Government cancer screening register delayed again: Labor

Australia's Shadow Minister for Health and Medicare Catherine King has accused Telstra of delaying the National Cancer Screening Register again, claiming the register will not be fully operational until March next year.

"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.

"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'."

Telstra, which signed the AU$220 million contract in May 2016, declined to provide a comment.

The telco had been contracted to develop and run the new 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.

In June, the Australian National Audit Office (ANAO) found 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 last December, 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 this year, the ANAO said, with Telstra's June response stating that the documents were "still being finalised".

"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.

"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 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.

"It is absolutely appalling that the Turnbull government has botched up something so important, and in the process delayed a cervical screening test which literally saves the lives of women around the country," King said at the time.

Labor has opposed the contract since the beginning, in September last year saying it would be pushing changes to prevent the pre-federal election deal from allowing Telstra to handle citizens' health data.

At the time, King said the government had signed the contract despite not having legislation in place to establish the register, which could allow Labor to make amendments.

"Labor will fight the government's plan to hand private and intimate health data that is usually only disclosed between a person and their GP to a for-profit telecommunications corporation," King said.

"In just another example of Malcolm Turnbull's determination to privatise our health system, the government has put Australians' Medicare numbers and Medicare claims information in the hands of a multinational telecommunications corporation.

"At least 27 times during the election campaign, Malcolm Turnbull said that he would never outsource Medicare -- but that's exactly what he is doing here."

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.

During the lead up to the federal election in 2016, Prime Minister Malcolm Turnbull had warned against outsourcing too many government services, after the government came under fire repeatedly by Labor for reported plans to have Medicare payments handled by the private sector.

"I think there is a risk that if you outsource too much of government services, you run the risk that you end up with very little talent or capability within government," Turnbull said at the time.

"The Medicare payments system is enormous, obviously, and I believe that we can -- well, it is not a question of belief, there is no doubt that we can -- bring that into the 21st century and do so within government."

Telstra's Health business has had several wins since launching in October 2014, including providing its Patient Flow Manager system to Epworth Richmond Hospital in February; winning a contract with the Western Australian government to roll out a AU$10 million Community Health Information System; and implementing an enterprise electronic medical record (EMR) system at the two new Australian hospitals in December.

The Telstra Health arm remains largely unprofitable, however, although Telstra last week said it is confident that it is on its way to becoming "very substantial".

"Telstra Health hasn't hit everything we expected it to do, but it's a startup business ... in a new area, we're bound to make some mistakes, we have made some mistakes, but we have also made a lot of successes," Telstra chair John Mullen said during the company's AGM.

"Very few businesses of scale make money from day one ... yes, we don't get every one right, and yes, it may take longer than everyone would like for something like Telstra Health to be profitable, but we are confident it will be, otherwise we wouldn't stay in it -- if it wasn't, we would cut it."

According to Mullen, Telstra Health has had success "under the covers", handling 260 million prescriptions annually, with 22,000 GPs and 35,000 pharmacists on its systems as well as 10 public hospitals using its patient flow and queue management software.

"We are the largest health software technology provider already, employing about 800 health professionals, and we are embarked on some very major projects like the National Cancer Screening Registry," Mullen said.

"It's exactly what we should be doing as a company; we should be taking risks that pay off -- sometimes they don't, sometimes they do -- but no one will affect the future of the company completely."

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