← All decisions

1. What was proposedShane RattenburyGreens · Crossbench
   Read the original wording (490 words)

   That this Assembly: (1) notes that: (a) system reform is required to provide greater integration, continuity of care and equity of health services in Canberra; (b) the Digital Health Record (DHR) identified several drivers for its implementation, including “The Digital Health Record will create a single system for the patient clinical record, making access to information efficient and user friendly”; (c) some general practitioners (GPs) are currently participating in a trial of DHR Link, which would allow for health records to be shared with participating GPs; and (d) the 2024 ACT Auditor-General’s Performance Audit Report review into Invoicing and Payments for Digital Health Record Hosting Services found that there has been higher than expected expenditure for DHR contracted services. It additionally notes that some transactions had neither a work order and/or a purchase order; (2) further notes that: (a) Deep End Canberra, with support from the Australian Medical Association and the Capital Health Network, surveyed primary care practitioners and held two workshops in 2023 to produce a report on how mental health services in Canberra would be improved. Their recommendations included: (i) highlighting the importance of accessible information, both for the patient and for healthcare providers to provide greater efficiency, equity and transparency in care, noting the Government must “Provide primary care teams and community services access to DHR”; (ii) many community service organisations lack any access to the DHR system. As a result “Patients have to start over at each transfer”, resulting in no clinical handover, disjointed care and patients having to continually self-advocate; and (iii) members of Deep End Canberra are a range of healthcare providers that work with vulnerable and at-risk youth, refugees and asylum seekers, people with a disability, people experiencing domestic violence, homelessness and drug dependency, LGBTQIA+ populations, and people in the criminal justice system. They note that these issues highlighted specifically, and most acutely impact, individuals experiencing economic inequality, and add additional barriers to the provision of healthcare; (b) healthcare practitioners from Canberra Health Services and Calvary Public Hospital, Bruce report spending significant administrative time attempting to access patient records. The lack of connectivity within the system results in healthcare providers having to spend time accessing required information from GPs or other allied health providers that could be provided through the DHR system; and (c) news reports have highlighted stories where patients have had referrals lapse or a lack of transparency of wait times whilst waiting for services; and (3) calls on the ACT Government to: (a) report back on the trialled DHR Link and the inclusion of GPs in the DHR system to the Assembly by 24 June 2025; and (b) implement changes to the DHR system to ensure greater efficiency, equity and transparency in care, by: (i) ensuring patient records from all healthcare providers are integrated into the system, inclusive of GP and allied healthcare providers; and (ii) integrating referrals into the DHR system, providing greater patient awareness. Debate ensued.

2. Proposed changeLeanne CastleyLiberal · Opposition8 May 2025

   Grouped by key words as: added a new call or point, changed a number or target, added reporting or consultation.

   The exact wording of this change

   Add new paragraphs: “(4) additionally notes that: (a) the development and implementation of DHR has an expected cost of $378 million, which is $160 million more than the original cost of $213 million, and that an additional $80 million will be required to support DHR over the next three years; (b) despite the enormous initial cost and the unexpected additional costs, requests by orthopaedic surgeons to include details of patient care, trauma sustained, and necessary operations, were not included and the surgeons were repeatedly told these functions were ‘not possible’; and (c) surgeons had a professional obligation to track this information and did so outside the DHR system because of its lack of functionality, only for the Minister to subsequently accuse them of keeping ‘secret lists’; and (5) additionally calls on the Minister to: (a) take the appropriate steps to ensure DHR incorporates all data kept by orthopaedic surgeons required to maintain a proper standard of patient care; (b) work closely with ACT orthopaedic surgeons to ensure the process minimises administrative workloads, is as seamless as possible and does not jeopardise patient care; (c) contact all other medical professional groups in the ACT who undertake elective surgery to confirm there are no other outstanding data or information issues that present a risk to patient care; (d) report back to the Legislative Assembly before the end of 2025 to confirm whether this work has been initiated, and again when the work is complete, including the costs involved; and (e) make an apology in the Assembly to orthopaedic surgeons for incorrectly claiming they kept ‘secret lists’.”. Debate continued.

   Not agreed on the voices. No individual votes were recorded.

3. Proposed changeThomas EmersonIndependent · Crossbench8 May 2025

   Added a note that health professionals had expressed frustration. Our summary, review in progress

   The exact wording of this change

   After paragraph (2)(c), insert: “(d) healthcare professionals have expressed frustrations regarding the way the DHR has been rolled out and continue to hold concerns about the administrative efficiency and effectiveness of the system;”. Debate continued.

   Agreed on the voices. No individual votes were recorded. Its wording is in the final text.

4. Proposed changeRachel Stephen-SmithLabor · Minister8 May 2025

   Grouped by key words as: rewrote the proposal, changed a date or deadline, turned an action into a review.

   The exact wording of this change

   Omit all text after paragraph (2)(d), substitute: “(3) calls on the ACT Government to provide the Assembly an update by 4 September 2025 on: (a) the trialled DHR Link and further inclusion of GPs in the DHR system; (b) potential changes that can be implemented to the DHR system to ensure greater efficiency, equity and transparency in care, including: (i) explore options for: (A) increased interoperability with My Health Record to improve integration across the health system, noting reform work currently underway by the Australian Digital Health Agency and Department of Health and Aged Care; and (B) opportunities for greater interoperability between DHR, My Health Record and Health Link, with the Commonwealth and other states and territories; (ii) improved integration of referrals in the DHR system, including providing patients with greater visibility of the progress of referrals, acceptance status of referrals, and triage category; and (iii) explore potential amendments to the Health Records (Privacy and Access) Act 1977, to reduce the high barriers to sharing patient information with GPs via DHR Link, whilst ensuring patient privacy.”.

   Agreed on the voices. No individual votes were recorded. Its wording is in the final text.

5. What the Assembly decidedAgreed

   Decided on the voices: no individual votes were recorded, so this doesn’t show that every MLA agreed.

   Final agreed wording, with changes marked

   That this Assembly: (1) notes that: (a) system reform is required to provide greater integration, continuity of care and equity of health services in Canberra; (b) the Digital Health Record (DHR) identified several drivers for its implementation, including “The Digital Health Record will create a single system for the patient clinical record, making access to information efficient and user friendly”; (c) some general practitioners (GPs) are currently participating in a trial of DHR Link, which would allow for health records to be shared with participating GPs; and (d) the 2024 ACT Auditor-General’s Performance Audit Report review into Invoicing and Payments for Digital Health Record Hosting Services found that there has been higher than expected expenditure for DHR contracted services. It additionally notes that some transactions had neither a work order and/or a purchase order; (2) further notes that: (a) Deep End Canberra, with support from the Australian Medical Association and the Capital Health Network, surveyed primary care practitioners and held two workshops in 2023 to produce a report on how mental health services in Canberra would be improved. Their recommendations included: (i) highlighting the importance of accessible information, both for the patient and for healthcare providers to provide greater efficiency, equity and transparency in care, noting the Government must “Provide primary care teams and community services access to DHR”; (ii) many community service organisations lack any access to the DHR system. As a result “Patients have to start over at each transfer”, resulting in no clinical handover, disjointed care and patients having to continually self-advocate; and (iii) members of Deep End Canberra are a range of healthcare providers that work with vulnerable and at-risk youth, refugees and asylum seekers, people with a disability, people experiencing domestic violence, homelessness and drug dependency, LGBTQIA+ populations, and people in the criminal justice system. They note that these issues highlighted specifically, and most acutely impact, individuals experiencing economic inequality, and add additional barriers to the provision of healthcare; (b) healthcare practitioners from Canberra Health Services and Calvary Public Hospital, Bruce report spending significant administrative time attempting to access patient records. The lack of connectivity within the system results in healthcare providers having to spend time accessing required information from GPs or other allied health providers that could be provided through the DHR system; (c) news reports have highlighted stories where patients have had referrals lapse or a lack of transparency of wait times whilst waiting for services; and (d) healthcare professionals have expressed frustrations regarding the way the DHR has been rolled out and continue to hold concerns about the administrative efficiency and effectiveness of the systemEmerson; and (3) calls on the ACT Government to provide the Assembly an update by 4 September 2025 on: (a) the trialled DHR Link and further inclusion of GPs in the DHR system; (b) potential changes that can be implemented to the DHR system to ensure greater efficiency, equity and transparency in care, including: (i) explore options for: (A) increased interoperability with My Health Record to improve integration across the health system, noting reform work currently underway by the Australian Digital Health Agency and Department of Health and Aged Care; and (B) opportunities for greater interoperability between DHR, My Health Record and Health Link, with the Commonwealth and other states and territories; (ii) improved integration of referrals in the DHR system, including providing patients with greater visibility of the progress of referrals, acceptance status of referrals, and triage category; and (iii) explore potential amendments to the Health Records (Privacy and Access) Act 1977, to reduce the high barriers to sharing patient information with GPs via DHR Link, whilst ensuring patient privacyStephen-Smith.

   Original and final wording compared

   taken out put in

   That this Assembly: (1) notes that: (a) system reform is required to provide greater integration, continuity of care and equity of health services in Canberra; (b) the Digital Health Record (DHR) identified several drivers for its implementation, including “The Digital Health Record will create a single system for the patient clinical record, making access to information efficient and user friendly”; (c) some general practitioners (GPs) are currently participating in a trial of DHR Link, which would allow for health records to be shared with participating GPs; and (d) the 2024 ACT Auditor-General’s Performance Audit Report review into Invoicing and Payments for Digital Health Record Hosting Services found that there has been higher than expected expenditure for DHR contracted services. It additionally notes that some transactions had neither a work order and/or a purchase order; (2) further notes that: (a) Deep End Canberra, with support from the Australian Medical Association and the Capital Health Network, surveyed primary care practitioners and held two workshops in 2023 to produce a report on how mental health services in Canberra would be improved. Their recommendations included: (i) highlighting the importance of accessible information, both for the patient and for healthcare providers to provide greater efficiency, equity and transparency in care, noting the Government must “Provide primary care teams and community services access to DHR”; (ii) many community service organisations lack any access to the DHR system. As a result “Patients have to start over at each transfer”, resulting in no clinical handover, disjointed care and patients having to continually self-advocate; and (iii) members of Deep End Canberra are a range of healthcare providers that work with vulnerable and at-risk youth, refugees and asylum seekers, people with a disability, people experiencing domestic violence, homelessness and drug dependency, LGBTQIA+ populations, and people in the criminal justice system. They note that these issues highlighted specifically, and most acutely impact, individuals experiencing economic inequality, and add additional barriers to the provision of healthcare; (b) healthcare practitioners from Canberra Health Services and Calvary Public Hospital, Bruce report spending significant administrative time attempting to access patient records. The lack of connectivity within the system results in healthcare providers having to spend time accessing required information from GPs or other allied health providers that could be provided through the DHR system; [taken out: and](c) news reports have highlighted stories where patients have had referrals lapse or a lack of transparency of wait times whilst waiting for services; and [put in: (d) healthcare professionals have expressed frustrations regarding the way the DHR has been rolled out and continue to hold concerns about the administrative efficiency and effectiveness of the system; and](3) calls on the ACT Government to [taken out: (a) report back][put in: provide the Assembly an update by 4 September 2025]on: [put in: (a)]the trialled DHR Link and [taken out: the][put in: further]inclusion of GPs in the DHR system; [taken out: to the Assembly by 24 June 2025; and](b) [taken out: implement][put in: potential]changes [put in: that can be implemented]to the DHR system to ensure greater efficiency, equity and transparency in care, [taken out: by:][put in: including:](i) [taken out: ensuring patient records from all healthcare providers are integrated into][put in: explore options for: (A) increased interoperability with My Health Record to improve integration across]the [put in: health]system, [taken out: inclusive][put in: noting reform work currently underway by the Australian Digital Health Agency and Department]of [taken out: GP][put in: Health]and [taken out: allied healthcare providers;][put in: Aged Care;]and [put in: (B) opportunities for greater interoperability between DHR, My Health Record and Health Link, with the Commonwealth and other states and territories;](ii) [taken out: integrating][put in: improved integration of]referrals [taken out: into][put in: in]the DHR system, [put in: including]providing [put in: patients with]greater [put in: visibility of the progress of referrals, acceptance status of referrals, and triage category; and (iii) explore potential amendments to the Health Records (Privacy and Access) Act 1977, to reduce the high barriers to sharing]patient [taken out: awareness. Debate ensued.][put in: information with GPs via DHR Link, whilst ensuring patient privacy.]

   Compared word by word by computer, ignoring punctuation. It shows what differs, not which change made each difference; the steps above show that.