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

I rise to support the Families, Housing, Community Services and Indigenous Affairs and Other Legislation Amendment (Further 2008 Budget and Other Measures) Bill 2008. I will be talking in particular about schedule 1 in relation to my support for this legislation. The bill will provide for certain further budget measures and other non-budget measures affecting the Families, Housing, Community Services and Indigenous Affairs and Veterans’ Affairs portfolios. The measures allow for the payment of the maternity immunisation allowance in two instalments and extended eligibility for children adopted from overseas, the ceasing of the payment of the partner service pension for married partners who are separated but not divorced and minor technical amendments to child support.

I will now look at the bill in a little more detail, paying attention in particular to schedule 1. Schedule 1 makes amendments to better align the maternity immunisation allowance with the National Immunisation Program by paying the allowance in two equal payments for children who meet the 18-month and four-year-old immunisation requirements. Recipients of the maternity immunisation allowance may also be eligible if they have an approved immunisation exemption for their children. Exemptions may be granted if there is a conscientious objection to the immunisation or if there are medical reasons why the child should not be immunised. The maternity immunisation allowance is currently a one-off, lump sum payment of $236.70. It is paid for children immunised to the level recommended for an 18-month-old child. The payment must be claimed on or before the child’s second birthday and is not means tested. The payment was designed to provide an incentive to encourage parents to vaccinate their children before the age of two years. The payment is indexed twice a year—in March and September. The maternity immunisation allowance was paid to around 247,000 children in 2006-07 at a cost of $56.2 million. It is estimated that 38,500 of them were the children of parents who had valid immunisation exemption reasons, including 2,500 children of conscientious objectors.

The measure of paying the allowance in two equal payments aims to increase the proportion of four-year-old children in Australia who are fully immunised. The existing single lump sum payment provides an incentive for parents to have their children immunised at 18 months but does not provide a similar incentive for parents to have their four-year-olds immunised. As at 30 December 2007, 93 per cent of children aged between 24 months and 27 months were fully immunised. The proportion of older children who are fully immunised is lower, with approximately 88 per cent of children fully immunised at the age of six. Vaccinations for four-year-olds, as recommended in the National Immunisation Program, currently include diphtheria, tetanus, whooping cough, measles, mumps, german measles and polio. The maternity immunisation allowance is also given if a child is stillborn or dies before reaching two years of age.

The bill will also extend the allowance to children who are adopted from outside Australia who enter Australia before turning 16 and are immunised appropriately after arrival. It will also make minor modifications to the rules for determining entitlement to the allowance. This particular part of the schedule is very close to my heart. I was adopted from New Zealand when I was three months old. Obviously the allowance was not available at that time, but there are considerable expenses for parents adopting children from overseas. It is a very welcome thing that those people who go through the difficult process of adopting children from overseas—and I must say that New Zealand is probably one of the easiest countries from which to adopt someone—will be able to make sure that their children are equally protected when they are in Australia. It is also important for Australian-born children that this happens because, with higher rates of immunisation, the diseases against which children are immunised are less likely to spread throughout the community. So it is a very important amendment to make sure that children who are adopted from outside Australia are also entitled to this allowance.

These amendments commence on 1 January 2009. After this date, parents and carers with children who meet the immunisation requirements for an 18-month-old will be paid the first maternity immunisation allowance payment of $148.40, which is indexed, when the child is aged between 18 months and 24 months. The second payment of $118.40, which is also indexed, will be available when children have received their vaccination at four years of age, or have an approved exemption, and must be claimed on or before the child’s fifth birthday. The payments will be indexed twice a year. In practice, the second instalment payment will be higher than the first, due to the subsequent indexation. Parents who have received the full immunisation payment for their children prior to implementation of this measure will not be able to claim the payment for immunisation at four years of age.

I can understand the position taken by conscientious objectors when it comes to immunisation, and I respect their right to object, but I must point out some of the very many positives that have resulted in Australia from past and present immunisation programs and just how important it is that immunisation does take place throughout the community in relation to these particular diseases. While the risks associated with the diseases are high, the risks linked with vaccination are low. It is important to remember that vaccines are many, many times safer than the diseases that children are vaccinated against.

Some vaccines have to be adjusted or updated over time. The oral polio vaccine, OPV, has been replaced with an inactivated polio vaccine, IPV, on the basis that the risk of vaccine-associated paralytic poliomyelitis from OPV now exceeds the risk of catching naturally occurring polio. This change in comparative risk has come about only because polio has been eliminated from Australia, with no naturally occurring polio cases reported in Australia since 1978. This is a very good thing and is a direct result of previous immunisation programs that have made naturally occurring polio nonexistent since 1978.

Vaccine-associated paralytic poliomyelitis, which occurs as a result of receiving oral polio vaccine, is extremely rare, occurring on average once in every 2.4 million doses of vaccine delivered, but can result in significant, ongoing paralysis. Since IPV replaced OPV in the United States in 2000, cases of vaccine-associated paralysis—which previously numbered eight to 10 cases per year in the United States—have been eliminated and the United States has remained polio free. IPV provides protection against all naturally occurring types of this disease worldwide, including here in Australia. Children are vaccinated in Australia against polio at two, four and six months and at four years of age.

Let us have a quick look at some of the other diseases which once had a far greater incidence in this country but, through immunisation, have been made far more rare and no longer impact on our children in the large numbers that they once did. Whooping cough is caused by the bacteria called Bordetella pertussis. This disease is highly infectious and most serious in babies. The disease is spread through droplets in the air and it can develop from windpipe infections into lung infections, known as pertussis pneumonia. Symptoms include coughing and ‘whooping’, which can continue for a few months. Complications of the disease include a lack of oxygen to the brain, leading to brain damage and possibly death.

Pertussis is a vaccine preventable disease. Vaccination recommended for routine childhood immunisation is listed on the National Immunisation Program schedule and funded for children under the Immunise Australia Program. People in high-risk occupations, such as health and childcare workers, are urged under the program to consider receiving a booster against pertussis. In my previous role as the National Secretary of the Health Services Association, we always used to say to our members and all health workers that this was something that they should be very aware of, and we urged them to make sure that they participated in a vaccination program so that they were safer when looking after the sick in our country.

No doubt most members are familiar with tragic stories of Australians, young people in particular, who have died or been left permanently scarred or disabled by meningococcal infections. Meningococcal diseases are caused by a number of different strains of a certain bacteria. Meningococcal diseases include meningitis, septicaemia, pneumonia, arthritis and conjunctivitis. It takes between one to 10 days after infection before symptoms show. Symptoms of meningococcal meningitis include high fever, headache, neck stiffness, nausea, vomiting, sensitivity to light, confusion, irritability and drowsiness. In Australia, meningococcal infections caused by strain C are vaccine preventable in all age groups, including babies and young children. Infections caused by strains A, C, W135 and Y are vaccine preventable in older children and adults. Vaccination recommended for routine childhood immunisation is listed on the National Immunisation Program schedule and funded for children under the Immunise Australia Program.

Diphtheria is another vaccine preventable disease, classed as an acute illness. Toxins produced by a bacteria that causes diphtheria affect the respiratory tract, the nervous system, the adrenal glands and the heart muscle cells. Spread by droplets or direct contact with wounds and materials soiled by infected persons, diphtheria takes two to five days after infection for symptoms to show. The disease mainly affects the respiratory tract but skin can also become infected. The bacteria form a membrane of dead, white blood cells in the upper respiratory tract, causing breathing difficulties. The diphtheria toxin can cause severe nerve and heart damage. Vaccination recommended for routine childhood immunisation is listed on the National Immunisation Program and funded for children under the Immunise Australia Program.

A number of immunisations are required in the first few years of a child’s life to protect the child against the most serious infections of childhood. The immune system in young children does not work as well as the immune system in older children and adults because it is still immature. That is why more doses of vaccine are needed for children. In the first months of life, a baby is protected from most infectious diseases by antibodies from his or her mother, which are transferred to the baby during pregnancy. When these antibodies wear off, the baby is at risk of serious infections and so the first immunisations are given before these antibodies have gone.

Another reason why children get many immunisations is that new vaccines against serious infections continue to be developed. The number of injections is reduced by the use of combined vaccines, where several vaccines are combined into one shot. The common side effects of immunisation are redness and soreness at the site of injections and a mild fever. While these symptoms may concern parents and upset their children at the time, the benefit of the immunisation program is protection from disease. More serious reactions to immunisations are very, very rare.

That is some of the background as to why immunisation is so important in the lives of Australians. Diseases which were once thought to be the normal risks of everyday existence in this country, such as polio and tetanus, are now fully preventable thanks to vaccines and immunisation. The changes made possible through this bill will give parents an incentive to have their four-year-olds given the recommended boosters before they start school and should result in many Australian children having a better overall level of immunisation.

There are other elements of this bill which I will touch on briefly. Schedule 2 of the bill contains amendments to the Veterans’ Entitlements Act 1986 that will give effect to the 2008-09 budget measure to cease eligibility for partner service pension for those partners who are separated but not divorced from their veteran spouses and who have not reached pension age. Under current provisions, a non-illness-separated spouse loses eligibility for the partner service pension from the date from which they enter into a marriage-like relationship. These amendments extend circumstances to lose eligibility to 12 months after the date of separation or when the veteran partner enters into a marriage-like relationship. These amendments commence on 1 January 2009.

Further amendments will set the eligibility age at 50 years for partner service pension for the partner of a veteran who is in receipt of the equivalent of or less than the special rate but above the general rate disability pension or who has at least 80 impairment points under the Military Rehabilitation and Compensation Act 2004. These amendments would only commence upon royal assent.

The bill also makes minor amendments to the child support legislation, notably to address anomalies in relation to the child support formula reforms that commenced on 1 July 2008. These changes include reflecting changes in care of less than 7.1 per cent in the child support assessment in certain circumstances, allowing the publication of de-identified reasons for decisions in child support cases by the Social Security Appeals Tribunal, allowing either parent to apply for a departure from assessments in high-cost care cases, and allowing departure prohibition orders to be enforced for overseas maintenance liabilities.

To briefly recap, this bill makes changes that will, firstly, restructure the maternity immunisation allowance to bring it more closely in line with the National Immunisation Program. The reasons why this needs to be done and why immunisation is so important have already been outlined. The first partner service pension measure in the bill will cease eligibility for those partners who have separated but not divorced from their veteran spouses and who have not reached pension age. Under this measure, eligibility for partner service pensions will cease 12 months after separation or if the veteran enters into a marriage-like relationship. The second partner service pension measure is to set the eligible age of 50 years for partner service pension for the partner of a veteran who is in receipt of less than the special rate but above the general rate of disability pension or who has at least 80 impairment points under the Military Rehabilitation and Compensation Act.

Australians have the second longest life expectancy, next to Japan, with Australians living an average of 81 years. Immunisation programs have played an important role, though they are not the sole determinant in this. It is vitally important for the future health of the nation, not only in making sure that we live longer but also in terms of the quality of life that Australians live, that immunisation programs are supported and encouraged so that we can have higher rates of immunisation. This will make sure that children are not made vulnerable to the various diseases that in past generations caused so much heartache and loss. It is vitally important that these immunisation programs are supported. It is vitally important that the amendments in this bill are supported so that young Australians, and those who are adopted from overseas and become Australians, are given the maximum encouragement and maximum opportunity to participate in our immunisation programs that bring about a healthier and longer-living citizenship in this country. I commend the bill to the House.

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