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

I rise to support the Australian National Preventive Health Agency Bill 2010. As I start my contribution, I find myself in the unusual situation of agreeing with a point made by the member for Boothby, which is that preventive health cannot stand alone in relation to the needs of our healthcare system. This makes absurd the position that the opposition have taken on a range of legislation that has been introduced into this place, including one piece of legislation that they most recently voted against. We are in the midst of seeing historic health reform—the greatest health reform that has occurred in this country since Medicare. What we are getting from the other side is blockage, opposition and amendment. They need to get out of the way or get on board with what the Australian public want, and that is serious health reform to all aspects of our health system. That is what this government is about, and this important legislation is part of that.

From those opposite we get opposition to key components of the legislation. The member for Boothby spoke about electronic records. His side of politics is actually opposing e-health, and it did so at the last election. They have opposed GP superclinics. They have opposed a whole range of important aspects to health legislation. They are even opposing our local hospital networks. Everyone in my area agrees that having our own area health service, our own local network, to look after the health needs of people on the Central Coast is absolutely vital.

I wrote my contribution to this legislation thinking that I would come down here and everyone would be supporting the bill because—and I again agree with the member for Boothby—these sorts of things should be no-brainers. But what we are finding or, rather, what we are not finding is a brain on the other side of the House, because we are continually seeing their opposition to these issues. We are finding that, yes, they are no-brainers and that is why the opposition is without its health brain when it opposes or seeks to obstruct these important pieces of legislation. This bill was first introduced into parliament on 10 September 2009. I also made a contribution on that occasion. The bill went through to the Senate, where it was being debated when the election was called. The bill lapsed, and that is why it is back here again. The objects of this bill are so important that I felt that I needed to again make a contribution on it.

Part of the investment this government is making in health involves campaigns to combat obesity, drug and alcohol abuse and smoking—just some of the key priorities of a new national preventive health agency. Let us look at some of the main reasons that we need such an agency in this country. Potentially avoidable diseases affect the lives of millions of Australians. They also account for around 20 per cent of the total healthcare expenditure. Currently, smoking kills about 15,000 Australians each year and costs Australia $31½ billion each year. More than 60 per cent of Australians aged over 18 are overweight or obese. More than 813,000 Australians aged 15 years and older were hospitalised for alcohol related injury and disease between 1996 and 2005. Unfortunately, the electorate that I represent is overrepresented in relation to rates of diabetes, obesity, respiratory illness and skin cancer. My electorate has some of the highest rates of these illnesses in New South Wales and, indeed, in Australia, so we are very much aware of the problems that come about through these diseases. People in my electorate are looking for leadership on how we can tackle preventable illnesses. It is also worth noting that electorates like mine that have lower socioeconomic profiles are more adversely affected by these sorts of diseases. Therefore, this bill, and what it aims to achieve, is very important for people in my electorate and other electorates like it around the country.

Poor health affects the quality of life of Australians and their families. It can also have significant economic affects on them, by reducing their ability to participate in the workforce, and on businesses, through lost productivity and higher costs. Our health system is struggling to deal with the longer term pressures of an ageing population, the increasing cost of pharmaceuticals and new technologies, the rise of chronic disease in our community and the increased expectations of access to high-quality health services in the community. Improving preventive health services and chronic disease management will deliver better health outcomes for Australians and their families and help contain growth in demand for hospital services in the future. It will also promote greater workplace participation and productivity.

Too many people who, with coordinated and preventative health care, need not be admitted to hospital end up there. Too many older Australians who have been admitted but assessed as requiring aged care or transitional care remain in acute hospital wards waiting for a more appropriate bed and denying another person a place. One of the other issues with preventative health care is making sure that there is adequate access to care. Primary care and the role that GPs play in our community are vitally important. I acknowledge here today the good work that is done by Dr Godden and Mr Bill Parker of the Central Coast Division of General Practice. They do a great job in my community, are great advocates of preventative health care and have been working very closely with this government on this agenda.

There has also been an issue in my electorate with access to GPs. My electorate is not alone in this. This problem has exacerbated the situation with chronic disease and early identification of disease. One of the key strategies to improve the health of residents of the Central Coast is to ensure we have more doctors in the community. We are constantly working towards that goal, including through the government’s initiative of setting up GP superclinics. In the electorate of Dobell, thanks to this government, a state-of-the-art GP superclinic is being built in a fast-growing area of the northern part of the Central Coast. The clinic, once completed, will employ in excess of 100 health professionals, including doctors, practice nurses, physiotherapists and others. It will also be the focus of training in conjunction with the University of Newcastle. At its temporary site there are already more than 2,000 patients on the books. This is already starting to take the pressure off the very busy emergency department at Wyong Hospital, which is only some kilometres away. It is the fourth busiest emergency department in New South Wales.

Nationally, the government is investing $1.2 billion in doctors, nurses and allied health professionals as part of the National Health and Hospitals Network. This funding will go to training an additional 5,500 new GPs and an additional 6,800 medical specialists over the coming decade. It will also improve support for 4,600 full-time equivalent nurses working in general practice and trained aged-care nurses. While the government is getting on with improving and reforming our health system, those opposite need to acknowledge that it was the Howard government putting a cap on the number of GP places which led to the chronic shortages of GPs and other health professionals in areas such as mine.

For the first time, the new National Preventive Health Agency will advise all health ministers and help coordinate preventative campaigns across the country. The agency will bring together some of the best expertise in Australia to gather, analyse and disseminate the latest evidence on ways to prevent chronic disease. A chief executive officer will manage the agency and will be directly accountable to the minister for the financial management of the agency and to the Australian Health Ministers Conference, via the minister, for the agency’s performance against agreed strategic objectives and operational plans. The Australian National Preventive Health Agency will have an advisory council comprising between seven and 11 members with preventative health expertise in a variety of disciplines and from a variety of sectors.

The agency is central to the Gillard government’s reform strategy to improve Australia’s health system. Under the reforms, for the first time the Commonwealth government will take the majority funding responsibility for public hospitals and full responsibility for primary health care. The reforms will provide a strong incentive for the Commonwealth to provide better primary care and preventative services to take pressure off our hospitals.

The new agency and its CEO will be responsible for supporting Australian health ministers in their efforts to combat preventable disease by: providing evidence based advice to health ministers on key national level preventative health issues—either at their direction or by providing information about emerging challenges and threats; providing national leadership and stewardship of surveillance and data on preventable chronic diseases and their lifestyle related risk factors in order to improve the availability and comparability of evidence; collating evidence available from a range of sources in order to assess and report biennially on the state of preventative health in Australia; supporting behavioural change through educational, promotional and community awareness programs relating to preventative health, including in relation to alcohol, tobacco and other substance misuse, and obesity; providing financial assistance to third parties to support the development and evolution of evidence around preventative health interventions and to achieve preventative health gains, for example, through grants supporting research; forming partnerships with relevant groups—industry, non-government and community sectors—to encourage cooperative action leading to preventative health gains; promulgating national guidelines, standards, codes, charters and other frameworks to guide preventative health initiatives, interventions and activities; and, finally, managing schemes rewarding best practice in preventative health interventions and activities.

The Council of Australian Governments agreed to establish the ANPHA in November 2008 as part of the National Partnership Agreement on Preventive Health. The creation of a national preventative health agency was also recommended in the report of the National Health and Hospitals Reform Commission released in July 2009 and in the National Preventative Health Strategy released in September 2009. A key initial role of the new agency will be to provide the leadership, coordination and monitoring required to support the successful implementation of initiatives funded through the prevention national partnership, including $692 million provided for interventions to help Australians modify their lifestyles. Beyond this, the agency will more broadly support Australian health ministers in meeting the challenges posed by preventable chronic conditions and lifestyle related risk factors. As the new agency is a COAG mandated body with the function of supporting all Australian health ministers, the minister will be required to consult with the Australian Health Ministers Conference when considering candidates for the CEO’s role and for membership of the advisory council; and to seek the agreement of the Health Ministers Advisory Council when setting the agency’s strategic directions and operational plans.

The agency’s impact will help take pressure off Australian hospitals as more people adopt healthier ways of living and reduce the risk of preventable illnesses. It is part of the Gillard government’s $872.1 million commitment over six years towards the National Partnership Agreement on Preventive Health. As I pointed out earlier, this is the largest investment ever made by an Australian government to support health prevention strategies. The agency will be responsible for three specific programs under the National Partnership Agreement on Preventive Health, which are the national social marketing programs relating to tobacco and obesity—$102 million over four years; a preventative health research fund focusing on transitional research—$13.1 million over four years; and a preventative workforce audit and strategy—half a million dollars over two years. This is in addition to the government’s commitments, following discussions with the Australian Greens and Senator Xenophon, to allocate an additional $50 million to the National Binge Drinking Strategy.

The agency will put in place national guidelines and standards to guide preventive health. It will also form partnerships with industry, non-government and community groups to promote healthier lifestyles. The government’s comprehensive approach to tobacco control, with sustained and coordinated actions, has seen smoking rates cut from 30.5 per cent in 1988 to 16.6 per cent in 2007. Campaigns such as Measure Up have already helped Australians recognise the link between their waist measurement and their chances of developing chronic disease.

This is an important piece of legislation. It is part of an historic reform to health care. It is part of a number of bills that have been introduced into this parliament this week. What we are seeing from the Gillard government is a constructive series of legislation aimed at reforming Australia’s health system to make sure that Australians have better access to health care generally while also making sure that we put important resources into key areas such as preventive health.

What we are seeing from the other side of politics in this health debate is negativity, wrecking, getting in the way, and a series of amendments trying to delay, put off and postpone the very important reforms that this government is seeking to make in relation to health. What people are saying out there is: ‘We want our health system to be improved. We want the federal government to play a role. We are sick and tired of the blame game that characterised the previous government’s term and the lack of contributions that they made in relation to the health debate. We want to see the change.’ I call on the opposition to get out of the way in relation to health reform. You can support what we are doing and support genuine reform in the various areas that we need to change in terms of health, including this bill and the important role it will play in preventive health. You should be either getting out of the way and not opposing it or you should be supporting it. That is what everyone out there in the electorate wants. They want to see some bipartisan support for important health reforms that this country needs.

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