Mark Butler (Hindmarsh, Australian Labor Party, Deputy Manager of Opposition Business in the House of Representatives) Share this | Hansard source

It gives me great pleasure to rise and speak on the Australian Immunisation Register Amendment (Reporting) Bill 2020, introduced last year, and recognise that we've cooperated in shifting the agenda around today to bring this bill on now so that it can pass with the support of both sides of the House this evening and be considered as a matter of urgency in the Senate, so that the bill passes this week. As a general proposition, this is important reform, but it's particularly important in the context of the COVID vaccine rollout strategy. So I want to indicate that the Labor Party will be supporting this bill without amendment. As a general matter, this is, as I said, an important reform to our National Immunisation Program, but it's particularly important to ensure the smooth, effective, timely rollout of COVID-19 vaccines.

I want to talk very briefly about the importance of the National Immunisation Program, the NIP. This program has enjoyed the bipartisan support of this parliament for many years. It's one of the pantheon of important public health measures that give Australians what is, I think, the best health system in the world. We have, at a relatively modest share of GDP, a fantastic primary healthcare system, underpinned by universal coverage through Medicare; we have the best medicine system, underpinned by the Pharmaceutical Benefits Scheme, introduced back in the 1940s by the Chifley government; we have a great public hospital system that takes in everyone that comes through its doors, not charging people, as you see in some developed economies; and we have a range of other measures as well.

One of the things of which we can also be proud is our immunisation and vaccination program. The NIP was started by the Howard government in the early years of the Howard government, but it came on the back of bipartisan support, which the idea of a robust, evidence based immunisation program has enjoyed from both parties in this House. In question time today, the minister quite rightly, I think, pointed to the extraordinary achievement that he reported a couple of weeks ago: reaching the benchmark 95 per cent immunisation rate for five-year-olds. The fact that the immunisation rate for five-year-old Indigenous children is 97 per cent is also an extraordinary achievement of which this chamber, the government, the broader community, the health community and all of the advocates of good evidence based immunisation programs can be rightly proud. This is going to have lasting public health benefits for the community, most notably for those Australians as they enjoy, hopefully, very full, robust, healthy lives.

On the back of the NIP, the register has been in place for several years as well. Its success has been more patchy. Although there are high levels of upload of childhood vaccinations to the register, particularly vaccinations for nought- to five-year-olds, the upload of vaccinations to the register for adolescents, adults and, in particular, older Australians is very patchy indeed. The minister said in his second reading speech that the upload rates for the two main vaccinations for over-70-year-olds, pneumococcal and shingles, are running at only about 40 per cent. He said in his second reading speech that the rate of registration of flu vax on the register was running at about a 50 per cent. I've read reports that last year's flu vax only achieved about a 40 per cent rate of registration. There may be obvious reasons for that lower rate last year given the pressure of the COVID crisis that the health system and health practitioners were under during that peak winter period—particularly in Victoria, but not only in Victoria. Clearly, those rates, whether they're 40 or 50 per cent, are not adequate. We need to lift them, particularly in the context of COVID, to as close as possible to 100 per cent.

There would be very good public policy reasons for this legislation, even if we were not struggling through a pandemic. The NIP is taxpayer funded, and the whole community should get the maximum benefit from that very substantial taxpayer investment. With all of the privacy assurances that the minister rightly gave us in the second reading speech, which I'm satisfied are contained in the legislation, I think it's reasonable to expect that immunisation funded by the taxpayer be uploaded to a register. It is for the benefit of the whole community. We and our health experts and agencies will be able to understand just how well our immunisation program is rolling out and how we can fill gaps, if there are gaps. Also, individuals will be able to access their own vaccination histories through the immunisation history statements—the personalised IHSs. That is, as a general proposition, a good public policy reform. But this is especially important in the context of COVID-19.

It is absolutely critical that not just the government but the whole Australian community understands how effectively the COVID-19 vaccine is rolling out, and we will only know that with good data. This is, as I have said before and as everyone in this House understands very well, the most monumental challenge we have faced in our health system in living memory. We are going to have to give two doses of a COVID vaccine to as many Australians as we can. The Pfizer vaccine is only approved through the TGA for those aged over 16. That may change over time, but, certainly for adults and older adolescents, we want to hit pretty much everyone if we can. We are talking about 40 million or 50 million doses of the COVID vaccine over the next several months. In the midst of that, we are going to have to have the usual flu vac campaign properly spaced around the two doses of COVID vaccine. This is a monumental logistical challenge and we will only know how well we are tracking on that if we have good data. The best way to get that good data is for it to be uploaded to the AIR, the register, for our departmental bureaucrats to be able to check very clearly.

It is also going to be important for consumers to be able show a record of their own immunisation. I've said it is a good thing, as a general proposition, that people are able to access details of their immunisation history through their HIS. This is going to be a good thing as a general proposition. But we know, as we continue to work through this pandemic, that, for many people, access to their workplaces, to their employment, is going to be dependent upon being able to demonstrate their vaccine record in a COVID context. Travel overseas is, most likely, going to require very clear, authoritative vaccine histories, and the AIR will be critical to that.

In his second reading speech—and I endorse this absolutely and without any hesitancy—the minister said mandatory reporting does not mean mandatory vaccination. There is a critical difference here. To the extent that there has been some concern and opposition raised in stakeholder consultation and community consultation around this bill, the minister and the department make the point that that is generally based on an innocent misunderstanding that, when we are talking about mandatory reporting, we are talking about mandatory vaccination. The minister has said—and Labor endorses the position—that the COVID vaccine is a voluntary vaccine. We encourage everyone to take it, unless there are very good reasons not to—and you should talk to your treating practitioners about that. Subject to that qualification, we encourage everyone to take it. But it is a voluntary vaccine.

All this bill does is say that, if you take the vaccine—if you take a flu vac or any of the other vaccines on the NIP—it will be uploaded to the register. A whole range of privacy protections have properly been put in place by the government. These are reflected in the bill and, importantly, they have been echoed by the minister again in his second reading speech. So I want to emphasise again that mandatory reporting does not mean mandatory vaccination. The minister made that point, and I echo the minister's statement.

The bill makes it clear that it is intended that this will get up and running pretty quickly—and so it should. If this vaccine rollout is going to be smooth, timely and effective, the provisions of this bill that make mandatory the uploading of vaccination histories will start on 1 March for the COVID vaccines and for the flu vac. That is something we support very strongly. For all other vaccines on the national immunisation program, the start date will be 1 July. Obviously, this being a mandatory scheme, as set out in this bill there will be penalties and consequences for noncompliance. Some of those are reasonably substantial fines, penalty units, contained in the bill. The department, as I understand it, have made it clear that they intend to take an escalating approach to non-compliance, focusing very much on education and information of health practitioners. Labor very much supports that. Of course in any mandatory framework there needs to be a series of consequences for non-compliance. But we understand, as I know the government understands and members on the government benches understand, the pressures our health system are under, the pressures our doctors, our nurses, our aged-care facilities, our Aboriginal community controlled health organisations and others right through the health system are under. This is another systemic requirement we are expecting them to undertake, and we should take an escalating approach to their compliance with it.

I want to note that this reform, which we say is a sensible, important reform, has been supported by a range of key stakeholders, including the AMA, the college of GPs and a range of others. As I said, to the extent that there has been some opposition expressed to this legislation, the government makes the point that much of that is based on the innocent misunderstanding that what this legislation is seeking to do is to make the vaccination mandatory, rather than the reporting of a voluntary vaccination. I want to make that point as well. This is part of the reason we're not only agreeing to the bill but agreeing to bring it forward and have it debated in an expedited fashion in this House and ultimately in the Senate so we can pass it this week. This is a critical link, one of many critical links in the chain of a successful vaccine rollout here.

We dealt with another element in that chain, another piece of reform to existing legislation, only yesterday with some of the therapeutic goods legislation as well. We are trying—I know my predecessor as the shadow health minister, the member for McMahon, was very focused on the opposition being as constructive as we possibly can be through the pandemic. We know that is what our communities want. It doesn't matter if they're Liberal, Labor or swinging voters; all they're focused on is their government succeeding. They don't care so much whether they're a federal Liberal or a state Labor or state Liberal government; they want their governments to succeed in the fight against the virus, and they expect their oppositions to be as constructive as they possibly can be. That doesn't mean giving a blank cheque and not asking questions that need to be asked, but it means being as constructive as we possibly can be.

I said before that we've been very supportive, broadly, of the vaccination strategy that's been outlined by the government. There are questions, though, that we are continuing to ask, and we think the community wants clear answers to them as soon as they are available. We want to know when supplies will arrive from overseas. We understand that that is not within the control of the government. We understand that there are a whole range of important politics—I don't say that critically—being played out in the EU. We understand that the scale of the emergency in the European countries, the UK, North America and many countries besides is much higher than we're lucky enough to deal with here. But Australians do want to know when it's likely that the Pfizer and the imported batches of the AstraZeneca vaccine are going to land in Australia, how long batch testing will take and when we will actually start to get needles in people's arms. I will continue to make that point in as constructive a way as I can. I know the minister is approaching this with extraordinary hard work, with very good will, and I'm happy to say with a great deal of ministerial experience.

We also want information as soon as we're able to get it about the logistics of booking. The online entry point—it's been called different things at different times—that Accenture has been contracted to provide for the government is going to be critically important so people can easily work out how they make a booking for a vaccination. If their GP practice is not one of the, as I understand it, 2,000 or so out of 7,000 that have so far expressed interest in being part of the rollout, how they get connected to a GP they've never visited before; the extent to which they need to take their medical history; if theirs is not an aged based eligibility but a medical condition based eligibility, how will that work? How are aged-care facilities going to work through this system?

These are all important questions that Australians are asking, GPs are asking—I know—and aged-care facilities are asking. They're not asking them in a political way. They're asking them because they want us, as 'team Australia'—to take a description from the Prime Minister—to do this in the most timely, effective and speedy way we possibly can.

The last thing we do need to have a discussion about is how negotiations are progressing between the government and other suppliers. We do have supplies coming our way from Pfizer and from overseas, from AstraZeneca. We're leveraging that extraordinary asset we have in CSL at Broadmeadows. It's just a wonderful national asset, so we will be able to manufacture about 50 million doses of the AstraZeneca vaccine here in Australia. That's a wonderful thing, but we do want to know what the government is doing to diversify supply for down the track, because we know we are going to need additional supplies of vaccines, whether they are booster shots or what have you. It is important that the community broadly continue to be updated on how negotiations, for example, are progressing with a company like Moderna. It has a highly effective mRNA vaccine that it's already rolling out to some other countries. We'd like to know how negotiations are progressing for some future supply of that mRNA vaccine that is likely to be easier to adapt, to the extent we need booster shots that take account of the mutations or variants that we're already seeing in the virus around the world. I say that in a constructive way. I'm going to continue to ask these questions. I know that the minister is bringing very good will and is working extremely hard on this national pandemic. With those closing remarks, I commend the bill to the House and indicate the opposition's support for it.

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