AMA President Discusses Smartcard

DR HAIKERWAL: Well again, some of the themes that were talked about earlier, I would certainly agree with - that we need to take, break this debate down to three different things.

First of all, if there's a replacement for the current Medicare card, that might make identification of individuals seeking services easier. It might make electronic commerce easier, so people can get rebates from Medicare and so on back.

I see a problem, an initial problem is that we'll need to make sure that people who are itinerant or have difficulty getting hold of cards or, you know, are in care or whatever; also get access to Medicare services and other services. And that the difficulties getting hold of cards don't preclude them.

The second part really is about medical information, from our point of view. And that would not necessarily be stored on the card. The card would be seen as a key, like a 'hole in the wall', like the card for the 'hole in the wall' - so you stick it into a reader and then you get access to the medical information data that you, the patient, have allowed to be stored, because you're happy for that to happen.

And that the access to that needs to be very clearly marked 'for your eyes only' for those people that you're happy to have read it.

ADAM SPENCER: As a privacy concern?

DR HAIKERWAL: As a privacy concern. You need to make sure that you have an ability to read that information and change things that are not correct, but also you need to be sure that it's up to date, so that then brings into play the need for people in - whether it's the ambulance service or the hospital service or the general practice area - to actually be able to read to it and write to it, and so on.

And so that key is really one that would be defined by agencies. So, the people at Centrelink for instance, if it happened to have a multiple use, would not be able to access your medical information; unless you say you want them to; which you probably wouldn't; and so on.

So that's where the privacy would be built in.

Once you take it the third step, which is to start confusing this with the debate about a national identity card … any of the multiple safeguards we've had put in already - and we've got a national e-health transition authority that's putting down standards on privacy standards on security and so on to make sure we have a standard relegated across the country.

And any of the sort of confidence we might have in this as a system - because we know that we can trust the people generally who maintain your medical records already - may well be defeated and blown out of the water, if we haven't finished, concluded the debate as to whether we want a national identity card or not.

ADAM SPENCER: And you might also cross a barrier in people's minds where they're just going to baulk at the prospect in general.

DR HAIKERWAL: Well that's exactly right. That would be a sad loss to a potentially beneficial part of any sort of new electronic health system. And that's why you've got to do it very carefully, and you've got to use the information that we've had already.

We've had multiple trials across the country, which have proven by and large, reasonably successful. And we've just got to build on those and make sure we use the correct way of approaching people about this, so that they don't get spooked.

ADAM SPENCER: I get the impression that you and Roger Clark both agree, Dr Mukesh Haikerwal. It's going to be very interesting to see what emerges from Cabinet on this one.