House debates

Tuesday, 8 August 2017


Australian Immunisation Register and Other Legislation Amendment Bill 2017; Second Reading

6:32 pm

Photo of Ms Catherine KingMs Catherine King (Ballarat, Australian Labor Party, Shadow Minister for Health) Share this | Hansard source

I rise today to speak on the Australian Immunisation Register and Other Legislation Amendment Bill 2017. This bill makes two minor changes to the No Jab No Pay arrangements. First, it adds four medical specialties to the list of providers who can grant medical exemptions for vaccination requirements—paediatricians, public health physicians, infection disease physicians and immunologists. Second, it clarifies that only recognised vaccination providers and these four specialties can tell the government whether children and families have actually met the vaccination requirements.

Labor supports this bill and the practical benefits which will arise from its passage. Ensuring vaccination rates are as high as possible is one of the most important health responsibilities of a government. While this bill makes minor changes, the issue at hand is not minor. Having this legislation in front of us is a good reminder of the importance of vaccination and a reminder of the role of everyone in this place to ensure we spread the message about protecting our society. Because despite all of the scientific evidence, Australia is in the midst of a renewed debate about vaccination, a debate that ended long ago, since the scientific evidence that vaccines save lives is overwhelming.

In early March, Senator Hanson questioned the safety of vaccinations on national TV, sparking renewed discussion on the issue. Senator Hanson later backed down from her suggestion that parents should use a non-existent test for vaccine allergies but she has not apologised for her earlier comments linking vaccines to cancer and to autism. Medical experts said Senator Hanson's comments were ignorant and dangerous. Disappointingly, the Prime Minister could not bring himself to directly criticise Senator Hanson on this issue.

One of the most naive things I hear from people talking about vaccination is because there are not any current outbreaks of diseases commonplace 100 years ago that their kids will be safe. That attitude completely threatens the ongoing success of our vaccine program. Professor Clem Boughton was once the senior physician at the Division of Infection Diseases at Prince Henry Hospital in Sydney—in other words, he was at the front line of treating these diseases. He hit the nail on the head about the reason complacency is creeping in on vaccines when he said: 'As a result of the effectiveness of immunisation programs, most young parents have not seen any of these conditions once so common in the community, and do not realise how dangerous they are.'

The result of such complacency? According to official statistics, there were 340 cases of measles in 2014, almost double the 158 measles cases in 2013. So when I hear leaders questioning the validity of vaccines, anger does not even come close. There will always be misinformed opinions, with proponents clustering on hidden Facebook groups and sharing discredited research. Do a quick search of Google and you will find uninformed and dangerous views flooding the results. But it is completely unacceptable for a politician, a national leader, to use their public platform to put a shadow of a doubt in one person's mind about something as critical as vaccination. Vaccination isn't just about protecting personal health; it's a social responsibility. Herd immunity is critical to protecting Australians who simply cannot be immunised for medical reasons.

The reason that most of us cannot fathom the devastation that diseases such as rubella, measles, diphtheria and polio cause is because of our successful immunisation programs. Australia's strong immunisation program is critical to eradicating life-threatening diseases, and failure to vaccinate is a threat to public health. Our leaders need to be doing everything possible to ensure that parents know about the deadly risks of failing to vaccinate their children, not spreading misinformation.

Only last week we saw a screening of a dangerous anti-vaccination film at a large cinema in central Melbourne by an active anti-vaccination group. And while activities such as this are taking place there is a risk that uninformed views are introduced into the mainstream discussion. We cannot afford a single shadow of a doubt to be put into anyone's mind about vaccination. Accordingly, we need to refute the uninformed discussion in order to protect population health.

In line with this, Labor welcomes the government finally funding a public campaign to combat the dangerous misinformation being spread on vaccinations. This is something we have been calling on the government to act on, writing to the Prime Minister back in March to encourage urgent action. However, I will note that Labor is disappointed the government has not allocated more resources to this critical initiative. The government should not drag their feet to act on this. They dragged their feet to act on this and then failed to put enough money behind it to seriously combat the level of misinformation circulating in the community. For months Labor has been calling on the government to fund a public campaign to combat the dangerous misinformation on vaccinations.

This is a really important issue—an incredibly important issue. Health experts have consistently reiterated the importance of getting accurate information to parents, and have been calling on the government to act. Michael Moore, the president of the Public Health Association of Australia said:

We need ... to maintain accurate information in the face of the misinformation that tends to be circulated.

The president of the Australian Medical Association, Michael Gannon, makes it clear:

It is absolutely essential that we have accurate information, and this fatuous idea that parents can spend half an hour on Wikipedia and come to a greater understanding of the issues than their doctor and the accumulated wisdom of all the world's medical scientists is ludicrous.

I ask: does the Turnbull government seriously think that the small amount of funding allocated will be enough to fight against what has become widespread misinformation on vaccinations? Dangerous misinformation peddled by anti-vaccination proponents should never take the place of proven scientific advice. We welcome a step to ensure parents are equipped with the right information, and we hope that parents now take the responsible step and protect their and other people's children.

Of course, there are clear consequences if parents do not protect their children, with the No jab, No pay arrangements establishing a clear financial link. Since 1 January 2016, only families who fully immunise their children, who are on a recognised immunisation schedule or who have an approved medical exemption can receive family assistance payments linked to immunisation status, such as childcare assistance and family tax benefit part A supplement.

These reforms build on Labor's track record to use every lever possible to boost immunisation rates and to protect our children. In government, Labor made important changes to family payments to lift immunisation rates, including linking the family tax benefit end-of-year supplement to immunisation. Ahead of the 2013 election, Labor committed to further tightening immunisation requirements within the family payments system, so we were very pleased to support the No Jab, No Pay legislation, having built on our reforms. We are pleased to support the changes in this bill today.

As the shadow health minister, I am particularly pleased to see the increase in immunisation rates. I am aware that since the No Jab, No Pay measures commenced, more than 210,000 families have taken action to ensure they now meet the immunisation requirements. This means increased immunisation rates for our children. As one example, I am aware from December 2015 to March 2017 the immunisation rate for one-year-olds increased 1.35 percentage points to 93.63 per cent. Of course, it will continue to be important to support people in vulnerable communities to catch up with their vaccination requirements and to make sure they understand the consequences of failing to make sure all vaccinations are up to date.

As it stands, the Australian Immunisation Register is only able to recognise medical exemptions to vaccination assessed by general practitioners. Whilst this tightly restricted approach was appropriate when the original legislation was introduced, it is appropriate to revisit it at this time to ensure the legislation is working as well as it possibly can. As noted in the explanatory memorandum, the restriction to general practitioners was taken to prevent medical practitioners not specialising in immunisation from conducting assessments and also to protect individuals' privacy in moving from the Australian Childhood Immunisation Register to a whole-of-life register, the Australian Immunisation Register. The explanatory memorandum notes the Department of Health has received feedback from some specialists requesting the ability to have their assessments of medical exemptions recognised in the Australian Immunisation Register. These clinicians have advised that having to send patients to a general practitioner to get medical exemptions has added a burden of time for patients. Passage of this bill will allow paediatricians, public health physicians, infectious disease physicians and clinical immunologists to have their assessments of medical exemptions to immunisation recognised by the Australian Immunisation Register in addition to general practitioners.

This bill also makes a minor amendment to make it explicit that vaccination information can only be provided by recognised vaccination providers and not by members of the public. Labor thinks these are sensible amendments in line with feedback from experts. We note these changes are likely to see a reduction in the number of referrals and appointments, creating efficiencies for both patients and for our health systems.

But of course there is more work to be done. In March 2017 the government announced to pursue No Jab, No Play laws. These are state and territory laws that allow childcare centres to turn away children who are not immunised. Whilst some states and territories have them in place, there is not a not a national approach. If the announcement sounded familiar, it is of course because the Abbott-Turnbull government already announced this policy almost four years ago. In May 2013 the member for Warringah and then-Opposition Leader committed, 'If childcare centres want to implement "no jab, no play" then they should be free to do so, and we will work with the states and territories to make it happen.' This government has been in office for 3½ years and, frankly, they have not worked with the states to implement No Jab, No Play, so we welcome the government's renewed commitment on the issue. Labor will certainly be holding them to account on this promise.

The other issue I want to note in this debate is the availability of vaccines and the government's failure to do more on this issue. Since last year, Australian parents have been grappling with ongoing shortages of the meningococcal vaccine, Bexsero. In February the minister boasted he had acted on the shortage and had a firm conversation with the manufacturer to restore supply in Australia. Despite this, nothing changed and parents were still being turned away when they tried to obtain the vaccine. The minister's comments misled parents into the false hope that they would be able to protect their children immediately. I am now pleased that the manufacturer advised the shortage was resolved in June, finally. But we are now seeing similar issues with the Menveo vaccine. Australian teenagers are caught in a state-by-state lottery when it comes to being protected against meningococcal W, with the Turnbull government failing to progress a national response to the growing threat of this disease. State governments in Victoria, Queensland, Western Australia and New South Wales currently fund immunisation programs, with the Victorian government confirming in June that 51,000 doses of the vaccine for meningococcal W have been distributed across the state. But with ongoing shortages of the vaccine and a lack of national leadership, teenagers in other states and territories will continue to miss out on this critical vaccine. The Therapeutic Goods Administration confirmed that shortages of vaccine to protect against meningococcal W are expected to continue until September. While shortages continue, states with funded immunisation programs are prioritised for supply.

At a time when there has been increased incidence of the disease, the Turnbull government must do more to protect our children. The federal government should make it a priority to work with the manufacturer of the vaccine, address shortages and make sure parents have the most up-to-date information. In the long term, Labor urges the government to work with the manufacturer and the Pharmaceutical Benefits Advisory Committee to negotiate a way forward, including whether this vaccine should be accessible for all children on the Australian Immunisation Register, because access to life-saving vaccines shouldn't depend on which side of the border a child lives on.

In conclusion, I'd like to revisit the comment made by Professor Boughton, who said it is the result of the effectiveness of immunisation programs that most young parents do not realise how dangerous some conditions are. I would like to finish today by sharing a story of a Western Australian family who I met a number of years ago and who continue to be huge champions for vaccination. They have had very personal and deep experience of just how dangerous vaccine-preventable diseases are. I refer particularly to Catherine and Greg Hughes, who've experienced what no parent should have go through, losing their baby boy to whooping cough. At three weeks of age, Riley started displaying a mild, cough-like symptom and developed an occasional cough. The doctors began treating him for pertussis, commonly known as whooping cough, but on his fourth day in hospital he was taken to the paediatric intensive care unit with pneumonia. These are Catherine's own words about what happened:

His heart was failing, his lungs were filled with thick mucus, as the toxins from the pertussis and the subsequent pneumonia had ravaged his body. My whole world was crumbling, and while I don’t think I was a total mess, inside my heart was breaking. We mentioned that when it was time for him to go, we’d like to be holding and cuddling him, not have him lying alone on the bed. The rest of the morning was spent crying, texting family and friends about what was happening, spending time with Riley, and asking my brother to bring in our three year old daughter so she could say goodbye.

This is the heartbreaking reality of these diseases and the reason that we cannot be complacent about the importance of vaccination. If that wasn't enough for the Hughes family, they were then subject and continue to be subject to a targeted campaign of online abuse and harassment from the antivaccination movement. But they have kept up their public campaign, because they know better than anyone else the devastating consequences of these diseases.

There is a generation of Australians who remember growing up facing the threat of vaccine-preventable diseases. Some of them live with the impacts even now. As an example, in 1953 Australia had just come through its worst ever polio epidemic. At its peak about 10,000 people a year, mostly children and teenagers, were coming down with polio. One of them was my mum, who died around this time last year. She spent a year in Fairfield Infectious Diseases Hospital at the age of 17, having contracted polio. She described the absolute terror that swept through communities and families when a polio diagnosis occurred and when polio was within communities. We have been very lucky in Australia that we don't have polio anymore. Australia started using the vaccine two or three years later, and by the end of the 1950s the disease had almost been eliminated in this country. That is the power of vaccines, and that is why we need to do everything in our power to ensure that the importance of vaccination is not forgotten by society.

6:48 pm

Photo of Tim WilsonTim Wilson (Goldstein, Liberal Party) Share this | Hansard source

It's a pleasure to follow on from the remarks made by the previous speaker in the context of the importance of immunisation, particularly for children's health, and some of the stories she has recited, particularly around some of the behaviour of people opposed to immunisation and the consequences when people are in a traumatised stage of life. I think everybody in this place, regardless of their circumstances, knows that when families and children are vulnerable, particularly related to terminal diseases, we have to make sure that we always show a high degree of respect, not use it as the basis on which we advance our own political causes or arguments.

I wish to make some brief remarks around the Australian Immunisation Register and Other Legislation Amendment Bill 2017 to highlight the Turnbull government's commitment to the importance of improving vaccination rates amongst Australians. Since the introduction of the No Jab, No Pay policy, the government has seen over 200,000 extra children vaccinated in just over a year. In my former capacity as Human Rights Commissioner—

Photo of Andrew LamingAndrew Laming (Bowman, Liberal Party) Share this | Hansard source

And a good one.

Photo of Tim WilsonTim Wilson (Goldstein, Liberal Party) Share this | Hansard source

That is very kind of you, Member for Bowman. When I was Human Rights Commissioner, people regularly came to talk to me about so-called human rights abuses that occurred as a consequence of this policy. But I have to say that the arguments presented to me were farcical. Firstly, adults have a choice about what they decide to put in their bodies; people of sound and mature mind can put themselves in a position to make judgement calls. That has not been the case with children. We have always had different laws applying to children and we should have different laws that apply to children, because of their lack of maturity and their lack of understanding.

In terms of their capacity to do things, this means that, for instance, we do not allow them to drink at a certain age. We do not allow people, let's face it, to vote for the people in this parliament until they are a certain age. We have to make sure that parents take a degree of responsibility and guide children as part of the nurturing journey towards adulthood. So policies like No Jab, No Pay are not in the framework of human rights. In fact, if you want to go down the international legal path—which, I have to say, I am not a big fan of, but that is a separate point—and if you look at human rights, they essentially apply to adults. When you talk about the rights of children—particularly around parents of children, that includes the right of children to be raised in the traditions and customs or culture of a family's background; equally parents are able to make decisions in the best interests of their children, particularly when it comes to issues around health. So this is not a human rights issue in the way some people would like to frame it. It is about making sure we take care of children and about making sure that children are in the best position not just to make their way to adulthood but to do it in a healthy way.

Since the implementation of the AIR Act from 1 January 2016, feedback from a range of health professionals has indicated that this means highly qualified specialists, such as paediatricians, infectious disease physicians, public health physicians and clinical immunologists are required to refer back to GPs for assessment and medical exemptions recognised by the Immunisation Register. This can create complex pathways of care, including multiple practitioner visits. Based on that feedback, this bill proposes to address these two issues by amending the act to extend the range of specialists who can provide assessments and medical exemptions recognised by the AIR, making it explicit that only recognised vaccination providers can provide vaccination information to the AIR and not members of the public or parents.

This bill will affect paediatricians, public health physicians, infectious disease physicians and clinical immunologists who will be able to have assessments of medical exemptions recognised by the AIR for family assistance payment purposes and in addition to general practitioners. This will streamline the way individuals are assessed for a medical exemption. Through the above-mentioned, medical practitioners will also reduce the time taken for a small number of individuals who retain a medical exemption for immunisation through these medical specialists. I am sure—I hope—all members of parliament will recognise the simple reforms proposed in this piece of legislation are not only consistent with government policy and our collective commitment to taking care of children, but it is also a pathway to make sure we are implementing sensible, practical policies to improve the lives of children, so they can have the best chance of growing up to be healthy, happy adults.

6:53 pm

Photo of Emma HusarEmma Husar (Lindsay, Australian Labor Party) Share this | Hansard source

I am pleased to support this bill which makes minor changes to the No Jab, No Pay arrangements. Unfortunately for some in the community, the immunisation debate continues to exist. It is a debate that should have ended long ago. The scientific evidence that vaccines save lives is overwhelming. It is unfortunate as well that we have some people in parliament who believe we should be having a debate and stopping immunisation. Senator Hanson's questioning of the safety of vaccines does nothing but put people's lives—and children's lives—at risk. While Senator Hanson backed down from her suggestion that parents should use a non-existent test for vaccine allergies, she still has not apologised for her earlier comments linking vaccines to cancer or autism.

Let me tell you, as a mother who is raising a child with autism, I would still take raising him—with all of his quirks—over not having him at all and his life being cut short by a disease that we managed to find a vaccine for and which we have reduced or eliminated.

Medical experts—experts, Senator Hanson, those people who dedicate their entire lives to research, developing knowledge and providing advice to the community—were all in agreement that your comments were ignorant and dangerous. The only person, however, who did not criticise her—his key preference dealer—was the Prime Minister. My office was inundated with criticism of Senator Hanson, not only on this issue but also on the segregation of children with special needs.

Australia's strong immunisation program is critical to eradicating life-threatening diseases, and failure to vaccinate is a threat to public health. Our leaders and the people in these places need to be doing everything possible to ensure parents know about the deadly risk of failing to vaccinate their children, not spreading misinformation. That's why Labor has called on the Turnbull government to fund a national education campaign on vaccines, and I am pleased to see that this is now happening.

People like Senator Hanson would benefit from this, but she undermines the confidence in the Immunise Australia Program, and the confusion has only the potential of lowering immunisation rates and causing harm. Parents are only interested, I believe, in doing what's best for their children. They don't need extra confusion, and they don't want to put their children in danger. A national education campaign that delivers the message that vaccines are safe and effective and save lives is thoroughly warranted. This should include advertising and information based on science, not opinion, for parents.

It is vitally important that our hospital system is not placed under any more duress. In my seat of Lindsay, we know only too well the impacts of flu this season. I couldn't imagine how the system could handle an epidemic or outbreak on top of it. Just last Sunday I was at Nepean Hospital's emergency department, and I saw firsthand the state that it's in: 83 patients at 3.30 in the afternoon in an emergency department that has only 32 beds. We have been given no additional clinical services, just billboards and promises. Imagine the inundation with an unvaccinated community.

While parents wait and staff are under enormous pressure in Nepean Hospital, the state government announces plans for a car park. There are no beds in car parks. There are no doctors or nurses in car parks either. We need some serious action now. A health precinct that cannot meet current capacity with certainty is not going to meet future needs with our ever-increasing population growth. It has now been seven years, and Liberal member Stuart Ayres has done nothing to increase staffing or bed capacity at the Nepean. The promise of an upgrade is a mere mirage. And, after 12 years, our local after-hours GP clinic, which was co-located at the entry of the emergency department, has been moved off site without any consultation with our community. The whole issue around stress of our health system is interrelated. I have mentioned flu, and this is an issue that we could also help with better education and with better vaccination campaigns.

As well as encouraging immunisation and shutting down stupid comments by preference dealer Hanson, the government must play its part in ensuring that the vaccine supplies are available. I note the recent shortage of the meningococcal B vaccine and am pleased that it is now resolved. I am pleased that action has been taken to protect our children from this devastating disease. I know firsthand the effects of meningococcal disease and how horrendous it is. My only sister, who is older than me, contracted the deadly disease 17 years ago. She spent weeks in hospital and was in a coma. Any steps that undermine our population's health should be called out.

Finally, the government announced that it would pursue No Jab, No Play laws. These are state and territory laws that allow childcare centres to turn away children who are not immunised. While some states and territories have them in place, there isn't a national approach. If the announcement sounded familiar, it's because the Abbott-Turnbull government already announced this policy almost four years ago. In May 2013, the member for Warringah and then Leader of the Opposition committed:

If childcare centres want to implement "no jab, no play" then they should be free to do so - and we will work with the states and territories to make it happen …

This government has been in office for over four years, and what has it done on the No Jab, No Play policy? Still, we welcome the government's renewed commitment on this issue, and I commend my support.

6:59 pm

Photo of Nola MarinoNola Marino (Forrest, Liberal Party) Share this | Hansard source

Australia has a very proud history in the field of immunology. Even though penicillin, arguably the most important breakthrough in modern medicine, was discovered by Sir Alexander Fleming, a Scottish biologist, it was actually Howard Florey, an Australian pharmacologist, who conducted the first clinical trials of penicillin and really made it useful and effective. Howard Florey is estimated to have saved over 200 million lives since his discovery. Prime Minister Menzies described Florey as 'the most important man ever born in Australia'. Now the science has conclusively proven that immunisation is an essential part of modern health care. It has significantly contributed to the eradication of smallpox, the first disease that was completely defeated and eliminated.

We understand very well how vaccines prevent diseases. They reduce the risk of infection by working with the body's natural defences to help it safely develop immunity to the disease. When germs such as bacteria or viruses invade the body, they attack and multiply and become an infection that causes illness. The immune system then has to fight the infection, and the body is left with a supply of cells that help to recognise and fight that disease in the future.

The government understands the importance of immunisation, which is why we introduced the Australian Immunisation Register Act 2015. This legislation created a new consolidated legislative framework for the establishment and ongoing management of Australian immunisation registers. The Australian Immunisation Register and Other Legislation Amendment Bill 2017 is a further part of the government's very firm, clear and absolute commitment to a No Jab, No Pay program. This program actively encourages immunisation and vaccination to lift the rates of safety for our children and for the children of others with whom each of our offspring play. We know how children play. Any parents or even grandparents here in the chamber know how quickly a cold or virus spreads around when children are young be it at day-care, at a preschool, at a house or when one gets sick.

I believe that there is overwhelming scientific evidence supporting immunisation, not the least of which is to protect our precious children from infectious diseases. Put simply: vaccination saves lives. There was a family of a baby who died of whooping cough in Perth in 2015. His name was Riley John Hughes. He died at Princess Margaret Hospital. The family took to social media at the time not only to share they grief but also in a desire to help eradicate the disease. They were encouraging people to make sure that their children were vaccinated. In the days before Riley's death, Mrs Hughes made an impassioned plea to other families to consider vaccinating their children against the disease. She said, 'If you have not been immunised against whooping cough, please consider getting it done. It was heartbreaking to watch four-week old Riley struggle with it at PMH. Please keep him in your thoughts.' This is the last thing that any parents would want. The Australian Medical Association President, Michael Gannon, in the article also said that the case was a very tragic reminder that people needed to get vaccinated against potentially fatal infections and, of course, this is exactly why vaccinations are so important.

The Centre For Disease Control and Prevention estimates vaccinations will prevent more than 21 million hospitalisations and 732,000 deaths among children born in the last 20 years. More than three million people actually die from vaccine preventable diseases each year. Approximately 1.5 million of those deaths are in children less than five years of age. What better reason could there be for vaccination than that? We have had the 2015 observance of World Immunisation Week. I want to commend the Rotary Clubs around Australia. In their great efforts to deal with the global polio eradication, they have also then taken this further into measles as well.

In 1988 Rotary joined together the World Health Organization, UNICEF and the US Centers for Disease Control and Prevention on the absolute goal of protecting the world's children by eradicating polio, and they have worked constantly ever since. Over these 20 years, Rotary and its partners have reduced the number of polio cases by 99 per cent. There are now only three countries in which polio transmission has not been stopped. I commend all of the Rotarians who have committed so much of their efforts and resources to this program. And these polio assets have been applied in tandem now to measles elimination, with similar strategies to deal with this. I encourage Rotary to continue in this. Polio Plus was launched in 1985. I commend Rotary for all their work in this space.

This legislation is about a range of matters. It is about ensuring safety across the board and the importance of vaccinations, including for measles and mumps. It is about rubella and shingles. There is a vaccination for shingles. And it is about the tragic outcomes I mentioned around whooping cough. And deaths from these diseases are absolutely preventable. Immunisation is critical to maintaining public health and preventing the outbreak of infectious diseases. I am pleased that the government's approach to vaccination for young children has support from both sides of the parliament. The Turnbull government is committed to further improving vaccination rates. Since the introduction of the No Jab, No Pay policy the government has seen an extra 200,000 children vaccinated in just over a year. This has meant vaccination rates have increased to 93 per cent for the general childhood population and to 94.5 per cent for those covered by the particular measures.

It is fundamentally good public policy to ensure good public health outcomes for Australians at the most important level—the individual family. It is good public policy that protects and saves lives. You would understand that, Mr Deputy Speaker Hastie. I understand that your next child is not far away from being born. So you, of all people, would be very protective of your children and babies and understand the critical nature of vaccinations. Even Her Royal Highness Princess Mary of Denmark has lent her support to vaccination. She has seen firsthand the effect of infectious diseases in Africa. This is another way of reinforcing the importance of vaccination right around the world.

In each electorate, many places offer child vaccinations and there are many opportunities for parents to make sure their children are covered. Since the introduction of the AIR Act, immunisation clinicians have requested that other specialised medical professionals have their assessments for medical exemptions recognised under the act in addition to general practitioners. And this is a fair and reasonable and very sensible proposal, put forward by the medical profession, to advance the objectives of the No Jab, No Pay policy. These additional practitioners include paediatricians—a very good idea—public health physicians, infectious disease physicians and clinical immunologists. Specialists have advised that having to send patients back to general practitioners for medical exemptions has added an unnecessary burden of time for patients and in some cases may risk recognition of those families that actually have done the right thing. In rural and regional areas, the more efficient we can be the better. The four specialist groups identified in the legislation today, therefore, provide care to the most vulnerable children in the country, including those with complex illnesses and healthcare requirements. This is a very sensible response put forward by the profession and is yet another example of the Turnbull government consulting with professionals and making changes to ensure the legislation is fit for purpose—the purpose of good public health outcomes. As the minister did, I too want to thank and acknowledge the work of the AMA and the Royal Australian College of General Practitioners. It is important that the government work with the profession to make sure that the No Jab, No Play policy is effective.

It's important to acknowledge the bipartisan support lent by the opposition. I understand they've also been a very constructive partner in the push to ensure that vaccination becomes a universal outcome for Australian children, other than those with a genuine medical exemption. The Prime Minister has made this a signature personal area of investigation and action in terms of preventive health, public health and protecting children. He deserves great credit for ensuring the focus on this area. I strongly support this policy and make no apologies for the tough stance this government's taking on the vaccination of our children. I commend the Australian Immunisation Register and Other Legislation Amendment Bill 2017 to the House, and I am sure that every member of this place is greatly committed to the health of children and babies. That is why there is such widespread and bipartisan support for this important bill. I commend it to the House.

Photo of Andrew HastieAndrew Hastie (Canning, Liberal Party) Share this | Hansard source

I thank the member. On this subject, we are of one mind.

7:11 pm

Photo of Meryl SwansonMeryl Swanson (Paterson, Australian Labor Party) Share this | Hansard source

I thank you, Mr Deputy Speaker, and I thank the member for Forrest for her comments as well. I too rise to speak on the Australian Immunisation Register and Other Legislation Amendment Bill 2017. I am pleased to speak in support of the bill because it is high time that the government took a harder line to ensure that parents can no longer play Russian roulette with their children's health.

I applaud the minor amendment to the bill that adds four medical specialities to the list of suitably trained and qualified experts who can grant vaccination exemptions. They are, quite rightly, paediatricians, public health physicians, infectious disease physicians and clinical immunologists. Labor agrees that these people are among the very few qualified to make the potentially life-threatening call to not administer a vaccination to a child. It is right and proper that they are also the only people who will now be qualified to tell the government whether children and families have met vaccination requirements. I therefore commend the government for this second minor but positive change to the No Jab, No Pay arrangements. The government must encourage and protect the collective immunity of all Australians, and that's what we're really talking about here.

I'm delighted to report that the high schools of my electorate of Paterson, in Maitland, have vaccination rates among the highest in New South Wales. This is largely due to the efforts of a wonderful woman, my good friend and Labor colleague Councillor Loretta Baker. Loretta is a candidate for the 2017 Maitland City Council mayoral election, which is coming up very shortly. In her day-to-day life, however, Loretta is a community health nurse whose work involves a great deal of time vaccinating children in schools. Indeed, she has vaccinated my own children. Apparently, she doesn't hurt a bit! In Paterson, it appears that many people are embracing the message that a failure to vaccinate is a threat to public health thanks to the education and leadership of people such as Loretta Baker. Francis Greenway High School at Beresfield achieved a 100 per cent vaccination rate for the first shot to protect against human papillomavirus, 98 per cent for diphtheria, tetanus and pertussis, and 90 per cent for the shot that wards off chickenpox. That's well worth the investment to any parent who's ever endured chickenpox, especially over the summer. Across town, Maitland Grossmann High School recorded 90 per cent uptake for HPV vaccinations, 91 per cent for DPT and 79 per cent for chickenpox.

However, many parents in Paterson recently received bulletins from their local primary schools warning of the high rates of influenza and also the symptoms of whooping cough—yes, that's right. In 2017 there are people in our communities who have whooping cough—pregnant mothers who have whopping cough and tiny babies whose bodies are racked by the incessant, life-draining and life-threatening whoop. This can occur even among those who have been immunised, as vaccines may be ineffective in a small percentage of the population. That's why it is so desperately important that all who are medically able to receive immunisation do so. It is for the good of our community—our herd. As leaders, our goal should be to eradicate life-threatening diseases, not just in our electorate, state or nation, but across our globe. This should be our mission. The World Health Organization recognises the role of vaccinations in helping achieve the 2030 UN sustainable development goals. Here in Australia, the Immunise Australia Program is fundamental.

However, we are concerned that some recent commentary around vaccinations and purported links to autism might undermine confidence in the program. Even by engaging on the topic we encourage the illusion that there remain two sides to the argument. In turn, this creates more material that becomes cannon fodder for vaccine sceptics. The debate about whether vaccines are life saving or life threatening should have ended long ago. I believe it takes a special mix of arrogance and ignorance for a person to believe they know better than a highly trained medical professional. But, as Dr Michael Gannon recently said, about eight per cent of the population are so-called 'vaccine hesitant'. That means they are looking for any hint that might cause them to stray from a vaccination program. It is absolutely essential that we have accurate information and that members of the public have access to this information too.

Science provides us with answers that are tested and agreed upon by people who devote their whole lives to studying certain areas of expertise, and these experts have determined that the only people who should be eligible for a medical vaccination exemption are those who truly need it. This includes those who have a history of anaphylactic reactions to components in the vaccine or those who are temporarily immunocompromised. Having an innate suspicion of mass vaccination programs isn't an adequate excuse, and neither is spending an evening with 'Dr Google' or buying into viral Facebook tin-hat conspiracy theories that play on parents' fears for the safety of their child. It is imperative that the Prime Minister puts an end to the politics of fear. Again and again we see this government and its allies drive dodgy agendas pulling the wool over the eyes of the good people of Australia.

Fear is such a powerful motivator. The member for Wentworth and others have been very busy during the past couple of weeks, fanning huge clouds of fear around Labor's plan for a more equitable tax system. They've been largely silent on and, as such, permissive of Senator Hanson's ignorance and vitriol towards our residents. The Prime Minister has stayed shtum as his preference deal partner has linked vaccines to cancer and autism. That's right—Senator Hanson, such a multi-skilled purveyor of expertise, somehow became a televised expert on the subject of vaccines. She spoke about a non-existent test for vaccine allergies and encouraged parents to use it. She linked vaccines to both cancer and autism. These unfounded and downright dangerous comments—which, not surprisingly, echo those of Donald Trump—were made to a potentially national audience. Senator Hanson later backed down on her comments about the non-existent vaccine allergy test. Medical experts decried her comments and described them as ignorant and dangerous. But the damage was done. Every time we allow the vaccination debate to reignite, we give parity to a non-argument. Every time we allow this ridiculous position air, we give a patina of credibility to it. We pretend there are two sides of the argument. We create more material that populates the ethernet and eventually becomes the cannon fodder of the vaccine sceptics.

As science has demonstrated, the debate about whether vaccines are life threatening or life saving should have ended long ago. The debate is over. The science is in. The evidence that vaccines save lives is overwhelming. We should not be having this debate. It is time that the government, once and for all, moves beyond the uninformed discussions that continue to put our most vulnerable at risk. Dr Michael Gannon has referred to vaccinations as the most important public health program we have. Yet this government continues to be far too tolerant of those who encourage opting out of children's vaccination programs due to conscientious objections. Even today, as I speak, there is no national approach guiding childcare centres regarding accepting enrolments of children who are not immunised. While some states and territories have laws that allow centres to turn away children who are not immunised, it is not a universal approach. That is simply not good enough, particularly when you consider that, in May 2013, the member for Warringah, then the opposition leader, made a commitment that he would work with states and territories to develop a uniform approach. Yes, that was 3½ years ago, and what has transpired? Very little. While parents and health services around the globe plead for international aid programs to help vaccinate children from preventable diseases, here in Australia we have a government that remains tolerant of a populist and ridiculous wave that persists in linking vaccines to illness.

I put it to you that it is deadset wrong for the government to permit a culture of fear and ignorance to fester around an issue of life and death. The government must adopt an absolute position. Just weeks ago in Charlestown Square, which is a popular shopping centre in the Hunter Valley frequented by a lot of my constituents from Paterson, the Australian Vaccination-sceptics Network dropped in for a screening of Vaxxed. Although the antivaxxers plugged it as a documentary, I refer to it as a mockumentary. Its central premise is that vaccines against measles, mumps and rubella may be leading to an autism epidemic. People who came along to the $25-per-adult screening also got to participate in a question-and-answer with one of the biologists featured in the mockumentary. A roaming camera crew filmed attendees and recorded their vaccine injury stories. This was appalling: sad and angry people venting their fears and suspicions, only to have this private grief and fear captured by the unscrupulous as further evidence of the evils of vaccination. It was not just in the Hunter Valley either. Only last week there was an antivaccination film screened in central Melbourne.

It is critically important that the government does all it can to counter movements such as the Australian Vaccination-sceptics Network. Our leaders at local, state and federal levels must be united in their commitment to educate and inform parents about the deadly risks associated with the failure to vaccinate children. Labor wrote to the Prime Minister in March to encourage decisive and urgent action. While we are pleased that the government is finally revisiting the No Jab, No Pay arrangements, we are disappointed that more resources have not been allocated. We must refute the uninformed discussions that are taking place in our communities about vaccines. It is essential that we educate people about the inherent risk of these preventable diseases and protect the health of our population. If the antivaccine proponents shout loudly, we must shout louder. When uninformed views make their way into mainstream discussions, we must draw on science and refute them absolutely. If there are mockumentaries and public forums fanning fear about Australia's world-class immunisation program, we must counter them with equally emotive and powerful messages of truth. We must work to ensure that the dangerous misinformation peddled by the antivaccination proponents never, ever takes the place of proven scientific advice.

During this education program, we will have the support of the Australian Medical Association, the Australian Academy of Science, Australia's medical colleges, nurses, and the Public Health Association of Australia. We all agree that it is critically important that the public continues to be educated about the importance of vaccines. So, while Labor welcomes a federally funded public education campaign, we call on the government to allocate more resources to this critical initiative. We must eliminate any confusion, and give people access to information across a variety of channels. Parents must know the deadly risks of failing to vaccinate their children.

As the daughter of a polio survivor, I have a very personal interest in this. My father, who passed away last October, had infantile paralysis, as they called it in 1931, as a two-year-old boy. It did not deter him. His right hand was slightly less strong than his left, and he was a man who worked physically hard with tools all of his life. He never sought any sort of compensation or payment for what was a disability, but he worked so hard his whole life to put that aside and just be an incredible contributor to our society.

I say to anyone who fears vaccination: you should fear polio and the other scourge diseases that could wrack your child in a much greater way than the marvellous science that has gone into immunisation. It is the great gift of human medicine over the last 100 years and we should all be embracing it. I do thank the government. I urge them to put more resources into this. It is our responsibility to support parents and make sure they vaccinate their children. Thank you.

7:25 pm

Photo of Jane PrenticeJane Prentice (Ryan, Liberal Party, Assistant Minister for Social Services and Disability Services) Share this | Hansard source

I rise today to speak to Australian Immunisation Register and Other Legislation Amendment Bill, a bill that makes minor amendments to the Australian Immunisation Register Act 2015 to expand the list of health practitioners who can assess the contraindication young individuals may have to a vaccine or natural immunity to a disease. Notably, and consequential to the amendment, changes will be required of the A New Tax System (Family Assistance) Act to align with the medical practitioners who are able to certify a medical exemption to immunisation for family assistance payment purposes. The opposition should be supportive of this initiative—and I note that the speakers to date are—because the coalition will ensure that those families unable to immunise their children for a legitimate medical reason do not have any of their family assistance payments impacted.

Immunisation is critical to maintaining public health. It is as simple as that. Vaccination is a fundamental achievement of our modern times. Immunisation is the most significant public health intervention in the past 200 years because it provides a safe and effective way to prevent the spread of many diseases—diseases that would otherwise cause hospitalisation, serious ongoing health conditions and, in some instances, death. Since the introduction of vaccination for children in Australia in the early 1930s, deaths from vaccine-preventable diseases have fallen by 99 per cent, despite that at the same time our population has increased threefold. Members should perhaps take a moment to fathom the effects on Australia's population if vaccination had not formed an integral part of our health policy. Vaccination policy is good policy. Vaccination saves lives. This policy enhances the integrity of our No jab, No pay strategy.

I further want to impress upon the House that this bill is not about parents seeking exemption from immunisation simply because of their views on vaccination formed by reading outlandish online forums or following paleo-hungry celebrities. Some specialist immunisation clinics have approached the Department of Health since the AIR commenced. Just like the medical specialist clinics in my electorate of Ryan, they have continued to advocate the consideration for paediatricians, public health physicians, infectious disease physicians and clinical immunologists to be recognised as being able to assess for medical exemptions. Feedback received from specialist clinics indicates that the current practice sees patients being sent to general practitioners to get a medical exemption. Like many members here today who are parents, we understand and appreciate that this scenario is burdensome for already time-poor mums and dads. Expanding the numbers of those who can assess for medical exemptions will reduce the number of referrals and appointments patients would need. It will also ensure that the most vulnerable and those living with complex illnesses are afforded the best possible care available. This further demonstrates that through smart coalition policy Australian families are benefitting.

With highly infectious but easily preventable diseases like measles, the rate of immunisation required to interrupt disease transmission—also known as herd immunity—is above 95 per cent, a mark that we are still short of. Vaccination is one area of life where it pays to be part of a crowd. I wonder if One Nation Western Australia Senator-elect Peter Georgiou will now advocate for immunisation, given his run-in with the measles which delayed his swearing-in—no doubt much to the embarrassment of his colleagues and Senator Hanson, who was recently attributed with critical comments about Australia's vaccination program. The regularly-quoted this evening Dr Michael Gannon, head of the Australian Medical Association, went as far as to say that he was appalled by Senator Hanson's remarks, emphatically stating that the comments could have a damaging effect on those less-informed Australians who are already marred by the controversial debate by flat-earthers who do not accept science and vaccination.

Debate interrupted.