Peter Dutton (Dickson, Liberal Party, Shadow Minister for Health and Ageing) Share this | Hansard source

Certainly, Madam Deputy Speaker. The objective of preventative health measures to alleviate pressure on the public hospital system is rightly supported by both sides of politics. However, it is the policy measures employed where stark differences arise. There is a fine line for government in such a debate. Informing people of risks associated with certain lifestyle choices can easily drift into telling people how to live their lives and attempting to socially engineer a homogenous lifestyle for the latest government citizenry.

The Minister for Health and Ageing penned an article in the Punch recently by the title of ‘I’m no nanny, it’s about saving lives and the system’ and, in doing so, acknowledged the Orwellian-like concerns associated with government going down this path. The issue is complex. As unpalatable as it may be, the taxpayers should pick up the bill through the health system for someone who lives their life with reckless disregard for the health consequences. Government intrusion into an individual’s life and lifestyle should always be closely scrutinised.

This bill states the functions of the agency through the CEO will include the following: first, advise and make recommendations to the minister, ministerial council and various governments on matters relating to preventive health; second, gather, analyse and disseminate information; third, conduct awareness campaigns; fourth,  make financial assistance grants on behalf of the Commonwealth; fifth, develop national standards and codes of practice; sixth, manage schemes and provide awards; and, finally, any other function as determined by the minister. Quite a wide scope.

So, whilst we have been given an initial indication of the reach of the agency, it is by no means an exhaustive list. The statistics on the impact of obesity, tobacco and alcohol on quality of life and on our health system are confronting. With 32 per cent of Australia’s burden of disease attributable to modifiable risk factors, there is capacity to alleviate pressures on hospitals and the health budget. Preventative health measures which deliver tangible health outcomes assist in ensuring the viability of the health system as we move forward. I was surprised to hear the minister state in her second reading speech:

In the past the prevention effort was neglected.

I would strongly disagree with that statement as, I suspect, would other members on both sides of the House. I would suggest to the minister that we are fortunate in Australia that the objective of preventative health, fundamentally the reduction of premature illness and death, is generally supported by both sides of parliament.

If we look objectively at the efforts of previous governments, improvements have been made by both sides through changes in tobacco excise, education and awareness campaigns, immunisation, bowel cancer screening and breast and cervical cancer screening to name just a few. Significant gains have been made. From 1996 to 2007 the coalition government also invested $1.8 billion in immunisations; a further $704 million in 2006 for the HPV and rotavirus vaccination program; $211 million from 1999 to 2007 to fight HIV-AIDS, hepatitis C and sexually transmitted infections; and $18.5 million in 2006 for the nation’s first national skin cancer awareness and education campaigns.

The previous coalition government commenced funding of the Bowel Cancer Screening Pilot Program in 2000. Following the pilot, as part of the 2005-06 budget initiative Strengthening Cancer Care, the coalition provided $43.4 million for the phasing in of the National Bowel Cancer Screening Program. I acknowledge and give credit where it is due to the current government for continuing this important Howard government initiative, which reduces morbidity and mortality from bowel cancer. With respect to tobacco, the final death knell for tobacco advertising in this country—a complete ban on all international sport and cultural events—was announced by the then Minister for Health and Aged Care, Dr Michael Wooldridge of the Liberal government, on 2 November 2000.

Interestingly also, this government refused the coalition’s proposal this year to increase the tobacco excise by 12.5 per cent to fund the proposed cuts to the private health insurance rebates. Instead, the minister pushed ahead with her attack which would have led to insurance downgrades and higher premiums and pushed people into the public system, hardly helping to build a sustainable health system.

Preventative measures cannot work in isolation. The health system needs to support early interventions in order to avoid disease progression. It is of little use spending $102 million in social marketing over four years, as proposed by this bill, if the government’s other policies increase the burden on public hospitals. The $102 million for social marketing that is proposed in this measure dwarfs the mere $16 million over four years the minister was trying to save by capping the Medicare safety net for injections into the eye.

The minister boasts about her supposed efforts in preventative health—the new preventative health agency and its huge taxpayer investment in advertising. However, if you look at the tangible action that this minister has taken in this area, the reality quickly deflates all her embellished rhetoric. This minister has proceeded against all sensible advice and reasoning to halve the Medicare rebate for cataract surgery. Whilst the minister likes to silence any scrutiny of her ideological crusade, it is important, in the context of this bill, that we scrutinise this government’s record on preventative health.

There are over 200,000 cataract operations annually in Australia and cataracts are currently the leading cause of blindness in the world. As elected representatives, we need to question whether it is right that this government spends an additional $102 million on marketing and $17 million on additional administration under this agency when they claim they cannot afford to continue providing mostly older Australians with a full rebate for this very important preventative procedure. The minister stated on 25 August 2009:

If we are to embark on a next stage of health reform—to improve the health system for all of us—we will need to find further savings and efficiencies to fund our priorities.

It should be very concerning to the Australian public that this minister believes areas to be targeted for savings should include vital life-changing—and in some cases life-saving—and preventative surgery, with those funds now to be used to fund advertising.

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