Sophie Scamps (Mackellar, Independent) Share this | Hansard source

I rise to speak in support of the Australian Centre for Disease Control Bill 2025 and the Australian Centre for Disease Control (Consequential Amendments and Transitional Provisions) Bill 2025 and commend the government for establishing an Australian CDC to permanently monitor and assess public health risks, proactively work to prevent them and prepare Australia for future health crises. The establishment of an Australian centre for disease control is long overdue and a welcome initiative. It represents a critical step forward in strengthening our national public health infrastructure and ensuring we are better prepared for future health emergencies.

The COVID-19 pandemic exposed serious gaps in our readiness, coordination and data sharing, and this bill seeks to address many of those shortcomings. The idea of a national CDC has been discussed for multiple decades, with repeated calls for it to be established from public health experts and professional bodies dating back to the 1980s. It was promised during the 2022 federal election and has been the subject of extensive consultation since.

While I strongly support the intent of this bill, I do have a number of concerns about specific provisions and believe the bill could be improved. These concerns relate to: the exclusion of prevention of non-communicable diseases or chronic conditions from the foundational scope of the CDC; the lack of an independent selection progress for the employment of the director-general and the members of the advisory council; the lack of an explicit climate change ambit; and the limited functions of the director-general, which currently do not include the promotion of research or ensuring workforce capability. I have raised these concerns in detail with the Minister for Health and Ageing with the aim of ensuring that the final legislation delivers the robust, independent and effective public health agency that Australians deserve, and I thank the minister and his staff for their time and consideration.

I want to speak firstly to the foundational scope of the CDC, which does not reflect Australia's burden of disease. Currently, the scope of the CDC excludes prevention of non-communicable diseases or chronic conditions altogether. While the draft legislation specifies that the inclusion of chronic conditions in the CDC's remit will be considered by a review of operations and funding in 2028, the reality is that our population and our health system cannot wait. Excluding the prevention of chronic disease from the foundational scope of the CDC is a missed opportunity for the future of public health. Chronic conditions are driving right now the greatest morbidity, inequity and health costs in our country. As asserted by the University of Sydney School of Public Health, the Australian CDC will underperform if it is purely limited to infection diseases outbreaks from the outset and must include chronic disease prevention. Both the George Institute for Global Health and the Royal Australian College of General Practitioners support the establishment of an Australian CDC that incorporates both communicable and non-communicable disease prevention.

This year's General practice: health of the nation 2025 report shows that, in 2022, an estimated 15.4 million Australians were living with a long-term or chronic health condition. The report, based on the results from the health of the nation survey of nearly 3,000 GPs, found that the prevalence of chronic diseases, including diabetes, obesity and cardiovascular conditions, is a major concern for GPs across the country. These conditions are often presenting earlier and with greater complexity and multimorbidity, requiring sustained and coordinated management.

The alarming fact is that more than one-third of Australia's burden of disease in 2024 could have been prevented by reducing exposure to modifiable risk factors. GPs are uniquely placed to provide comprehensive preventive care, and the health of the nation report shows that four in five GPs want to provide more of this type of care, but they need increased MBS rebates and incentive schemes to be able to do so. Waiting another two years to consider including prevention of non-communicable diseases in the remit of the Australian CDC is not good enough. We must listen to the healthcare professionals who are seeing the costly and debilitating impact of chronic disease on Australians and include the prevention of chronic conditions in the mission of the Australian CDC from the start.

Next, I am deeply concerned by the lack of an independent appointment process for both the director-general and the advisory council members. Both the director-general and the advisory council members represent significant public appointments, and they should be subject to a transparent and quality appointments process. Ideally, this would be undertaken within a comprehensive Commonwealth framework for transparent and quality appointments, such as was put forward in my own Transparent and Quality Public Appointments Bill that I introduced in this place in 2023. However, in the absence of this framework, the bill itself should be amended to ensure that the appointment of the director-general and members of the advisory council is independent from government. This is essential not only to safeguard the integrity of the CDC's scientific advice but also to avoid any perception of political interference, undue influence or jobs for mates. Public trust in the CDC will depend on its ability to operate transparently and free from partisan interests, and that begins with how its leadership is selected.

As we prepare for the creation of our own Australian Centre for Disease Control, many have looked on with deep concern at recent developments in the US, where Secretary of Health and Human Services Robert F Kennedy Jr's former deputy has been selected as the interim director of the US CDC. As a doctor, I understand intimately the importance of ensuring that public health advice is grounded in science, not personal opinion or political ideology. That is precisely why double-blind randomised controlled trials are considered the gold standard of medical evidence. They are designed to minimise human bias and uphold scientific integrity. In the case of the US CDC, we are now witnessing one of the world's most respected scientific institutions being influenced by a figure with a well-known history of vaccine scepticism. This shift has been made possible in large part because the health secretary holds the power to hire and fire the CDC leadership. Dr Susan Monarez was dismissed as director of the US CDC by Secretary Kennedy after just one month in that role. In testimony before the US Senate, she stated that her dismissal followed her refusal to terminate senior scientists or to preapprove changes to vaccine guidance without access to the relevant scientific data. The White House later confirmed that she was removed because she was 'not aligned with the President's agenda'. This example underscores the critical importance of ensuring that our own CDC is built on a foundation of independence, scientific rigour and transparency.

I will be moving amendments to the bill to ensure that the appointment of both the director-general and members of the advisory council includes the establishment of an appropriately qualified selection panel for purposes of assessing whether a candidate is suitable for the appointment; a requirement for the panel to advertise the appointment, conduct interviews and shortlist at least three candidates for appointment; a requirement for the panel to consider the criteria set out in clause 10 as well as quality, experience, integrity and opportunities for promoting diversity in the public sector; a requirement for the panel to provide a comparative assessment of the candidates and a certification statement indicating that they are eligible for the appointment; and, finally, a requirement that the minister may only appoint from those shortlisted candidates. I also support the member for Indi's related amendment that would ensure an independent and transparent review of the operation of the act, and I will be moving an amendment to ensure that the chair of the advisory council is selected from the council rather than being the director-general, which, as currently drafted, unnecessarily risks undermining the independence and accountability of the council's advice.

Next I want to turn to the relationship between the CDC and climate change and how this connection could be strengthened to ensure our public health response is aligned with the realities of a warming world. Climate change is one of the greatest threats—is the greatest threat—to global public health. It is already driving increases in heat related illnesses, the spread of infectious diseases, food and water insecurity, and the displacement of vulnerable populations. A national CDC must be equipped to respond to these complex and evolving challenges with evidence based strategies and long-term planning.

While the current interim CDC includes a climate and health expert group charged with implementing a national health and climate strategy, it is not clear whether it will be funded and staffed to undertake this role before the agency's initial review in 2028. Additionally, one of the key functions of the director-general is the provision of public health advice to Commonwealth ministers, Commonwealth entities, state and territory entities, international organisations and a range of other public health bodies. While this advice must relate to public health matters, which is defined broadly at clause 5 of the bill to include 'preventative health, environmental health and the health effects of climate change', it is currently not an explicit function of the director-general to consult with and provided advice to bodies whose objects include mitigation of an adaptation to climate change. The member for Kooyong is moving an amendment to that effect, and I wholeheartedly support the amendment. I also strongly support the member for Kooyong's amendment that would require the minister to prepare a biennial statement on the health effects of climate change to be tabled in each house of the parliament. Health and climate are inextricably linked, and we must recognise and respond to the growing health impacts of a warming world.

Finally, the Australian Centre for Disease Control must be properly funded to fulfil its mandate. Preventive health care is consistently underfunded and often overshadowed by more immediate and politically visible health pressures, but the establishment of the CDC presents a rare opportunity to shift that pattern. The government's current commitment of $250 million over four years, with further funding for ongoing annual operations, falls well short of what is needed. For comparison, the Rudd government allocated $218 million to chronic disease prevention programs in a single year. With a total health and aged care budget of $146 billion in 2024-25, the CDC's proposed funding is entirely inadequate. If we are serious about building a strong, independent and effective public health institution, we must back it with the resources it needs to succeed.

In conclusion, I commend the government for taking this important step in establishing the Australian Centre for Disease Control, and I acknowledge and thank the minister for his leadership in bringing this long-awaited reform forward. With some targeted improvements, such as embedding prevention and chronic disease within the CDC's foundational scope, ensuring an independent appointment process for its director-general and advisory council, strengthening it remit on climate and health, and providing it with adequate and sustained funding, the CDC could be truly a world-class institution that protects and promotes the health of all Australians.

I move the amendment circulated in my name:

That all words after "House" be omitted with a view to substituting the following words:

"(1) notes that:

(a) chronic conditions:

(i) are the biggest killer in Australia, contributing to nearly 9 out of 10 deaths;

(ii) result in 6.4 million preventable hospitalisations per year costing approximately $82 billion in health expenditure; and

(iii) are estimated to cost $67.7 billion in lost labour force participation by 2030; and

(b) preventing and reducing this burden of disease would provide an estimated $8 billion in extra earnings, and $6.3 billion in welfare support and hospital admission savings annually; and

(2) calls on the Government to include prevention of chronic conditions as part of the Australian Centre for Disease Control's mission from the outset".

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