House debates

Wednesday, 27 October 2010

Australian National Preventive Health Agency Bill 2010

Second Reading

Debate resumed from 29 September, on motion by Ms Roxon:

That this bill be now read a second time.

11:32 am

Photo of Andrew SouthcottAndrew Southcott (Boothby, Liberal Party, Shadow Parliamentary Secretary for Primary Healthcare) Share this | | Hansard source

Approximately 32 per cent of Australia’s burden of disease is attributable to modifiable risk factors. We need to invest more time and energy into preventing chronic or life-threatening disease. While the 2010 state of the nation’s health report indicates that Australia ranks in the top third of the OECD for life expectancy, at birth and at age 65, for both men and women and, in fact, in the top handful of countries anywhere in the world, we are ranked in the bottom third of the OECD on obesity. Within the OECD we compare poorly on measures for diabetes and fruit and vegetable consumption, and we are mid-ranking on alcohol consumption.

Our tobacco smoking rates are amongst the lowest in the world. The combined efforts of national and state governments over 30 years have seen the incidence of smoking fall from 36 per cent of the adult population in 1977 to 19 per cent by 2007. When we look at smoking this can be held up as a long-term, successful public health campaign. It has involved targeting and advertising in the workplace, in entertainment places, in hospitality places and at point of sale. There is still a lot more that we can do. Smoking rates are still too high in specific groups, especially amongst Indigenous populations, and there are still too many women smoking during pregnancy. There is more to be done but we can hold up the reduction in rates as a great success.

Preventive health needs to be on the national agenda. Chronic disease leads to substantial economic and social costs for all Australians. Managing preventable diseases is a significant burden on Australia’s healthcare system; a system that is already under considerable pressure. An increased focus on preventive health and keeping people healthy and out of hospital are important goals for any government. On this point the coalition agrees entirely.

In fact, this is not the first time federal parliament has turned its attention to preventive health. Ten years ago in the context of tax reform the Howard government responded to the advocacy of many health groups to move the taxation of cigarettes, the taxation of tobacco, to a per stick excise rather than on the basis of weight. Two years ago the member for Wentworth proposed an increase in the level of tobacco excise as part of the budget-in-reply recognising that cigarette smoking still represents the largest burden of disease and preventable death.

The Minister for Health and Ageing has said that we have been sitting on our hands all this time. This is not true. Yes, we could always do more, but both sides of politics have long been engaged on this issue. Changes have been made to tobacco excise, lifestyle campaigns, anti-alcohol abuse campaigns and anti-drug campaigns. Measure Up, for example, is a government initiative which was introduced by the coalition in 2006. As part of the Australian Better Health Initiative its aim was to reduce the risk factors associated with chronic diseases such as cancer, heart disease and type 2 diabetes.

In an effort to invoke drama in the chamber, the minister has failed to acknowledge the previous efforts of both sides of the House. The object of preventive health is a fundamental goal for us all; that is clear. The Australian National Preventive Health Agency Bill 2010 has been canvassed as an instrument for revitalising Australia’s preventive health capacity and alleviating the pressure on our overstretched hospital and healthcare system. The coalition supports encouraging healthy lifestyles and reducing the risks for many chronic diseases—it is a no-brainer. As conceived, the Australian National Preventive Health Agency will conduct social marketing campaigns and research into preventive health.

Obviously, both of these activities have been conducted by successive federal governments, at least since the Fraser government. The ‘Life. Be in it’ campaign was an initiative of the Fraser government. Tobacco advertising was banned by the Fraser government in 1978. It is ludicrous to suggest that no-one has taken preventive health seriously until this minister came to the job, so the Preventive Health Agency will be a warehouse for activities already occurring.

However, the bill as it stands raises more questions than it answers. It is really an attempt to be seen to be taking action in the health portfolio, where, for the large part, after three years of government and a lot of talk there is not much in the way of achievement. The functions of the agency, as provided by the bill, are far reaching, to say the least. In summary, the National Preventive Health Agency, through the CEO, is designed to: (1) analyse and disseminate information on preventive health to the public, business and government; (2) make recommendations and provide policy advice on preventive health matters; (3) conduct awareness and educational campaigns; (4) make financial assistance grants on behalf of the Commonwealth; and (5) develop national standards and codes of practice.

This bill adds yet another layer of bureaucracy without any assurances of real results for the health sector. Like a lot of things that this government has turned its attention to, it is something that sounds good but in delivery may well be a lemon. The government has failed to follow through in so many areas: good ideas that sound good but lack any attention to detail. In this legislation it has failed to ensure that this agency will be a transparent body with purpose. That is why during the consideration in detail stage the coalition will be seeking to move amendments that address the objectives of the agency. Currently there are none. We are also proposing to increase the transparency of the body. The changes will mean that the CEO must publish a copy of any advice or recommendations on the agency’s website. This is about open government. It is about having a transparent process, and we should be aware of any advice or recommendations that the CEO provides to the minister.

Since the introduction of the original bill in the previous parliament, the government has restricted the account to which there is public information available on this proposed body. The explanatory memorandum to the original bill provided a breakdown of fund allocation over the forward estimates. That breakdown has not been provided in this current bill and we would like to know why it has been left out. What is more, the explanatory memorandum has restricted social marketing campaigns to campaigns that only target obesity and smoking. We want to know whether this is deliberate or simply an error in the drafting of the explanatory memorandum. Will the problems of teenage drinking, binge drinking and harmful drinking be getting a social marketing campaign?

Social marketing is an important focus for the agency. The minister must also provide clarity as to the intended scope of social marketing within the context of this bill. Research has shown that social marketing campaigns carried out in isolation are inadequate in influencing behavioural change. It would be more effective to broaden the scope of social marketing in order to integrate other measures such as telephone counselling or online tools. The Quit campaign is a good example of where taking a collaborative, holistic approach to selling the message has proved successful. We already have much existing infrastructure geared towards achieving preventive health outcomes. The degree to which this agency is successful will depend on the degree to which they successfully engage with all stakeholders. Most Australians will have paid a visit to their GP some time in the previous 12 months. GPs are geared up to provide anti-smoking advice to help people give up smoking and make lifestyle changes. It is important that the agency not operate in isolation but have a very strong engagement with all stakeholders to achieve behavioural change.

As I mentioned previously, there already are a number of existing awareness campaigns. The opposition would like to know whether the social marketing campaigns proposed in the bill will supplement or, rather, substitute these campaigns. Similarly, with the research already occurring in the areas of obesity, drug and alcohol abuse and cigarette smoking, will what is proposed for this agency supplement or simply substitute the activities already going on? The provision of $102 million for a national social marketing campaign is significant and the minister needs to provide further clarification as to where the money will be spent.

I have spoken with a number of stakeholders in the health sector and it has become apparent that, whilst  the broad function of the CEO and agency is far reaching, the extent to which the CEO or agency can conduct education or awareness programs relating to mental health is limited. At present, the CEO or agency may conduct programs relating only to alcohol, tobacco use, other substance abuse and obesity, as drafted in the bill. This does not provide the opportunity to achieve broader community benefits than those focused on in the bill. That is why the coalition is proposing amendments to ensure that the agency can address other areas of preventive health and, most importantly, the promotion of a healthy lifestyle generally. For example, while obesity is one of the highest risk factors for burden of disease, the problems of nutrition more broadly are also important, and that, both in the preventive health task force and in the way the agency is proposed, has not been addressed.

Finally, we need to revise the membership structure of the advisory council. The coalition will be moving amendments to ensure that the advisory council has broad representation from government and health experts as well as industry and consumer groups. In order to achieve positive outcomes for preventive health, there must be a collaborative effort. It is essential for the proposed agency to work with industry and with consumers to achieve results. The opposition believe that by working with industry and preventive health experts we can see improvements in healthy lifestyle. For example, DrinkWise is an independent, not-for-profit organisation that was established by the alcohol industry in 2005 to promote change towards a healthier and safer drinking culture in Australia. We think this sort of engagement with industry to encourage responsible drinking and to minimise harmful drinking is a better way to go. It is essential that government, health experts, consumer groups and industry continue to engage on this issue. There needs to be a national approach that combines the voices of all sectors in order to achieve practical outcomes that have a lasting effect on the overall health of Australians.

The coalition supports a greater focus on the health system in its move towards prevention. However, preventive health measures of this nature cannot work in isolation. Early detection and intervention to avoid disease progression are just as important. As I said before, we also have an existing infrastructure which needs to be utilised to harness our preventive health efforts. Most Australians will make a visit to their general practitioner. The innovations of computerisation and practice nurses over the last decade now mean that family practices are well placed to lead the preventive health effort and encourage individuals to change their behaviour. The bottom line is that there is general consensus for an increased focus on preventive health—we all know this. However, it is not enough that we simply agree on the importance of preventive health. The agency needs to show that it is a viable and transparent body, with clear objectives. It must be well governed. We need to be assured of positive, practical results in the area of preventive health. We would like the minister to respond to the legitimate questions we have asked.

11:46 am

Photo of Craig ThomsonCraig Thomson (Dobell, Australian Labor Party) Share this | | Hansard source

I rise to support the Australian National Preventive Health Agency Bill 2010. As I start my contribution, I find myself in the unusual situation of agreeing with a point made by the member for Boothby, which is that preventive health cannot stand alone in relation to the needs of our healthcare system. This makes absurd the position that the opposition have taken on a range of legislation that has been introduced into this place, including one piece of legislation that they most recently voted against. We are in the midst of seeing historic health reform—the greatest health reform that has occurred in this country since Medicare. What we are getting from the other side is blockage, opposition and amendment. They need to get out of the way or get on board with what the Australian public want, and that is serious health reform to all aspects of our health system. That is what this government is about, and this important legislation is part of that.

From those opposite we get opposition to key components of the legislation. The member for Boothby spoke about electronic records. His side of politics is actually opposing e-health, and it did so at the last election. They have opposed GP superclinics. They have opposed a whole range of important aspects to health legislation. They are even opposing our local hospital networks. Everyone in my area agrees that having our own area health service, our own local network, to look after the health needs of people on the Central Coast is absolutely vital.

I wrote my contribution to this legislation thinking that I would come down here and everyone would be supporting the bill because—and I again agree with the member for Boothby—these sorts of things should be no-brainers. But what we are finding or, rather, what we are not finding is a brain on the other side of the House, because we are continually seeing their opposition to these issues. We are finding that, yes, they are no-brainers and that is why the opposition is without its health brain when it opposes or seeks to obstruct these important pieces of legislation. This bill was first introduced into parliament on 10 September 2009. I also made a contribution on that occasion. The bill went through to the Senate, where it was being debated when the election was called. The bill lapsed, and that is why it is back here again. The objects of this bill are so important that I felt that I needed to again make a contribution on it.

Part of the investment this government is making in health involves campaigns to combat obesity, drug and alcohol abuse and smoking—just some of the key priorities of a new national preventive health agency. Let us look at some of the main reasons that we need such an agency in this country. Potentially avoidable diseases affect the lives of millions of Australians. They also account for around 20 per cent of the total healthcare expenditure. Currently, smoking kills about 15,000 Australians each year and costs Australia $31½ billion each year. More than 60 per cent of Australians aged over 18 are overweight or obese. More than 813,000 Australians aged 15 years and older were hospitalised for alcohol related injury and disease between 1996 and 2005. Unfortunately, the electorate that I represent is overrepresented in relation to rates of diabetes, obesity, respiratory illness and skin cancer. My electorate has some of the highest rates of these illnesses in New South Wales and, indeed, in Australia, so we are very much aware of the problems that come about through these diseases. People in my electorate are looking for leadership on how we can tackle preventable illnesses. It is also worth noting that electorates like mine that have lower socioeconomic profiles are more adversely affected by these sorts of diseases. Therefore, this bill, and what it aims to achieve, is very important for people in my electorate and other electorates like it around the country.

Poor health affects the quality of life of Australians and their families. It can also have significant economic affects on them, by reducing their ability to participate in the workforce, and on businesses, through lost productivity and higher costs. Our health system is struggling to deal with the longer term pressures of an ageing population, the increasing cost of pharmaceuticals and new technologies, the rise of chronic disease in our community and the increased expectations of access to high-quality health services in the community. Improving preventive health services and chronic disease management will deliver better health outcomes for Australians and their families and help contain growth in demand for hospital services in the future. It will also promote greater workplace participation and productivity.

Too many people who, with coordinated and preventative health care, need not be admitted to hospital end up there. Too many older Australians who have been admitted but assessed as requiring aged care or transitional care remain in acute hospital wards waiting for a more appropriate bed and denying another person a place. One of the other issues with preventative health care is making sure that there is adequate access to care. Primary care and the role that GPs play in our community are vitally important. I acknowledge here today the good work that is done by Dr Godden and Mr Bill Parker of the Central Coast Division of General Practice. They do a great job in my community, are great advocates of preventative health care and have been working very closely with this government on this agenda.

There has also been an issue in my electorate with access to GPs. My electorate is not alone in this. This problem has exacerbated the situation with chronic disease and early identification of disease. One of the key strategies to improve the health of residents of the Central Coast is to ensure we have more doctors in the community. We are constantly working towards that goal, including through the government’s initiative of setting up GP superclinics. In the electorate of Dobell, thanks to this government, a state-of-the-art GP superclinic is being built in a fast-growing area of the northern part of the Central Coast. The clinic, once completed, will employ in excess of 100 health professionals, including doctors, practice nurses, physiotherapists and others. It will also be the focus of training in conjunction with the University of Newcastle. At its temporary site there are already more than 2,000 patients on the books. This is already starting to take the pressure off the very busy emergency department at Wyong Hospital, which is only some kilometres away. It is the fourth busiest emergency department in New South Wales.

Nationally, the government is investing $1.2 billion in doctors, nurses and allied health professionals as part of the National Health and Hospitals Network. This funding will go to training an additional 5,500 new GPs and an additional 6,800 medical specialists over the coming decade. It will also improve support for 4,600 full-time equivalent nurses working in general practice and trained aged-care nurses. While the government is getting on with improving and reforming our health system, those opposite need to acknowledge that it was the Howard government putting a cap on the number of GP places which led to the chronic shortages of GPs and other health professionals in areas such as mine.

For the first time, the new National Preventive Health Agency will advise all health ministers and help coordinate preventative campaigns across the country. The agency will bring together some of the best expertise in Australia to gather, analyse and disseminate the latest evidence on ways to prevent chronic disease. A chief executive officer will manage the agency and will be directly accountable to the minister for the financial management of the agency and to the Australian Health Ministers Conference, via the minister, for the agency’s performance against agreed strategic objectives and operational plans. The Australian National Preventive Health Agency will have an advisory council comprising between seven and 11 members with preventative health expertise in a variety of disciplines and from a variety of sectors.

The agency is central to the Gillard government’s reform strategy to improve Australia’s health system. Under the reforms, for the first time the Commonwealth government will take the majority funding responsibility for public hospitals and full responsibility for primary health care. The reforms will provide a strong incentive for the Commonwealth to provide better primary care and preventative services to take pressure off our hospitals.

The new agency and its CEO will be responsible for supporting Australian health ministers in their efforts to combat preventable disease by: providing evidence based advice to health ministers on key national level preventative health issues—either at their direction or by providing information about emerging challenges and threats; providing national leadership and stewardship of surveillance and data on preventable chronic diseases and their lifestyle related risk factors in order to improve the availability and comparability of evidence; collating evidence available from a range of sources in order to assess and report biennially on the state of preventative health in Australia; supporting behavioural change through educational, promotional and community awareness programs relating to preventative health, including in relation to alcohol, tobacco and other substance misuse, and obesity; providing financial assistance to third parties to support the development and evolution of evidence around preventative health interventions and to achieve preventative health gains, for example, through grants supporting research; forming partnerships with relevant groups—industry, non-government and community sectors—to encourage cooperative action leading to preventative health gains; promulgating national guidelines, standards, codes, charters and other frameworks to guide preventative health initiatives, interventions and activities; and, finally, managing schemes rewarding best practice in preventative health interventions and activities.

The Council of Australian Governments agreed to establish the ANPHA in November 2008 as part of the National Partnership Agreement on Preventive Health. The creation of a national preventative health agency was also recommended in the report of the National Health and Hospitals Reform Commission released in July 2009 and in the National Preventative Health Strategy released in September 2009. A key initial role of the new agency will be to provide the leadership, coordination and monitoring required to support the successful implementation of initiatives funded through the prevention national partnership, including $692 million provided for interventions to help Australians modify their lifestyles. Beyond this, the agency will more broadly support Australian health ministers in meeting the challenges posed by preventable chronic conditions and lifestyle related risk factors. As the new agency is a COAG mandated body with the function of supporting all Australian health ministers, the minister will be required to consult with the Australian Health Ministers Conference when considering candidates for the CEO’s role and for membership of the advisory council; and to seek the agreement of the Health Ministers Advisory Council when setting the agency’s strategic directions and operational plans.

The agency’s impact will help take pressure off Australian hospitals as more people adopt healthier ways of living and reduce the risk of preventable illnesses. It is part of the Gillard government’s $872.1 million commitment over six years towards the National Partnership Agreement on Preventive Health. As I pointed out earlier, this is the largest investment ever made by an Australian government to support health prevention strategies. The agency will be responsible for three specific programs under the National Partnership Agreement on Preventive Health, which are the national social marketing programs relating to tobacco and obesity—$102 million over four years; a preventative health research fund focusing on transitional research—$13.1 million over four years; and a preventative workforce audit and strategy—half a million dollars over two years. This is in addition to the government’s commitments, following discussions with the Australian Greens and Senator Xenophon, to allocate an additional $50 million to the National Binge Drinking Strategy.

The agency will put in place national guidelines and standards to guide preventive health. It will also form partnerships with industry, non-government and community groups to promote healthier lifestyles. The government’s comprehensive approach to tobacco control, with sustained and coordinated actions, has seen smoking rates cut from 30.5 per cent in 1988 to 16.6 per cent in 2007. Campaigns such as Measure Up have already helped Australians recognise the link between their waist measurement and their chances of developing chronic disease.

This is an important piece of legislation. It is part of an historic reform to health care. It is part of a number of bills that have been introduced into this parliament this week. What we are seeing from the Gillard government is a constructive series of legislation aimed at reforming Australia’s health system to make sure that Australians have better access to health care generally while also making sure that we put important resources into key areas such as preventive health.

What we are seeing from the other side of politics in this health debate is negativity, wrecking, getting in the way, and a series of amendments trying to delay, put off and postpone the very important reforms that this government is seeking to make in relation to health. What people are saying out there is: ‘We want our health system to be improved. We want the federal government to play a role. We are sick and tired of the blame game that characterised the previous government’s term and the lack of contributions that they made in relation to the health debate. We want to see the change.’ I call on the opposition to get out of the way in relation to health reform. You can support what we are doing and support genuine reform in the various areas that we need to change in terms of health, including this bill and the important role it will play in preventive health. You should be either getting out of the way and not opposing it or you should be supporting it. That is what everyone out there in the electorate wants. They want to see some bipartisan support for important health reforms that this country needs.

12:01 pm

Photo of Andrew LamingAndrew Laming (Bowman, Liberal Party, Shadow Parliamentary Secretary for Regional Health Services and Indigenous Health) Share this | | Hansard source

Today will be marked in the history of public health in Australia as another one of the days under a Labor administration that broke the hearts of people waiting for preventive and public health outcomes. With the Australian National Preventive Health Agency Bill 2010, we have a Labor administration utterly focused on inputs. That means that when there is hard and adaptive work to be done on one of the great challenges of health around the world—that is, preventive and public health—they revert to type. They have turned to a new bureaucracy, a new statutory authority, in the third and soon to be the fourth year of their administration.

It was incumbent upon a new Labor administration in 2007 to pick up on the great work that had already been done and build upon it. This debate would be incomplete without a recognition of the history of the impressive work done by Australia in the area of preventive health. I give this history in no way to discredit the work of those who come before us, because obviously in something like preventive health the work of successive administrations has always improved and built upon that which came before. As early as the 1990s we had the national agenda for early childhood, which was implemented under the Howard regime, and I could even go back earlier to the national nutrition strategy under the Keating administration in 1995. From there we already recognised as a nation the importance of nutrition and the importance of physical activity in combating the unhappy triad of obesity, hypoglycaemia and high blood pressure.

We have moved on. I could go through the child obesity summits that occurred in 2002. They were led by a number of people but Senator Guy Barnett played a significant role in organising that refocussing on obesity rather than just communicating about nutrition and physical activity, which had never gained traction as much as we would hope. Then there was the focus on weight loss in 2008, the national public health partnerships and a real shift through the 2000s towards a focus on new qualifications for those in the health workforce who would deliver those preventive measures, acknowledging and recognising that it was not always frontline service delivery individuals who performed those roles and that we had to move outside of hospitals. There was even an acknowledgement that the greatest health outcomes can often be achieved outside of the health system itself. There was a very important refocussing and acknowledgement that we need to not only look at the ethnic minorities—immigrants, Aboriginal and Torres Strait Islanders and those of low socioeconomic means—but also recognise that health sits upon a foundation that is based upon having tenure in one’s home, levels of education and children going to school. Obviously those elements are just as important as an explicit focus on health care and health checks.

Let me be honest: public health has for a long time been not only a very small part of the annual health expenditure in this and other developed economies but also very fragmented. With eight jurisdictions, as I have said before, we have both the opportunity to learn from the work and the excellence in certain jurisdictions but also the challenge to reach across and make sure that those efforts are coordinated. As one state heads down towards tuckshop campaigns and another state heads off towards teleconferencing or call centre facilities, we need to make sure that there is a level of consistency around the nation. That is why the Commonwealth will always have an indisputable role.

Acknowledging what this current administration has done in an attempt to have a single-funder arrangement for preventive care would have very little opposition from this side of the House or from the general community. I think a bigger challenge is to acknowledge that there is a certain right of passage in an area as tough as preventive health. It is an area that requires the adaptive work to be done—bringing people together from seemingly unconnected professions to achieve an outcome. There is a certain right of passage and I will tell our health minister what it is: some of that adaptive work gets done, you get some results on the ground, and then the health minister has the right to introduce this slew of statutory authorities and bureaucracies. My problem is where administrative change is all that is occurring. Apart from a fiddling of the Commonwealth-state funding arrangement and a construction of regional health boards that are fundamentally a fourth level of health bureaucracy, there is very little happening on the ground to lead to better public health outcomes. Those on the other side of the chamber will ask: why can’t we simply herald the arrival of a new preventive health authority? The answer is this: in two, three or five years time, when people read the contributions made in this debate, let it be very clear that this opposition said, ‘It is fine to have the bureaucracy—we want it as small and streamlined as possible—but you cannot have it without any action on the ground.’

On this side of the House we want to see more than this solitary focus on statutory bodies and authorities. Not everything can be done by big government. It is challenging enough to deliver services that are coordinated from Canberra. But I beg this government, I beg the Minister for Health and Ageing: when $130 million floats past the Prime Minister and down to the health minister’s office, do not just fall for the trap of yet another series of television ad campaigns about why people should be switching off the television. I beg the health minister, when you think about 13 per cent and $17.6 million to administer this behemoth, ask the very question: is that just a 13 per cent administrative fee, sliced off the top of what should really be preventive health outcomes on the ground? Or, possibly, is this actually too small to enable you to effectively bring together the disparate public health communities in this country and come up with the answers that we really need? Is this absolutely microscopic contribution towards research adequate to fund even a single multicentred study to give us the evidence we need? The answer is absolutely not. The tokenistic millions for research is such a tiny amount that it is almost an embarrassment to include it in this bill. I would argue that that money needs to be where it belongs: being contested openly through the NHMRC.

The other great uncertainty among the rest of Australia about where exactly this government is heading, as we see boxcarred before us legislation after legislation pertaining to new bureaucracies, is: exactly what is the relationship between this new authority and the health minister? The answer is quite simple. There are nine members plus a chair, and they are all appointed by the minister. Can you imagine the lifespan of a member of that authority if they have to recommend something that is against the government’s objectives? I would have thought that the best way to empower the experts in this field is not to select nine—however distinguished the individuals are—fawning sycophants who will tell the minister only what she wants to hear. The last thing members of this authority are going to want to do is recommend something that the government does not support.

Of those nine plus ‘the chair’, only two positions are for state representatives. Given that, historically, the great effort in preventive health has been made by state administrations—they have a wealth of experience, and an enormous amount of state funding supports that research work—I would argue that there is a formula here for great frustration among states that are not represented. It would have been far wiser, I believe, to have had all states involved early on, until there is a significant clarification of the direction of this body.

Next, of course, is the concern about how this body will function here in Canberra. Are we simply going to be populating the authority with public servants out of the Department of Health and Ageing? Will we have the capacities—and can we afford them—in this administration as it has been set up? There are significant questions around that. The agency itself could well have been an advisory committee bringing the smartest minds together, lean and mean and focused. But what we have here, presented before us, is vague, with an overwhelming focus on television public health advertisements. The great concern is that this administrative body, in the end, will simply monitor and transact contracts regarding TV ad campaigns. Will we be any further advanced? Will the tiny child living in a remote community even feel the slightest change in public health service delivery as a result of this body if the overwhelming proportion—nearly 75 per cent—of the entire funding attached to this legislation is for TV ad campaigns, probably telling people to switch the TV off and be more physically active?

There is an ideological division here, because fundamentally we have a government that believes that the bigger the bureaucracy gets, the better people will live their lives. Fundamentally, the flaw in this is that we are missing the incentives to bring professional groups together and come up with the innovative approaches that were delivered quite effectively and efficiently by the Howard administration—the lifestyle prescriptions that were GP focused, that allowed people who had recurrent contact with a GP 6.8 times per year to talk about lifestyle issues. It was highly, highly targeted; it was a one-to-one discussion with a highly qualified practitioner. We needed a multidisciplinary approach so that preventive health care did not float off on its own, and, of course, we needed to work on systems that brought together the best people in communities to come up with interventions.

My great concern is that this new authority is a cost-recovery administration. Every time a state administration asks for some advice from this authority, they will be given a bill—given a chit to pay. This, again, heralds this new Labor approach that the more something works, the more you tax it. I implore this government: the better it works, let it rip, let it go, let it use its own creativity and achieve great things. Instead we have seen, consecutively, taxing of the things that are good, resulting in good money going after bad. That is what needs to be avoided. We need to talk about a whole range of issues around health promotion, awareness and, of course, the regulatory changes that may well be needed. But what chance does a committee that is fully appointed by the minister have in recommending some regulatory change that may not be popular with the government?

There is inadequate separation. This group needs to be more separated from the health minister. We need it to be truly independent—to not have money already set aside for nothing more than public awareness campaigns. Moving into the fourth year of this administration, we have seen almost no progress. We will hear from the government a chorus of what will happen if we rip money out of the health system now. However, in no year—ever—did funding to health decrease. There was no more money ripped out of the health system under the Howard government than there was money ripped out of the school system under the Rudd-Gillard government because they built a hall last year and did not build a hall this year. The pure reality is that the increases in health funding were slightly lower in the subsequent agreement but that it never came close to going down. There was no ripping of money out of anything but simply growth that was not as large. For a whole host of reasons, including the fact that debt was paid off over a decade, there were considerable challenges to the health system, which, I am proud to say, the Howard government did not pass on to the current administration.

We are touching now on an opportunity to address health inequalities. We genuinely have the option to take great information and advice from overseas and apply it to preventative health. But let us be honest: when it comes to preventative health, this is an intensely personal choice about the degree to which we exercise, how much time we spend in a sedentary lifestyle and many hours we spend at work. They are some of the great challenges we face in moving the titanic of preventative health even a millimetre.

I do not put unreasonable expectations on this government. I do not ask them to prove within 12 months that they can gain improvements, because that may be way too ambitious. But there is a rite of passage in this game. If we go back into the history of Australian healthcare delivery, there are generations of great work that have achieved slow and careful gains. It is inadequate to simply set up an authority over the top and promise miracles.

This will be hard work, but we cannot afford to have an authority that is top-heavy and full of fawning sycophants—and I mean that with no offence. We need some separation from the minister and we need to give board members the freedom to be able to reach out and fund the work that needs to be done. Part of that is reaching out and using overseas information. Australia does not have to reinvent the preventative health world; it simply needs to pull together best practice.

Most of this is already well known. Most of this information is available from any school of public health around this nation, each of which have provided some of the world’s greatest practitioners. What we know is that there must be a focus on high-risk populations to start with. There needs to be a focus on using existing structures to make it a natural part of people’s lives. Yes, I can see that there needs to be some cross-corroboration and some translational research that takes great ideas from one area and applies them more broadly. That is fine, but you do not need an authority to do that. What you need is a lean and mean advisory committee, as I have already argued. They have existed before and they worked perfectly well.

I encourage this government, but not because I do not concede that one authority is probably okay. What we have seen is a health administration that has lurched from taxing alcopops and driving young people towards 750 millilitre bottles of spirits, and we have seen a focus on slicing cataract rebates in half and ripping out private health care—but, in the end, public and preventative health will be the victim.

12:17 pm

Photo of Shayne NeumannShayne Neumann (Blair, Australian Labor Party) Share this | | Hansard source

I rise to speak in support of the Australian National Preventive Health Agency Bill 2010. If we were looking at simply one piece of legislation today that dealt with health, there might be some substance and accuracy in what the member for Bowman has said. But if he actually looked at the daily program today he would have seen that there are five bills that relate to the Gillard government’s health and hospital reforms. The contention that we have somehow got an isolated piece of legislation that establishes a grand bureaucracy that provides no money to the health and hospital system and simply inflates the bureaucracy is just plain nonsense—absolute nonsense.

When we came to office the federal Labor government commissioned three key reports to examine critical areas of the health system: the National Health and Hospitals Reform Commission, the Preventative Health Taskforce and the National Primary Health Care Strategy. As a result of those reports, it was recommended that we have an Australian national preventative health agency. As early as the 2020 Summit, this was suggested by the men and women of Australia who were called here to have their say. The task force also recommended this. We are listening to the independent experts and acting on their advice. We are also providing about $7.4 billion in extra funding to the health system.

We went to the last election campaign offering far more funding for health and hospitals than the coalition. I have heard speakers opposite talk about e-health. The coalition went into the last campaign opposed to e-health. They were opposed to our primary care infrastructure. They were opposed to the GP superclinics. They were opposed to system reform. If they had their way the Ipswich GP superclinic in my electorate of Blair in South-East Queensland would not be open for business. They would close it down. They did not offer any funding for it; they opposed it tooth and nail. My predecessor wrote a letter to the editor recently which criticised the Queensland Times for its support of the Ipswich GP superclinic. He still has not gotten over the 2007 loss and is critical of what we have had to do. They have opposed every reform to the health system which they de-funded. The budget papers make it crystal clear that those opposite de-funded health and hospitals in this country.

In October 2007 the Institute of Health and Welfare, an independent body that is not exactly affiliated with the Australian Labor Party, examined health and hospital funding for the previous decade. It found that the states and territories, which were much vilified by health ministers in the Howard coalition government, had actually taken up the slack for the de-funding of the health and hospital system in this country by the Howard government. The proportion of federal funding for health and hospitals in this country plummeted to just over 40 per cent while those opposite occupied the treasury bench. They have a record of ignorance, idleness, inaction and inertia over health and hospital reform, and of opposing our health and hospital reforms.

The member for Bowman came in here and said he was opposed to what we have to do. I am simply amazed that the coalition are opposed to this legislation. They opposed it last time. When we come into this place there are some things that you kind of know that those opposite are going to oppose. I know that they generally oppose our position on industrial relations. I know that those opposite have opposed us on issues relating to climate change because so many of them do not believe that human beings make any contribution to climate change. But there are some things they are opposed to which I find inexplicable. The only thing I can think of is that they are in the pockets of the big liquor and tobacco companies, because I cannot for the life of me understand why they are opposed to this legislation.

The Gillard government are pouring money into health and hospitals in this country. Earlier this week there was a private member’s bill from the opposition’s health spokesperson, the member for Dickson, in relation to mental health. Mental health is a very important part of the health and hospital system in this country. The truth is that this government have provided $1.2 billion from 2010-11 to 2013-14 for mental health services in this country. The Howard government put $516 million in from 2004-05 to 2007-08. The facts speak for themselves. Those opposite simply ignored health and hospital funding in this country.

We are making major changes to this funding. Specifically, our legislation provides that we will fund 60 per cent of the efficient price of every public hospital service provided to public patients. We are taking over 100 per cent of GP and primary healthcare services and 60 per cent of capital expenditure, and 60 per cent of recurrent expenditure on research and training functions undertaken in public hospitals. We are pouring money into the health and hospital system of this country, which was neglected for so long when those opposite were in government.

This legislation is really important. We know that preventative health care works. For example, we know that admonitions, warnings and advice to the Australian public work—whether it is HIV-AIDs campaigns; campaigns to wear seatbelts, which we now have to wear and which save lives; campaigns to wear bicycle and motorcycle helmets; or advice to keep fit. There are Australians and many in this House who keep fit and run regularly. We know that when councils put pathways and bike-ways in suburban communities, more people will walk, run and get exercise. We see it every day. When a local council builds a wonderful park, we see people flocking to it. The Ipswich City Council recently rebuilt Lobley Park in Churchill, not far from where I live. Every time I drive past it, I see young people and old people, mums and dads and kids, running around getting exercise. Preventative health care works. We do not spend anywhere near enough on that.

This bill proposes an Australian National Preventive Health Agency with strategic plans for a five-year period. It will specifically target challenges in relation to alcohol abuse, tobacco use, substance abuse and obesity. What is wrong with that? The amount of money we are using to establish this agency is small compared to the totality of the funding we see on budget night. This particular organisation is not top heavy. It involves stakeholders in the process. It will also provide an advisory role.

We have committed ourselves to making a difference to tobacco consumption. If you travel through South-East Asia, you will see many people smoking. Far more people smoke in the Third World and elsewhere than people in Australia do because the Australian public have been told time and time again to reduce their use of tobacco. The advertising and the government strategies have worked. We have committed ourselves to stopping smoking in this country as much as possible. The tobacco excise was increased by 25 per cent in April this year. We invested another $5 million in the Quitline services and another $85 million in anti-tobacco campaigns. I warmly welcomed our proposals on the packaging of tobacco products, which makes sure that tobacco companies cannot lure and entice young people to use this iniquitous substance, which will impact their lives and cause financial deprivation and future health problems in the form of circulatory and respiratory problems.

Australians drink at high levels. In my childhood and adolescence, I endured the pain of having an alcoholic father. Many Australians will have had similar experiences. Many Australians have seen what alcohol or drug abuse can do to the lives of families. Many families, individuals and children endure financial deprivation, domestic violence, embarrassment, shame and humiliation because of a parent suffering from alcohol abuse. The Australian National Preventive Health Agency will make a difference in terms of policy and advice, and will put a big focus on those health issues.

Too many Australians drink at levels that are harmful. It is said that about three in 10 alcoholics do not actually admit it. We do not have enough services in this country that deal with the long-term effects of alcoholism on individuals and on families. We have taken huge steps, such as the $103 million national anti-binge drinking campaign, and I was happy to have supported ending the tax loophole on alcopops, which targeted young people. We have seen the consumption of alcopops reduced by 30 per cent. In my electorate, there are a number of great organisations dealing with this, and I particularly want to commend Tanya McKenna, a teacher at Ipswich State High School, who has made a difference to young people with mystery tours, which this federal government have in part funded. These mystery tours offer an alternative to those young people who might engage in binge drinking on their graduation and formal nights. This prototype at Ipswich State High School has now been adopted at Bremer State High School and Redbank Plains State High School. Preventative health care works and it has worked for those young people at those high schools in my electorate of Blair.

A new approach is needed with respect to health care in this country. The federal government are making a big difference and we will in the future with the National Health and Hospitals Network and the Medicare Locals. We are making a big difference in my electorate by funding the after-hours clinic at Ipswich General Hospital, run by the division of general practice; the Ipswich GP superclinic; and the psychology clinic at the University of Queensland. We are making a difference with federal funding for great organisations such as Kambu Medical Centre, helping our Indigenous people in the Ipswich and West Moreton areas, where over 4,300 people live. We are making a difference, but there is so much more to do. The agency created by this bill will make a difference to the lives of our young people, our middle-aged people and our elderly people. It will make a difference to the lives of each and every community across the length and breadth of this country, and it is an absolute shame and tragedy that those opposite are not prepared to support this vital legislation.

12:30 pm

Photo of Luke SimpkinsLuke Simpkins (Cowan, Liberal Party) Share this | | Hansard source

It is great to have the opportunity today to speak on the Australian National Preventive Health Agency Bill 2010. One thing for sure is that everybody in this House agrees on the importance of preventative health. But the trouble is that, when you come into this place and follow government speakers, they stand up and give one side of the story. They can very easily just say, ‘You guys oppose this,’ or ‘You’re against this.’ It sort of hangs out there as though the opposition have no plan for health. The reality is that if you have alternatives then that is a plan. If we say, ‘You have a plan; we think it’s wrong for the following reasons; here’s our plan,’ then that is an alternative. It is another plan, another idea on the way health could be pushed forward in this country. The government say, ‘You opposed everything we did.’ There was good reason. We opposed things because we did not think they were going to work. We thought they were going to be too expensive and they were not focused properly. What is the matter with that? Nothing. We stand by our positions and by our policies.

When we look at what happened over the life of the last government, the Howard government, we know that all the time the health budget expanded. Yet there was a time when the state governments were held to account for their health systems. Of course, some people call that the blame game. But why shouldn’t focus and scrutiny be placed upon those who are running the state health systems? But a lot of that accountability appears to have just been pushed out of the door. I wonder whether those who live in Queensland and New South Wales really believe that the hospital systems in those states are exemplars of state-of-the-art systems. If you read the media or if you hear the personal experiences of many people in those states then maybe there is room for a little bit of accountability and scrutiny. I make those points before moving on.

In commenting on this bill, the two principles with which I will approach my contribution today are, firstly, that this legislation should be about outcomes and not about another layer of bureaucracy and, secondly—a personal favourite of mine and possibly of quite a few in this House, particularly on this side—that it should be about personal responsibility. This contribution will all be to do with preventative health issues. This morning, whilst in the gym, I was listening to the ABC. I certainly felt that on this occasion the ABC were providing some very interesting and balanced information. They were talking about the mental health situation with regard to teenagers, the point being that teenagers are moving away from physical exercise in their lives towards the focus of the school curriculums on academic achievement. Obviously, we have no problem with academic achievement. The pursuit of excellence, or at least reaching your potential, is very much an important part of the lives of our young people in this country. However, there is still a need for physical exercise. The point is that the lack of physical exercise and sport within the curriculum is leaving young people and teenagers just with academic subjects, so they are not getting tired through physical pursuits and are staying up later, still having to get up at the same time of day. As we know, and as has been proven, lack of sleep is bad for the mental health of young people. Younger children need enough sleep to keep growing and reach their physical potential. In addition, social interaction using technologies such as the internet and mobile phones—if you can call it social interaction—means that young people are staying up late and of course this is reducing their sleep. Those were the two aspects of the ABC report today. I would say there is a place in the curriculum for physical education and sport. I support that and I am sure we all support that.

But the thrust of the report was really about how this is a school responsibility—that was it: a 100 per cent school responsibility. That was certainly the implication from the report. But, in reality, what about personal responsibility? What about parents encouraging their children to become involved in sport, not just at school but afterwards as well—in clubs after school time and opportunities like that? There is a lot to be said for identifying, in your own life—or parents identifying in their children’s lives—the opportunities for this physical education as well, to supplement what is done in schools. This is a basic responsibility of parenting; it is not just the responsibility of curricula; it is not just the responsibility of government. It is time to look in the mirror, in a lot of respects, Mr Deputy Speaker Murphy. Sorry, I am not talking about you personally, of course—but any parent in this country should keep that in mind.

In the electorate of Cowan we have so many wonderful sporting institutions: the Wanneroo District Netball Association; the Kingsway Little Athletics Centre, which is another great example of opportunities for young people to be involved—and with netball, of course, adults as well. We have football clubs, we have cricket clubs, we have the state badminton organisation as well in Cowan, so that is also very good. So there are opportunities for parents to encourage their children to participate.

Recently, I was at Koondoola Primary School. Koondoola primary is in a more challenged area, a lower socioeconomic area within the electorate of Cowan. I was having a discussion with two of the deputies at the school. They were saying that the cost of fees for club sport participation for young people was quite an issue for people there—and that worries me. I wonder sometimes whether possibly the education rebate could be expanded to include an element of sporting club fees—I mean, that is preventative health for you, and I certainly think that would be a good way forward.

I think there is the opportunity out there in the community for sporting and physical exercise to be able to take place, not just in schools but in the wider community. And that, ultimately, is the responsibility of parents—to encourage and assist their children to participate, whether that is at primary or secondary school level; all through those ages. At the same time, of course, as parents we have the responsibility to lead by example. On Sunday, just before we flew back, I took the opportunity to take my kids to the local pool, Wanneroo Aquamotion. As the weather gets warmer and warmer, we will find ourselves at the beach more, in the park, maybe going for bike rides—with helmets, of course; another big preventative health issue: all children and all adults should wear helmets. So there are these sorts of opportunities where often you do not need to pay, particularly with beaches, bike riding, visits to parks, kicking the football around. There are no limitations on this. These are the opportunities where parents can lead by example.

I was talking to one of the parents at our local primary school, Hawker Park Primary School. Graham Barrett is his name. He has five children, and they all go down to the Sorrento Surf Lifesaving Club, doing the training. It is a very big thing now in Perth; lots of kids from our school go to surf lifesaving. Graham actually participated in the Family Iron Man at the end of last season, which involved a run and a swim. I think there might have been board paddling as well. So he was out there, not just talking the talk but walking the walk, and that is exactly the way forward.

When they take opportunities in the gym, a lot of people should maybe consider that, if you actually want to look at your weight issues, there are a number of ways to try to reduce your body weight. Getting the heart rate up into the sustained training range—which you can determine at your local gym, as they always have those heart rate charts; or you can consult with your family doctor—is very good. But above all—we can all turn up to the gym; we can all go for a walk or a bike ride occasionally—it comes down to diet. As a PTI, a physical training instructor, in the Army once said in front of a number of us, you can do a thousand sit-ups a day and you will end up with a fabulous set of stomach muscles; however, unless you reduce your food intake, they will be a fabulous set of stomach muscles underneath quite a substantial level of fat. So it is more than exercise; it is about diet. And when we talk about high-salt and high-fat diets then we also open ourselves up to the risk of stroke, diabetes type 2 and a number of other health issues to do with the heart and other more general issues.

So, in a lot of ways, I appreciate that there is a part to play for government in preventative health, and I think a big part of that is education. And there is a part for schools to play. But ultimately it comes down to the decisions we make in our own lives, the self-inflicted injuries that we so often incur—the pizza too many nights a week, or maybe too many nights a month; the KFC; the ‘Oh, I’m too tired to get up this morning to go out for a run or exercise’; or the ‘That’s all right, little Johnny, you can go and play with your DS or your PlayStation all day.’ These are personal decisions that we make, and maybe sometimes we should just look in the mirror and work out whether that decision has an impact on ourselves. And, more than that, as parents we have a responsibility to not only talk the talk about little Johnny, or little Emily—saying that we want them to go out and do physical exercise; our children should see that we also believe that and that we walk the walk as well as talk the talk.

As I said at the start, a lot of what I talk about is personal responsibility, taking that look in the mirror and judging ourselves before we look for some problem in society to blame for the problems that we so often place upon ourselves. In the very limited time left, I will just finish by saying that our position is that we want tangible outcomes from this sort of legislation. There are enough bureaucrats in Canberra and across the country without imposing more unless there are real, tangible benefits. Unless there are outcomes that can be measured, I wonder why we move forward with these things. Ultimately, it is about the individual doing the right things for themselves, first and foremost accepting that responsibility, and then it is about government putting education in place and then being able to assess the outcomes in the end.

12:46 pm

Photo of Mike SymonMike Symon (Deakin, Australian Labor Party) Share this | | Hansard source

I speak in support of the Australian National Preventive Health Agency Bill 2010. As the member for Cowan was just talking about physical fitness, I can attest that he is a very keen and regular attender at the parliamentary gym, and I do know that his heart is definitely in that.

Photo of Luke SimpkinsLuke Simpkins (Cowan, Liberal Party) Share this | | Hansard source

As are you, mate.

Photo of Mike SymonMike Symon (Deakin, Australian Labor Party) Share this | | Hansard source

Thank you. The Australian National Preventive Health Agency will be responsible for supporting Australian health ministers in their efforts to combat preventable diseases. A key role of the agency will be to provide the leadership and coordination required to support the implementation of the National Partnership Agreement on Preventive Health, an agreement of the Council of Australian Governments. This agreement between the state, territory and federal governments recognises that greater coordination is required in our efforts to tackle preventable chronic conditions.

Initially, the Australian National Preventive Health Agency will focus its efforts on social marketing campaigns to reduce the risks posed by tobacco consumption, alcohol consumption and obesity. The ANPHA will develop a five-year national preventative healthcare strategy to coordinate and provide national leadership on the issue of preventative health as well as to conduct relevant research in these vital areas.

The Gillard government has committed to fund the ANPHA with $133 million over four years. This includes $102 million over those four years to fund important campaigns that go to issues that are here and now. As I mentioned before, tobacco use and the rates of obesity are issues that government should concentrate on. Tackling preventable diseases is one of the most effective ways of improving health outcomes in Australia, saving our country, our community, a lot of money and saving people’s lives.

Too often in the past individuals, communities and governments have focused on the issues of treating people after they have become sick. Of course, we still need to do that, but there are so many things that happen over a lifetime that may cause an illness later on that need to be concentrated on now so that we save that money, that illness and those deaths down the track. Governments in Australia have looked at some of these issues in the past, but what is proposed with this bill is a much more comprehensive and, I think, better targeted package to look at these issues both now and in the future. I think the debate we are having now should have been held many, many years ago. When the bill that was similar to this one was put up to the last parliament, we had the debate back in October 2009, and I thought, ‘This is good; it’s going to happen,’ but that bill never made it through the last parliament, so we are back here today having this debate.

In Australia, it is estimated that one-third of the burden on our health system relates to the health behaviour and lifestyle factors of individuals. I think that with education and resources these behaviours and factors can be modified. But it is not a short-term fix. It is not something such that you can get a message across today and change someone’s behaviour of a lifetime the next day. It takes reinforcement and a lot of education and help. When we encourage individuals to make different choices, we start to divert people from life-threatening diseases and illnesses and we can make inroads, as I said, on the costs of health and make for a happier, healthier community—not just a few people but everyone.

The Australian Institute of Health and Welfare has identified the seven risk factors that contribute the most to the burden of disease. They are tobacco use, high blood pressure, obesity, lack of physical activity, cholesterol levels, alcohol intake and the low intake of fruit and vegetables. They all sound fairly straightforward, but of course they all have huge impacts. The financial cost that these factors pose to our health system is significant, while the cost to our community in mortality and morbidity is considerable and is growing.

For instance, in the 2004-05 financial year, the health costs associated with tobacco were estimated at $31 billion. As the member for Dobell noted in his contribution to this debate, we have seen in Australia, through anti-smoking campaigns and price signals, the rate of smoking cut from 30½ per cent in 1988 down to 16.6 per cent in 2007. What the member for Dobell did not note and I will is that even that rate is much reduced from what it used to be. In the 1950s, it was estimated that 70 per cent of adult males and 30 per cent of adult females who lived in Australia smoked. We now see a lot of those problems many, many years down the track, when people who have smoked—and a large percentage of the population have smoked—present with what can be in many cases incurable diseases or chronic diseases that are there for life. There are some other interesting figures on smoking, and it is good to see the rates going down. One that I found while looking up information for this bill is that there are now more former smokers in Australia than there are current smokers. That is a good sign for the future.

A recent report from VicHealth in 2009 titled The health and economic benefits of reducing disease risk factors showed that if the smoking of tobacco were reduced to the rate of smoking in California, which is down to 15 per cent, then 5,000 lives per year could be saved in Australia. The report went on to note that there would be 158,000 fewer new cases each year of illness from tobacco use in Australia. The Gillard government has introduced world-leading reforms to further reduce Australia’s smoking rates, which are already among the lowest in the world but, as I said, need to go lower. These reforms include a 25 per cent increase in tobacco excise, an $85 million investment in anti-smoking campaigns and being the first government in the world to introduce plain packaging of tobacco products. This new body, the Australian National Preventive Health Agency, will continue this work to reduce tobacco use in Australia.

Obesity is emerging as one of the major challenges to the health of Australians. Earlier this year, the OECD predicted that in the next decade almost two-thirds of the Australian population would be either overweight or obese. That huge figure almost defies belief but, when we look at our existing figures, we are actually not a long way off that. The World Health Organisation has labelled obesity a worldwide epidemic. To give the House some idea of that, in Australia in 2007-08, 61 per cent of adults were overweight or obese and 25 per cent of children aged five to 17 years were overweight or obese. So we are not actually very far off the prediction of the OECD for the next decade. It is a prediction I hope we as a country do not reach.

The National Preventive Health Strategy, the road map for action, says that by 2032 the leading cause of disease for males and the second leading cause of disease for females will be type 2 diabetes. This will result in an increase in direct healthcare costs for type 2 diabetes to about $8 billion annually from the current $1.3 billion. The rise in type 2 diabetes rates is significant because it in many ways reflects the rise of obesity in our community. Poor diet and lack of physical activity lead on to larger health complications. And diet is so important. As noted in Australia’s health 2010, only one out of every 20 children aged 14 to 16 consumed the recommended intake of vegetables in 2007. If you start out life without the right eating habits, I am sure it is only downhill from there. As the previous speaker noted, there are many who get an addiction to eating junk food rather than eating food that fuels their bodies. The VicHealth report that I referred to previously found that a cut in physical inactivity of only five per cent would save the health sector $48 million a year. But in 2007-08 only 37 per cent of adult Australians exercised sufficiently to obtain benefits to their health. In addition, and very importantly, 1,000 lives per year could be saved, and there would be 3,000 fewer cases of illness, for that five per cent cut in physical inactivity. The Gillard government recognises the challenge of tackling obesity and has committed to the National Partnership Agreement on Preventive Health, which will invest a total of $872 million over six years, with a focus on obesity in that preventive health area.

Another factor that will be a focus of ANPHA is the consumption of alcohol and other substances. Australia still has a very high per capita consumption of alcohol and, although that has dropped overall slightly in recent years, the detrimental effects of excessive alcohol consumption on a person’s health are well known. It is estimated that in 2004-05 Australia spent $1.9 billion on health in relation to the harmful consumption of alcohol. Also associated with the overconsumption of alcohol is the loss of workplace productivity, estimated to be worth another $3.5 billion, according to the Australian Institute of Health and Welfare. The Gillard government has already taken action to deal with part of this problem by investing $103 million in the National Binge Drinking Campaign and has raised the taxes on alcopops, sugary drinks favoured by many young drinkers.

Given that the evidence shows the role that lifestyle and behavioural factors play in individual health outcomes and that we have known this for some time now, the question that could be asked is why previous governments have not given this the same priority as it is now being given in this place. I think it is a wise investment decision for any government to spend now on preventive health to prevent greater expenditure in the future. But that is not always an easy thing to explain to colleagues in the House or to convince those on the other side or even to convince the public, because the benefits are not necessarily quantifiable, they are not sitting in front of us right now. A cost to the current budget for a return many years down the track is always a difficult case to argue, but in terms of health I think those outcomes can be measured from research that has already been done, and the capacity of governments to fund the system in the future if we do not act now is something that is in doubt because these problems were only going to magnify and grow as the population ages and as our population grows in the future.

In contrast to previous governments, the Gillard Labor government is taking action by funding preventive health programs. We are listening to experts like the people involved in the National Health and Hospitals Reform Commission and practitioners on the ground. The Gillard government is investing in preventive health and has been working with state health ministers to deliver the National Partnership Agreement on Preventive Health, which overall will invest $872 million in that area. Investment in preventive health is about helping our community have the knowledge to make healthier decisions and making these decisions easier for the individuals who live in those communities. By taking the lead in preventive health, the Gillard government is looking to our country’s future. I am certain that this investment now in funding preventive health programs will lead to a lesser expense for the community as whole in the future. I commend this bill to the House.

12:59 pm

Photo of Judi MoylanJudi Moylan (Pearce, Liberal Party) Share this | | Hansard source

I rise to speak on the Australian National Preventive Health Agency Bill 2010. Well before this century reaches its half term, the management of chronic disease will have seriously challenged the health budgets of all nations, and Australia is no exception. Chronic diseases are illnesses prolonged in duration and rarely curable. The range of illnesses is staggering, with examples varying from diabetes, which we know contributes to many other diseases, to HIV-AIDS and to cancer.

In addition to the pain and suffering the illness and disability causes, chronic diseases are a significant economic burden. Estimates from the Australian Institute of Health and Welfare show that total health expenditure in Australia, including hospital, out-of-hospital and pharmaceutical costs, is approximately $60.9 billion of which $40.9 billion is recurrent expenditure on the management of various diseases and conditions. It is not only a cost to the national budget; it is a lost economic opportunity to individuals. It affects the economic wellbeing of individuals and the carers of those individuals, who sometimes suffer debilitating chronic illnesses.

The origins of chronic illness are complex and in many cases not completely understood, with multiple factors compounding over a period of time contributing to their onset. While we rarely know the exact causes, comparison of the dedicated research into individual illnesses has identified shared risk factors as well as protective factors. Recognising the commonalties, stakeholders have pushed for a coordinated national approach, with greater emphasis on both research and education. The creation of a National Preventive Health Agency appears to meet the calls of stakeholders, but there is no point in creating another layer of bureaucracy without tangible outcomes being realised. I am sure that this has the capacity to realise some of those benefits.

The explanatory memorandum to the bill outlines that the agency will focus its attention on obesity, excessive alcohol consumption and tobacco use, with $102 million of the $133.2 million cost going toward national level social marketing campaigns. Campaigns highlighting issues of physical inactivity, smoking and binge drinking have all been effectively undertaken in the past though health departments. Many people can instantly recall quit smoking campaigns, which have reduced the number of smokers very dramatically in this country. We know that one of the outcomes of those public campaigns, and education in schools, is that kids often go home and encourage their parents to give up smoking. So they have had quite a dramatic impact. We have seen a number of other campaigns over time to encourage people to do more physical activity. The catchphrase ‘find 30’ and the HIV adverts with the grim reaper were part of effective campaigns. The pertinent question then is: how will moving such functions to a national agency add further value to such campaigns?

Advertising is an effective tool in trying to change lifestyle habits that increase risk factors for chronic disease, but it is not a silver bullet. An advert warning against the dire consequences of physical inactivity, no matter how clever or shocking, will achieve little if the government does not follow-up with support to actually get people engaged in physical activity.

Because I have chaired the Parliamentary Diabetes Support Group, which is an informal group established across the benches in this place to try to deal with the relentless march of diabetes, I want to pay tribute to the work of people who have worked with me on the executive: the member for Lyons; the member for Isaacs; the member for Moore in Western Australia, Dr Washer; and my good colleague from the senate Senator Guy Barnett. Guy Barnett actually put out a book in 2006 called The Millennium Diseasehe edited that—and, in 2004, before this book came out, he pushed the then Howard government to commit to a program called Building a Healthy, Active Australia. There were a couple of really significant programs that came out of that and the Howard government did actually commit $116 million over four years for a couple of programs. The first was a $90 million after-school physical activity program and the other was $15 million in grants to parents and citizens associations to encourage them to set up healthy eating canteens. Then there was some more money—I think it was about $11 million—that went to trying to have an information program that would give parents and children and communities information and encouragement to adapt to and adopt more healthy eating habits and lifestyle changes that produce better health outcomes over a longer period of time.

A few weeks ago I had the great pleasure of presenting to Mount Helena Primary School in my electorate the award as the Swan East Region Super Site for the Active After-School Communities program. I spoke about this in the adjournment debate last week. In a meeting with the staff, I was struck by the great passion they have for trying to get students involved—very successfully in this case—in physical activity and sport both in school and outside school hours. Their enthusiasm clearly rubbed off on the students. Through the program, the school continued its involvement in the City to Surf fun run with great success. Mount Helena Primary School is an outstanding example of the benefits of the program that was introduced in 2004. It targeted young primary-school-age children between the hours of 3 pm and 5.30 pm. It aimed to engage children in a variety of sports and develop a love of sport to inspire children to join local sporting clubs and make sport a lifetime activity.

Yet, despite the program’s overwhelming success, its funding is not secure. Its funding has been extended for another 12 months, but to date there has been no commitment to longer term funding. That is a tragedy, because it is difficult to retain the incredibly talented human capital that has worked over several years to build up this program and has made it so successful. These people have no security of tenure in the work that they are doing. It would be wonderful to get a longer term approach to ensure the general continuity of the program and greater longer term certainty for those who currently work in it.

Along with the Active After-school Communities program, I will mention the $15 million in grants for parents and citizens associations to encourage them to set up healthy eating options canteens. I had the pleasure, some time ago, to visit the Arbor Grove Primary School in Ellenbrook in my electorate. Arbor Grove Primary School provides a standout example of how a school can, with the commitment of some marvellous parents, turn around the whole attitude and philosophy of the school towards healthy eating. Through the canteen and the dedication of a number of parents, a range of healthy options have been devised for lunches and snacks and have been presented in such a manner that they are made attractive and exciting to kids, who are looking forward to eating healthily. This is enormously important for young children, not only for their physical health but also for their capacity to pay attention and to learn. We know that the type of food that kids eat can have an impact on the way in which they behave in school. The government would do well to support and expand these programs which have been so successful. They have a proven track record and could play a very important part in a larger strategy to promote greater intake of fresh fruit and vegetables, which is an important aspect, as we heard from the previous speaker.

Along with such programs, we need to put greater emphasis on primary health care if we are going to deal with chronic illness. The Australian Institute of Health and Welfare notes:

More than half of all potentially preventable hospitalisations are from selected chronic conditions … such as diabetes, asthma, angina, hypertension, congestive heart failure and COPD.

COPD is chronic obstructive pulmonary disease. These hospitalisations could have been avoided had there been more ready access to GP services. Rather than creating—in some cases, in suburban inner city areas—GP superclinics that are set up often in competition with existing services, perhaps we should take a more constructive approach and get the government to focus its resources on examining where the gaps in primary health care are and supporting existing services, especially where there is intense pressure on those services.

General practitioners undoubtedly are the key to preventing hospitalisation and complications, as they provide the crucial link between someone being aware of risk factors and those risk factors being identified and acted on. The public may be fully aware that hypertension, high cholesterol and low insulin levels—or high insulin levels in some cases—are high-risk factors in developing a number of chronic diseases, but ultimately GPs must diagnose and guide patients to a risk management program. It is here that there are preventative health bottlenecks, because of the high pressure on local clinics, and this is where the difficulties lie. It can, as some of my constituents have reported, take up to three weeks to get a doctor’s appointment. Sometimes they just give up. The long wait can prevent or dissuade people from seeking a check-up. Often, people wait until late-stage symptoms develop, at which point hospitalisation may result. If they had had earlier diagnosis and treatment, they might have avoided serious complications and so saved significant pain and suffering—and money. While advertising may be able to bring about general societal awareness, nothing is more powerful than a doctor telling a patient that if they do not change their habits they are likely to develop a chronic illness. More support must be given to reduce the bottleneck. The government needs to listen to the concerns of general practitioners, especially where superclinics are planned, to make sure that we are filling those gaps and are value adding, rather than simply replicating services.

The other issue I will touch on is oral health. Sometimes the first sign of a serious chronic health issue is seen in a person’s oral health, yet this remains one of the seriously neglected areas of health reform. It is absolutely critical that people have access to dentists and good oral health, because this is undoubtedly a significant factor. The shadow health minister, the member for Dickson, has made some very sensible and supportable recommendations in relation to this bill. We need to deal with this terrible scourge of chronic illness, which is going to cost us dearly, not only in human suffering but in the financial cost to the nation, communities and individuals. The recommendations in relation to this bill are very sensible and supportable. I hope the government does work in a bipartisan way to ensure the very best outcome in how we approach the public in order to minimise chronic illness, and all of its complications and high costs, in the community.

1:14 pm

Photo of Jill HallJill Hall (Shortland, Australian Labor Party) Share this | | Hansard source

I commence my contribution to this debate on the Australian National Preventive Health Agency Bill 2010 by also imploring that we have a bipartisan approach to this legislation and by encouraging the opposition to support the establishment of the Australian National Preventive Health Agency. I know that this bill or a very similar bill—there have been some amendments to the legislation—was introduced into the parliament in 2009. I spoke in the debate at that time and I listened to the contribution of the member for Dickson. It disappointed me that he could not give wholehearted support to the establishment of this agency because this government—the previous Rudd government and now the Gillard government—has had a very strong commitment to fighting preventable diseases. This is best done through having a very strong preventative health strategy and through a coordinated National Preventive Health Agency.

This bill currently has a commencement date of 2010. The agency will commence automatically six months after the bill receives royal assent if it is not proclaimed before then. This is very important because it means we will not be back here debating this legislation again if there is some hiccup in the other place. It is very important that we get the Australian National Preventive Health Agency operating, because we have so many lifestyle diseases in this country. We have so many diseases that can be addressed through preventative health strategies. This agency needs to be operational. The legislation we have before us today looks at the number of meetings of the advisory council in 2011, the timing around the development and approval of the strategy, and timing and presentation of annual reports to the parliament. This legislation creates a framework for the agency.

I would like to touch a little, in the time I have before the parliament, on the importance of fighting preventable diseases. One of the earmarks of the Labor government has been its approach to preventable diseases and how we can combat them—preventable diseases such as obesity, drug and alcohol abuse and smoking. They will be key priorities of the new National Preventative Health Agency. This government has joined forces with peak health groups to call on the parliament to support this legislation. The original bill received wide consultation and was broadly welcomed by stakeholders. Many urged that it be quickly introduced into parliament. I last spoke on this 12 months ago and we still have not got an operational agency. The Commonwealth government will take the major funding responsibility, as we all know, and I spoke about this in my contribution to a debate earlier this week on public hospitals and primary care. Along with that, we need to have in place a structure, an agency, to deal with preventable diseases and take a lot of the pressure off our hospitals. If you can deal with a problem before it becomes a major illness, then we will be a lot better off.

I would like to address a couple of the preventable diseases that this agency will oversee and some of the lifestyle issues that are associated with it. In this parliament I have introduced five private members’ motions. The first one I introduced looked at stroke and discussed Stroke Awareness Week. It looked at the number of people that suffer from stroke and strategies to deal with stroke. One of the key factors was to address issues such as obesity as well as tobacco and alcohol abuse. That just demonstrates how important this agency will be.

I had a private member’s motion in the House this week on Pink Ribbon Day looking at breast cancer. Once again, lifestyle issues impact on the number of people who develop this type of cancer, along with many other cancers. I also have a motion on the Notice Paper looking at cardiovascular disease. That motion talks about what cardiovascular disease is, talks about the fact that it kills one Australian every 11 minutes, looks at the effect that cardiovascular disease has on Australians and looks at how it prevents 1.4 million people in Australia from living a full life because of the disability caused by that disease. The motion goes on to state what the risk factors are for cardiovascular disease—tobacco smoking, insufficient exercise, poor nutrition, alcohol consumption, high blood pressure, high cholesterol, being overweight and having diabetes. These are all lifestyle issues. Cardiovascular disease can be addressed if these issues are addressed.

In my previous contribution to this debate, I highlighted issues such as binge drinking. I referred to the fact that the AMA sees this as one of the biggest problems in our society. Not only does it affect a person’s health; it leads to road accidents, domestic violence, vandalism and chaos within our community. Figures that I have looked at show that there is a very high level of alcohol use and abuse in Australia. Ninety per cent of people have tried alcohol and 83 per cent have consumed an alcoholic drink in the past 12 months. Only about 10 per cent of people have never tried alcohol. The AMA has found that about eight per cent of Australians drink daily and about 41 per cent of Australians drink weekly. There is an enormous cost associated with alcohol abuse, and alcohol abuse is responsible for large numbers of hospital beds being occupied in our country. This is an important issue to address, and what better way of addressing it than through the Australian National Preventive Health Agency?

I also have a motion on the Notice Paper about obesity. In the last parliament, the House of Representatives Standing Committee on Health and Ageing held an inquiry into obesity. The report from that inquiry was called Weighing it up. We looked at a number of issues surrounding obesity, such as diet, exercise and planning at a local government level. In looking at this, we found that Australia is one of the countries in the developed nations with the greatest number of people who are overweight. That is quite frightening. It is associated with diseases such as diabetes, which the member for Pearce spent some time talking about; cardiovascular disease, which I touched on earlier in my contribution to this debate; stroke; and breast cancer—it is also a factor there. It is an issue that we as a nation need to address.

One in two adults and one in four children in Australia are overweight—frightening statistics. We face a situation in which children growing up in Australia look like they will die at a younger age than the generation that we are part of. That has never happened before. It will be a very sad state of affairs if it is allowed to happen. Establishing this agency, which will allow the Commonwealth to control and coordinate a cross-government approach to obesity, is one of the most important things that we in this parliament can do in this regard. Everybody involved in the sector needs to be brought together so that they can work to address the issue of obesity.

The agency will allow for a strong social marketing program, with the government providing education, including education on nutrition, exercise and lifestyle issues. A healthy lifestyle means eating well, exercising well, using alcohol sensibly and cutting out smoking. If we do those things, we will reduce the number of people who require beds in our hospitals and reduce the cost to government from these lifestyle diseases that are largely preventable.

One lifestyle choice that people make is to smoke. Smoking is responsible for a large number of people requiring hospital beds. The government has a proposal to bring in plain cigarette packaging. There is no better place to coordinate that through than this proposed new agency. The government has led the world in reforms to stop smoking, such as by increasing the tobacco excise this year by 25 per cent, by investing another $5 million in quit services, by investing $85 million in anti-tobacco campaigns and by being the first country in the world to introduce plain packaging for tobacco products. Those are very important steps and strategies to address the issue of those lifestyle diseases that have developed in our country.

I implore those on the other side of the House to support this legislation. We need a National Preventive Health Agency in this country to coordinate our approach to fighting all the lifestyle diseases that I mention and to address the causes of those diseases, such as smoking, alcohol abuse and obesity. This is really important legislation that needs to pass this parliament as soon as possible.

1:29 pm

Photo of Deborah O'NeillDeborah O'Neill (Robertson, Australian Labor Party) Share this | | Hansard source

In the short time that I have been in this place I have often heard other members say that they are pleased to be able to speak on various pieces of legislation, and I imagine this will generally be the case for me too. But, having reviewed the background to this debate and seen the evidence of aching need for preventive health in our community, I really cannot be pleased about the fact that the Australian National Preventive Health Agency is not already doing the work that it is meant to do.

Today we are revisiting a bill that, as far as I can see, should have been made into law a year ago. We are debating the Australian National Preventive Health Agency Bill 2010 one whole year after the Australian National Preventive Health Agency Bill 2009 should have been enacted. That is a whole year in which the Australian National Preventive Health Agency could have set its agenda and progressed its preventive health campaigns as a statutory authority. In fact, it is now almost two years since COAG agreed to the establishment of ANPHA. That is a whole year of prevention lost. Had last year’s legislation been passed, ANPHA would already be functioning with its own CEO and advisory council and working to its own strategic plan and operating plan. The agency would already be prosecuting life-altering and, I do not think it is an exaggeration to say, life-saving national health education campaigns on smoking and obesity and supporting the nation’s health ministers in that considerable task.

That the agency is not already in existence to carry on its preventive health work is an indictment of the obstructive culture of the coalition that has flourished under the current Leader of the Opposition. How does delaying the installation of ANPHA ‘hold the government to account’, as the Leader of the Opposition is so fond of saying? This has absolutely nothing to do with holding the government to account and everything to do with holding back the government in its legislative agenda—never mind the social and health costs on the way.

The Leader of the Opposition has shown a callous disregard for the health of Australians who might be spared the burden of chronic disease by the work of the agency in not allowing this legislation to progress through the parliament. By way of preparation for today, I reviewed the Hansard of the debate on the Australian National Preventive Health Agency Bill 2009. That debate took place before the current Leader of the Opposition assumed the position. It was encouraging to read a number of wise contributions from both sides in September last year, when the bill was debated in this House. The member for Isaacs pointed out the direct support for ANPHA from organisations such as the Heart Foundation, the Public Health Association of Australia and the Royal Australasian College of Physicians. The member for Pearce, whom I understand has a longstanding involvement with diabetes treatment and who spoke here again today, gave her total support to the general direction of the previous bill. My Central Coast colleague the member for Dobell, who spoke last year and again today, last year spoke of the productivity lost to our economy due to obesity—an enormous $21 billion in 2005. It seemed like everyone was in heated agreement.

What happened? The legislation reached the other place, where the record shows that opposition senators, for no reason other than political opportunism, consigned the establishment of our first national preventive health agency to legislative purgatory. Twelve months later many of you find yourselves here again with pretty much the same bill. Only the date and the time frame have changed.

As a new member I now have the chance to contribute to the debate, but that is neither here nor there. It is regrettable, even shameful, that the establishment of ANPHA is still a matter for debate. I found the Senate Hansard of 27 and 28 October last year, when the previous bill was debated in that place, particularly disturbing—especially the contributions of Senators Cormann and Birmingham. Did they even address the need for a preventive health agency, as agreed by COAG under the National Partnership Agreement on Preventive Health? No, they did not. Did they address how they themselves would approach alleviating the $6 billion annual cost to our healthcare system of chronic disease or the loss of productivity of approximately $13 billion? No again. In fact, they failed to address any substantive preventive health arguments. Worse, Senator Birmingham spoke of preventive health initiatives as infringing on ‘the way people choose—quite knowingly—to live their lives’. He even said:

… there are limits to how much government should interfere in people’s lives to discourage them from leading unhealthy lives.

The current level of chronic disease in this country is a very serious matter. Frankly, it beggars belief that some of those in the opposition—note that I do not include them all here because I do not believe that there is a total moral vacuum on this issue in the coalition ranks and obviously the bipartisan support for the bill before the House reaffirms that—should be so blase about something like smoking, an addiction that looks set to kill one million Australians over the next decade. Is the death of these people and the suffering of their families really of such little import to the likes of Senator Birmingham? Is the preventable death of one million Australians a toll that is really something to be discounted and dismissed with that kind of misguided libertarian one-liner? Are these people for real?

The facts on smoking are compelling. I direct members to figure 1.1 in the Preventative Health Taskforce’s National Preventative Health Strategy. The strategy reveals clearly that tobacco is the No. 1 risk factor contributing to Australia’s overall burden of disease. The statistic, sourced from the Australian Institute of Health and Welfare, shows tobacco causing just under eight disability-adjusted life years. In layman’s language that means almost eight years off your life.

Almost 2.9 million Australian adults smoke on a daily basis. Around half of these people who continue to smoke for a prolonged period will die early. Half will die in middle age. The total quantifiable costs of smoking to the economy, including the costs associated with loss of life, are estimated to be over $31 billion. This information is all readily available for all to see in the strategy, yet it seems some in the Liberal Party are in no hurry.

I have a theory on smoking. Shall we say the smoke lifted during the election campaign when the links between the Liberal Party and big tobacco became clear. The Leader of the Opposition tried his hardest to weasel out of the connection and play it down but he was fooling no-one. How do you explain away $2½ million in donations from British American Tobacco and Phillip Morris in the past 10 years?

There was also the attack ad campaign by the so-called Alliance of Australian Retailers against plain packaging for cigarettes. These ads had Liberal Party fingerprints all over them. Those opposite may try to deny it, but we all know that where there is smoke there is not only fire; there is also money for those willing to compromise their principles. I am proud to be in a party that has chosen, as a matter of principle, not to take donations from tobacco companies. I understand that some individuals on the other side may make a stand on principle too. I am sure these donations to the Liberal Party horrify many members of that party. But while the Liberals and the Nationals take big tobacco’s dollar, how can they have any credibility when it comes to the preventive health sphere? I urge those right-thinking members opposite to reform their party so that, like the Labor Party, they take no donations from big tobacco.

When operational, ANPHA will take carriage of national-level social marketing campaigns on critical issues like smoking, obesity and binge drinking. Those of us in this place who care for the health outcomes of our constituents want this agency in place, to roll out consistent, effective social marketing campaigns that will help us in our quest to change risky behaviours. I note the Parliamentary Library’s excellent briefing in the Bills Digest and commentary about social marketing being most effective when integrated with other programs such as information about intervention, counselling and the like. And of course I have a particular interest in education within the school sector.

No-one underestimates the difficulty of what is involved in prevention education, but there are communities out there struggling with destructive cultures, particularly binge drinking. Changing such cultures requires persistence. We have to increase the sense of antithetical attitudes in communities, attitudes which stand in complete opposition to notions of binge drinking being normal Australian behaviour. As the minister has rightly pointed out, any debate about preventive health inevitably turns to disadvantage. So we look to where the worst health outcomes are.

Unsurprisingly the greatest prevalence of risk factors for chronic preventable disease are in the communities of greatest socioeconomic disadvantage. Perhaps that is why the Leader of the Opposition is so disinterested in preventive health, other than his own. The evidence is there for all to see, if they choose to. The National Preventative Health Strategy outlines how being overweight or obese and regular tobacco use are significantly greater among the lowest socioeconomic group of the Australian population. Excess body weight becomes more prevalent among Australians as they drop down the socioeconomic scale. Many factors—inequity in physical and social experiences in early life, access to and quality of education, exposure to marketing, even how cities are planned and designed and transport options—are linked to increased consumption of tobacco, alcohol and energy-dense nutrient-poor foods. And which group bears the greatest burden of chronic preventable disease in our country? Our Indigenous communities. This is, without doubt, our greatest area of need.

Closing the gap in preventive health terms will mean lowering smoking rates from 50 per cent in Aboriginal men to the less than 20 per cent in the rest of the community. I should add that the aim is to get smoking rates down to below 10 per cent. The member for Dobell spoke earlier today about the 1970s and 1980s when Australia had a fantastic international reputation with our Quit smoking campaign, which was emulated in the state of California where they are continuing to advance their efforts through creative ways of engaging the community, acting in their own interests for the best health outcomes.

In the case of alcohol, one in six Indigenous adults reports drinking in such a way as to pose a long-term risk to their health. That figure, sadly, has risen since 2001. In this context, it is unconscionable that this bill be delayed any longer. We on this side of the House have made a record commitment to preventive health. I commend the minister for her efforts. I commend her also for ensuring that obligations under the National Partnership Agreement will still be met despite the opposition’s intransigence.

The Commonwealth is progressing activities that the agency will take carriage of once it is operational. We are steadily moving to deliver better, fairer health outcomes for the Australian people. And the Australian people will hold the opposition accountable for any further obstruction to the rollout of a preventive health agenda. They must not take the wrecking ball to this important piece of legislation. I commend the bill to the House.

1:43 pm

Photo of Kirsten LivermoreKirsten Livermore (Capricornia, Australian Labor Party) Share this | | Hansard source

As pleased as I am to speak in this debate and voice my strong support for Australian National Preventive Health Agency Bill 2010, it is very frustrating to know that over a year has passed since I made a similar speech about the government’s commitment to this area of health policy and the importance of the national leadership and governance of preventive health initiatives at the heart of this bill. The government has long grasped the urgency for action in preventative health but it appears that the evidence of increasing rates of chronic disease, preventable disease more generally and the contribution of lifestyle factors to these problems, let alone any sense of responsibility to address this challenge, has passed the opposition and others by. As a result, the bill passed by this House at the end of last year did not pass the Senate before dissolution of the parliament in July. So we are back where we have started. We have lost much valuable time already, something all members and senators need to keep in mind as we debate the bill for the second time. Let us hope for a more responsible approach this time around.

There are a couple of changes to the bill as a result of the negotiation process and amendments which took place when it was before the Senate. The bill now requires the Preventative Health Agency to prepare strategic plans to run over a five-year period rather than the original three-year period. There is also now explicit reference to alcohol, tobacco and other substance abuse as well as obesity programs being included in the social marketing campaigns to be developed by the agency.

Photo of Bruce ScottBruce Scott (Maranoa, National Party) Share this | | Hansard source

Order! It being 1.45 pm, the debate is interrupted in accordance with standing order 43. The debate may be resumed at a later hour and the member will have leave to continue speaking when the debate is resumed.