Healthcare identifiers legislation : a whiff of Fourberie

The Healthcare Identifiers Bill 2010 (Cth), which will establish “the national e-health Healthcare Identifiers Service to provide that patients, healthcare providers and provider organisations can be consistently identified”, is in the process of being enacted by the Australian Federal Parliament. The legislation will enable the government to assign to each “healthcare recipient” a 26-digit electronic “Healthcare Identifier”, which will be accessible, with or without the recipient’s consent, to a broad range of health care service providers as well as other entities. The individual Healthcare Identifier file will initially contain such identifying information as, where applicable, the Medicare number and/or the Veterans’ Affairs number; name; address; gender; date of birth; and “the date of birth accuracy indicator”, presumably birth certificate. However, since each “service” provided by a health care provider to a health care recipient will be automatically recorded on each individual’s Healthcare Identifier file, in time these electronic files should contain a full record of such services or contacts. Moreover, the Healthcare Identifiers are considered a “key” to, or a “foundation stone” for, the implementation of the shared electronic health records scheme, because they will enable linkage with and retrieval of each patient’s clinical records throughout the health care service system. However, there has been virtually no discussion about the legal, ethical and social implications of this legislation.