed the 1st security milestone.

The next layer of ‘logical’ security is incredibly complex, and there is still no agreed best approach for securing eHR transactions and data. There are a lot of theories, but as yet, no expert consensus. (Search: IEEE eHR security)

I haven’t seen a single schematic that vertically integrates the OSI model as yet. Anything short of the kind of deployments banks run, from the network layer to application layer, isn’t good enough

Anything short of world’s best practice isn’t good enough – and with no agreement on that yet, the whole deployment is too early”

I also suggest you read the beautifully written piece by Dr Janakiramanan, which pays reference to vulnerable groups…
A Surgeons very real concerns about My Health Record
https://womensagenda.com.au/uncategorised/a-surgeons-very-real-concerns-about-my-health-record/

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David Fong
David Fong
Reply to  Jane Smith
6 years ago

Thanks for sharing that article Jane.

Unfortunately, the views of Dr Janakiramanan are rather devalued by the closing comment which is : ‘Personally, in the current environment, with a conservative government doing little for genuine health improvement, I would rather not see those records written at all, than trust in the bravery of a few to later light a match.’

So perhaps the author’s views will change if nothing was to change except a different government, which in fair appraisal has, in both historical and current world-terms, has almost the same ideologies and principles as the current government?

So the entire article is knowingly written in a partisan political manner.

Such a shame that matters of health have been subjugated by political attitudes.

There are other details which are disputable, such as that emergency department and hospital doctors are really comfortable with not knowing what medications the patient they are seeing are actually taking or known to be allergic to. I hazard to say that ‘medication errors’ is thought to be a cause of preventable death in the hospital situation.

Or that health records are really the principle target of a government or organization which are ‘over-interested’ in the details of individuals is the health record. “Real-world experience” is that a government which has considerable interest and investment in surveillance capacity on individuals (China) takes virtually no real interest in accessing individual private health information in a centralized computerized manner. China doesn’t even have central immunization databases. This is despite having made some attempt at setting up centralized computer records almost a decade ago.

As for computer security standards, I take it that your quote implies, the most likely location of security breath is at the small end-user stage (e.g. the surgery of doctors who work in small, or very-small, companies).

There are practice standards surrounding that. Perhaps those standard should be improved or enforced further. Is the main reason doctors are opposed to MyHealth are that doctors have inadequate computer security, both for accessing MyHealth, and for the accessing the copious amounts of even more-detailed and personal patient information that is stored outside MyHealth in the current clinical systems used by doctors?

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Stephan Hellmuth
Stephan Hellmuth
6 years ago

What has MHR done in the last ? 8 years to address privacy safeguards? Why did the medical representatives on the advisory board quit?.
I think if the access to MHR is only for the patient and his treating doctors(GP and hospital doctors) then MHR is worth having.

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