Australian Civil Liberties Union

Data Bank Of Medical Records

Patients' privacy is being threatened by a proposed national data base including details about medical records which could be accessed by other persons, breaching medical confidentiality.

The confidentiality of medical information has long been a tradition in medical circles, however it is under challenge now that the suggestion for such a national medical computer listing has received support from federal and state health ministers after a national taskforce examined the proposal last year, but it has been opposed by the Australian Medical Association.

More acceptable to the AMA is the concept of a portable computer record the size of a credit card that could be carried by individual patients to provide information for doctors and chemists, but Dr Hacker of the AMA believes it should be the patient's own decision whether or not to have such a card.

The AMA will discuss electronic health records at its national conference in May, 2000. Opposition health spokeswoman Jenny Macklin favoured electronic health records as a quick and convenient way of transmitting information to doctors but opposed a national database.

These suggestions seem to be a fulfillment of a report mentioned in The Age, 23 April,2000, released by the major charted accountant firm, Price Waterhouse, last year (1999) based on interviews with 400 health care officials, that there was a trend towards more use of the Internet, a better informed type of patient and predicted a single, electronic medical history record.

The privacy bill now before federal parliament lacks adequate safeguards in relation to the proposed data bank. Breaches of privacy should be a criminal offense, privacy commissioners should have more authority and have more potent audit powers over the suggested database. The recommendation to have a national data base will make both doctors and patients reluctant to supply information on the public record, especially if damaging the patient's interests.

A national data base does have some redeeming features. It could be useful in compiling national medical statistics, would be useful in an emergency and could track patients who go from one doctor to another. Even apart from the privacy issue, such a database may contain inaccurate information that could harm health users. The positive aspect is that, if such a national data base were to eventuate, it could provide patients with a better understanding of their health assessments and a more self-informed public.

The DNA data bank proposal use by police and law enforcement officials to promote a national database of DNA samples taken from criminals and suspects is a cause for concern. The argument is that since every person's DNA is unique, samples of DNA found at the scene of a crime will conclusively identify the culprit.

This was apparently the reasoning when, after a rape and bashing of a woman in the town of Wee Waa, NSW, police insisted on taking DNA samples of most of the town's male inhabitants, thus treating them as all potential suspects, arguing that only the guilty need fear a DNA test.

Many of the same cautions, however, apply to this as to a national data base of patients. Again, there is an invasion of privacy; it violates the principle of "innocent until proven guilty"; and provides an opportunity to "frame" someone by falsification of evidence by dishonest police or other people. Several Royal Commissions in Australia and elsewhere have shown that police can fabricate evidence to get a conviction. Also, the sheer volume of DNA records increases the possibility of error and there appears to be inadequate protection against possible abuse of power by those possessing such DNA records. The recommendation of NSW Privacy Commissioner Chris Puplick that each state or territory should have a privacy commissioner to oversee DNA records has been ignored by police officials.

Scientific evidence may not be infallible. Lindy Chamberlain had a long and expensive battle to clear her name and the Irish bombing cases in UK were mishandled.

It is a matter for concern, in view of possible abuse of the scheme, that a UK police officer, Robin Napper, has come to Australia to try and promote extended DNA databases in NSW and by the national Federal CrimTrac data-base system. In May 2000 the NSW government will introduce laws enforcing mandatory testing of suspects.

The Federal government has undertaken to remove from its DNA database those cleared of suspicion, to give access only to authorised officers and sentence anyone misusing data samples to two years' jail. But since much of this material is hidden from checking by sources outside the police, it can be open to abuse. And the case of a suspect of the Claremont killing investigation in Perth, who was cleared by DNA testing, did not lead him to escape police attention. He was still watched and pursued by police.

The new technology may promise conclusive evidence of crime but can be distorted and abused by corrupt police and officials. It will need proper safeguards to be established and maintained.