Regulation, policy oversight and funding of aged care services are predominantly the role of the Australian Government - under three successive Coalition governments needs are not being met

Regulation and policy oversight of aged care services are predominantly the role of the Australian Government. It funds residential aged care, home care and home support, with state, territory and local governments also funding and/or delivering some of these services directly. However, most services are delivered by non-government providers such as private-for-profit, religious and charitable organisations.

Government subsidises a significant portion of the cost of providing aged care, but clients and residents are expected to contribute where they can and may be charged fees and payments by service providers.

In 2018-19 there were est. 3.9 million people 65 years of age or older in the Australian population.

Of these older people:

236, 213 were in permanent residential care;

64,117 had received respite care;

24,137 had received transition care or short-term restorative care;

1,072 national ATSI flexible age care program places were operational;

826,335 were receiving home support; and

131,534 were receiving home care packages. 
[Productivity Commission, REPORT ON GOVERNMENT SERVICES 2020]

That is est. 1.2 million older Australians who are receiving some form of government funded care.

Government recurrent expenditure on aged care services was $20.1 billion in the 2018-19 financial year or $4,874 per older person, with the federal government providing 98.2 per cent of the funding.

That low annual level of expenditure per person may be one of the reasons for this…..

The Sydney Morning Herald, 23 January 2020:

The time it takes for older Australians to enter a nursing home after being assessed as needing residential care has blown out almost 50 per cent in two years, while waiting times for the highest level of home care package are 34 months.

The Productivity Commission reports that the median "elapsed time" between getting approval from an aged care assessment team (ACAT) and going to a nursing home was 152 days in 2018-19. This is up from 121 days in 2017-18 and 105 days in 2016-17.

In New South Wales, the median wait time was 143 days in 2018-19 and 124 days in Victoria. Across Australia, almost 42 per cent of older people entered a nursing home within three months of getting ACAT approval. Almost 60 per cent of people entered a nursing home within nine months.

The Productivity Commission explained the waiting time was influenced by the availability of places as well as an older person's "preference to stay at home for as long as possible". The commission noted people may choose to try to access formal help at home or more family help, instead of taking up a nursing home place.

It said there may also be delays if people sold their family home before going into residential care.

The Productivity Commission's annual report on government services follows the aged care royal commission's recent scathing assessment of the sector. In its interim report, the royal commission slammed the aged care system as "sad and shocking", "diminish[ing] Australia as a nation". It also comes amid pleas from the aged care sector for $1.3 billion in urgent financial assistance to keep nursing homes open around the country.

The Productivity Commission's report, released today, said the median time between ACAT approval and the offer of a home care package ranged from seven months for a level one package, to 34 months for a level four (highest needs) package in 2018-19.

The commission said there was no comparable data on home care package "elapsed times" for previous years, due to a change to the approval process in 2017. Federal government data released before Christmas showed more than 112,000 people were waiting for home care. The royal commission singled out the home care wait list for urgent attention last October, noting "many people die waiting".

According to the Productivity Commission, in 2018, 84.4 per cent of those who received a formal aged care service in the home over the previous six months said they were satisfied with the quality of help they received. This was down from 89.2 per cent in 2015.

The report also found that 34 per cent of people over 65 who live at home and were classified as "in need of assistance" said their needs were not "fully met"…..

Australian Prime Minister Scott Morrison & his merry band of cost cutters decided to save $9.2 million a year by cutting off CapTel phones for the profoundly deaf. Luckily this new front in Morrison's ongoing war on the poor & vulnerable was something of a fizzer

"The Commonwealth Government has awarded American company, Concentrix Services a contract to deliver the National Relay Service (NRS). One of the first things Concentrix is contracted to do is to shut down the CapTel handset service on 1 February 2020." [Deaf Forum of Australia, July 2019]

ABC News, 31 January 2020: 

Thousands of hearing-impaired Australians could face a return to 1980s technology from today after the Federal Government cancelled a deal to support text-captioning telephones. 

Phones with CapTel captioning display words on a large screen in near real time, so deaf and hearing-impaired users can make calls and see the responses. 

But in a decision criticised by disability advocates, the phones will not work as of February 1, after the Department of Communications declined to renew the service provider's contract with the National Relay Service (NRS).  
A new company won the contract. [Concentrix Services Pty Ltd, a subsidiary of the SYNNEX Corporation]

It will force users to take up alternative options, with many choosing to revert back to what are known as TTY teletypewriter phones — technology first introduced in the 1980s. 

For Christine O'Reilly, the CapTel phone changed her life. Ms O'Reilly's hearing has been deteriorating since childhood and now at 62, she is profoundly hearing impaired. 

"When I received the CapTel I was so overjoyed I burst into tears," she said..... 

Critics say the decision has come down to one thing: money. 

The cost of the NRS has blown out in recent years, from $26.3 million in 2015-16, to $31.2 million in 2017-18...... 

The new NRS contract awarded last June provides for $22 million per year over three years. 

Until recently there were more than 3,500 CapTel handsets distributed across Australia. The Department of Communications estimates about 1,000 are still active. 

"I certainly acknowledge any transition of this kind is challenging, particularly for older Australians who may not be as familiar with technology," 

Minister for Communications Paul Fletcher said. "We've retained a team of trainers who've been going to meet individually with CapTel users to brief them on their alternatives." .....

It is expected many users will switch to TTY teletypewriter phones, which have a small two-line screen for text above the number pad. 

"We're having to go backwards in time, and everyone else can get the latest iPhone," said Dr Alex Harrison, a profoundly deaf veterinarian in Adelaide. 

"[I feel] enormously frustrated and discriminated against," he said. 

Dr Harrison said the CapTel phone had revolutionised his practice, allowing him to easily make up to 10 calls a day. 

Making a call on a TTY phone is much more complicated. "If I want to make a phone call on the TTY, I have to call a 133 number first … and they'll put me through to an operator," he explained. 

Once you do that, you may be put on hold or told you are in a queue to make a call. 

On January 7, the department acknowledged wait times to get through were unacceptable. 

"We understand and acknowledge community disappointment about these issues and can assure you that we are focused on resolving these concerns as a priority," it said. 

To address the wait times, the relay service provider Concentrix is currently hiring and training additional staff. 

New staff took their first calls just prior to Christmas and more staff will commence during the rest of January. 

Other options offered by the Department of Communications are internet-based call captioning and apps designed to work on mobile phones and tablets. 

But users said many of the online options were much slower and less user-friendly, requiring them to fill in multiple fields just to initiate a phone call. 

"The other options are far too slow. They're primitive," Ms O'Reilly said. 

 And advocates point out the average age of CapTel phone users is more than 80. 

"For an elderly person who's not tech savvy, [these options] can be very intimidating, and often they can't do it. Some of these people are 80 or 90, and they really struggle with that," Dr Harrison said..... [my annotation in red]

"It is indeed a big shock to many Australians, and myself, who rely and need the Captel handset. It seems to me that this section of people with a hearing loss have been sacrificed in a big way so that the TTY can be ‘re-introduced’ and then plunge those who went deaf later in life and whom can speak, right back in the dark ages. It is also a direct insult to the intelligence of the people who worked long and hard to get Captel up and running in Australia. Many of our members have spoken of their dismay and disgust, particularly being isolated and the loss of their independence. In the long run, this move will cost the Australian government much more than it does now." [Deaf Forum of Australia, July 2019]

Thankfully, Captioned Telephone International, the company whose contact the Morrison Government refused to renew and, its president Rob Engelke, have bigger, kinder hearts than either Prime Minister Scott Morrison or Minister for Communications Paul Fletcher, as Mr. Engelke has committed the company to maintaining the CapTel system for those Australians who would otherwise lose their handsets by arranging for the routing of all calls through the company's U.S. captioning centres, while it investigates long-term options based in Australia.

Chromium-6: bushfire temperatures of up to 1,000 degrees can endanger human health long after the flames have gone out

"Fire-induced oxidation of Fe oxide-bound Cr(III) may represent a largely unexplored, yet globally-significant pathway for the natural formation of hazardous Cr(VI) in soil." [Burton E.D. el al, April 2019]

Echo NetDaily, 15 January 2020:

Scientists from Southern Cross University have made a startling discovery about the lethal threat of soils scorched by bushfires. 

The team, led by Professor Ed Burton, has found the naturally occurring metal chromium 3 can be converted by extreme bushfire heat into the highly toxic and cancerous chromium 6. 

Professor Ed Burton of Southern Cross Geoscience is looking at the levels of a toxic element in bushfire affected soil. 

Chromium 6 is the substance spotlighted by renowned American environmentalist Erin Brockovich, who blew the whistle on high concentrations in the water supply of her home town in southern California.

Professor Burton’s breakthrough research has confirmed bushfire temperatures of up to 1,000 degrees can endanger human health long after the flames have gone out. 

‘We’ve seen bushfires create conditions in the surface soil that transform the safe, naturally occurring chromium-3 into the toxic, cancer-causing chromium-6,’ Professor Burton said. 

‘Chromium-6 can cause lung cancer and leach into waterways.’ 

Professor Burton, an expert on the geochemistry and mineralogy of soils, sediments and groundwater systems, said frontline firefighters were immediately at risk but the contamination of water within catchment areas posed a wider threat. 

‘We know that firefighters have higher incidences of chromium in their urine and are more susceptible to cancer than other groups....

See the following peer-reviewed articles concerning the carcinogen Chromium-6:

Burton, E.D., Choppala, G., Karimian, N., Johnston, S.G. (2019) A new pathway for hexavalent chromium formation in soil: Fire-induced alterations of iron oxides. Environmental Pollution 247, 618-625; and 

Burton, E.D., Choppala, G., Vithana, C., Hockmann, K., Johnston, S.G. (2019) Chromium(VI) formation via heating of Cr(III)-Fe(III)-(oxy)hydroxides: A pathway for fire-induced soil pollution. Chemosphere 222, 440-444.

It should be noted that wildfires can also affect and possibly increase the mobility of other minerals naturally found in the soil. 

Initial research suggests that an example of this may be the carcinogen, arsenic. Additionally, past research suggests the potential of higher mercury content in freshwater fish after wildfire events.

The North Coast Public Health Unit is urging people in Yamba NSW to look out for measles symptoms, after a resident contracted the infectious disease

Northern NSW Health District, community announcement, 6 December 2019:

Measles on the NSW North Coast – Yamba

The North Coast Public Health Unit is urging people in Yamba to look out for measles symptoms, after a resident contracted the infectious disease.

People who visited the following areas on these dates may have been exposed:

• Thursday 28 November, Friday 29 November, Monday 2 December or Tuesday 3 December – anyone who travelled on bus routes 1, 2, or 4 in Yamba
• Saturday, 30 November – Maclean Golf Course between 8.00am to 1.15pm
• Saturday, 30 November – Yamba Fair Shopping Centre, including Coles, butchers, newsagent between 2.00pm to 3.00pm
• Sunday, 1 December – Yamba Bowling Club between 5.30pm to 7.00pm
• Tuesday, 3 December – Yamba Fair Shopping Centre around 4.00pm.

Acting Director of North Coast Public Health Unit, Greg Bell, said measles is highly infectious among people who are not fully immunised.

“Measles symptoms include fever; sore eyes, a cough, and a red, blotchy rash spreading from the head to the rest of the body,” Mr Bell said.

“Anyone who was in or has visited the locations listed should watch for symptoms until 21 December. These locations pose no ongoing risk to the public.

“It can take up to 18 days for symptoms to appear following exposure to a person with measles.

“If you develop symptoms of measles, please arrange to see your GP and phone ahead to alert them before arriving at the GP clinic.

Measles is highly contagious and is spread in the air through coughing or sneezing by someone who is unwell with the disease. Vaccination is your best protection against this extremely contagious disease.

The measles-mumps-rubella (MMR) vaccine is a safe and highly effective protection against measles, and is available for free for those born during and after 1966 from your GP.

“If you are unsure whether you have had two doses, it is safe to have another dose,” Mr Bell said.

Protecting children from potentially deadly diseases is a key priority for the NSW Government, which has invested approximately $130 million in the 2019-20 Immunisation Program budget, including Commonwealth and state vaccines.

For more information on measles, visit: 

https://www.health.nsw.gov.au/Infectious/factsheets/Pages/Measles_Factsheet.aspx.

[my yellow highlighting]

Australian Prime Minister Scott Morrison's cruel war on asylum seekers continues.....

On 4 December 2019 the Leader of the Morrison Government in the Senate, Mathias Cormann, moved to suspend standing orders to consider the for the remainder of the day.

According to the Government; The Migration Amendment (Repairing Medical Transfers) Bill 2019 (the Bill) amends the Migration Act 1958 (the Migration Act) to repeal the provisions inserted by Schedule 6 to theHome Affairs Legislation Amendment (Miscellaneous Measures) Act 2019 (the medical transfer provisions). As the medical transfer provisions do not provide for any return or removal mechanism, the Bill also amends the Migration Act to extend existing powers in relation to persons transferred to Australia under the medical transfer provisions to allow for their removal from Australia or return to a regional processing country once they no longer need to be in Australia for the temporary purpose for which they were brought. 

Thus Morrison wanted to ensure doctors did not retain more say in the medical treatment of offshore asylum seeker detainees and intended to remove those detainees already transferred to Australia in the last eight months as soon as possible. He and his government saw this as compatible with Australia's human rights obligations.

At 10.08 am Cormann moved that; That a motion to provide for the consideration of the Migration Amendment (Repairing Medical Transfers) Bill 2019 may be moved immediately and determined without amendment or debate.

This motion passed 38 to 36 with a majority of 2.

By 11.21am the bill was passed 37 to 35 with a majority of 2.

Those voting in support of the bill were:

Abetz, Eric (Lib-Tas) Antic, Alexander (Lib-SA) Askew, Wendy (Lib-Tas).

Bernardi, Cory (Ind-SA) Bragg, Andrew J (Lib-NSW) Brockman, Slade (Lib-WA).

Canavan, Matthew J (Lib-Qld) Cash, Michaelia C (Lib-WA) Chandler, Claire (Lib-Tas) Colbeck, Richard (Lib-Tas) Cormann, Mathias (Lib-WA).

Davey, Perin (Nats-NSW) Duniam, Jonathon (Lib-Tas).

Fawcett, David J (Lib-SA) Fierravanti-Wells, Concetta (Lib-NSW).

Hanson, Pauline (ON-Qld) Henderson, Sarah M (Lib-Vic) Hughes, Hollie (Lib-NSW) Hume, Jane (Lib-Vic).

Lambie, Jacqui (JLN-Tas).

McDonald, Susan (LNP-Qld) McGrath, James (LNP-Qld) McKenzie, Bridget (Nats-Vic) McMahon, Samantha (Lib-NT) Molan, A "Jim" (Lib-NSW).

O'Sullivan, Matthew A (Lib-WA).

Paterson, James (Lib-Vic).

Rennick, Gerard (LNP-Qld) Reynolds, Linda (Lib-WA) Roberts, Malcolm (ON-Qld) Ruston, Anne (Lib-SA) Ryan, Scott M (Lib-Vic)

Scarr, Paul (LNP-Qld) Seselja, Zdenko (Lib-ACT)  Smith, Dean A (Lib-WA) Stoker, Amanda J (LNP-Qld).

          Van, David (Lib-Vic).

These are the politicians who (along with their counterparts in the House of Representatives) returned Australian society to the days when, as a mattter of policy, offshore detainees were refused medical transfer to Australia unless they were on the brink of death. 

In the past this policy resulted in avoidable detainee deaths such as that of Hamid Kehazaei - it will likely do so again.

As soon as the Migration Amendment (Repairing Medical Transfers) Act 2019 receives assent, Prime Minister Morrison will in all probability quickly move to return the 179 medevac detainees back to Nauru and Manus Island.

Australian cardiologist Arnagretta Hunter: “On the coast of NSW this week we know there are more respiratory illnesses, heart attacks and strokes as a consequence of the terrible air pollution from the fires"

The Guardian, 14 November 2019:

Bushfire smoke blankets the morning sky in Glen Innes, NSW, on 11 November. Respiratory illnesses are rising as a result of air pollution from this week’s fires, cardiologist Arnagretta Hunter says following the release of the latest Countdown report on climate change and health worldwide. Photograph: Brook Mitchell/Getty Images

The federal government’s lack of engagement on health and climate change has left Australians at significant risk of illness through heat, fire and extreme weather events, and urgent national action is required to prevent harm and deaths, a global scientific collaboration has found.

On Thursday, international medical journal the Lancet published its Countdown report, a multi-institutional project led by University College in London that examines progress on climate change and health throughout the world.

Its first two assessments were published in 2017 and 2018, with annual assessments continuing until 2030, consistent with the near-term timeline of the Paris climate agreement. Findings relating to Australia were tracked and published by the Medical Journal of Australia.

Australia was assessed across 31 indicators divided into five broad sections: climate change impacts, exposures and vulnerability; adaptation, planning and resilience for health; mitigation actions and health co-benefits; finance and economics; and public and political engagement.

The report found that while there had been some progress at state and local government levels, “there continues to be no engagement on health and climate change in the Australian federal parliament, and Australia performs poorly across many of the indicators in comparison to other developed countries; for example, it is one of the world’s largest net exporters of coal and its electricity generation from low-carbon sources is low”.

“As a direct result of this failure, we conclude that Australia remains at significant risk of declines in health due to climate change, and that substantial and sustained national action is urgently required in order to prevent this … This work is urgent.”“We also find significantly increasing exposure of Australians to heatwaves and, in most states and territories, continuing elevated suicide rates at higher temperatures,” wrote the authors, led by Associate Professor Paul Beggs of Macquarie University’s Department of Earth and Environmental Sciences.

Spokeswoman for Doctors for the Environment Australia, Dr Arnagretta Hunter, agreed Australia was poorly prepared for the health challenge of climate change.

“Doctors around Australia are already seeing multiple health effects from climate change,” Hunter, a cardiologist, said.

“On the coast of NSW this week we know there are more respiratory illnesses, heart attacks and strokes as a consequence of the terrible air pollution from the fires. Doctors see the mental health effects of drought in rural communities. Patterns of infectious diseases are changing.

“Average summer temperatures in Australia have risen by 1.66C in the past 20 years, with the intensity of heatwaves rising by a third. And with the increasing temperatures over summer we know there has been increased hospital admissions with ill health. Mortality rates are also affected.”

In 2014, Melbourne experienced temperatures over 41C from 14 to 17 January, as well as 167 excess deaths and a new record set for the highest number of calls for ambulance services ever received in a day, she said. Hunter described Australia as the developed country with the most serious vulnerability to climate change through heat, fire, water shortages and extreme weather events.

“Doctors for the Environment Australia joins the loud chorus across Australia calling for the federal government to acknowledge the risk and act in proportion to the magnitude of the threat,” she said. [my yellow highlighting]

Read the full article here.

The 2019 report of the Lancet Countdown on health and climate change, 13 November 2019, can be found here.
  

Australian Medical Association formally declares climate change a health emergency

The Guardian, 3 September 2018: 

The Australian Medical Association has formally declared climate change a health emergency, pointing to “clear scientific evidence indicating severe impacts for our patients and communities now and into the future”. 

The AMA’s landmark shift, delivered by a motion of the body’s federal council, brings the organisation into line with forward-leaning positions taken by the American Medical Association, the British Medical Association and Doctors for the Environment Australia. 

The American Medical Association and the American College of Physicians recognised climate change as a health emergency in June 2019, and the British Medical Association the following month declared a climate emergency and committed to campaign for carbon neutrality by 2030. 

The World Health Organisation has recognised since 2015 that climate change is the greatest threat to global health in the 21st century, and argued the scientific evidence for that assessment is “overwhelming”. 

The AMA has recognised the health risks of climate change since 2004. Having now formally recognised that climate change is a health emergency, the peak organisation representing doctors in Australia is calling on the Morrison government to promote an active transition from fossil fuels to renewable energy; adopt mitigation targets within an Australian carbon budget; promote the health benefits of addressing climate change; and develop a national strategy for health and climate change. 

The AMA president, Tony Bartone, argues the scientific evidence is clear. “There is no doubt that climate change is a health emergency. The AMA accepts the scientific evidence on climate change and its impact on human health and human wellbeing,” he says. 

Bartone says the climate science suggests warming will affect human health and wellbeing “by increasing the environment and situations in which infectious diseases can be transmitted, and through more extreme weather events, particularly heatwaves”. 

“Climate change will cause higher mortality and morbidity from heat stress,” the AMA president says. “Climate change will cause injury and mortality from increasingly severe weather events. Climate change will cause increases in the transmission of vector-borne diseases. Climate change will cause food insecurity resulting from declines in agricultural outputs. Climate change will cause a higher incidence of mental ill-health. 

“These effects are already being observed internationally and in Australia.” 

Bartone told Guardian Australia the motion adopted by the federal council had followed an ongoing discussion among stakeholders, and medical practitioners within the AMA membership....... 

 The latest official data released last week confirms that greenhouse gas emissions continue to rise in Australia. National emissions increased by 3.1m tonnes in the year to March to reach 538.9m tonnes, a 0.6% jump on the previous year. 

Emissions in Australia have increased every year since the Abbott government repealed a national carbon price after taking office in 2013.

Do you know exactly who Medicare, your GP, specialist doctor or local area health service are sharing your personal medical information with?

Electronic Frontiers Australia, media release, 26 August 2019: 

Australia, Melbourne — Monday 26 August 2019 — EFA, Future Wise, Digital Rights Watch and APF today call again for a comprehensive review of privacy provisions for healthcare data. 

 Following the HealthEngine scandal in 2018, and the recent use of Pharmaceutical Benefits Scheme (PBS) data to assist recruitment into research on Bipolar disorder, a Twitter user on Friday 23 August shared a SMS message attempting to recruit him into a clinical trial. 

This appears to have occurred through the use of Precedence Healthcare’s InCa (Integrated Care) health platform. Research by members of digital rights organisations today revealed that sensitive patient details—including contact details, demographics and complete medical histories—can be shared with a wide range of partners, including, it appears, private health insurers. 

Dr Trent Yarwood, health spokesperson for Future Wise and a medical specialist, said “Secondary uses like this are a very ethically murky area. People don’t generally expect to have personal details from their healthcare providers made available to anyone, even if well intentioned.” 

The terms and conditions of the application include access to data from myHealthRecord. “While the My Health Records Act includes privacy provisions, once this data is accessed by an external system, these provisions no longer apply,” continued Dr Yarwood. “I’m very concerned that practices making use of this system are not aware of just how widely this data can be shared—and that they are expected to fully inform patients of the nature of the data use,” he concluded. 

“This kind of barely-controlled data sharing is only possible because of how little privacy protection is provided by the current legislation,” said Justin Warren, Electronic Frontiers Australia board member. 

“People have made it clear time and time again that information about their health is extremely personal, private, and they expect it to be kept secure, not shared with all and sundry,” he said. “What people think is happening is quite different to what actually is, and these companies are risking catastrophic damage to patient trust with their lust for data.” 

“If you found out your doctor was sharing your full medical history with private health insurers, or the police, would you keep seeing them?” he added. 

Robust privacy protections are needed for all Australians, such as by finally giving us the right to sue for breach of privacy, requiring explicit consent for each disclosure of medical or health data to a third party, and proper auditing of record-access that is visible to the patient. It is imperative that the risks of health data sharing receive greater attention. [my yellow highlighting]

Australian Health Information Technology, 25 August 2019: 

This Seems To Be A System Of Sharing Personal Health Information That Is Rather Out Of Control. 

I noticed this last week: How does Inca collect and share health information? 

Updated 1 month ago 

Precedence Health Care’s Integrated Care Platform (Inca) is a cloud- based network of digital health and wellness services, including MediTracker mobile application services. 

It is important that all users of Inca services understand how the network collects and shares health information (“personal information”) and are aware of their responsibilities for gaining informed consent from patients. 

To the extent applicable (if at all), the Health Privacy Principles (or equivalent), which operate in some jurisdictions, should guide your actions. In the absence of applicable Health Privacy Principles, you should refer to relevant Commonwealth, State or Territory privacy legislation, and assistance can also be derived by referring to the website of the Office of the Australian Information Commissioner. You should make sure you are familiar with the applicable principles or other relevant guidance, and also with Precedence Health Care’s Privacy Policy. 

Inca collects and shares personal information about patients and other persons under care (also called “consumers”) who consent to this information being stored and shared in the network. This information may come from a variety of sources, including the clinical software systems used by GPs (e.g., Medical Director, Best Practice); other members of the patient’s care team (e.g., allied health professionals, medical specialists); the patient themselves; participating health services and pathology services; and the Commonwealth’s My Health Record. 

Inca uses this information to provide a range of health care and wellness services to the patient and their care team. 

Prior to contributing a patient’s personal information to be stored in or used by Inca, users must obtain informed consent from patients for the collection and sharing of this information. Ensuring that patients are informed about what will happen with the information that is being shared is a fundamental component of best practice in privacy, so it is important that all Inca users and patients know what information is available on Inca and who has access to that information. 

When a patient’s GP or other person authorised by the GP uses Inca to collect personal information from their general practice clinical system, Inca will extract and share the following information: 

· Patient demographics 
· Alcohol consumption and smoking status 
· Allergies and adverse reactions 
· Family and social history 
· Observations and results 
· Current medications 
· Immunisation history 
· Current and past problems 

If the patient or the GP does not wish to share some of this information, the GP’s clinical system should provide a means for declaring such data “confidential” and thereby preventing it being sent to Inca. 

GPs who do not know how to do this should contact the provider of their clinical software. Inca may also collect and share information obtained from other sources. 

These include: 

· Information that the GP or any member of the care team or the patient themselves adds to the patient record or to any notes concerning the patient’s care using Inca services, web sites or mobile devices. This information may include contact information, measurements, care plans, assessments, referrals, progress notes, appointments, and other related personal and health information. 

· Information from participating Health Services, including discharge summaries and emergency department attendance. 

· Information obtained from My Health Record. This information may include some or all of the data stored in the patient’s My Health Record. 

It is the responsibility of the provider of information stored in or used by Inca, or the person who grants access to such information, to inform the patient of the type of personal information that is so provided or made accessible. 

Inca will provide access to a patient’s personal information with the patient’s GP and care team, the patient (or their carer as authorised by the patient), participating Health Services, and some others as necessary to provide the services of Inca. Precedence Health Care may share de-identified data (that is, data from which it is impossible to ascertain who you are) to persons or organisations who are engaged in research, trials and analyses relating to improvements in health and the management of health services. The way Inca shares and protects this information is described in the Precedence Health Care Privacy Policy. 

It is important that patients understand what information is being shared, who it is being shared with, and for what purpose. It is the responsibility of the persons providing this information to ensure that each patient is aware that their personal and health information is being stored on a computer system hosted on a secure site in Australia, as described in the Precedence Health Care Privacy Policy. 

It is also important for all users of Inca to be aware that this information may not be complete, up to date, or accurate. 

In seeking informed consent to participate, patients should be advised that any measurements or notes that they enter into Inca are not continuously monitored and will be available to members of the patient’s care team only when the provider next logs in to Inca. 

Patients who are concerned about any condition should contact their GP or other health care provider using their normal means (e.g., phone) and should not use Inca for this purpose. 

Please contact Precedence Health Care’s Privacy Officer on (03) 9023 0800 or email privacy@precedencehealthcare.com if you have any questions or concerns about our Privacy Policy, or if you wish to suggest improvements. You may also contact your State’s Privacy Commissioner or Ombudsman to get advice about privacy or make a complaint. 

Here is the link: https://phc.zendesk.com/hc/en-us/articles/360021090952-How-does-cdmNet-collect-and-share-health-information- 

For background Precedence Health run a shared patient data base which is accessible to GPs, Specialists and Allied Health Staff for the purpose of care planning and co-ordinating care. Using their system allows GPs to claim a Medicare Item No for this service. They also provide patient access to the data and have services such as reminders etc in an app. 

All that said this system, on its own statements, just sucks information from everywhere (GP systems, health services and the myHR) and pops it into one database. One user, who is now switching it off, revoking consent and getting out has described to me a collection of erroneous and mis-sorted data on their record. 

More they seem to be happy to hand out the data to others claiming it is de-identified – and we all know how in-effective that can be! 

The rather loose way consent rules for disclosure appear to be enforced is also a worry. 

They even have the legendary myHR disclaimer that “It is also important for all users of Inca to be aware that this information may not be complete, up to date, or accurate.” Doh! 

You can see the Privacy Policy here if you wish! https://phc.zendesk.com/hc/en-us/articles/360021091012-Privacy-Policy- 

Don’t know about you but none of my information would go anywhere near this if I could help it! It looks like a serious unthought through shambles to me. 

What do you think? 

David.  [my yellow highlighting]