Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Sunday, 16 December 2018

Baby power appears to be a ticking time bomb for consumers



Reuters Investigates, 14 December 2018:

Facing thousands of lawsuits alleging that its talc caused cancer, J&J insists on the safety and purity of its iconic product. But internal documents examined by Reuters show that the company's powder was sometimes tainted with carcinogenic asbestos and that J&J kept that information from regulators and the public….

J&J didn’t tell the FDA that at least three tests by three different labs from 1972 to 1975 had found asbestos in its talc – in one case at levels reported as “rather high.”……

…J&J has been compelled to share thousands of pages of company memos, internal reports and other confidential documents with lawyers for some of the 11,700 plaintiffs now claiming that the company’s talc caused their cancers — including thousands of women with ovarian cancer.

A Reuters examination of many of those documents, as well as deposition and trial testimony, shows that from at least 1971 to the early 2000s, the company’s raw talc and finished powders sometimes tested positive for small amounts of asbestos, and that company executives, mine managers, scientists, doctors and lawyers fretted over the problem and how to address it while failing to disclose it to regulators or the public.

The documents also depict successful efforts to influence U.S. regulators’ plans to limit asbestos in cosmetic talc products and scientific research on the health effects of talc.

A small portion of the documents have been produced at trial and cited in media reports. Many were shielded from public view by court orders that allowed J&J to turn over thousands of documents it designated as confidential. Much of their contents is reported here for the first time……

The World Health Organization and other authorities recognize no safe level of exposure to asbestos. While most people exposed never develop cancer, for some, even small amounts of asbestos are enough to trigger the disease years later…..

What J&J produced in response to those demands has allowed plaintiffs’ lawyers to refine their argument: The culprit wasn’t necessarily talc itself, but also asbestos in the talc. That assertion, backed by decades of solid science showing that asbestos causes mesothelioma and is associated with ovarian and other cancers, has had mixed success in court.

In two cases earlier this year – in New Jersey and California – juries awarded big sums to plaintiffs who, like Coker, blamed asbestos-tainted J&J talc products for their mesothelioma.

A third verdict, in St. Louis, was a watershed, broadening J&J’s potential liability: The 22 plaintiffs were the first to succeed with a claim that asbestos-tainted Baby Powder and Shower to Shower talc, a longtime brand the company sold in 2012, caused ovarian cancer, which is much more common than mesothelioma. The jury awarded them $4.69 billion in damages. Most of the talc cases have been brought by women with ovarian cancer who say they regularly used J&J talc products as a perineal antiperspirant and deodorant.

At the same time, at least three juries have rejected claims that Baby Powder was tainted with asbestos or caused plaintiffs’ mesothelioma. Others have failed to reach verdicts, resulting in mistrials.

J&J has said it will appeal the recent verdicts against it. It has maintained in public statements that its talc is safe, as shown for years by the best tests available, and that the information it has been required to divulge in recent litigation shows the care the company takes to ensure its products are asbestos-free. It has blamed its losses on juror confusion, “junk” science, unfair court rules and overzealous lawyers looking for a fresh pool of asbestos plaintiffs…..

Read the full article here.

Monday, 10 December 2018

Australia 2018: Is long-term rental destroying the wellbeing of low income households?



Across the nation, people who rent are living on insecure tenancies. Almost 9 in 10 Australians who rent (88%) are on leases of a year or less, and are not certain of where they will be living in a year’s time. This impacts a person’s ability to feel part of the local community and establish roots.







The Land, 1 May 2018:

AFFORDABLE rentals on the state’s North Coast are increasingly few and far between, but the continued rise of the Airbnb-model now sees 3000-plus homes sit empty while low-income and government-assisted tenants are shut out. 

Anglicare’s latest Housing Affordability Snapshot says the region’s rental crisis has worsened as property owners in Ballina, Byron Bay, and the Tweed are incentivised to target short-term holidaymakers through web-based booking companies instead of potential long-term renters. 

The Anglicare report, released on Sunday, showed available North Coast rental properties were in steep decline (down from 795 in 2017 to 660 in 2018) with all family groups on income support, and single households on minimum wage, likely to struggle to find housing for themselves and their children.

Clair, A. et al, 24 May 2016, The impact of housing payment problems on health status during economic recession: A comparative analysis of longitudinal EU SILC data of 27 European states, 2008–2010, excerpt:

Transitioning into housing arrears was associated with a significant deterioration in the health of renters…..

Housing arrears is one of the so-called ‘soft’ ways in which housing influences health (Shaw, 2004), especially mental health, alongside the ‘hard’, physical impacts of the infrastructure itself, such as damp, mould, and cold. A growing body of scholarship indicates that people who experience housing insecurity, independent of other financial difficulties, experience declines in mental health (Gili et al., 2012Keene et al., 2015Meltzer et al., 2013Meltzer et al., 2011Nettleton and Burrows, 1998). 

In Australia, analysis of the longitudinal HILDA dataset found that those in lower income households who had moved into unaffordable housing experienced a worsening in mental health (Bentley, Baker, Mason, Subramanian, & Kavanagh, 2011), with male renters faring worse (Bentley et al., 2012Mason et al., 2013).

One has to wonder if being a long-term renter affects quality of life to such a degree that on average renters die earlier than home-owners.

Friday, 30 November 2018

Call to protect infants from dangerous infectious disease, whooping cough



The Daily Examiner, 27 November 2018, p3:

NSW Health is urging all pregnant women and new parents to be aware of the symptoms of whooping cough and to ensure they and their children are vaccinated on time.

Despite almost 95 per cent of infants in NSW now vaccinated against the disease, outbreaks still occur every three to four years as community immunity wanes, and recent high numbers indicate an outbreak might be on the way.

Dr Vicky Sheppeard, NSW Health’s Director of Communicable Diseases, said that in October 2018 almost 800 people in NSW were notified with whooping cough (pertussis), the highest number since October 2016.

Acting director of North Coast Public Health Greg Bell said a similar situation was emerging in Northern NSW where there have been 36 cases of whooping cough reported in the past four weeks.

While these levels of whooping cough across Northern NSW are similar to the averages of the previous five years, pertussis notifications are trending upwards.
The latest Australian Immunisation Register quarterly report shows that at September 2018 90.4 per cent of five-year-olds and 88.9 per cent of 12-month-olds in Northern NSW Local Health District were fully vaccinated.

These figures represent an increase on vaccination rates in 2010 under the-then North Coast Area Health Service, when 84.9 per cent of children aged 5 and 87 per cent of 12-month-olds were fully vaccinated.
Even in highly vaccinated populations it is not possible to eliminate whooping cough…..

 “The aim of whooping cough control is to protect infants, who are at highest risk of severe disease or death if they contract whooping cough. Whooping cough vaccination is effective in preventing severe infection.”

Friday, 16 November 2018

Yet other digital privacy betrayals


The global situation......

The Guardian, 14 November 2018:

Google has been accused of breaking promises to patients, after the company announced it would be moving a healthcare-focused subsidiary, DeepMind Health, into the main arm of the organisation.

The restructure, critics argue, breaks a pledge DeepMind made when it started working with the NHS that “data will never be connected to Google accounts or services”. The change has also resulted in the dismantling of an independent review board, created to oversee the company’s work with the healthcare sector, with Google arguing that the board was too focused on Britain to provide effective oversight for a newly global body.

Google says the restructure is necessary to allow DeepMind’s flagship health app, Streams, to scale up globally. The app, which was created to help doctors and nurses monitor patients for AKI, a severe form of kidney injury, has since grown to offer a full digital dashboard for patient records.

“Our vision is for Streams to now become an AI-powered assistant for nurses and doctors everywhere – combining the best algorithms with intuitive design, all backed up by rigorous evidence,” DeepMind said, announcing the transfer. “The team working within Google, alongside brilliant colleagues from across the organisation, will help make this vision a reality.”

DeepMind Health was previously part of the AI-focused research group DeepMind, which is officially a sibling to Google, with both divisions being owned by the organisation’s holding company Alphabet.

But the transfer and vision for Streams looks hard to reconcile with DeepMind’s previous comments about the app. In July 2016, following criticism that the company’s data-sharing agreement with the NHS was overly broad, co-founder Mustafa Suleyman wrote: “We’ve been clear from the outset that at no stage will patient data ever be linked or associated with Google accounts, products or services.”

Now that Streams is a Google product itself, that promise appears to have been broken, says privacy researcher Julia Powles: “Making this about semantics is a sleight of hand. DeepMind said it would never connect Streams with Google. The whole Streams app is now a Google product. That is an atrocious breach of trust, for an already beleaguered product.”......

Here in Australia......

Canberra Times, 15 November 2018, p.8:

The chairman of the agency responsible for the bungled My Health Record rollout has been privately advising a global healthcare outsourcing company. Fairfax Media discovered the relationship between the UK-based company Serco and the Australian Digital Health Agency (ADHA) chairman Jim Birch after obtaining a number of internal documents.

The revelation comes as Health Minister Greg Hunt was forced to extend the My Health Record opt- out period after a compromise deal with the Senate crossbench and a last-minute meltdown of the website left thousands of Australians struggling to meet the original deadline. 

Since April 2016, Mr Birch has been ADHA chairman with oversight of My HealthRecord, the online summary of key health information of millions of Australians. Documents from the ADHA, released under freedom of information laws, show Mr Birch registered his work for Serco in November 2017, but the relationship was never publicly declared.

After Fairfax Media submitted questions last week on whether the relationship posed a conflict of interest, Mr Birch quit the advisory role.

Serco has won a number of multibillion-dollar government contracts to privately run - and in some cases deliver healthcare in - some of Australia's prisons, hospitals and detention centres.

The ability of Serco to navigate the controversial area of digital health records would be invaluable to any future expansion plans.
A spokeswoman for federal Health Minister Greg Hunt said all board members had declared their interests.

"Board members do not have access to system operations, and board members cannot be present while a matter is being considered at a board meeting in which the member has an interest," she said.

Lisa Parker, a public health ethics expert at University of Sydney, said the public had been asked to trust the agency is acting in its best interests. She said they should make public any information relevant to that trust…..

The register also shows Mr Birch knows the chief executive of start-up Personify Care, Ken Saman, and has been giving him advice since August last year. The software company recently released "Personify Connect", a product that provides hospitals with "seamless integration" of its original patient monitoring platform with My Health Record.

Despite being scheduled to speak at a "Personify Care breakfast seminar" later this year, Mr Birch has never publicly declared this interest. Mr Birch is also chairman of another start-up called Clevertar that allows businesses to create "virtual agents" and offer "personalised healthcare support, delivered at scale". This relationship is on the public record. 

Public sector ethics expert Richard Mulgan, from Australian National University, said the chairman should submit to a higher standard than ordinary board members and distance himself from anything suggesting a conflict of interest.

He said perception was just as important as reality and the public, not the people involved, was the best judge of whether there was a problem.

"The personal interests register must be published," he said.

"The fact they haven't can only lead to the perception there are conflicts of which they are ashamed."

Mr Birch, Personify Care and Clevertar did not respond to Fairfax Media's questions.

A Serco spokesman confirmed the company met with Mr Birch "occasionally ... over the past 12 months regarding business management", but did not answer whether it paid him.......

The Courier Mail, 15 November 2018, p.4:

Your dietitian, dentist, podiatrist, occupational therapist or optometrist will be able to see if have a sexually transmitted disease or an addiction unless you set access controls to My Health ­Record.

Major new privacy concerns emerged after the Federal Government was yesterday forced into an embarrassing call to delay the rollout.

People trying to access the controversial My Health Record hotline and computer portal experienced major delays during a rush to opt out before the system was rolled out tomorrow.

Health Minister Greg Hunt was forced to delay the opt out period until January 31 after pressure from health groups and crossbench senators.

The Australian Medical Ass­ociation was the only major health group not calling for a delay.

The vast majority of groups were concerned the record would come into ­effect before key privacy and secu­rity upgrades had been passed by ­Parliament. AMA president Dr Tony Bartone denied its position was related to his need to keep the Health Minister onside while he negotiated key reforms to general practice care.

Wednesday, 24 October 2018

Morrison Liberal-Nationals Coalition Government begins to position itself for forthcoming federal election


No, the Morrison Coalition Government has not suddenly developed empathy for others, a genuine understanding of its obligations under international law or a measure of respect for Australian courts.


Sensing the growing threat to its chance of holding onto government Messrs. Scott Morrison and Peter Dutton are finally allowing very ill children detained in offshore detention on Nauru to enter Australia for medical treatment.


ABC News, 22 October 2018:

Australian Border Force officials have revealed 11 children were transferred off Nauru today for medical attention, with another 52 minors remaining on the Pacific island.
Officials have amended the figure to 11 after initially saying it was 16.

The update comes as the federal Greens float a compromise agreement that could allow families to resettle in New Zealand with their families.

The Federal Government has indicated it may accept New Zealand's offer to take up to 150 refugees, but only if legislation passes Parliament ensuring people sent to offshore detention can never travel to Australia.

Home Affairs secretary Michael Pezzullo said that legislation, which has been sitting in Federal Parliament since 2016, would close a "back door" to dissuade further boat arrivals.

According to the latest figures, there are 652 people on Nauru, with 541 classed as refugees and 23 as failed asylum seekers. The status of another 88 is yet to be determined.

The United States has accepted 276 people as part of a resettlement deal and rejected an additional 148.

There is growing pressure from crossbench MPs for the Government to accept New Zealand's offer, with incoming independent Kerryn Phelps describing the issue as a first priority.

The Greens are now open to considering a travel ban for the group, but only if all children are first brought to Australia for medical treatment, and restrictions only applied to the cohort sent to New Zealand.

"We need to put the politics aside and look after these children, who are being traumatised and brutalised right now," leader Richard Di Natale told the ABC.

"If resettlement after that means resettlement in New Zealand with limited restrictions, just on that group, that's something we will consider.

"What we won't consider is putting bans or restrictions [on] those people who have been left behind.".....

Wednesday, 29 August 2018

“Shit Life Syndrome” is sending Britons and Americans to an early grave…..



With Scott Morrison as the new prime minister, the Abbott-Turnbull era persistent attacks on the social fabric of the nation are bound to continue. Thus ensuring that Australians follow down the same path as Britain and America?
The Guardian, 18 August 2018:

Britain and America are in the midst of a barely reported public health crisis. They are experiencing not merely a slowdown in life expectancy, which in many other rich countries is continuing to lengthen, but the start of an alarming increase in death rates across all our populations, men and women alike. We are needlessly allowing our people to die early.

In Britain, life expectancy, which increased steadily for a century, slowed dramatically between 2010 and 2016. The rate of increase dropped by 90% for women and 76% for men, to 82.8 years and 79.1 years respectively. Now, death rates among older people have so much increased over the last two years – with expectations that this will continue – that two major insurance companies, Aviva and Legal and General, are releasing hundreds of millions of pounds they had been holding as reserves to pay annuities to pay to shareholders instead. Society, once again, affecting the citadels of high finance.

Trends in the US are more serious and foretell what is likely to happen in Britain without an urgent change in course. Death rates of people in midlife (between 25 and 64) are increasing across the racial and ethnic divide. It has long been known that the mortality rates of midlife American black and Hispanic people have been worse than the non-Hispanic white population, but last week the British Medical Journal 
published an important study re-examining the trends for all racial groups between 1999 and 2016.

The malaises that have plagued the black population are extending to the non-Hispanic, midlife white population. As the report states: “All cause mortality increased… among non-Hispanic whites.” Why? “Drug overdoses were the leading cause of increased mortality in midlife, but mortality also increased for alcohol-related conditions, suicides and organ diseases involving multiple body systems” (notably liver, heart diseases and cancers).

US doctors coined a phrase for this condition: “shit-life syndrome”. Poor working-age Americans of all races are locked in a cycle of poverty and neglect, amid wider affluence. They are ill educated and ill trained. The jobs available are drudge work paying the minimum wage, with minimal or no job security. They are trapped in poor neighbourhoods where the prospect of owning a home is a distant dream. There is little social housing, scant income support and contingent access to healthcare.

Finding meaning in life is close to impossible; the struggle to survive commands all intellectual and emotional resources. Yet turn on the TV or visit a middle-class shopping mall and a very different and unattainable world presents itself. Knowing that you are valueless, you resort to drugs, antidepressants and booze. You eat junk food and watch your ill-treated body balloon. It is not just poverty, but growing relative poverty in an era of rising inequality, with all its psychological
side-effects, that is the killer.

Shit-life syndrome captures the truth that the bald medical statistics have economic and social roots. Patients so depressed they are prescribed or seek opioids – or resort to alcohol – are suffering not so much from their demons but from the circumstances of their lives. They have a lot to be depressed about. They, and tens of millions like them teetering on the edge of the same condition, constitute Donald Trump’s electoral base, easily tempted by rhetoric that pins the blame on dark foreigners, while castigating countries such as Finland or Denmark, where the trends are so much better, as communist. In Britain, they were heavily represented among the swing voters who delivered Brexit.

Read the full article here.

NOTE: The last time the United States saw a prolonged life expectancy decrease due to natural causes was during the Spanish Influenza pandemic of 1917-1919 when life expectancy fell by twelve years. 

Tuesday, 7 August 2018

Australian Digital Health Agency is considering adding DNA data to My Health Record


Crikey.com.au, 6 April 2018:

DNA DEBATE

The federal government’s controversial My Health Record program is capable of storing genomic data, such as cancer risks, using technology that both has huge research applications and highlights privacy and security concerns.

The Sydney Morning Herald reports that genome-sequencing company Genome.One, which can track genetic variations and therefore disease risks, has built “necessary infrastructure” for uploading sensitive genomic data into the opt-out system.

University of Canberra privacy expert Bruce Arnold has criticised the inherent risks of DNA-tracking technology and, just a week after the government backdown on police access to My Health Records, today’s news as again demonstrating a lack public consultation.

The Australian Digital Health Agency (ADHA) which is responsibe for My Health Record gave Genome.One, a wholly-owned subsidiary of The Garvan Institute, $40,000 in September 2017 to support the development of this software.

Its GoExplore™ software provides sequencing and analyses of patients’ DNA samples to assesses their risk of developing 52 hereditary conditions, including 31 cancers, 13 heart conditions, as well several other conditions where monitoring or intervention can be of benefit. 

In a change of focus, Genome.One and The Garvan Institute are reportedly no longer offering clinical reporting for genetic disease diagnosis or personal health genomics in Australia. This service was priced at $6,400 plus GST, with no Medicare rebate.

Staffing numbers in Genome.One have been severely cut, new capital is being sought and, Gavan has stated that it intends to spin off Genome.One software into a new company in which it will be a minority shareholder.

However, Genome.One still intends to pilot its genomics technology integrated into GP practice software and on !8 April 2018 its CEO stated; “We're working with some electronic medical record providers and we're hoping that we can get a trial underway at some point this year”.

Thursday, 2 August 2018

NSW Roads & Maritime Services finally come clean: We don't give a damn about any of the concerns Woombah & Iluka residents have about our asphalt plant, it's only Pacific Complete's bottom line that matters


The Daily Examiner via Press Reader, 1 August 2018:

ROADS and Martime Services has revealed it will build at least two asphalt batching plants near the Pacific Highway, most likely between Tyndale and the Iluka turnoff, next year.

Pacific Highway general manager Bob Higgins said the RMS has pressed the pause button on construction of one plant at Woombah, but the need to supply the Glenugie to Iluka Rd turnoff section with 170,000 tonnes of asphalt would require two plants.

He said the RMS would review the supply strategy for the manufacture and delivery of asphalt on the stretch of highway upgrade after protests from the Woombah community.

But Mr Higgins said if push came to shove when the RMS review decided on locations, residents’ objections would take second place to the technical needs of the project. [my yellow highlighting]

What a travesty Pacific Highway Upgrade community consultations are cannot get much clearer than this.

I'm sure local residents will not be pleased to have their fears confirmed.

Whether he meant to or not, Bob Higgins has probably just cemented the proposed Woombah asphalt batching site as a March 2019 NSW state election issue in the Clarence electorate for both the NSW National Party and the Berejiklian Coalition Government.

No-one likes to be told their valid concerns - about environmental impact, road safety, air quality and potential reduction in tourism numbers which underpin the local economy - don't matter to the state government down in Sydney.

BACKGROUND






Sunday, 29 July 2018

When it comes to My Heath Record the words horse, stable, door, spring to mind


In January 2016 the Australian Digital Health Agency (ADHA) became a corporate Commonwealth established under the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule.

It has a board appointed by the Minister for Health in whose portfolio it is situated and the board is the accountable body of the ADHA.

Currently Mr Jim Birch AM, Chair. Mr Rob Bransby, Dr Eleanor Chew, Dr Elizabeth Deven, Ms Lyn McGrath, Ms Stephanie Newell, Dr Bennie Ng,  Professor Johanna Westbrook and Michael Walsh sit on this board.

The executive team is headed by Tim Kelsey as CEO, with Professor Meredith Makeham as Chief Medical Adviser and Bettina McMahon, Ronan O’Connor, Terrance Seymour & Dr. Monica Trujillo as the four executive managers.

ADHA is also the designated Systems Operator for My Health Record which currently holds the personal health information of 5.98 million people across the country and will add the remaining 19 million after 15 October 2018 unless they opt out of being included in this national database.

Given the potential size of this database the question of cyber security springs to mind.

It seems that the Australian Digital Health Agency has not been independently audited for cyber resilience by the Australian National Audit Office (ANAO) ahead of beginning the mammoth task of collecting and collating the personal heath information of those19 million people.

Australian National Audit OfficePotential audit: 2018-19:

Management of cyber security risks in My Health Record

The audit would examine the effectiveness of the Australian Digital Health Agency’s management of cyber security risks associated with the implementation and ongoing maintenance of the My Health Record system.
My Health Record creates a record of Australians’ interactions with healthcare providers, and more than 5.5 million Australians have a My Health Record. The audit would focus on whether adequate controls are in place to protect the privacy and integrity of individual records.

It seems that the Australian general public still only has the honeypot's dubious word that it cannot be raided by unauthorised third parties.

Prime Minister Malcolm Turnbull has reacted to growing community concern about the number of agencies which can access My Health Records with a vague promise of "refinements" and with this outright lie; "The fact is that there have been no privacy complaints or breaches with My Health Record in six years and there are over 6 million people with My Health Records".

The Office of the Australian Information Commissioner has recorded complaints and at least 242 individual My Health Records have been part of mandatory data breach reports in 2015-16 to 2016-17, with nine of the 51 reported breach events involving "the unauthorised access of a healthcare recipient’s My Health Record by a third party".

BACKGROUND

Intermedium, 8 May 2018:

Re-platforming options for the My Health Record (MHR) system will soon be up for consideration, with an Australian Digital Health Agency (ADHA) spokesperson confirming that a request for information will be released in the next few months to inform plans to modernise the infrastructure underpinning Australia’s mammoth patient health database.

An open-source, cloud-based environment has already been flagged as a possibility for the MHR by Department of Health (DoH) Special Adviser for Strategic trategic Health Systems and Information Management Paul Madden at Senate Estimates in May last year. He also said that the re-platforming decision was one of many “variables” that needed to be squared away to accurately gauge how much the MHR system will cost beyond 2019-20.
“The variables in there include the re-platforming of the system to an open source environment, using cloud technology… which will be something we will not know the cost of until we hit the market to get a view on that”, Madden said last year. “Our commitment is to come back to the budget in 2019 to paint out those costs for the four years beyond.”
ADHA is scoping out MHR re-platforming options early, with the existing contract with the Accenture-led consortium not set to expire until 2020. As the “National Infrastructure Operator”, Accenture is tasked with running and maintaining MHR’s infrastructure. The prime contractor works with Oracle and Orion Health to provide the core systems and portals behind MHR.
Accenture was awarded the contract to design, build, integrate and test the then-personally controlled electronic health record system (PCEHR) back in 2011, and has signed 13 contracts worth a total of $709.53 million with DoH in relation to the MHR in that time. With the original infrastructure now over seven years old, ADHA recognise the importance of modernising the environment supporting the MHR....

The Sydney Morning Herald, Letter to the Editor, 26 July 2018. p20:

What happens to medical records when opting out?

Dr Kerryn Phelps reminds us that, if people don't opt out, the My Health Records Act allows disclosure of patients' health information to police, courts and the ATO without a warrant ("My Health Record backlash builds", July 25). This would be in addition to "health information such as allergies, medicines and immunisations" available for emergency staff.

How can the access be restricted to emergency staff? How can only certain categories of information be released when allergies and medication are part of general medical notes? I was not reassured by "serious penalties relating to the misuse of information do not apply to accidental misuse" on the website. I opted out.

My GP has told me that, nonetheless, she will be obliged to upload my records - which sounds credible since I have formally opted out with the government, not with my doctor's practice. So what happens - does my health record get kicked off "the cloud"? What exactly did I opt out of?

Denise De Vreeze [my yellow highlighting]

Tuesday, 24 July 2018

Australian Health Minister Greg Hunt is not being truthful about My Health Record and he knows it


On 16 July 2018 the Australian Minister for Health and Liberal MP for Flinders, Gregory Andrew 'Greg' Hunt, characterised My Health Record as a "secure summary" of an individual's key health information.

The Office of the Australian Information Commissioner (OAIC) tells a rather different story.

One where at least 242 individual My Health Records have been part of mandatory data breach reports in 2015-16 to 2016-17, with nine of the 51 reported breach events involving "the unauthorised access of a healthcare recipient’s My Health Record by a third party".

A story which also involves at least 96 instances of Medicare uploading data to the wrong digital health records and also uploading claim information to another 123 My Health Records apparently without the knowledge or consent of the persons in whose names these My Health Records had been created.

There were other instances where MyGov accounts held by healthcare recipients were incorrectly linked to the My Health Records of other healthcare recipients.

Prior to the database name change and system change from opt-in to opt-out there had been another 9 data breaches of an unspecified nature reported, involving an unknown number of what are now called My Health Records.

More instances are now being aired in mainstream and social media where My Health Records were created by DHS Medicare Repository Services or other agents/agencies without the knowledge or consent of the individual in whose name the record had been created.
Healthcare IT News 16 July 2018


If this is how the national e-health database was officially functioning malfunctioning by 30 June 2017, how on earth is the system going to cope when it attempts to create millions of new My Health Records after 15 October 2018?

On the first day of the 60 day opt-out period about 20,000 people refused to have a My Health Record automatically created for them and at least one Liberal MP has also opted out, the Member for Goldstein and member of the House of Representatives Standing Committee on Health, Aged Care and Sport Tim Wilson. 

Prime Minister Malcolm Bligh Turnbull has stated his view that mass withdrawals will not kill the national digital health records system - perhaps because he and his government are possibly contemplating adopting the following three coercive recommendations found amongst the thirty-one recommendations included in the Siggins Miller November 2016 Evaluation of the Participation Trials for the My Health Record: Final Report:

20. Use all mechanisms available in commissioning and funding health services as vehicles to require the use of the My Health Record to obtain funds where practical.

21. Consider ways to require the use of the My Health Record system by all healthcare providers and how to best use the Government’s purchasing power directly (e.g. in the aged care sector), via new initiatives as they arise (such the Health Care Home initiative) or via PHNs commissioning clinical services (e.g. require use of the My Health Record system in all clinical and aged care services that receive Commonwealth funds). Such requirements should have a timeframe within which healthcare providers need to become compliant.

22. Explore with health insurers how they could encourage preferred suppliers and clients to use the My Health Record system as part of their push for preventive care and cost containment.

That the My Health Record is not about improving health service delivery for individual patients is indicated by the fact that a My Health Record is retained by the National Repositories Service for between 30 and up to 130 years after death and, even during an individual's lifetime can be accessed by the courts, police, other government agencies and private corporations listed as research organisations requiring medical/lifestyle information for what is essentially commercial gain, at the discretion of the Secretary of the Department of Health or the Digital Health Agency Systems Operator. See: My Health Records Act 2012 (20 September 2017), Subdivision B - s63 to s70

To put it bluntly, this national database will allow federal government to monitor the personal lives of Australian citizens more closely, enforce civil & criminal law, monetise collated data for its own benefit  and, weaponize the personal information collected anytime it feels threatened by dissenting opinion.

NOTES

OAIC annual reports:


The Guardian, 22 July 2018:

Australia’s impending My Health Record system is “identical” to a failed system in England that was cancelled after it was found to be selling patient data to drug and insurance companies, a British privacy expert has said.

My Health Record is a digital medical record that stores medical data and shares it between medical providers. In the UK, a similar system called care.data was announced in 2014, but cancelled in 2016 after an investigation found that drug and insurance companies were able to buy information on patients’ mental health conditions, diseases and smoking habits.

The man in charge of implementing My Health Record in Australia, Tim Kelsey, was also in charge of setting up care.data. 

Phil Booth, the coordinator of British privacy group Medconfidential, said the similarities were “extraordinary” and he expected the same privacy breaches to occur.

“The parallels are incredible,” he said. “It looks like it is repeating itself, almost like a rewind or a replay. The context has changed but what is plainly obvious to us from the other side of the planet, is that this system seems to be the 2018 replica of the 2014 care.data.” [my yellow highlighting]

North Coast Voices , 22 July 2018, Former Murdoch journalist in charge of MyHealth records –what could possibly go wrong?

UPDATE

Australian Parliamentary Library, Flagpost, 23 July 2018:

Section 70 of the My Health Records Act 2012 enables the System Operator (ADHA) to ‘use or disclose health information’ contained in an individual’s My Health Record if the ADHA ‘reasonably believes that the use or disclosure is reasonably necessary’ to, among other things, prevent, detect, investigate or prosecute any criminal offence, breaches of a law imposing a penalty or sanction or breaches of a prescribed law; protect the public revenue; or prevent, detect, investigate or remedy ‘seriously improper conduct’. Although ‘protection of the public revenue’ is not explained, it is reasonable to assume that this might include investigations into potential fraud and other financial offences involving agencies such as Centrelink, Medicare, or the Australian Tax Office. The general wording of section 70 is a fairly standard formulation common to various legislation—such as the Telecommunications Act 1997—which appears to provide broad access to a wide range of agencies for a wide range of purposes. 

While this should mean that requests for data by police, Home Affairs and other authorities will be individually assessed, and that any disclosure will be limited to the minimum necessary to satisfy the request, it represents a significant reduction in the legal threshold for the release of private medical information to law enforcement. Currently, unless a patient consents to the release of their medical records, or disclosure is required to meet a doctor’s mandatory reporting obligations (e.g. in cases of suspected child sexual abuse), law enforcement agencies can only access a person’s records (via their doctor) with a warrant, subpoena or court order....

It seems unlikely that this level of protection and obligation afforded to medical records by the doctor-patient relationship will be maintained, or that a doctor’s judgement will be accommodated, once a patient’s medical record is uploaded to My Health Record and subject to section 70 of the My Health Records Act 2012. The AMA’s Guide to Medical Practitioners on the use of the Personally Controlled Electronic Health Record System (from 2012) does not clarify the situation.

Although it has been reported that the ADHA’s ‘operating policy is to release information only where the request is subject to judicial oversight’, the My Health Records Act 2012 does not mandate this and it does not appear that the ADHA’s operating policy is supported by any rule or regulation. As legislation would normally take precedence over an agency’s ‘operating policy’, this means that unless the ADHA has deemed a request unreasonable, it cannot routinely require a law enforcement body to get a warrant, and its operating policy can be ignored or changed at any time.

The Health Minister’s assertions that no one’s data can be used to ‘criminalise’ them and that ‘the Digital Health Agency has again reaffirmed today that material … can only be accessed with a court order’ seem at odds with the legislation which only requires a reasonable belief that disclosure of a person’s data is reasonably necessary to prevent, detect, investigate or prosecute a criminal offence…..

Although the disclosure provisions of different agencies may be more or less strict than those of the ADHA and the My Health Records Act 2012, the problem with the MHR system is the nature of the data itself. As the Law Council of Australia notes, ‘the information held on a healthcare recipient’s My Health Record is regarded by many individuals as highly sensitive and intimate’. The National Association of People with HIV Australia has suggested that ‘the department needs to ensure that an individual’s My Health Record is bound to similar privacy protections as existing laws relating to the privacy of health records’. Arguably, therefore, an alternative to the approach of the current scheme would be for medical records registered in the MHR system to be legally protected from access by law enforcement agencies to at least the same degree as records held by a doctor.