Patient privacy kaput

April 17, 2009 at 3:00 am Leave a comment

Forget the European Union snooping on emails, text messages and web page visits, Australia is giving the EU a run for its money with a Big Brother proposal. The Federal Government is tightening its Medicare scheme to curb breaches of the Medicare system by medical practitioners.  Nothing wrong with this but if it threatens patient record security or the right to patient privacy, then I see a problem.

As often happens when Governments want to sneak in controversial legislation, they introduce it on a Friday night or better yet the day before Easter Friday. That’s what happened last week – an exposure draft of legislation known as the Health Insurance Amendment (Compliance) Bill 2009 was released to stakeholders for review.

Let me cut to the chase here – this draft legislation basically abolishes patient privacy. It will give the Australian Federal Government the following powers:

  • under section 7 Health information: “The power ….. to require a document, extract or copy to be produced includes the power to require the production of a document, extract or copy containing health information (within the meaning of the Privacy Act 1988) about an individual”;
  • compel doctors and medical providers to hand over patient files to justify Medicare claims;
  • under the draft legislation, it seems that patients do not need to be informed that their medical records are being accessed.

Now, the astute amongst would immediately sniff a few things here:

  • potentially very sensitive information could be handed over to bureaucrats. Details of a patient’s sexual history, overall health, test results, mental health and so on.
  • I can imagine bureaucrats, in order to justify a doctor’s claim, will ask all sorts of probing questions like why a test was ordered or whether a pre-existing condition was known. Information that a private patient doesn’t really want Government snoops to know about.
  • I think it will prompt many people to go to doctors under a false name or be reluctant to confide to doctors their most intimate or personal details, thereby potentially endangering patient health. I know I will be thinking twice about what I say and how much I provide next time I see a medical practitioner.
  • it is not the business of Government to interfere with a doctor/patient relationship. The Hippocratic Oath a doctor takes bestows a professional duty of confidentiality on a doctor. It provides for an even relationship – the patient feels safe in entrusting confidential information to a doctor and the doctor is professionally bound to keep the doctor/patient relationship confidential.  So is the Federal Government asking doctors to break their Hippocratic Oath?  From reading the draft legislation, it seems it is all about the Government, its processes and saving AU$70.3 million. Forget doctor/patient confidentiality!!!
  • Why is the patient not asked for consent first? It is very Big Brother for a Government to be able to demand of a medical practitioner that a patient’s file be handed over without the patient even knowing that his or her personal medical history is be disclosed and why.
  • Will bureaucrats even understand doctor’s notes and scribbles?

The President of the Australian Medical Association is aghast and says:

“It is remarkable that a government should take such a step as to violate your personal medical record. This is ‘Big Brother’ at its worst”.

And adds: “This is an act of bureaucratic voyeurism that strips patients of all rights to privacy. It presses the face of government at the keyhole of every surgery in the country. Doctors will be compelled to hand over highly sensitive medical information to justify Medicare claims potentially including a patient’s intimate concerns and examination findings, their test results, weight, sexual health, infections … nothing is protected.”

It it true that a patient’s medical record can be subpoenaed, say for example in a workplace injury case, and the medical history could end up on an insurance claim file because a doctor has had to comply with a subpoena. But this draft legislation is quite different. I have no doubt that there are some doctors who rort the system and order unnecessary tests but for the Government to now be interfering with the doctor/patient relationship is a step too far.

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Entry filed under: Medicine, Surveillance society. Tags: , , .

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