A centralised health database without an opt-out mechanism is set to be established in Victoria after controversial legislation passed Parliament with amendments aimed at strengthening privacy protections and oversight.
The Health Legislation Amendment (Information Sharing) Bill 2023 passed through the Legislative Council after several hours of debate late on Thursday afternoon with government amendments secured by the Greens. It will now be signed off by the Legislative Assembly.
The Greens sided with the government, which does not have majority in the upper house, in return for amendments that enshrine a privacy management framework and a review of the system after one year.
Animal Justice and Legalise Cannabis crossbenchers also voted for the legislation, which represents that government’s second attempt at introducing a centralised electronic patient health information sharing system.
Amendments moved by the Liberals to have an opt-out mechanism inserted in the bill, as is the case with the federal My Health Record system, was voted down, as was an Liberal Democrats amendment for an opt-in function.
“While we will not be supporting a blanket opt-out provision as has been proposed, the Greens do hold a range of concerns about privacy, autonomy and data integrity related to this bill,” Greens MLC Sarah Mansfield said.
“For this reason, we have worked with the government to secure a legislated privacy management framework so we and the public can have confidence patient privacy will be central to the development of the platform.”
Ms Mansfield said the framework would seek to “safeguard information that is highly sensitive”, while also protecting the “identity of patients who may be at risk of harm, including survivors of family violence”.
The framework will also “allow patients to get reports on who has accessed their [health] records” and “regular audits and compliance checks” of the system to ensure any inappropriate use is detected.
An independent expert review of the legislation and privacy management framework will also be conducted a year after it begins, with the minister to “either adopt the recommendations… or explain to Parliament why not”.
While supporting the amendment used to “placate” the Greens, Liberal MLC and shadow health minister Georgie Crozier said it was “way short of what’s required”, reiterating her argument for an opt-in mechanism.
Ms Mansfield, meanwhile, described the creation of a blanket opt-out mechanism a “blunt instrument” and that it was far more important to “ensure that privacy is built into the system for everyone from the outset”.
The bill will now move to the Legislative Assembly for consideration later this month. The government hold the majority in the lower house, meaning it is unlikely the bill will change before it passes into law.
The plan for a centralised electronic patient health information sharing system has been in the works since 2020, with such a system first recommended in an independent report on the elimination of avoidable harms and deaths in 2015.
The bill was initially introduced in 2021 but lapsed when Parliament was prorogued ahead of last year’s election. After securing an improved majority in November, an identical bill was reintroduced last month.
The system – expected to contain prescribed medicines, discharge summaries and other health information from the last five years – will be used by public hospitals, the ambulance service, community health centres and other public health services
It is expected to lead to improved health outcomes by centralising medical records with a system that health services can use to share information, as is the case in New South Wales and Queensland.
But it has been criticised by the Law Institute of Victoria and privacy advocates for not containing an opt-out functions, with Digital Rights Watch labelling the proposed system “worse than My Health Record”.
The government has developed a business case for the proposed system, which is currently being considered, but no funding has yet been provided. It plans to have up and running 12 months after the passage of the legislation.
Do you know more? Contact James Riley via Email.