Saturday, June 23, 2012

Is Our Democracy Up To Addressing Complex Technical Problems Sensibly? I Fear It Might Be Struggling.

Over last week I provided reports on the Hansard Record of the debate in the Senate and Reps on the PCEHR Legislation which saw the Bills passed last Thursday - 21 June, 2012.
There reports are found here:
and here:
and provide links back to the formal Government record.
In thinking about what went on I found myself asking is the adversarial political system we have well equipped to manage a topic so riddled with complexity, risk and expense as the PCEHR program.
At first blush you would have to say that maybe things could have been handled a great deal better.
The process of having the Government come up with a proposal that then is presented to the Parliament as some legislation (missing some important clarity around exact regulations etc. which are still causing considerable angst as recently as a few days ago) which then results in a brief enquiry and multiple submissions, which seem to have largely been ignored in terms of what finally becomes law, can hardly be an ideal way to handle issues of this sort I believe.
You can see how much concern there is about the heavy handed way DoHA has gone about things with recent articles like this.

Defiant doctors force e-Health backdown on PCEHR liability

TWO weeks before the introduction of the Gillard government's $1 billion e-Health scheme not one medical practice has signed up to use it, forcing Canberra to back down on a move to compel doctors to accept full liability for problems with the initiative.
The Department of Health and Ageing this week agreed to remove contentious contract conditions that would have made doctors liable if one of their employees leaked information contained in a patient's electronic health record.
It has also amended a clause that would have allowed government officials to raid surgeries and remove computers and records when a breach of the e-Health system was being investigated.
Full article here:
As late as Friday there was still no release of what is finally going be demanded that I am aware of.
What I find even more concerning is that there was no real process at the beginning of the PCEHR journey some two and a half years ago to properly research and frame an approach that might be ideal - despite having a well thought out National E-Health Strategy which at that point was unfunded and which did not in any way recommend what was then announced.
It is also a considerable worry that despite all sorts of concerns and recommendations from both the Opposition and the Greens that the legislation is just essentially ‘waved through’ without all the major concerns expressed both in submissions and by parliamentarians remaining, to my eye at least, unresolved.
I guess the issue is really whether this a systemic problem with non-experts attempting to manage complex technical and professional issues - in which case we need to work out how we can properly address highly technical matters via the present democratic processes - or is this just a poor Government which does not know how to correctly handle the resolution of stakeholder concerns in a reasonable way. Of course the third choice is that it is all fine, the system worked as it should and that the PCEHR Program is just ‘tickety boo’ in all aspects.  
In all this I would be the first one to admit I would be utterly clueless in trying to sort out issues like the Murray Darling Basin and the needed Nuclear Waste Dump where local vested interests seem to be able to endlessly delay and obstruct any real outcome. Both are clearly - among a host of others - clearly able to be rationally addressed based on the evidence but that does not somehow seem to be enough! Politics and very small sectional interests seem to be blocking the best overall outcome which is really needed.
What do readers think - is what we have fine - or do we, for complex technical issues, need a way to supplement the decision making capacities of Parliament for the good of all? If so how might this be done? You only have to watch European politicians trying to handle the aftermath of the GFC to see how technical and political complexity can lead to paralysis and potentially catastrophe.