Thursday, 23 February 2023

Health Legislation Amendment (Information Sharing) Bill 2023

Second reading

Debate resumed on motion of Mary-Anne Thomas:

That this bill be now read a second time.

and Emma Kealy’s amendment:

That all the words after ‘That’ be omitted and replaced with the words:

‘this bill be withdrawn and redrafted to provide for an opt-out provision and for the Department of Health to be subject to freedom of information requests about the scheme’.

Nina TAYLOR (Albert Park) (16:08): I note that to date with debate on this particular bill much has been said about the consequences of the fragmentation of patient health information. I am just thinking about a medical professional having to get on the fax or sitting on the end of a phone losing precious time when they could be administering any number of medical solutions or medications or alternatively could be at risk of causing an anaphylaxis if there is some sort of untoward interaction between whatever medication or medications the particular patient is on versus what solutions might be proposed based on what they are being presented with at that time. Therefore there is very much a strong imperative to see these very important reforms passed through the house.

Before I proceed to some of the more technical elements of the bill, I did want to reflect on a personal situation which I was inspired to think about when I was reading this particular bill. The actual incident was not about me, I should say, but actually with regard to a relative. I recall I came into the kitchen and a relative of mine was lying on the floor, which was unusual; my relative would not normally be lying on the floor. You do not normally lie on the floor in the kitchen, (1), but (2) he was singing opera, and never in my life had I seen this relative singing opera. I thought, ‘I think something’s wrong here.’ I am not a medical professional, but after a few seconds seeing that something was seriously wrong it suddenly occurred to me that my relative might have hypoglycaemia.

I went to get a can of lemonade. Unfortunately, when I snapped the first can of lemonade, I broke the little seal on the thing and I could not open it because I was under pressure and – Murphy’s Law – this is exactly when that happens. I then went to a second can. I was successful this time in opening the lemonade, and I tipped the lemonade down my relative’s throat. There was risk in that, because we know that with hypoglycaemia there is a certain point where a person can tip into a coma, so you have to be very careful because you do not want to actually cause them to choke. So there are those delicate elements of that process. Thankfully, I did the right thing. As I say, I am not a medical professional, but because I had prior knowledge that this relative had diabetes, I was able to take a reasonable guess that the lemonade would actually address their particular condition. Thankfully, he is alive and well to this day.

I am not crediting myself with any particular special attribute in that regard, save to say: wasn’t it great that I had context and I had that information readily available, because had the relative tipped into a coma, you can imagine the various consequences that could have flowed from that. Reading this bill brought home that particular memory, because incidents like that in your life you never forget. They stay with you forever, because you go into fight or flight and they stay within your memory. I realised: what if my relative had presented at a hospital and had lain on the floor and sung opera? Would the attending physician have said, ‘Oh, well, they have hypoglycaemia.’ They might have. Maybe the blanched appearance, the sweating and other aspects might have clued them into that; I do not want to undermine the professionalism of a medical professional who might have been able to make that assessment. Having said that, I note it is entirely possible that other decisions could have been made. They could have thought perhaps the person was drunk, because sometimes when a person goes into hypoglycaemia they can appear like they are inebriated. I can assure you that my relative had not had a single drop of alcohol that day. He had simply done a lot of exercise, a lot more than normal, and so therefore had burnt through his sugars rather quickly.

The point of me raising that particular story is just to say how critical it is that we do support these very well-considered and timely reforms through the house, because we do not want to put medical professionals under any more pressure than they already are in situations that they have to face day in, day out, every day of the week for our benefit. I would hate to think that there was some unnecessary delaying or deterrence in passing this bill when we are not thinking about, fundamentally, the people who we expect to look after us at the end of the day. I hope that that conveys some of the sentiment. But it is beyond sentiment; it is pragmatic. These changes fundamentally are dealing with issues that are easily and entirely foreseeable. I was horrified when reading this bill to learn about the various consequences of the current system and the way it really is not functioning as it ideally should. I would like to think that collectively we would all do our best – and I believe those on the Labor side of the house certainly are doing that, I can vouch for that – to ensure that we really back in our medical professionals with regard to being able to access the information they need to make the best possible decision in a timely manner. I think that is only fair and reasonable.

Further to that, we know that there is strong support from clinicians and health services for these reforms. It is not just a flight of fancy; this is actually based on proper consultation and feedback that we have from those who are relying on us to bring forward these changes here today. The reason for the strong support – I hope I have illustrated the imperative – is it would result in improvements in practice and patient outcomes. Is that not fair and reasonable? I put it to you. I mean, it is fair and reasonable, so really the impetus is on us. On the one hand, medical professionals take the Hippocratic oath. They are there and I believe genuinely, day in, day out want to get the best outcomes for everyone who presents at emergency or otherwise, so I consider it is our role and it is upon us to pay respect to that, to pay heed to problems identified within the system to help drive a better outcome.

I did want to acquit, in the time that I have available, just a couple of the further issues that have been raised along the way. With regard to patient FOI rights, this bill does not change a patient’s right to access their full medical records from their health service provider under FOI and privacy legislation. To ensure efficiency and timely care, the information that will be included upon the proposed platform is only the most relevant clinical data, relevant for the purposes of treatment, not the full medical history of the person. This includes allergies to medication, hospital treatment summaries and diagnostic reports. So again, we can see the very pragmatic and reasonable elements that are being addressed through this legislation.

Importantly, this bill does not enable FOI requests on the health sharing system. This is because it would require the department to access clinical information to respond to questions which would be inappropriate and counteractive to the strict protections and access controls the bill seeks to establish. We can see the tension here, but it is an appropriate tension and it is based on a sound rationale. It is not there to be antagonistic or unreasonable but rather it is balancing the fundamental premise of the bill – to enable appropriate protections to ensure that it does serve the community well in terms of delivering better patient outcomes and backing in our medical professionals but at the same time not compromising the privacy of the information that has been provided. I think in that regard we can see why those various elements of the bill have been put in place.

Finally, I was just going to say that there are certainly important restrictions to sensitive information to ensure additional protections for vulnerable groups, like victims of domestic violence, and only designated health service staff who need to see the information for clinical decision-making purposes will have access to it. I am sorry, I rushed that a little bit, but I just wanted to make sure that it is on the record that vulnerable persons, people who are victims of domestic violence or otherwise, have been absolutely prioritised and factored into the drafting of this bill.

Anthony CIANFLONE (Pascoe Vale) (16:18): As I said in my first speech, the health and wellbeing of every Victorian and every resident in Pascoe Vale, Coburg and Brunswick West is paramount. Regardless of age, income, background, location or circumstances, all Victorians deserve access to world-class and accessible healthcare. That is why Labor has been investing record amounts into our health system and backing in our doctors, nurses, paramedics and community healthcare workers to make sure every Victorian can get the care they need when they need it. But just as importantly, it is also critical to ensure health workers have quick and efficient access to the information they need, particularly in crucial situations when a diagnosis is critical or when a patient’s life hangs in the balance, and that is what this bill is fundamentally all about. It is about giving doctors, nurses and health workers access to the health information they need for patients so they can do their jobs, save lives and support the health and wellbeing of all Victorians from all of our electorates.

We trust our doctors, nurses and healthcare workers with our own lives and the lives of our families and loved ones. We can and should trust healthcare workers with the health information of patients when they need it most. Currently in Victoria, while doctors, nurses and health workers do a magnificent job in helping Victorians, particularly more than ever during the pandemic, the reality is that critical health information that they require to assist patients largely remains spread across different health services in separate systems and in paper-based records. This fragmentation of patient and health information often means that many clinicians across our system still manually gather patient health information, including through faxes or phone calls. While improvements have been made over recent years, the system still largely remains inconsistent with modern health record-sharing approaches that have been adopted by other Australian jurisdictions, such as New South Wales, Queensland, the ACT and South Australia, all of whom have successfully implemented information sharing technology at the point of care.

The Health Legislation Amendment (Information Sharing) Bill will finally enable better information sharing between specified health services across Victoria through the establishment of a secure platform that is operated and managed by the Department of Health. The bill will amend the Health Services Act 1988 to establish a health information sharing platform for relevant health services to share certain information and for the purposes of specifically providing medical treatment and care to patients. The amendments will also authorise the collection and disclosure of health information to the secretary for the purposes of establishing and maintaining the electronic health platform and will apply to some of the following specified entities, including public hospitals, denominational hospitals, prescribed health services, registered community centres, the ambulance service and the Victorian Collaborative Centre for Mental Health and Wellbeing. The application of the bill recognises the challenges of siloed information across the public healthcare system and the importance of strengthening the system for the health and wellbeing of all Victorians. A consolidated picture of a patient’s medical and health history is essential for the provision of safe and high-quality care across our health system.

This is a bill that has been developed on the sound and trusted advice of health and medical professionals. It is a bill that stems from and responds directly to the findings contained in the Targeting Zero report, which reviewed hospital safety and quality assurances in Victoria in 2016 and highlighted opportunities to strengthen quality care and reduce avoidable harm in the health system through better patient data management and information sharing. The Targeting Zero report consisted of in-depth consultation with many across the health sector, including stakeholders working in various branches of government, hospitals, not-for-profit organisations, private industry and academia through over 50 hours of interviews and five workshops involving 320 hospital board members, CEOs, leading clinicians, directors of nursing and medical services and other health sector staff. The report put forward a number of key findings and recommendations, which this bill is now seeking to directly deliver on.

In this regard I would like to draw the house’s attention to a number of key excerpts from the report, which directly relate to the need for this bill to be progressed and supported. As stated over pages 12 and 13 of the report, the review found:

Information is the lifeblood of a continuously improving hospital system … Much essential data –

in Victoria and currently –

are not collected, not used, or not made available in a convenient form, limiting hospitals’ and clinicians’ ability to use information to identify opportunities for improvement and strengthen care.

Furthermore, on page 188 of the report it states:

Electronic patient records … are expected to transform the capacity of the system to study and improve safety and quality of care. Research shows …

electronic records

… can improve information flows between and within hospitals, make it much easier to measure, manage and coordinate care, and reduce the risk of clinicians misreading forms and providing patients with inappropriate treatment as a result …

Some studies show the introduction of …

electronic records

… systems has been associated with significant quality improvement, including declines in length of stay, infection rates, mortality and medication errors …

That is why this report is very clear in recommendation 4.13.1, stating:

The department should support Victorian public hospitals to expedite their transition from paperbased to electronic patient record … systems developed to support clinical decision making and data analytic capability, which have proven benefits for safety and quality of care.

Recommendation 4.13.2 states:

The department should adopt a goal of ensuring that … all major hospitals have a fully electronic health record that enables interchange of information with other hospitals.

This bill will ensure we implement a new, modern information system as recommended by the Targeting Zero report across our health system in a manner that optimises privacy and safety for patients.

Locally this bill will have benefits for my health sector workers, residents and patients across Pascoe Vale. As I said in my first speech, it is health workers and community workers that make up the biggest industry of local residents in my area that they are employed in – almost 14 per cent. That is almost 13,000 residents. Almost 5000 local residents alone are employed in hospitals, making up 4.8 per cent of our local workforce. Many of these workers are the backbone of our hospitals, social services and medtech sectors across Melbourne, including at Parkville, the Austin and the Northern Hospital precincts. Improving data- and information-sharing capabilities for my local health workers, who I trust to have access to this information, across these sites will help them do an even better job.

For patients, the bill also provides numerous benefits. As the member for Pascoe Vale, most of my constituents who need to visit an emergency department or hospital would likely go to the Royal Melbourne, the Royal Women’s, the Austin or the Northern Hospital. For the little ones, it is the world-renowned Royal Children’s Hospital, which we are so lucky to have on our doorstep just in Parkville. If a local family is visiting a regional area over the Easter or Christmas breaks and needs urgent medical attention for whatever reason, and they are required to visit a regional health service, this bill will be about ensuring our health workers across the state have the tools and information they need in a modern, efficient and pragmatic way so they can do the job to support patients from my local community. If a local patient presents to an emergency department in an incapacitated state or if an accompanying family member is unable to fully recall a patient’s health history, the measures in this bill will help to ensure health professionals at these critical times have the immediate background and history they need to treat a patient in an effective way. I think my local residents would have an expectation and presume, as the member for Geelong mentioned yesterday in this debate, as did the member for Brunswick, that our hospital systems would already be able to effectively share this health information, including in the event of a patient transferring between hospitals.

Locally this bill will also benefit the high number of elderly residents and those of non-English-speaking and culturally diverse backgrounds, whom I am so proud to represent. Over 17,000 local residents across Merri-bek are aged 70 years and over, or 10 per cent of our local population, and 35 per cent of residents speak languages other than English, including 5 per cent of residents who do not speak any English at all. That is 8000 local residents in my municipality. This bill will play a crucial role in overcoming language and comprehension barriers at critical times for so many vulnerable people in my community.

As outlined in the 2021 ABS census, the residents of Merri-bek also experience a range of health conditions, many of which would likely be the cause of presentations to hospitals and health services. Almost 19,000 local residents experienced a mental health condition, including depression or anxiety. That is 11 per cent of locals, compared to 8.8 per cent on average across Victoria. 8.6 per cent suffer from asthma, 6.8 per cent suffer from arthritis, 4.3 per cent have diabetes, 3.1 per cent are diagnosed with heart disease, 2.3 per cent have some form of cancer and 1 per cent have a lung condition.

Locally I have a number of longstanding local health services who I would like to acknowledge and pay my due respects to for their ongoing work and who seek to benefit from this bill and our broader health reforms. Merri Health is the second-largest local employer in my electorate, employing up to 500 health staff, and has proudly provided health and wellbeing services to Melbourne’s north for almost 50 years. Merri Health is also one of the state’s largest not-for-profit health providers, having last year alone provided over 270,000 unique service contacts, including having administered over 4700 vaccinations and conducted 22,000 COVID tests. I was pleased to have had the Minister for Health visit Merri Health in July last year to announce a $236,000 grant towards the purchase of new medical equipment. Merri Health’s work will continue to play a critical role in improving local preventative health and wellbeing outcomes. I look forward to working with them, including in the context of the proposed Coburg health precinct, which has the potential to create a further 1000 local health and community service jobs and improve local health services.

I would also like to acknowledge John Fawkner hospital, situated on Moreland Road in Coburg, which first opened its doors in 1939 and has continued to provide critical health services and care for residents of the north. Today John Fawkner provides 186 beds for major and acute health conditions and a 24-hour emergency department.

I commend this bill to the house. I am just so proud to be part of a Labor Party and a Labor government as well that has supported such big health reforms in the past. Whether it was Medicare, the NDIS or the introduction of free nursing and health services, or whether now it is, through this bill, improvement of patient information and sharing systems across our health network, it is Labor that has always backed in our health system, health workers and patients. As I said, I commend the bill to the house, and I am thankful for the opportunity to contribute to the debate.

Jordan CRUGNALE (Bass) (16:28): What a remarkable contribution from the member for Pascoe Vale – to a point where I think I even considered moving to Pascoe Vale.

Members interjecting.

Jordan CRUGNALE: No, no, I am not going to. Back to Bass. I rise to speak on the Health Legislation Amendment (Information Sharing) Bill 2023. I guess, to follow on from the member for Pascoe Vale, when I look at the electorate of Bass, we have phenomenal health services, whether it is the Kooweerup Regional Health Service, Bass Coast Health or Monash Health, who run a lot of services in the northern part of my electorate. When we look at the Bass Coast shire, it is one example of where there are 30,000 or 40,000 people during the year and then during the very busy periods we swell to about 120,000 or 130,000 people. This is where this bill and the information sharing would certainly be of huge benefit to anyone presenting at our hospitals.

We have had a few personal stories, and I may as well go there. I have spoken about this person before, who I grew up with, who I adored, who I cherished, who I loved to bits – someone very, very important to me. I am not sure if I mentioned it in my inaugural speech, but for probably 12 years or so it is something that I have been flagging at every turn is this whole information sharing between hospitals. She presented to six different emergency departments (EDs) in six months and never once was anything shared between those emergency departments. She was presenting with, I guess, a symptom of many of the other underlying things that were going on for her, which were around addiction, mental health and all the ramifications of what comes out of that.

As I said, there was a long battle with alcohol addiction, there was an eating disorder in there as well and the bone density, poor dental and trace elements – every time she presented at an emergency department she would be having all those trace elements and blood tests done, but never once was anything underlying picked up. Sadly, the sixth time she presented to hospital there was a flag in the system through ConnectED – I was working at Prahran Mission at the time – but it was the day that she actually passed away. So that did not quite help her, but I certainly hope that this bill will help many people in Victoria. With information sharing between hospitals, if it had been available, clinicians could have identified her deterioration and then could have provided immediate emergency care, which may have had very different results. As I said, this legislation could save lives.

We are as a government committed to improving patient safety and continuity of care for Victorians. Our health services and clinicians have a single point of complete and accurate patient information. Most Victorian patients will often be treated at different, separate health services over their lifetime and cannot know what information from the past will be critical to their medical future. Currently in Victoria critical health information is spread across different health services depending on where a patient has visited or been transferred, and these records are also in separate systems and paper files, making them difficult to find in times of need and urgency. We have heard through other contributions on this side of the house too that health services can and do share information for the purposes of patient care, but current communication methods are very antiquated, disjointed and cumbersome. There is ringing around to other hospitals, and we have heard a lot about faxes. Obviously phone calls, sharing over email and piecing together someone’s history without access to the full picture is not really that effective, and it is certainly not an efficient use of our amazing healthcare workers’ time – neither is redoing all the records or repeating tests, which leads to delays in treatment and to potentially overlooking key details. This process does need to be modernised. Under this bill health services will be guided by the department secretary in providing and updating patient information, which will then be stored securely and provided as necessary for patient care.

Further, we have heard about the opt-in, opt-out model, and it is not about whether the public health services should or should not share information; this is about establishing a secure and more efficient platform for clinicians to access the relevant clinical information to treat patients safely. There are currently no opt-out arrangements under existing legislation, and Victorian public health services currently share information for the purposes of treatment. The opt-out model suggested by David Limbrick in the other place and others is a step backwards. It undermines the primary objective of the bill, which is to ensure clinicians have access to relevant medical information to provide timely care.

The primary management framework will be implemented prior to the commencement to limit access to and management of highly sensitive health information. We do know that access will be shared on a platform to specific entities, so that is public hospitals, multipurpose services, denominational hospitals, metropolitan hospitals, prescribed health services, registered community health centres, the ambulance service, the Victorian Institute of Forensic Mental Health and the Victorian Collaborative Centre for Mental Health and Wellbeing.

Paul Edbrooke: Tell us about Bass.

Jordan CRUGNALE: Tell us about Bass, yes. There is a lot happening in Bass – I know, with 3 minutes to go. We did just open recently a new ED, and it was great to have the Premier.

A member: Who funded that?

Jordan CRUGNALE: It was the Labor government, of course, and we have committed to doing stage 2.

A member: Good local member.

Jordan CRUGNALE: That is right. We had a ministers statement from the Premier just last sitting week on Wonthaggi Hospital and all our investment in regional and rural health services across the state. Well, not that you want to get sick, but it is great to have this amazing new ED and expanded services. We will be able to treat 26,000 emergency presentations each year. The great thing also is that previously you had to walk up the stairs with a crying baby and navigate yourself through an old hospital, and now you just sort of walk straight in. So that is a bit of a highlight for Bass Coast. If I am going to talk about Bass, we have got community hospitals in both the neighbouring electorate of Cranbourne and the new neighbouring electorate of Pakenham, which the constituents of Bass will certainly be accessing.

I was talking earlier around the information-sharing systems that are already operating in other jurisdictions. In New South Wales, Queensland, the ACT and South Australia they are all successfully implementing systems and sharing health information at the point of care. I do not know if they share across the states, but that might be something to consider as well, knowing that people do move around the country and move residences.

The member for Albert Park was talking about medications and how they may interact. We have drug allergies, alerts such as severe asthma, past biopsy results, diagnoses that take months to make and results of tests and scans, which all sit in these digital records. It will also be useful for patients with chronic conditions, assist those with language barriers, provide better support for telehealth and help Ambulance Victoria make more accurate assessments of patient care needs. Most importantly, this central information system will help the state’s embattled care workers in emergency situations where patients are too sick or unable to communicate important health information.

In conclusion, I am always thanking those who developed this legislation and all those who were consulted and contributed to its development. It has been a significant task which will have an important impact on the health outcomes of Victorians. We are committed to supporting our health services and improving patient care, and the electronic health information sharing system outlined in this bill will do just that – it will modernise current practices, better facilitate continuity of care statewide and help to prevent unnecessary treatment delays while promoting patient safety. I commend the bill.

Kat THEOPHANOUS (Northcote) (16:38): Deputy Speaker, it is always –

Jess Wilson: Deputy Speaker, I just draw your attention to the state of the house.

Quorum formed.

Kat THEOPHANOUS: As I was saying, Deputy Speaker, it is wonderful to have you in the chair and to follow the wonderful member for Bass, who made an incredible contribution just then. I rise to speak in support of the Health Legislation Amendment (Information Sharing) Bill 2023. I am prouder than ever to be standing in this place representing the community of Northcote as part of a re-elected Andrews Labor government, because I know our government is here again for one simple reason: to do what needs to be done to make things better for all Victorians. We make things better by building better schools so our kids can learn and thrive, we make things better by building a better transport network so we can all get to where we need to go safely when we need to get there, we make things better by bringing back the SEC to lower our emissions and our energy bills, we make things better by building better hospitals to ensure we have got world-class places to go to get the treatment and care we need when we need it most and we make things better by listening to our health experts when they tell us they need better tools to be able to provide the highest level of care, because that is what we are about and that is why the people of Victoria put us here.

No-one is in any doubt that our health system is under immense pressure. We have an aging population, a mental health system in the process of reform, the impacts of a global pandemic – which has meant a huge effort is needed to catch up on delayed care – and worldwide staffing shortages. It is no wonder that our healthcare workers are under enormous pressure. As we continue our recovery from the shocks and disruptions we have experienced over the past few years, we continue to learn so many things about ourselves, our communities, our systems of government and the systems within which we deliver our public services. We have learned a lot about our own resilience, the power of simple acts of kindness and compassion. We have learned how challenging it can be when we are isolated and alone.

We know, as the government that has been elected to lead, that we can never become complacent or stop working to improve our essential public services and the systems that they rely on. We know we can create a more efficient and integrated health service. Information sharing is absolutely a critical part of that because the truth is it is a fragmented system, a system within which patient information is siloed and inaccessible from one public health service to the next. The problem that fragmentation and siloed information is causing for our already stretched clinicians is one of needless delay, frustration and sometimes despair. For healthcare workers that is not abstract; it is the clenched-up feeling, the knot inside when they are unable to deliver the treatments their patients need when their patients need it because they find themselves waiting for a fax to come through from a neighbouring hospital containing test results that are critical to making a diagnosis. All the while the clock ticks down, the odds narrow and the prognosis gets worse. This is quite literally putting the lives of patients presenting to our emergency departments at risk.

Thankfully we know that we have the tools and technology we need to fix the problem, and with this bill we have the legislative framework within which we can do so safely and securely – because of course we are not blind to the challenges that building this new system presents and the safeguards that we need to be built into it from the very start to make it safe. We know that patients have the right to their health information remaining private and secure. We know that only specified healthcare workers who are directly involved in a person’s care and treatment should be able to access medical information for the sole purpose of providing treatment. We know that our systems for storing sensitive information must be secure and stringently protected. We know that strict controls need to be made to designate who can access which information and when, and we know that there need to be serious penalties put in place to prevent prohibited access and unauthorised disclosure of a patient’s private information. That is exactly what this bill will do.

It will establish an independent oversight committee, supported by a clinical advisory group, to advise the Secretary of the Department of Health on the implementation and successful operation of the system before it comes into being. Included in their remit will be an obligation to establish the appropriate risk, control and compliance frameworks as well as a primary management framework, which will limit the access to and management of highly sensitive health information. So despite what some of the fearmongering Luddites over there on the other side of the house might have us all believe, this bill is not about taking away anyone’s rights. This kind of narrative skirts dangerously close to some of the misinformation we already witnessed during the pandemic, and we do not entertain that kind of thing. We know that this bill will save lives. It will assist our health workers, our mental health workers and our clinicians right across Victoria, who are working under intense circumstances to do their vital work. This bill is about bringing a healthcare system that is still reliant on 19th-century technology here to meet the needs of all of us living in the 21st century. It does this by equipping our doctors, our ambos and our nurses with the tools that they keep telling us they need so they can do their jobs properly here in 2023.

The first commercial fax service began operating in 1865, predating even the telephone, and frankly I reckon it is time for retirement. I know there are some across the chamber who may wish for our society to remain in the 1800s, but it is pretty astounding to think that in 2023 critical patient treatment right across our public health system is still being delayed because doctors and nurses are having to wait for faxes to come through from other public health providers. It is devastating when you think of the frustration they must feel when they find out, after being forced to send their patients off for ever more tests, that it was all unnecessary because they have been blind to the existence of the same test results sitting siloed in a filing cabinet at another public health provider. Without reform and modernisation, our hardworking healthcare workers will continue to be forced to spend unnecessary hours wrestling with an unwieldy system which is ill equipped to handle the increasing demands of our rapidly growing society. Through this bill the Andrews Labor government is modernising our healthcare system so that all Victorians are able to safely access the healthcare treatments they need when they need them most.

As we know, the Andrews government is investing big to build the hospitals Victoria needs now and into the future – in fact one of them, the Victorian Heart Hospital, opened its doors this week. We do this because we know that as our state grows we must grow the system of public health infrastructure to match. Now this bill is not about building anything physically tangible or as exciting as our government’s heart hospital or the recently announced Parkville and Arden hospital precincts – to be fair, it is hard to be as exciting as Australia’s biggest hospital infrastructure project, especially when it involves $5 billion to $6 billion in investment that will boost research, create jobs and create these new campuses. Nonetheless, I diverge – this bill is equally as important and relevant because this bill will enable us to build something that will benefit every one of the thousands of Victorians who interact with our public health system each and every day. We will do this because we know we need to listen to those who are out there each day working in our public health system. Victoria’s public healthcare workers are world class – world class. We know that when they tell us they need better tools at their disposal to enable them to deliver world-leading public health care, we need to listen.

In preparing this bill we also listened to and considered the recommendations of the Targeting Zero and Strengthening Medicare Taskforce reports. Through these reports we were given a clear diagnosis: the public health information sharing system we are currently using is not working. So I think it is clear what we need to do and why we need to do it: we need to use the technology we have at hand today to secure the healthcare system we need now and in decades to come. We need to do this to free up our ambos, our doctors, our nurses, our public healthcare workers and our clinicians more broadly so they can all get back to what they went into this industry to do in the first place – to help treat all of us when we are sick, when we need that care, when we are in dire straits. Despite all the frustration of this current system, we know we can do better, and I am proud to be part of the Andrews Labor government because I know that we will always look for those ways to do better and those ways to help those people that spend their lives giving back to us. I would like to say thank you to the minister for bringing this bill to the house for debate. It is an excellent bill. I commend it, and I will leave my contribution there.

Daniela DE MARTINO (Monbulk) (16:49): I rise to speak on the Health Legislation Amendment (Information Sharing) Bill 2023. Before I commence I would like to acknowledge and thank the wonderful nurses, the doctors, the paramedics, the allied health professionals and the ancillary staff across our health networks. They work every day to provide great care to their patients, and their dedication should be acknowledged and praised. Much has been said thus far in this place on the merits of this bill. I would like to add my contribution, which is quite personal. I am absolutely convinced that this bill is not only welcome but utterly necessary for the good functioning of our health system and ultimately better health outcomes for Victorians across our state, including the residents of Monbulk.

As the member for Northcote eloquently put it, this bill will ensure that 19th-century technology is replaced by modern, reliable technology. This bill is designed to improve the communication of health information between health services. The information that will be included on the proposed platform is only the most relevant clinical data for the purposes of treatment, not the full medical history of the person. This includes allergies to medication, hospital treatment summaries and diagnostic reports.

I would like to note that this communication already exists without an opt-out system. The problem is that much of that information sharing is via paper, pen and facsimile machine. I was almost certain that the sounds of the fax machine were consigned to the 1990s, maybe the early noughties, but in our public health system and across most health systems, unfortunately, it is still not the case. In 2023 I am sure that the general public expects better than clunky, laborious fax machines being the method for transmitting critical health data between health services when treating patients, and they are more than entitled to have this expectation. There is a reason fax machines have been superseded by more efficient database technology: they are cumbersome, they are clunky, they are slow and they are subject to failure. This bill will see the exit of such old technology.

My experience with the health system, a regular occurrence over the past 17 years since my mum was diagnosed with cancer and kidney failure, is a case in point of just why this bill is vital to providing the best possible health outcomes for my mum and my two children. I speak with their permission here today. Without divulging the specifics of Mum’s history, I can say that in addition to being a dialysis patient for the past decade, she has had a hospital admission via emergency on average every year for the last 10 years for around seven-plus days at a time – most recently eight days ago. On each occasion, barring one time when I was not there for her admission following my inaugural speech in this place, when she fell and broke three ribs, I have been by her side. I have been there to support her and, critically, to discuss with the triage nurses and the multiple doctors Mum’s situation and health history over the past 17 years. She can be hard of hearing, and by the time she needs to visit emergency she is often fatigued and not really up for explaining her health history at any great length.

Her history is long and it is complex; so is her medication list. Missing any critical piece of her hospitalisation history or medications could lead to a very poor outcome for her. Last Wednesday, when she attended the emergency department, Mum’s medication history was not readily accessible on a database by the pharmacist, but all her medications were in her bag, which we packed for her prior to bringing her to hospital. Approximately a dozen medications were in that bag. Each one had to be noted and handwritten by the pharmacist there. This bill would have assisted that pharmacist in accessing prepopulated information, which sounds like vital efficiency to me. The room for error or omissions of information is all too great.

In addition to my experiences as a daughter in emergency departments, I have, unfortunately, had multiple experiences as a mother. Just this week my daughter had surgery. Following her surgery, she was given medication to combat nausea, an anti-emetic. For the first time, having had several surgeries in the past, she had an allergic reaction to that particular medication. The wonderful nurses noticed immediately and ceased administering the drug. We now know that she needs to avoid this medication at all costs for the rest of her life. The challenge is that I will need to recall the name of that medication, or her father will need to recall the name of that medication, or she will need to recall the name of that medication, for any future admissions to hospital, because if she is treated in a hospital outside of the one where she had that reaction, they do not have access to that information. Needless to say, the consequences could be dire if one of us gets it wrong. This bill would see a health system of shared information which would mitigate that issue for my daughter.

My other child has a heart issue he was born with, which is dangerous and requires specific treatment and management. He was admitted twice via emergency within three months last year with a very rapid heart rate. The second time he was admitted, having been driven by ambulance from school, the attending doctor queried him about illegal substance use. After I gave a full run-down of my son’s cardiac history, starting from his birth, the doctor apologised for asking the question and explained that given my son’s age, without any medical history to hand, his first guess would be drug use and he would commence treatment for that. Accurate and timely diagnosis would have been more readily achieved through easy access to my son’s medical history upon presentation to emergency. It would have contained a list of his specialist contacts and diagnostic results. For me it is without contention that this bill is both important and necessary. I thank the minister for this bill and I commend it to the house.

Lauren KATHAGE (Yan Yean) (16:55): I rise to speak in favour of the Health Legislation Amendment (Information Sharing) Bill 2023 or, as so aptly named by the member for Point Cook, the ‘axe the fax bill’ – thank you for that. The Labor government has always been committed to ensuring quality health care across Victoria. The government is not new to investing in health care, so we have a deeper understanding and a deeper commitment to looking at each of the components that makes up quality health care and proactively making improvements. We are getting it done. This bill will improve a key component of the provision of quality health care, making sure clinicians have the information they need to quickly and accurately diagnose and treat patients. This is good for the patient, good for the clinicians and good for the health system overall, as it will mean that resources will be freed up to treat the next patient and unnecessary, duplicative tests are not carried out.

Most Victorian patients will often be treated at different health services over their lifetime, and patients cannot know what information from their medical past will be critical to their medical future. This bill will improve the safety and quality of care provided to residents of Yan Yean. Yan Yean is a large electorate which sits between multiple health services, including Northern Health, Austin Health and Kilmore District Health. A resident living in Doreen or Yarrambat may choose to go to the Northern, or they may choose to go to the Austin. As a result, relevant clinical data may be fragmented across the two services. You can imagine a situation arising where a patient may prefer going to one particular hospital but when a health situation arises and they are taken in an ambulance, the ambulance might take them to the other hospital, meaning that the emergency clinicians there would have no record of their health history – and they may not be in a fit state to communicate. I have experienced that myself, having had my pregnancy care in one health service and then emergency care for my pregnancy in another health service. How much better it would be if patients at their most vulnerable moments, such as the one I have just described, were able to be treated by clinicians who could address their relevant critical needs.

I mentioned earlier that this government invests in all components of the health system. That includes investments in infrastructure. The fact that we build not close, that we build not privatise, means that the number of patient interfaces in our area is increasing. We are serious about delivering quality health care closer to home. Our $1 billion northern hospitals plan will see a new emergency department built at the Northern and significant upgrades at the Austin. We will also have three new community hospitals in our area: Craigieburn, Mernda and the Eltham area. The Craigieburn and Mernda community hospitals will be managed by Northern Health and Eltham by Austin Health. We are working so hard to deliver quality health care close to home for people in the north.

While I know that many would agree that the infrastructure investments are impressive, I am so glad that the Liberal Party’s plan to stop works on the Mernda community hospital was knocked on the head by the people of Yan Yean last November – a verdict, I believe, on the Liberal Party failing to notice that the Northern Hospital exists by failing to commit to any works at the Northern Hospital. They were roundly rejected by the people of Yan Yean last November. Our infrastructure investments are impressive. They are the right things to do, and so is system improvement. That is why this bill is so important for our health system in Victoria. I commend it to the house.

The SPEAKER: The time set down for consideration of items on the government business program has arrived, and I am required to interrupt business. The house is considering the Health Legislation Amendment (Information Sharing) Bill 2023. The minister has moved that the bill be now read a second time. The member for Lowan has moved a reasoned amendment to this motion. She has proposed to omit all the words after ‘That’ and replace them with the words which appear on the notice paper. The question is:

That the words proposed to be omitted stand part of the question.

Those supporting the reasoned amendment by the member for Lowan should vote no.

Assembly divided on question:

Ayes (56): Juliana Addison, Jacinta Allan, Daniel Andrews, Colin Brooks, Josh Bull, Anthony Carbines, Ben Carroll, Darren Cheeseman, Anthony Cianflone, Sarah Connolly, Chris Couzens, Jordan Crugnale, Daniela De Martino, Gabrielle de Vietri, Steve Dimopoulos, Paul Edbrooke, Will Fowles, Matt Fregon, Ella George, Luba Grigorovitch, Bronwyn Halfpenny, Katie Hall, Paul Hamer, Martha Haylett, Sam Hibbins, Mathew Hilakari, Melissa Horne, Natalie Hutchins, Lauren Kathage, Sonya Kilkenny, Nathan Lambert, Gary Maas, Alison Marchant, Kathleen Matthews-Ward, Steve McGhie, Paul Mercurio, John Mullahy, Tim Pallas, Danny Pearson, Tim Read, Pauline Richards, Ellen Sandell, Michaela Settle, Ros Spence, Nick Staikos, Natalie Suleyman, Meng Heang Tak, Jackson Taylor, Nina Taylor, Kat Theophanous, Emma Vulin, Iwan Walters, Vicki Ward, Dylan Wight, Gabrielle Williams, Belinda Wilson

Noes (24): Brad Battin, Jade Benham, Roma Britnell, Tim Bull, Martin Cameron, Annabelle Cleeland, Chris Crewther, Sam Groth, Matthew Guy, David Hodgett, Emma Kealy, Cindy McLeish, James Newbury, Danny O’Brien, Michael O’Brien, Kim O’Keeffe, John Pesutto, Richard Riordan, Brad Rowswell, David Southwick, Bridget Vallence, Peter Walsh, Kim Wells, Jess Wilson

Question agreed to.

Motion agreed to.

Read second time.

Third reading

Motion agreed to.

Read third time.

The SPEAKER: The bill will now be sent to the Legislative Council and their agreement requested.