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Overseas implementation example—the United Kingdom Personal Demographic Service (PDS) with information on over 48 million health consumers has been in the process of implementation in the United Kingdom since July 2004. The PDS will replace a number of locally held data bases in the various National Health Service (NHS) regions. Each person's PDS care record comprises demographic information, such as name, address, date of birth and NHS number as well as medical information. The PDS does not hold any clinical health information or sensitive data such as ethnicity or religion. The PDS includes information governance controls protecting patient information, such as registration and authentication processes to identify actions taken by particular healthcare professionals, controls on the information available to healthcare professionals and privacy controls to check who has accessed or amended patient records. The level of access to patient records is determined by the role an NHS staff member has in dealing with patients—for example, a consultant is able to see more information than a medical receptionist. There are logs kept of those who access patient care records. These show who has accessed the records and what they added or changed. Patients can ask to see this information. It is expected that eventually patients will be able to check their own details through a secure NHS web service. Disciplinary action can be taken for unauthorised access to patient information. This can include criminal action under the United Kingdom Data Protection Act or civil action for breaches of confidentiality.[52] |
NEHTA has noted a number of benefits of a national e-health system:
On the other hand, as the National Electronic Health Records Taskforce has pointed out, there are a number of risks that have to be recognised and appropriate counter measures put in place to manage those risks within acceptable limits.
These risks include:
The Taskforce considered that strict criteria for counter measures needed to be in place to ensure these problems would not eventuate. These included:
The Healthcare Identifiers Service which will implement the system of healthcare identifiers is to be funded to 30 June 2012 as part of $218 million allocated by the Council of Australian Governments to NEHTA in November 2008.[55] Under the National Partnership Agreement on E-Health, funding is contributed to by the Commonwealth, state and territory governments.[56]
NEHTA has allocated $52.02 million to fund the operation of the Healthcare Identifiers Service by Medicare Australia for 2010–11 and 2011–12.[57]
In addition, the Commonwealth has provided funding of $0.5 million for 2010–11 and 2011–12 to the Office of the Privacy Commissioner to provide regulatory oversight and advice on the introduction of healthcare identifiers.
Funding for the Healthcare Identifiers Service from 30 June 2012 will be determined through discussion between the Commonwealth, states and territories.
There are seven parts to this Bill.
Part 1 of the Bill (clauses 1–4) contains preliminary information relating to the title of the Act to be enacted, commencement and the purpose of the Act. Clause 4 provides that the Act will bind the Crown in right of Commonwealth and the states and territories, but and they will not be liable to prosecution for any offence under the Act.
Clause 5 lists definitions of terminology used in the Bill. Key definitions used are:
healthcare: means health service within the meaning of subsection 6(1) of the Privacy Act 1988.
healthcare identifier has the meaning given by section 9 of the Bill (see below).
healthcare provider means:
(a) an individual who:
(i) has provided, provides, or is to provide, healthcare or
(ii) is registered by a registration authority as a member of a particular health profession or
(b) an entity, or a part of an entity, that has conducted, conducts, or will conduct, an enterprise that provides healthcare (including healthcare provided free of charge).
healthcare recipient means an individual who has received, receives, or may receive, healthcare.
health information has the meaning given by subsection 6(1) of the Privacy Act 1988.
Clause 6 defines the Chief Executive Officer of Medicare Australia as the (Healthcare Identifiers) service operator, but allows that alternative operator can be specified in the regulations. Clause 33 requires the Minister to consult with the Ministerial council before the regulations are made by the Governor General under clause 39.
Clause 7 defines the information which will be required by the service operator in order to assign and maintain healthcare identifiers to healthcare providers and individual healthcare recipients. Personal information, such as name, address, gender and date of birth will be required for individuals. Name, address and CAN, ABN and other information as prescribed in the regulations will be required by healthcare providers. Other information, such as a Medicare number may be required.
Clause 8 describes a national registration authority as one prescribed in the regulations.
Part 2 (Clauses 9 and 10) provides information on assigning healthcare identifiers. Sub clause 9(1) will authorise the service operator to assign a unique healthcare identifier number to a healthcare provider (as prescribed in the regulations), or to an individual. The service operator will determine whether to assign an identifier (Subclause 9(4)) irrespective of the wishes of the potential assignee.
As the Explanatory Memorandum to the Bill notes, from July 2010 a national scheme will be established for the registration of health professionals in ten professions.[58] These national registration bodies will be able to, under certain circumstances, assign healthcare identifiers to individual healthcare providers under subclause 9(2). Individual health care provider identifiers for health care providers who are not included in the national registration and accreditation scheme will be provided by the service operator subject to the individual providers meeting criteria set out in the regulation and to their providing identifying information as set out in clause 7(1).[59]
Subclause 9(3) will provide that health care identifiers will be able to be assigned to individual healthcare providers, enterprises that provide health care and to individuals. The regulations may provide requirements for assigning healthcare identifiers (Subclause 9(5)).
Subclause 9(6) will provide that health care identifiers are subject to the National Privacy Principle 7.[60] This principle provides that a private organisation must not adopt as its own an identifier of an individual that has been assigned by the Commonwealth Government.
Clause 10 will require the service operator to establish and maintain an accurate record of assigned healthcare identifiers and information relating to those identifiers, including requests made to disclose those identifiers (under Division 2 of Part 3).
Part 3 refers to proposals for the use and disclosure of healthcare identifiers and other information. This part provides for limited authorisation for private organisations to use and disclose healthcare identifiers.
Division 1 - Use and disclosure of identifying information for assignment of healthcare identifiers
Clauses 11–15 refer to use and disclosure of identifying information for assignment of healthcare identifiers by healthcare providers, data sources and national registration authorities.
Subclauses 11(1) and (2) will authorise a healthcare provider to disclose identifying information about an individual healthcare recipient to the service operator for the purpose of assigning a healthcare identifier to the individual. The service operator will be authorised to collect the information and use it for assigning an identifier.
Subclauses 12(1) and (2) will authorise a data source (Medicare Australia, the Veteran Affairs’ Department or an entity prescribed by the regulations) to disclose identifying information it holds about an individual healthcare recipient or healthcare provider for the purpose of assigning a healthcare identifier. The service operator will be authorised to collect the information and use it for this purpose.
Subclauses 13(1) and (2) will authorise a national registration authority to disclose a health care identifier or information relating to a healthcare identifier to the service operator for the purpose of establishing or maintaining the healthcare identifiers record referred to in Clause 10.
Clause 14 enables the making of regulations to require healthcare providers to provide the service operator with up-to-date information about themselves.
Clause 15(1) provides that a person commits an offence if the person, without appropriate authorisation, discloses or uses information collected under Part 2 or Division 1 of Part 3. The penalty is two years or 120 penalty units ($13 200) or both. A body corporate may be subject to a fine of up to 600 penalty units ($66 000). Subclause 15(3) is similar and relates to a person who acquires information in contravention of subsection 15(1) and uses and discloses the information.
Division 2 - Disclosure of healthcare identifier by service operator
Subdivision A
Clause 16 will authorise a healthcare provider to disclose identifying information about a healthcare recipient to the service operator to obtain the recipient’s healthcare identifier.
Subdivision B
The service operator will be authorised to disclose healthcare identifiers to an identified healthcare provider or an authorised employee of such a provider. The health care provider must notify the service operator about which employees are so authorised. The healthcare provider or authorised employee will be authorised to collect the healthcare identifier information (Clause 17).
Clauses 18 will require the service operator to disclose to the healthcare recipient (or the person responsible for the healthcare recipient under subclause 2.5 of National Privacy Principle 2) the person’s healthcare identifier or information that relates to the person and which is included in the service operator’s record maintained under section (clause) 10.
The service operator will be authorised under clause 19 to disclose a healthcare provider’s healthcare identifier to a registration authority so that the authority may register the provider.
Clause 20 will authorise the service operator to disclose a health care provider’s identifier to an entity to enable the provider’s identity to be confirmed in electronic transmissions.
Clauses 21 and 22 allow for the regulations to prescribe rules about the disclosure of healthcare identifiers by the service operator, and to require an entity to which information has been disclosed to provide certain information relevant to that disclosure to be made to the service operator. The regulations may provide for the imposition of a penalty of up to 50 penalty units ($5 500) for contravention of a regulation.
Division 3 - Use, disclosure and adoption of healthcare identifier by a health care provider
Clause 23 will authorise a healthcare provider to disclose a healthcare recipient healthcare identifier to the recipient or to a person responsible for the recipient.
Clause 24 sets out the proposed terms for disclosure and other uses.
Paragraph 24(1)(a) sets out the proposed permitted uses and disclosures of healthcare identifiers by healthcare providers for the purpose of communication or management of information as part of:
Paragraph 24(1)(b) authorises a healthcare provider to use or disclose healthcare identifiers if the provider reasonably believes it is necessary to lessen or prevent a serious threat to an individual’s life, health or safety or a serious threat to public health or public safety.
As the Explanatory Memorandum notes, ‘express authority permitting a healthcare provider to use or disclose healthcare identifiers is necessary in light of the restrictions under National Privacy Principle 7 of the Privacy Act on private sector organisations using and disclosing Commonwealth government assigned identifiers’.[61] A note to the clause indicates that Division 3 does not apply to personal health information other than that specified. Collection, use, disclosure or adoption of other personal information is dealt with in other legislation.
Subclause 24(2) provides that where a healthcare provider discloses a healthcare identifier to another entity for a purpose defined by subclause 24(1), the entity is authorised to collect, use or disclose it to a healthcare provider for the purpose for which it was disclosed to the entity.
Subclause 24(4) provides that a healthcare identifier cannot be used by an insurer to underwrite health insurance or determine eligibility or cover level for health insurance or for the purpose of employment.
Clause 25 will provide for healthcare providers to adopt an identifier of a healthcare recipient as their identifier to that healthcare recipient. As the Explanatory Memorandum points out, this authority is needed because of the prohibition under National Privacy Principle 7 of the Privacy Act that prevents private sector organisations adopting Commonwealth government assigned identifiers.
Division 4 - Unauthorised use and disclosure of healthcare identifiers
Clause 26 sets out offences and penalties proposed for the unauthorised use and disclosure of healthcare identifiers. Subclause 26(1) will make it an offence if a healthcare identifier is disclosed to a person and that person uses or discloses the healthcare identifier. The penalty for this offence as committed by an individual is a fine of 120 penalty units, imprisonment for two years or both. If the offence is committed by a corporation, a fine of 600 penalty units will apply.
Under Subclause 26(2) this penalty will not apply if a person is authorised to use or disclose the healthcare identifier and the use and disclosure is in accordance with the purposes defined in subclause 24(1), the use or disclosure is authorised under another law, or the person discloses the healthcare identifier for the purpose of, or in connection with, the person’s personal, family or household affairs (within the meaning of section 16E of the Privacy Act 1988).
Division 5 - Protection of Healthcare Identifiers
Clause 27 proposes that an entity holding a healthcare identifier must protect it from misuse, loss, unauthorised access, modification or disclosure. Additional requirements may be imposed under regulations.
Clause 28 proposes that an authorisation to collect, use or disclose a healthcare identifier under this legislation will also be considered an authorisation for the same purpose under the Privacy Act 1988.
Under subclause 29(1), an act or practice which contravenes the legislation or regulations (once enacted) will be considered as a breach of privacy under the Privacy Act 1988.
Subclause 29(3) will allow the Privacy Commissioner to undertake audits of healthcare identifiers under the Privacy Act in relation to personal information.
The Privacy Commissioner will be required to prepare an annual report on compliance and enforcement activities undertaken in relation to the Healthcare Identifiers Service. A copy of the report must be provided to the Ministerial Council by 30 September of each year clause 30). A copy of the report must be tabled in each House of parliament within 15 days sitting days after the report is submitted to the Minister.
Subclause 31(1) will require the service operator to establish and maintain a Healthcare Provider Directory. This will detail the professional and business details of healthcare providers who have consented to having these details included in the Directory.
Under subclause 31(2) the service operator will be able to disclose details from the Healthcare Provider Directory to other participating healthcare providers or employees, authorised to act on the healthcare provider’s behalf.
The Explanatory Memorandum cites the establishment of the Healthcare Provider Directory as a key benefit of the Healthcare Identifiers Service as it aims to improve communication between healthcare providers by providing ‘a reliable source of identifying and contact information about other participating healthcare providers’.[62]
This part proposes that the responsible Minister in consultation with the Ministerial Council is able to issue written directions by legislative instrument to the service operator in relation to the operation of the Healthcare Identifiers Service (clause 32). Under the proposed clause 33 the Minister responsible will be required to consult with the Ministerial Council prior to the Governor General making regulations.
Clause 34 will require the service operator to prepare an annual report and to provide that report no later than 30 September each year. The Minister must table the report in Parliament within 15 sitting days after the service operator has submitted it to the Minister. A review of the operation of the legislation within three years is proposed under clause 35.
The Explanatory Memorandum explains that a review will be required to provide necessary regulatory support to enable the Healthcare Identifiers Service to operate efficiently and effectively and to assess Medicare Australia’s role as the service operator.
It also notes that requiring consultation with the Ministerial Council recognises the important role states and territories play in managing the operation of the Healthcare Identifiers Service to ensure it appropriately supports the needs of national public health policy.[63]
Clause 36 proposes that the authorisation for a particular purpose which applies to an entity under this Bill applies to a person employed by the entity. This would be subject to the requirement under clause 17 of the legislation.
Relationship to state and territory laws
Under subclause 37(1) it is proposed that laws of the states and territories will operate concurrently with the healthcare identifiers legislation to the extent to which those laws are ‘capable’ of doing so. The Government considers this will allow existing privacy arrangements in the states and territories to continue to operate if they do not conflict with the provisions of the Bill. If an offence under this legislation is also an offence under state and territory law then a person will only be able to be convicted of one of the offences (subclause 37(2)).
Subclause 37(3) will ensure that nothing in this Bill (once enacted) limits, restricts or otherwise affects any right or remedy a person would have had if this Act had not been enacted.
Under subclause 37(4) if the Minister responsible for the administration of the health identifiers legislation makes a declaration relating to specific provisions and specified public bodies of a state or territory under subclause 37(5), the provisions referred to will not apply to those authorities.
Subclause 37(5) will oblige the Minister to declare that certain provisions of this Bill will not apply to relevant state or territory public bodies if both a state of territory Minister requests such a declaration in writing, and the Minister is satisfied that an appropriate law is in force in that state or territory that has provisions that have been agreed by the Ministerial Council.
Subclause 37(6) will oblige the Minister to revoke a declaration made under subclause 37(4) where a Minister of a state or territory makes a request or where a state or territory law previously agreed to by the Ministerial Council is amended without their agreement.
Under subclause 37(7) neither section 42 (disallowance) nor Part 6 (sunsetting) of the Legislative Instruments Act 2003 will apply to a declaration or revocation made under subclauses 37(5) and 37 (6).
Clause 38
Severability – additional effect of Parts 3 and 4
Clause 38 will provide that the legislation ‘is given the widest possible operation consistent with Commonwealth constitutional legislative power’.[64] Subclause 38(1) proposes that without limiting the effect of the Act, Parts 3 and 4 will also have the effect as provided by subclauses 38(2) to 38(10) relying on different elements of Commonwealth power.
Clause 39 – Regulations
Subclause 39(1) will provide that the Governor-General is able to make regulations which may be required, necessary or convenient for the operation of, or giving effect to, the Bill
(once enacted). Consultation with the Ministerial Council will be required prior to the making of such regulations. Regulations will be able to be made in relation to a number of areas.
Subclause 39(2) proposes that regulations may provide for the imposition of a penalty for not more than 50 units ($550).
There appears to be general agreement that e-health has the potential to improve the delivery of healthcare for consumers and healthcare providers alike. Healthcare Identifiers have been recognised as a fundamental part of the national infrastructure required to deliver secure electronic communications across the health system.
Concerns have been raised, however, that patient privacy will be compromised by technology. Consumer groups in particular have been critical of identifiers because they believe these will be misused and the privacy of individuals will be breached from the onset. Additionally, they consider there is the possibility that in the future, the identifiers may be used for purposes other that healthcare. It is of particular concern also for these groups that the legislation will be in place before it is clear how the Privacy Act 1988 will be updated to address the impact of electronic technologies on the privacy of individuals
While this Bill appears to make serious attempts to address these issues, critics are not fully satisfied that the proposed legislation is sufficiently rigorous to ensure there are no adverse consequences for health consumers. Supporters of the legislation on the other hand, are convinced that the introduction of healthcare identifiers is indeed a first and vital step towards creating a safer health system which ensures that ‘the right people have access to the right information at the right time’.[65]
Members, Senators and Parliamentary staff can obtain further information from the Parliamentary Library on (02) 6277 2429.
[1]. House of Representatives Standing Committee on Family and Community Affairs, Health on line: a report on health information management and telemedicine, Australian Government Publishing Service (AGPS), Canberra, 1997, pp. 90–92, viewed 12 February 2010, http://www.aph.gov.au/house/committee/fca/tmreport.pdf
[2]. National Health Information Management Advisory Council (NHIMAC), Health Online: a health information action plan for Australia, NHIMAC, 1999. Not available online. Revised version 2001, viewed 12 February 2010, http://www.health.gov.au/internet/hconnect/publishing.nsf/content/7746b10691fa666cca257128007b7eaf/$file/actplan2.pdf
[3]. National Electronic Health Records Taskforce, A health information network for Australia: report to Health Ministers by the National Electronic Health Records Taskforce, July 2000, viewed 12 February 2010, http://www.health.gov.au/internet/hconnect/publishing.nsf/Content/7746B10691FA666CCA257128007B7EAF/$File/ehrrept.pdf
[4]. Ibid.
[5]. T Abbott (Minister for Health and Ageing), Medicare smartcard launched, media release, 28 July 2004, viewed 16 February 2010, http://parlinfo/parlInfo/download/media/pressrel/SX9D6/upload_binary/sx9d62.pdf;fileType=application/pdf#search=%22medicare%20smartcard%20launched%22 and Medicare Australia, Medicare smartcard brochure, May 2005.
[6]. Archived website for HealthConnect, information on National E-Health Transition Authority (NEHTA) website, viewed 15 February 2010, http://www.health.gov.au/internet/hconnect/publishing.nsf/Content/nehta-1lp
[7]. The Commonwealth and the states and territories contributed on a 50/50 basis to this funding.
[8]. Senate Community Affairs Committee, Answers to Estimates Question on Notice, Health and Ageing Portfolio, Supplementary Budget Estimates 2009–2010, 21 October 2009, Question: E09–244.
[9]. N Roxon (Minister for Health and Ageing), and J Ludwig (Minister for Human Services), Federal-state collaboration advances electronic health agenda, joint media release, 12 January 2008, viewed 15 February 2010, http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr08-nr-nr006.htm?OpenDocument&yr=2008&mth=1
[10]. Ibid.
[11]. R LeMai, ‘Too much haste not good for e-health’, MIS Financial Review, 15 February 2008, viewed 15 February 2010, http://www.misaustralia.com/viewer.aspx?EDP://20080215000020304888
[12]. Deloitte, National E-Health and Information Principal Committee, National E-Health Strategy, 2008, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/604CF066BE48789DCA25751D000C15C7/$File/National%20eHealth%20Strategy%20final.pdf
[13]. Australian Institute of Health and Welfare findings in Australia’s Health 2002, which cite statistics as quoted in Deloitte, National e-health strategy, op. cit.
[14]. Deloitte, National e-health strategy, op. cit.
[15]. Ibid.
[16]. National Health and Hospitals Reform Commission (NHHRC), A healthier future for all Australians, final report, June 2009, viewed 15 February 2010, http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/1AFDEAF1FB76A1D8CA257600000B5BE2/$File/Final_Report_of_the%20nhhrc_June_2009.pdf
[17]. Ibid.
[18]. Ibid.
[19]. S Mitchell, ‘Privacy warning on Medicare smartcard’, The Australian, 22 November 2005, p. 2, viewed 15 February 2010, http://parlinfo/parlInfo/download/media/pressclp/2W0I6/upload_binary/2w0i64.pdf;fileType=application/pdf#search=%22privacy%20warning%20on%20Medicare%20smartcard%22
[20]. Australian Health Ministers’ Conference, First step taken towards national e-health system, media release, 13 July 2009, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/pacd-ehealth-consultation/$File/AHMC%20-%20out%20of%20session%20eHealth%20communique%2013%20July%2009%20FINAL.pdf
[21]. Australian Health Ministers’ Advisory Council, Healthcare identifiers and privacy: discussion paper on proposals for legislative support, July 2009, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/pacd-ehealth-consultation/$File/Typeset%20discussion%20paper%20-%20public%20release%20version%20070709.pdf
[22]. Office of the Privacy Commissioner, Healthcare identifiers and privacy: Discussion paper on proposals for legislative support, submission to the Australian Health Ministers’ Conference, August 2009, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/eHealth-061
[23]. Ibid.
[24]. Consumers Health Forum of Australia (CHF), CHF Submission on the Healthcare identifiers and privacy: discussion paper on proposal for legislative support, August 2009, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/eHealth-030/$FILE/030_Consumers%20Health%20Forum%20of%20Australia%20pt%201_14-08-09.pdf
[25]. Australian Privacy Foundation (APF), APF response to AHMAC paper: Healthcare Identifiers and privacy: discussion paper on proposals for legislative support, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/eHealth-018/$FILE/018_Australian%20Privacy%20Foundation_03-08-09.pdf
[26]. Australian Health Ministers’ Conference, Communique, 13 November 2009, viewed 15 February 2010, http://www.ahmac.gov.au/site/media_releases.aspx
[27]. Exposure draft, Healthcare Identifiers Bill 2010, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/E7C1554B9FBFB924CA25768400812AAF/$File/Exposure%20Draft.pdf
[28]. Australian Privacy Foundation, submission to Exposure draft, Healthcare Identifiers Bill, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/eHealth2-044/$FILE/044_Australian%20Privacy%20Foundation_07-01-10.pdf
[29]. Australasian College of Health Informatics, Response to request for comment on the draft health identifier legislation, January 2010, viewed 15 February 2010, http://www.health.gov.au/internet/main/publishing.nsf/Content/eHealth2-045/$FILE/045_The%20Australasian%20College%20of%20Health%20Informatics_07-01-10.pdf
[30]. K Dearne, ‘E-health logjam frustrates health providers’, The Australian, 9 September 2008, p.27, viewed 19 February 2010, http://parlinfo/parlInfo/download/media/pressclp/ETHR6/upload_binary/ethr60.pdf;fileType%3Dapplication%2Fpdf
[31]. Reference to report by R Viellaris, ‘Health ID cover-up for some exposes risks’, The Courier Mail , 20 January 2010 and ABC Radio morning program, 20 January 2010, presenter Madonna King in letter from Australian Privacy Foundation Chair, Health Sub Committee, Dr J Fernando, to Minister for Health and Ageing, viewed 19 February 2010, http://www.privacy.org.au/Papers/Roxon-HI-100122.pdf
[32]. Letter to the Australian Privacy Foundation from Liz Forman, Assistant Secretary, eHealth Branch, Department of Health and Ageing, on behalf of Minister for Health and Ageing, 9 February 2010, viewed 19 February 2010, http://www.privacy.org.au/Papers/RoxonResponse-100209.pdf
[33]. Letter from Australian Privacy Foundation Chair, Health Sub Committee, Dr J Fernando, to Liz Forman, Assistant Secretary, eHealth Branch, Department of Health and Ageing, 12 February 2010, viewed 19 February 2010, http://www.privacy.org.au/Papers/Hlth-PatientAccess-100212.pdf
[34]. T Warner, Is the e-Health initiative healthy? Victorian Council for Civil Liberties, Liberty website, viewed 19 February 2010, http://www.libertyvictoria.org/node/134
[35]. Ibid.
[36]. Ibid.
[37]. K Dearne, ‘Compromised confidentiality’, The Weekend Australian, 13 February 2010, p. 12, viewed 15 February 2010, http://parlinfo.aph.gov.au/parlInfo/search/display/display.w3p;query=Id%3A%22media%2Fpressclp%2FL0WV6%22
[38]. Ibid.
[39]. Quoted in S Dunleavy, ‘Health number ID for all: patients have no choice’, The Daily Telegraph, 17 February 2010 p.11, viewed 19 February 2010, http://parlinfo/parlInfo/download/media/pressclp/04XV6/upload_binary/04xv60.pdf;fileType=application/pdf#search=%22health%20number%20id%20for%20all%22
[40]. Dunleavy, ‘Health number ID’, op. cit
[41]. Ibid.
[42]. D Pauli, e-health news sparks more criticism, Computerworld website, 21 January 2010 viewed 19 February 2010, http://www.computerworld.com.au/article/333262/e-health_news_sparks_more_criticism/
[43]. Ibid.
[44]. T Shepherd, ‘No privacy: expert claims health records can’t be kept secret’, The Adelaide Advertiser, 19 January 2010, p. 1, viewed 19 February 2010, http://parlinfo/parlInfo/download/media/pressclp/9BOV6/upload_binary/9bov60.pdf;fileType=application/pdf#search=%22no%20privacy%22
[45]. Pauli, op. cit.
[46]. K Dearne, ‘State plans to build on patient identifier on imaging, radiology’, The Australian, 9 February 2010, p. 29, viewed 19 February 2010, http://parlinfo/parlInfo/download/media/pressclp/AHUV6/upload_binary/ahuv60.pdf;fileType=application/pdf#search=%22state%20plans%20to%20build%20on%20patient%20identifier%20on%20imaging,%20radiology%22
[47]. Royal Australian College of General Practitioners (RACGP), College of GPs welcomes new step for e-health, media release, 10 February 2010, viewed 19 February 2010, http://www.racgp.org.au/media2010/36073
[48]. Ibid.
[49]. J Bajkowski, ‘Privacy push for e-health data’, The Australian Financial Review, 9 February 2010, p. 31, viewed 19 February 2010, http://parlinfo/parlInfo/download/media/pressclp/LDUV6/upload_binary/lduv60.pdf;fileType=application/pdf#search=%22Privacy%20push%20for%20e-health%20data%22
[50]. R Bolton, ‘Electronic health system on sick list’, The Australian Financial Review, 2 February 2010, p. 1, viewed 19 February 2010, http://parlinfo/parlInfo/download/media/pressclp/70SV6/upload_binary/70sv60.pdf;fileType=application/pdf#search=%22Electronic%20health%20system%20on%20sick%20list%22
[51]. Ovum research, National e-health strategy progress in Australia, report cited in Bolton, op. cit. Report is not publicly available.
[52]. More information is available on the Personal Demographics Service on the National Health Service website, viewed 22 February 2010, http://www.connectingforhealth.nhs.uk/systemsandservices/demographics/pds
[53]. NEHTA Strategic Plan, 2009–2012, viewed 19 February 2010, http://www.nehta.gov.au/about-us/strategy
[54]. National Electronic Health Records Taskforce, A health information network for Australia, op. cit.
[55]. Council of Australian Governments’ Meeting, 29 November 2008, Outcomes, Attachment A, Health and Ageing, viewed 12 February 2010, http://www.coag.gov.au/coag_meeting_outcomes/2008-11-29/attachments.cfm
[56]. That is, the Commonwealth contributes just over 40 per cent and the states and territories contribute on a proportional basis, the remaining funding. Council of Australian Governments (COAG), National partnership agreement on e-health, viewed 12 February 2010, http://www.coag.gov.au/coag_meeting_outcomes/2009-12-07/docs/npa_e-health.pdf
[57]. Funding will be $26.01million in both financial years. Explanatory Memorandum, Healthcare Identifiers Bill 2010 and Healthcare Identifiers (Consequential Amendments) Bill 2010, viewed 12 February 2010, http://parlinfo.aph.gov.au/parlInfo/download/legislation/ems/r4299_ems_b3f370a9-21fa-4d53-a227-65c1fcaad5df/upload_pdf/339202.pdf;fileType=application%2Fpdf
[58]. The professions are: medical, nursing and midwifery, pharmacy, physiotherapy, dental, psychology, optometry, osteopathy and chiropractic. A further four professions—Aboriginal and Torres Strait Islander health practice, Chinese medicine, medical radiation practice, occupational therapy are expected to be added to the scheme in 2012 and other professions may be added in the future. Explanatory Memorandum, p. 10. See also the Intergovernmental agreement for a national registration and accreditation scheme for the health professions, signed 26 March 2008 , viewed 16 February 2010, http://www.nhwt.gov.au/documents/National%20Registration%20and%20Accreditation/NATREG%20-%20Intergovernmental%20Agreement.pdf .
[59]. Explanatory Memorandum, p. 11.
[60]. The National Privacy Principles can be found in Schedule 3 of the Privacy Act 1988, viewed 16 February 2010, http://www.austlii.edu.au/au/legis/cth/consol_act/pa1988108/sch3.html
[61]. Explanatory Memorandum, p. 18.
[62]. Ibid., p. 21.
[63]. Ibid., p. 23.
[64]. Ibid., p. 24.
[65]. N Roxon, ‘Second reading speech: Healthcare Identifiers Bill 2010’, House of Representatives, Debates, 10 February 2010, pp. 3–5, viewed 22 February 2010, http://parlinfo/parlInfo/genpdf/chamber/hansardr/2010-02-10/0013/hansard_frag.pdf;fileType=application/pdf
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