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Issue #1849      November 21, 2018

My Health Record

As the profits churn

The My Health Record (MHR) website crashed and its telephone lines were in melt-down in the lead-up to the November 15 deadline for opting out of the system. As more and more information becomes available about MHR and its likely uses and security risks, the number of people seeking to opt out has increased.

Under immense public pressure, the government agreed to an extension of the opt-out deadline to January 31, 2019. The two-and-a-half month extension, which runs over the Christmas/holiday shutdown, was supported by a number of cross-benchers.

It falls far short of the 12-month extension recommended by the Senate Community Affairs Reference Committee’s report on the MHR and being called for by various medical, privacy, political and other organisations. It is far too short a time.

The Communist Party of Australia recommends opting-out as it is always possible to opt-in at a later date. Once in, it will be possible to opt-out, but the data in the system will not be destroyed.

According to Health Minister Greg Hunt, more than six million people already had a My Health Record and over 14,000 healthcare professional organisations were connected. These included general practices, hospitals, pharmacies, diagnostic imaging and pathology practices.

The privacy risks have been well debated. Serious breaches are inevitable. The Office of the Australian Information Commissioner – which is the independent regulator of the privacy aspects of the system – in a recent submission to a Senate inquiry reported nearly 100 breaches. Asked how this fitted with Hunt’s statement, his office said these were either Medicare breaches or breaches where human error was involved – they were not cyber attacks on the platform.

By October 19, more than one million Australians had opted out.

Cannot be trusted

Some of the amendments to the legislation on the MHR system are still before Parliament and Health Minister Greg Hunt has signalled that more are to come. It is an evolving system.

The scheme was launched under the Labor government in 2012 as the Personally Controlled Electronic Health Record. Towards the end of 2015, a Coalition Health Minister quietly presented legislation to rebadge e-health as MyHealth and to change the system from opt-in to opt-out

We already have a punitive social security system which seeks to control how recipients spend their income with the basics card and penalties for substance use. There is the possibility of the government withholding payments from people whose medical records reveal substance abuse or other “undeserving” behaviour such as allegedly related to sexual activity.

The promise was that it would only ever be an opt-in system. That means that anyone joining it, with the exception of minors, would be giving their permission, making a conscious decision and hopefully a well-informed one.

But there are no such things as guarantees when it comes to legislation. Laws can and are changed. Promises are made and broken. In the case of MHR, Labor made the original commitment that it would always be an opt-in system, and the Australian Greens supported changing it to an opt-out system in 2015.

The scheme collects information on people’s health in a national data base. The concept that such data could be accessed by health professionals is good in theory. In medical emergencies, for example, having access to details of medications or medial conditions could save lives.

But, in practice, access and use will be much wider, extending far beyond medical purposes. Serious doubts have also been raised about the accuracy and usefulness of MHRs with GPs not willing to spend the time updating them, MRI scans not being recorded, but rather an individual’s report on them, and so on.

The government is also keeping quiet on such important questions of access by intelligence agencies, military, police and other non-health related outfits.

Private sector interests

The private health, travel and life insurance companies are lobbying hard for access. At present the government says they will not be given access. But for how long? It would be like gold to them to be able to rate people’s risk based on such personal data.

The person responsible for designing MHR also set up the British version which was almost identical to Australia’s version. It had to be abandoned in 2016 when the on-selling of personal data to pharmaceutical and insurance companies became known publicly.

The Australian Digital Health Agency (ADHA) is responsible for the delivery of digital healthcare systems and the national digital health strategy for Australia. It is a statutory authority in the form of a corporate Commonwealth entity, set up by the Coalition and commenced operations in July 2016.

Fairfax media have revealed that its chairman, Jim Birch, has been privately advising a global healthcare outsourcing company Serco, a fact not listed on his curriculum vitae on ADHA’s website. Serco is a UK-based global corporation with numerous contracts for health and other services with government agencies.

The Herald discovered this after obtaining internal documents through Freedom of Information that detail Birch’s conflicts of interest. He has since officially resigned from his advisory role to Serco.

Another director, Rob Bransby, has held a full-time role as managing director of the private health insurer HBF, since 2008. In all he spent 12 years at HBF. He is also the immediate past-President of the private health industry lobby group, Private Healthcare Australia.

Privatisation

There is also the real danger that the government will privatise the management of the centralised data system for recording medical information. Then there will be no control, no accountability or transparency as to how that data is used or on-sold.

The government previously called for tenders for the privatisation of the management of the Medicare, Pharmaceutical Benefits Scheme and aged care payments systems. It was forced to pull back when this became public, but it has not abandoned its privatisation agenda.

MHR is not about improving health outcomes, but about new avenues of profit-churning for private operators.

Next article – Editorial – The return of colonialism

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