Mark Coulton (Parkes, National Party, Shadow Parliamentary Secretary for Ageing and the Voluntary Sector) Share this | Link to this | Hansard source

As a member state of the World Health Organisation, Australia is party to the International Health Regulations. In the old days, the IHR applied mostly to cholera, plague and yellow fever. However, the world is going through a phase of globalisation. The dynamics of the way infectious diseases spread have changed. These days more people travel by plane and international trade is common. So a health crisis in one country can quickly become a health crisis in another country, including in Australia.

Polio was a disease that was close to being eradicated worldwide and had not been seen in Australia since the 1970s, but in 2003 unfounded fears about the safety of the vaccine emerged in Nigeria and authorities simply stopped vaccinating children. From that period we saw the polio eradication program set back significantly. Polio ended up as close to our borders as Indonesia and there were very real fears that polio cases would re-emerge here. The World Health Organisation kicked in and in a relatively short time the program was restarted. Today only Afghanistan, India, Nigeria and Pakistan have endemic polio. The International Health Regulations provide a binding legal arrangement by which the World Health Organisation can minimise the impact of outbreaks of communicable diseases. The IHR were bought in on 15 June 2007. They require countries to report certain disease outbreaks and public health events to the WHO.

Living in a globalised society brings risks, benefits and obligations. We in Australia are blessed with high levels of clinical care and the very best doctors, nurses and other health workers. We have a duty to endorse the hard work of groups such as the World Health Organisation. We also have a duty to Australians to protect their health in the best way possible. In this regard the Minister for Health and Ageing has a lot to answer for. In her first six months in the job she has put in train a series of steps that will seriously diminish the health and wellbeing of many vulnerable Australians. The minister wasted no time in office and immediately dismantled Medicare dental. This program allowed people with complex medical conditions to access a dentist rapidly and to qualify for $4,250 worth of dental treatment over two years through Medicare. So popular was this program that its intake doubled every month peaking in March, the month before it was scrapped, at over 92,000 services.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

Madam Deputy Speaker, I rise on a point of order going to relevance. Unfortunately, as much as I hate to say it, the comments by the member for Parkes have absolutely nothing to do with the legislation.

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

I thought the member was straying from the topic of quarantine amendments by going on to dental. I will ask him to come back to the bill at hand.

Mark Coulton (Parkes, National Party, Shadow Parliamentary Secretary for Ageing and the Voluntary Sector) Share this | Link to this | Hansard source

Dental disease is a serious problem for Australians—

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

The member is completely disregarding my call. I ask him to return to the bill at hand. You can continue your remarks. I know you have been put in an untenable situation and I appreciate that, but if you could continue your remarks in regard to the bill.

Mark Coulton (Parkes, National Party, Shadow Parliamentary Secretary for Ageing and the Voluntary Sector) Share this | Link to this | Hansard source

I will endeavour to move on. Similarly, the minister has taken a baseball bat to private health insurance, raising the Medicare levy—

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

Madam Deputy Speaker, I rise on a point of order going to relevance. This is about quarantine. It is a very specific kind of legislation. I believe the member needs to return to the topic.

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

Member for Parkes, I do appreciate that you have been put in a very awkward situation. I appreciate you filling the gap that we have, but I do need you to refer to the legislation before us.

Mark Coulton (Parkes, National Party, Shadow Parliamentary Secretary for Ageing and the Voluntary Sector) Share this | Link to this | Hansard source

At that point I will close my remarks but in doing so point out the importance of the World Health Organisation in securing our borders with respect to the incredibly mobile population that our world has become. I ask that this bill be given due consideration.

Ms Anna Burke (Chisholm, Deputy-Speaker) Share this | Link to this | Hansard source

I want to thank the member for Parkes for his endeavours before the House today.

Richard Marles (Corio, Australian Labor Party) Share this | Link to this | Hansard source

At the risk of attracting the same objection, I start by commending the member for Parkes on his taste in ties. I seek your indulgence, Madam Deputy Speaker—and risk social death—for wearing the same tie as the member for Parkes today. It is a very beautiful tie, and clearly he is a man of great taste. I will return to the matter at hand before an objection is raised about the relevance of my speech.

I rise to speak in support of the Quarantine Amendment (National Health Security) Bill 2008. This is a very important bill for the future safety and health security of our country. It has enormous implications for all of Australian society. Evidently, a breach to our nation’s health security has the potential to give rise to devastating effects on our economy. It can have the effect of threatening our way of life and of jeopardising the health of all Australians.

Under the Constitution the Commonwealth government is granted the power of dealing with quarantine. The principal act by which this is done is the Quarantine Act 1908, and this bill today seeks to amend that principal act. This bill builds upon a very significant history of Labor attention to the issue of quarantine in this country and to making sure that we have strong quarantine security. The Fisher government enacted the Quarantine Act in 1912. The Chifley government amended the act in 1947 on two occasions, the Hawke government amended it in 1983, 1984, 1985 and 1991 and the Keating government similarly improved the quarantine regime around this country in 1994—and that is just a sample of the bills in this area throughout the history of Labor governments.

The Rudd government is very much committed to building upon the strong Labor tradition of having a secure quarantine network around Australia. It would also be fair to say that many of the initiatives of the Howard government in relation to quarantine are a result of thinking which occurred through the eras of Labor government. A ground-breaking report in relation to quarantine, Australian quarantine: a shared responsibility, also known as the Nairn report, was from an independent review commissioned by the Keating government and chaired by Professor Malcolm Nairn into Australia’s quarantine policies and programs in October 1996. Indeed, in 1997 the Howard government accepted the majority of the review’s outcomes and legislated accordingly as a result of that. Whilst that review was predominantly around plant and animal quarantine issues, the Australian Quarantine and Inspection Service, AQIS, commissioned its own report in relation to human quarantine issues in response to the Nairn report. This AQIS report formed the basis of much of the activity of the Howard government’s policy initiatives in relation to quarantine, in particular in relation to human quarantine issues in the early years of that government.

The existing legislative environment sees that the Australian Quarantine Inspection Service conducts most of Australia’s quarantine duties. However, its duties in relation to human quarantine are largely administrative. Broadly speaking, the role of the Department of Health and Ageing, which is charged with the construction and maintenance of Australia’s public health and human quarantine policy, is to ensure national health security by implementing public measures to guard against the potential outbreak of quarantinable diseases. Of course that includes the identification and monitoring of people who are potentially exposed to such diseases and the provision of appropriate medical treatment when that is necessary.

The communicable diseases which are the subject of quarantining control in this country are smallpox, yellow fever, the bubonic plague, cholera, rabies, avian influenza in humans, SARS and viral haemorrhagic fever. Furthermore, the Department of Immigration and Citizenship, in screening visa applications, is also required to ensure that appropriate prophylaxis has been undertaken so as to permit entry to this country. Importantly, at present the financial obligation arising from the costs of meeting the quarantine requirements of a temporary or permanent visa for entry to this country falls upon the applicant.

The basis of this bill lies very much in the International Health Regulations 2005, otherwise known as the IHR agreement. Australia was a negotiating party at the 58th World Health Assembly where the current IHR 2005 framework was established. The IHR is a set of regulations which exists under the auspices of the World Health Organisation. Together, they are a longstanding framework which deals with the international community’s response to international health issues. There is a long history to the World Health Organisation and the International Health Regulations, which it administers. In fact, it dates back to the cholera epidemics in Europe between 1830 and 1847, which gave rise to the International Sanitary Conference in Paris in 1851, which led to the first international response to health epidemics and dealing with communicable diseases.

In 1948, the World Health Organisation was constituted and came into force, and it took over the management of those same international sanitary regulations. These were replaced in 1969 and renamed the International Health Regulations, which, of course, were the first guise of the regulations we are currently dealing with today. The International Health Regulations were then modified in 1972 and 1981 before again being dealt with in the recent modification in 2005. The 2005 reforming of the International Health Regulations was to meet the challenges of the new global village in which we are living in the early part of the 21st century. In the discussions around the development of the International Health Regulations 2005, it became clear that the previous framework of 1969 was very much outdated, dealing with only three diseases—cholera, the bubonic plague and yellow fever. They did not require any mandatory reporting of disease outbreaks, which then led to a number of countries not fully reporting disease outbreaks in their own countries for fear of trade and travel restrictions being imposed upon them.

The 2005 International Health Regulations framework has become a much more robust regime to deal with the contemporary environment. It requires participant states to report ‘all events that may constitute a public health emergency of international concern and to respond to requests for verification of information regarding such events’. As part of the World Health Organisation’s encompassing of the epidemic and pandemic alert response measures, of which incorporate the International Health Regulations, coverage of new diseases extends to anthrax, avian influenza, Crimean-Congo haemorrhagic fever, dengue haemorrhagic fever, Ebola haemorrhagic fever, hepatitis, influenza, Lassa fever, Marburg haemorrhagic fever, meningococcal disease, the bubonic plague, Rift Valley fever, severe acute respiratory fever—which is SARS—smallpox, tularaemia and yellow fever. From that list, you can clearly see that the International Health Regulations are now a far more robust regime, one which is much more fitted to the 21st century environment, where far more global travel is occurring.

The International Health Regulations came into effect on 15 June last year. So that Australia can meet its obligations under these treaties, it is now incumbent upon the Commonwealth government to legislate in accordance with those guidelines. That is what this bill is doing today. It needs to be done in a timely manner as the agreement, which is the basis for the International Health Regulations, states:

Countries that are States Parties to the Regulations have two years to assess their capacity and develop national action plans followed by three years to meet the requirements of the Regulations regarding their national surveillance and response systems as well as the requirements at designated airports, ports and certain ground crossings.

This bill, in essence, brings Australia into line with the International Health Regulations obligations. It seeks to enact, if you like, those regulations into the Australian jurisdiction, and it does so in three key ways.

Firstly, this bill ensures that Australian travellers and quarantine support staff can be required to submit to a vaccination or other prophylaxis as defined by the International Health Regulations—or as recommended by the World Health Organisation, when required, which is obviously with a view to preventing the spread of disease. To make clear how that differs from the current environment, currently there is a requirement for travellers and quarantine support staff to submit to vaccinations but not to other prophylaxes. Nor is there a requirement to submit to vaccinations or other prophylaxes for diseases which are otherwise recommended by the World Health Organisation. In other words, this amendment extends the range of diseases that can be the subject of compulsion to have a vaccination or a prophylaxis. This legislation increases the range of prophylaxes that can be required to be used in relation to travellers and quarantine support staff. An example of that may be antiviral drugs for influenza. That is the first way in which the legal regime will be changed in Australia by virtue of this bill.

The second is that it expands the current certification requirements to bring them into line with the International Health Regulations. At the moment, the only disease where there is required to be certification of a vaccination in order to enter certain countries is yellow fever. Now, as a result of the International Health Regulations and as a result of this bill, there will be an expanded range of diseases and vaccinations and other prophylaxes which can be certified. That is a very important advance because it increases the amount of documentation which exists in relation to travellers and what vaccinations and other prophylaxes they have received.

Finally, this bill ensures that the costs associated with maintaining these more stringent quarantine requirements will not be borne by travellers, except for persons seeking temporary or permanent residency in Australia. These are very important measures. They bring Australia into line with the new international quarantine regime. It strengthens the quarantine network around Australia and enacts the International Health Regulations of 2005 into our jurisdiction.

This is an important piece of legislation for my electorate of Corio. In the seat of Corio is the port of Geelong, which is the second largest port in Victoria and handles 25 per cent of the state’s exports. It is an avenue by which people, particularly crews of vessels, enter into Australia, so this quarantine regime obviously applies to them. It is very important for the safeguarding of not only the Geelong community but the Australian community that there be a proper quarantine network which applies to these people. Also, as I have mentioned previously in this place, there is a hope that at some point in the not too distant future Avalon Airport, which is currently a domestic airport servicing about 1.4 million travellers in Australia, will expand its operations internationally. Were that to be the case, there would be another international gateway into this country coming through Geelong, and an expanded quarantine network would be important for dealing with those passengers.

In conclusion, this bill is not large in terms of its measures but it is very important for ensuring the public safety of all Australians and our national health security. For those reasons I very much commend it to the House.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

I congratulate the member for Corio on the very detailed and insightful speech that he just made. He touched on all the really important issues associated with this Quarantine Amendment (National Health Security) Bill 2008. I can see how this legislation is important for his electorate, but I see it as being important for all electorates and for all of Australia. As he so aptly pointed out, these days of international travel—where people are travelling from country to country and continent to continent on a very regular basis—and the global economy make this legislation, although small in content and very technical, very important to the health security of Australia and of the people who live here.

This legislation amends the Quarantine Act 1908. It is the legislative basis for implementing Australia’s treaty obligations under the International Health Regulations 2005, the IHR. In relates to vaccinations and vaccination certificates for international travellers and charges levied on travellers for public health measures. The proposed amendments will enable persons seeking permanent or temporary residence to be charged by the Commonwealth. Very importantly, there will be no charge borne by Australian citizens. Only a very small group of people will be charged under this legislation. It is not expected that there will be any great costs associated with the implementation of this legislation, but any costs associated with it are well and truly worth while because this health measure can prevent the spread of communicable diseases in Australia which can have most serious implications for the Australian community.

The amendments are required to enable Australia to fully comply with the IHR 2005, which came into force on 15 June 2007. The IHR is an international agreement aimed at protecting public health security. It does that by controlling the spread of infectious diseases in ways that avoid unnecessary interference with international trade and traffic. Once adopted by the health assembly of the World Health Organisation the IHR 2005 is legally binding—and that is fairly important—for all WHO state parties that neither rejected nor filed a reservation to the IHR 2005 by 15 December 2006. The IHR 2005 came into force on 15 June, as I have previously stated, and Australia neither rejected nor registered an objection, so we have obligations and this legislation is delivering on those obligations.

The IHR was revised in 2005, broadening its scope to include all public health emergencies of international concern. The IHR 2005 requires state parties to develop certain minimum core public health capacities to detect, assess and notify the WHO of health emergencies that are of international concern. You only have to look back to the crisis of the SARS virus and the talk of flu pandemics to understand just how important this legislation is and its implications for the community as a whole.

There are three key parties involved in this legislation. Obviously, the Commonwealth government is responsible for the legislation, but the legislation comes under the Australian Quarantine and Inspection Service, AQIS, so they have responsibility in this area. The Department of Health and Ageing has responsibility for developing human quarantine and public health policy in Australia. Human diseases that are subject to quarantine control in Australia are plague, rabies, cholera, yellow fever, viral haemorrhagic fever, smallpox, SARS and avian influenza in humans. The last two in particular are new diseases that the government has to turn its mind to when it is looking at immunisation, quarantine and the protection of the population in our country. Those diseases really emphasise the importance of this legislation. This bill is part of a package of new health security legislation which specifically addresses the requirements under IHR 2005 regarding vaccinations and related health certificates and charges.

The Quarantine Amendment (National Health Security) Bill 2008, as I have already pointed out, implements Australia’s international public health security obligations under the International Health Regulations. Proposed amendments will require travellers who are subject to quarantine to submit themselves to vaccination or other prophylaxis if this is necessary. Australia currently has the capacity to require vaccination; however, this is not extended to other prophylaxis or to diseases recommended by the World Health Organisation that are not quarantinable diseases. It is very important that this is addressed, which is another reason that this legislation is very important.

The issue of health certificates ensures vaccination and other prophylaxis is in accordance with the requirements set out in the IHR. As has previously been stated, currently yellow fever is the only disease for which proof of vaccination or prophylaxis may be required of travellers. There is potential for new vaccines to be introduced, and therefore it is important that we extend the legislation to cover new vaccines that come on the market. It is critical that Australia, along with our international neighbours, has the ability to require the necessary prophylaxis and it is essential that the paperwork is in line with international standards. Once again, that is what this legislation ensures.

The amendments align the current provisions relating to certain health measures with the requirements of the IHR. The amendments provide that, except for persons seeking temporary residency, there will not be any charge. When I was reading up on this piece of legislation, I noted that in some circumstances insurance companies may be required to actually pay for the vaccinations. Basically, this legislation is delivering on Australia’s obligations under the IHR of the World Health Organisation and should be supported by all members of the House.

Bill Shorten (Maribyrnong, Australian Labor Party, Parliamentary Secretary for Disabilities and Children's Services) Share this | Link to this | Hansard source

I thank the members who have spoken on the Quarantine Amendment (National Health Security) Bill 2008. I appreciate their contributions to this debate. The bill before parliament today is the second to implement Australia’s treaty obligations relating to public health security under the International Health Regulations, also known as the IHR. It builds upon the Rudd government’s commitment to ensure that all Australians continue to be protected in case of a major health emergency such as pandemic influenza.

The entry into force of the IHR in June 2007 was a public health landmark for the World Health Organisation and for all member states including Australia. It provided the international community with a new legal framework to better manage its collective defences against public health risks that can spread globally and with devastating effect. The National Health Security Act 2007 was passed by the parliament in September 2007. It provides the legal authority and establishes the operational arrangements for Australia to meet its IHR obligations to notify the World Health Organisation of health emergencies and to exchange surveillance information.

The proposed amendments to the Quarantine Act 1908 will implement IHR requirements in relation to vaccinations and prophylaxis and health certificates and charges that may be levied on travellers for measures to protect public health. Firstly, travellers who are subject to quarantine may be required to submit to vaccination or other prophylaxis if this is necessary to prevent the spread of a quarantinable disease or if the vaccination or other prophylaxis is specified in the IHR or recommended by the World Health Organisation.

Under our Quarantine Act, Australia has had the capacity to require vaccination for quarantinable diseases for the past 100 years. However, this has not extended to other prophylaxis or to diseases recommended by the World Health Organisation that are not quarantinable diseases. Other forms of prophylaxis include antivirals to treat pandemic influenza or antibiotics to treat bacterial infections. This provision would only be applied for diseases with the most serious of consequences such as SARS, plague, rabies, cholera, smallpox or avian influenza. A decision requiring a traveller to be vaccinated or take other forms of prophylaxis would be made on the advice of a qualified medical practitioner having balanced the wishes of the traveller with the broader public health interest in preventing the spread of a dangerous disease in Australia. A person refusing to comply cannot be forcibly vaccinated but could, for example, be kept in isolation until any danger to the community had passed.

Secondly, these amendments also provide for the issuing of health certificates proving vaccination or other prophylaxis in accordance with the requirements set out in the IHR for standardised certifications. It is critical for public health and to facilitate travel that Australia, along with our international neighbours, has the capacity to issue all essential paperwork in line with international standards.

Thirdly, the amendments take the existing provisions in the Quarantine Act relating to charges for certain health measures and align them with the requirement of the IHR. These amendments provide that, except for persons seeking temporary or permanent residence, charges will not be applied for certain health measures administered to international travellers to protect public health. This includes measures such as medical examinations to ascertain the health status of a traveller, vaccinations or other forms of prophylaxis, and restrictions on travel that may be necessary to prevent the spread of disease.

Charges for such measures will not be levied on travellers who are Australian citizens or who are in transit to another destination. Charges will, however, be able to be levied on persons seeking temporary or permanent residence in Australia. The bill authorises the minister to set, by legislative instrument, fees for the provision of health measures in these cases. Such fees will be limited to the actual cost of necessary health measures and must be published 10 days before they come into effect. The Commonwealth may also seek reimbursement from insurance companies or, in the case of crew members, from the master, owner or agent of the vessel. In addition to the amendments giving effect to the IHR, the opportunity has been taken to make some minor technical housekeeping amendments to the Quarantine Act.

I stress the importance of this bill in ensuring that we fully implement our international treaty obligations. The Rudd government is committed to ensuring that Australia has the capacity to respond appropriately to public health risks, and this bill will help to ensure this.

Question agreed to.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.

Ordered that this bill be reported to the House without amendment.