My one-page submission to the Senate Inquiry into the draft NHPA Bill suggests that “transparency, a principal aim of the Bill, will be enhanced if the major financial interests of NHPA members are published where they can be seen, on an accessible website.” The reasoning was that an agency with the power to call health-care operators to book, without the say-so of the Minister or the Secretary, would need a Chief Executive of a pay-grade sufficient to stand up and question the status quo on behalf of the taxpayer. Such a Chief would have to be beyond reproach, especially in current and past dealings with elements of the health-care industry. Since most high-level actors in the health-care field have had to exist in ethical relationships with the industry, it seems the best way to management potential conflicts is by open disclosure.

The Committee has supplied answers to questions arising from submissions, including one regarding my suggestion. The answer to Question 14 is “The National Health Performance Authority will not be involved in determining government expenditure on health services and will not be involved in the purchase or provision of improved drugs or services. The requirements to disclose interests to the minister and the authority, and for a member to not be present or take part in any discussion or decisions in which a member has an interest, and for this to be minuted, are thought to be sufficient.”

The supplied answer to another Question (13) states, in part “The availability of mechanisms for ministerial oversight is fairly standard across agencies established under the Financial Management and Accountability Act 1997 (the FMA Act).”

The FMA Act says nothing about management of conflicts of interest, so where do Ministers find their guidance in this important matter?

By those answers to Questions on Notice, it seems this Authority will not have the robust independence of the ACCC or the Productivity Commission. Why, then, does it need to be glorified with a Bill of its’ own? Why not park it behind another desk in the corridors of the existing bureaucracy and save the expense?

As he has noted, that integration cannot occur until the privacy laws are reformed. The various public and private operators will not be able to exchange data unless all agree to a unified set of privacy principles. Judging by the painfully slow progress to date, we are years away from that aim. While the Senate quibbles over definitions, more children will suffer.

At least, we know that Mr Hockey has his heart in the right place.

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(not published, see TheOz)

As much as innovation drives advances in care across that spectrum, and private enterprise holds the keys, it is essential that governments act to negotiate the inevitable conflicts. New, national legislation is needed to ensure the same standards of privacy protection apply across the whole of society. Private providers need that assurance, but they cannot have it until the Gillard government gets on its skates and enacts a new set of laws, the Australian Privacy Principles.

While there are two sets of privacy laws, one each for public and private spheres, no-one should expect any worthwhile advance in health information technology.

We ought, also, look at the Productivity Commission’s recommendations for aged care. The key driver for better in-home care will be competition between providers. Again, those essential improvements will not be possible without unification of the nation’s privacy rules.

But, let’s step down into the heat of the kitchen. In NSW, the job of the Chief Information Officer was to consolidate over one hundred disparate IT systems across that State. For instance, there were (are?) fifty different payroll systems. Sure, some doctors would love to practice their crafts remotely via a telemedicine hook-up, but they will get very irritated if they don’t get paid, as happened in QLD.

So, in asking about the status of the national IT plan, and its’ prospects for the future of health care, we need to know what is happening to core IT systems in NSW. Their CIO, Emmanuel Rodriguez, has announced he is moving on. Perhaps he has given a confidential briefing to Nicola Roxon.

It’s a mistake to piggy-back the national Health IT reforms onto the NBN without taking account of necessary rationalisations of State IT systems.