Interview with Dr Kerryn Phelps, AMA President, Radio 2UE - Discussion on GPs being involved with health software company which will sell patient records to pharmaceutical companies

The company is called Health Communication Network or HCN. They provide GPs with free software that allows them to write electronic prescriptions. But HCN is also involved in gathering material which could and most likely will be on-sold.

Around 170 doctors, according to the reports, are involved in a pilot program with HCN and the National Prescribing Service and it's designed, they say, to improve the use of antibiotics as well as the diagnosis of depression.

But while the practice is not illegal, it certainly raises ethical and moral concerns. The AMA has echoed those concerns. They want privacy laws introduced to stop the sale.

Doctor Kerryn Phelps has got a million things on her plate as the Federal President of the AMA. She's on the line. Doctor Phelps, good morning.

PHELPS: Good morning, Alan.

JONES: God, you've got a lot to deal with haven't you?

PHELPS: Oh medicine is a very big field, medico politically, I have to say.

JONES: Medico politically - everyone medico politically's in the eye of the storm these days aren't they?

PHELPS: Indeed.

JONES: I mean, this has got to be of some concern though, to rank and file people who just don't understand what is happening to their private records.

PHELPS: We've been most concerned about this for quite some time and in fact we've made representation to government through the AMA echoing the concerns that you've raised and saying that we have to have overarching national legislation that covers privacy specifically for health because it's such a special and delicate area. And so far we've been met with a brick wall.

JONES: So basically, we'll give you the software and you give us the information?

PHELPS: Well, the software for practice management is certainly not free. It costs practices about $5,000 an then there's a maintenance charge every quarter for updating. So, I don't know where this story about it being free comes from.

JONES: Well, is that a trade-off though, are they giving the GPs the free software. They write the electronic prescriptions and then that material is, I suppose, centrally compiled and HCN can sell it on and get the money back that way?

PHELPS: Well, not that I'm aware of. I think that some GPs have been contacted and asked if they will be involved in clinical audit, which basically means providing the identified information to the National Prescribing Service through this computer company. Which will be part of their continuing medical education which is compulsory for all doctors in order to stay on the vocational register, you have to undertake certain -

JONES: Yeah, update yourself

PHELPS: Updating -

JONES: Just, Kerry, what if, just so that our listeners who go to doctors every other day, what obligation is there on a doctor to protect the privacy or the right of the patient?

PHELPS: Well, without national privacy legislation, really, there are very little in the way of protection for that sort of information.

I mean, doctors, individual doctors are very much bound by ethics but any information that passes between them is, stays exactly there.

One of our big concerns with this wave of corporatisation that's been coming across the country is that the reason some of these big business players have gotten into general practice is that data is going to be the new gold.

You're going to see data mining be the new gold prospecting. And there's big money in data and health data particularly if it's being sold or has the potential to be sold onto commercial interests like insurance companies or pharmaceutical companies and governments. Then it's a very valuable commodity.

JONES: But this outfit says that the patient names will be removed. I mean they make no bones about the fact that there's a market for data, which is the point you've just made, but they say, the patient names will be removed before collation and no-one's identity will be revealed. There's no-one out there listening to you and me who would believe that.

PHELPS: No, well the AMA has very serious concerns, even about the identified information. We want to see legislation and we want to see it urgently, that covers exactly what can and cannot be bought and sold. And we just don't think that patient's personal health information is a commodity that should be bought and sold.

JONES: And it's not just the identity that is a valuable piece of data, is it. I mean, there's one report this morning, that raising the scenario that it wouldn't be beyond the realm of possibility that a profile could be brought of the residents of a certain street, in terms of the drugs prescribed and that information could be used to determine common illnesses and then sell it to the insurance companies and they'd then raise premiums or refuse cover for people if the treatment was too expensive to provide.

PHELPS: That's exactly the sort of scenario that we've been warning about and we don't the assurances. I mean, there are a lot of unknowns about this and we've been asking for further information through the AMA and we've been asking government to take this whole matter seriously.

JONES: So are you saying that the information about you, Dr Phelps, or me Alan Jones, as a patient, should not be passed on to anybody under tight privacy laws without our authority.

PHELPS: Absolutely.

JONES: That's pretty simple, isn't it.

PHELPS: Patients should give their permission for that information, I think it's pretty straight-forward.

JONES: Could I ask you something which is also pretty straight-forward, for which I suppose you've got no hope of winning the battle. But, I was reading that, there's another argument I thought while I've got you here now, I'd ask you. Another argument about what the GP gets paid and your arguing for the schedule fee to be increased.

I mean 85 per cent of the bulk bill rate that the Medicare doctor gets or a doctor gets from Medicare, gives him what, $27 for a GP. I had a bloke in to fix the fridge the other day and he wouldn't come in the door for less than $95 and he put a screw in. How do you win this battle?

PHELPS: Well, the bulk of the rates are even worse than that, it's 22.95, because there's only 85 per cent.

JONES: Oh 85 per cent of 27 is 22.95. So a GP comes to patient or bulk bills a patient for $22.95.

PHELPS: Yes, which is why we're talking about having to review the Medical Benefit Schedule, because it's just become a farce.

JONES: But you'll get done over by saying you're defending rich doctors.

PHELPS: I think we've got a pretty good argument to make. The AMA's been involved in an exhaustive study over the last six years, which Government has been co-operating with the AMA on this particular issue. And we've come up with what they call a relative value study which is complete revision of the Medical Benefits Schedule.

Our argument is that this a scientifically based study which it should be the umpire. There's no argument one way or the other about whether doctors are or are not earning too much or too little.

The writing is there, the information, the evidence is there that doctors, particularly in certain specialties are very much disadvantaged by the current schedule and unless that schedule is reviewed then Medicare just won't survive.

JONES: And my medical records should be my records unless I give authority for them to be someone else's.

PHELPS: That's what I believe, yes.

End