Thursday, 30 March 2006
Cancer Australia Bill 2006
That this bill be now read a second time.
I seek leave to have the second reading speech incorporated in Hansard.
The speech read as follows—
The establishment of Cancer Australia as a new national agency delivers on the Government’s 2004 election commitment. The Government will provide a total of $13.7 million over five years to establish this new agency.
It will be an umbrella organisation to various cancer groups to provide leadership and vision, support to consumers and health professionals and make recommendations to the government about cancer policy and priorities. This should mean more research funding for cancer care, better support for those living with cancer, strengthened palliative care services, guidance in improvements in the prevention of cancer and better support for cancer professionals.
In addition, Cancer Australia will have a role in the implementation of the following initiatives as part of Strengthening Cancer Care:
- New approaches to mentoring regional cancer services;
- A grants process targeted at building cancer support groups;
- A national awareness campaign for skin cancer, to be developed in conjunction with State and Territory Governments;
- A new dedicated budget for research into cancer, to be administered in conjunction with the National Health and Medical Research Council; and
- Funding for Clinical Trials infrastructure for cancer patients.
Cancer Australia is being established in consultation with national and state cancer councils, other cancer organisations and people living with cancer. The national priorities and strategies for the development of Cancer Australia came from a workshop of key cancer stakeholders in March 2005. Cancer organisations have shown strong support for the development of Cancer Australia, to increase collaboration and reduce duplication in cancer control.
This bill establishes Cancer Australia as a new statutory agency. It outlines the functions of Cancer Australia and includes the terms of appointment and roles of the CEO, support staff and the Advisory Council.
The new agency will comprise a Chief Executive Officer (CEO), Advisory Council and support staff. The CEO will head the agency and will report to the Minister for Health and Ageing. The Advisory Council will be advisory to the CEO and will consist of a Chair and a maximum of 12 other members.
The Chair of the Advisory Council Dr Bill Glasson, former President of the Australian Medical Association (AMA) 2003-2005, has been appointed. The position of CEO has been advertised nationally with applications closing in February 2006.
In addition to government funding, it is expected that Cancer Australia will seek funding from other sources, particularly from the private sector.
An important first step in developing Cancer Australia’s role will be to map the current roles and responsibilities in cancer policy and determine future roles.
I look forward to Cancer Australia making an important contribution to improving Cancer Care in Australia in the years ahead.
It is ironic that here we are on the last day of the autumn sitting scrabbling to pass the Cancer Australia Bill 2006, a bill that we have been waiting for for more than 12 months. It was in September 2004 when the Howard government, pushed into action by the success of Labor’s cancer policy announcements, finally put out their cancer policy with the establishment of Cancer Australia as its centre. But, since then, nothing has happened except for the announcement last year that Dr Bill Glasson has been selected to chair Cancer Australia and, finally and belatedly, the far more recent announcement of the remainder of the advisory committee members. Even now with the final enactment of this piece of legislation we will not see this body up and running inside two years since it was first promised. That means that many other election commitments on cancer made at that time have not been fully implemented because they are contingent on the establishment of this authority.
Labor’s inquiries at Senate estimates, through the Parliamentary Library and questions on notice have failed to elicit any real information about the state of implementation and the reason for the delays. In fact I asked through questions on notice, on 10 October last year, a series of very straightforward questions about cancer, including: where is the establishment of Cancer Australia up to; when will this body be set up—very straightforward questions—how many additional undergraduate places for radiation therapists were provided in 2005-06; and what is the current state of development and implementation of the continuing professional education modules for cancer professionals? They were extremely straightforward questions. Why has it taken since 10 October last year to the end of March to answer these very simple questions?
In the lead-up to making this contribution this evening, I thought it would be timely to ring the minister’s office to actually find out and advise him, as I did this morning, that I would make mention of this fact today. I can report to the Senate that earlier this afternoon my office received a call from Minister Abbott’s office to say that he has apparently signed the answer to that question, for which I am pleased, but I continue to wait to receive a copy of the answer. We need more than non responses to questions to understand why it has been so slow for the minister for health to enact, firstly, Cancer Australia and, secondly, the commitments that are attached to it.
This bill is to establish, as I said, Cancer Australia as a statutory agency. Cancer Australia will provide national leadership and coordination of cancer control in Australia, guide improvements to cancer prevention and care, and ensure treatment is scientifically based. It will coordinate and liaise between the wide range of groups and providers with an interest in cancer, make recommendations to the Australian government about a cancer policy and priorities, and oversee a dedicated budget for research into cancer. It will assist with the implementation of Australian government policies and programs in cancer control and undertake any functions that the minister, by writing, directs the chief executive officer to perform.
The stated aim is to provide a national voice with more research funding for cancer care, better support for those people living with cancer and strengthened palliative care services and better support for cancer professionals. The bill outlines the responsibilities and conditions of employment of the CEO and allows for the appointment of a chair and up to 12 other members of an advisory council. I must say that it is intriguing to note that the bill provides no criteria for the expertise of these members. This is surely a surprising oversight, given the important and sometimes technical work which Cancer Australia will have to perform and the imperative that a range of perspectives, including those of cancer patients, are represented on the council.
While it is hard to fault the qualifications of the people who have ultimately been named to the initial advisory council, we are entitled to expect that there is some prescription about the qualifications of those who have been appointed. In particular it is, in our view, a serious oversight that there is no specific requirement that cancer patients and consumers are represented. That is why I indicate at this point that Labor will be supporting amendment (3) of the tranche of amendments which are being proposed by the Democrats to resolve that issue.
The government initially committed a total of $13.7 million over four years to 2007-08 to establish this new agency. Due to delays, this funding has been rephased over four years to 2008-09. However, it is unlikely that the $4.546 million allocated to 2005-06 will actually be spent this financial year. I should comment also that there is some concern about this statement in the minister’s second reading speech:
In addition to government funding, it is expected that Cancer Australia will seek funding from other sources, particularly from the private sector.
Does this mean that the Howard government is not going to provide Cancer Australia with all the funds needed for this important policy work? Does it mean that a national government agency will be engaged in fundraising activities, using government funds to compete against not-for-profit community groups and non-government bodies for donations to cancer work? I hope the minister will use his response to clarify that position.
During the 2004 election campaign, two days after the release of Labor’s well-received cancer policy, the Howard government announced their Strengthening Cancer Care policy. Cancer Australia is a key plank of that policy. Cancer groups around Australia greeted this with reserved enthusiasm, which has diminished with the increasing delays in its implementation. The Cancer Council Australia, the National Cancer Control Initiative and the Clinical Oncological Society of Australia said in their joint submission to the recent Senate Community Affairs References Committee inquiry into cancer services:
There is great potential for reforming cancer services in Australia to better meet the needs of the individual patient, their carer and family. … the forthcoming establishment of the Federal Government’s new national cancer agency, Cancer Australia, could provide an authority for its implementation; and existing clinical practice guidelines, if adopted nationally, provide best practice protocols.
The mismanagement and absolute incompetence dashes the hopes of cancer patients, researchers, policy makers, health care professionals and the cancer councils and community groups for a coordinated and reinvigorated approach to cancer policy and funding priorities. It has also meant the untimely demise of the National Cancer Control Initiative.
The NCCI was the key expert reference group on cancer, set up to advise the federal government on all aspects of prevention, detection, treatment and palliation. It was proposed that the NCCI would be subsumed into the new Cancer Australia, and the NCCI had begun the essential task of developing initial priorities for the new body. However, the NCCI was provided with no further funds, and the last head of it, Professor Mark Elwood, was forced to send a letter to key constituents and supporters outlining the dilemma confronting the organisation and its staff. Many have left and all will leave in May.
Along with failing to deliver on Cancer Australia, Minister Abbott has retreated on the promise of a national screening program for bowel cancer. At election time the minister was promising that all older Australians—that is, over 55—would be screened every two years for bowel cancer and acknowledging that, every week, 90 people die from bowel cancer. That promise was dumped at budget time, and what was billed as ‘a major priority for the next term’ became a continuation of the current trials, not due to start until July 2006. But even this date is in doubt, as the states and territories are expressing concerns about the fact that significant funding, management and operational issues are still to be resolved.
The Australian Health Ministers Advisory Council met in February and they wanted answers about a whole host of issues. Unfortunately they found those answers were not forthcoming. The states and territories are concerned that the bowel cancer screening program has no clear set of objectives and strategies, has no clear specification of roles and will add additional cost burdens to the states. They are concerned that it has not addressed the need for affordable access to colonoscopy and it has no information and database management systems. Their concerns include that it has no clear funding arrangements between the states and the federal government and has no communication program to educate health professionals and consumers. They claim the whole program, a very important program for the health of all Australians, is at significant risk of failure.
But unfortunately there is more. Parliamentary Secretary Pyne’s only effort to deliver the promised program to help pregnant women quit smoking, which was also an election commitment, has been a media statement issued in June last year about an advisory group, which has yet to be announced and has yet to meet. About 20 per cent of pregnant women smoke, and babies of smoking mothers are more likely to be smaller, are three to four times more likely to die of sudden infant death syndrome and are more likely to suffer respiratory disorders and intellectual impairment. With such a large body of research showing that parental smoking has a serious impact on the health of babies, there can be no justification for delay on implementing this commitment.
I note that the second reading speech states:
… Cancer Australia will have a role in the implementation of the following initiatives as part of Strengthening Cancer Care:
- New approaches to mentoring regional cancer services;
- A grants process targeted at building cancer support groups;
- A national awareness campaign for skin cancer …
- A new dedicated budget for research into cancer … and
- Funding for Clinical Trials infrastructure …
I think we can be pretty sure that these election commitments are not up and running yet. The Howard government’s election commitments on cancer have been exposed as a sham. Mr Abbott has broken yet another election commitment in health. Australian cancer patients, their families and their treatment deserve better than this delay and incompetence.
In December of last year we all mourned the sad and untimely death from cancer of our friend former Senator Peter Cook. We all acknowledged his important last legacy in the recommendations contained in the Senate committee report, Cancer journey: informing choice. This report contained a raft of recommendations which, if implemented, could improve cancer care. The report deserves not just a detailed response but an expeditious one. In particular, the recommendation that requires us to establish a new Medicare item so that every cancer patient can have a multidisciplinary plan developed for them is a crucially important thing to do. This was Peter’s lesson to us, this was his experience and he was in a position to push it, unlike many others, and he has acknowledged that. We need to ensure that all Australians benefit from this, that doctors and health professionals work together and that we get a team approach.
Unfortunately, we are still waiting for the response to that report. Minister Abbot regularly pats himself on the back about his commitment to cancer but it seems that his commitment and enthusiasm do not extend to releasing the government’s response to that report, which has been on his desk since last July.
Labor supports this bill to establish Cancer Australia and in doing so we will also highlight the government’s failure to fully implement a raft of election commitments to prevent cancer and to improve cancer care. This is not a government which can lay claim to any real commitment to improving cancer care in Australia, and thousands of Australians will suffer unnecessarily as a result.
The incorporated speech read as follows—
The Cancer Australia Bill is designed to establish Cancer Australia which is to be a statutory agency based within the Health and Ageing Portfolio. The government first announced the intention to set up this organisation back in 2004 as part of its Strengthening Cancer Care election policy.
Cancer Australia’s main functions are to improve coordination within the cancer sector; to guide scientific improvements to cancer prevention, treatment and care; to coordinate and liaise between the groups and health care providers with an interest in cancer; to make recommendations to the Commonwealth Government about cancer policy and priorities; to oversee a dedicated budget for research into cancer; to assist with the implementation of Commonwealth Government policies and programs in cancer control; to provide financial assistance, out of money appropriated by the Parliament, for research and for the implementation of policies and programs in cancer control; and for other functions as directed by the Minister.
The Greens are broadly supportive of this move to set up Cancer Australia, and in particular would like to encourage this Government to further develop programs such as this that focus on preventative healthcare, which is central to The Greens approach to health.
The Greens strongly advocate a preventative approach to healthcare because it helps people to stay well rather than just treating people when they get sick. Preventative health care delivered at a community level is the best investment we can make in the health of this nation. And it makes both medical and economic sense.
From time to time this government makes claims that it is increasing emphasis and resources in the area of preventative health care. However its attitude to universally accessible Medicare over recent years has undermined much of this good work. This government’s move to a two-tiered healthcare system that is based on a private system for the wealthy and a public system for everyone else is the wrong direction. The Australian Greens believe that access to a bulk billing doctor is a fundamental preventative health care measure.
The Howard government’s unsteady approach to preventative healthcare is further illustrated by the blight of tobacco-related illness. As a major cause of cancer, tobacco and its advertising remains an area where this government has fallen well short of the mark.
While The Greens are pleased with the roll out of the new health warnings on tobacco products we are concerned that manufacturers and retailers are doing what they can to shirk their responsibilities. Anne Jones from Action on Smoking and Health Australia or ASH points out that:
“Stockpiling by tobacco retailers and peel-off health warnings are two of the tactics being used to delay smokers and potential smokers (ie children) access to the new, graphic health warnings on all tobacco products”
ASH recently conducted spot checks on around 50 tobacco retailers in Sydney in the first 15 days of March and found that:
“The new health warnings were yet to appear on tobacco products—suggesting stockpiling of old stock—as graphic health warnings are required by law to be on all tobacco products produced from the 1st of March.”
A trend being followed by cigarette retailers to re-package cigarettes in tins that don’t require a health warning is another way in which display of these health warnings is being avoided. One major brand is packaging its co-called soft-packs inside popular black metal tins with health-warning labels that are very easy to peel off. Similarly some Sydney Hotels are selling cigarettes in tins that only feature the Hotel logo in a deliberate tactic according to ASH to cover up the new warnings.
People question the strength of the government’s commitment to reduce lung cancer when they look at the ongoing flow of political donations from tobacco companies to Labor, Liberal and the Nationals. Last year nearly $170,000 flowed to the Coalition from Phillip Morris Ltd who has Nick Greiner on the board and British American Tobacco. The obvious question people ask is “What do they get in return?”
Another preventative healthcare area where this government is falling short of their responsibility is the pressing issue of childhood obesity. Approximately 1 in 6 Australian children are now considered overweight. Childhood obesity leads to higher incidence of diabetes, heart disease, kidney disease and bowel cancer. Experts from the Australian Medical Association have recently expressed concern that the rise in childhood obesity may, for the first time in Australian history, result in a decline in the life expectancy of newborn children.
Concern with the level of junk food consumption, and in particular, the way that it is marketed to children, has been expressed by the Australian Medical Association, the Australian Dental Association and the Royal Australian College of General Practitioners. Even the former Minister for Children, Larry Anthony, referred to the need to consider tougher regulations on junk food advertising.
In a recent survey of over 1600 Australians, 86 per cent of respondents agreed with the statement that there should be more limits on advertising to children. Despite the widespread support for restrictions of junk food advertising from peak medical bodies and the overwhelming public support for such restrictions, there has been no indication that the Howard Government is willing to address this problem. They have so far lacked the political will to stand up to the manufacturers and advertisers of junk food and the television stations who broadcast such advertisements. It appears that pandering to pleas of the Coalition’s ideological brothers-in-arms is more important than listening to overwhelming public and expert opinion about what needs to be done for the health of Australian children.
And there are others areas that The Greens believe could do with an added dose of preventative care from this government. A vibrant nationally funded public dental scheme would allow lower and middle income Australians access to dental services. Because a regular checkup at the dentist for preventive maintenance is out of financial reach, many Australians now only see a dentist when expensive emergency work is required.
The same situation can be seen in the area of mental health, where early intervention is the key preventative mechanism to avoid a lifetime of mental health problems in later life. As I have said in this chamber before, the Howard government and other governments simply do not give mental health care services the priority they deserve, and this is well illustrated by the fact that Australia spends only seven per cent of its health budget on mental health issues while the OECD average is 12 per cent. The Greens yet again call on the government to take further action in this area, and in particular support additional resources for community based mental health care centres. We look forward to the report from the Senate Select Committee on Mental Health, and we hope that the government considers the committee’s recommendations positively.
Indigenous Health is yet another area of healthcare that requires significantly more federal resources and a good dose of preventative medicine. So many of the medical problems faced by the first Australians will be most effectively dealt with using preventative approaches based on poverty alleviation and community education. There is simply no reason anyone in a rich country like Australia in the 21st century should be living with the scourge of preventable 19th century illness such as rheumatic heart disease.
This leads me to my final point which is that The Greens believe one of the most all encompassing preventative health measures with significant benefits to both mental and physical health is based on the protection of our environment. The protection of our forests, our waterways and our oceans, the reduction of pollution and prevention of chemical exposure, and ensuring the purity of our food supplies are just some of the paramount preventative health measures that The Greens will continue to work towards for the benefit of all Australians.
I endorse fully the comments made by Senator McLucas in relation to the Cancer Australia Bill 2006. I have had cancer and that, as it will become clear during my contribution, is why I am making this contribution this evening. Like a number of cancer sufferers—and my colleague here, Senator Moore, has also been through the journey—I am quite reluctant to talk about what I have been through. I was diagnosed with cancer three months after I came here. That was not good considering that I had decided, and so had my party, that I had some contribution to make to this place. I went through the journey of the chemotherapy, the radiation and all that that entails. I got very sick at one point. I spent about two weeks in the palliative care ward at Nepean Hospital, which one would call the dispatch rooms. It is not much fun being in that area when people are dying around you and you are hoping you are not going to join them—I can tell you.
I got through that with the support of my family, friends and colleagues and my faith. I got very ill again in 2003. I had to go through a probably unnecessary preselection, but that was a bit of bloody-mindedness by the leadership of my faction in New South Wales. When I first got diagnosed I had to get a letter from my surgeon to say that I was going to live, because there was a lot of quiet agitation within the ranks of some of the right of the New South Wales branch about the pending vacancy. So, unlike probably most of the people in this chamber, I have a letter to say that I am going to live. I have it framed in my office so everybody can see it when they come in.
During the last week of parliament in 2004 I was seriously ill again and was not able to make parliament. Last year I was out of action for some time. I had five operations last year. The first was in February, which was about 10 hours; there were three minor ones that were only for a few hours; and then I had another one in November which went for about 9½ hours.
As I said, I have been reluctant to talk about my illness because, as cancer sufferers will tell you, it is pretty much a private thing. While I was recovering I was looking at the Sunday Telegraph of 18 December last year in which there was an article by Paul Dyer titled ‘MPs working less.’ I read the article. This particular journalist slags off a number of colleagues. In particular, he says:
Senators and MPs can be granted leave for illness, family reasons or if they are on parliamentary business.
But federal politicians are not granted leave for other absences, such as holidays or campaign work.
The figures show 40 senators missed sitting days without being granted leave, amassing a total of 96 days off.
NSW Senator Steve Hutchins missed 11 days without leave. He also had 11 days off with leave granted.
The first time I rang the journalist I was quite angry about it and I explained to him what I have just explained to you, Mr Acting Deputy President—on five occasions I was operated on and I was probably in hospital for at least two months last year. I explained this to Mr Dyer and I asked him if he would not mind clarifying it in the next edition of the Sunday Telegraph. The Sunday Telegraph came out on Christmas Day and has come out ever since and neither Mr Dyer nor the Sunday Telegraph have sought to clarify why I was absent from parliament. I have to go and get operated on again next Thursday. I can handle that and I am not worried about that. But if I am absent it will be because of illness, not because I am malingering or bludging somewhere.
As a cancer sufferer and a survivor, I want to comment on some of the things that cancer sufferers and survivors go through. If you have ever been to the cancer care units where you get the chemotherapy and the radiation therapy, you can see in a lot of people’s eyes whether they have surrendered or not. Some of them look quite healthy, active and prepared. They do not look ill at all but you can see in their eyes that they have surrendered. In a number of people’s eyes you can also see the anguish and the anxiety about what is going to happen next: ‘Am I about to depart?’ Unfortunately, people in that predicament—and I never felt that I was in that predicament—look for alternatives and quick fixes.
I spoke to my surgeon yesterday because I am going to see him again next Thursday, as I said. I’ll only see him briefly before he knocks me out! I asked Professor Cartmill about complementary and alternative medicines and he said to me that complementary treatments are used with conventional medicine—and this is my interpretation—whereas alternative treatments can and have been used instead of conventional medicine. That is probably the difference between complementary and alternative medicines. There have been plenty of examples over the last 30 years where people have had quick fixes offered to them and have grasped them.
The other thing that Professor Cartmill said to me was that the other test should be how expensive some of these CAMs are. You can look at the history of the last 30 years. In Queensland there was Milan Brych, who was offering all sorts of cures. In fact, he went from Auckland to the Cook Islands and ended up in Queensland. Joh Bjelke-Petersen wanted him to set up a clinic there. It was only the heroic efforts of the Liberal leader and Minister for Health, Sir Llew Edwards, that prevented Milan Brych getting started up there. He ended up in jail in 1993 in California. There was recently a veterinary surgeon called Ian Gawler who claimed that cancer could be cured through meditation and the adoption of a variety of diets and herbal treatments, including coffee enemas. This was proven to be of dubious nutritional value and has not gone anywhere.
There is a drug called laetrile that is apparently an extract of apricot pips. It has been banned in the US because it is of no value at all. In fact, it is regarded as dangerous, but laetrile clinics have been set up in Mexico and people go over there. There has been a view that shark cartilage can be a cure for cancer because, it is alleged, sharks do not get cancer—but I understand that sharks do get cancer. There is no value in that. There is something called a glucose-blocking treatment, a blood zapper, a white food diet and an energy cleaning machine. Stabilising of oxygen and electrolyte disturbances occur as a result of coffee enemas.
In just September last year the federal government had a review of what is called ‘microwave cancer therapy’. The National Health and Medical Research Council reviewed this microwave therapy practice by Dr John Holt in Western Australia. The review committee on the microwave cancer therapy undertook the assessment of the methods used by Dr Holt, including examination of Dr Holt’s past and present patient records. They examined the published scientific evidence on microwave cancer therapy. The review committee found no scientific evidence to support the use of microwaves in treating cancer either alone or when combined with other therapies. The press release put out by the National Health and Medical Research Council, which is available for people—or I can give them a copy of it—goes into much more detail about why this treatment is not going to cure your cancer.
I made these contributions because I thought it was time to put on the record why I have been absent, particularly last year. I know that a lot of you were aware of that, and I got a lot of support and messages from all sides. In fact, I got a very nice phone message from the previous Leader of the Opposition, Mark Latham. I know that might surprise some on my side, but Mark left me a very nice message last year when he found out that I was still on the journey of cancer.
I commend this bill as a sufferer and as someone who has come through it. It changes your outlook on life a bit. Immediately after you recover you go about a million miles an hour. People try to catch you and you try to make up for a bit of lost time. I fortunately did not lose my hair from the chemotherapy. I got a No. 2 cut in case I was going to, but I never ended up losing it. As I say, I commend this bill. I know one of my colleagues has gone through the journey and is about to follow me. We help each other out every now and again, and talk about the past and what the future holds.
Senator Hutchins was actually referring to Senator Moore. Cancer is a journey that I have been fortunate enough to avoid, but I have known a number of people who have travelled that long journey. At the outset of my contribution I would like to place on the record my acknowledgment of the incredible journey that, in particular, Senator Hutchins has undertaken. It is a life-changing journey but, as we all know, there are a number of people—many members of this place, never mind the wider community—who have had to have their own personal battles with cancer. Most recently, apart from Senator Hutchins of course, was Senator Ferris, who I will refer to a bit later on.
From a Western Australian perspective, the late Senator Peter Cook—like Senator Hutchins in his contribution—sought to place on record some of the concerns that people may have about treatment options and about some of the people who call themselves professionals in this area. As Senator Hutchins, being someone who has suffered from that disease, tried to use his role in this place to the overall good of people, so did Senator Cook. When faced with what was ultimately a disease that took his life, it was certainly a little challenging for him initially, but he decided to use not only his suffering of that disease but also his role in this place to get us to focus on this enormous challenge to our community and to try and pull together a treatment regime and address the issues of those who suffer from cancer.
It is an incredible opportunity that we have in this place that we get to examine policy and make recommendations to government, and it is always moving when a member of this place takes and tries to use those very personal challenges and experiences to frame good public policy for the betterment of our community. It is a useful contribution that all of us make here, and it makes this chamber a much better place. In listening to Senator Hutchins’s contribution earlier, it is an incredibly challenging personal journey.
However, one things that concerns me, and it is one of the reasons I think that this legislation and the establishment of Cancer Australia will be to the betterment of the community, is that you are looking at people who are staring their future and their life in the face and a lot of these so-called quasiprofessionals prey on some of the most vulnerable members of our community. So it is very timely that we put some of those concerns on the record and we have an agreed position of progressing not just research but treatment for Australians.
The Senate would be aware that the Senate Community Affairs References Committee recently had an unusual process where we had a hearing regarding a petition that was tabled in this place about the issues of gynaecological cancer, the testing regime and treatment thereof, and the research that needs to be undertaken. One could not help but be moved by the evidence there. Unlike other cancers, where symptoms become very obvious, this is one of the most insidious and nasty cancers that a woman can suffer from. In fact, it has been a very personal journey in this place because Senator Ferris took us through her own experiences.
Gynaecological cancer is starting to affect more and more women, yet it is one of the hardest to detect because, if you are like many of the women, the only immediate symptom after this cancer has been developing for a while is unremitting tiredness. I can tell you that I, especially when I have been over here, have been prone to feeling unremitting tiredness, so that is not necessarily the best symptom—and if it is the only symptom it does not make detection that easy. So it is certainly my hope that we will continue to progress that issue. I know Senator Ferris has plans, as I said, to use her personal journey to frame good public policy and assist other women in Australia who may face that challenge.
However, I know from the evidence we got from the department at that time that the establishment of a body like Cancer Australia is going to make the coordination of research, testing and treatment of these challenging diseases a lot more effective in Australia, and for that it is to be commended. As has been said, there have been vast improvements in the treatment of not so much gynaecological cancer but other forms of cancer. Some cancers, when diagnosed, no longer have to be the death sentence that they once were. So if we can have a body that will pull together the research and improvements in treatment then that is all to the good. Of course, one of the most significant advances in Australia has been in the treatment of breast cancer, where we now have an incredible success rate. It no longer automatically has to be an invasive process. It is not fun, as I am sure others will be able to tell you, but it does not have to be as dramatic and invasive a process as used to be the case, and it is not automatically a death sentence, as was the case before.
I want to finish my brief contribution on this by again commending the role of the people who served on the cancer inquiry. People made a lot of comparisons to the cancer inquiry when dealing with the mental health inquiry report, which we tabled earlier today. Maybe it is because there is a group of people in this place who are interested in the same kinds of issues so we tend to be involved in the same inquiries, or maybe it is just that that is so much at the forefront of our minds. As Senator Humphries mentioned, we compared attitudes to mental health to the fact that there is a lot of community awareness and sympathy when someone says that they have been diagnosed with cancer. However, there is now a growing body that says: ‘When you’re diagnosed with that, we’re going to treat you as a whole person. We’re not just going to put you into hospital and operate on you and remove the nasty bit or whatever the appropriate treatment model is. We’re going to try and address all of your needs.’ I know Senator Ferris says this was the case with the treatment she received at Canberra Hospital.
Cancer is a life-changing experience for anyone who has suffered from it. As with mental illness, all of us are touched by it—we have a family member, a friend or a colleague who has gone through it or we personally go on that journey. When talking to people who have been on those journeys, the most common thing that they say is that their life ended up in two different compartments—there is before they got sick and after they got sick. That is how life changing it is. That is the way they view what happened. Before they got sick they were a different person, psychologically, to when they came out the other end of the treatment regime. Maybe they are stronger. Maybe they are a better person. Maybe they have a greater outlook on life and the need to get on and confront the challenges of life. However, it is a very challenging journey to assist anyone to go on—never mind having to go on it personally. I therefore commend the government for creating Cancer Australia.
I certainly want to welcome the initiative of formulating Cancer Australia and I want to go on record this evening very briefly in this debate to acknowledge that we now have information about what this body is going to do and to make some comments about the kind of work we did. A number of us in this place were involved in the Community Affairs References Committee report, The cancer journey: informing choice, and we have spoken about it. I know that Senator Adams speaks about it quite regularly when we have the opportunity.
That particular inquiry was formulated in very special circumstances. There was an urgency and a passion around the issue because of the experience of Senator Peter Cook. What came out of that particular inquiry that operated over a couple of months last year was some genuine commitment and hope for the future. That particular inquiry attempted—and I think successfully—to draw together the experience, the knowledge and the hope of a range of people in the Australian community who want to be involved. I know these words sound very similar to words I have spoken before in this place but, as Senator Webber has said, today we brought down the select committee report on mental health and consistently, whilst we were taking evidence and working through the process, the similarities came forward. But I will focus on this particular initiative.
Those of us who were privileged to be involved in the committee that produced The cancer journey: informing choice were able to work with a range of people across the Australian community who had amazing knowledge. These people had great expectations—of what was going to come out from this committee and from what they were led to believe by the promises made by the government during the previous election campaign. One of the positive aspects of that election process in 2004 was that for once the issue of cancer care was an election issue. Too often things like individual experiences are caught up in wider policy announcements but during the election process in the last federal election there were quite considerable and detailed policies before the Australian electorate focusing on the treatment and the development of research around cancer in Australia. That has got to be positive. After the election was over there was stated public commitment from the government that they were going to proceed with a number of quite specific initiatives that were put forward at that time.
Our experience on the committee was that people had read that particular government proposal. They had accepted it and they wanted to be part of it. In fact, in framing the evidence that they gave to our committee, and subsequently when our committee framed our recommendations, we openly referred to what we hoped would be the role of Cancer Australia. There was a feeling when we were doing the community consultations and the submissions and the drafting of the report that was handed down in this place in June last year that Cancer Australia was imminent and that very soon the 12 specific recommendations in the committee recommendations—I think that there were over 30 recommendations—referring to the role of Cancer Australia would be operational.
Almost 12 months later we see this legislation—through the role it gives Cancer Australia and what is says Cancer Australia will provide to the community—picking up some of those things. In the list that is here in the legislation, Cancer Australia will be providing national leadership and coordination of cancer control. Certainly they were two things that were pointed out during our cancer inquiry that we desperately needed. There needed to be national leadership to draw together the various research bodies and treatment models that both Senator Hutchins and Senator Webber have referred to, and there needed to be genuine coordination in our community. We were looking at a real coordination and liaison role for this central body, instead of having people working in isolation and sometimes in fact operating in a very competitive model, seeking the research funding and the research brains across the country and finding that there was almost direct competition to draw to particular research areas the best brains and the best knowledge. In fact there was definitely a need at the national level to draw a more coordinated approach. With the best will in the world, if people are actively competing there may be less encouragement to share knowledge and success, and sometimes less chance of getting a better result by working together.
Clearly, the role of Cancer Australia must be to make recommendations to the government. That was said during the election promises: that the government would take the best possible advice. The role of this new body would be to provide detailed recommendations to the government about policy—and there is a range of things there—and also about priorities, because in this wide range there will always be a need for prioritisation. That is a very difficult issue and, in trying to balance where the best value would be for immediate funding and consideration, there must be a process that involves a coordinated approach that looks across the whole view and does not get caught up with individual demands and the definite emotion and need that comes forward. There is need everywhere. We just have to be able to better organise and plan around that.
Throughout our process there has been very deep interest in the budget area. Whilst the new body, Cancer Australia, will not be determining exactly what the budget will be, it must have a role of overseeing what will be a dedicated budget for research into cancer. Consistently we had evidence during the cancer inquiry, and during the recent roundtable exercise on gynaecological cancers, to which Senator Webber referred, about the absolute need for a high level of funding into research. We know that the expertise is here in Australia. We are confronted by the amount of knowledge and commitment we have. But consistently the call comes that research must be effectively funded. Unless we do that at the local level, the resources will go elsewhere or be diverted into other areas of research. So the idea, as put forward by the government, of the dedicated budget being overseen by this new body is strongly supported.
I particularly like the last one. Being an ex-public servant, I am very keen to see anything in a statement that says something like ‘undertake any other functions as required’, and I note that, in the process, that is one of the roles for Cancer Australia. So, given the concept of having the body and having its role spelt out the way it is in the legislation, of course we support it, and of course I will be supporting Senator McLucas’s amendments.
The issue that I would like to mention very briefly at this moment is the make-up of Cancer Australia. Through people being involved in their health issues, we have a greater knowledge now of the role of consumers. I do not actually like the term ‘consumer’, but it is accepted in the industry. By having people who are part of the process, who are living the experience, being involved in whatever way in the development of policy and in the coordination and administration of what goes on, the role of consumer is being reinforced in a range of areas. We heard today that the role of consumers in mental health is one that must be enhanced and also put into whatever legislation or regulation is developed. I add my voice to that call in the formulation of who exactly will be on Cancer Australia, because it must allow for people who have the immediate experience to be involved in this process. We need to be aware of the process that will be followed to appoint people to this body and of what kind of background they will have. We also need that process to be very public and transparent.
My point tonight is to show concern that a body that we had hoped would be imminently put in place in June 2005 is still in the consideration phase. It is sad that there has been that delay in the process, as we who were working with the community 12 months ago were of a clear understanding that this body was going to be instituted very quickly and in place and that the work would actually be being achieved rather than it happening sometime in the future. Of course all actions need effective planning and will operate into the future, but the delay in the introduction of Cancer Australia has already, in some ways, caused some distrust and concern in those bodies that the government needs to be involved in where we go next. All these areas rely firmly on a spirit of trust, a sprit of involvement and a spirit of loyalty. When you have already had a delay in expectations being met, it makes it that much harder to implement a positive move into the future.
I trust that the government will acknowledge that there is some concern in the community and in the medical profession about this delay and some hope that we will be able to move more effectively into the next stage, taking into account that there must be involvement in the community. Senator Webber and Senator Hutchins were explaining about the model of care in this area being transferred from one which is imposed upon people to one which is actually stimulated by the person at the centre of the treatment model. That same model should be extended, I believe, to the administration and the development of the policies from here on. It must involve those who are best able to talk about what it is like to live the cancer journey.
We strongly endorse the development of the Cancer Australia model. We have awaited it for too long, but we hope that it is yet another stage in something that the Australian people have been led to expect—that we will be a leader in this field and that we will involve all of our community in our joint effort to defeat cancer in Australia.
I have really enjoyed the contributions from members opposite. I am stating the obvious when I say that everyone in this place has been touched by the scourge of cancer, either directly—and we have heard the personal testimonies of senators who have spoken tonight—or indirectly through closeness to a loved person, relative, friend or colleague, as has been the case in this place.
Let me pay tribute to those people who have spoken here tonight and to a couple who have not spoken on this bill. Senator Moore, as other people have said, has made the journey, and it is wonderful to see her so vibrant and so healthy on a night like tonight. I knew Senator Hutchins was ill, and I prayed for him, as we all did, but I did not know the extent of his illness until he outlined it tonight. I do hope that the public record in his local newspaper is corrected and that he gets the satisfaction which he so richly deserves and which is his due. Jeannie Ferris is a walking miracle, as far as I am concerned. Jeannie has come back looking as well as she does, still fighting the battle. Her courage, like that of Anne Lynch, has touched so many of us. We continue to pray and wish for them a total recovery so that they go about the business of their lives fulfilled in every way possible that they wish. The late Senator Cook blazed the trail as an example to us all with his inquiry and his sheer personal commitment under very adverse personal circumstances.
I know a lot of the feelings. My late father was diagnosed with severe cancer, and I went through the process of the hospitals and the doctors. I was assisted by other people who loved him, but I was there much of the time. Eventually, it was not cancer that got him; it was a heart attack, but cancer was there. I have had very direct experience. He passed away just over a year and a half ago. You cannot help but be touched, particularly by the testimony this evening.
I will not go through a lot of the detail of Cancer Australia. I have not said this before, Senator Moore, but I really do enjoy your speeches, and I really enjoyed the one you just delivered. You deliver them with such clarity and graceful movement always. I really do enjoy your speeches, and tonight was one of your great ones. I hope I do not do your political future any permanent damage by saying this, but you did clearly explain why this bill enjoys so much support in this place, including the support of the opposition and everybody else here.
I want to try to answer, in as bipartisan a fashion as I can, the concerns that have been raised by members opposite. Senator McLucas raised several issues, and I will try to cover them. One of her questions was: will Cancer Australia be in competition with other organisations? I can assure her that Cancer Australia will not be competing with other organisations for charitable contributions. It may, however, receive funding from other organisations, from a state or territory government or from private organisations. But it certainly will not be out there competing for funds for which there is increasing competition, not just by organisations that deal with cancer issues but also by so many other very worthwhile charitable and community based organisations.
The theme that has come through from contributions opposite has been: why has there been a delay in implementing Cancer Australia? Senator Moore invited me to acknowledge that there is concern in the community about the delay. It has been mentioned by senators opposite and by those who have spoken in the other place. I do quite a bit of mixing with people who do very good work in this area of vital research, and Senator Moore is right: some people have expressed concerns, but others think that the process that the government has put in place, and which will lead to a satisfactory outcome in this place tonight, has been a reasonable process. We have been working very hard to ensure that the governance arrangements for Cancer Australia are right, and I think that is an important point to acknowledge.
The consultations have been comprehensive, as one would expect them to be. Comprehensive discussions do take some time. The minister has moved forward where he has been able to; for example, the membership of the advisory council for Cancer Australia was announced on 7 March. I am pleased to hear that the council consists of key members of the Australian community, including a number of cancer experts and eminent professionals. Nobody disagrees with the appointment of an eminent person such as Dr Bill Glasson, the former President of the Australian Medical Association. It is a plus that he has agreed to chair the council, and I think that his stewardship will bring direction and focus to the activities and deliberations of the council. The advisory council will support the CEO of Cancer Australia. The process of recruitment of the CEO is currently being undertaken. The position was advertised in the national press, and applications closed in February 2006.
In the context of the discussion about the time that it has taken to arrive at the stage where we are tonight, I think it is important to state on the record that the Strengthening Cancer Care policy does deliver $189 million to improve cancer care in Australia. To date, the government has delivered on the vast majority of the commitments in the Strengthening Cancer Care package, including $10 million to the Royal Children’s Hospital in Melbourne and $7 million for the first round of local palliative care grants. That means funding for more than 80 local palliative care groups to support patients and their families. Grants of $1 million each have been provided to the Make-a-Wish Foundation and Camp Quality. The Breast Cancer Network has been provided with $200,000 per annum to assist with the development and dissemination of resources to help those diagnosed with breast cancer. We have also entered into a grant agreement with the Peter MacCallum Cancer Centre to provide $3.5 million over four years for training nurses specialising in cancer care.
In addition to those very worthwhile funding initiatives and the implementation of good policy, the government is currently finalising $5 million worth of grants to support clinical trials to 10 groups around the country. We are finalising $4 million in grants to some 20 organisations for mentoring regional hospitals and cancer professionals, and we have allocated $5 million for an MRI unit at the Sydney Children’s Hospital.
The question was also raised as to what is going to happen to the NCCI. The government recognises the valuable contribution made by the NCCI. That organisation’s management committee made a decision to wind up the initiative from the end of May this year—it was their decision—and the functions of the NCCI will be incorporated into Cancer Australia, but we will continue funding until the end of June this year.
The other serious point that was raised, and which I think deserves serious comment, is the claim that the response to the Senate committee report has been slow. Let me state right from the word go that we regret the delay in responding to Senator Cook’s important inquiry. Having said that, while there has been a delay in the response, the government has moved to implement one of the key recommendations from that inquiry.
Honourable senators would be aware that at last month’s COAG meeting the government committed to providing a new MBS item for case conferencing. From November that will provide increased support for cancer specialists to bring together all experts working with an individual patient. That has been one of the major themes of the contributions from all senators, including the very forceful way in which Senator Webber put the need to look at the totality of the treatment and the totality of the impact on a cancer sufferer’s attitude and physical wellbeing and the psychological consequences. Without in any way wishing to sound political, I am sure that all senators would agree that the best response to Senator Cook’s very worthwhile report is action on his recommendations. We have moved very substantially on what could be considered one of Senator Cook’s major recommendations.
It is also important to note that the peak organisation, Cancer Council of Australia, has described the commitment of the Howard government to improving cancer care in Australia as:
... the most comprehensive set of government-funded cancer control priorities ever announced in a Federal budget.
I wish to remind honourable senators opposite, who have not been stridently critical but have been critical of the delay in bringing to fruition Cancer Australia, that it was this government that actually put together that package that was so described by Cancer Australia; it was not the party of members sitting opposite. However, I do very richly and genuinely acknowledge their support for the initiative. I want to be totally moderate in my comments in responding to statements made by senators opposite by acknowledging the very strong bipartisan feeling that I sense in here tonight.
I would particularly like to talk about the national bowel cancer screening program. I was briefed quite extensively on this program this morning, because it is going to be a topic of some interest and possible contention at the forthcoming meeting of federal and state ministers at the ministerial conference in Wellington on Friday week. Because time is moving on, I will not say a lot about it other than to again remind the Senate that the Australian government provided $43.4 million over three years in the 2005 budget to phase in a national bowel cancer screening program, which is scheduled to commence in mid 2006. The Australian government is fully funding all the infrastructure and direct program costs of the national program. States and territories are being asked to provide colonoscopies where a program participant is referred as a public patient. Currently around 70 per cent of these procedures are funded under the Medicare Benefits Schedule. If any senators opposite wish to receive further detail as to where the implementation of that program is at, I would be happy to provide them with a briefing at a later stage or as early as is practical, which could be any time tonight or tomorrow after we wind up this debate.
I reiterate what I said at the beginning: I have really enjoyed this debate because of the bipartisan nature of it but, more importantly, because of the strength of the human spirit in facing adversity. Cancer is one of the most difficult adversities that anybody can face. I again pay tribute to those senators who have spoken here tonight. Good on you. As you continue to look after yourselves, just know that you have the best wishes, goodwill and prayers of everybody in this chamber.
Question agreed to.
Bill read a second time.