Matt Thistlethwaite (Kingsford Smith, Australian Labor Party, Shadow Parliamentary Secretary for Foreign Affairs) Share this | Hansard source

I am pleased to make a contribution in this debate because, quite simply, this is lousy public policy. This is a backward step when it comes to preventative health and providing better health outcomes for the Australian people. The Australian National Preventive Health Agency (Abolition) Bill 2014 repeals the Australian National Preventive Health Agency Act and seeks to abolish the Australian National Preventive Health Agency, unwinding decades of progressive work on improving public health outcomes by preventative health campaigns throughout Australia.

Labor established the Australian National Preventive Health Agency in 2011 to take national leadership on preventative health for Australia to coordinate, analyse and advise on key statistics and data in relation to chronic disease and prevention, and to deliver and administer a preventative health research fund. The Australian Labor Party recognise the value and need for long-term, sustained investment in preventative health and for the benefits to health outcomes and savings to the health system that this preventative investment can achieve. It is often said that prevention is the best cure and that is the view of health experts. That is the view of health professionals. Here we have a bill that seeks to undermine all of the good work that has been done at a government level to encourage preventative health throughout Australia, to encourage people to live healthier lifestyles, to encourage people to visit their doctor when they have minor ailments so that they do not become major ailments.

Since its establishment, the ANPHA has sought to embed preventative health as central to the delivery of health care. In particular, the ANPHA has been working with Medicare Locals to enhance the primary-care sector's focus on prevention. Now that approach is being undermined. We have seen that this government is seeking to undermine the Medicare Local network, those integrated health-care packages that have been developed by health professionals, by GPs in concert with specialists and allied health professionals in local areas to reduce some of the complexity involved in dealing with numerous layers of health bureaucracy throughout the country.

In the wake of the recent Abbott government budget, one thing has become resoundingly clear—that is, this government is bad for Australia's health. Despite promising otherwise before the election, once the government was elected they took an axe to the nation's health-care sector, cutting billions of dollars from hospitals and from the health budget. They are seeking to introduce a co-payment for Medicare and GP visits. The first level of health care in this country is usually a visit to the GP. By introducing a co-payment, the government is seeking to deter people, particularly those on low incomes and fixed incomes such as pensioners and the vulnerable within our society from making important visits to the doctor.

In the weeks after the budget, despite the fact that the program has not actually been introduced, it has not gone through the parliament and become law, despite the fact that it is not programmed to commence as law until 1 July next year, we have seen a dramatic reduction in consultations with GPs. We saw that anecdotal evidence from the Australian Medical Association, saying that in various surgeries and GP clinics throughout the country people had rung their doctor and said that they could not afford the co-payment and they were cancelling their consultation. That is even before the system was introduced. Imagine what it will be like when the $7 becomes a reality. And it is not just on GP consultations, of course. It is on imaging and pathology services. It is on other related health care, such as scripts and consultations with pharmacists. It is bad policy because it deters people from seeking preventive health actions. It deters people from visiting their local GP. That first line of consultation with health professionals is being undermined by a co-payment.

The other point to make in respect of a co-payment is that it will not work. The evidence from throughout the world demonstrates that. Australia's public health costs—as the previous speaker, who is a former doctor, admitted—are relatively modest compared to the rest of the world. Our public health costs, as a percentage of GDP, are about 11.5 per cent; the OECD average is about 11.3 per cent. So we are right on the average. If you look at a system such as the United States', which relies much more on private consultations and private health insurance—it is a privatised system of health care—the public health costs as a percentage of GDP are up around 15 per cent. So not only is this bad public policy, in terms of not encouraging people to take preventive health actions; it will result, I believe, in an increase in our public health costs. That is not the manner in which we should be administering the public health system in Australia.

This government has taken short-sightedness to new lengths by scrapping the National Partnership Agreement on Preventive Health and the National Tobacco Campaign. It has shown a complete lack of vision in relation to understanding the challenges facing the health system into the future. Labor is also opposed to this government's decision to cut vital preventive health funding to the states and territories for work on increasing physical activity, improving nutrition and healthy eating, and reducing harmful alcohol consumption in communities around Australia.

Recently, the Global Burden of Disease Study was published in The Lancet. It is a study that is undertaken periodically by the University of Washington. The results are alarming: they demonstrate that Australia is facing an obesity epidemic. One in three Australians is currently obese. That is 5.2 million Australians with a body mass index of 30 or higher, defined as obese by this international study. That represents an 80 per cent increase in the past 33 years. Australia is now one of the fattest nations in the world. We ranked 25th in the world, just behind the United States but ahead of France and Germany.

We all know that obesity is linked to higher risks of heart disease and stroke, blood pressure and bowel problems, oesophageal and pancreatic cancer, and osteoarthritis. Despite these sobering statistics about trends in the health of Australians, and despite these studies, which are becoming increasingly prevalent, about the increasing costs of treating people for preventable diseases such as diabetes, heart disease and obesity—despite these facts, the government is showing complete indifference to preventive health measures designed specifically to help Australians make healthy lifestyle choices. I ask the government: how is cutting funding for preventive health programs good for the fitness and health of our nation and its people? How is cutting funding for national partnerships on preventive health good for the health of our nation? How is cutting funding for, of all things, the National Tobacco Campaign—which is aimed at providing information encouraging Australians to quit smoking—good for the public health of our nation? And how is abolishing the National Preventive Health Agency through this bill good for the health of Australians? Quite clearly it is not. It is a backward, regressive step, and it clearly represents the approach of this government when it comes to public health.

This is also a massive breach of trust and faith with the Australian public. It was the Prime Minister who said, a couple of days before the election, that there would be no cuts to health, no cuts to education, and the like. But, clearly, what we see manifest in this bill, in the cuts to hospital funding and in the $7 GP co-payment is a breach of faith—a clear broken promise; a lie to the Australian public about this approach to national health.

Australia's first national nutritional survey in 20 years, conducted by the Australian Bureau of Statistics recently, revealed that, confronted with record obesity levels, Australians are not only not adopting more healthy eating habits, but we are eating more sugar, more fat, more salt and more processed foods. My wife is a nurse. She works in a large public hospital in Sydney. She sees the results of the worsening of Australia's public health. She deals every day with preventable disease. And, since the last survey, the amount of fruit and vegetables in our diet has dropped by an alarming 30 per cent. Less than seven per cent of the Australian population now follows the recommendations on the appropriate number of serves of vegetables to be eaten each day. Among those surveyed, a quarter had consumed alcohol in the past day, and more than a third of the kilojoules they ate came from foods labelled 'discretionary', which include cakes, chips, chocolate, biscuits and the like. More and more, we are unhealthy. More and more, we are eating the wrong foods. And this is pushing up public health costs. People like my wife, working as a nurse in a public hospital, are dealing with this every day. And we all pay for it. We all pay for it through our public health costs.

But instead of encouraging greater dissemination of information to assist Australians to make the right choices about what they put on their plate—instead of encouraging Australians and providing more information in the public health realm about healthy eating—what is this government's approach?

This government's approach has been to pull down a website that was aimed at encouraging greater public health, about encouraging Australians to eat healthy foods, about providing Australians with more information about better nutrition, about changing behaviour regarding eating healthier food in Australia and, ultimately over time, about changing the culture of junk food in Australia to ensure that we are healthier and, over time, reducing preventative disease and the burden on the Australian healthcare system.

The great disappointment about this decision by the assistant health minister was that two years' worth of work had gone into this program—two years' worth of hard work and research about providing information through a website to the Australian public. It was torn down on the advice of a person who worked for the assistant health minister, and it was discovered later on that in a previous career they were an alcohol and soft drink lobbyist. You cannot get a more disgraceful decision by a minister of the Crown that affects, and will have a likely effect, on health outcomes in this country. And cuts to prevention come on top of other budget measures which will put a financial barrier in place, deterring people from accessing primary health care, which is an essential part of preventative healthcare delivery.

The Australian National Preventive Health Agency was not something that was dreamed up overnight. It was recommended by experts who comprised the Preventative Health Taskforce. This was not knee-jerk public policy. It was sound public policy that followed a lot of actions that have been taken throughout the world. It is proven that you can be positive and progressive on public health outcomes and get results.

I evidence the reforms that were introduced by New York's, Mayor Bloomberg—particularly in banning trans fats in fast food throughout New York—and the positive agenda that was introduced by that particular governing authority to improve public health outcomes in New York. It proves that if you make an investment in preventative health you will get healthier outcomes and you will see Australians reduce the amount of preventative disease. Ultimately, we will see Australians happier, healthier and less of a burden on our public health system.

This bill comes before the parliament at a time when our health system is under unprecedented attack from this government. It is an attack that is based on broken promises; an attack that seeks to attack Medicare and dismantle universal healthcare in Australia; to rip money away from hospitals; to shift the cost of health care from the government onto low- and middle-income Australians; and to attack families. This bill is bad public policy—it is lousy public policy and it must be opposed.

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