Government bowel cancer screening register delayed to 'late 2019'

The Australian Department of Health has notified a joint committee that the National Cancer Screening Register for bowel cancer, being delivered by Telstra, will not be operational until late calendar 2019.

Speaking before a public hearing of the Joint Committee of Public Accounts and Audit on Wednesday morning, Department of Health National Cancer Screening Taskforce First Assistant Secretary Bettina Konti said the department and Telstra are continuing to focus on delivering the cervical cancer screening register.

"All our focus is on ensuring that we can complete the National Cancer Screening Register to support cervical screening, and for that reason we and Telstra Health have moved our resources into that in order to ensure that occurs. Once that is implemented and stable, the planning will recommence for bowel cancer transition," Konti told the committee.

"It's a shift in date."

However, while late 2019 is the goal, Konti admitted that "there isn't a target date" for the bowel cancer screening register, because the inefficient paper-based register can continue being used until then.

"We know that for every stage in a person's bowel cancer screening pathway, the amount of information that is reported back to the [existing paper-based] register becomes less and less because it is a reporting burden for the clinicians," Konti conceded.

"The inefficiency is what is intended to be corrected by the transition to the National Cancer Screening Register."

The Telstra-delivered register will therefore better "support the information exchange that allows the program to make decisions about how we might improve participation in the future".

"It is all around a better-connected health system," she said.

The audit committee hearing had kicked off due to findings in June 2017 by the Australian National Audit Office (ANAO) that the Department of Health had no plan for how privacy and security would be handled by Telstra for the National Cancer Screening Register, with "inadequate" planning leading to additional costs.

The telco's proposed data protection plan had been rejected in December 2016, as it did not comply with the contract's requirements, the ANAO said it its report, while key objectives had not been met in the agreed timeline due to limited consideration of privacy, security, and conflicts of interest.

The contract had required Telstra to submit a data-protection plan within 40 days of signing the contract, and thereafter a privacy policy and security risk management plan, with Telstra and its sub-contractors also required to sign a confidentiality and privacy deed. Employees with direct access to the register would also need to have appropriate security clearance.

All of these requirements were "incomplete" as of March 2017, the ANAO had said.

"Telstra takes its obligations to securely manage data seriously, and has progressed a range of actions necessary for the implementation of the register and restricting access to sensitive information," Telstra stated in its response to the ANAO's report last year.

"By way of example, Telstra had built a secure ISM-certified environment to receive the required data by 1 December 2016."

Telstra had attributed its previous missed deadline of May 1, 2017, to the "complexity of assimilating and migrating data from eight state and territory cancer registers into one register", and said it was aiming to have the register operational by December 2017.

At the time, the ANAO said the first missed deadline led to additional costs of around AU$16.5 million, due to the Department of Health having to pay pathology providers to continue providing pap smear tests until the screening can begin through the new register.

During Wednesday's committee hearing, Konti had said the Department of Health had weighed up the "risks" associated with each tenderer, but ultimately decided to go with Telstra to deliver the system.

The news of further delays follows Australia's Shadow Minister for Health and Medicare Catherine King in October accusing Telstra of delaying the cervical cancer register out to March 2018.

"The government said that this register and test would prevent around 140 cases of cervical cancer every year -- now it has been delayed by almost 12 months, they need to come clean about the deadly toll of this delay," King said at the end of last year.

"The national register will not be able to send cervical screening histories to pathology laboratories until March 2018 at the earliest, with laboratory staff concerned about the 'serious implications for patient safety'."

Labor has opposed the Telstra contract since the beginning, in September 2016 saying it would be pushing changes to prevent Telstra from handling citizens' health data. Labor was looking to move amendments to ensure that the National Cancer Screening Register could only be run by the government or a non-profit organisation, and not by a private company.

Telstra signed the AU$220 million contract in May 2016 to develop and run a new digital Australian National Cancer Screening Register for the next five years, with the database to maintain patient records for cancer testing across the country.

Under the deal, Telstra Health will create a database of cancer records for those who have been screened for bowel and cervical cancer, with patients and doctors able to access the register online. The register will integrate eight existing cervical cancer registers and the current bowel cancer register, with more than 11 million separate records being amalgamated onto a single platform.

The register will be overseen by health professionals, and will link records from federal, state, and territory government agencies, My Health Record, and Medicare, as well as private health service providers, pathologists, and general practices. It will provide mail-based reminders for patients whose cancer screening is due, and a contact centre for those needing assistance.

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