Doctor-patient relationship `at risk`

A plan giving Medicare bureaucrats access to private patient records will send a
shiver down the public's spine, a parliamentary inquiry has been told.
But federal health department officials insist proposed obligations for doctors to
justify Medicare claims simply will not allow auditors to paw over patients'
sensitive clinical files.
The federal government has released an exposure draft of legislation implementing a
crackdown on doctors rorting Medicare.
It announced the compliance audit program, forecast to save $70.3 million over four
years, in its last budget and it is due to start on July 1.
Under the changes, Medicare Australia could require doctors to hand over records to
substantiate their claims.
If they refuse, they will have to return the Medicare payment received for providing
the service and may be fined.
The Australian Medical Association (AMA) has circulated a petition against the
proposed changes to GP surgeries for patients to sign.
"If passed, this legislation would have a dark and fundamental impact on the health
of this nation," AMA president Rosanna Capolingua told a Senate inquiry into the
bill on Wednesday.
"Helping doctors to understand and comply with the increasingly complex system would
deliver far greater long-term benefits than sacrificing the privacy of all
Australians to catch a handful of doctors and a few honest mistakes."
She said doctors would be forced to hand over patients' confidential medical records
to bureaucrats.
Patients would withhold relevant information from their doctors once they learnt
their private records could be released, which would compromise their care, Dr
Capolingua said.
"If I had a letter saying to me that a Medicare officer is going to be reading my
notes, understanding the sort of things that patients have in their notes, some
patients could be - you could drive someone to suicide," she said.
Department of Health and Ageing deputy secretary David Learmonth said doctors could
provide documents showing consultations and procedures were performed and black-out
patient details.
"This is really crunched down to the absolute minimum of what's required to
substantiate a claim," he said.
"This is not about bureaucrats pawing over patients' whole files at their leisure."
Medicare Benefits Schedule (MBS) payments have more than doubled in the past decade.
The scheme costs taxpayers more than $13 billion a year.
One in five doctors fail to provide information to substantiate claims when
requested by Medicare and currently they are not obliged to do so.
"It's a significant weakness in our capacity to protect public money," Mr Learmonth
said.
"It seems somewhat unusual that any funding or benefits program ... enables people
to choose whether or not they are audited."
Liberal senator Gary Humphries said the changes would damage the doctor-patient
relationship.
"If people knew their records were being checked by bureaucrats and confidential
information on those were available to people, I think that they would be horrified.
"Won't that send a shiver down a lot of people's spines?"
Public Interest Advocacy Centre solicitor Peter Dodd said the auditing plan would
not erode the doctor-patient relationship.
The draft bill struck the right balance between preserving the integrity of Medicare
and the privacy of health records.
Human Services Minister Joe Ludwig said Medicare auditors were bound by the
provisions of the Privacy Act.
"This legislation won't give Medicare unfettered access to patient records," he said
in a statement.
The inquiry will deliver its report to parliament on June 10.