Showing posts with label human rights. Show all posts
Showing posts with label human rights. Show all posts

Wednesday, 12 February 2020

Shorter Residential Aged Care Industry Message in 2020: If you personally pay us more we will treat you better


"If we expect people to pay more [in the future], we have to deliver much better care" [Catholic Health Australia chief executive Pat Garcia quoted in The Sydney Morning Herald, 9 February 2020]

ABC News, 9 February 2020:

Sydney's streets were thick with smoke as the blazes took hold on December 5 last year. 

That may explain why few noticed or cared about the final sitting day in Canberra.

But what happened in the Senate that day shows just how strong the ties that bind the aged care lobby and government really are.

At 9.30 that day, some crucial amendments to aged care legislation were introduced which would force nursing home to reveal how they spent their $20 billion of taxpayer funds each year — specifically, how much went to staff, food and "the amounts paid out to parent bodies".

Unlike hospital and child care centres, aged care facilities can employ as few staff as they like because there are no staff-to-resident ratios in nursing homes.

When it comes to food, a study of 800 nursing homes shows the average spend is just $6 a day.

The Senate vote was taking place just five weeks after 
the scathing interim report from the Royal Commission into Aged Care Quality and Safety.

Among its findings of a "sad and shocking" system which was 
"inhumane, abusive and unjustified", the commissioners also commented on the lack of transparency in aged care, with the numbers of complaints, assaults and staff numbers all kept secret from the public.

"My amendments are all about transparency and accountability — 
and, boy, do we need more of this," said Senator Stirling Griff from Centre Alliance, who proposed the amendments.

When the crucial vote came, Labor, the Greens, Centre Alliance and Jacqui Lambie supported it. But the Government voted against it and, with the help of Pauline Hanson, the reform was defeated.

It might seem an odd choice for Pauline Hanson, who has previously rallied against the aged care sector for "rorting and malpractice", but it shouldn't be surprising that the Government voted it down.

The influence of lobbyists

The aged care industry has been successfully lobbying governments for years. The influence of the industry through government committees, think tanks and policies is well known and is being rightly questioned at the royal commission.

For example, when the Queensland Government proposed laws requiring nursing homes to publish their staff numbers last year, the federal Department of Health sent a six-page document arguing against it, saying it might "confuse or mislead" families and "appears to create a reporting burden on providers with no clear benefits to consumers".

If you think the Federal Government's objections sound a lot like those of the aged care lobby, you wouldn't be wrong.

In fact, the industry group Leading Aged Services Australia (LASA) argued in its own submission that few families would be interested in accessing a website with such information and that the numbers could be used "to push a particular medically based care model (which may be contrary to the preferences of residents)".

That's an argument LASA has been using for years. It's code for arguing against more registered nurses for fear it spoils the "home-like" atmosphere of an aged care facility.

Others might argue that the hundreds of stories told to the royal commission of poor wound care, misdiagnosis and failure to send sick residents to hospital may have something to do with that lack of a "medical model".

Currently there's no requirement, except in Victorian state run facilities, for an RN to be employed at a nursing home.

The aged care lobby doesn't want that to become a national trend.

Why can't we know how many staff there are?'

The industry and Federal Government's opposition to the argument against making the staff numbers public didn't wash with the Queensland Government.

"We report the number of teachers to students in classes, educators to children in child care, why the hell can't we know how many staff there are in aged care facilities?," said Queensland Health Minister Stephen Mills, who successfully passed the legislation and says he will "name and shame" nursing homes which refuse to make staff numbers public.

Prime Minister Scott Morrison will argue that the Government voted against the federal moves for financial transparency because it doesn't want to introduce any major reforms before the final report from the royal commission.

However, that excuse didn't stop the Federal Government from its massive reform of putting the publicly funded Aged Care Assessment system out to tender last year.

The move to privatise it was widely denounced by state ministers (including from the NSW Liberal Government), advocates and the medical profession.

But the aged care lobby groups are big supporters of the change…...

Read the full article here.


The Sydney Morning Herald, 9 February 2020:

...the federal Health Department revealed it was yet to implement key recommendations of the Australian Law Reform Commission's 2017 report on elder abuse. 

Responding to a question taken on notice at a Senate estimates hearing, Health Department bureaucrats this week said a "scoping study" was being done on a register of aged care workers, while "preparatory work" was under way on a serious incident response scheme for assaults in care. 

Labor's aged care spokeswoman, Julie Collins, said older Australians at risk of abuse deserved "immediate action, not years of inaction and delays". 

Official data shows there were 5233 assaults in residential aged care facilities in 2018-19. 

Catholic Health Australia outlined its proposed new means-testing rules in a pre-budget submission to the federal government.

There is a question begging to be answered here. 

If Scott Morrison and his Lib-Nats cronies go down the path of attempting to permanenltly conceal what amounts to institutionalised elder abuse, allows residential aged care providers to further entrench differing levels of care based on an ability of the frail aged to pay and goes ahead with further aged care services privatisation in order to avoid accountability - has Morrison himself calculated just how many elderly Australians will be likely to commit suicide soon after being told they will be entering residential aged care?

Sunday, 9 February 2020

State of Play in Scott Morrison's Personal War On The Poor And Vulnerable: at least 9,600 angry people are taking on the federal government over 'robodebt'


These emails are just two examples of correspondance which has seen the light of day, concerning the legality of Morrison Coalition Government's Dept. of Human Services-Centrelink income compliance program or 'robodebt', since government made admissions in Amarto v The Commonwealth and was notified of an intent by certain persons to commence a class action arguing that the Commonwealth has taken money from Centrelink recipients unjustly.











The emails indicate the federal government's knowledge that sole use of the automated data matching system to calculate a 'robobebt' was unlawful. 

However they do not indicate exactly when the federal government became aware of this fact and Minister for Government Service & Liberal MP for Fadden Stuart Robert is refusing to disclose the exact date - in large measure because at least 9,600 people have now registered to take part in a class action being undertaken by Gordon Legal.

This class action asks the Federal Court of Australia not just to rule on the legality of 'robodebt', but also to determine whether the so-called collection fees levied by Centrelink should be refunded, whether those who have repaid all or part of those amounts should be paid interest and, whether the persons affected are entitled to compensation for any distress or inconvenience caused.

Gordon Legal has said it is pursuing the class action despite the government’s backdown, given that Centrelink has not promised to return the money taken from its clients nor promised to provide compensation for inconvenience and distress.

Tuesday, 28 January 2020

Lismore Diocese in the NSW Northern Rivers region once again focus of historical child sexual abuse allegations


Former Catholic priest Clarence David Anderson died in retirement at Toowoombah Qld in April 1996 and peacefully rests in a Goonellabah NSW cemetery, but his alleged victims are still seeking justice....

Newcastle Herald, 23 January 2020: 

A PARISH priest is suing a NSW Catholic diocese and an order of nuns [believed to be the Presentation Sisters] in what is believed to be the first Australian case of a serving Catholic priest seeking compensation for alleged child sexual abuse by a priest. 

 The Diocese of Lismore has denied liability for alleged crimes by the late charismatic "surfer priest" Clarence "David" Anderson against the then 12-year-old altar boy in the 1960s, and has given notice it will seek a permanent stay against the priest's case in the NSW Supreme Court. 

The move, initiated by the diocese last week, means survivors are "back to square one" in some dioceses despite legal reforms following the Royal Commission into Institutional Responses to Child Sexual Abuse, the priest's lawyer Mark Barrow said. 

The permanent stay application is despite the diocese offering compensation to two families in 2004 who alleged Anderson sexually abused two brothers aged 9 and 14 in the Macksville area between 1966 and 1968, and two other brothers, aged 9 and 15, in Tweed Heads parish in 1969.

Melbourne-based Broken Rites put the two families in touch with each other after both were told they were the first to complain about Anderson, and that the diocese had no knowledge of allegations about him. Anderson was a priest for just seven years. One of his alleged victims was advised by the Diocese of Lismore in 2002 that Anderson resigned in 1970. He died in 1996......

The Guardian, 25 January 2020:

The abuse is said to have occurred at a church on the north coast of New South Wales, which sat on the grounds of a boarding school....

It is the second time in recent months that the diocese has attempted to have an abuse case thrown out due to delay.
In December, the Lismore diocese successfully applied to permanently stay a case brought by a woman who alleged she was abused in the 1940s by a priest named John Curran, who has since died.
The church’s approach to delay conflicts with findings of the child abuse royal commission.
According to Broken Rites; In 2020, a legal firm is acting for eleven of Father David Anderson's victims, suing the Lismore Catholic Diocese for compensation.

Thursday, 5 December 2019

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.

Wednesday, 6 November 2019

Many of the cases of deficiencies or outright failings in aged care were known to both the providers concerned and the regulators before coming to public attention. Why has so little been done to address these deficiencies?


Opening page of the Royal Commission interim report on Aged Care in Australia......

Royal Commission into Aged Care Quality and Safety, Interim Report, Volume 1, p.1: 

It’s not easy growing old. We avoid thinking and talking about it. As we age, we progressively shift our focus from work to the other things that give us purpose and joy: our children and grandchildren, our friends, our holidays, our homes and gardens, our local communities, our efforts as volunteers, our passions and hobbies. The Australian community generally accepts that older people have earned the chance to enjoy their later years, after many decades of contribution and hard work. Yet the language of public discourse is not respectful towards older people. Rather, it is about burden, encumbrance, obligation and whether taxpayers can afford to pay for the dependence of older people. 

As a nation, Australia has drifted into an ageist mindset that undervalues older people and limits their possibilities. Sadly, this failure to properly value and engage with older people as equal partners in our future has extended to our apparent indifference towards aged care services. Left out of sight and out of mind, these important services are floundering. They are fragmented, unsupported and underfunded. With some admirable exceptions, they are poorly managed. All too often, they are unsafe and seemingly uncaring. This must change. 

Australia prides itself on being a clever, innovative and caring country. Why, then, has the Royal Commission found these qualities so signally lacking in our aged care system? We have uncovered an aged care system that is characterised by an absence of innovation and by rigid conformity. The system lacks transparency in communication, reporting and accountability. It is not built around the people it is supposed to help and support, but around funding mechanisms, processes and procedures. This, too, must change. 

Our public hearings, roundtable discussions with experts, and community forums have revealed behaviour by aged care service providers that, when brought to public attention, has attracted criticism and, in some cases, condemnation. Many of the cases of deficiencies or outright failings in aged care were known to both the providers concerned and the regulators before coming to public attention. Why has so little been done to address these deficiencies? We are left to conclude that a sector-wide focus on the need to increase funding, a culture of apathy about care essentials, and a lack of curiosity about the potential of aged care to provide restorative and loving care—all of which is underpinned by an ageist mindset— has enabled the aged care system to hide from the spotlight. This must also change. [my yellow highlighting]

Left isolated and powerless in this hidden-from-view system are older people and their families. ‘This is not a life.’ ‘This is not my home.’ ‘Don’t let this happen to anyone else.’ ‘Left in her own faeces, and still no one came.’ ‘Mum doesn’t feel safe.’ 

This cruel and harmful system must be changed. We owe it to our parents, our grandparents, our partners, our friends. We owe it to strangers. We owe it to future generations. Older people deserve so much more. 

We have found that the aged care system fails to meet the needs of our older, often very vulnerable, citizens. It does not deliver uniformly safe and quality care for older people. It is unkind and uncaring towards them. In too many instances, it simply neglects them.

Friday, 18 October 2019

Seems Australian Prime Minister Scott Morrison's personal war on the poor and vulnerable may have its roots in the right-wing American culture he so admires


Stricter eligibility requirements when applying for Centrelink benefits, allowances and pensions. Reducing the scope of human intervention in decision making. Automated assessment of ongoing eligibility. Automatic suspension of cash transfers.

Sound familiar? Well it seems that the U.S.A. refined applying punitive measures to the poor and vulnerable long before Australia's right-wing warriors in the Abbott-Turnbull-Morrison Government began their all out class war.

American began limiting eligibility and applying algorithms in the 1970s and 1980s

The Guardian, 14 October 2019: 

All around the world, from small-town Illinois in the US to Rochdale in England, from Perth, Australia, to Dumka in northern India, a revolution is under way in how governments treat the poor. 

You can’t see it happening, and may have heard nothing about it. It’s being planned by engineers and coders behind closed doors, in secure government locations far from public view. 

Only mathematicians and computer scientists fully understand the sea change, powered as it is by artificial intelligence (AI), predictive algorithms, risk modeling and biometrics. But if you are one of the millions of vulnerable people at the receiving end of the radical reshaping of welfare benefits, you know it is real and that its consequences can be serious – even deadly. 

The Guardian has spent the past three months investigating how billions are being poured into AI innovations that are explosively recasting how low-income people interact with the state. Together, our reporters in the US, Britain, India and Australia have explored what amounts to the birth of the digital welfare state. 

Their dispatches reveal how unemployment benefits, child support, housing and food subsidies and much more are being scrambled online. Vast sums are being spent by governments across the industrialized and developing worlds on automating poverty and in the process, turning the needs of vulnerable citizens into numbers, replacing the judgment of human caseworkers with the cold, bloodless decision-making of machines. 

At its most forbidding, Guardian reporters paint a picture of a 21st-century Dickensian dystopia that is taking shape with breakneck speed. The American political scientist Virginia Eubanks has a phrase for it: “The digital poorhouse.” 

As one recipient described it: “You owe what you have eaten.” 

In the UK, we investigate the secure government site outside Newcastle where millions are being spent developing a new generation of welfare robots to replace humans. Private companies including a New York outfit led by the world’s first bot billionaire, are supercharging a process which has spawned a whole new jargon: “virtual workforce”, “augmented decision-making”, “robot process automation”. 

The government is rushing forward with its digital mission despite the pain already being inflicted on millions of low-income Britons by the country’s “digital by default” agenda. Claimants spoke of the hunger, filth, fear and panic that they are enduring.

In Australia, where the Guardian has reported extensively on robodebt, the scheme that has been accused of wrongly clawing back historic debts through a flawed algorithm, we now disclose that the government has opened a new digital front: using automation to suspend millions of welfare payments. Recipients are finding their money cut off without notice.

Read the full article here.

It is not hard to draw a line between Australian Prime Minister Scott Morrison's admiration for all things Republican and religiously conservative in America and his apparent desire to place all welfare recipients on the Indue Limited cashless debit card before the next federal election in 2022.

Scott Morrison's war on the poor is being expanded under the Social Security (Administration) Amendment (Income Management to Cashless Debit Card Transition) Bill 2019 which is currently before the Senate Standing Committees on Community Affairs which will report to the Australian Parliament on 7 November 2019.

To date no welfare recipients have made submissions to the Senate standing committee on this bill. I suspect that this is due in large measure to the fact that Centrelink in particular has released personal information about welfare recipients who have gone public in the past and, there is anecdotal information that certain recipients who have spoken out publicly about life on the cashless welfare card have been sanctioned in some manner.

Wednesday, 28 August 2019

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]

Monday, 26 August 2019

Morrison Government's understanding of human rights and aged care appears flawed


"Restrictive practices can elicit concern for a number of reasons. Fundamentally, they impact on the liberty and dignity of the care recipient. In circumstances where they are not absolutely necessary, their use is likely to sit uncomfortably for many. Their use without lawful consent may infringe the resident’s legal rights and constitute a civil or criminal offence, such as assault or false imprisonment, although there are very few cases in Australia where a criminal or civil complaint has been pursued to challenge the use of a restraint in an aged care setting. Physical and chemical restraint can have significant adverse effects on a resident, both physically and psychologically. There are also fundamental questions about their effectiveness."  [Royal Commission into Aged Care Quality and Safety, Background Paper 4, May 2019]

9 News, 20 August 2019: 

The Commonwealth government recently introduced changes aimed at limiting the use of restraints in residential facilities. 

But experts believe the regulations have created many more problems than they solved. 

They are urging the Commonwealth to scrap the regulations and start again from scratch. 

Queensland's public guardian Natalie Siegel-Brown said the changes placed her agency and the community in a "really compromising" position. 

"Unfortunately in their current form, the principles actually regress the recognition of human rights of people living in aged care, particularly with respect to chemical restraints," she told the committee in Sydney on Tuesday. 

"But the entire suite itself lacks any monitoring, enforcement or oversight in any event, and this can lead to greater problems." 

Colleen Pearce, from the Victorian Office of the Public Advocate, said aspects of the regulations were flawed and ambiguous. 

"We consider the principles are inconsistent with people's human rights (and) would preferably be contained in legislation," 

Dr Pearce told the committee. "(The principles) introduce, in the case of physical restraints, a new flawed and ambiguous substitute decision-making regime, provide virtually no regulation of chemical restraint usage, and lack the safeguards of other restrictive practices regulatory schemes." 

Joseph Ibrahim, the head of the Health Law and Ageing Research Unit at Melbourne's Monash University, described the regulations as stupid. 

"There is no monitoring mechanism, there are no sanctions associated, there is no way of implementing or making sure the law comes into effect," Professor Ibrahim said. 

A group of advocates believe the government should be prohibiting the misuse of restraints and over-medication, rather than regulating them. 

They argue medication should only be used for therapeutic practices and be administered with a patient's free and informed consent. 

The group includes Aged and Disability Advocacy Australia (ADA) and Human Rights Watch, both of which addressed the hearing on Tuesday. 

"Older people in nursing homes are at serious risk of harm if this new aged care regulation is allowed to stand as is," ADA chief executive Geoff Rowe said. 

"Australia's parliament should act urgently to ensure that everyone, including older people, is free from the threat of chemical restraint.".....

The Canberra Times, 21 August 2019:

New rules on the use of restraints in aged care could lead to more elderly residents being sedated, a parliamentary inquiry has heard. 

The regulation is also unenforceable, and does nothing to relief the staffing pressures that have led to the use of restraints, expert witnesses have said..... 

Professor Joe Ibrahim from Monash University's Health Law and Ageing Research Unit said the regulation also did not recognise the pressures within aged care that forced staff to use restraints. 

"Staff restrain residents to get through their day because they don't have enough hands to get through what's needed or they don't have the skills, knowledge, ability to assess why a person has responsive behaviours or unmet needs to address that," Professor Ibrahim said. 

"A law that isn't monitored, has no sanctions, no way of checking, it will drive practice underground." 

Queensland Nurses and Midwives Union professional officer Jamie Shepherd said he knew of a case where one registered nurse had to administer medication to 166 residents on night shift, and management resisted rostering on an enrolled nurse to help until the RN threatened to call an ambulance each night to assist. 

Australian Nursing and Midwifery Federation federal professional officer Julie Reeves said through a recent member survey, she learnt of an aged care home where there were just six staff rostered on overnight to look after 420 residents. 

"We cannot always effectively manage challenging behaviour issues for dementia residents while at the same time caring for others who have very complex health issues. 

We receive little to no support from management when things don't go as planned," she quoted the member as saying. 

Australian Human Rights Commission president, Emeritus Professor Rosalind Croucher said while parts of the regulation had merit, it should not be allowed to proceed unless there was a mechanism for independent oversight. "If it's a choice of it or nothing, nothing might be better than it as it is," Professor Croucher said....

Physical restraining devices currently allowed in Commonwealth-funded aged care facilities are:

Bed rails
Chairs with locked tables
Seat belts other than those used during active transport
Safety vests
Shackles
Manacles
[my yellow highlighting]


Chemical restraint is any medication or chemical substance used for the purpose of affecting a person's behaviour, other than medication prescribed for the treatment of, or to enable treatment of, a diagnosed mental disorder, a physical illness or a physical condition. 

Use of chemical restraint is specifically excluded from assessment in the National Aged Care Mandatory Quality Indicator Program. [See p.15]


BACKGROUND:

 Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019