Julia Gillard (Lalor, Australian Labor Party, Shadow Minister for Health and Manager of Opposition Business in the House) Share this | Link to this | Hansard source

Labor will support the National Health Amendment (Immunisation) Bill 2006, but I move a second reading amendment in the following terms:

That all words after “That” be omitted with a view to substituting the following words: “whilst not declining to give the bill a second reading, the House expresses its concern that the Government has:

(1)

consistently ignored the expert advice of the Australian Therapeutic Advisory Group on Immunisation (ATAGI) with respect to the inclusion of pneumococcal, oral polio and chicken pox vaccines on the National Immunisation Program;

(2)

failed to provide the Pharmaceutical Benefits Advisory Committee (PBAC) with the needed expertise in immunisation as required; and

(3)

failed to provide adequate ongoing funding for essential vaccines over the forward estimates of the 2006-07 Budget, leaving the Government’s long-term commitment to the National Immunisation Program in doubt.’’

This legislation is needed because the Howard government did not pay attention to the role of the states and territories in delivering the National Immunisation Program. Last year the parliament passed amendments to the National Health Act 1953 to change the way in which vaccines were listed on the National Immunisation Program, as announced in the 2005-06 federal budget. The National Health Amendment (Immunisation Program) Act 2005 removed responsibility for approval of vaccines for universal access on the National Immunisation Program from the Australian Technical Advisory Group on Immunisation and gave it to the Pharmaceutical Benefits Advisory Committee.

Labor supported this legislation, with some considerable reservation given the Howard government’s incredibly poor record on accepting and acting on expert advice about which vaccines should be made available on the National Immunisation Program. We would all recall that it took a huge community campaign and a huge campaign from Labor to finally get this government, particularly the current Minister for Health and Ageing, to act on listing the pneumococcal vaccine, the oral polio vaccine and the chickenpox vaccine. We need to recall that these vaccines were assessed as both cost-effective and clinically effective by the Australian Technical Advisory Group on Immunisation. But it was not a question of just months going by; it was literally a question of years going by until the Howard government finally made funding available for these vaccines. I think every member of this House would recall with some horror the callous performances of the Minister for Health and Ageing, time after time, when he was asked why these vaccines were not being funded. In what we believe to be a reprisal against the Australian Technical Advisory Group on Immunisation, in 2005 the government moved to give the responsibilities of the Australian Technical Advisory Group on Immunisation to the Pharmaceutical Benefits Advisory Committee.

Now some 12 months later we find out that the legislation which achieved that reprisal had some serious drafting errors and oversights. The amendments made by the National Health Amendment (Immunisation Program) Act 2005 failed to give the minister power under the act to continue the current arrangements with states and territories for assistance in procuring goods and services related to vaccine provision, for example vaccine storage and delivery. The 2005 amendments also failed to provide for continuing government funding for essential pre or post vaccine requirements under current arrangements—for example, the pre-vaccination screening test for Q fever vaccine.

The explanatory memorandum to this bill makes it clear that that was not the intention of the 2005 legislation—that is, the explanatory memorandum to this bill makes it clear that the government made an error when it amended the National Health Amendment (Immunisation Program) Act in 2005. We trust that the government is to be believed on that and that it was a simple error, not an endeavour to get away from funding essential vaccines. Even if the government’s version of events is accepted, it does leave you to wonder how it is possible that a government can be so unbelievably incompetent.

Here we have a government that has decided, we believe by way of reprisal, that it wants to get rid of the Australian Technical Advisory Group on Immunisation and has brought forth legislation to the parliament to achieve that result. We have a minister who is assisted by literally thousands of public servants. With all of the resources of government being brought to bear and all of the considerable resources of Minister Abbott’s office being brought to bear, how can basic errors like this be in the bill presented to the parliament? If it were not about a matter as serious as vaccines, it really would be a joke that a government can be so unbelievably incompetent in the area of health that it brings forward legislation to this parliament that forgets it has cooperative arrangements with the states and territories relating to vaccine provision, including vaccine storage and delivery, and it forgets that it is involved in funding pre or post vaccine requirements for vaccines like Q fever vaccine. You really would want an explanation of what is going on.

The Minister for Health and Ageing is clearly incompetent—it is his legislation. His office is unbelievably incompetent because the error was not picked up. And what is happening in the department that a bill so fundamentally flawed could be presented to this parliament with all of the time and resources then devoted to it that a debate of parliamentary legislation requires? So yet again in this place we are fixing up the Howard government’s incompetence—and it happens time after time—when it comes to health. We think there is a reason that the Howard government is incompetent in the area of vaccines: it has never really had a strong commitment to funding and supplying vaccines to Australians. It has been very focused on paying back ATAGI for making recommendations that embarrassed the government but it has not been focused on vaccine provision. The case that I referred to earlier of the failure to fund the pneumococcal and chickenpox vaccines for so long is evidence for every Australian of the lack of commitment of this government to the vaccination program.

The bill that is before the parliament today is a small technical amendment with no financial impact; but the fact that we are even here doing this this morning speaks volumes about the Howard government’s attitude to ensuring effective immunisation programs. They just do not care, and they are not competent to deliver on vaccines. The Howard government stand condemned for a shameful record of inaction on the funding of vaccines for Australian children.

We should remember that in September 2002 the Howard government’s own ATAGI recommended the funding of pneumococcal vaccine, chickenpox vaccine and injectable polio vaccines. What happened then? Absolutely nothing, even though the experts were saying that these vaccines were very important for children and that they were both cost-effective and clinically effective. The government received those recommendations and did nothing. In September 2003, the National Health and Medical Research Council made the same recommendation. What did the Howard government do then, having received the recommendation from a second expert group? You guessed it: absolutely nothing. So we saw Australian children going without vaccines that the experts recommended they should have, and the attitude of the Howard government was to do absolutely nothing.

In May 2004, the record changed from sins of omission to sins of commission. We know that in the process of putting together the May 2004 budget, the Howard government’s Expenditure Review Committee specifically debated whether or not to fund these vaccines and decided not to. There was no oversight or incompetence in that. There was direct consideration by Howard government ministers of funding these vaccines. They sat around a cabinet table and, faced with evidence that these vaccines would save the lives of Australian children, they said, ‘No, we won’t fund them. We just don’t care enough about them to put the dollars behind them.’

The only reason these vaccines were funded is that in the Labor budget reply speech in May 2004, Labor committed to funding these vaccines. On the same day that Labor committed to funding the vaccines, the Minister for Health and Ageing went out to a hurried and unseemly press conference and said that he would fund them as well. So the only thing that made the government fund these vaccines was its fear of political exposure. A fear about the health, safety and welfare of Australians—and Australian children in particular—did not motivate them to move at all.

Even at that stage, the minister for health refused to fund the chickenpox and injectable polio vaccines. We continued to campaign for the funding of those vaccines, and the minister for health ducked and weaved and basically did nothing. It was only in March 2005 that the minister for health finally—after an original recommendation in 2002—agreed to fund these vaccines. We need to remember that the minister for health had conceded that chickenpox killed at least 19 Australians each year and hospitalised some 3,300 people in a two-year period. So we were not surprised when the minister for health moved to gag ATAGI, the independent group on immunisation, because it had been vocal in its recommendations. It made recommendations fearlessly about the funding of these vaccines; and, when asked whether or not those recommendations stood, it always stood behind them. Of course, history has shown that, if you stand up to the Howard government, you pay a price. ATAGI paid that price in 2005 with its abolition and the movement of the assessment of vaccines to the Pharmaceutical Benefits Advisory Committee.

We have been watching since that move in 2005, and we remain concerned about the new vaccine approval system. We want to know: where are the immunisation experts on the PBAC? The 2005 legislation required the appointment to the PBAC of two additional experts in immunisation. If you were actually at a stage where you said, ‘We’re going to get rid of the Australian Technical Advisory Group on Immunisation and move its functions to the Pharmaceutical Benefits Advisory Committee,’ it would make sense that you would want to have within the Pharmaceutical Benefits Advisory Committee people who were experts in immunisation. We were told that there would be two of them. To date, only one appointment has been made. One needs to ask: why is that?

This legislation was brought in in 2005 and here we are in 2006. Vaccines are pretty important to people’s health. I do not think there would be anybody in this parliament who would contest that very basic proposition. This is a country that runs to a lot of experts in vaccines. It is not that we do not have people who can advise on these questions. We have in this country some of the world’s leaders on the question of vaccines. But the Howard government cannot, or will not, fill two expert positions on the PBAC. What could explain that degree of incompetence, that degree of neglect, and that degree of shameful inaction? Maybe we will have an explanation from the minister for health when he sums up the debate on this bill. But it is a mystery to me why there is still an appointment that is unfilled.

It is a tragedy that there is still an appointment unfilled, because we know that, at the present time, the PBAC is making some very important decisions about vaccines. Australians would have read, I think with great delight, about the pioneering work of the Australian of the Year, Professor Ian Fraser, and about what to many Australians would seem like a miracle—that is, the fact that we now have an effective vaccine against cervical cancer. Of course, it is the PBAC that is going to have to assess the clinical data and the cost-effectiveness data for the cervical cancer vaccine and make some decisions and recommendations about the way in which this vaccine should be funded and how it should be delivered to Australian women and girls.

Surely you would want that decision—a groundbreaking decision; a decision about a medical miracle—to be made by a PBAC with a complete range of advice about immunisation available to it. Why would you leave unfilled one of the spots for an immunisation expert at the time that the PBAC is considering such a groundbreaking vaccine? And it is not the only vaccine. There is also the rotavirus vaccine. The rotavirus vaccine can prevent children getting a disease which causes diarrhoea. In some children, of course, that can be a minor issue, but I am sure the minister at the table, Dr Nelson, with his medical qualifications, would know that diarrhoea in very young children can in fact be a major medical problem because of dehydration. It is a particular problem in Indigenous communities, where children, because their health status already tends to be poor, when they get rotavirus, tend to suffer with the illness more acutely than Australian children generally. But I do not mean to say that it is not a problem amongst Australian children generally; it is.

Once again, the PBAC is there, considering a new vaccine which prevents this virus and, consequently, the diarrhoea it causes and the hospitalisation that can result from that because of dehydration. The PBAC is considering that vaccine now—once again not fully advised on immunisation questions because the government has not bothered to fill the second spot. What would explain that unbelievable act of negligence? We are in a situation where doctors know how important these vaccines are. They want them funded. They are there and dealing with the agony of seeing children in families they know would benefit from the vaccines but are unable to afford them. They are therefore waiting anxiously for the PBAC to make decisions on these vaccines, and the PBAC does not have available to it the full range of expertise.

Our second question is: where is the ongoing funding for essential vaccines? The 2006-07 budget papers show a drop in PBS funding for essential vaccines from $184 million in 2007-08 to $120 million in 2008-09 and $122 million in 2009-10. We would like an explanation of what is going on here. I am sure that the minister for health will have one of his usual dodgy explanations, but the fact is that the money should be allocated for vaccine supplies into the future and it is simply not there in the budget papers. If we had a government with a better record of delivery on vaccines, we might be less concerned, but with this government we are highly concerned that that money is missing from the budget papers.

Then we would like an answer to the question: what is going to happen with the 12½ per cent price cut policy when it comes to the application of vaccines? This is a policy where a mandatory price cut comes into play for pharmaceuticals if a generic product is listed. In the pharmaceutical manufacturing business, generic products that are chemically identical to the branded product come on the market routinely, and consequently price issues arise. But, in the world of vaccine supply, there is a difference. There tends to be one supplier of any vaccine listed on the national immunisation program—indeed, one would say that there should only be one supplier of a vaccine to the immunisation program because, with vaccines, supply issues are often difficult. Every batch of vaccine must be approved separately, and it is not uncommon for individual batches to fail because the titre—the levels of active ingredient or antibody—is not adequate. Also, if there is an outbreak of disease elsewhere in the world, supplies can be diverted. Vaccine manufacturers have written to the minister for health, asking him about this issue, but they have not had any response—and they deserve one.

The fact that the 2005 amendments also omitted to provide for continuing government funding for essential pre-vaccination screening tests for Q fever highlights the Howard government’s failures around Q fever. CSL is the only manufacturer in the world of a vaccine to protect meatworkers and veterinarians against Q fever. This vaccine was made in a small-scale, rather old-fashioned operation and the vaccine needed to be subsidised by the government to ensure that the target population received it. However, the TGA last year required that CSL upgrade their Q fever vaccine manufacturing operations to meet good manufacturing processes. That meant substantial costs and consequently, in the absence of continuing government subsidies, the vaccine would now cost around $500 a dose. CSL announced it would stop making the vaccine. Not surprisingly, the meatworkers and veterinarians who are exposed to this disease were upset, and protested.

It is not at all clear what the Howard government is doing to address this. The simplest answer would seem to be to subsidise a new production facility at CSL, and perhaps to offset this by selling additional Q fever vaccine overseas. But instead the Howard government has put out an international tender for the supply of Q fever vaccine when the only manufacturer in the world is here in Melbourne. That seems a pretty roundabout way to get to a situation where we have a continuous and affordable supply of Q fever vaccine for workers at risk of this disease.

Once again, in addressing a health bill in this House, I am in the unfortunate situation where the health bill itself raises the continuing failures of the Howard government with respect to vaccines. We will support this legislation, but the issues dealt with in my second reading amendment are substantive and need to be answered by the Howard government.

Harry Jenkins (Scullin, Australian Labor Party) Share this | Link to this | Hansard source

Order! Is the amendment seconded?

Laurie Ferguson (Reid, Australian Labor Party, Shadow Minister for Consumer Affairs) Share this | Link to this | Hansard source

I second the amendment and reserve my right to speak.

Wilson Tuckey (O'Connor, Liberal Party) Share this | Link to this | Hansard source

As is typical of the member for Lalor, she has a very bad memory gap in debating the National Health Amendment (Immunisation) Bill 2006. She talks about the issues of today but forgets the circumstances that existed as to immunisation when the Australian people put the Labor Party on the opposition benches. In 1996 this Commonwealth government’s expenditure on immunisation was $13 million; today it is $285 million. Whilst I am one who says that you do not measure excellence by expenditure, I want to remind the House of why that expenditure was so low in the years leading up to 1996. The reason is the Labor Party did not approve of immunisation. They listened to a typical minority group who were associated with some of the areas from which Labor required preferences. They listened to a lobby group that opposed immunisation, and the best way that they could respond to that group was to fail to fund it. They removed the money quietly: they never advertised, they never made speeches and they never did anything to encourage the parents and elderly within Australia to take the advantages that immunisation provided. It was not until Minister Wooldridge, having recognised the extreme risk to our community of this negative policy, stood up in this parliament and raised the issue, raised public awareness and, in fact, took a measure of punishment—as these things are not necessarily vote winners—and told parents that they would lose certain welfare entitlements if they did not get their kids immunised that we turned this issue around.

I am looking, as I did last night, at the amendments proposed by the opposition. They are all negative. There is nothing in them that says we should hurry up and put the vaccine for cervical cancer through the PBAC. Instead we get a story about one vacant position. As I pointed out last night, these bodies that give advice to government, particularly on the efficacy of drugs—which is most important when the taxpayer is obliged to pay for them and so needs to know that they deliver benefits—seek advice from a broad range of experts in the community before making decisions. They do not necessarily have to be the sole source of that advice. That is something that the opposition does not appear to understand.

Furthermore, considering the predilection of the Labor Party to move pious amendments of this nature, I find it quite interesting that when the original legislation that this legislation is correcting used some fairly sensible words written by a draftsman—that the purpose of the previous legislation was to arrange the provision of designated vaccines—that suddenly, however, created the problem of what was not designated, there was not an amendment promoted by the Labor Party at the time. According to the member for Lalor, this government was unbelievably incompetent not to see that that form of drafting was inadequate—but she, legally trained, did not pick it up either! Instead of writing all these negative pious amendments to somehow make it that the Labor Party has got a better strategy on this matter—notwithstanding their record—than the government, why not put down some positive measures? Why aren’t you doing this? Why have you got this particular restrictive description in the legislation? By so doing, the opposition probably would have got the cooperation of the government. It was equally available to the member for Lalor, with her legal training, to say, ‘Do you realise you have left out Q fever scratch tests?’ It is a funding provision, of course—it did not stop people having them—but few people might know just how important a Q fever scratch test is inasmuch as that, without it and the information that it provides, people can be made severely ill or risk death if they are immunised prior to knowing the antibodies that they already contain.

Whilst I am on my feet, let me say in respect of Q fever that it is all right for the member for Lalor to say the government has called an international tender ‘when the only manufacturer in the world is in Melbourne’. That is not correct. There is no manufacturer in the world. CSL, the only manufacturer in the world, ceased production. I am advised that CSL, having suddenly recognised their failure in that regard, are building a new facility. But if someone else in the world—some of the giants of pharmacy—could provide that vaccine quicker why shouldn’t the government test the market in that regard? Some of these people have got such huge resources, both in personnel and finance, that they might have been able to provide it more quickly.

There has been a big debate in this place in recent times about the staffing of meatworks where Q fever is prevalent. It is a very serious disease and, quite properly, OH&S conditions demand that no-one starts work in an abattoir in Australia without having been immunised—and you wonder why there is a so-called skill shortage. It takes 30 days to complete that treatment. If an Australian who had previously worked in a meatworks applied for a job and had not previously been immunised, in the present employment environment they are then told, ‘Go off and have a scratch test. After the results are available, if you require a Q fever vaccine’—it is in extremely short supply; I am constantly approaching the Minister for Health and Ageing on behalf of the meatworks in my electorate on this matter—‘and if we can get you some vaccine, you can start work X days after that.’ The person picks up the paper the following morning and sees a job—perhaps in the north-west and probably paying better money—and says, ‘I do not think I will bother.’

This is just a collateral or contingent result of a very necessary process but it is aggravated by the lack of this product because of a commercial decision of CSL, which did not think they were making enough money out of it. For the government to test the international market is surely not a matter for criticism, but instead just shows the paucity of the debate of the member for Lalor. She sits there never arguing in the positive but only in the negative. I do not know how that sort of policy will ever qualify people to run the country. I well remember her criticism of the government for its failure to have a virtually universal immunisation policy for pneumococcal and she may be right that the government was tardy in doing so. But I also remember that at the time the advice to government was that, because of the incidence of this particular disease, it could have a targeted program—for instance, amongst Aboriginal children—and that would meet the requirements at a reasonable cost to the taxpayer.

In the end she won that argument. It is probably to her credit when one looks at the statistics because pneumococcal disease attacks have dropped dramatically as a result: by 2005 it had reduced from 213 cases to 40 cases, a decrease of 81 per cent. I am more than happy to give her credit for her campaign on that occasion because she was talking about something positive. But boy, you can go through a lot of her speeches before you find another example of that nature.

This bill deals with the immunisation legislation of 2005 which provided an arrangement whereby the states, considering their management of health services, could be funded by the Commonwealth to provide an extensive range of free immunisation services. The arrangement for the provision of designed vaccines seemed to cover that and I assume ‘designated’ meant that it could be dealt with by regulation, but it did not say ‘scratch test’ and it did not say a couple of other things. It has been pointed out, presumably by Treasury, that the Australian government has no power to pay that money, and this legislation corrects that. It is not the first time and it will not be the last when a government of whatever political colour is called upon by their departments to correct legislation drafted with goodwill. For the member for Lalor to use words over and over like ‘unbelievably incompetent’ is silly; she also did not see the mistake in reviewing this legislation. It is about time she found some reasons to do so.

I repeat that there is no government on record that had such a poor record of delivery of immunisation services than the Hawke and Keating government. Not only did they find $13 million for a $250 million need; they also had a fundamental philosophical opposition to immunisation. They listened as they always do to some minority group. They were not interested in immunisation and it is a tragedy. When they start throwing around insults and accusations, please remember the facts. If it had not been for Michael Wooldridge bringing this to people’s attention and forcing the issue with those who were frightened—as half of them were, as they get frightened in this place on other issues, such as the nuclear issue—by people seeking political advantage. They had to be forced. They had to be threatened with a reduction in some of their welfare benefits. This government stood up to that and the results are a matter of record. Yes, we are spending a lot of money but we are not measuring success by expenditure. The Hawke-Keating Labor government had no credibility on this issue whatsoever and it should never be forgotten.

I wish to return just momentarily to the Q fever issue which is mentioned as a matter that this legislation will correct. It is an extremely important issue throughout the meat industry. Lay the blame on the government, lay the blame on CSL, lay it where you like, but you cannot have a meat industry in Australia—and I would think in many other parts of the world—without immunisation against Q fever. I think there is a member in this House who has contracted it and has advised me that it is a serious and recurring disease and, I gather, a bit like malaria in its effect and its recurrence. More particularly, it creates a huge employment problem when you cannot get the stuff on the shelf.

The response to scratch tests—and Q fever is mentioned—which are not designated vaccines, is extremely important in the vaccination program. Yes, it should have been recognised at the time, but the draftsmen did not recognise it. They thought they had covered the matter adequately, and it is no fault of the government. Furthermore, it brings no credit to the opposition when, having not noticed it themselves, they stand up here and use emotive words like ‘unbelievably incompetent’. It is silly, and it is about time they woke up. This bill should be passing through the House. It should be dealt with in the Main Committee and it should go through in a couple of minutes, as it is such a positive measure.

I also wish to take a moment to congratulate Professor Frazer for his wonderful achievement. From my understanding of what he has said, he has not found a cure or a vaccine for cervical cancer; he has found a vaccine for a virus that creates the conditions for cervical cancer. That is the technical fact and that is a great advance in pharmacology and in immunisation—looking behind the disease that kills women and finding out the cause of the disease.

I was very proud to see in the last budget the significant increase this government allocated to funding for medical research. The Labor Party amendment has no word of congratulations to the government on substantially increasing that funding. It was a huge increase and one that arguably might be funded by the sale of Medibank Private. What a good idea that would be. We have made the advance payment already; we did not wait. But these things follow, and where should a government provide assets?

The measures in this bill are best described as routine measures. They deal with areas of drafting deficiencies in the original legislation. There was a failure to include the incentive payment that we pay state governments so that they will be careful with the vaccines that we pay for. When someone pays money and another person spends it, the old saying is that it is a lot easier to spend it than it is to raise it. And it is a good policy to give an incentive to people not to overorder these vaccines and then have to throw them out because they pass their use-by date et cetera. That is another measure that is being corrected, and quite properly so.

May I say to all members of this place: I hope you are all taking the opportunity to have an annual flu vaccination and encouraging your staff to do so: (1) if I can take the commercial approach, it keeps us all at work; (2) not only does it save people from great discomfort in their younger years but also it saves people’s lives in their older years. I contacted Michael Wooldridge and he implemented the vaccination program in this place, which we members pay for. That is quite proper. It is convenient for people who work seven days a week, and I would not criticise anybody in this place for doing otherwise. If they do not find time to get vaccinated, they can be suddenly debilitated by their failure to do so and then may not be available for the efforts they so willingly make.

The simple fact is that this bill corrects a couple of drafting errors. It is not a matter of incompetence. The record of this government, measured in money—$13 million to $285 million—is clear evidence of its commitment and of the failure of the previous government in that regard. I think the bill should be passed with acclamation and probably should have been dealt with in the Main Committee, because it did not even need a 30-minute speech from the member for Lalor.

Michael Hatton (Blaxland, Australian Labor Party) Share this | Link to this | Hansard source

Or, therefore, the 20-minute speech from the member for O’Connor. If there was not anything to talk about, you could have simply noted it and done that.

Wilson Tuckey (O'Connor, Liberal Party) Share this | Link to this | Hansard source

I spent all my time having to correct the misstatements of the previous speaker.

Michael Hatton (Blaxland, Australian Labor Party) Share this | Link to this | Hansard source

For the member for O’Connor’s benefit, I might spend 20 minutes doing the same thing with regard to his speech. He made a bald assertion about funding in 1996. If you look at the whole funding year for 1996, you see that part of that year—fully one-third of that financial year—included funding when the coalition came to government in March 1996, so a quarter of the time is allocated to them. But he took a point in the Bills Digest and said that funding for immunisation in that year was $13 million and that funding in 2005-06 has risen to $290 million.

The member for O’Connor argues—I think he argued it three times in his speech—that that is the fundamental pole on which you would sit Labor and the government in determining whether or not they were committed to immunisation. He does not take into account relative costs. He does not take into account that the pneumococcal vaccine was funded as a result of immense pressure from the Labor Party over a period of three years. It was only when Labor committed to that for the 2004 election that the minister, on the same day, announced that the government would do it. But, in the other two areas that we are looking at, an injectable polio vaccine and a chickenpox vaccine, he determined that the government would not go ahead. They chose pneumococcal only. The cost of the pneumococcal vaccine is very great—something in the order of $70 million a year. The cost of some of the other vaccines that will possibly be taken up—we are not sure whether they will or will not be—is also very large.

Anyone at all familiar with the Pharmaceutical Benefits Advisory Committee’s job of trying to restrain costs in the pharmaceutical area will know this. Connected to this, of course, what this government has done is to take the job relating to vaccines away from the technical advisory group, a group of experts who really knew what they were doing and who were specialised with regard to vaccination and immunology, and they have given the job to the cost cutters. As good as the PBAC are, their fundamental focus—what their driving instructions are—is to make sure that there is not only quality but also cost-effectiveness in the provision of service to the Australian public. At this point in time they have not been able to properly take account of what the theoretical and practical arguments are in regard to immunisation and the use of vaccines. Since the chair of the ATAGI cancelled himself out, we have not had a full substitution of qualified people. That continues to sit there. At this point in time, he has argued that it has not yet become a major problem. But it is indicative of this Minister for Health and Ageing and how he has treated the situation.

The fundamental reason for the difference between 1996 or 1997 and 2005-06 of $13 million is the relative cost of the new vaccine and the emphasis given to medical research in Australia and to the development of new vaccines in Australia and those that have been developed overseas. There has been a massive increase in capacity and in our ability to target diseases that research could not target previously. The cost of those, as with the cost of all major pharmaceutical provision, is very great, particularly in the period before they become generics. So it is a false argument.

I will come to the second part of the member for O’Connor’s argument—apart from his not taking into account relative cost. It is not just an inflation factor over that period of time but it is the fact that, when you incorporate high-cost drugs into the system compared to what was there previously, you get a relative disparity. That disparity will grow over time as we introduce new drugs. There are those that were introduced yesterday, as the minister indicated just before this bill came into this House. He indicated that there would be funding for Herceptin—that is a major cost—and there is a series of others that will be of a large cost as well. The government, rightly, has determined to make those funds available.

There is a cost to the Australian people. It is a question of balancing up the cost of those with the benefit that will be provided. There are lots of pharmaceutical companies and other companies with vaccines that have their hands up and are demanding to be part of that program. There is always a balance necessary to what government decisions should be on the basis of the qualified advice that they get, in this case from the PBAC. Previously, it was directly from ATAGI in relation to this. Now they have just a tangential advisory role in regard to it.

The core issue in what the member for O’Connor put was the second part of it—just the most outrageously stupid argument that, in the 13 years of the Hawke-Keating government, immunisation in Australia under that government effectively did not exist. His argument was about the $13 million and that what happened for 13 years was that the Minister for Community Services and Health, Neal Blewett, and other health ministers after him were so little concerned about immunisation that they took direct note of the very small group of people who were waging campaigns against immunisation. I well remember that period. I well remember the campaigns that were waged not within the government or within the government’s backbench or the government’s ministerial frontbench but in the public media in regard to this and the airtime and the prominence that they were given—another case of almost complete irresponsibility on the part of our press and our media. The full story was not told—the other key side of the story: the beneficial effects of vaccination and immunisation.

I can well understand the problem that some people have with the whole idea of vaccination and I can understand that people can in fact be directly affected. I have a cousin who has had autism since she was nine months old. Up until she was nine months old, as far as we know and can determine, she was a perfectly normal baby. She got a triple antigen shot—a series of three different vaccines in one shot—when she was nine months old, when she had a cold. She was speaking—‘mum’, ‘dad’; as much as that—at nine months. She was as advanced as that. She has never uttered a word since—total, complete autism.

It took a long time to determine it. It was in the very early days in relation to experience, in the sixties and seventies. We have much more experience with autism now than we had. But the probability—not the certainty—is that there was a conjunction. It was an immense problem for her parents. It ended up in the break-up of their marriage. It is a 24 hour a day, seven day a week problem.

If you extrapolated from that one experience, no-one would ever be immunised. But you cannot just extrapolate from the individual experience. Immunisation is about getting as many people as possible, if not the whole cohort that you are dealing with, vaccinated and immunised. That is the greatest victory the world has ever seen in Jonas Salk’s development of the polio vaccine—the eradication of polio from the world—and the eradication of smallpox. Those two massive campaigns did so much to transfigure the lives of millions of people, when there had been so much transfiguring for the worse. In the case of smallpox, there had been massive infection throughout history. In the case of polio, people like Alan Marshall had their lives entirely distorted and destroyed because they got juvenile polio. Vaccination programs work; immunisation works.

The Labor government of the Hawke and Keating period was as committed to immunisation as the Menzies government was, as the Chifley and Curtin governments were and as previous governments were, from the point that the great advances in the modern era had taken place, where we had the capacity to save people’s lives. Penicillin is not vaccination, but penicillin is effectively an Australian invention. Fleming may have found the mould, but the person who developed it was an Australian.

Drugs can save lives and save them in the millions, which is what happened during World War II—we lost 30 million but millions survived. Hundreds of millions of people have survived since because of the direct effect of penicillin. In respect of vaccination, preventing the problem is fundamental to its cure.

Another point the member for O’Connor made was a bit strange. He argued how the vaccine against cervical cancer was not a vaccine against cervical cancer but a vaccine against the virus that causes it. Well, blow me down with a feather! What does he think vaccination is about? It is not about the end condition; it is about the active agents that cause the condition in the first place. To go back to Louis Pasteur and his invention of a cowpox vaccine, the whole prospect was to get to the active causative agent—not its fundamental manifestation. The modern understanding, from Pasteur on, that you can target viruses and bacteria and develop a mechanism to make the population safe from them is fundamental. For the member for O’Connor, on behalf of the government, to traduce the entire history of immunisation through that 13-year period is a vast and gross distortion that takes no account of the relative cost of modern vaccines.

I commend Minister Wooldridge for what he did in 1977 and the vigour with which he pursued a campaign which was initially focused on Aboriginal communities but which then became a broad campaign throughout the community. He was fundamentally responding to the low rates of immunisation that had developed over a period of time, not because of inertia on the part of the previous government but because of the fact that, once people become used to something and it is part of their set environment, then their level of anxiety or their level of concern about it drops off. The trajectory is very steep. In trying to get people to understand the importance of a major immunisation campaign Australia-wide so that the whole cohort was affected, Dr Wooldridge used his medical expertise and understanding to drive that campaign and to make it a signature part of what he did as health minister. I congratulate him for it. He reflected the fact that, in the modern era, since the development of the first major vaccines and during the 1950s, 1960s and 1970s in particular, vaccination became relatively low cost. Major advances such as being able to vaccinate against polio and smallpox were not low cost to start off with but the relative cost decreased dramatically, which is simply an economic function of ramping up production capacity. If you have a big enough group to distribute the product to, you will knock your costs down. If you are producing for only a very small group, all of the costs cannot be amortised.

It is the very success of the great immunisation and health campaigns in the 1950s, 1960s and 1970s that created the conditions for people to be certain that things would just roll through, and so they took their eyes off the ball. Rather than looking at relative cost, you should look at the attitudinal situation. In the public health area, particularly in regard to vaccination and immunisation, you have to focus on public health policy. At times you have to ramp it up, rejig it and have a fundamental focus on it. You have to work against the public campaigns that have been run and put something else in there. I think we had reached that point. Dr Wooldridge recognised that, and I congratulate him for what he did. This bill is minor, it is technical. It seeks to fix a government stuff-up—or a series of them.

When I spoke on the bill in 2005, I mostly concentrated on the fact that ATAGI had been wiped out of the picture and we had moved over to the PBAC. Most of this arose from the discomfiture of the minister for health. Labor launched a three-year campaign in regard to the pneumococcal vaccine, the injectable polio vaccine and the chickenpox vaccine and there was immense resistance to it. It finally crumbled before the 2004 election. We have a problem in putting into process a regime where there is a direct connection.

This is all about funding the states and making sure that the states have the facility to get the vaccine—to buy it in the first place—to distribute it freely and to make sure all the preceding infrastructure is in place. This bill fixes it. I support that; Labor supports that. However, the core question is a question of attitude. There is a difference in attitude between Minister Wooldridge and this minister. It concerns whether you use the media and the facilities that are available to us to advance a campaign to get immunisation to the highest levels we can across a range of fundamental diseases or whether you want to use the media in a journalistic sense simply to push a very narrow agenda. Part of the problem here and the reactive nature of what the minister has done in regard to the pneumococcal vaccine is that I do not have a clue whether in 2006 we are going to get a renewal of that pneumococcal vaccine. We know that in 2004, under Labor pressure, the minister buckled and said he would fund it. We know that it is costly, at $70 million a year. We know that, from the data that I understand has come through, it has been very effective, but when he funded it, he funded it for two years. That is up this year.

What are we going to do? I would like the minister to be able to tell us whether he is going to continue that funding, whether he thinks his advice is appropriate and whether there can be certainty for not only those people faced with the prospect of suffering from this disease but also those who have been assisted during that time. I would also like to know whether he and the government are committed to continuing this immunisation campaign or whether they have decided it has got them through the last election and that is enough. This also relates to other decisions that have been determined.

I do not say that you can give everything that people want in this area. Companies put their arguments but if they are not well founded—if, on balance or from the best advice given, people do not think a vaccination program is going to work at all or well enough or that the cost is so great that other means might have to be sought to try to fix it—then a different set of questions is raised. But the key issue here is commitment.

For the member for O’Connor to argue that the Hawke-Keating government had no commitment to immunisation and that they were imprisoned by a very small but vocal group that did not want any immunisation at all is a complete travesty, an utter falsity and an untruth. That is not uncommon in this place of overblown verbiage, but his argument is a direct attack on the history of immunisation in Australia. Throughout the decades, you could attack any Australian government in the same way because the fundamental problem was not just the availability of the vaccines but the programs and how they were driven. We were dealing with an Australian population that had become relaxed and comfortable with the immunisation program because it had been so successful. When signals to be alert are not there, you can get significant problems. So I congratulate Dr Wooldridge for the campaign that he initiated. I also congratulate the shadow minister for health on what she did on the pneumococcal vaccine.

In response to this very small technical bill, I would like to see the minister give an affirmation that the pneumococcal program will be continued if the advice to him is that it is appropriate to do so—and it should be—and to give a better understanding of how committed the government will be—(Time expired)

Judi Moylan (Pearce, Liberal Party) Share this | Link to this | Hansard source

I am very pleased to have the opportunity to speak on the National Health Amendment (Immunisation) Bill 2006. Before the member for Blaxland leaves the chamber, I want to say that I was very pleased to hear him acknowledge the work of the former Minister for Health and Aged Care, the Hon. Dr Michael Wooldridge, who used his fine medical experience to ensure that we returned to a strong immunisation program in this country. It is always good to hear the opposition acknowledge the particular efforts of ministers in that regard.

The purpose of this bill is to amend the National Health Act to deal with an unintended consequence of the National Health Amendment (Immunisation Program) Act, previously passed in this place, and to enable the current Minister for Health and Ageing, the Hon. Tony Abbott, to arrange for the provision of goods and services associated with or incidental to the provision or administration of designated vaccines.

Since coming to government in 1996, the Howard government has placed a very strong and major emphasis on improving immunisation rates. I understand that, prior to that, it was a responsibility of the states. Former health minister Michael Wooldridge was alarmed at the low rate—in fact, in 1989 and 1990 it fell to as low as 53 per cent of children of 12 months of age. That gave rise to considerable concern. The government recognised the failure of the states to maintain a strong and comprehensive immunisation program and the serious risk that this posed for an outbreak of preventable childhood diseases occurring.

Modern reality demands that immunisation be given priority as, apart from the usual risks to school children, more children these days are placed in child care and at increasingly younger ages. Some of the babies placed in child care are not at an age where they have received their first immunisation shots or completed them. So they are particularly at risk if other children have not been vaccinated and there is an outbreak of some of the more common childhood diseases. They are the realities that we have to deal with today. It is important that we maintain a strong immunisation program and seek the cooperation of the state governments in doing so.

I understand, as the member for Blaxland pointed out very graphically by illustrating a case in his own family, that there are small risks involved in vaccination, and this concerns some people. I have had people in my electorate come to see me about vaccination. They do not believe that their children should be vaccinated. Although one must of course respect individual beliefs on this, there is absolutely no doubt that overall immunisation has proven to be one of the best medical interventions in our time for reducing the risk of many common childhood illnesses, which often have complications and are life threatening or, as the member for Blaxland illustrated so well, have the impact of taking away the quality of life of those who have the disease. There are occasionally risks from the vaccine—but that is fairly rare. As I said, there are many benefits provided through immunisation. These include: happy healthy children and peace of mind for mums and dads and, I suspect, for many grandparents, and a reduction in hospital visits and, therefore, a decrease in the emotional strain that many families might otherwise suffer.

Who could forget the terrible polio epidemics in the early 1950s? I am old enough to remember those, as are some others in this place. I know children from my own school who were afflicted by polio who either lost their lives or whose quality of life, particularly in childhood and later, was seriously impacted because of that disease. Today, thankfully, we have very little risk to our children from such diseases. So there are important reasons to maintain strong immunisation programs.

It has been proven worldwide that immunisation forms an important part of any health program and assists to reduce the incidence of disease, and even death, time and time again. The Australian government has had an excellent record in recent years when it comes to vaccinations, and it continues to provide adequate funding to assist people with what could be a very high-cost health care measure.

I am informed that the largest vaccination program ever undertaken in Australia was the National Meningococcal C Vaccination Program, which has achieved significant results. In 2003, before the program began, there were 213 cases of meningococcal C disease reported to the National Notifiable Disease Surveillance System. In just two years, by 2005, that incidence had reduced to about 40 cases. That is a great result—a significant decrease of 81 per cent. At this time, deaths from this disease have also been reduced further.

Funding for this and other similar vaccination programs is delivered by the federal government to the states and territories to assist them in purchasing vaccines under the National Immunisation Program, for the delivery and storage of vaccines and for pre- and post-vaccine tests. The government understands that Australia needs a strong National Immunisation Program and continues to ensure that it runs as effectively and efficiently as possible, in consultation and collaboration with the states and territories. This is evident by the considerable amount of federal government spending on vaccines, which went from $13 million in 1996, when the Howard government took office, to $285 million in 2004-05. That is a huge jump in spending, and there can be no greater priority than protecting our children in particular from these childhood diseases.

In January of this year as a result of the passing of last year’s National Health Amendment (Immunisation Program) Act 2005, as I said earlier, the Pharmaceutical Benefits Advisory Committee now undertakes the role of recommending to the minister for health which vaccines should be funded under the National Immunisation Program. As an indirect and unintentional result of the passing of that act, I understand that certain goods and services such as the important Q fever skin tests were no longer subsidised. This bill will rectify that situation and ensure that the Q fever skin tests are covered again.

People in the electorate of Pearce, whom I represent, who live in rural and regional areas and particularly residents who work with livestock are required to have Q fever tests, and if they have not been exposed to the disease they must have a vaccination. On several occasions constituents have contacted my office to inquire about the rising costs of these necessary tests and vaccinations. Many people are aware that the Q fever program used to be covered but was stopped. I know that these people will be very pleased to know that these will be included once again. Shearers, those managing shearing teams and owners of big agricultural enterprises informed me that they could ill-afford to pay the costs for each of their workers to have these tests and vaccinations and that if workers were unable to pay for the tests themselves they would be unable to work in that job. So this further exacerbated the shortage of workers in rural areas, particularly farm workers. So I think people in the constituency of Pearce who are running agricultural enterprises will certainly welcome this amendment to the act today.

The second service to be added back onto the list is the provision of the five per cent incentive payments to states and territories. The five per cent payment is an incentive to state and territory governments to increase their immunisation rates and to reduce wastage of vaccines. Under the Australian Immunisation Agreements, five per cent incentive payments are provided if the states and territories succeed in ‘controlling leakage and wastage of vaccines and have high immunisation coverage rates’. The incentive funding can be used for activities such as cold-chain management and transportation of designated vaccines, which I guess avoids wastage and spoilage. I understand that these changes will come into effect fairly quickly after the passage of this bill, and that is very welcome.

The government acknowledges that it is also important to have a strong public information campaign to provide education and information to the community and to the professionals working in these areas so that they can take advantage of the immunisation program and make sure that people get the best information possible. It is always sobering to consider that probably fewer than 100 years ago, and certainly in my lifetime, if people did get certain childhood diseases it often meant that people died and, as I said earlier, their quality of life was interfered with to a very great extent. So immunisation protects children and others against disease, and certainly if they do get a disease there is likely to be a reduced complication rate.

We are a lucky country when it comes to health. When you look at the health systems around the world, Australia has a world-class health system. When you look at other countries—and I had the opportunity to visit Africa earlier this year—you see that some of the people in some of these countries do not have access to very basic healthcare. In some countries we know that when mothers are giving birth, often both the mother and the baby are exposed to tetanus, with devastating results. I think I spoke in this House some time ago about this particular matter, trying to get greater coverage worldwide to prevent tetanus of mothers giving birth and of newborn babies, because some doctors say it is the most painful of deaths. So we are indeed a lucky country to have pretty much eradicated all of these kinds of diseases. In fact, I venture to say today that we have dealt fairly efficiently with the issue of childhood diseases.

The issue that challenges us today is that of chronic illness, particularly diabetes. While it is not the subject of this bill today, I am always pleased to have an opportunity to talk about it, because diabetes of course is one of the great challenges for our community, particularly type 2 diabetes, and particularly type 2 in young children. It was never seen before in young children, and it is being seen at an increasing rate, with devastating consequences. It can often—but not always—be linked back to lifestyle choices: obesity, lack of exercise, eating the wrong foods and overeating. So they are the kinds of challenges that substantially face us today.

But we cannot ever let up on making sure that we continue with a strong immunisation program against preventable diseases because, when those rates of immunisation fell to 53 per cent, it did put many people at risk. As I said, with the modern reality of children entering child care at a much earlier age and babies being cared for in centres with other children, they are particularly at risk when they are unable to be vaccinated when they are so young. So we cannot ever let up on our concerns for strong immunisation programs in this country.

The Commonwealth government continues to provide excellent healthcare to all Australians. I am confident that this bill will help us to maintain our vaccination rates through its subsidies, through the considerable educational and promotional activities of the government and through its overall health strategy and its willingness to work in partnership with the state and territory governments to ensure that we have appropriate action in regard to immunisation. I am supportive of the amendments made by this bill today.

Justine Elliot (Richmond, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak on the National Health Amendment (Immunisation) Bill 2006. We have heard many speakers today talk about the importance of immunisation over the years and about many of the diseases that have been eradicated over the years, and immunisation is of course vitally important. It certainly is shameful that this government has on so many occasions really dragged its heels in getting those vaccinations out to the community, particularly with so many cases where it was so desperately needed, and much to the detriment of so many families, who were very angry that the government dragged its feet in so many areas.

I support the second reading amendment proposed by the member for Lalor:

... the House expresses its concern that the Government has:

(1)

consistently ignored the expert advice of the  Australian Therapeutic Advisory Group on Immunisation (ATAGI) with respect to the inclusion of pneumococcal, oral polio and chicken pox vaccines on the National Immunisation Program;

(2)

failed to provide the Pharmaceutical Benefits Advisory Committee (PBAC) with the needed expertise in immunisation as required; and

(3)

failed to provide adequate ongoing funding for essential vaccines over the forward estimates of the 2006-07 Budget, leaving the Government’s long-term commitment to the National Immunisation Program in doubt.

This bill is put forth by the government to allow the provision of goods and services that are associated with or incidental to the provision or administration of designated vaccines. The bill is a necessary amendment, and one which I do not oppose.

However, it is disappointing that these matters were not appropriately dealt with during the 2005 amendment legislation. One would assume that with all the resources of government this would have been done properly the first time. Instead, this amendment bill is now necessary as a result of the way that the government mishandled those 2005 amendments and really did manage to bungle this quite severely, because the 2005 amendments did not give the minister power to continue the current arrangements with states and territories for assistance in acquiring goods and services related to the provision of vaccines. Those 2005 amendments also went against the intention of the act by preventing the government from providing funding under the act for essential pre or post vaccine requirements.

This is just one more failure from this government in the area of immunisation. Indeed, it is one more failure in a long line of failures in the general area of health. Of course, the failure of the government in immunisation is also directly related to those failures in the area of health. When we look at the failures of the government, one of the major areas is the lack of GPs and the workforce shortage in regional areas, which causes great distress, particularly in electorates such as mine that have so many elderly people. In my electorate, 20 per cent of people are aged over 65. We have certainly seen the government’s lack of commitment to providing proper healthcare, whether it be in immunisation, in making sure that there are enough trained GPs, in providing enough funding for the PBS, or the fact that the government slashed the Commonwealth Dental Scheme. There are so many areas in health where this government has totally failed the Australian community, and certainly one of its most shameful is its record on vaccines for Australian kids. That record of inaction has been seen time and time again in a lack of funding for vaccines for our children.

In September 2002, the Howard government’s own Australian Technical Advisory Group on Immunisation recommended that the government fully fund pneumococcal, chickenpox and injectable polio vaccines. But what happened? The Howard government did nothing. That was the response in relation to it, and of course these vaccines were desperately needed in the Australian community at that time. In September 2003, the National Health and Medical Research Council made that same recommendation that had been made previously in September 2002. What happened then? Again the Howard government did nothing in relation to it, despite the fact that these two bodies had both recommended that.

In May 2004, Labor announced its commitment to fully fund these vaccines. When Labor announced that we would fund the vaccines, the government then had to play catch-up politics on this very important issue. Essentially, the government was shamed into announcing time limited funding for the pneumococcal vaccine. This was not a decision to save lives; it was purely a decision to save face. And what will happen when the time limit the government set on the funding runs out? What is the process then?

And what about what happened with the vaccines for chickenpox and injectable polio vaccines? The government received the recommendation for funding and decided at the time not to fund a vaccine that would prevent a disease that kills children. I find it utterly appalling that the government made that conscious decision to not save the lives of children. Certainly as a parent I was so concerned—and so were the many parents I spoke to—that the government made that decision to not take that action immediately. It is quite appalling to think how the government could consciously decide not to do that. It really is a reflection as to how the Howard government is not concerned about families and is so out of touch with the needs of families. It completely ignored that advice and did not take the necessary action on it.

If this government cared about the future of our nation and the children of today who represent that future, it would have immediately complied with the recommendation of the Australian Technical Advisory Group on Immunisation and funded the vaccine. It would have taken that action immediately and made this available. Instead, the Howard government did nothing; it just sat on that recommendation and did not act on it. For two long years it sat on that recommendation, and yet again it was Labor that had to shame the government into providing funding for this.

It really is pathetic that the government has neglected for so long the needs of our children and the needs of families in our community. On behalf of the 19 Australians who died from chickenpox, the government should be ashamed that it sat on its hands and did not follow the recommendation of its own advisory board. We all know chickenpox can be fatal, and it is certainly shameful that those 19 Australians had to die while the government did nothing, took no action. It is also shameful on behalf of the 3,300 people who were hospitalised as a result of this government’s failure to act on immunisation.

This very shameful record really does give me great concern for the future of many vital vaccinations that are coming into force now and about what action this government will or will not take. We have all heard and read recently about the cervical cancer vaccine. A vaccine such as this would have a huge effect throughout the community. We know that 75 per cent of people who are infected with the human papilloma virus, HPV, will develop cancer. This virus is the predisposition for a number of cancers but especially cervical cancer. Every year in Australia 700 cases of cervical cancer are diagnosed and it causes about 270 deaths. There is a vaccine that is designed to give immunity to HPV, which causes cervical cancer, and as soon as this vaccine meets the required tests it of course should be placed on the National Immunisation Program. But I have grave concerns when we look at the history of this government failing to act on necessary vaccines. One like this, which would provide protection against cervical cancer, is absolutely necessary.

We saw the government sitting for two long years on the recommendation to add a vaccine for chickenpox to the National Immunisation Program, and in that two long years 19 people died as a result. So how many women will need to die of cervical cancer before the vaccine for the human papilloma virus is considered for the National Immunisation Program? How long are we going to have to wait until the government takes action for that? I suspect once again that it will be left to Labor to shame the government into ensuring that needed new vaccines continue to be made available in a timely fashion and that these are funded when it is considered appropriate by the medical experts. The government should be listening to those experts and taking action in relation to this. It should not always be the case that it has to take pressure from this side of the House for the government to do the right thing, for this government to reach into its pockets and save lives. These are issues that do relate to saving lives, and we need to see the government taking greater action.

The government has not given the Pharmaceutical Benefits Advisory Committee the needed expertise in immunisation as required. This is not a surprise, given that this government has a dismal record with immunisation advisory groups. Let none of us forget that this government consistently ignored the expert advice of the Australian Technical Advisory Group on Immunisation with respect to the inclusion of pneumococcal, oral polio and chickenpox vaccines on the National Immunisation Program. When the Australian Technical Advisory Group on Immunisation gave advice that the government did not want to hear, the government sent that advice back for reconsideration. We all know that is code for: ‘You’re not telling us what we want to hear, so we are sending it back so you can tell us what we want to hear.’

But the Australian Technical Advisory Group on Immunisation retained their integrity and confirmed their original advice. This government then repaid that integrity by gagging them and giving their power to provide advice on cost-effectiveness to the Pharmaceutical Benefits Advisory Committee. And now we have the situation that this government has not given the Pharmaceutical Benefits Advisory Committee the needed expertise in immunisation as required. Surely that body needs to have that expertise. It is no wonder that the chairman of the Australian Technical Advisory Group on Immunisation resigned after these changes were made, because the 2005 amendments were basically political payback.

This government has also failed to provide adequate ongoing funding for essential vaccines over the forward estimates of the 2006-07 budget. This leaves the government’s long-term commitment to the National Immunisation Program in doubt. Where does that leave the families of our nation? Families need to be certain that they have a federal government which is committed to ensuring Australia has a long-term immunisation program, in particular to protect our kids. The entire health of our nation is in doubt because the government has failed to provide certainty, continuing the government’s lack of commitment to adequate immunisation.

When people are not being provided with vaccination against disease, that places a lot of pressure on our health systems. The federal government needs to invest in training more health professionals, particularly in regional areas where we certainly have a major shortage. It is also very difficult for many people in regional areas and for elderly people to find doctors who bulk bill. The government needs to focus on investing in more health professionals right across Australia.

The government needs to reintroduce the Commonwealth Dental Scheme, an issue I have spoken about many times in this House. We need the government to stop consistently hacking away at Medicare and the PBS, demonstrating its lack of commitment to health care right across our nation. We also need the government to abandon its plans to sell Medibank Private. Many people in the community have spoken out about their concerns about that sale and the subsequent rise in premiums that will no doubt flow from it. The government should focus on addressing the health needs of our ageing population. There are so many areas in our health system that need a commitment to proper funding. The government needs to do much more, specifically about immunisation. It needs to be serious about recommendations for immunisation that is desperately needed.

The government also needs to be continually educating the public on the necessity of vaccination. The government needs to provide publicly funded immunisation as vaccines become available for diseases identified as posing a risk. We cannot continually see the government dragging their feet on these very important issues. This government also needs to focus on raising the vaccination rate among Indigenous, low-income and rural and remote Australians.

There is no doubt that immunisation is an important aspect of our healthcare, it is so important for the children of our nation. As we have heard many speakers say, vaccination is important for disease reduction and disease control. We all know that prevention is better than cure. Being immunised is an important safeguard against many of the world’s worst diseases. We should be focusing on providing funding for their prevention. All parents should have access to vaccines to protect against diseases that can be potentially fatal for their children. The government needs to ensure that vaccinations are made available in a timely manner once they have met the test for clinical effectiveness and cost-effectiveness. I find it very disappointing to look at the very shameful history of this government as it completely disregards the advice of medical experts in relation to funding very important vaccinations and immunisation programs. The fact that they can wait two years after being told about the necessity to fund such a program I fund absolutely shameful. I cannot imagine what responses could possibly be given to that. How can you consciously decide not to take action to fund an immunisation program that will specifically benefit the children of our nation? It causes me great concern that we have seen inaction time and time again, particularly in relation to future vaccines such as the one I spoke about earlier for cervical cancer. I do not want to see the government dragging their feet on that for two years—it is too important.

The government’s record is indeed very shameful. They certainly need to be made constantly aware of the future of our children and our families. They need to be very serious about providing immunisation and vaccinations in a timely and efficient manner for the Australian community.

Kay Hull (Riverina, National Party) Share this | Link to this | Hansard source

One could be forgiven for being confused by the speech of the previous speaker, the member for Richmond. It might lead one to believe that Labor in government had a very good track record of being on top of the immunisation agenda, but of course we all know that that is not true. We all know that under the Labor government the immunisation coverage rate fell to as low as 53 per cent for children under or at 12 months of age. Well before I was in this parliament, when I was Wagga Wagga City Council Deputy Mayor, trying to extol the virtues and benefits of having children immunised, I was well aware that the immunisation rates were dangerously low. As a community representative and citizen at the time, I undertook many programs and promotional opportunities to encourage our young mums who had not been exposed to or seen the devastation that the very serious illnesses of polio and whooping cough bring and were more concerned about the effects of vaccines than the illnesses themselves to have their children vaccinated. At that time, under Labor, there was an extraordinarily low rate of vaccination for our children.

I am not so sure that the previous speaker has really understood the intention of the immunisation agenda, what this government has been able to achieve and the benefits that it has been able to bring about. Expenditure on vaccines has increased 22-fold from around $13 million in 1996, when this government came to power, to $285 million in 2004-05. It is obviously still increasing. We have a very good story to tell. In fact, the number of children vaccinated at 12 months has now increased to an all-time high of well over 90 per cent. I think credit needs to be given. Listening to the previous speaker, you would not believe that any credit was attributable.

The bill that we have before us today, the National Health Amendment (Immunisation) Bill 2006, focuses on an unintended consequence of the National Health Amendment (Immunisation Program) Act 2005. We passed that last year in this parliament and it came into effect on 1 January 2006. The unintended consequence was that goods and services associated with the provision or administration of vaccines could not be provided under the National Health Act. This unintended consequence needs to be rectified. In principle, it needs to be rectified to enable the provision under the National Health Act of Q fever skin tests and five per cent incentive funding to the states and territories to keep their immunisation rates high.

I want to focus particularly on the Q fever skin tests. That this amendment bill is critical to overcoming this unintended consequence is very clear to rural and regional people. We believe that a strong national immunisation program is terribly important. As new and more complex vaccines are developed, steps must be taken to ensure that the immunisation program is as efficient and effective as possible for all Australians. As I said, my focus is on one area of the bill in particular and that is Q fever—the very area that this amendment is designed to fix.

Earlier this year, a practice manager of the local doctors surgery in my electorate wrote to me with concerns about CSL Ltd’s proposal to withdraw the Q fever vaccine for people other than abattoir workers until the end of 2007. This is because of limited supply. This person was advised that CSL’s belief was that abattoir workers are most at risk. Abattoir workers are at risk. In my electorate this issue is of concern because we have Cargill Beef Australia’s processing facility, established in 1991, with a daily processing capacity of 1,200 and employing about 625 staff. The manager of this general practice indicated to me that Cargill Beef Australia do about 60 Q fever vaccinations per month for their own employees. In addition to those, Cargill require that all employees of contractors have valid Q fever vaccinations or certification of prior exposure, as they should do. Q fever is an extraordinarily difficult and dangerous disease. These persons are dealt with not by Cargill but by private medical practices. The practice that brought this matter to my attention provides most of the services within my electorate of Riverina.

There are so many other employees who need to be vaccinated or certified, including operators of livestock selling centres, stock and station agents, livestock transport carriers and local primary producers. The practice also provides Q fever services for Charles Sturt University, in Wagga Wagga, which offers agriculture courses, equine studies and the much heralded new veterinary science courses, as well as doing significant research in these areas. The issue here will only grow as more students enrol in these courses, with the state-of-the-art new facilities that were unveiled by our fantastic Minister for Education, Science and Training, the Hon. Julie Bishop, just a fortnight ago. The figures from the local practice for the period January 2005 to February 2006 show that they tested 156 people and have provided vaccine for 108 of these people. In addition, the surgery estimates that about 110 people from Charles Sturt University have been tested from January 2005 to this date.

Q fever is found worldwide in wild and domestic animals. It is an acute and occasionally chronic illness caused by infection with the bacterial organism called Coxiella burnetii. A number of other local medical practices in the region also provide Q fever services. I believe that it is critical that this bill, with the purpose of amending the National Health Act 1953 to allow the provision of goods and services that are assessed with the provision of administration of designated vaccines, be passed. As I said, this bill is really about amending the Health Act to provide assistance for Q fever skin tests.

The amendments made by the immunisation act did not give the minister power under the act to continue the current arrangements with states and territories for assistance in procuring goods and services related to vaccine provision—for example, vaccine storage and delivery. The immunisation act amendments also prevent the Australian government from providing funding under the act for essential pre- or post-vaccine requirements under current arrangements—for example, the pre-vaccination screening test for Q fever vaccine. This was not the intention of that act and it is only right that this government should move to ensure that the intention of the act is maintained. The effect of the principal amendment in the bill will be to allow the minister for health to make arrangements to provide goods and services other than vaccines which are essential for the provision of designated vaccines.

The response to representations made regarding CSL Ltd was that we the government were certainly acting as quickly as we could to address the situation that the company intended to cease production of a number of injectable vaccines, including the Q fever vaccine Q-Vax. I was very pleased that the government moved very quickly on the issue of concern for the surgery that was dealing with the primary issue of Q fever across the electorate of Riverina and could see the real problem in the limited numbers of vaccines—and what that would cause in an area that has a large vaccine requirement. A tender process was initiated by the government to attract new supply of Q fever vaccine. Although, firstly, CSL was controlling distribution of Q fever vaccine to the private market until alternative arrangements are made, secondly, the government was advised that abattoir workers, trades on the abattoir campus and other people visiting abattoirs were given priority access to the remaining supplies of Q fever vaccine and, thirdly, a discretionary approach will be adopted regarding supply to other persons potentially at high risk, it is alarming—and it was alarming to the government—that this happened in the area and that the provision of vaccines through priority was recognised as clearly necessary. I applaud the government for having made a very quick and decisive move to ensure that people in my electorate and across Australia are able to access the Q fever vaccine.

This legislation shows the commitment and recognition the Australian government has given to ensuring vaccines can be more readily accessed in Australia. I have given you a prime example of what took place with Q fever vaccine. The government’s expenditure on vaccines has increased. We have a very good track record and I look at what we have in place at the moment as being one of the best assets of having a coalition government.

The supply of vaccines, especially for Q fever, is an extremely important issue for the agriculture and livestock industries across Riverina. When this issue arose it was understood that peak meat and livestock industry councils and other stakeholders were analysing exposure risks, and health authorities considered what alternative management strategies could have been implemented in the short term if there were a temporary shortage. CSL advised clinicians who administer the vaccine of the supply limitations and requested the vaccine be provided to individuals with a high risk of infection, but this is a concern also. There simply should not be a shortage or limit on vaccines as significant as Q fever vaccine.

This bill preserves the current funding arrangements between the Commonwealth, state and territory governments and rectifies the unintended consequences of previous legislation to enable the continuing provision of Q fever skin tests and five per cent funding incentive to states and territories. I believe this bill will assist in making sure that vaccines are more readily available in my electorate and across Australia. It is a very important issue with many livestock selling centres, stock and station agents, livestock transport carriers, and local primary producers needing to be vaccinated or certified. It is for this reason that I wholeheartedly support this very common-sense bill that the minister has put before us.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I will commence my contribution to the debate on the National Health Amendment (Immunisation) Bill 2006 with some comments on Q fever, following the remarks made by the member for Riverina. I was going to discuss Q fever as part of my contribution to this debate, but I think it is important that, given the comments previously made, I continue on and discuss Q fever. As I am sure all members know, Q fever is a bacterial infection which has similar symptoms to the flu, but its long-term effects can be a lot longer lasting. It can damage the liver, heart and bones.

The people who are at risk are people who work with cattle, sheep, goats and wild animals. We are faced with a shortage of Q fever vaccine. Prior to 2006, CSL manufactured a sufficient quantity of Q fever vaccine based on the historical uses. The vaccine was funded under a government program. This program will come to an end in most states and is only scheduled to continue in Queensland, Victoria and South Australia.

It was thought at the end of 2005 by the Howard government that there would no longer be a need to fund the vaccine for Q fever. I am pleased that the government has realised the error it made and is covering Q fever in the bill that we are debating today, but I think it is very important to put on the record that the shortage of the vaccine for Q fever has occurred purely and simply because of the government’s ineptitude and the fact that it was trying to save money—cost cutting—and, as such, decided that the vaccine would not continue to be produced.

I think most honourable members of this House and people in the community who have had any contact with a person that has suffered from Q fever would know of the devastating impact of the illness and how it creates quite serious symptoms that incapacitate the person that has it. This bill contains a minor administrative amendment to preserve the current funding arrangements between the Commonwealth and the states and territories with respect to the continuation of activities in the light of shortages of the Q fever vaccine, as I have just discussed, and distribution arrangements for the national immunisation program. The purpose of the bill is to amend the National Health Act 1953 to ‘allow the provision of goods and services that are associated with, or incidental to, the provision or administration of designated vaccines’. These goods and services ‘could not be provided under the act following amendments to the act made by the National Health Amendment (Immunisation Program) Act 2005’.

The amendments made by the act were enacted to change the way in which vaccines were listed under the national immunisation program as announced in the 2005-06 budget—and I will be talking a little bit more about that. The amendments made by that act did not give the minister the power to continue the current arrangements with the states and territories as to assistance in procuring goods and services related to vaccine provision—for example, vaccine storage and delivery. The amendments also prevented the government from providing funding under the act for essential pre- or postvaccine requirements under the current arrangements, and the example that I just gave related to prevaccination screening tests for Q fever. The effect of the principal amendment in this bill will allow the minister to make arrangements to provide goods and services which are essential for the provision and designation of vaccines. The bill will have no financial impact.

It would be appropriate to refer to immunisation per se in relation to this bill. Australia has some of the highest immunisation rates in the world. The state that has the highest rate of immunisation of children between the ages of 12 and 15 months is Tasmania, where 93.8 per cent of these children are fully immunised. Since the introduction of childhood vaccinations for diphtheria—in 1932—and the widespread use of vaccines to prevent tetanus and whooping cough and poliomyelitis—in 1950—and measles, mumps and rubella—in the 1960s—the number of deaths in Australia from preventable disease has declined by 99 per cent. That is an incredible figure given that in that period of time the Australian population has increased by 2.8 per cent. There has been an absolute association between vaccination and the decline of these diseases. Diphtheria, whooping cough and tetanus vaccinations have saved a total of 70,000 lives and prevented untold life-threatening symptoms or ongoing morbidity. Poliomyelitis and measles vaccinations have prevented a further 8,000 deaths. Poliomyelitis was still common when I was young. In fact, my paternal grandfather had poliomyelitis. He was quite debilitated by it. He had a number of the problems associated with having suffered from poliomyelitis and he died at what I consider to be a relatively young age. Since that time we have learnt that there is a postpoliomyelitis syndrome. If what is now known was known then maybe he could have been treated differently.

I am examining a very interesting graph. In 1932 the school based diphtheria vaccination program commenced. At the time there were over 1,000 deaths per year. After that program commenced there was a dramatic decline—and remember that the coverage of that vaccination program would be nowhere near the level of coverage of the program that we have in Australia today. In 1939 tetanus vaccination was introduced. Once again, there was a decline in the number of deaths of children suffering from this preventable disease. It fell to around the 500 mark. Vaccination against whooping cough or the pertussis virus was introduced in 1942. Poliomyelitis vaccination was introduced in 1955. In 1970 measles vaccination became widely available. All these vaccination programs have had an enormous impact on mortality and morbidity in Australia, particularly amongst infants. No matter what political party has been in power in Australia, we have had a very strong government commitment to vaccination and research into new vaccines. So I think that governments of all persuasions, both Commonwealth and state, have been very committed to vaccination programs and to ridding our society and nation of these diseases.

In 2005 we supported the government’s new vaccine policy, but we did have some concerns at that time. The concerns related to the expanded role of the Pharmaceutical Benefits Advisory Committee and their expertise in evaluating vaccines that were to be funded under the National Immunisation Program. That evaluation had previously been performed by the Australian Technical Advisory Group on Immunisation, ATAGI. At the time, we on this side of the House were most concerned that that function was being taken away from the body that had the expertise, the knowledge and the experience in evaluating which vaccines should and should not be listed. That role was taken away from ATAGI purely and simply because it had recommended that the government fund the meningococcal vaccination. It was pure payback. I do not believe that the government should act in such a way. It should really look at which is the best possible body to decide what should and should not be listed.

On this side of the parliament we have been very committed to funding new research into vaccines—new research that will immediately impact on those diseases that we believe can and should be prevented. While I am talking about that, I have to take to task the government for their decision in 2003 when they refused to consider the recommendation that they fully fund the meningococcal, chickenpox and injectable polio vaccinations. I think that that was a missed opportunity. The Minister for Health and Ageing dug his toes in and said that he would do nothing. It took the Labor opposition in May 2004 to announce a commitment to fully fund these vaccines for the minister to be shamed into announcing funding for the meningococcal vaccine. All members in this parliament will know the level of fear that exists in the community about meningococcal, and they will know that parents were depending on the government to announce the funding of this vaccine. It is being funded now and I believe that that is a very positive outcome. I think it also demonstrates very aptly how an opposition can position a government to change its policy. I am quite sure that without the opposition’s input into that issue the vaccine today would not be funded and all those young children would not be receiving the vaccine.

I referred a moment ago to the government’s reaction to the recommendation by the Australian Technical Advisory Group on Immunisation, ATAGI, that the government fund this vaccine. The government chose to ignore that recommendation. ATAGI are independent experts on immunisation, as I have already highlighted. I believe as a direct result of ATAGI’s recommendation, and of the government being so reluctant to fund it, the minister, in a bloody-minded action, decided to transfer many of ATAGI’s functions to the PBAC. I suppose that is fair warning to any government agency or anyone who is giving advice to the Howard government. If you give independent advice you are in danger of being punished—payback. ATAGI gave independent advice to the health minister and they suffered the consequences of his bloody-mindedness.

The vaccine manufacturers are a little bit concerned about some of the changes that are taking place, but I would like to put on record my strong support for the new vaccine against cervical cancer. I think it is imperative that the vaccine routinely be given to young women. I think it is a very important health issue and that a member’s or a minister’s personal beliefs should not influence decisions in relation to the overall good—the overall health needs—of a community. This is one vaccine that has the potential to make an enormous impact on the health of young women in this country, and older women because of its flow-through effect.

I will conclude where I started—that is, by saying that this bill makes only minor administrative amendments and will preserve the current funding arrangements between Commonwealth, state and territory governments. I would like to conclude with a very strong supportive statement for our national immunisation program. I commend all governments since 1932 for the development and implementation of vaccines, which has changed the face of our society. We have a society in which disability relating to certain childhood diseases and deaths from those diseases are no longer apparent in our community. Vaccination programs are the best form of medication that Australians can have. Prevention beats cure any day.

Kerry Bartlett (Macquarie, Liberal Party) Share this | Link to this | Hansard source

I am very pleased to speak on the National Health Amendment (Immunisation) Bill 2006, because this government’s record on immunisation is a particularly proud one. It is one of the coalition government’s many achievements in the area of health policy. In contrast to the relative neglect of immunisation that we had seen under Labor, this government has been involved in a substantial and significant refocusing on this important area of preventative health. We can see that in the funding committed to immunisation, which has risen from a mere $13 million a year when we came into office in 1996 to $148 million a year in 2003-04 and to $254 million last year. I acknowledge that that was partly because of two new pneumococcal vaccination programs. Under this government there was a substantial increase in funding for immunisation, reflective of a renewed focus and commitment to preventative health via vaccination and immunisation. And we can see that in the results. It is not just a matter of money; it is a matter of significant headway and results in the whole area of immunisation.

To give one illustration, in 1995, only 52 per cent of nought- to six-year-olds in Australia were immunised and only 53 per cent of children up to 12 months old were immunised. Since this government has focused attention on immunisation under the Immunise Australia Program, we have seen a dramatic increase in immunisation levels. Immunisation levels are at an all-time high for children and are at over 90 per cent for those up to 12 months old. Because of this government’s focus on lifting immunisation levels, in the past 10 years the immunisation rates for children up to 12 months of age have increased from 53 per cent to 90 per cent. As a result, we have seen a decline in the number of vaccine-preventable diseases in Australia, and I am confident we will continue to see a decline in those diseases. For example, under the National Meningococcal C Vaccination Program, we have seen a decline in the number of reported cases, from 213 cases just four years ago to 40 cases last year. That is a substantial decrease in the number of reported cases of meningococcal C. There has been an 83 per cent decrease in deaths from meningococcal C. This government’s focus on immunisation has led to a substantial reduction in vaccine-preventable diseases and its record of reversing the relative neglect and apathy that we saw during the Labor years has been significant.

As we know, this bill constitutes a minor administrative amendment. Its aim is to tidy up funding arrangements between Commonwealth and state governments to allow for the continued storage and distribution of vaccines.

While I am on my feet, I want to put this emphasis on immunisation in the broader context of the coalition government’s focus on health policy. That focus has seen a massive increase in Commonwealth government funding on health during the past 10 years. In 1995-96, the last year of the Labor government, only $20 billion a year of Australian government money was being spent on health. We have seen a massive increase in the past 10 years: the Australian government now spends $45 billion a year on health through a whole range of programs. So there has been a massive increase in spending and a massive focus on health policy by the coalition government. We can see that in so many areas. We can see, for example, the enormous boost in funding for health research, which doubled to $414 million in 1999 and was boosted again in subsequent years. Then, in this year’s budget, an extra $500 million was announced. So we are now spending four times the amount that was previously spent on health research into obtaining cures, into looking at new approaches to prevention and into achieving better health in Australia. There has been a fourfold increase on the amount being spent in 1996. So there is a substantial commitment to health research spending in this country.

There are many other areas benefiting as well as a result of this increased spending on health: the Stronger Medicare program, increased Medicare rebates in 2005 and the introduction in 2004 of the Medicare safety net. This has been a wonderful initiative which has added great security to the way in which Medicare operates to provide security and confidence for Australian individuals and families that their out-of-pocket bills will be capped and that they will eventually have to meet only 20 per cent of those because the government will come to the party to meet 80 per cent of those out-of-pocket expenses—a really substantial initiative to strengthen the operation of Medicare, without a doubt the most substantial initiative since Medicare was introduced.

Other areas include measures to increase aspects of health workforce shortage. For instance, there is the practice nurses initiative, which in my electorate in the Hawkesbury and the Blue Mountains is really taking pressure off the shortage of GPs by allowing them to better use their resources. The practice nurses initiative, along with other initiatives to address doctor shortages, is a wonderful initiative by this government.

There is the initiative to encourage the take-up of private health insurance: the 30 per cent rebate on private health insurance, along with those extra rebates for older Australians, to give Australians who want private health insurance that choice in order to give them the peace of mind that that option brings and also to take the pressure off the public hospital system. There are a number of other important initiatives, and I could go on all day here: the focus on mental health, with the $1.7 billion announced in the 2006-07 budget; increased funding for other priority areas, such as asthma, cancer, diabetes and cardiovascular disease; and the government’s Tough on Drugs policy, which has really focused on education and prevention to reduce the devastating impact of the abuse of both legal and illicit drugs. This is a very significant policy which contrasts markedly with the wishy-washy, weak and can I say dangerous approach of Labor’s policy on this.

In short, this immunisation program—in itself a very positive program—is to be seen in the context of this government’s very substantial progress in policy initiative areas, new measures and initiatives, backed up with massive increases in funding, as I said, from $20 billion to $45 billion a year, just over the life of this government. This government’s immunisation program is one of which we can be very proud. The program is working. It has been backed up by extra funding. The results are proof that the program is working. I strongly support this government’s immunisation program and the legislation, including this amendment, that assists the delivery of this program.

Brendan O'Connor (Gorton, Australian Labor Party) Share this | Link to this | Hansard source

I rise to make some comments on the National Health Amendment (Immunisation) Bill 2006 and also to support the amendment moved by the shadow minister for health. I heard the Chief Government Whip comment on the record of the Howard government in relation to vaccination. I understand it is the obligation of a chief government whip to do all things in this place to provide the government some cover, as he did in that speech. Indeed, his own attendance and his wanting to get on to the speakers list shows that he is aware—as you would expect other government members would be aware—that the government are failing to turn up and speak on very important matters, including the National Health Amendment—

Jennie George (Throsby, Australian Labor Party, Shadow Parliamentary Secretary for Environment and Heritage) Share this | Link to this | Hansard source

Ms George interjecting

Brendan O'Connor (Gorton, Australian Labor Party) Share this | Link to this | Hansard source

The member for Throsby is also well aware of this. The fact is that this is the closest the government has got to approaching the number of opposition speakers on a particular bill for some time. It is still half the number of speakers that the opposition has listed to talk on this matter.

Arch Bevis (Brisbane, Australian Labor Party, Shadow Minister for Aviation and Transport Security) Share this | Link to this | Hansard source

Put them on performance pay!

Brendan O'Connor (Gorton, Australian Labor Party) Share this | Link to this | Hansard source

The shadow minister for homeland security, who is at the table, knows this only too well. In debating his amendments to a previous bill, last night 13 opposition members spoke on the bill and you, Mr Deputy Speaker Somlyay, were the only contributor for the government. Again, it does not surprise me to see the Chief Government Whip in here trying to add a few numbers, because clearly the entire government is on rostered days off with respect to this chamber when it comes to debating public policy.

This bill is under consideration, of course, after sloppy drafting of the National Health Amendment (Immunisation Program) Act 2005 disallowed the provisions of goods and services associated with the provision or administration of designated vaccines. The amendments made by the immunisation act were enacted to change the way in which vaccines were listed on the National Immunisation Program, as announced in the 2005-06 budget.

The effect of the principal amendment in this bill will be to allow the minister to make arrangements to provide goods and services other than vaccines which are essential for the provision of designated vaccines. Labor supported the original bill but with a strong second reading amendment, as you may recall, Mr Deputy Speaker, highlighting the concerns about the government’s vaccine policy. I think it is fair to say that, with the advantage of hindsight, Labor has been proven absolutely correct—there has been a failure by government to attend to the needs in this important health area.

That bill expanded the role of the Pharmaceutical Benefits Advisory Committee to include evaluating the cost-effectiveness of new vaccines for funding under the National Immunisation Program, a role previously performed by the Australian Technical Advisory Group on Immunisation. This was not opposed by any of the stakeholders. Labor contended that this action was taken to downgrade the role of the ATAGI as punishment for the advice that vaccines such as pneumococcal, oral polio and chickenpox should be funded. This opinion was widely supported by public commentators and authorities in the area.

Indeed, it was the first time in Australian history that the government refused to find money to fund the vaccine recommended by its own Australian Technical Advisory Group on Immunisation. The headline in the Courier-Mail said it all, as you might recall: ‘Children are dying but Howard refuses to help’. Pneumococcal disease is the most common bacterial cause of serious disease in Australian children, so the decision not to fund the vaccine was a complete abrogation of responsibility by the Howard government, made even more obscene since this was the year the Treasurer had bragged of record tax cuts but, indeed, the government had placed children at risk of debilitating disease, brain injury, deafness and death.

This was yet another example of the Howard government spitefully punishing the public bodies whose advice it finds embarrassing or politically inconvenient. We have seen this government blaming statutory authorities and other bodies rather than taking the responsibility for its own decisions. We have seen it blame its public servants and others where it finds the truth too embarrassing to admit its fault. Again, in this area we have seen an independent body punished for providing advice contrary to the intentions of the government. In this case the decision was critical. The loser was children’s health.

As Labor has repeatedly pointed out, the Howard government has a shameful record of inaction on the funding of vaccines for Australian children. This has been mentioned before by a number of members, but I want to repeat it for the record. We heard from the Chief Government Whip how proud he was of how well the government is doing in this area. I remind the House that in September 2002 the government’s own technical advisory group recommended that the government fully fund the pneumococcal, chickenpox and injectable polio vaccines, yet it refused. In September 2003 the National Health and Medical Research Council made the same recommendation. The Howard government considered this recommendation in the lead-up to May 2004 and again did nothing. After Labor announced it would fully fund these vaccines, two days after the May 2004 budget, the minister for health was shamed into announcing funding for pneumococcal vaccine. However, only two years of funding was announced. Nobody knows what will happen when the funding runs out in this important area of children’s health.

The minister for health refused to fund the chickenpox and injectable polio vaccines as Labor continued to campaign for full funding for the vaccines and again, the Howard government and the minister for health did nothing. Finally, the minister for health matched Labor’s plan to fund these vaccines in March 2005. In doing so, he conceded that chickenpox had killed at least 19 Australians and hospitalised 3,300 people in the last two-year period alone—and unnecessarily so, we would contend. So we do not want to hear the glib remarks by the Chief Government Whip about the record of the Howard government on vaccines. Clearly it is a record of neglect and contempt—contempt for the advisory bodies that recommended vaccination in these areas in the first place and contempt for the children of this nation, who of course are not in the position to advance their own interests.

In this area of health we should be doing everything as a parliament—and indeed the government should be doing everything—to protect our children from the threat of disease, but the record speaks for itself. It is a record of neglect and contempt, with little regard for the concerns raised by the families who have lobbied the government and the independent bodies that have advised the government. Whilst this bill is a rather technical bill, intended to amend the sloppy legislation that was put together by government last year, the second reading amendment moved by the shadow minister for health should be taken seriously by the government because there is no room for playing politics with children’s health. I finish by reminding the House of some of the concerns raised by the shadow minister for health in her second reading amendment to this bill. The amendment states that, whilst not declining to give the bill a second reading:

... the House expresses its concern that the Government has:

(1)

consistently ignored the expert advice of the Australian Therapeutic Advisory Group on Immunisation (ATAGI) with respect to the inclusion of pneumococcal, oral polio and chicken pox vaccines on the National Immunisation Program;

(2)

failed to provide the Pharmaceutical Benefits Advisory Committee (PBAC) with the needed expertise in immunisation as required; and

(3)

failed to provide adequate ongoing funding for essential vaccines over the forward estimates of the 2006-07 Budget, leaving the Government’s long-term commitment to the National Immunisation Program in doubt.

Annette Ellis (Canberra, Australian Labor Party) Share this | Link to this | Hansard source

Labor supports the National Health Amendment (Immunisation) Bill 2006 because it provides a minor amendment that preserves the current funding arrangements between the Commonwealth and state and territory governments. It will allow continuation of vital activities such as vaccine storage and distribution for the National Immunisation Program. The only reason this amendment is necessary is because there was a drafting error in the National Health Amendment (Immunisation Program) Act 2005, which now unintentionally takes away the power of the minister to continue the current arrangements with states and territories in relation to vaccine provision.

Whilst I support this bill, I would like to take the opportunity to highlight concerns I have about the Howard government’s vaccine policy, particularly on pneumococcal disease. The deadly pneumococcal bacteria causes a whole range of serious illnesses just like meningococcal, including pneumonia, meningitis and septicaemia. The vaccine protects even very young babies, those most at risk, against pneumococcal. The best age to give babies the vaccine dose is at two, four and six months. Every year around 1,800 cases of pneumococcal disease in children are reported and some 50 children die. If a child survives pneumococcal infection, unfortunately there can be serious side-effects. A significant number of children who survive are left with brain problems—cerebral palsy and epilepsy—blindness, deafness, spinal problems such as scoliosis and other side effects. This is clearly a serious public health issue that should not be ignored by any government.

Mr Deputy Speaker, you and I and other members in this place know how difficult it can be for families dealing with children who have a disability or an acquired brain injury through one form of misfortune or another. It could be because of any number of reasons. Not only is it hard on the child—let me say that straight up—but the whole situation is extremely difficult for the family concerned. The cost of living with someone with those sorts of conditions can be very high socially, emotionally and financially, so we should be encouraged wherever possible to do everything we can to avoid such things occurring.

In September 2002, the Howard government’s own technical advisory group recommended that the government fully fund the pneumococcal, chickenpox and injectable polio vaccines. To the amazement of public health officials, the government ignored the recommendation. In September 2003, the National Health and Medical Research Council made the same recommendation. This is a body whose role it is to provide expert advice on important health issues, on the allocation of government funding for health and medical research and on ethical issues in health and research involving humans. The Howard government considered this recommendation in the lead-up to the 2004-05 budget and then, unbelievably, decided to ignore it. This is what Labor’s shadow minister for health said on 16 January 2004:

This deadly disease—

pneumococcal—

kills and seriously disables more Australians than meningococcal C disease, for which there is a government funded vaccine.

…            …            …

Parents face a heart-breaking choice: do they pay the $450-500 out of their own pockets to fully immunise their child or, if they cannot afford this bill, take the risk that their child will not contract pneumococcal disease? Doctors will tell parents that all the vaccines on the Australian Standard Vaccination Schedule are needed, but only some will be funded under the National Immunisation Program. Now even if parents are able to afford the vaccine, it may not be available.

Two days after the May 2004 budget, Labor announced its commitment to fully fund the recommended childhood vaccines, including pneumococcal, chickenpox and injected polio. As a result of Labor shaming the Howard government, the minister for health then announced that the government would provide funding for the pneumococcal vaccine. Unfortunately, funding was announced for only two years. The Howard government still refused to fund the chickenpox and injectable polio vaccines. Labor continued to campaign for full funding for the vaccines, but the government continued to ignore the issue for almost one year.

In March 2005, the government finally matched Labor’s plan to fund these vaccines. In doing so, the minister for health conceded that chickenpox had killed—unnecessarily—at least 19 Australians and hospitalised some 3,300 people in the last two-year period alone. In another demonstration of the government’s arrogance, it gagged the technical advisory group—which had maintained that the pneumococcal vaccine should be funded by the government. This is how we see the government treating its independent advisory groups.

Vaccine manufacturers have supported additional funding of the vaccines but they are concerned that, if a second vaccine is listed, it might trigger a 12.5 per cent price cut and this would be inconsistent with the principle of encouraging security of supply. The manufacturers have asked the minister for health to clarify whether the price cut will apply, but I believe that the minister has not yet responded.

There is also a major concern that there will be unnecessary delays in the introduction of the new vaccines to the National Immunisation Program. Many public health experts are worried that the new vaccines against cervical cancer and rotovirus, which are currently under consideration by the PBAC, might not be considered for the National Immunisation Program. My Labor colleagues and I are watching this new process carefully to ensure that new vaccines become available as soon as possible and that they are funded through the National Immunisation Program when they are considered to be appropriate by medical experts.

As a result of the concerns that I have highlighted, I fully support the second reading amendment moved by the shadow minister for health. It reads as follows:

... the House expresses its concern that the Government has:

(1)

consistently ignored the expert advice of the Australian Therapeutic Advisory Group on Immunisation (ATAGI) with respect to the inclusion of pneumococcal, oral polio and chicken pox vaccines on the National Immunisation Program;

(2)

failed to provide the Pharmaceutical Benefits Advisory Committee (PBAC) with the needed expertise in immunisation as required;

(3)

failed to provide adequate ongoing funding for essential vaccines over the forward estimates of the 2006-07 Budget, leaving the Government’s long-term commitment to the National Immunisation Program in doubt.

In conclusion, of course we support this technical bill—a bill which is to in fact correct an error—but, in doing so, we must put on record our views and concerns about the ongoing questions about an appropriate immunisation program in Australia.

Christopher Pyne (Sturt, Liberal Party, Parliamentary Secretary to the Minister for Health and Ageing) Share this | Link to this | Hansard source

In summing up, I would like to thank those members who have contributed to the debate on the National Health Amendment (Immunisation) Bill 2006. They include: the members for Lalor, Blaxland, Richmond, Shortland, Gorton, and Canberra from the opposition; and the members for O’Connor, Pearce and Riverina from the government. As the member for Canberra just said, this is a highly technical bill designed to amend two unintended consequences of amendments to the National Health Act 1953 that would enable the Minister for Health and Ageing to arrange for the provision of goods and services such as Q fever skin tests and for five per cent incentive payments to states and territories that are associated with the provision or administration of designated vaccines.

In short, this bill will allow the minister for health to continue using those two facilities before they impact on the states and territories or on the provision of important vaccines. This bill ensures that the unintended consequences of those earlier amendments do not impact on consumers in particular.

The member for Lalor in typical style made an amendment to this bill, which touched on a number of issues that had no bearing at all on the National Health Amendment (Immunisation) Bill 2006. This comes as no surprise to those of us who know the member for Lalor. In the amendment, she tries to save face over the embarrassment of her health policies in the last federal election. The third aspect of her amendment, which I would like to comment on, says that we failed to provide adequate ongoing funding for essential vaccines over the forward estimates of the 2006-07 budget and that somehow this means that we have doubt about the long-term commitment of the government to the National Immunisation Program.

The member for Lalor is trying to scare the Australian public into believing that this side of the House does not have a commitment to the National Immunisation Program. The two things I would say about that are: firstly, the proof of the pudding is in the eating. This side of the House provided a 90 per cent coverage of 12- to 15-month-old children with important vaccines in 2006. When we took over 10 years ago from the now opposition, the immunisation rates were 52 per cent. In that 10-year period we have dramatically increased the number of children who are immunised. It is an embarrassment that the opposition would even seek to pretend that they have any clothes to wear when it comes to immunisation rates. We had one of the lowest immunisation rates in the Western world in 1996—an embarrassment in a country like Australia. Today, 10½ years later, we have one of the best in the Western world. So I think our record speaks for itself.

Secondly, the member for Lalor suggests that, because the figures from the 2006-07 budget are not in the forward estimates, somehow this means that we are not going to continue to fund the National Immunisation Program. The member for Lalor only exhibits her complete ignorance of governments and of budgets, which of course would come from not ever having had any experience of government, as a shadow minister who has come into this House since Labor has been in opposition. If we were to put the figures in the forward estimates for the National Immunisation Program, which we have never done, we would be flagging to the pharmaceutical companies exactly how much money we were prepared to spend. As we are trying to keep the costs of these products as low as possible in order to be responsible with taxpayers’ money, it would be irresponsible if we were to flag to the very people we would be paying for these vaccines exactly how much we were prepared to pay and so render our negotiating position completely useless. The member for Lalor might like to spend a bit more time on how budgets work and the health portfolio, and perhaps in the future she won’t propose such embarrassing amendments to government technical bills. I thank the House.

Alex Somlyay (Fairfax, Liberal Party) Share this | Link to this | Hansard source

The original question was that this bill be now read a second time. To this the honourable member for Lalor has moved as an amendment that all words after ‘That’ be omitted with a view to substituting other words. The immediate question is that the words proposed to be omitted stand part of the question.

Question agreed to.

Original question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.