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

The Australian government has every reason to be proud of its achievements in the area of health. Unfortunately, the same cannot be said for some of our state Labor governments, especially the Queensland state government, which has a dismal record of failure and mismanagement in this area. The Howard government constantly seeks to be proactive in tackling health problems and costs. We know that we face escalating health costs—firstly, because of the scientific and technological advances in medicine; secondly, because our expectations for treatment have risen with those advances; and, thirdly, because we are an ageing population with all the health problems that that entails.

It therefore makes sense to concentrate resources on building good health and immunity from infancy, and on the prevention of disease or injury, to minimise future health costs. In my role as Chair of the House of Representatives Standing Committee on Health and Ageing, I am involved in an inquiry at the moment into the breastfeeding of babies in Australia and have heard much evidence regarding the long-term health benefits that this gives our children. We are listening to people and gathering data so that we can say to parents, ‘Here is the latest information; here is the data so that you can make informed choices about ensuring the best lifetime health outcomes for your child.’ A healthy nation is also a more productive nation. Building immunity is an important step in keeping our people healthy, which of course is good for our people, for our economy and for our future health costs. We start building that immunity with care, nutrition and immunisation of babies and young children.

Under the Immunise Australia Program, we fund vaccinations in babies and children for a wide range of diseases including hepatitis B, diphtheria, tetanus, whooping cough, polio, pneumococcal, measles, mumps, rubella and meningococcal C.

Over the last 20 years, child mortality rates in Australia have been reduced by half; however, some years ago many parents stopped vaccinating their children because diseases such as diphtheria, tetanus, polio and whooping cough appeared to have been eliminated. In 1989-90, only 53 per cent of one-year-olds were immunised; since 2000—that is, on this government’s watch—that figure has been over 90 per cent. When we came to government in 1996, Australian government expenditure on vaccines was $13 million a year—I repeat: $13 million a year. In 2006-07, our vaccine expenditure was $283 million, and that was before the introduction this year of the National Human Papillomavirus—HPV—Vaccination Program, and also the rotavirus vaccinations. The addition of rotavirus vaccine to the National Immunisation Program will cost $124.4 million over five years, while the HPV vaccine program commenced with vaccine funding of $475.9 million over five years. The Australian government’s commitment to vaccine funding in this financial year is estimated to be over $443 million. That contrasts again with the $13 million that it was in 1996.

In 2007-08, our expenditure is to be, as I said before, $443 million. That is a very large commitment to proactive health care from the federal government. We would not be responsible managers if we did not try to ensure that that investment is both effective and cost-effective.

The National HPV Vaccination Program, announced by the government in November 2006 and introduced in April this year, funds free HPV vaccine for females in the 12- to 26-year-old age group, with the aim of reducing the incidence of cervical cancer. The vaccine is most effective if given before any exposure to HPV infection and is administered as a series of three injections over a period of seven months.

As part of that program, the National Health Amendment (National HPV Vaccination Program Register) Bill 2007 establishes a register of those vaccinated. There are a number of very good reasons for this register. The first is to ensure that each young woman completes the full course of three injections. The second is that research on this vaccine is ongoing and it is possible that a booster may be necessary in future years. The register enables women to be notified if this is necessary. The third is that it provides data on the efficacy of the vaccine, as well as ascertaining whether the vaccine program causes any drop in the number of women having their regular pap smear test under the National Cervical Cancer Screening Program.

Routine pap smear tests have proved highly effective in detecting cervical cancer in early treatable stages, significantly reducing the mortality rate, but there is concern that the vaccination may give some women a false sense of security leading them to neglect having these routine tests in the future. Another concern is that, although the vaccine protects against two strains of HPV responsible for 70 to 80 per cent of cervical cancers, other strains may also adapt or develop over time. Cross-referencing the vaccines with NCSP data will help monitor such changes and allow us to be proactive in combating them.

I know most of us get a little bit nervous about personal information being gathered on a computer that may be shared with unknown people or organisations. In this instance, we are talking about a record of vaccination, not of an illness. There are in-built safeguards. The first safeguard is that the HPV register will also hold information about general practitioners and registered nurses who are recognised for the purpose of the HPV register as vaccination providers. Only those registered providers would be given access to the register for the purpose of making an entry or checking the vaccination status of their patient. The second safeguard is of course choice. All vaccinations are voluntary. Good sense, yes; highly desirable, yes—but still voluntary. On top of that, this bill makes the provision for a female or her parent or guardian to make a request in writing at any time to have her details removed from the HPV register. That request must be complied with as soon as practicable.

We all need to make choices, preferably informed choices, in our own health care. The government can only do so much to help protect us. We, as individuals, have to make health choices for ourselves and our children regarding diet, lifestyle, exercise, smoking, medical practitioner treatments, vaccinations and the use of this register. I believe it is an important tool in the fight against cervical cancer. Obviously the government also believes that the bottom line is that each individual has a choice. Australia has a world-class immunisation system and we should be proud of it. It is part of this government’s forward-thinking and proactive approach to health. We also have world-class health professionals and clinicians. The problems lie in the administration by state government.

I do not mean to play the blame game, which was the name of the report that I tabled last year on behalf of the House of Representatives Standing Committee on Health and Ageing, but unless you look at where the problem is coming from, look at the cause, not the excuse, you cannot fix the problem. While the federal government, through the GST, funds most state hospitals and health costs, they are administered by the states and the Commonwealth has no say in how those dollars are spent. I find it particularly difficult to see the level to which funding health care in my own state, Queensland, has sunk. This is affecting the morale and retention of health professionals working in the public system, which of course exacerbates the problem.

In the Courier-Mail on 6 August there is an article about a report released this week on Queensland Health by the former head of the University of Queensland School of Medicine, Mr Ken Donald. The article says:

The latest inquiry into the department, once envied by other states as delivering a model of public health care, reveals a system in meltdown … In five years’ time the breakdown in services will be ‘out of control’.

Queenslanders already know about the long waiting lists for public hospitals and the secret waiting lists—the lists that you have to get on to get on the list. That arrangement is used deliberately to mislead people over the length of a waiting list. Last week’s report reveals that in spite of all the press conferences, assurances and hand on heart declarations, the situation is becoming so desperate that some in Queensland Health are marking patients’ files never to be seen by a doctor. Minister Robertson insisted that these people only had minor ailments, but how do you know that they are minor until the person has been examined? Also, the ailments include cancer and stroke—and they are hardly minor conditions.

I mention the sad state of Queensland Health as a contrast. This bill is indicative of the federal government’s attitude that it is far more effective to be proactive and spend money ensuring better health early than to wait and treat the problem when it is serious. Queensland Health’s approach to its own health has been to try to hide and deny the symptoms until it is at a point of collapse even in coping with emergency calls. I commend this bill to the House.

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