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No place for photo ID checks in General Practice

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Universal access to health care is highly valued by Australians. The furore caused when a badly designed co-payment model was proposed provided strong evidence that Australians will not tolerate any threat to their right to access medical care when needed. The AMA strongly advocated to protect vulnerable patients’ access to care at the time.

Following the sale of a small number of Medicare numbers on the dark web, AMA advocacy is needed to ensure the Government’s response is proportionate and that attempts to improve the security of Medicare numbers do not diminish patient access to care.

To the Government’s credit, it was quick to react to security concerns raised by the alleged breach, commissioning an independent review of the accessibility by health providers of Medicare card numbers. The Review is being led by Professor Peter Shergold, with the AMA represented on the review panel. The panel recently released a discussion paper, giving stakeholders the opportunity to provide submissions, with a final report due by the end of this month. 

The AMA President has met with both the Ministers for Health and Human Services on this issue and the AMA has also provided a submission in response to the discussion paper.

This is a good opportunity for the Government to assess the risks to its systems. However, the AMA has made it very clear that an excessive response could impact adversely on patients and practitioners.

The Department of Human Services’ Health Professional Online Services (HPOS) is a valued service for health care providers and their delegates, enabling streamlined and secure access to Medicare Australia and Department of Human Services programs, services, tools and resources. Every day there are around 45,000 interactions with HPOS.

HPOS has continuously evolved since its introduction to ensure it increasingly enables secure and streamlined transfer of data between providers and Government entities and timely access to information. Nevertheless, there are still some clunky aspects to using HPOS, particularly when it comes to the use of PKI certificates.

The introduction of PRODA has made it much simpler for individual health care providers or delegates to securely access HPOS. However, PRODA is yet to provide the same secure business to business functionality of the PKI site certificate.

The AMA believes that introducing this functionality in PRODA as soon as possible would make it easier for providers to interact with HPOS. It would ensure provider systems flexibility by removing the need for a physical certificate tied to a physical machine, retain secure capability, and streamline provider access. We need to keep up with technological developments in an increasingly mobile, digital, online and cloud based world.

What we don’t want to see as an outcome of this Review is over-the-top security measures that go well beyond the problem that has been identified. Ideas like requiring photo ID to see a GP are heavy handed and simply add to a practice’s administrative burden. It could also see patients unable to access care and place reception staff in a very difficult environment, facing sick and often distressed people who will not be able to understand why their Medicare card is no longer sufficient enough evidence to access a basic right – health care.