Brian Mitchell (Lyons, Australian Labor Party) Share this | Hansard source

I rise to speak on the National Cancer Screening Register Amendment Bill 2024. Strengthening Medicare and improving healthcare services is an absolute priority for the Albanese Labor government. In our first 23 months in office, we've made huge strides in building back the healthcare system that was so sadly neglected by those opposite. We've opened 58 urgent care clinics across Australia for non-life-threatening urgent care, including four in my home state of Tasmania. We've made the largest investment in bulk-billing in the proud 40-year history of Medicare. We've tripled incentives for GPs to bulk bill kids, pensioners and concession cardholders, delivering direct benefits to 11 million Australians. We've made the biggest reduction to PBS medicine prices since the scheme was introduced; thousands of Australians had been putting off getting the medicines they need, simply because they couldn't afford them, but we've made medicines cheaper, saving Australians $250 million in 2023 alone. We're also cutting the cost of more than 300 common medicines by allowing doctors to prescribe 60-day prescriptions, saving patients money and time. And we've brought in other bills to strengthen our healthcare system, with a plan to reduce nicotine addiction for Australians and, just this morning I spoke on extending the scope of practice for midwives and nurse practitioners.

When it comes nicotine addiction, our excise tariff amendments, which increase the tax on tobacco by five per cent for three years—in addition to the ordinary annual indexation—aims to reduce smoking rates to below 10 per cent by 2025 and, hopefully, to five per cent or less by 2030. And our government is tackling the insidious introduction and rapid rise of consumer vaping head-on. E-cigarettes and vapes have been sold to governments and communities around the world in the past decade as a therapeutic good; that they were a product that could help hardened smokers kick the habit. These are usually men and women in their 40s or 50s who are smoking a pack, or more than a pack, a day. Getting them onto vaping, e-cigarettes, instead was sold as a way to get people off the fags. But what we see now is a new generation taking up vaping up—kids. We see them every day in our streets, vaping, with lolly flavoured nicotine. It's an entirely new generation of nicotine dependency being born, and the biggest issue is absolutely with school-age children. If vapes are therapeutic goods, as they have been sold to us, then it is entirely appropriate that Australia should regulate them as therapeutic goods instead of allowing them to be sold in convenience stores, so often close to schools.

At the same time that all of this is going on, our government remains focused on increased education and support, and the 2023-24 budget included $63 million for public health information campaigns to discourage Australians from taking up vaping and smoking and to encourage more people to quit. We don't do this for the hell of it. We know that, when you smoke or when you vape, you increase your likelihood of getting illnesses and cancer. A further $30 million has also been invested in support programs to help Australians quit. These measures aim to address the significant threat to public health that is caused by cigarettes and vaping.

We want to do everything we can to avoid people suffering from preventable lung cancer. While advances have been made in the diagnosis, treatment and care of people with lung cancer, it remains the leading cause of cancer related deaths in this country. The 2023-24 federal budget provided $263.8 million for a new national lung cancer screening program, intended to commence in July 2025, to support earlier detection of lung cancer, when treatment is likely to be more effective. Compared to most other cancers, the survival rate of people with lung cancer remains poor. On average, only 20 per cent of people diagnosed with lung cancer survive five years after diagnosis, compared to a five-year survival rate of more than 70 per cent for all other cancers combined. Some of that's to do with the late diagnosis of lung cancer, when it has often spread throughout. But that's a big difference—a five-year survival rate of 70 per cent for other cancers and just 20 per cent for lung cancer.

Indigenous Australians are twice as likely to be diagnosed with lung cancer, compared to non-Indigenous Australians. They're also twice as likely to die from lung cancer, compared to the general population. When you look at smoking rates among Indigenous Australians, you can see the correlations.

In addition to Indigenous Australians, people living in remote and regional Australia and in areas of greatest socioeconomic disadvantage are disproportionately affected by lung cancer, with higher lung cancer incidence and mortality in these populations.

I'll just briefly touch on my own electorate, which had the unenviable record of having the highest smoking rates in the country in 2020. In a suburb in my electorate, Bridgewater, which is very socioeconomically disadvantaged, it's estimated that 40 per cent of the adult population smoke daily, and they're 3½ times more likely to die from smoking related illnesses. That compares to 14 per cent of the national population that smokes daily. Some people have a cigarette at a party; they call themselves social smokers. But 14 per cent of the national population smokes daily, compared to 40 per cent in that suburb in my electorate.

The estimated number of new cases of lung cancer in Australia in 2023 was more than 14,000, with lung cancer contributing to nine per cent of all new cancer cases diagnosed. We lost as many as 8,691 Australians to lung cancer last year, and, although age, working conditions and family history can contribute, smoking of nicotine products is the major contributor. On average, 350 Tasmanians a year are told they have lung cancer—not news you want to get—and Tasmania had the second-highest mortality rate in Australia for lung cancer in 2019. That's 33 per 100,000 people.

The new screening program this bill enables is expected to prevent more than 500 lung cancer deaths every year.

The National Cancer Screening Register Amendment Bill 2024 amends the National Cancer Screening Register Act 2016, which provides the legislative framework for the operation of the register. Specifically, the bill before the House today adds lung cancer to the definition of designated cancer and into coverage by the register. Currently, the designated cancers in the act are bowel cancer and cervical cancer. This allows the register to support the National Bowel Cancer Screening Program and the National Cervical Screening Program respectively. This bill provides the legislative basis for the register to deliver the NLCSP, including handling of program participants' personal and sensitive information in connection with lung cancer screening and diagnosis.

Adding lung cancer as a designated cancer will extend the existing protections in the act to lung cancer screening information held in the register. These protections include prohibiting the collection, use or disclosure of personal information in the register in connection with the NLCSP outside circumstances set out in the act. These limited authorisations ensure personal information is only collected, recorded, used or disclosed to or from the register for specific purposes. Adding lung cancer as a designated cancer in the act extends the existing data breach framework to an individual's lung cancer screening information held in the register. This includes requirements for notification and handling of contraventions and possible contraventions in relation to protected information.

While the bill is small, containing just two minor amendments, its impact will be substantial for people with lung cancer. The National Lung Cancer Screening Program focuses particularly on First Nations people and priority populations, including those living in rural, remote and very remote areas; people with disability; and culturally and linguistically diverse population groups. I will certainly make the case to see a focus on the program in suburbs in my electorate. The program is intended to commence in July 2025, and its aim is to reduce the burden of lung cancer in the community, including incidence of death, morbidity and mortality. It will facilitate this by detecting lung cancer earlier than would be the case in the absence of screening, thereby improving health outcomes: the earlier you know about it, the earlier you can treat it. The program will target asymptomatic individuals aged 50 to 70 years who have a history of cigarette smoking of at least 30-pack years and if an individual has a history of cigarette smoking but has quit within the past 10 years.

Inclusion of lung cancer as a designated cancer allows the National Lung Cancer Screening Program to be the third program to be delivered by the register, enabling the expansion of the purposes already in place for bowel and cervical screening programs. We have seen success with those programs, and we certainly hope to see that success replicated with lung cancer. As I said, the bill extends the protections in the act fo4r screening information. These include prohibiting the collection, use and disclosure of information.

The Albanese Labor government is absolutely committed to strengthening Medicare and to strengthening and improving health care across our nation. We've introduced so many new measures since we were elected to office in May 2022. We've delivered cheaper medicines and urgent care clinics; we've invested more in bulk-billing; and we've increased the scope of practice for nurse practitioners. I'm so proud of the work we're doing in health care; we're making health care more affordable and more widespread so that more Australians can stay well, and, if they're not well, to get better quickly. The Albanese Labor government is absolutely committed to strengthening Medicare, and this expansion of the National Cancer Screening Register to incorporate lung cancer screening will absolutely help to deliver better healthcare outcomes for all Australians and will keep more Australians alive for longer. I commend the bill to the House.

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