Joe Ludwig (Queensland, Australian Labor Party) Share this | Hansard source

I too rise to speak against the Australian National Preventative Health Agency (Abolition) Bill 2014. In many ways this bill represents the absolute worst excesses of this government's pig-headedness and short-termism. It represents their complete lack of understanding not only of the needs of the community but also of sensible economics and healthcare concerns. We have already seen brutal cuts to health delivered in the May budget. Despite the Prime Minister's promises before the election, the truth has become evident. There were cuts to health in the budget, just as there have been cuts to education. His promises have been found to be hollow—and this bill is just another dreadful example of this Prime Minister's crass untruths to the Australian people prior to the election.

Universal access to healthcare means that people can seek and receive treatment when they are ill, not just when they can afford it. The Preventative Health Agency is about getting in front of the nation's healthcare problems before they pose a massive economic and social drag on the whole system. Abolishing the National Preventative Health Agency will tear more than $360 million from programs that were tackling obesity, increasing physical activity and improving healthy eating for adults and children around Australia. Labor increased investment in preventative health. Preventative health relieves the pressure on our health and hospital network and it builds healthy communities. The National Partnership Agreement on Preventative Health was an agreement with states and territories to fund critical programs for adults and children, with reward funding provided for achieving targets on health improvements.

When you go back and look at the primary documents that established the agency, you see that they were effectively a watershed period in healthcare. They looked at the science and the research about how you drive the curve downwards—in other words, how you drive preventative health outcomes into healthcare so you can reduce the negative health outcomes. Australia: the healthiest country by 2020National preventative health strategy brings forward the real watershed and why this bill should be abolished and why the agency should continue to do its work, and I quote:

Obesity, tobacco use and alcohol consumption feature in the top seven preventable risk factors that influence the burden of disease, with over 7% of the total burden being attributed to each of obesity and smoking, and more than 3% attributed to the harmful effects of alcohol. Along with a range of other risk factors, and accounting for their interactions, approximately 32% of Australia’s total burden of disease can be attributed to modifiable risk factors.

In short, modifiable risk factors relate to things that individuals can do to prevent risks down the track. But what this government want to do is shunt it down the track. They do not want to have an agency playing a coordinating role to prevent negative health outcomes.

This bill will repeal the National Preventative Health Agency Act. The aim is to abolish the National Preventative Health Agency. This is a government that is wedded to abolition. It is wedded to repeal. It even had, oddly enough, an omnibus bill that just abolished things today. It is not a building government. It is not a supporting government. It is not an outcomes focused government. It is not even a performance government. This is a government that can only tear things down. The National Preventative Health Agency was established by Labor in 2011. And that seems to be the only reason that the government want to tear it down—because Labor supported the agency. The evidence is there to support the agency, but this government only want to tear things down.

This agency was established to lead in preventative health for Australia. It has been playing a pivotal role in tackling the health sector to ensure that we establish preventative health as central to the delivery of healthcare. It has been working with Medicare Locals to ensure that there is a heightened awareness of the value of prevention in health services delivery. It has been long recognised that there is a significant benefit in focusing on prevention. That is why Labor established a dedicated agency to drive the agenda for the long term—not the short term as with this coalition government—in order to drive positive changes in the rate of obesity and the levels of tobacco and alcohol use. It is imperative that we have a dedicated agency tasked with the role of working with the likes of the National Heart Foundation, the Public Health Association and the Royal Australasian College of Physicians.

This side of politics does not support a callous cut such as this. I have seen over the last couple of months some pretty horrendous and callous cuts by the coalition government—making sure that public servants do not have a future in the Public Service and making sure that they foist their awful policies on the Australian people—but this is one of the most callous cuts I have seen. It attacks children, communities and families. This callous cut is about putting the emphasis on the wrong side of the equation. This strikes at the very core of how a proper healthcare system would work.

Prevention is plain common sense. I make the mistake of thinking that the coalition would have even an ounce of common sense when it comes to the health of Australians. The government think that it is cheaper to simply cut programs than support prevention. They have shifted the burden down the track without a strong preventative agency. All that will happen is that the health system will keep having larger and larger demands placed on it and no strategic way of mitigating that demand. The agency was established to address the challenges in the health system and was recommended by experts who were part of the National Preventative Health Taskforce. So this is also a government that has a tin ear. It does not even want to listen to experts in the health system. It wants to close its ears and hide behind the phrase, 'We can't afford it—we can't afford this; we can't afford that.' You will not be able to afford a healthcare system if you do not put in place preventative healthcare outcomes for the Australian people. The agency was established to address the challenges in the health system and, as I said, it was recommended by experts who were part of the National Preventative Health Taskforce.

It seems that the government does not see the growth in lifestyle related chronic diseases such as type II diabetes and the contribution of modifiable risk factors such as smoking, diet and alcohol consumption, which have prompted calls for stronger national action on disease prevention and health promotion. The major report since 2009 supports this call for a greater focus on preventative health efforts—the sensible direction. I ask too much of the coalition when I say 'sensible'. The sensible direction is to support this agency. It is clear that a greater focus on preventative health will reduce healthcare costs.

Unsurprisingly, the Senate majority report found in favour of the abolition. Labor cogently argued in the dissenting report as to why this bill should not pass. Essentially, the argument by the government is that the government is satisfied that the transfer of the agency's roles and responsibilities to the department should not result in any diminution of the commitment to preventative health programs and policies. I will say that again: they argued that it would not result in any diminution of the commitment. So they are only going to support a commitment; they are not going to put it into an agency which will coordinate the action. These are hollow words by hollow people. It is a weak and equivocal statement. The emphasis here is on 'should not'. The committee has taken the view of the minister rather than look at the evidence. The phrase amounts to weasel words by the coalition. The department should not result. They cannot even categorically say 'will not' or 'shall not'. They hide behind the word 'should'. It is not surprising, unfortunately.

I do remain confident that, without coordinated action led by this agency, preventable disease will continue to rise. This shift is most noticeable in health where the government is ripping billions of dollars out of the healthcare system. It is not only on one side of the equation—that is, on the preventative health side. They are ultimately saying, 'We'll take it out of an agency that coordinates the action, can work with the states and territories and can do more than simply lead; it can coordinate and influence prevention programs on the market for individuals to take up.' They then said, 'We'll drag that agency out and trash it and the department can continue to do those functions.' More weasel words, quite frankly: 'the department can continue to do those functions'. Where in the department are they going to put them? Are they going to ensure the department has the resources to be able to undertake that work, lead and coordinate? It has not been able to do it until now, and that is why we had those significant reports in 2009 which pointed to the establishment of a body that could take the role, independent of government, to drive outcomes. We know that if you drive outcomes you will get results.

If you look at the work done by the committee, they said:

Embedding prevention and early intervention

Among health commentators, it is almost axiomatic to say that we have an excellent ‘sickness’ system, but not a system focused on keeping us healthy.

They went on to say:

The availability of preventative interventions, the change in disease patterns, and the ability and support available to introduce and persist with prevention makes this aspect of care a ‘no-brainer’.

The coalition have topped that. They do not have a brain. To take this action and do this work, everyone except the coalition accepts that it is a no-brainer. But on the other side of politics, they have suffered the worst of all fates: not only have they left their brains behind the door when they came in here, because they are going to vote for the abolition of this, but they will have to wear the phrase. And many on the other side could also help with undertaking preventive health care work. Otherwise, they also will be a drag on health care into the future.

The real question for us is: what action can we put forward? The task force said the first thing we should do given the systemic failures of the system up until then to bring coordinated effective action is to create a new Australian health promotion and prevention agency. That was the first thing that they proposed. This idea, which was also recommended by the National Preventative Health Taskforce, has already been partially picked up in the new National Partnership Agreement on Preventive Health and was included in the Commonwealth government's 2009-10 budget. They said it was a good start, but only a start. And what we have here today is the coalition taking that start away completely. So we are not even going a couple of paces forward and a couple of paces back; in this instance we are going right back to the start with the abolition of this agency. It is short-term and it is short-sighted.

Recently I was able to look at some of the work done by the Labor government when it was in office. I was able to tour the Logan Hospital with the Deputy Leader of the Opposition, Tanya Plibersek, and local MP Jim Chalmers. I thank the Logan Hospital for allowing us to tour the premises. We spoke to health workers there who are suffering from not only the stresses and strains of the hugely important job of serving the community but also the rolling cuts by the governments led by Mr Campbell Newman and Mr Tony Abbott. They are battling against arrogant and out-of-touch governments that know the cost of everything and the value of absolutely nothing, particularly when it comes to health care.

Since the Newman government was elected in March 2012 there have been 4,379 full-time equivalent jobs lost from Queensland Health. In the metro health area, which includes Beaudesert Hospital, Logan Hospital and Princess Alexandra Hospital, the Newman government was cutting staff. They were also cutting funding. So what we have is a real twin-barrel shotgun by the coalition. They have taken away preventive health and they have also cut health and hospital funding in the order of $80 billion—out of education and health. They have implemented the broken promise of a new $7 GP tax—so they have whacked the patients. But they have done worse than this. You would not imagine that you could do worse than knocking away prevention funding, dragging health funding down and cutting staff. But in this instance there is more. What the Prime Minister wanted to do was force hospitals to tax you if you ended up in an emergency department. What the states have been doing in response is to draw their funding out of preventive health and leave it to the Commonwealth to fill the gap. But the Commonwealth in this instance is not filling the gap whatsoever.

So what we have between the twin storms of these two governments is a complete diminution of our health and hospital system. It is being exacerbated by the work of the coalition federally. The abolition of the Australian National Preventive Health Agency is axiomatic of this government: it does not care one jot for individuals, communities and people who rely on our healthcare system. The coalition government is only interested in saying: 'We want individuals to support themselves in the community and pay for their own health and hospital outcomes. We want to line the pockets of big companies. What we don't want to do is ensure that there is a direct line to hospitals for communities to ensure that they can have positive outcomes.'

The removal of the Australian National Preventive Health Agency is one of the dreadful things that this coalition government is doing. It stands as a stark reminder for all to see how this government acts, how it can simply abolish an agency that is about improving healthcare outcomes for individuals.