Locke Keith: Health (National Cervical Screening Programme) Amendment Bill — In Committee 
Locke Keith: Health (National Cervical Screening Programme) Amendment Bill — In Committee 
[Volume:615;Page:11276] 
KEITH LOCKE (Green) 
: 
 Dame Silvia Cartwright who is now the Governor-General wrote a very highly commended report some years ago in relation to cervical cancer after that very thorough inquiry. She said: “If such a register is set up it must be maintained under the strictest rules of confidentiality and privacy.” This bill does not allow that because it is quite clear that the evaluators that it talks about do have the right to go through women’s medical records without their permission. Of course the bill says that can be done only to get what is needed but in terms of medical records what is needed is often amongst a lot of other stuff and one cannot help but notice the other material when trying to get at what is needed. 
The control supposedly is that the doctors have oversight. Well when I go to my doctor there are 20 people in the waiting room. The doctors are shuffling through patients and they do not have the time to step aside. They will be reluctant to stand around while an evaluator trawls through a record to get what is needed. Even the Minister of Health when she made her comments before did not say that the doctor will be looking over the shoulder of the evaluator. She said that the doctor will have the right to have oversight. As my colleague Sue Kedgley points out the word used in the legislation is “may”. So there is no guarantee at all that there will be proper oversight and that information that women do not want accessed will not be accessed or seen. 
My colleague also made the point that the women do not know what the information is that the evaluator will obtain. They are a bit in the dark and they are a bit worried about what that information might be. Judith Collins’ previous speech will not have made them any happier because both Judith Collins and Sue Kedgley said that there does seem to be in many people’s minds a relation between sexual history and cervical cancer. So the evaluators and the researchers will be interested in that. I think that is one of the problems and one of the things that will scare people off. Because the evaluators are moving into an unknown area and because sexual history is relevant they might look at the files in that respect and women will not want anything to do with it whereas if women were given the right to buy in to give their consent consciously they might be more happy about the whole process. 
A doctor’s skill is to elicit from a patient very personal information; that is his or her skill. A doctor can use this skill effectively because confidentiality is well built into the medical profession and that is why the medical profession and many health practitioners are up in arms about this provision breaching confidentiality. It is very difficult for a doctor to get personal sexual information because most people for a start are very embarrassed about disclosing much about their sexual history. Whether women or men people are very embarrassed on that level and often are very embarrassed about what might be the consequences if that information were to get out especially if it involves things like sexually transmitted diseases and AIDS. Sometimes information about a male’s or a female’s other sexual partners is disclosed to the doctor as a health measure but the last thing that the patient wants is for that information to get out amongst other people and perhaps back to his or her partner. People do not want that. The other function of a doctor who might not be fully trained to the level of a psychologist is to play a counsellor role to a lot of patients. All of those things mean we have to defend confidentiality very greatly.