House debates

Wednesday, 27 October 2010

Australian National Preventive Health Agency Bill 2010

Second Reading

Debate resumed.

5:53 pm

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

Before the debate was interrupted earlier this afternoon, I was talking about a couple of small changes that have been made to the Australian National Preventive Health Agency Bill 2010 compared to the form it took when it last passed the House in 2009. Apart from those two small changes, the scope and purpose of the bill remain unchanged.

This bill fits within the overall health reform agenda of the Labor government. This government is committed to improving the health of all Australians through policies that deal with the challenges of access, affordability and the overall cost of providing quality health care. We are doing that in the face of evidence that warns us that those aims will be hard to achieve in the coming decades due to the increased demands and costs associated with the ageing population and increasing rates of chronic disease. That is why we place such a priority on preventative health policies, and this bill is an integral part of that important strategy.

We will not get on top of the rising costs of providing health care to Australians unless we direct more resources towards preventative health and do it in a strategic and nationally coordinated way. The challenge is enormous and growing. 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 around 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. And more than 800,000 Australians aged 15 years and older were hospitalised for alcohol related injury and disease between 1996 and 2005. We have to be able to do better and, frankly, we cannot afford not to.

The reform agenda Labor are driving has made it clear that we recognise that our health system should be as much about keeping people in good health as it is about treating them when they are sick. The focus on preventative health, however, involves a major change in the way we organise and fund our health system and in the way people think about their lifestyles and personal responsibility for their wellbeing. That requires national leadership, something that was recognised and recommended by both the Health and Hospitals Reform Commission and the national Preventative Health Taskforce.

The government sees the Australian National Preventive Health Agency as a key part of the national effort towards driving those essential changes in the way we look at health. The need for and rationale for the National Preventive Health Agency have been endorsed by groups that know all too well the personal and financial costs of ignoring the current trends of chronic and preventable disease. For example, the Heart Foundation has welcomed the establishment of the National Preventive Health Agency, saying that it ‘heralds an important and proactive focus for preventative health care, especially in the major health risk areas of tobacco and obesity, that could potentially shift the significant burden of cost that accompanies chronic diseases such as cardiovascular disease’. Similarly, the Public Health Association of Australia and the Royal Australasian College of Physicians have indicated their support for the agency and the desire for it to be up and running as quickly as possible. That is exactly what the government is striving for.

The bill before us today establishes the Australian Preventive Health Agency to support Australian health ministers in tackling the complex and growing challenge of preventable chronic disease. The bill specifies the functions, governance and structure of the agency, including the interaction with the Commonwealth Minister for Health and Ageing and the Australian Health Ministers Conference. An important part of the structure of the Preventive Health Agency is the advisory council, which will be made up of between seven and 11 members with experience in the preventative health sector in a variety of disciplines and from a variety of sectors across that area.

The agency takes its place within a much broader preventative health effort being undertaken through a historic partnership on preventative health between the Commonwealth and state governments. Early in this government’s first term, COAG signed off on the National Partnership Agreement on Preventive Health. That partnership represents an initial $872 million investment in preventative health measures developing strategies to inform people of the risks of obesity, smoking and drinking and encouraging people to make choices that will lead to better long-term health outcomes. That investment of $872 million is the largest ever investment by an Australian government to support preventative health initiatives.

That partnership agreement included the establishment of this Preventive Health Agency. COAG recognised that supporting or enabling infrastructure such as the Preventive Health Agency and its research and surveillance capacity was required to support the Commonwealth and the states in their efforts to tackle the complex challenges associated with preventable chronic conditions and achieve the outcomes specified in the prevention partnership signed off at COAG, particularly those around healthy weight, physical activity, healthy eating and smoking.

In fact, it is Australia’s track record in bringing down the rates of smoking that should give encouragement to all of us about what it is possible to achieve through concerted strategies to educate the community, promote health messages and back that up with action. Australia has one of the lowest rates of smoking in the world as a result of hard-hitting social marketing campaigns backed up by measures such as increasing the excise applying to tobacco products, banning tobacco advertising and introducing graphic warning labels. This government wants to go further by making Australia the first country in the world to introduce plain packaging of tobacco products.

We have seen the results on smoking rates but more needs to be done on that, as well as on the rising incidence of obesity and harmful drinking. Up until now there have been programs running here and there across multiple jurisdictions and departments, but it is time for a fully coordinated national approach backed up by the best research into the exact dimensions of the problem, including a full understanding of the social determinants of health outcomes.

A key initial role of the National Preventive Health Agency will be to provide the leadership, coordination and monitoring required to support the successful implementation of initiatives funded through the prevention partnership, including $692 million out of that $872 million I mentioned earlier. From the recommendations of the agency a consistent and clear policy is to be delivered in order to ensure that this nation’s health risks are met with action. Under the prevention partnership the Commonwealth will provide funding of $133 million over four years for the National Preventive Health Agency. Of this, $17.6 million will be provided for the establishment and maintenance of the agency. Other funds will be used for social marketing—an amount of $102 million—and there is $13 million to support preventive health research, particularly that which focuses on the translation of research into practice. There is also money to audit workforce availability and to develop a strategy to address any identified gaps in that workforce.

We know that the challenges associated with chronic disease and lifestyle risk factors are very large. There are already numerous programs across the country aimed at increasing Australians’ physical activity levels and reducing those lifestyle factors that impact so negatively on people’s health. I spoke in the last debate on this bill about the 10,000 Steps program, which originated in Rockhampton in my electorate and which continues to play an important role in educating people about the importance of incorporating exercise into their daily lives and establishing a research base, backed up by the Central Queensland University, about the effectiveness of such community-wide campaigns.

The federal government is also supporting the Stephanie Alexander Kitchen Garden program, and I had great pleasure in joining the community on Saturday morning to celebrate the opening of the kitchen garden project at Farnborough State School on the Capricorn Coast. I was very proud when Farnborough State School was chosen to be amongst the first schools to be funded after the program was expanded beyond Victoria, thanks to a commitment made by this government in the 2007 election. It was truly astonishing to see what the school has achieved with the support of the Stephanie Alexander Foundation; funding from our government, including from the BER; and a great deal of hard work by teachers, especially Pam and Sue, the students and community volunteers. The program seeks to revolutionise the way children approach and experience food. It teaches children to grow, harvest and prepare healthy, nutritional food and experience the home-grown taste that is lacking in much of the processed food that makes up our diets today. The Farnborough students are developing the knowledge and skills that can set them up for a lifetime of good eating habits. We saw plenty of evidence of the power of this project at Farnborough as the students served guests samples of the beautiful food they cooked themselves using the produce from the extensive school garden.

Not so obvious but just as important are the social and educational benefits that are flowing from the school’s embrace of this project, as we learned from one of the mothers who shared her child’s kitchen garden experience with the audience at the opening. She said:

For a special needs child the Stephanie Alexander project gets these kids out of the classroom which is so overwhelming and into the outdoors, gardening where they can be themselves and nothing is expected of them. I think they blossom 100 per cent. Many schools only offer sports as outside activities, which is not what autistic or Asperger’s kids would consider as fun. The garden is a much better alternative. The garden and kitchen are teaching them so many life skills without them realising, whether it’s tending to plants or following a recipe. My child makes some pretty good salads and is a great help in the kitchen at home. My child was struggling with reading but can follow a recipe no worries. The Stephanie Alexander Kitchen Garden project is not just a garden or a kitchen. It is my child’s happy place.

We were all so pleased to hear of that experience and that Amanda was able to share that with us on Saturday morning.

So it is great to know that, with the assistance of $12.8 million in federal funding, by 2012 there will be 200 schools and over 20,000 children sharing this experience nationwide. It shows us that there are things out there that work to put Australians on the path to being better informed about the choices they make. The challenge to governments is to reverse the traditional health policy model which puts preventive health initiatives at the edges of the health system and instead give them priority within a fully integrated health system. Australia is now getting the leadership and the funding it needs to tackle the complex and growing challenge of preventable disease caused by smoking, obesity, alcohol and poor lifestyle choices.

I commend this bill to the House as one more step towards tackling that challenge. When smoking kills 15,000 Australians every year and our children are facing a shorter life expectancy than the current generation, I call on the opposition to stop wasting valuable time and to support this bill.

6:05 pm

Photo of Dick AdamsDick Adams (Lyons, Australian Labor Party) Share this | | Hansard source

I am very pleased to speak on the Australian National Preventive Health Agency Bill 2010. This is tremendous legislation before the parliament and we should be very proud of the minister for bringing it to the parliament. Like the previous speaker, I am appalled that the opposition, the Liberal and National parties, are opposing this legislation. The bill seeks to focus and revitalise Australia’s preventive health capacity. It also extends the period of the agency’s strategy plan to cover a five-year rather than a three-year period and explicitly mentions programs related to obesity and to alcohol, tobacco and other substances of abuse as being included in the scope of social marketing campaigns to be undertaken by the agency.

In 2008 the government reached agreement with the states and territories through COAG, among other things making historic investments in Indigenous health but also in prevention, and part of the agreement in prevention was to create the agency and commit funding to it, with an investment of over $130 million for its establishment, preventive health research and social marketing campaigns. And it was not going to be just a poster and T-shirt campaign or another calendar; it was real substance by this government and by the COAG ministers.

Preventative health is an area to which this government has given the highest possible priority. The government has committed $872.1 million over six years from 2009-10 under the COAG National Partnership Agreement on Preventive Health. This is the largest single commitment to health promotion by an Australian government. There are a range of initiatives under the Preventative Health Strategy targeting the lifestyle risk factors of chronic disease, including: settings based interventions in preschools, schools, workplaces and communities to support behavioural changes in the social contexts of everyday lives, and focusing on poor nutrition, physical inactivity, smoking and excessive alcohol consumption, including the scourge of binge drinking, which probably every member has in their electorate; social marketing aimed at obesity and tobacco; and the enabling infrastructure, including the agency.

The agency is part of the government’s broader health reform agenda and was recommended in both the National Health and Hospitals Reform Commission’s report, released in July 2009, and in the final report of the Preventative Health Taskforce, released in September 2009, based on good solid work. In response, the government released Taking Preventative Action in May 2010, outlining the government’s preventive health initiatives. There is a rising incidence of chronic illness. Combine this with an ageing population and the sorts of lifestyles we have been leading, and we have a very explosive health situation, in terms of cost of dealing with illness, the hospital system and, in very personal terms, the impact that illness has on people’s lives in both cost and productivity.

This bill establishes national infrastructure to help drive major change in the way we deal with our health. Most people want to do something about their health, especially if it affects the way they look and feel. But the knowledge is just not there to develop a healthy and sustainable lifestyle. The National Preventative Health Taskforce stated that if obesity trends are left unchecked the life expectancy for Australian children alive today will fall by two years by the time they are just 20. The National Partnership Agreement on Preventive Health will invest $872 million for prevention, in particular with a large emphasis on tackling obesity through workplaces, local governments and programs targeted at children.

It will take all levels of government and all sorts of cross-agency programs to deliver this outcome. It is a great opportunity for our nation. We must ensure that Australia moves forward in health delivery. Success in changing lifestyles takes a long time, a systematic approach informed by the latest evidence and ongoing evaluation of results—getting away from the public relations exercise of the poster and T-shirt, as I mentioned earlier. It needs engagement, action and responsibility to be taken by individuals, families, communities, industries and businesses.

But we believe government can play a leadership role by gathering, analysing and disseminating the best available evidence and implementing programs and policies based on that evidence. We need to bring together the best experience in the country and we need to engage employers, businesses and the wider community in this preventative health debate. A new approach is needed. It needs to be the responsibility of everyone to ensure their families, their households and their communities are moving towards healthier outcomes. And it must include information. This must include clarifying what is contained in our processed food, so food labelling becomes vitally important. It also means that we need to know how our individual bodies work. Going to the doctor should not just be when you are sick; it should also be for advice when you are well, so he or she, the deliverer of primary health care, can ensure you stay well.

Some of the examples I have observed in my communities over the years have been working towards this. At a fun day some years ago at Rosebery, a mining town that is no longer in my electorate sadly, there were giveaway crib boxes full of healthy fresh food for the children to encourage sensible eating—fitting into their community life, as dad takes a crib off to the mine each day. It was very sensible and a very good initiative. Schools and the parents and friends organisations have been keen to improve and to provide healthy foods in canteens at schools for many years now. I am sure you, Madam Chair, would have been interested in that over the years. There should be plenty of choice of healthy foods available to encourage good eating, particularly in the teenage years.

We must start here. I noted that the Prime Minister participated in a walk to work to her office the other day. Maybe we should re-evaluate our hours of work in this place to allow more exercise and stimulation. Being in here at 7 am and leaving at 10.30 pm or later does not allow much attention to health issues! When I mention to people who have worked in the health sector—a few medicos and others in this area—they all agree that we are not setting a very good example. Available food in the building should indicate its food value so that we can make those good choices.

Local government needs to be encouraged to put value on such infrastructure as walking tracks, swimming pools and permanent exercise equipment—outside activities that encourage participation by both the fit and unfit. Local swimming pools must be upgraded or built in areas that do not have them already. It can be done in conjunction with schools or aged person facilities, or as part of local government activities programs. At the moment local government has no incentive to keep pools going for health outcomes. Yet a pool can be used as part of local competitive swimming early in morning, by the oldies for some healthy and warming activities during the day to overcome arthritis through movement programs, along with rehabilitation after accidents or operations, and then by youngsters for recreation and at other times for learn-to-swim or other activities. Swimming days can encourage the whole community to participate.

Talking of swimming pools, I had a meeting recently with a famous Australian, Shane Gould. She is an Olympic gold medallist who is now living in the good electorate of Lyons. She is doing some work on swimming pool use and design and the issue of people’s swimming activities. She said that we have to change the design of swimming pools to fit the needs of particular communities. Swimming pools are not just for people to swim up and down. Some of my community are also trying to deal with the costs of swimming pools. We need to find new business models so we can find ways to pay for our swimming activities.

All activities should be encouraged by putting more information on signage, like the lengths of walking tracks. I understand that, if you put a time on a walking track and where it goes to, 50 per cent more people will actually use that track because they feel comfortable about it. The degree of energy required to participate in the activity could also be included on signage. There is a whole range of things that we can put on interpretive signs within our communities. We also have to learn about how our bodies work under strain.

School sports and physical education should be put firmly back into the curriculum with resources to run them. Help for programs such as Little Athletics and swimming lessons may need to be reconsidered as well. We must encourage youngsters to join sporting clubs and participate in whole-of-club activities, with the less fit being encouraged to support their teams through important activities such as maintaining the scoreboard or equipment until they are fit enough to be involved.

I have mentioned food labelling as part of these comments, but we also need to look at food advertising under the truth-in-advertising legislation. We need to look at school vegetable gardens from kindergarten up—and the previous speaker mentioned the Stephanie Alexander program, which has been a great program for focusing on growing food and the nutritional value of that food. We also need to ensure that health and food education extends through the whole education process, much like literacy and numeracy do now. Then there is the slow food movement, which encourages us to know how what we eat affects us and to give ourselves time to prepare and eat healthy foods. We must not let this program become elitist. It must be affordable for everyone and must not impinge on the day-to-day budget. It must help change the way people use their food budget or their entertainment budget. Those are some of the goals and aims that can come out this movement.

I am very encouraged by this. For the first time since I have been in this parliament I have seen major change on really tackling health issues in a proper, constructive and strategic way. This is the biggest opportunity we have ever had to change the way we do things. Australians can lead the way in being responsible for our own health, so that we can cut down illness costs, both personally and to the community. It is the only way to do it and I fully support the intention of the bill. I look forward to supporting the bill when the vote comes on and I am extremely disappointed that the Liberal and National parties are opposing this bill. I think they are really failing the people of Australia.

6:20 pm

Photo of Steve GeorganasSteve Georganas (Hindmarsh, Australian Labor Party) Share this | | Hansard source

I too rise to support the Australian National Preventive Health Agency Bill 2010. Before I do so I would like to congratulate the member for Lyons on the well-presented views and thoughts he placed on the record in this place. Australians are living longer, and that is a good thing, but there are still too many among us dying before their time or growing old with chronic illnesses that quite simply can be prevented. We have a responsibility to use the knowledge we have gained through the best medical research from Australia and around the world and, in the case of preventable disease, to actually prevent it. I rise today to speak on this bill because it is a groundbreaking initiative to help make us a healthier nation.

We all grew up with the truism that an ounce of prevention is worth a pound of cure. We have all heard that, yet for too many years we have dealt with health issues after they have developed. The Australian National Preventive Health Agency, as the name suggests, is going to dramatically change that culture and address chronic preventable health problems before they start. The benefits of this approach are first and foremost about our health. But there are also economic benefits. A healthier nation, particularly a healthier ageing nation, is a good thing for the economy. People work longer, which makes them more productive and greater consumers. They require less medical assistance and less hospitalisation.


As Chair of the Standing Committee on Health and Ageing, I am very encouraged by this long, long overdue and welcome shift in our approach to preventive health care. The combination of an ageing population and a rise in the incidence of chronic illness makes this sort of approach essential to a healthier Australian population. It has been identified by many groups, such as the Health and Hospitals Reform Commission and the National Preventative Health Taskforce, and was a significant proposal to come out of the 2020 Summit.

We have some very obvious health issues relating to cigarettes, alcohol and obesity, to name just three. But despite their transparency, we are too often striving to fix a problem that should never have developed in the first place. Certain facts cannot be argued with or ignored. For example, a quarter of all cancer deaths in Australia are a product of smoking and alcohol abuse. Smoking leads to the premature deaths of hundreds of thousands of Australians. One in four Australians is at short-term risk through drinking and one in 10 at long-term risk. Again, Australia is one of the most obese nations on earth.

These are preventable problems, yet they cost this nation dearly on both a deeply personal and an economic level. Despite these facts, we currently spend less than two per cent of our annual health budget on preventive measures. When you consider that our preventive health problems add up to a lot more than two per cent of all health issues, that just does not make sense. It is not the right thing to do from a medical perspective, and it is certainly not sound economics. This bill addresses that anomaly with a commitment of well over $800 million towards preventive health care. It is a massive, unprecedented investment in Australia’s wellbeing.

Just as there has been a concerted and highly successful push to reduce smoking in this country, we need to deal with the problem of obesity. A report to the Standing Committee on Health and Ageing revealed that obesity cost the Australian economy almost $8 billion last year alone. Consider that fact from a purely economic standpoint—$8 billion. Obesity leads, as we heard earlier, to an increase in diabetes, cardiovascular disease and complications associated with surgery and other interventions. It affects people of all ages, it affects people of all ethnic backgrounds and it affects people in all socioeconomic areas, and it can be prevented.

Preventive health measures and their impact on the ageing have an even greater bearing on the people in the electorate I represent. Hindmarsh, in Adelaide’s west and south areas, is one of the oldest electorates in Australia, with more than 20 per cent of residents aged over 65. These are people who have worked hard all their lives to enjoy their retirement or to stay in the workforce longer, and preventive health reforms will help them achieve that. Many older Australians, in particular, suffer from illnesses and conditions that could and should have been prevented. They do not need to have a terminal condition for their quality of life to be severely affected or to be in a position where they can no longer walk or even have a part-time job.

The Gillard Labor government has made a genuine commitment to preventive health care. It is a major priority, and it is a major key focus of our reform agenda. For example, a national preventive health system will bring enormous advantages to Australia in the future and help develop a culture where people think about prevention first and cure second.

This bill has been rejected by the opposition, sad to say—it has already been rejected, in October of 2009. The opposition has also resisted the prevention of poor health that results as a direct consequence of the absence of adequate dental care. The opposition’s position of washing its hands of the onset of preventable conditions and the distress, decreased productivity and loss of freedom that comes from not having good health is sickeningly predictable and an affront to all Australians who value the wellbeing of our families, friends, neighbours and workmates.

The government has, over recent times, made unprecedented investments in infrastructure that will enable the Australian economy to grow with more strength well into the future. The government has also made unprecedented investments in our secondary and especially our primary education system, advancing all primary schools’ capital works programs in ways the schools thought would never, ever happen.

The government intends to similarly invest in Australians’ lives—in their wellbeing as maintained through good health and the avoidance of preventable disease. Any objection to such an objective—the pursuit and maintenance of the good health of our fellow citizens—should invoke the disgust of all of us and deserves our utter contempt. Nothing is clearer than the merits of avoiding problems before they occur. So, I commend the bill to the House.

6:28 pm

Photo of Warren SnowdonWarren Snowdon (Lingiari, Australian Labor Party, Minister for Defence Science and Personnel) Share this | | Hansard source

I am very pleased to be participating in this debate this afternoon on the Australian National Preventive Health Agency Bill 2010. The bill establishes, as we know, the Australian National Preventive Health Agency to support Australian health ministers in tackling the complex and growing challenges of preventable chronic disease. Others in this place have spoken about the construction of the agency. It has its origins in the report of the National Preventative Health Taskforce, which was a very worthwhile and detailed document. The taskforce outlined a comprehensive plan to advance the prevention agenda in Australia and identified that to address the disparity in sickness and death in the Indigenous population, in particular, we needed to focus on tobacco, alcohol and obesity.

I will talk about those two elements in a moment, but I just remind the House that the establishment of the agency was also a recommendation of the final report of the National Health and Hospitals Reform Commission, chaired by Dr Christine Bennett. I know that members on this side of the House read that report assiduously. Recommendation 9, which is significant, recommends the establishment of an independent national health promotion and prevention agency, and it says:

This agency would be responsible for national leadership on the Healthy Australia 2020 goals, as well as building the evidence base, capacity and infrastructure that is required so that prevention becomes the platform of healthy communities and is integrated into all aspects of our health care system.

I want to speak briefly about some elements that were identified by the National Preventative Health Taskforce and I want to illustrate why it is so important that health prevention is given the priority that this government seeks to give it. The first element is that we now know that smoking continues to be Australia’s largest preventable cause of death and disease. The National Preventative Health Taskforce report identifies that smoking is the cause of 20 per cent of all deaths and is the major single contributor to ill health amongst Aboriginal and Torres Strait Islander people. Amongst Aboriginal and Torres Strait Islander people generally, smoking rates are about 50 per cent. For the non-Aboriginal and Torres Strait Islander population, smoking rates are about 16 per cent. There are smoking rates of up to 83 per cent recorded in some communities.

Under the COAG National Partnership Agreement on Indigenous health outcomes, the Commonwealth is already providing $100.6 million directly for the Tackling Smoking measure. This includes the establishment of a new workforce of regional tobacco coordinators and tobacco action workers led by Mr Tom Calma. This shows what is required to prevent tobacco consumption. The new tobacco workforce will work directly with Aboriginal and Torres Strait Islander communities on healthy lifestyle development and quitting smoking.

Alcohol was another significant issue that was raised by the taskforce. I will not go into detail because the time for debate is about to elapse, but I want to make sure that people understand that the Commonwealth government recognises the importance of investing resources into addressing alcohol misuse because of its impact on Aboriginal and Torres Strait Islander health outcomes. We are investing $164.7 million over six years to increase treatment and rehabilitation services, $22.3 million for local capacity building pilot programs and $2.5 million for foetal alcohol spectrum disorders. In addition, 120 Aboriginal and Torres Strait Islander substance abuse services across Australia are being supported under the Australian government’s Aboriginal and Torres Strait Islander substance misuse program.

I conclude by saying that there are other areas where communities have shown the way in prevention and I want to pinpoint one. The community of Amata in the north-west of South Australia made a decision that its store should no longer stock drinks with high sugar content. As a result, there has been a reduction in sugar consumption in that community alone of 4.3 tonnes. This is a really important example of how communities, if they are aware of what is required, can take the sort of action that is needed to address issues relating to prevention. By doing so, they can have a direct impact on the early onset of diabetes, and in the longer term these communities can address the issue of life expectancy, which is the issue we are focused on.

This is a very important piece of legislation. It again highlights the reformist attitude of this government in the health field. I hope that the opposition will not do as they have done previously and oppose this legislation. It is for the benefit of all Australians. I hope the opposition will see the merits of this legislation and support the government in its endeavour to make prevention a priority for all Australians.

6:35 pm

Photo of Nicola RoxonNicola Roxon (Gellibrand, Australian Labor Party, Minister for Health and Ageing) Share this | | Hansard source

in reply—It gives me great pleasure to briefly sum up on the Australian National Preventive Health Agency Bill 2010. I understand that it is the intention of the opposition to move a number of amendments to this bill. I will sum up this debate by first quoting Michael Moore, the CEO of the Public Health Association, who earlier this year referred to this legislation in the following terms:

This is vital legislation for anyone who is serious about keeping all Australians healthy and particularly the most vulnerable of our people.

This is a very important and timely reminder. I think the Minister for Indigenous Health touched on the potential for an agency to drive these sorts of reforms and deliver to the community. I noted the comments from many speakers on this bill and I want to thank the large number of people who spoke on it. It is clearly an issue that many people are passionate about. I know that the shadow minister spoke passionately about the need for more investment in prevention. We do not totally agree on the best ways to do that, but I do not doubt that people are determined to try to make a difference.

Unfortunately, the approach of the opposition to date has meant that an agency that would have been focusing Australia’s attention on prevention from 1 January this year has been delayed. We hope that it will not be delayed again when there are so many opportunities for us to be able to invest in sensible initiatives in the areas of obesity, alcohol and tobacco. Of course, there is the potential for the agency to grow over time and invest in many other preventative health measures. Dr Andrew Pesce from the AMA has said that this would:

… put momentum back into the prevention focus in Australia.

These sorts of endorsements are important ones, because the opposition want to paint this as a frolic by the government or as the government being interested just in establishing a new bureaucracy, for the hell of it. In fact, nothing could be further from the truth. We believe this is a way of establishing an independent agency, separate from government, with its own budget to be able to drive important public health messages in partnership and collaboration with government, non-government organisations, consumers, industry and public health organisations.

We would like to thank the many people across the community who have worked with us to try and see this agency become a reality: the Public Health Association in particular, the Cancer Council, the Heart Foundation, VicHealth, Quit Victoria and the AMA—just to name a few who have been very supportive of the establishment of this agency. The non-government sector really have shown leadership in health prevention to governments of all persuasions and I want to pay tribute to their work.

Finally, I thank the many members who have made contributions in this debate. I hope that in this place today we will be able to say that two important pieces of health reform legislation were passed. Of course, this House passed the first piece of health reform legislation earlier today, establishing the Commission on Safety and Quality in Health Care. We hope the House will see good sense on this and be in that happy place again. In the spirit of working together in this new parliament, I indicate for the benefit of members that we intend to, and are prepared to, accept a number of amendments that have been put forward by the opposition. However we do not intend to accept all of them. I have had those discussions with the shadow minister. He is determined to put each of those amendments, as is his right, and we will speak briefly to those as they are moved. I commend the bill to the House.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.