Dr Kerryn Phelps, AMA President, with Richard Perno, Radio 2CC

Releasing the Draft Health Privacy Guidelines for public comment,

Malcolm Crompton said the move would strengthen consumer control of health information and improve the relationship between doctor and patient. Health providers are going to be required to provide ourselves, clients if you like to call us that, patients, free access to records within 30 days. Patients will also have the right to correct any inaccuracies. But doctors have criticised the plan to give patients the right to have access to medical records. The proposals contained in the Draft Guidelines issued by the Privacy Commissioner say that it'd enhance the relationship between doctors and patients.

AMA's Head, Dr Kerryn Phelps, you're not so sure about this, are you, Kerryn?

PHELPS: No. We've got some serious concerns about the health privacy guidelines that have been produced. We don't think that they are strong enough to protect privacy in the e-health age.

PERNO: Now, that doesn't mean you're hiding something away from patients, does it?

PHELPS: Absolutely not. I mean, doctors by and large are very very happy for patients to have their health information. I think that there is a very good case for patient-held health records where patients actually keep a file of all their investigation results and the procedures they've had done and the doctors that they've seen and the diagnosis they have and the medications they take. It's a matter of continuity and safety for them.

PERNO: All right, let's take one step back. Where does the law stand now? I could actually ask for these from my doctor now, can't I, Kerryn?

PHELPS: You could ask it, but the doctor actually owns the records and that would still remain the case, because they are the doctor's thoughts and the doctor's property. There are two levels of health information and I think this is where the guidelines perhaps have got it a bit wrong and now, with e-health, there's also the electronic form of records.

But there's the type, part of the record that contains things that you need to know for continuity of care and it's issues like the medication that someone's on, investigations they've had, procedures they've undertaken, diagnosis and so forth, which you would need when you saw any other doctor or health professional to be able to follow what your management plan was, and your treatment.

And I think that there is the other level of health, of health records, which is the doctor's own private thoughts about the possible diagnosis, the possible treatment plan, which may not end up becoming the diagnosis or the treatment plan but is really the doctor's own intellectual property and thoughts. And I think that that's a level that we would have some reluctance in some cases. But by and large that, you know, in the vast majority of cases, it wouldn't be a problem.

PERNO: All right, Kerryn, what is the advantage of me knowing my history or what the doctor thinks?

PHELPS: I think there are great advantages to patients understanding their condition and understanding the management plan and being actively involved in their treatment. There's no problem with that and I think that one of the concerns that we have with the way these guidelines have been announced is that it's using that issue of patients' access to their own records to get away from the, we think, more serious issue of what happens with electronic health records. Because it's not just about patients accessing their own records, it's about who else can access your records. Could it be your insurance company? Could it be a pharmaceutical company? Could it be some sort of marketing company who wants that information so that they can market directly to you? Now, these are the sorts of issues that we think the privacy rules do not cover anywhere near adequately for people to have their information protected against other sources of people accessing that information.

PERNO: Invading your own private health, I mean. And what closer to your own life can you have but your health? What about an employer, too. They could actually tap into that?

PHELPS: Well, these are the concerns that we have, and we're also not the slightest bit convinced that de-identified data, once information is de-identified on an electronic data base, then it doesn't fall under the privacy rules any more. But, there's nothing to say that that information can't be electronically re-identified at some stage.

PERNO: All right, so what moves are the AMA going to make, Kerryn?

PHELPS: We're making a lot of noise about it and we have been for a long time. We've been speaking to the Privacy Commissioner. He doesn't seem to get it in terms of what we're very concerned about and, in this new electronic age, I think people do have a lot to be worried about with privacy and I don't want to see us trying to scrabble around making legislation when it's too late. When there has been a disaster of information being forwarded on to parties that they shouldn't have been forwarded to. We already know that data is being bought and sold …

PERNO: …that's right.

PHELPS: And in the new corporatised world of medicine we're also seeing that data is a bit like a gold mine.

PERNO: Yeah, the only thing I'm fearful about is that the, that those who want to push this forward, Kerryn, will be saying, 'oh, doctors just want to hide your records, you know, what are they hiding, they've got nothing to hide'.

PHELPS: Yes, this is why I think that the way the media announcements have been made have been a little bit misleading because it's focused really on, you know, patients being able to get access to their information and, I mean, that's something that doctors are very happy, by and large, for patients to have, unless there's a damn good reason why they shouldn't have that information - where it might be of danger to the patient or to a relative.

PERNO: So, what you're after is protection? You don't want to stop the idea of getting medical records available to patients, you just want to make sure that there's protection for that patient.

PHELPS: Absolutely.

PERNO: Yeah, will you get there?

PHELPS: Well, we'll keep on plugging away at it until we're happy with it. This document's out for public comment and we're making public comment.

PERNO: All right, we'll leave it there for now. Good to talk with you, as always, Doctor.

PHELPS: Thanks, Richard.

PERNO: Dr Kerryn Phelps, who is the President of the AMA, not saying no we can't access our records, just a little caution please, go steady before records, medical records are available. Not just electronically, but even over the counter the records available would include information from doctors and hospitals, the counsellors.

As I mentioned, on the internet, the gyms, weight loss people, maybe even your future employer who then will be able to obtain records of your health and then make judgements on you and your life, and where you're going. Just on the basis of what information they're getting.

Ends