Tim Watts (Gellibrand, Australian Labor Party) Share this | Link to this | Hansard source

The bill before the House repeals the Australian National Preventive Health Agency Act 2011 and abolishes the Australian National Preventive Health Agency, a body established by my predecessor in the electorate of Gellibrand, Nicola Roxon, during her very successful period as the federal Minister for Health and Ageing. It is a testament to the short-term, self-destructive approach taken by those opposite since they came to government. Chronic disease is one of the biggest and fastest-growing cost burdens on the Australian healthcare system. There was ample evidence of the need to respond to this chronic illness crisis at the time of the establishment of the ANPHA. As my predecessor told this House in the second reading speech for the bill establishing this agency, Australia has serious preventative health issues in relation to alcohol:

… our overall per capita consumption of alcohol is high by world standards.

One in four Australians drink at a level that puts them at risk of short-term harm at least once a month.

Around 10 per cent of Australians drink at levels that put them at risk of long-term harm.

A similar story can be seen in Australia's obesity statistics. I quote again from the second reading speech at the introduction of this agency:

… we are now one of the most obese nations in the world.

The National Preventative Health Taskforce stated that if obesity trends are left unchecked the life expectancy for Australian children alive today will fall by two years by the time they are just 20.

The burden of chronic disease is particularly clear in my electorate. At present, men living in Melbourne's west are not healthy. There are areas in my electorate where over 50 per cent of men are overweight or obese and where one in three men smoke. The consequence is very high rates of diabetes, heart disease, lung disease, renal diseases and bowel and digestive cancers. As a result, in my electorate we have one of the lowest average life expectancies for men in urban Victoria.

During the lives of people afflicted with these illnesses, we also have a healthcare system struggling under the burden of providing ongoing and costly treatment of these chronic diseases. The cost-effective way to respond to these diseases is through investment in prevention, not in treatment after the fact. You cannot cut your way to a more cost-effective healthcare system in a developed economy, certainly not through cutting preventative health measures, at least. This is why there is such a significant need for the Australian National Preventive Health Agency.

The ANPHA was recommended by both the National Health and Hospitals Reform Commission and the national Preventative Health Taskforce. The ANPHA was established under the National Partnership Agreement on Preventive Health, a COAG initiative announced in November 2008. Through this national partnership, the previous Labor government agreed with the states to commit to a wide range of initiatives targeting the lifestyle risk factors of chronic disease, including:    interventions in preschools, schools, workplaces and communities to support everyday behavioural changes focusing on diet, physical inactivity, smoking and excessive alcohol consumption, including binge drinking. The ANPHA's role in this process was to monitor and evaluate the effectiveness of these interventions—to gather evidence about the effectiveness of various preventative health interventions by collecting data and collating statistics and then, on the basis of this evidence, to administer a preventative health research fund to inform future interventions.

The ANPHA provided leadership in centrally coordinating preventative health interventions across the health sector—across non-government providers and the health promotion and primary care sectors. Making this kind of coordinating role work requires long-term institutional leadership. It is not the kind of role that can be effectively performed within a Public Service juggling many other priorities, many of which are more pressing and immediate in nature but not more important in the longer term. A stand-alone body dedicated to maintaining a long-term focus on the importance of evidence based preventative health interventions is crucial to the long-term cost-effectiveness of our healthcare system. We need a body that will coordinate and maintain a focus on preventative health interventions beyond the budget cycle and beyond the political cycle.

The ANPHA provided the institutional infrastructure needed to operate an effective and efficient system of preventative health interventions in this country. That is why the establishment of the ANPHA was supported by public health groups like the National Heart Foundation, the Public Health Association, the Cancer Council, VicHealth, Quit Victoria and the Royal College of Physicians, to name just a few. Given this, you would think the value of such a body to Australia would be pretty near to incontrovertible. You would think this would be like debating the merits of motherhood. But no; instead this bill has been caught up in the ideological inanity that is the obsession of those opposite with the 'nanny state'.

We know the real reason why those opposite are opposed to the ANPHA. It is because preventative health institutions like the ANPHA are opposed by the big food, big tobacco and big alcohol industries. It is the same reason that these measures are so stridently opposed by the Institute of Public Affairs. In fact, the abolition of the ANPHA is No. 29 on the Institute of Public Affairs list: 75 radical ideas to transform Australia, a list which is rapidly becoming the governing blueprint for what was a craven and substance-less opposition.

Of course, the IPA's radical ideas list also targets other preventative health initiatives, introduced by my predecessor in the seat of Gellibrand including:    the repeal of tobacco plain-packaging legislation; the repeal of the so-called alcopops tax; the rejection of proposals for compulsory food and alcohol labelling—we recently saw how well that was managed by the Assistant Minister for Health's office—and the end of all government-funded 'nanny state' advertising, whatever that means.

I suppose it is a quite radical approach to reject an evidence-based approach to policymaking. I suppose it is a radical approach to disregard expert advice on preventative health policy. But I cannot for the life of me understand it myself. I particularly cannot understand how anyone could think that these are five of the 75 most important issues for our nation.

If the IPA revealed the sources of its corporate funding we might be able to draw inferences about the reasons for the prioritisation of these issues but, as it refuses to provide even the most basic transparency about its funding sources, we are left utterly in the dark.

Of course, it is not just the ANPHA that is being attacked by the Abbott government; preventative health initiatives across the board are currently under attack.    Funding for the states and territories for vital preventative health programs has been slashed, programs designed to increase physical activity, improve nutrition and healthy eating, help people to quit smoking and limit their alcohol consumption.

The Medicare Local system, established by the previous government, as a key partner with the ANPHA in enhancing the primary care sector's focus on prevention, will also be abolished. In my electorate our Medicare Local is already playing a key role in delivering preventative health interventions.

The north-west Melbourne and Macedon Ranges Medicare Local has joined with the Western Bulldogs AFL club to create the 'Sons of the West' Men's Health Program, a community health initiative, which is designed to support men living and working in Melbourne's west.    Partly based on a similar program, run successfully by Liverpool Football Club in the United Kingdom—a place like Melbourne west, facing major issues with chronic disease—this program aims to engage up to 2,000 men in Melbourne's west to promote healthy living and prevent disease. 'Sons of the West' is an innovative example of how to engage and encourage men to take control of their own health. The 12-week program emphasises activities that are social and fun, and alternates training activities with barbecues, health checks, comedy nights and do-it-yourself training. The men undertaking this program will train with the legends of the Western Bulldogs football team, including Steve Kretiuk, Brad Johnson, Scott West, Doug Hawkins and Tony Liberatore, and will learn how to prepare healthy meals from Jamie Oliver's Ministry of Food.

At the end of the program, if the men get in good enough shape to drop a shirt size, they will also be rewarded with a free Western Bulldogs guernsey.    This program is just one example of the fantastic work our Medicare Locals do in providing tailored and coordinated support to the healthcare needs of our community. Yet, like the ANPHA, our Medicare Local and preventative health interventions of this kind are now facing the axe from the Abbott government.

Of course, all of these cuts to preventative health also come at the same time that the Abbott government has ripped billions of dollars out of frontline healthcare funding and is attacking the foundations of Medicare through its GP tax. This is a government that promised 'No new taxes,' and then slugged Australians with a $7 GP tax every time they visit the doctor.    This is a government that promised 'No cuts to health' and then ripped billions of dollars in funding from our hospitals.    This is a government that has shifted the costs or passed the buck for health care onto the states and onto the family budgets of low- and middle-income Australians.

As a result of these attacks, a typical Australian will pay an extra $270 a year in healthcare costs and even more if they have a chronic condition such as asthma, diabetes or some other form of ongoing disability.

I can reassure the House that Labor will always be the party of high-quality, affordable health care. We will fight these regressive policies in this chamber.    We will also fight them in the other place. We will fight them in our communities in the lead-up to the next election and we will ensure that this government faces a reckoning for these policies. The Australian people did not vote for the Abbott government's attack on our healthcare system at the last election and they do not want it. Over the next two years, before the next election the Labor Party will work to ensure that the Abbott government pays the price for it.

Andrew Laming (Bowman, Liberal Party) Share this | Link to this | Hansard source

Australia has indeed a fine history of public health. It is worth recounting briefly as we debate the Australian National Preventive Health Agency (Abolition) Bill 2014. As we consider the future of the Australian National Preventive Health Agency in this country, this is another example of yet another agency, well meaning, filled with talented and committed people but which is, ultimately, unaffordable.

In the years it existed, ANPHA failed to carve out its own space, supported by states and territories, its information not requested by jurisdictions. Ultimately, there is a certain impotence about collecting data which no-one uses. One of the great frustrations in the health system is that there are up to a dozen data-collecting agencies. There is no doubt that that cannot be good for managing an individual's health.

We know that over time, more so now, public health has shifted its emphasis from infectious diseases to diseases of lifestyle, obesity, diet, lack of physical activity, alcohol abuse and smoking. These lie at the core of what determines how long we live.

Everyday observers would probably say, 'Surely, just being healthy in and of itself is reason enough to lead a healthy existence.' But, alas, no. There is a need for both services to support health and ultimately public communication to remind people of the benefits, and significant investment. So we have a $130 billion health system to do just that. Australia is a developed economy and invests about 45 per cent of that in just two per cent of the population. The challenge for us is trying to extend disability-adjusted life expectancy as far as we can. We are now No. 2 in the world. But at some point we have to work out where along the life continuum is the best place to brief interventions from professionals that can change the course of our life. Ultimately, let us not forget what public health's limitations are. Ultimately, we all have to choose a door to pass through at the end of our lives. That time must come eventually. Public health may offer us a slight extension, it may improve the quality of that life but, ultimately, when that time comes those First World health expenses cannot be avoided—the need for that heart procedure, the long-term care if one suffers from dementia or those expensive treatments to slightly prolong life and reduce suffering if you contract terminal cancer.

For these three great doors, public health is trying to extend the quality of life and obviously reduce suffering as long as we can. It sounds quite heartless, as a health economist, to say that what we really want is to live a long, pain-free, productive life but in the course of that demise and decline that we do so as inexpensively as possible. That is the honest, laid-bare rationale behind health economics. So what do we have? We have a four-pillared health system of MBS, PBS, public hospitals and private health. It is the envy of the rest of the world. We still spend less than 10 per cent of our GDP on health care but achieve outstanding results. That is in no small part due to the people who now work at ANPHA, committed professionals, as I have said before, who have worked in a number of roles before they came to ANPHA, took on that opportunity because the previous government presented that to them. It just seemed at one point, having already had AHPRA and APPRA and running out of acronyms, this government had to call it the Australian National Preventive Health Agency because they were running out of options. But in the three years they had they committed an enormous amount of goodwill and intellectual energy to the task.

In trying to address social determinants that lie around these health risk factors, we know that we can move to education in the early years, we can look at the quality of housing, we can look at the amount of physical activity people are engaged in, we can look at a whole range of personal behaviours, but ultimately publicly funded professionals cannot kick a door in and tell people how to lead their life. So it is a frustrating job for people working in public health to try and find interesting ways in to a person's life, be it Summernats or a football game or sponsoring an app. You can see that some of these appear clumsy from the outside and sometimes wasteful, but in the end decision makers in this chamber have to say, 'Is the dollar best spent there or is it best spent making sure that that old bloke can get his knee done?' And we have to make sure that young children turning up to casualty are seen in a reasonable time. We have to make sure that people who need an operation for a hip can get it. We have to make sure that life-saving surgery can continue in well-funded hospitals. This is that terrible Hobson's choice.

In making that decision we need to have a clear way in which we proceed. We can never stop funding a hospital, we can never stop funding the subacute that transitions people out, we can never stop funding the aged care that delivers the transition for our seniors. But we have to then work back and say, for those who regularly are in and out of our hospitals with chronic disease, who can we best support to reduce those visits to hospital, those unnecessary trips back, the surgery that goes wrong, their mishaps within hospitals that could have been avoided? Nations overseas are becoming quite vicious about the way they will not fund wasteful health expenditure.

In Australia we are privileged to have the answer to the question I have just posed. It is our 35,000 general practitioners, some of the highest trained public officials or recipients of public funding in the country. Training for no less than 10 years, their job is within five to 10 minutes to be able to deal with the health concerns of a concerned and often unhealthy Australian. They do it every day, all day, in every corner of this country. They are the linchpin, the cornerstone of our health system. We must support them in every way. So if they are working in increasingly complex team based arrangements to share information, to identify the people that need the health care most, to make sure that the people who are most ill get the most time, we need a quite elaborate and sophisticated health system to meet that challenge. If we are going to have public health interventions, they need to be cheek and jowl with general practitioners, because that is the front line.

With the greatest respect to many of us in this chamber who know no more about the health system then when visiting hours are at the local hospital, until you have worked and sat in a room with a general practitioner you cannot possibly begin to understand the complexity and the challenge of fixing this problem. With the greatest of respect, asking people to sit at shopping centres and encourage people to go in walking groups just sets up a weird kind of adverse selection where the worried well, the people we least need to worry about, start consuming public health resources. It is only the general practitioner who sets up that chronic disease management plan and knows that the extra time and money is best invested right there. If the general practitioner knows when that needs to be, with the greatest of respect, we do not need to be chasing young, fit people and telling them that the way they lead their life is no good. It is simply not an effective use of public resources. I have no problem with highly expansive and elaborated primary health care and health promotion as long as we get the tertiary end right, but at present the tertiary end is in many cases a shambles. General practitioners send their patients to a specialist. Letters come back in hard copy. There is no record available to the ambulance. They turn up at hospital and have all of their tests replicated. These most simple challenges to our health system are still in many cases beyond us. That must be our focus—we must get that part right.

Only one or two per cent of our population are in this category: high need, complex, chronic disease patients, usually with limited resources. Their entire calendar is devoted to marking off when their next health appointment is. When you health calendar and diary takes over your social calendar and diary, these are people that genuinely need extra investment because that will keep them out of hospital for longer and able to enjoy their life. It is not the focus to be putting out apps to people and counting your successes in downloads. No downloading of an app will stop a person smoking. It is the cigarettes that you do not smoke that fixes your health. We are winning with cigarettes but there is still long way to go with diet, exercise and alcohol. So let us start counting outcomes, not inputs. This is the great Labor myth: how much money we spent, how many apps got downloaded. But you know what? We never checked how many people stopped smoking. We did not write that in because if we did we might prove the waste of money that it was. Sure, you downloaded the apps. That is exciting stuff. But nobody has stopped smoking, they kept smoking. Australia's drops in smoking rates were under the Howard government and the clear warnings on 30 per cent of the front and 80 per cent of the back brought in by the current Prime Minister. Australia's smoking results are the one positive trend that we see in public health. All of the others are potentially heading the other way.

If we are designing this for Australia we need to come right back to general practitioner, the average GP working full-time, 25 patients a day, 150 a week, working till 6 pm at night with barely enough time to spend with people who truly need it and virtually no super-clinical coordination of the extra services that the GP needs to do it right. That post stroke rehabilitation nurse who could be in seeing five of that GPs patients needs to be easily accessible to truly make a difference. They do not exist in every practice but they have to be easily accessible to the GP. That support to help them to do their job well is what matters. You do not need a five-storey building to do that. What you need is a care navigator sitting in the large practices identifying the 100 most high priority patients for that extra coordination and support. That can be SMS reminders, it can be calling them back in but not to see the general practitioner, that can be to do all sorts of help promotion activities, but let it be run through general practice.

We did not invest all this money in general practice only to set up a parallel entity like potentially, as we will debate later this year, the role of Medicare Locals. I have no problem with the staff of Medicare Locals. Many of them are highly talented people, but they had no commissioning and no direction. They were simply unleashed by the previous government, who knew so little about a health system that they figured Medicare Locals would work it out for themselves. What we are left with are large entities, employing sometimes more than 100 people with large amounts of money in the bank and unable to spend it. I will do my best to stimulate again the Parliamentary Secretary to the Minister for Finance, who is at the desk. He has a Medicare Local in his electorate and he must be genuinely concerned whether they are satisfactorily supporting his general practitioners. We must connect the information from specialists and from local public hospitals to support a GP's work, that is the essence of public health. That is what we call front-line services.

Right now, we have not had a satisfactory state buy-in for very good reasons. For the last 10 years, states have been slowly pulling back their services to in-patient related work and they are very happy to vacate the public health space to the Commonwealth. That presents us with a significant cost-shifting challenge. But, ultimately, the Commonwealth is arguably best placed to do primary health care. We are funding the general practice system already. We are putting enormous amounts of investment into vaccination. The last thing we need are three levels of government trying to do all of that at the same time. The last thing we need is a large Medicare Local over here and a large community health building over there, and none of these people know what the others are doing. That is the risk of Labor's monolithic bureaucracies getting involved in the health system and the millions of dollars that follow those dreams.

I anticipate that the people working in Medicare Locals, and potentially ANPHA, will find a role much closer to the front-line. It is where they need to emphasise their work. If we can get the tertiary, recurrent, complex patient area right, the big savings accrue mostly to state governments. If we can reduce the need for unnecessary admissions and procedures, that will be a saving for state governments. The problem is in state public hospitals where there are long waiting lists and it is effectively a ration system. Basically the faster they work, the quicker they go broke. So they have this enormous challenge where they need support from general practice to do everything possible to avoid unnecessary and poorly timed admissions. That can only be done if we identify our high-risk patients in every general practice, share that information with the local hospital, cooperate within that region and then play the efficiency game, and do as well as we can with those patients to reduce total health expenditure. If you get them right and we get tertiary health prevention right for the sickest Australians, then let's return here and let's have a debate about a role for ANPHA, for primary health initiatives and prevention. But right now that money is not well spent in that area, so long as we have poorly coordinated and fragmented tertiary services.

Matt Thistlethwaite (Kingsford Smith, Australian Labor Party, Shadow Parliamentary Secretary for Foreign Affairs) Share this | Link to this | Hansard source

I am pleased to make a contribution in this debate because, quite simply, this is lousy public policy. This is a backward step when it comes to preventative health and providing better health outcomes for the Australian people. The Australian National Preventive Health Agency (Abolition) Bill 2014 repeals the Australian National Preventive Health Agency Act and seeks to abolish the Australian National Preventive Health Agency, unwinding decades of progressive work on improving public health outcomes by preventative health campaigns throughout Australia.

Labor established the Australian National Preventive Health Agency in 2011 to take national leadership on preventative health for Australia to coordinate, analyse and advise on key statistics and data in relation to chronic disease and prevention, and to deliver and administer a preventative health research fund. The Australian Labor Party recognise the value and need for long-term, sustained investment in preventative health and for the benefits to health outcomes and savings to the health system that this preventative investment can achieve. It is often said that prevention is the best cure and that is the view of health experts. That is the view of health professionals. Here we have a bill that seeks to undermine all of the good work that has been done at a government level to encourage preventative health throughout Australia, to encourage people to live healthier lifestyles, to encourage people to visit their doctor when they have minor ailments so that they do not become major ailments.

Since its establishment, the ANPHA has sought to embed preventative health as central to the delivery of health care. In particular, the ANPHA has been working with Medicare Locals to enhance the primary-care sector's focus on prevention. Now that approach is being undermined. We have seen that this government is seeking to undermine the Medicare Local network, those integrated health-care packages that have been developed by health professionals, by GPs in concert with specialists and allied health professionals in local areas to reduce some of the complexity involved in dealing with numerous layers of health bureaucracy throughout the country.

In the wake of the recent Abbott government budget, one thing has become resoundingly clear—that is, this government is bad for Australia's health. Despite promising otherwise before the election, once the government was elected they took an axe to the nation's health-care sector, cutting billions of dollars from hospitals and from the health budget. They are seeking to introduce a co-payment for Medicare and GP visits. The first level of health care in this country is usually a visit to the GP. By introducing a co-payment, the government is seeking to deter people, particularly those on low incomes and fixed incomes such as pensioners and the vulnerable within our society from making important visits to the doctor.

In the weeks after the budget, despite the fact that the program has not actually been introduced, it has not gone through the parliament and become law, despite the fact that it is not programmed to commence as law until 1 July next year, we have seen a dramatic reduction in consultations with GPs. We saw that anecdotal evidence from the Australian Medical Association, saying that in various surgeries and GP clinics throughout the country people had rung their doctor and said that they could not afford the co-payment and they were cancelling their consultation. That is even before the system was introduced. Imagine what it will be like when the $7 becomes a reality. And it is not just on GP consultations, of course. It is on imaging and pathology services. It is on other related health care, such as scripts and consultations with pharmacists. It is bad policy because it deters people from seeking preventive health actions. It deters people from visiting their local GP. That first line of consultation with health professionals is being undermined by a co-payment.

The other point to make in respect of a co-payment is that it will not work. The evidence from throughout the world demonstrates that. Australia's public health costs—as the previous speaker, who is a former doctor, admitted—are relatively modest compared to the rest of the world. Our public health costs, as a percentage of GDP, are about 11.5 per cent; the OECD average is about 11.3 per cent. So we are right on the average. If you look at a system such as the United States', which relies much more on private consultations and private health insurance—it is a privatised system of health care—the public health costs as a percentage of GDP are up around 15 per cent. So not only is this bad public policy, in terms of not encouraging people to take preventive health actions; it will result, I believe, in an increase in our public health costs. That is not the manner in which we should be administering the public health system in Australia.

This government has taken short-sightedness to new lengths by scrapping the National Partnership Agreement on Preventive Health and the National Tobacco Campaign. It has shown a complete lack of vision in relation to understanding the challenges facing the health system into the future. Labor is also opposed to this government's decision to cut vital preventive health funding to the states and territories for work on increasing physical activity, improving nutrition and healthy eating, and reducing harmful alcohol consumption in communities around Australia.

Recently, the Global Burden of Disease Study was published in The Lancet. It is a study that is undertaken periodically by the University of Washington. The results are alarming: they demonstrate that Australia is facing an obesity epidemic. One in three Australians is currently obese. That is 5.2 million Australians with a body mass index of 30 or higher, defined as obese by this international study. That represents an 80 per cent increase in the past 33 years. Australia is now one of the fattest nations in the world. We ranked 25th in the world, just behind the United States but ahead of France and Germany.

We all know that obesity is linked to higher risks of heart disease and stroke, blood pressure and bowel problems, oesophageal and pancreatic cancer, and osteoarthritis. Despite these sobering statistics about trends in the health of Australians, and despite these studies, which are becoming increasingly prevalent, about the increasing costs of treating people for preventable diseases such as diabetes, heart disease and obesity—despite these facts, the government is showing complete indifference to preventive health measures designed specifically to help Australians make healthy lifestyle choices. I ask the government: how is cutting funding for preventive health programs good for the fitness and health of our nation and its people? How is cutting funding for national partnerships on preventive health good for the health of our nation? How is cutting funding for, of all things, the National Tobacco Campaign—which is aimed at providing information encouraging Australians to quit smoking—good for the public health of our nation? And how is abolishing the National Preventive Health Agency through this bill good for the health of Australians? Quite clearly it is not. It is a backward, regressive step, and it clearly represents the approach of this government when it comes to public health.

This is also a massive breach of trust and faith with the Australian public. It was the Prime Minister who said, a couple of days before the election, that there would be no cuts to health, no cuts to education, and the like. But, clearly, what we see manifest in this bill, in the cuts to hospital funding and in the $7 GP co-payment is a breach of faith—a clear broken promise; a lie to the Australian public about this approach to national health.

Australia's first national nutritional survey in 20 years, conducted by the Australian Bureau of Statistics recently, revealed that, confronted with record obesity levels, Australians are not only not adopting more healthy eating habits, but we are eating more sugar, more fat, more salt and more processed foods. My wife is a nurse. She works in a large public hospital in Sydney. She sees the results of the worsening of Australia's public health. She deals every day with preventable disease. And, since the last survey, the amount of fruit and vegetables in our diet has dropped by an alarming 30 per cent. Less than seven per cent of the Australian population now follows the recommendations on the appropriate number of serves of vegetables to be eaten each day. Among those surveyed, a quarter had consumed alcohol in the past day, and more than a third of the kilojoules they ate came from foods labelled 'discretionary', which include cakes, chips, chocolate, biscuits and the like. More and more, we are unhealthy. More and more, we are eating the wrong foods. And this is pushing up public health costs. People like my wife, working as a nurse in a public hospital, are dealing with this every day. And we all pay for it. We all pay for it through our public health costs.

But instead of encouraging greater dissemination of information to assist Australians to make the right choices about what they put on their plate—instead of encouraging Australians and providing more information in the public health realm about healthy eating—what is this government's approach?

This government's approach has been to pull down a website that was aimed at encouraging greater public health, about encouraging Australians to eat healthy foods, about providing Australians with more information about better nutrition, about changing behaviour regarding eating healthier food in Australia and, ultimately over time, about changing the culture of junk food in Australia to ensure that we are healthier and, over time, reducing preventative disease and the burden on the Australian healthcare system.

The great disappointment about this decision by the assistant health minister was that two years' worth of work had gone into this program—two years' worth of hard work and research about providing information through a website to the Australian public. It was torn down on the advice of a person who worked for the assistant health minister, and it was discovered later on that in a previous career they were an alcohol and soft drink lobbyist. You cannot get a more disgraceful decision by a minister of the Crown that affects, and will have a likely effect, on health outcomes in this country. And cuts to prevention come on top of other budget measures which will put a financial barrier in place, deterring people from accessing primary health care, which is an essential part of preventative healthcare delivery.

The Australian National Preventive Health Agency was not something that was dreamed up overnight. It was recommended by experts who comprised the Preventative Health Taskforce. This was not knee-jerk public policy. It was sound public policy that followed a lot of actions that have been taken throughout the world. It is proven that you can be positive and progressive on public health outcomes and get results.

I evidence the reforms that were introduced by New York's, Mayor Bloomberg—particularly in banning trans fats in fast food throughout New York—and the positive agenda that was introduced by that particular governing authority to improve public health outcomes in New York. It proves that if you make an investment in preventative health you will get healthier outcomes and you will see Australians reduce the amount of preventative disease. Ultimately, we will see Australians happier, healthier and less of a burden on our public health system.

This bill comes before the parliament at a time when our health system is under unprecedented attack from this government. It is an attack that is based on broken promises; an attack that seeks to attack Medicare and dismantle universal healthcare in Australia; to rip money away from hospitals; to shift the cost of health care from the government onto low- and middle-income Australians; and to attack families. This bill is bad public policy—it is lousy public policy and it must be opposed.

Andrew Southcott (Boothby, Liberal Party) Share this | Link to this | Hansard source

In speaking to the Australian National Preventive Health Agency (Abolition) Bill 2014 I just want to emphasise that the preventive health effort will continue if this bill is passed. The efforts in reducing smoking, reducing levels of harmful drinking and addressing our growing problem with overweight and obesity will be where they have always been at the Commonwealth level, and that is in the Department of Health.

Right now some of the claims that have been made that this winds back decades of effort in preventative health are absolute rubbish! What absolute rubbish, the idea that abolishing the Australian National Preventive Health Agency will wind back decades of progress in this area. This is a new agency that came out of one of the peaks of Kevin Rudd-style activism.

The previous speaker election the fact that people are not eating the recommended amounts of fruit and vegetables. That is correct. But how many people know that there was a national partnership agreement with all of the states and territories where we were going to measure the amount of fruit and vegetables that each state and territory was eating, and the states were going to be given reward payments for this. What we now know is that those national agreements, and the National Agreement on Preventive Health, have been a spectacular failure.

One of the issues with the Australian National Preventive Health Agency was that it was meant to be a collaborative effort with the state and territory governments. The state and territory governments do have jurisdiction over the preventive health agency, and yet no state or territory has ever put in one dollar into the preventive health agency.

So we see duplication and confusion about the roles between the agency and the Department of Health. If you look at the area of tobacco control, the Australian record is one that we should be very proud of. Over the last 33 years we have seen the rates of tobacco smoking amongst men and women decline in both genders by more than 40 per cent. And there is only a handful of countries that have seen anything like that progress. Really, Australia now has one of the lowest smoking rates of anywhere in the world and we are a country that has been very successful in changing the culture and reducing the levels of smoking. And that will continue.

There have been a lot of good reports provided to government, and the Preventative Health Taskforce did actually outline a lot of things that any government can pick up on. When we look at smoking, there are many groups where smoking rates are still too high: the Indigenous community, people with mental health issues and lower socioeconomic groups. Any future campaigns really need to look at those groups.

When we look at alcohol, Australia is in the middle ranks of OECD countries in alcohol consumption. We do have problems with levels of harmful drinking. We have got problems with binge drinking. One of the things that came out of the Preventative Health Taskforce was: while there are a lot of measures that are controversial, there is one that actually is not controversial and which provides enormous benefit—that is, a targeted intervention from a general practitioner really does pay dividends. That is something that I think this government needs to focus on.

It is true, when we look at our levels of overweight and obese Australians, that we are one of the top countries now. It is not something to be proud of. It is something which has happened within the space of a generation. All countries are seeing this. France has had some success in actually halting it and there is some evidence from the United States that they have had some success in stabilising their very high levels of obesity.

One of the campaigns in this area that I think was a particularly good one and which has continued is the Measure Up campaign. It started in 2006 and it recognised that in this area you need to have TV advertising, you need to have advertising on bus shelters and you need to work with health professionals especially GPs so they have got the material. It does require a multipronged strategy to really start to get our nation healthy, otherwise there will be a huge burden in the future.

The preventative health effort will continue. It will be run by the Department of Health at the Commonwealth level. The buck will stop with the Minister for Health and the Assistant Minister for Health. One of the things that I think is of concern around the country is the state and territory governments are getting out of the primary health care space, the preventative health space and the community health space at a rate of knots. They have taken the opportunity from Kevin Rudd's dramatic reforms to vacate that space. It is something that is going to be left with the Commonwealth government in the future. We need to continue to have strong tobacco control policies. We need to do much better in the areas of alcohol and obesity because those things will continue.

Kelvin Thomson (Wills, Australian Labor Party) Share this | Link to this | Hansard source

In my speech on the 2014 budget, I flagged that I intended to become more expert and involved in the area of health policy. One area of health policy I particularly intend to become more expert in is preventative health—policy promoting good health. I am therefore pleased to have this opportunity to talk about preventative health and the promotion of good health, though I regret the government initiative that has led to this debate.

As part of my journey into the area of good health policy, I met yesterday with the CEO of the Public Health Association of Australia, Michael Moore. I am indebted to him and to the Public Health Association for some of the following material.

Why do we need a National Preventive Health Agency and why is it wrong to be abolishing it as this bill proposes? For me, the first reason is obesity. Obesity is Australia's most important public health issue. Obesity increases morbidity and mortality due to insulin resistance and type II diabetes, high blood pressure, cardiovascular disease, stroke, sleep apnoea, gallbladder disease and osteoarthritis. It is linked to cancer of the stomach, prostate, breast, uterus, cervix, ovary, oesophagus, colon, rectum, liver, gallbladder, pancreas and kidney.

The National Preventive Health Task Force reported that in just 15 years, from 1990 to 2005, the number of overweight and obese Australian adults increased by 2.8 million and predicted that if these trends continue almost two-thirds of the population will be overweight or obese in the next decade. Last Thursday, the Institute for Health Metrics and Evaluation published a report in the Lancet saying that Australians are fattening up faster than anyone else. The proportion of obese adults went up from 16 per cent in 1990 to 29 per cent last year. Australia and New Zealand experienced the largest absolute increase in adult obesity in any of the 188 countries studied. An estimated 11 million Australians are now overweight, almost half of them severely.

One of the saddest aspects of obesity is the impact on children. There is increasing evidence that obese parents are producing obese children. The National Preventative Health Taskforce identified that a quarter of our children are now overweight or obese. This is up from just five per cent of our children in the 1960s. Almost a third of children do not meet national guidelines for physical activity and only about a fifth meet dietary guidelines for vegetable intake.

There was a report in the Weekend Australian Saturday magazine last Saturday entitled Why childhood obesity is out of control, which gave a troubling insight to the battles faced by parents with their children, reporting that kids as young as two are going to obesity clinics. One health expert said that obesity is killing our children, giving an example of a severely obese 10-year-old, who died of sleep apnoea after his heart stopped. Children now consume 400 kilojoules a day more than they did 40 years ago, encouraged by processed food that is high in sugar, fat and salt.

What does the Public Health Association of Australia say we can do about it? Quite a lot. In the first place they propose that we develop a national nutrition policy which links in with other policies such as the National Food Plan and policies in the area of physical activity, women's health, Indigenous health and the national curriculum. It further suggests a levy or tax on nutritionally undesirable food such as sugary drinks with a view to using the funds for preventative programs and to subsidise nutritionally desirable foods for disadvantaged groups. They also suggest legislated controls and active monitoring to protect children from the advertising and promotion of nutritionally undesirable foods—those that have low nutrient density or that are high in fat, salt, sugar or energy. They advocate improved labelling of foods so that nutrition and health information is clear and consistent, with effective controls to stop false health claims for nutritionally undesirable food. They also propose research and implementation of effective health and physical education in schools in the new Australian curriculum.

There is certainly a need for real action to tackle obesity and the damage it is doing to our nation's health, and in particular to our children. And it makes me wonder why this government wants to abolish the Australian National Preventive Health Agency. Labor established this agency in 2011 to take a national leadership role in preventive health for Australia; to coordinate, analyse and advise on key statistics and data in relation to chronic disease and prevention; and to deliver and administer a preventive health research fund.

The Australian National Preventive Health Agency has been providing leadership across the non-government, health promotion and primary care sectors, in order to deliver coordinated and effective preventive health activities and policies. It has been playing a central role in collaborating across the health sector to embed preventive health as central to the delivery of health care, in particular the agency has been working with Medicare Locals to enhance the primary care sector's focus on prevention. We recognise the value and need for long-term, sustained investment in preventive health, and for the benefits to health outcomes, and savings to the health system, that this investment can achieve. This is why we established a dedicated agency, to drive the agenda over a sustained long-term period and provide the infrastructure for this to continue beyond the budget cycle.

Prevention became a central focus for the health system, and the agency was directing action specifically around obesity, tobacco and alcohol use. Many of the most important organisations working directly in public health supported the agency, including: the National Heart Foundation, the Public Health Association and the Royal Australian College of Physicians.

We will oppose this bill for the short-sightedness that it demonstrates in relation to the key priorities facing Australian's health today, and for the lack of vision the government has in relation to understanding the challenges facing the health system into the future.

Labor is also opposed to the government's callous decision to cut vital preventive health funding to the states and territories for work in increasing physical activity, improving nutrition and healthy eating, and support for smoking cessation and reduction of harmful alcohol consumption in communities around Australia.

This bill comes before the parliament at a time when our health system is under an unprecedented attack from the government; an attack that is based on broken promises, an attack that seeks to attack Medicare and dismantle universal health care in Australia, an attack that seeks to rip money away from hospitals, and an attack that seeks to shift the cost of health care from the government onto the strained budgets of low- and middle-income Australians. This attack that will see a typical family pay more than $270 a year in healthcare costs—and it will be even more for senior Australians and families dealing with disabilities and chronic conditions like asthma and diabetes.

These decisions, in combination, are likely to impose a significant setback to the preventive health agenda and the efforts that states and territories were contributing to. Combined with the government's other health budget decisions—the GP tax, more expensive medicines and substantial cuts to hospital funding—the decision to rip money away from prevention will add to the potential for people to become more sick because of financial barriers to seeking primary care and the cessation of community initiatives supporting them to stay healthy and out of hospital.

I believe preventative medicine should always be the cornerstone of a nation's health policy. Health is a state of complete physical, mental and social wellbeing, and not merely the absence of disease and infirmity. One of the things I have noticed when reading about these things is that part of this is a healthy exposure to the natural world, to the environment. In a paper by Graham Rook from the Centre for Clinical Microbiology, Department of Infection, and the National Institute for Health Research and University College London Hospitals Biomedical Research Centre, which states:

Numerous studies demonstrate that living close to the natural rural or coastal environment, often denoted 'green space or 'blue space,' respectively, is beneficial for human health. It reduces overall mortality, cardiovascular disease, and depressive symptoms and increases subjective feelings of well-being. The beneficial effects are particularly prominent in individuals of low socioeconomic status.

There is evidence that access to green spaces can provide health benefits, through improved mental wellbeing and levels of physical activity, and reduced exposure to pollution and high urban temperatures. For example, the National Health Service in the United Kingdom is increasing green space on its estates through the NHS Forest Project, which will plant 1.3 million trees by 2015.

The UK Public Health White Paper 2010 notes that green spaces can improve mental health and the quality of community life. Researchers have observed a link between increasing urbanisation and psychosis or depression; living closer to urban green spaces is also associated with lower mental distress. One study of the same 10,000 people over 18 years concluded that living in an area with high levels of green space led to a decrease in mental distress, compared with living in areas with little green space, once factors such as age, gender and income have been statistically accounted for.

Experimental evidence suggests that spending time in green space, or simply having views of nature, can improve reported mood, self-esteem and concentration, and treat stress and mental health disorders. The UN Millennium Ecosystem Assessment 2005 and the second phase of the UK National Ecosystem Assessment identify the multiple benefits of nature for mental wellbeing. The magnitude of these benefits is partly dependent on the quality of a green space, so careful design and maintenance is important.

In the 19th century, public open space was created in the United Kingdom and the United States precisely with a view to improving the health and quality of life of the working classes living in squalid and crowded living conditions. Perceived as the 'lungs' of polluted cities, public open space provided alternative activities for the workers, who were seen to be slipping into what was described as moral decay, as well as a place for physical recreation. Today, well-designed public open space that encourages physical activity is a community asset that contributes to the health of local residents. A study published in the American Journal of Preventative Medicine confirmed that public open space is an important community resource. Good access to attractive and large public open space is associated with higher levels of walking. Public open space continues to play an important role in contemporary society.

It is clear that this government intends to slash spending on health as part of one of the most radical programs of welfare-state retrenchment in recent times. The then Shadow Treasurer said in London in April 2012, 'The age of entitlement is over'. Just so no-one misunderstood, he went on to say, 'Government spending on a range of social programs including education, health, housing, subsidised transport, social safety nets and retirement benefits has reached extraordinary levels as a percentage of GDP.' There is no evidence for this claim, and I note that Professor Peter Whiteford, from the Crawford School of Economics at the Australian National University, recently stated that OECD data shows that Australia is 'relatively low in terms of social security and around average in terms of spending on health'. Of course we know that this government rejects the advice of experts that do not agree with the opinions of the Prime Minister, but it is important that we have an ongoing national investment in health, because the consequence of not doing this for our community and for our children will be very severe.

Labor will always be the party of health care. By contrast, Australians know that the coalition simply cannot be trusted when it comes to providing a strong, sustainable and universal healthcare system. Unlike those opposite, Labor understands the importance of investing in preventive and primary health care. We understand that preventive health is not a dispensable plaything to be thrown around in budgets; it is a crucial component of public health policy pivotal in ensuring a strong and sustainable healthcare system. It is regrettable that the government has introduced this bill. I hope that it does not pass the parliament. I hope that we as a country continue to have a strong focus on preventive health.

George Christensen (Dawson, National Party) Share this | Link to this | Hansard source

I strongly support the Australian National Preventive Health Agency (Abolition) Bill 2014, because it is a removal of duplication and expense that is an unnecessary drain on taxpayer funds and I question why we need to have an agency that tell us exactly what to do. Before the election the Liberal and National parties said that we were going to remove unnecessary red tape and regulation, and that is what we are doing. We are doing it here today because the Australian National Preventive Health Agency is a redundant agency. It is funded by the Commonwealth, funded by taxpayers, in addition to the Commonwealth Department of Health, despite the fact that most of its functions actually overlap the functions that are in the Department of Health.

In addition, a range of other Commonwealth research bodies have been funded to work in the same space: the Australian Research Council, the National Health and Medical Research Council, the Productivity Commission and the Australian Law Reform Commission. None of these bodies, though, were ever specifically tasked by government to actually lobby government, but this agency that we are abolishing here today was. One of the legislatively defined functions of the agency is to lobby and advocate for public policy change. The agency is a taxpayer funded lobby group—government giving money to an agency to then lobby the government for particular changes. How crazy is that?

I read a lot from the Institute of Public Affairs. They put out a lot of good stuff. One of the reports they had, which was called The biggest vested interest of all: How government lobbies to restrict individual rights and freedom, said:

One-third of the submissions to the Preventative Health Taskforce—which established the Australian National Preventive Health Agency—were from bodies which received large amounts of taxpayer funding.

So, there you go: taxpayer dollars going to agencies that are going to another taxpayer funded agency to recommend that an agency be created that recommends back to government programs that have to be funded out of taxpayer dollars. It is absolutely crazy.

The method of this self-lobbying works something like this: (1) Taxpayers fund an agency to come up with a health-first paternalistic policy; (2) taxpayers fund research to justify the policy; (3) taxpayers pay for the agency to lobby the government to impose the policy; (4) the policy is then introduced; (5) the policy is then measured and evaluated; (6) if the policy was ineffective, a stronger policy is then proposed, because the earlier one failed; and (7) if the policy was effective, a stronger policy is proposed because the earlier one succeeded. And round and round we go on that taxpayer funded merry-go-round. We end up with a self-reinforcing taxpayer vortex of control.

While, with this bill, we are getting rid of some duplication, this bill includes transitional provisions for functions from the agency to transfer the Department of Health. I am glad that this agency is going, because it is, as far as I can see, a lead apparatus in the creeping nanny state. We have seen the nanny state creeping into our lives, particularly under the last government—riding on the back of these supposed preventative health measures. We have just heard from the member for Wills and after I had listened to about five minutes of his speech, I thought, 'God, I should be dead'—after all that doom and gloom. I am one of those people, as you can see, Mr Deputy Speaker, who suffers from something called obesity.

Michael McCormack (Riverina, National Party, Parliamentary Secretary to the Minister for Finance) Share this | Link to this | Hansard source

Surely not! Surely you jest.

George Christensen (Dawson, National Party) Share this | Link to this | Hansard source

No, it is true, Member for Riverina. I am going to echo some of the words that the member for Herbert said—and I am glad he is here. He went public with some of this. When Labor sees a fat person, they think, 'Oh, that person has a problem; let's set up a bureaucracy.' When they see someone smoking, they say, 'Oh, he's got a problem; let's set up a bureaucracy.' When they see someone having more than the standard number of drinks at night, they say, 'Let's set up a bureaucracy to deal with the person.'

But it actually has to come back to individuals making choices, sure with the help of some community support. I have to tell you something. When the Labor Party were in government, they eroded the community support there was for individuals. They established these things called Medicare Locals, which were, again, a creation of government, a quasi government department, and they stripped all of the health funding that was going to community groups running local, on the ground, preventative health measures in which people could actively get involved and they transferred them over to the Medicare Locals. Because of what Labor did, the Burdekin Centre for Rural Health is about to lose over half a million dollars in annual funding because all of their functions have slowly been transferred over to the Medicare Local and they will not be rolling out to the degree that the Burdekin Centre for Rural Health is engaged. That is a prime example of the rhetoric we hear in this chamber not matching the reality when it comes to what Labor actually does.

Ultimately, the individual is responsible for their own actions. That is why, when the Rudd-Gillard-Rudd government legislated plain packaging for cigarettes, I spoke against that bill. I did not believe then and I do not believe now that inch by inch encroachment into our personal lives is what our society should be about. We, as Australians, have the right to make our own choices and every time the government makes that little bit more regulation to force a particular world view onto the choices we make, our personal freedoms are eroded. At the time I said that, if the regulators and the Labor Party felt so strongly about telling people what they can and cannot do, they should just ban it. If we honestly believe that smoking is that evil we should have the guts to ban it. If we do not feel that strongly about it, then get out of people's lives, let them make their own choices and let them live the way they want to live. We have seen regulation after regulation applied to the tobacco industry and still people smoke. I talk to local shops. They report that the number of people buying cigarettes is increasing.

The previous Labor government attempted to drive smoking underground, so much so that sellers are not even allowed to display their little olive green products. It does not appear to have made any difference because in the three years since the legislation was introduced, the nanny state advocates have produced no evidence to suggest it has changed smoking rates in Australia. That seems a bit odd, given there has very likely been some surveys done in the course of those three years. Surely there are teams of wowsers waiting for the opportunity to tell us, 'I told you so.' Given that smoking rates in Australia have been steadily declining since 2001, even business-as-usual decline could have been twisted into some kind of 'proof' that interfering with people's lives actually works. It is not news the nanny state wants to hear but there is at least some feedback on the Australian experience being presented in the UK. The Times reported on 3 February this year:

Cigarette plain packaging law a failure, tobacco industry tells UK. Putting cigarettes in plain packs has failed to cut smoking in Australia, led to record levels of smuggling and could be illegal in the UK, the tobacco industry has warned a British government review of the measure.

Was there an outcry about the claims? No. The usual suspects argued the toss about the sale of illegal tobacco. An article in The Age, on 12 April 2014 read:

Last week, Fairfax Media visited several retailers in Melbourne's west including gift shops, milk bars and liquor stores, with the ex-Purana Taskforce detective employed by British American Tobacco. Illicit tobacco products were freely available upon requests for 'cheap cigarettes' and pre-rolled 'tubes' of loose tobacco or 'chop chop'. Illegally imported cartons of Marlboro Red and Dunhill Red cigarettes were sold at half the legal retail price, while other brand-named packs of 25 cigarettes cost as little as $8, compared to the normal price of almost $20. One Asian grocery store in Sunshine was asking $90 for a 10-pack carton of Manchester cigarettes—a fake brand manufactured in the Middle East for the black market. None of the illicit cigarettes were sold in the plain, olive-green packs required by Australian law, and many had no health warnings.

So what is the score on plain packaging? I will tell you what it is: free choice 1, nanny state nil. Even more questionable programs have been the photo competition run through the 'Be the Influence' campaign, calling for entrants to submit photos of their 'memorable moments' from One Direction concerts and spending $200,000 on developing a cookbook. One Direction fans could win One Direction merchandise, so there is a great investment of taxpayer dollars. And the cookbook included such classics as baked beans on toast, chicken and avocado sandwiches and 'the daily snack, banana and yoghurt'. Apparently these measures are about preventative health and reducing tobacco consumption.

This year—and last year as well—we have seen the nanny state sticking its nose into alcohol consumption. In February, the Australian National Preventive Health Agency produced its draft report Alcohol Advertising: The effectiveness of current regulatory codes in addressing community concern. I have concerns with the whole concept of telling people how to live their lives. I also have concerns about the 'evidence' the agency has used to justify that interference. The agency needed something on which to base their interference. For the record, here is some of their recommended interference for the media in relation to alcohol:

Free-to-Air Television: Remove the exemption for free-to-air television that allows direct advertising of alcohol products before 8.30 pm as an accompaniment to live sports broadcasts on public holidays and weekends.

Subscription Television: Restrict direct advertising of alcohol products on subscription television before 8.30pm and after 5am.

Cinema: Restriction on the direct advertising of alcohol products on-screen in cinemas before 8.30 pm and after 5 am.

Outdoor and billboard: Increase the distance of advertising from schools from 150 m to 500 km.

Then there is the thought police recommendation:

Where an advertisement has a strong or evident appeal to children or adolescents, then it should be found to be in breach of the Code irrespective of whether the marketing is also appealing to adults or the community generally or whether the advertisement is deemed not to be directed to children.

On the subject of social media, the report notes how the agency has wrestled with control of the internet:

Many of the alcohol-related fan, event and group pages on Facebook are accessible to users of any age. The video viewing site YouTube also allows alcohol companies to develop their own pages and there are seemingly no age restrictions on viewers. YouTube provides a platform for companies to display recent and previous television advertisements, which may include older advertisements that do not satisfy current codes.

So next batter up on the nanny state hit list is YouTube. That is no surprise. But if there is concern about old advertisements 'that do not satisfy current codes' being accessible to children, then burn down the library. Burn it down. Burn down all the books and the microfiche that documents our history. Burn the old newspaper archives, the magazine archives. Don't leave behind any trace of a culture that was once great and things that were done in the past because they do not satisfy the standards of the day. Because that is what this is really all about: the nanny state trying control society, trying to manipulate our lives, our actions and our thoughts.

According to an article in The Australian on 14 February this year, it goes even further: fizzy drinks. 'Fizzy drink tax could save 67 lives: study'—that was the headline. It is a pretty specific outcome for a tax. The story kicks off with:

A 20 per cent tax on fizzy drinks would save about 67 lives a year, a new study says.

Researchers at the National Institute for Health Innovation at Auckland University, aided by Otago University, estimate such a tax would reduce energy consumption by 20 kilojoules a day, or 0.2 per cent.

This would be enough to help avert about 67 deaths from cardiovascular disease, diabetes and diet-related cancers a year, according to the study, published in the New Zealand Medical Journal on Friday.

I have got to tell you: if the greatest Treasurer in the world could not get the mining tax right, I do not know about these guys with their 67 lives, either. As one commentator said about the tax:

If there are 67 people out there so close to death yet so bent on avoiding even the measliest of changes to their eating and drinking habits that they could save their own lives by cutting just one diet soft drink from their diet every day then the cost of soft drinks is not the problem—those people are, and that’s not a problem you can attack with a tax on all soft-drinkers.

Another blogger lamented:

Through laws and taxes and regulations they try to consign us to an existence instead of a life; and this is not because the decisions they would make for us are necessarily bad decisions, but because they are not our own.

Society is not determined by some herd of hand-wringing heifers and steers in a departmental subcommittee's focus group. Culture is not ordered off a left-wing menu like some half-strength double decaf soy latte in a recycled paper cup. Society and culture are about people. Our culture is the function of our people—all the people, not just a select few. It is a combination of the lives, the actions, the thoughts and the choices of individuals. Some individuals will choose to drink alcohol. Some will choose not to. I do not believe the non-drinkers have any moral right or obligation to enforce their view and their personal choices on to anyone else's. This is not your culture; it is our culture. And our culture evolves individual by individual. We do not need a pseudo health agency to manufacture a culture for us; we need a health department to look after health.

And, sure, there are a lot of things that affect our health—drinking, smoking, eating, sugar, salt, caffeine, fat, carbohydrates, protein, gluten, wheat, vitamin supplements, water and air. If anyone holds strong convictions about any one or more of those things, that is fine. They can choose to consume or not consume. If they have scientific evidence to support it, that is fine. They can report those findings. But if we listened to every bit of advice about what not to consume, we would all be dead. Somewhere in the middle there may be a truth, but the question is this: for whom is it a truth and who has the right to impose their interpretation on everyone else?

According to the Australian Taxpayers Alliance, the interpretation should not be with ANPHA. They said in a media release earlier this year:

ANPHA was an uninspired tax sinkhole that a power-drunk wowser elite used to advocate banning, taxing, and taking away consumer’s choices ...

They have taken every chance to promote policies of control, because they are the only way to meet ANPHA’s increasingly neurotic standards of acceptable quantity of life.

They’ve wasted millions of taxpayer dollars on feeble, nagging media campaigns for no measurable benefit …

I support the bill.

Russell Broadbent (McMillan, Liberal Party) Share this | Link to this | Hansard source

I thank the member for Dawson. Clearly you do.

Jim Chalmers (Rankin, Australian Labor Party, Shadow Parliamentary Secretary to the Leader of the Opposition) Share this | Link to this | Hansard source

It is my honour to follow the member for Dawson. The member for Dawson is often entertaining but almost always wrong. He is wrong in this case about the Australian National Preventive Health Agency (Abolition) Bill 2014. As hard as it is to believe, this bill does abolish the Australian National Preventive Health Agency, and in doing so it takes Australia a huge leap backwards in the area of public health. It is being abolished not because it was not doing good work but because it was a proud achievement of the former Labor government. In that respect, the short-sightedness when it comes to investing in the future is breathtaking.

The abolition of this agency is not an isolated assault. It comes on top of tens of billions of dollars in cuts to hospitals, attacks on Medicare and the scrapping of the National Partnership Agreement on Preventive Health—all in this one horror budget. The $360 million worth of cuts to the national partnership funding, for example, will see the closure of countless programs that were tackling obesity, that were increasing physical activity and improving healthy eating for adults and children right around the country. Not only will this government make it harder for Australians to see the doctor; they will make it harder for people to develop the healthy lifestyles that will keep them away from the doctor's office to begin with.

The government is trying its absolute hardest to turn Australia's proud system of universal Medicare into a two-tiered American style health system in which only the richest have access to good quality health care. Labor will resist this government's attempt to undermine the founding principle of our health system, that Australians should get the health care they deserve and not just the health care they can afford.

Cuts to preventative health are just one of many cruel cuts in the Abbott government's budget of broken promises and twisted priorities.    The day before the election, the Prime Minister now famously went on Sunrise on national television and told Australia that there would be no cuts to health and that in fact funding for health would go up. Like so many others, this has proven to be a broken promise and a clear demonstration that this Prime Minister and this government just cannot be trusted when it comes to health care in our country.

Cuts like these are not just cruel. They are not just crazy. They are both. Cuts to preventative health will cost Australians in the long term, placing a greater burden on the hospitals and primary health care providers of tomorrow. But it goes further than this. Investment in preventative health is investment in healthier, happier and far more productive communities.    This government's attack on preventative health funding is an attack on those communities—on my own community in Rankin—and will lead to worse health outcomes for countless Australians.

I spoke in this place last week about the human face of this budget of broken promises and twisted priorities. I would like today to talk about the human face of the brutal cuts to preventative health in the budget, including the cuts to the National Preventive Health Agency and also the national partnership that I mentioned a moment ago. After the budget a couple of weeks ago, I met with a group of very concerned locals—devastated locals—who described to me the devastating impact of the health cuts on the Good Start Program on the Maori and Pasifika communities that this program seeks to support. The Good Start Program does some tremendous work in my area and in the member for Forde's area as well, reaching out to Maori and Pasifika families to combat community health problems like obesity, unhealthy eating and physical inactivity.

Health statistics amongst the Pasifika community in Queensland are really scary. The death rate for diabetes among Queenslanders born in Oceania is almost 230 per cent higher than the rate among Australian-born Queenslanders. Maori and Pasifika people are also far more likely to suffer from heart disease, vaccine-preventable diseases and smoking related diseases as well.

It is not okay for a government to sit on its hands as a sizable group of its residents die prematurely from preventable diseases. We need to do all we can to make sure that the Maori and Pasifika kids that live in my community, kids that I see around Rankin every day, live lives as long, healthy and productive as other Australians. We need to do all we can to eliminate the health divide that continues to widen not only between Pasifika Australians and the general population but also between low-income Australians and the better off, rural Australians and the city-dwellers, and Aboriginal and Torres Strait Islander Australians and the rest of us.

My community is incredibly fortunate to have a program like Good Start. It is a disgrace to see that it only has a few more weeks to run. The electorate of Rankin has the second-largest number of New Zealand-born residents of any community in Australia, with almost 14,000 people. As such, my area—and that of the member for Forde—is hit harder than many by the higher incidence of preventable disease among Maori and Pasifika Australians.

This is one reason why the last Labor government invested so much in preventative health in Australia. It is why we introduced the Australian National Preventive Health Agency: to lead a concerted national approach to preventative health in Australia. It is why, through national partnership agreements with the states, we funded programs like Good Start to attempt to narrow that divide in health outcomes among the general populace.

Good Start has entered into partnership with several schools and community groups in my area to work collaboratively to improve health outcomes. They have tailored the fundamental lessons of community health—which are nutritious eating, physical exercise and moderation in alcohol consumption—to the large Pasifika and Maori community in my area, and it is beginning to work. The preliminary evaluation of the Good Start Program in schools, conducted by the University of Queensland in the second half of last year, is really encouraging. The report says:

Preliminary results show that the Good Start Program is having a positive effect on knowledge and attitudes with regard to both fruit and vegetables, and physical activity—both important lifestyle influences of chronic disease.

This is an excellent outcome for health and wellbeing in my community but unfortunately one where the investment is about to be cut off.

The results of the study are fantastic, but the schools and community groups involved with Good Start do not need these academic studies to tell them how important their work is. Woodridge State High School, in my electorate, have described the program as 'outstanding' and attribute a substantial increase in HPE results among Good Start participants as a sign of its success.

Te Korowai Aroha, an organisation devoted to raising the profile of Maori and Pacific islander people in my area, have a strong working relationship with Good Start and nominated them for a public sector multicultural award last year. Together, they have worked towards offering healthier options at the annual Waitangi Day festival at the Kingston Butter Factory, in my electorate.

The Mater Child and Youth Mental Health Service coordinator describes the Good Start Program as 'a crucial service for the Pacific island communities in Queensland' and as a 'vital health service'—'the only culturally tailored service in response to chronic disease'.

And yet, because of this budget of broken promises and twisted and sick priorities, funding for Good Start will cease on 1 July this year. The result is that hundreds of children in my area who already have the scales of probability of future health issues tipped against them will miss out on these unique, life-improving, culturally tailored education programs. A Change.org petition calling on the Queensland Minister for Health, Lawrence Springborg, to continue the Good Start Program is already attracting lots of support, and I would encourage all of those who care about this issue to get on board with that survey.

The government's short-sighted position when it comes to preventative health funding is a clear indication of their warped values and priorities. They can find room in the budget to pay $50,000 to millionaires to have babies. They can find room in the budget to give superannuation tax concessions to the wealthiest 20,000 Australians. They can find room in the budget for a $100 million union witch-hunt and $20 million for marriage-counselling vouchers. But they cannot find room in the budget for preventative health services to improve the life quality and life expectancy of some of our most disadvantaged Australians.

It does speak to the difference between the two parties. On this side of the House, when we were in government, we did recognise the value of and the need for long-term investment in public health. We did see the need for a National Preventive Health Agency to drive a long-term agenda of improved public health outcomes and to develop the infrastructure necessary for important programs to get off the ground.

You only need to look at the list of programs and projects that the agency manages to see its importance. For example, there is the independent review of the advertising of unhealthy food and drinks to children; the National Binge Drinking Strategy and the associated investigation into the public interest case for establishing a minimum floor price for alcohol; and its National Tobacco Campaign and the My QuitBuddy smartphone app that it developed to help Australians stop smoking. The app has been downloaded over 265,000 times, and over 40 per cent of smokers using the app reported being smoke-free after six months. That is a whole lot of people living healthier and happier lives directly as a result of the work of the Australian National Preventive Health Agency. It is also a whole lot of people who are far less likely to develop smoking related diseases, saving the health system money in the long term.

The Labor Party understands that spending on preventative health is an investment that will pay off in the future. Apart from it saving us money to treat preventable diseases in the future, studies have also shown that improving general health also, in turn, improves economic wellbeing. So these cuts to preventative health have the potential to lead to a less productive workforce and a less prosperous economy in the months and years and decades to come.

Cuts to preventative health also underline the hypocrisy of this government's approach to health policy. The Treasurer and the Minister for Health have attempted to justify their $7 GP tax as some kind of attempt to ensure the sustainability of Medicare. But, at the exact same time, they attack the sustainability of the health system through these cuts to preventative health, which defer the burden of health spending into the future. Their hypocrisy on this point just shows that their attack on Medicare and the health system is ideological and has no basis in rational and strategic thought. As I said before, the short-sightedness of this cut is absolutely breathtaking.

The Labor opposition will be opposing these cruel cuts to preventative health, as we will be opposing the brutal attacks to Medicare in the weeks to come. We are not doing so just because they are a broken promise by the Prime Minister, although they are most certainly that. We are doing so because these cuts will lead to a worse Australia in the future, an Australia which is less healthy, less active and less economically productive. My community in Rankin, the people I represent, the people who send me here, will be worse off as a result of these harsh health cuts.

Bert Van Manen (Forde, Liberal Party) Share this | Link to this | Hansard source

Have you been there?

Jim Chalmers (Rankin, Australian Labor Party, Shadow Parliamentary Secretary to the Leader of the Opposition) Share this | Link to this | Hansard source

I am there in that community in Logan City much more than the member for Forde is. At four mobile offices in my electorate on the weekend—four more than the member for Forde would have done in his electorate, because he would have hidden from this budget of broken promises and lies—people came to me concerned that they would no longer be able to afford the health care—

Bert Van Manen (Forde, Liberal Party) Share this | Link to this | Hansard source

Mr Deputy Speaker, I rise on a point of order. I think the member for Rankin can focus on his electorate. We are out in the electorate plenty. I am happy to explain the budget to my constituents.

Russell Broadbent (McMillan, Liberal Party) Share this | Link to this | Hansard source

There is no point of order.

Jim Chalmers (Rankin, Australian Labor Party, Shadow Parliamentary Secretary to the Leader of the Opposition) Share this | Link to this | Hansard source

I would have thought the member for Forde would be too embarrassed to interject on something like this, given we both represent the same city council of Logan. As I was saying before I was so rudely interrupted, at four mobile offices in my electorate on the weekend, people came up to me concerned that they would no longer be able to afford the health care that they need. It is on behalf of my entire community—and on behalf specifically of the local Maori and Pasifika community, who will miss out on this vital public health education program I have spent some time on today—that I will be voting against these health cuts. Anyone who votes for them is consigning our communities and our country to a sicker and poorer future, and that is unforgivable.

Ewen Jones (Herbert, Liberal Party) Share this | Link to this | Hansard source

I like to follow the member for Chalmers—I mean the member for Rankin. He has not had a seat named after him yet. No doubt there will be one! Well may we say 'glory days', because that speech left me dazed! The problem we have with this budget is that you just seem to be so totally opposed to absolutely everything—vuvuzelas of negativity, as the member for Grayndler used to say about us in the last parliament. I want to address a couple of things that the member for Rankin was just talking about. This notion about broken promises is so blatantly wrong. All the way through, our promises were: we would stop the boats—

Jim Chalmers (Rankin, Australian Labor Party, Shadow Parliamentary Secretary to the Leader of the Opposition) Share this | Link to this | Hansard source

'No cuts to health'!

Ewen Jones (Herbert, Liberal Party) Share this | Link to this | Hansard source

No cuts to health. There are no cuts to health. I will take the interjection. I will skip all this stuff and the member for Fremantle will be able to get up sooner, because I want to get this thing through. You have got record spending in health from this government for the next four years. There is no deal. You have to try and come to the Australian people and tell them how this works. The Labor government sat down with a bunch of state premiers and said, 'We want you to commit to this plan.' 'We don't want to commit to it.' 'Would an extra $1 billion help you?' 'No.' 'Would an extra $2 billion help you?' 'No.' 'Would an extra $10 billion help you? Would an extra $40 billion help you? Would an extra $80 billion help you? Anything—just sign up.' There was no plan.

We have just been through 15 minutes of the member for Rankin's speech. He said, 'We're going to oppose these things. We're going to oppose absolutely everything.' Where is his plan? Where is the money coming from? Spending in this budget still goes up by 2.7 per cent. Those opposite, including the member for Rankin, who is supposed to be a doctor—I'll get a script off you for that thing there; make you see these pretty colours!—will cap spending to two per cent. So they have got a find another 0.7 per cent on top of all this extra money that they are saying we are cutting out. Where is their plan? The Leader of the Opposition in his budget reply speech was saying, for 33 minutes, 'Try us on!' and 'We're a party that stands for something!' Give us something. Give us an option. Tell us what you are going to do, because there is nothing there.

I understand what it is like in opposition. It is hard when you have not got the staff anymore and all that stuff, but at the end of the day you have to stand for something. Whether or not you believe our projections about the $123 billion worth of deficits and the $667 billion worth of gross debt if we do not do anything, it does not matter. I will let you get away with that. I do not care what you believe in. What the opposition cannot possibly deny is that we have just racked up, as a nation, $191½ billion worth of successive deficits. That is what we have racked up. All the way through, as soon as you start talking about deficits, you always hear them say, 'But it was the GFC.' Let us be very serious about the GFC. The GFC was principally a North American and European thing. During the late nineties and early 2000s, we faced the Asian financial crisis, and we stared that down. The Howard government went into deficit for one year by $1 billion. That is how we dealt with that. We were in surplus the next year and we continued to pay down debt. That is how you respond. You do not keep on spending.

Before I came here, I made my commercial life from 1990 as an auctioneer. My specialty was insolvency. It got to the stage where I would walk into a business and I would know why they were going bad—because the business would have taken its eye off the ball. I had a classic one. A businessman had a fantastic nursery. He used to grow plants and sell them. He made a lot of money. His accountant told him he should diversify, so he went and bought something else. He bought another business, about which he knew absolutely nothing. That business started losing money, so he started taking money off the other business to prop up the business that was failing, because he knew nothing about it. Eventually, he lost them both because he took his eye off the ball as to why he was there. He was there to provide employment for his people, to secure his future with his business. And because he took his eye off the ball and started mucking around with things, about which he had no knowledge, he lost the lot.

When it comes to things that the Labor Party do not know anything about, they do not know anything about adding up. They can count the numbers in the caucus and that is about it. They just cannot add up. When it comes to balancing the books or managing finances, they just do not get it and they should walk away.

The first thing you do when you take over a business, move into a new business or take over a new branch or anything like that, you walk around and you see what the place is like, how well it has been organised and how well it has been run. This Friday, 6 June, Queensland Day, D-day, will mark 20 years that I have lived in Townsville. When I took over the Townsville office of the auctioneering firm for which I was working, I walked into that place and it was untidy. It was dirty and they had all their stuff that could not be sold because the reserves were too high crushed up against one wall. We had to go through it. I worked the first 12 weeks, seven days a week, to get that place tidied up.

When we came into government and had a look at the books, we saw the exact same thing—the place was a mess. There was no care and attention paid to anything. When that happens, decisions have to be made. When you are losing money in a business, when you are racking up debt in government, you only have three options: continue to borrow, continue to make a mess or fix it.

Before the election, we said well and truly that our philosophy on health was to get help as close as possible to the customer, the client, the person. We wanted a GP focus. That is what we said all the way through. The Australian National Preventive Health Agency, about which we are speaking here—the abolition bill 2014—was an organisation that was just set up to spend more money. It did not really provide anything. We had the member for Rankin talking about the Good Start program and that it was starting to show results. Worldwide, we are getting fatter. So please tell me where the results are—maybe not the member for Throsby, although I will say that during his effort on the MPI he nearly broke the record for the most number of talking points in a five-minute speech and the most number of cliches at the same time.

This is about trying to get things as close as possible to the customer, the client. When it comes to this matter, our philosophy is to get rid of bureaucracy all the way through. We believe in smaller government. We believe that the federal government has a role in providing funds for general health, but we do not believe we should be too involved in it because we do not do it well. Federal public servants do a good job, but we do not do these things well, so we should stay out of them.

I want to tell you another story about what Labor did whilst in government in relation to bureaucracy. A mate of mine works at the Townsville Hospital. Following the Dr Patel matter, they brought in another layer of bureaucracy. He is a clinician and he had to take Fridays off, because he could no longer just put notes on a piece of paper; he had to load them into a computer. They brought in another layer of bureaucracy that checked his notes, as opposed to what was actually happening with the client. He was smart. When the file was open, he was to be notified. He had done this for three years under Labor and not once were any of his files opened. So for three years he had a whole day, a Friday—20 per cent of his working week—taken out to do this, with no result whatsoever. Labor have never met a layer of bureaucracy that they cannot add. They have it stacked too high.

That is why we as a government have decided that agencies like this no longer have a role in this place. We have to ensure that people are getting a relationship with their GP. Agencies like this take up more money and provide fewer services. They do have to pay the ultimate price and go, and I do not think we should be making any apologies for that.

I support this abolition bill and I am happy to go out and speak to my people about it. When you have no money, you have very few options. We have to get back to the situation where we are able to afford what we are trying to do and, in the meantime, we have to target our resources at the best. This simply is not it. I thank the House.

Melissa Parke (Fremantle, Australian Labor Party, Shadow Assistant Minister for Health) Share this | Link to this | Hansard source

I rise today to speak against the proposed abolition of the Australian National Preventative Health Agency. It was at the recommendation of the health experts who comprised the National Preventative Health Taskforce, and with support from, among others, the Royal Australian College of Physicians, the National Heart Foundation and the Public Health Association that the Labor government created this agency for the purpose of improving the health of Australia's people in the long term and reducing costs to the health system.

In everyday life we often use the phrase 'prevention is better than the cure' metaphorically, but of course this axiom is the literal explanation of why preventative health measures, both for individuals and for national health outcomes, are so valuable.

By focusing on some of the biggest health challenges we face, tobacco use, excessive alcohol use and obesity, the agency was building its strategy for a comprehensive and coordinated attack on preventable conditions. For a modest cost, this agency would deliver far greater savings to future health budgets and, most importantly, would prevent people from becoming ill in the first place. Unfortunately, it does not appear to matter to this government that prevention is far preferable and less expensive than a cure.

The government's approach to agencies that work to minimise the harm done by chronic health problems was first seen with the abolition of the Alcohol and Other Drugs Council. Now, in the context of this health-slashing budget, we see preventive health removed in the name of short-term savings, while the personal and long-term systemic costs are left to lie where they fall. And one suspects this government sees no problem with disregarding expert advice or ignoring the potential for positive health outcomes if it means posturing against government involvement or intervention in areas of health, like obesity and addiction, where the ultra-liberal view is that individuals should be entirely responsible for avoiding such health impacts. With this bill and its swag of other budget cuts to health, the Abbott government has set about destroying the very foundation of affordable and universal public health care in this country. Left on this trajectory, we will certainly see a two-tiering of the health system and a disproportionate representation of poor health among our poorest and most vulnerable citizens.

In the 2010 legislative debates that led to the creation of the Australian National Preventive Health Agency, coalition participants appeared to support a greater focus on preventive health in this country. Indeed, the speakers at that time noted and appreciated the ultimate cost-benefit merits of funding preventive health initiatives. Speaking to the point that 32 per cent of Australia's disease burden stems from modifiable risk factors, Senator Fierravanti-Wells said:

Investing time and energy into preventing chronic life-threatening disease will obviously assist. The coalition believes preventive health should be on the national agenda because treating people with chronic preventable diseases leads to a substantial reduction in economic and social costs. Chronic disease is a significant burden on our healthcare system. This leads to substantial economic and social costs for all Australians. If we can manage these costs then it will raise a significant burden from Australia's healthcare system—a system that is already under a lot of pressure. Increased focus on preventive health—keeping people healthy and out of hospital—is a very important goal for any government. Of course, we agree with provisions to this effect.

And Senator Barnett made the following contribution:

We need a total paradigm shift in this country in supporting health prevention measures. I am pleased to say that this bill goes some way to starting that effort and making a difference.

Senator Birmingham had this to say:

The coalition are supporting the passage of this legislation because we recognise that there is more work to be done in the area of educating people and ensuring a greater understanding by all Australians of what we should engage in to live a healthy lifestyle.

Deputy Speaker, of course you would be hard-pressed to find anyone in this place disagreeing with the benefits of preventive health programs and measures. Yet in this very bill the government demonstrates its disregard for preventive health strategy, coordination and program assessment. In doing so it is ignoring the fact that the community, and especially stakeholders in the health arena, expect governments to lead, to coordinate, and to assist in tackling the very significant health challenges facing our nation. This government and its members talk about the value of preventive health while ripping away the key statutory agencies and funding that actually work to help make that change. It is frankly appalling that expert advice which recommended a focused, concentrated, educational approach is being cast aside. Instead, we will see the targeted effort subsumed within the broad health portfolio and no doubt weakened and diluted within a prevailing atmosphere of funding cuts and uncertainty. Preventive health will not be on the front-burner; it will not be prioritised to help make a paradigm shift in society; and people will continue to suffer from preventable chronic diseases, with all the individual and health system burdens these bring.

In its short life, the National Preventive Health Agency has already demonstrated ingenuity and contemporary relevance in its social marketing approach. Its free My QuitBuddy app, designed to help smokers beat their addiction, has proved to be an innovative and effective tool in the war against smoking, receiving a gold medal at the Association for Data-driven Marketing awards. As previous speakers have mentioned, we have today seen the health minister attack this, and other preventive health measures. The reality is that the ANPHA funded promotion of the My QuitBuddy app through the Summernats events was undertaken precisely because it attracts over 100,000 people, with the large majority being 25- to 40-year-old men. This is a core target audience for the National Tobacco Campaign and the promotion was undoubtedly a success, with 55,000 downloads of the app in the month of January, when Summernats occurred, compared with 19,000 in December. That is virtually a 300 per cent increase from one month to the next—and it is exactly what a smart and well-designed promotional campaign should deliver.

In its final report, handed down this month, the agency explored the often canvassed idea of placing a minimum price on alcohol to reduce harmful consumption. Contrary to the intuitive reasoning that stands behind minimum pricing, the report concluded that such an approach was not advisable. It said:

As Australia's alcohol distribution and retail systems are fully private, a regulated minimum price increase (as distinct from a tax) would lead to profit increases flowing to the private sector from the monopoly rents created. This significantly reduces the available public benefits which could be used to further reduce or treat alcohol-related harm or be redistributed by government for other purposes.

I am not sure that I entirely agree with that conclusion—and I am aware that experts in this area believe that a minimum floor price, along with other measures, including a comprehensive recasting of the current inconsistent excise arrangements, does have a role to play in reducing the severe impact of alcohol-related harm. But the report nonetheless demonstrates the critical and valuable role the agency is performing, and the value of its independent input into the public policy process. With its dedicated focus, the agency is equipped to respond quickly and specifically to issues as they arise. The agency's Be the Influence—Tackling Binge Drinking campaign has successfully connected with its young target audience; it is amongst the most popular government social media pages with 189,000 Facebook likes. This campaign also has a presence within 16 national sporting organisations to help reduce the exposure to alcohol imagery and break the links between sport and alcohol. Under this government, disappointingly, the funding for Be the Influence is about to disappear. The funding of campaigns and the examination of questions like those I have just mentioned need to be sustained. This critical area of work must be continued and expanded if we are to achieve the aim of reducing the prevalence and impact of preventable chronic disease in this country.

Increasing the cost of visiting the doctor in order to create 'new' medical research funds while at the same time cutting perfectly functional and forward-looking programs and agencies, and acting to strip future hospital funding, is simply topsy-turvy nonsense. In The Age on 16 May, economics editor Peter Martin pondered the government's health priorities as follows:

Imagine for a moment the government is serious about reining in health costs. What should it do? Should it invest heavily in preventive health, trying to change lifestyles so more people don't get ill in the first place, or should it amass billions for medical research?

A government concerned about pay-offs will do the first. Or it may decide to do both, investing in preventive health while also putting aside funds for medical research. What it won't do is shut down existing attempts to prevent illness in order to fund research. That's if it is serious.

Sadly, this government is not serious about sensible, balanced, long-term health policy—and its abolition of the Australian National Preventive Health Agency is yet another example of this nation being put into reverse gear with barely a glance in the rear-view mirror for the dire health consequences that await.

Stephen Jones (Throsby, Australian Labor Party, Shadow Parliamentary Secretary for Regional Development and Infrastructure) Share this | Link to this | Hansard source

I rise to speak on the Australian National Preventive Health Agency (Abolition) Bill 2014, the sole purpose of which is to abolish the only agency dedicated to preventative health policy at the Commonwealth level, the only Commonwealth agency capable of delivering the sorts of programs that my friend the member for Fremantle and my predecessor in the role as assistant shadow minister for health outlined so eloquently in her address on this bill. I think if you want to understand the disposition of those who move such legislation in the House, it is instructive to look at what they have said on the matters in the past, and I did exactly that. I had the opportunity of availing myself of the second reading speeches of the then Minister for Health, former member for Gellibrand, Nicola Roxon. Some excellent speeches were made in the introduction of the original bill which founded this agency. She talked about the fact that it arose out of discussions and consultations through the National Health and Hospitals Reform Commission. There were consultations at the COAG level, and it received expert advice. The tenor of that advice was that we needed a stand-alone expert agency to focus on the issue of preventative health. We needed to do that because the existing department, as good as it was, did not have the sole focus on preventative health measures. That is the tenor of the second reading speech of the then Minister for Health.

I then pulled down a copy of the second reading speech of the now Minister for Health, who sponsors this bill that is before the House. I think the attitude in that speech is very revealing of why we are now debating a bill to effectively dissolve the Preventive Health Agency. I will concede this: it is always very dangerous to pick up a speech from a member of parliament and focus in on one or two sentences and say, 'This is the ratio of the argument.' Nothing bespeaks the attitude of the Minister for Health more than this contribution in his second reading speech on the National Preventive Health Agency bill, where he had this to say:

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.

I think that says it in a nutshell. Before he has already started, the minister has thrown his hands up and said: 'There is nothing that we can do in this space that is going to make a difference. The only thing we can do is pick up the bill at the end of the day.' It really is an extraordinary admission from the same minister who is introducing proposals into this place which are going to massively slash Commonwealth expenditure in the health area—over $80 billion of cuts in health and education funding to states and massive cuts to expenditure in other areas of the health portfolio. So it is really extraordinary that you have the minister before he even gets going saying, 'The only role as the Commonwealth is to pick up the bill at the end of the day. We have no role in saying anything about the lifestyle choices or the consumption behaviours of consumers.'

You do not have to go back to 2009 to see those sorts of attitudes when it comes to preventative health. I have the great benefit of sitting in front of gorgeous George Christensen, the member for Dawson, in the House of Representatives. I am often amused by his contributions. We can share a joke but we do not share many opinions on many things. When I listened to his contribution in this debate, I formed the view that he represents the extreme libertarian view on this particular matter. The member for Dawson was essentially saying that there is no role for government in preventative health, that individuals should be able to eat what they like, smoke what they like and drink what they like in complete disregard of the consequences, and there is no role for government in this space.

I agree in part with the member for Dawson. It is not the role of the government to stand by the pantry door and tell people what they can and cannot eat. It is not the role of government to stand by the bar and say, 'Do you really need that extra middy?' It is not the role of government to be standing outside the building, except in the planning sense, and telling people, 'Really, you should put that cigarette away.' But it is the role of government to be engaged in education, to be engaged in research and to be informing the public debate. It is certainly the role of government to be informing the public debate about the consequences of our lifestyle choices. I have said at this dispatch box before, if we were to just leave it to business and if we were to just leave it to civil society, we would not know a hell of a lot that we now know about the negative health consequences of many products that are on the market. I have used the example of asbestos in the past. Had it not been for the research organisations funded by government and ultimately the regulations by government, the health consequences of that building product would not be known. And we could, without dragging the analogy too far at all, make the same observation about so many other things.

I do not agree that it is the role of the government to be some sort of statutory fat-controller, but it certainly is the role of government to engage in education, research and dissemination of advice. It is simply not good enough for either the member for Dawson or the minister to be saying, effectively: 'The role of government is to pick up the bill. We've got no say about what's on the menu; in fact, we should remain completely silent about what's on the menu. We just pick up the bill at the end of the meal.' I think most Australians would find that view completely unsatisfactory.

There are a number of medical practitioners within this House, and you would normally rely upon them, in a debate such as this, to shine some light upon the issues before the House. That is why I tuned in to the contribution of the member for Lyne, who is a medical practitioner. I thought, 'This is a bloke who's going to be able to shine a bit of light on this debate and add a bit of sense to it.' I thought he might have something to say. So I listened very carefully to what he had to say in this debate, and I have got to say: never this evening was I more disappointed. His stunning contribution to the debate in the current environment was: 'We don't need a preventive health agency because we've got doctors and dieticians out there who can provide this sort of advice.' Knock, knock, Dr Gillespie—your side of the House is trying to stop people going to doctors and dieticians by putting in place a GP tax to make it more expensive because you think people are going too often. So to suggest that the answer to having a Commonwealth-funded preventive health agency is available through our GPs and dieticians shows that the good doctor is just not with the program.

The member for Lyne also suggested that the agency was somehow redundant because we had cooking shows and TV ads which filled the space. Well, the good doctor from Lyne simply has not been following the public debate on this issue. And there are a lot of things that I see advertised on TV that I am sure, when he was in private practice, he would not have been recommending to many of his patients.

The most stinging criticism that he made of the agency, and the reason he gave for it needing to be abolished, was that it had too many experts advising it. I can say to the good doctor: if there had been a few more experts advising the minister and the Treasurer over the last couple of months, they would not have made some of the stunning mistakes that they have made. A few experts might have been able to tell their Commission of Audit, and then the Treasurer and then the Minister for Health and the Minister for Social Services, that in fact Australians are not visiting a doctor on average 11 times a year, as they have built their whole health policy upon; it is actually less than half of that. If they had listened to the experts, they may have not built a health policy, the GP tax, on this terrible mistake.

If they had listened to the experts before they introduced these proposals into the House, they probably would not have had a string of experts from here to Hobart lining up to bash down their doors, saying: 'You've got it terribly, terribly wrong. Your GP tax is going to have a terrible impact on public health outcomes in this country. Your proposals to hike the PBS payments are going to have a terrible impact on public health in this country. And your cuts to health and hospital funding are simply unconscionable.' If they had listened to the health experts, they might have listened to advice such as this.

The work of this agency is too important to be glossed over. It focuses on some things that really ought to be at the centre of the public health debate in this country. Many other speakers have talked about the importance of having strategies around alcohol abuse and obesity, and 'Quit smoking' and antitobacco messages. I think these are all critical strategies.

But I would like to say a few things about the important work that the agency is doing when it comes to men's health. I am very pleased to see the member for Port Adelaide at the table as I make this contribution, because I know that he was very involved last year in the launching of a men's health strategy, and was particularly focused on the importance of having a mental health strategy for men. But he would recall—as I recall and as other members on this side of the House would recall—that, when we launched those policies, we had bipartisan support. We had former Liberal Party premiers up there as guest speakers at the event; we had former Liberal Party chief ministers backing the initiative; and we had a front row—you may even have been there yourself, Mr Deputy Speaker Vasta—full of Liberal Party and National Party MPs standing there saying: 'It is critically important that we have preventive health strategies addressing the issue of men's health.'

We know that there are particular issues when it comes to men's health. Men are four times more likely than women to commit suicide—it is five men a day, on average. Men are more likely to suffer from chronic diseases, cancer, heart disease, and a whole range of other issues. And if we are going to address the issues associated with men's health then we need a preventive health strategy.

We do not have a preventive health strategy. What we have in its stead is a wrecking ball. Instead of having a proactive strategy for dealing with preventable health issues, what we have is the GP tax. We have slashing of funding for hospitals in the states' health systems. We have the tearing up of the National Health Reform Agreement; we have the tearing up of the National Partnership Agreement on Preventive Health; we have the tearing up of the National Partnership Agreement on Improving Public Hospitals. The list goes on and on: the National Preventive Health Agency, which we are debating today; Health Workforce Australia; Medicare Locals, which are having their role downgraded; the Private Health Insurance Ombudsman and council; the Australian Institute of Health and Welfare; the National Blood Authority; General Practice Education and Training; the Medicare Safety Net, which is going to be altered; the Pharmaceutical Benefits Scheme, which is going to be altered—in fact, everything that we have built up, not only over this term of government but over the last 30 or 40 years, is standing in front of their wrecking ball. They do not have a policy for preventive health; they do not have a policy for public health. They have got a wrecking ball, and the people of Australia are being asked to pay the consequences.

Shayne Neumann (Blair, Australian Labor Party, Shadow Minister for Indigenous Affairs) Share this | Link to this | Hansard source

I speak in relation to the Australian National Preventive Health Agency (Abolition) Bill 2014.

When I was Parliamentary Secretary from Health and Ageing in the last government a few facts were really in the forefront of my thinking, particularly as I was involved in negotiating the front-of-pack labelling with the states and territories and in consultation with the Australian Food and Grocery Council, Choice and the Public Health Association of Australia. Those facts were these: today, more than four million Australians are obese, almost 10 million are overweight, one in four children are overweight or obese and Aboriginal and Torres Strait Islander people are almost two times as likely as non-Indigenous Australians to be obese. Overweight translates into chronic diet related diseases, hospitalisation and significant rises in long-term care.

We know that well-planned prevention programs work. The National Preventative Health Strategy clearly demonstrates that by putting a few facts in front of all of us. We know that the health programs in the 19th century were very successful in improving the longevity of life and the health and wellbeing of people. In the 1950s three-quarters of Australian men smoked—a figure that is unimaginable today as preventive health strategies have worked to reduce the rate of smoking amongst men and, indeed, women.

Deaths from cardiovascular disease have decreased dramatically from all-time highs in the late 1960s and early 1970s. Road trauma deaths on Australian roads have dropped by 80 per cent since the 1970s. Even deaths from SIDS have declined by almost three-quarters. And a study commissioned by the Department of Health and Ageing in 2003 showed spectacular long-term returns on investment in working on tobacco, road safety and programs in relation to cardiovascular disease. It showed that across 20 years, from 1975 to 1995, these programs prevented about 400,000 premature deaths in this country, saving a cost to the taxpayer of $8.4 billion. That is more than 50 times greater than the amount spent on anti-smoking campaigns over that period. In America, a study in 2008 in relation to Prevention for A Healthy America, showed that a return on the investment of one dollar resulted in a return to the health system of $5.6 within five years.

So we know that good programs and projects work well in reducing overweight and obesity problems, harmful use of alcohol and tobacco control. We know these programs work. We know that these are big problems in our country, so this is not the time to save a few million dollars by getting rid of an agency that is doing its job and for a faux budget crisis that does not exist.

This particular legislation is short-sighted, and I have spoken on this legislation before when we were setting up this agency. I cannot believe the nanny state arguments from those opposite. This abolition is short-sighted; it will go towards adverse outcomes in our people's health. This budget rips $377 million from preventive health alone by the abolition not just of this agency—which is a measly $6.4 million, in the context of the budget for health and ageing across this country—it delays, of course, the National Partnership Agreement for adult public dental services and it makes a whole range of cuts, not just in terms of children and older Australians but also Indigenous Australians.

These are cruel cuts because they will have an adverse impact on health and wellbeing across the country. And, of course, they have abolished the Medicare Locals—something that the now Prime Minister specifically said he would never do when debating Kevin Rudd, the then Prime Minister, on national television. In my region, the West Moreton-Oxley Medicare Local has been providing wonderful preventive health services and front-line services in Indigenous health, support for GPs, support for older Australians, after-hours clinic funding and HACC funding as well. And they are getting rid of this.

This is a terrible budget, and I think the most egregious aspect is the extra seven dollars to visit your doctor. Often people go to see the doctor for preventive health reasons, and this particular decision is very short-sighted. Of course, it is all about allegedly saving money for the taxpayer. But, in fact, if you look at the last year, the budget outcome is $18.8 billion worse under this mob than it was under us. Across the forward estimates it results in being worse by about $7 billion than under us. So they should not come into this place and tell us that it is all about budget cuts and getting the budget back to surplus because PEFO actually revealed the true story.

Today we had the Minister for Immigration and Border Protection revealing that he looked at PEFO actually to establish the true situation for the actual economic outlook and forecast for the country. Finally we had the minister saying something that was true in relation to that issue. Clearly, the Minister for Health does not understand the need for preventive health programs.

I am glad that the shadow assistant minister for health is here because he has pointed out clearly many times—and I have heard him talk about this—the impact of preventive health strategy failure by the coalition in regional and rural areas. These are the facts: it is 1.3 times more likely that people in those areas will have diabetes; they are 1.2 to 1.3 times more likely to have arthritis; 1.2 to 1.3 times more likely to get a melanoma resulting in cancer; 1.1 times more likely to be obese; and, if they are male, 1.3 to 2.6 times more likely to suicide. And that list goes on and on. So regional and rural areas will suffer worse as a result of the cuts—the cuts with the GP tax and the cuts to preventive health strategy and programs in this budget. It is also a brutal budget for my shadow portfolio of Indigenous affairs. There was $125 million stripped from programs.

Even in Senate Estimates last Friday, departmental officials had to admit that the organisations that fund and deliver services across the country in regional and rural areas, including in remote places like Alice Springs and Utopia homelands and other places up in the Kimberley, as well as in cities like Brisbane, Sydney and Melbourne will not know for six to 12 months whether those preventative health programs will still be funded. They have not been told and will not know for six to 12 months what will happen.

I say to the minister, who comes in here comes in and says things like he 'remains committed', they 'do not diminish', and their commitment is 'not jeopardised' by this legislation and by this decision to cut funding. This is Orwellian phraseology. If you say it; it does not mean it is going to happen. You have got back it up with political will and money. It is the sort of phraseology we saw in George Orwell's 1984war is peace, freedom is slavery, ignorance is strength, preventative health cuts equals preventative health care. That is the sort of language they are using. Those opposite cut the funding and claim to be still committed. How can they be?

I do not often quote this bloke, a Queensland LNP politician, but the Queensland Treasurer very clearly in his budget statement in the Queensland Parliament in George Street in Brisbane said:

Without a doubt though the most pressure relates to health. The problem is serious: National Partnership on Preventive Health—terminated; National Partnership on Improving Public Hospital Services—terminated. From 2017-18 the federal government is turning its back on the challenges of health funding.

That is what the LNP Queensland Treasurer in his budget speech said today. He went on:

With the ageing of the population and rapid advances in medical technology health expenditure is expected to grow by around 8 % per annum into the future. But the federal government—

Referring to the Abbott government—

thinks the states can survive with less. Their funding falls well short of what is required to meet the reasonable expectations of Queenslanders. Queenslanders can be reassured this LNP government will engage in a robust and vigorous debate with the federal government to protect their interests. This is a discussion we intend to have with the federal government over the coming months.

Good luck with that because they have cut the COAG process off in Indigenous health funding. They have cut the COAG process off in preventative health. So who are they going to discuss it with? This mob over there do not want to talk about it with the states and territories. The Queensland LNP Treasurer said today the consequences are devastating.

Let me give you an illustration in my area where this mob opposite, the government, actually do not care. When we were in government we funded in my electorate the HAPI Ipswich program—the healthy active people in Ipswich program—partnering with Jamie Oliver's Ministry of Food, Austcycle, the Heart Foundation Heart Moves and the Ipswich Hospital Foundation. The Jamie Oliver Ministry of Food is right in the heart of the Ipswich CBD, in D'Arcy Doyle Place. It is fully booked because people use the classes to learn about nutrition and how to cook well. I have seen young and old people there. In fact, I have seen primary school and high school kids there and I have even seen councillors from the Ipswich City Council there. I have visited there myself. It is a terrific initiative.

The HAPI Ipswich program has been terrific. It has been at the Ipswich show running these programs and holding classes. We funded that sort of preventive health strategy and program but it was terminated this year. It is gone; it is not being funded or continued on. That is one example locally in my electorate where the coalition has failed across this space.

The AMA is critical of the coalition in this. We see health professionals critical of these types of cuts. The new president of the AMA, Professor Brian Owler, made the point very clearly. He said of the health spending in the budget that he 'remained unconvinced'. He was talking about the $7 GP tax and he then referred to preventative health care. He said this:

Well, the safety net is a limit of 10 co-payments for people with concessions and also people under 16 years of age. But there are many people that fall outside of that safety net, particularly those with chronic disease. And so even a total of 10 $7 co-payments, $70, for some people, particularly if there are a number of people in the family, is prohibitively expensive.

Also concerned that in terms of preventative healthcare, making people for instance who want to go and have vaccination, if you're putting up a financial barrier to do that, for them to go and see their GP, it goes against the grain of what we've been arguing about the importance of preventative healthcare.

That was from the AMA.

The government has got their priorities wrong across this space. This is not about nanny-state stuff; this is about making sure that our people get the best health outcomes possible. It is also quite clear on cost benefit analysis that it is in the best interests of our economy as well as our society to make sure people are healthy and well, and live long productive lives and contribute.

This government is not listening to the expert advice. They do not like experts. They rejected world scientific consensus on climate change. They have not listened to experts when it comes to education. They have not listened to experts across a whole range of areas. We have not even got a minister for science in the government. What they failed to do is look long-term at the value of preventative health strategies, at the long-term sustainability of investment in preventative health, at the benefits to health outcomes, at the benefits to our economy and at the benefits to the health system.

We know what those investments can make. When we were in government, Labor provided $1.2 billion from 2010-11 to 2013-14 for those kinds of services nationally. We committed $516 million, as the shadow assistant minister said, for mental health services. We put a massive amount of funding across those spaces.

We know we must plan for the future, and that is why we established the National Preventive Health Agency to drive a preventative health agenda and provide the kind of assistance that goes beyond the cycle of three years of a parliament. We did it on the recommendation of the National Health and Hospital Reform Commission, the Preventative Health Taskforce and the National Primary Health Care Strategy in accordance with that strategy. So we listened to the experts and we did what we were supposed to do. This government will not listen to the experts. It will not listen to science. It will not listen to the healthcare professionals. It will not listen to Indigenous people who want to roll out the types of programs that I mentioned. It will not listen to councils like Ipswich City Council, which wants to roll out those types of programs. It is just not listening to preventative health.

Sharon Claydon (Newcastle, Australian Labor Party) Share this | Link to this | Hansard source

Labor established the Australian National Preventive Health Agency in 2010 to take a national leadership role in preventive health in Australia. The agency's goal is simple and is listed clearly on the top corner of their website. They exist to promote a healthy Australia. Unfortunately, the home page of their website now carries another message under the title of 'Budget Outcome for the Preventive Health Agency'. The message details that the Abbott Liberal government plans to (a) close the agency and (b) terminate the National Partnership Agreement on Preventive Health. This government's message is clear. They have given up on coordinated preventive health. They do not understand the benefits of preventive health today or the benefits it provides for the future.

Since the Preventive Health Agency was created, it has provided leadership across the non-government, health promotion and primary care sectors to deliver coordinated and effective preventive health activities and policies. They play a central role in collaborating across the health sector, embedding preventive health as central to the delivery of health care. Labor understands and recognises the value and need for long-term, sustained investment in preventive health. We appreciate the benefits of investment for improved health outcomes and acknowledge the savings to the health system that this investment can achieve. This is why we established a dedicated agency to drive the agenda over a sustained long- term period and provide the infrastructure for this to continue beyond the budget cycle. We built the agency so that prevention became a central focus for the health system.

The agency's programs direct actions specifically at obesity, tobacco and alcohol use—three core issues where preventive measures can have a profound impact on our health and on our overall health spend. Unlike those opposite, Labor understands the importance of investing in preventive health and primary health care—it makes sense. Indeed, it makes sense to everyone but this government. The government's ignorance was on show again today in the Daily Telegraph, when the Minister for Health attempted to discredit the Australian National Preventive Health Agency and undermine the value of preventive health by attacking targeted funding programs. The minister was especially critical of a program that the agency funded at Summernats, an event that attracts over 100,000 people, principally 25- to 40-year-old men—a notoriously difficult demographic to reach and engage with, but a core target audience for the National Tobacco Campaign. It makes perfect sense to direct a health message at an event where this demographic will be gathered in large numbers, and that is why the agency funded the promotion of an innovative quit smoking app at Summernats.

The campaign clearly had an effect, with 55,000 downloads of the app in January, when Summernats was held, compared with 19,000 in the month before—a threefold increase in just one month. The QuitBuddy app that was promoted at the event helps people to get and stay smoke free—a key preventive health measure. It helps to get the quit smoking message across when smokers need support most—like at the end of a long, stressful day, or perhaps after preparing a budget that has misled millions of people and is full of broken promises. It is clear that more needs to be done to cut through with the quit message, even to the well-educated. Innovative programs like the QuitBuddy app are making a difference. Targeting the message in a coordinated fashion, as the Preventive Health Agency has been doing, is the best way to do this. Labor will oppose the Australian National Preventive Health Agency (Abolition) Bill 2014—the abolition of the Preventive Health Agency. The abolition is short-sighted and demonstrates the lack of vision this government has in understanding the challenges facing the health system both now and into the future.

Labor is opposed to the government's callous decision to cut vital preventive health funding to the states and territories for their work in increasing physical activity, improving nutrition and healthy eating and supporting smoking cessation and reduction of harmful alcohol consumption in communities around Australia. In fact, rather than cut preventive health programs and funding, I urge the government to look to communities like Newcastle, which have successfully implemented strategies that are helping to curb binge drinking and are addressing the nutrition and healthy living habits of our youth, ably guided by the research work of Professor Clare Collins and her team from the University of Newcastle.

It is not just preventive health that this government does not understand; it is the whole health portfolio. What is becoming increasingly clear is that this government—led by their health minister and with a former health minister now as Prime Minister—is on the wrong path when it comes to health policy. They clearly do not understand what is best for the health of the Australian people. We will be paying for their mistakes for generations to come. Professor of Public Health Policy at Curtin University, Mike Daube, puts it simply:

This is a distressing budget for anyone concerned for the community's health.

The Prime Minister promised before the election that there would be no cuts to health. He has broken that promise. In this, their very first budget, the government has taken a scalpel to health spending, slicing out more than $50 billion from public hospitals, including more than $156 million from hospitals in my local area. The New South Wales Liberal government has confirmed these cuts will start hitting hospitals this year—next month, in fact; not in future years, as the federal government is suggesting. After the budget, the New South Wales Liberal Premier, Mike Baird, said:

We cannot absorb these cuts ...

…   …   …

The impact starts on the 1st of July. The equivalent here in New South Wales is over 300 hospital beds in funding disappears.

These cuts will clearly have an impact on preventive health.

It is also worth noting at this point just some of the other budget measures this government has introduced that we know will also have an impact on preventive health. The $391 million of funding for the National Partnership Agreement for adult public dental services has been deferred and $229 million has been cut from the Dental Flexible Grants Program. Funding has been cut from the Charles Sturt University dental and oral health clinics. The Diagnostic Imaging Quality Program has been stopped. The National Partnership Agreement on Improving Public Hospital Services has been ended.    Funding to the World Health Organization has been reduced. GP Education and Training Limited and Health Workforce Australia have been abolished. Funding has also been axed for nursing and allied health scholarships in Tasmania. The list goes on and on.

The rollout of the Partners in Recovery Program, which has been very successful in my electorate, has also been delayed by this government. Nearly $54 million of funding to set up 13 Partners in Recovery centres around Australia has been pushed back for another two years. As the program is already operating in Newcastle we have been spared; however, others around the country with severe mental illness and complex support needs are left without the much-needed support it offers. Unfortunately, those who need help cannot just 'defer' their illness like the government is deferring the program funding. What a shameful legacy this government is leaving for those living with mental illness, their families and loved ones.

Also, with this budget the Abbott government has gone back to its roots and launched the greatest attack on Medicare and universal health care that our nation has seen. Liberals have always opposed Medicare—it is in their DNA. This Liberal government is no exception, having already commenced their ideological disintegration of our greatest preventive health measure, Medicare. This year we celebrated Medicare's 30th birthday, but if the Liberal Party had not got their way the first time around we would have been celebrating its 40th anniversary. Instead, it took 10 years to get Medicare through the Australian parliament. Despite the wait, few could argue Medicare has not been a benefit to the health of all Australians. We live better, healthier lives because of Medicare. Dismantling Medicare does not make sense. This government is pulling apart the most efficient aspect of our primary healthcare delivery.

A broken promise from the Prime Minister, that there will be no new taxes, is at the core of Medicare's destruction. The introduction of a new $7 GP tax and an increase in the cost of medicines are indeed new taxes that are another hit to preventive health in Australia. This broken promise of no new taxes will cost a typical family up to $270 per year. The GP tax alone will cost Australian families $3.5 billion in on-out-pocket expenses. This is a tax that hits everyone: pensioners, parents, unemployed, low-income earners, people with a disability, even veterans. In my electorate of Newcastle the $7 GP tax will add more than $5 million to the healthcare bills of Novocastrians every year. This is a policy that will hit the 13,000 families in my electorate hard, especially the low- and middle-income families.

The GP tax is flawed policy, and the experts agree. The AMA, the College of Emergency Physicians, the Doctors Reform Society, the Public Health Association,    the Royal Australian College of General Practitioners, the Consumer Health Forum, the Australian Healthcare and Hospitals Association and countless health academics and economists have all advised against this tax, but the government is doing it anyway. What arrogance! The AMA has been especially critical of the tax. They have said that targeting GP services for health savings is a false economy that will lead to much greater health costs down the track. When the discussions on a co-payment were gathering momentum in January, Dr Steve Hambleton, president of the AMA at the time, said general practice was the most efficient part of Australia's health system. His greatest concern, however, were the barriers that the GP tax would put in the way of people seeking relatively inexpensive GP treatment for health complaints that might develop into much more expensive and serious problems if not treated early. In an interview with ABC Radio, Dr Hambleton said:

The main problems we've got with our health system are the growing amounts of chronic disease and our ability to treat lots of diseases that we couldn't treat that well in the past.

Our concern is that both people who need to go [to the doctor] and who don't need to go, will not go—

because of the co-payment. We do not want people to second-guess the need to see their GP because of cost.

In February when I raised the issue of the government's plan to introduce a GP tax in this place I was heckled by those opposite. They admonished me as a scaremonger, yelling and interjecting as I highlighted the impact of this attack on Medicare and universal health care and what the GP tax would mean for the people of Newcastle. But as it turns out, as we have seen in this budget and in the Commission of Audit report, there was a plan all along to introduce a GP tax. The backbench may not have been told about this plan, but it was there and the media knew about it too. I did, however, make a mistake when I first spoke about this issue in the House. I suggested a $6 GP tax would hit families hard. Well, a new $7 tax will hit even harder. And the $15 proposed by the Commission of Audit, the Liberal Party's blueprint for the future, will be diabolical.

If the Prime Minister gets his way and the GP tax is introduced, Australia will be left with a two-tiered, American-style health system in which only the richest have good access to quality health care—a system where your wealth determines your health. Labor believes all Australians should get the health care they need, not just the health care they can afford. The Abbott Liberal government are a government with the wrong priorities. Their short-sighted approach to preventive health is a clear example of their misguided direction.

The Australian National Preventive Health Agency does great work. It provides a national capacity to drive preventive health programs and policy. We need a coordinated approach, not a scattergun random approach. Abolishing the agency is not good policy, nor are the Abbott Liberal Government's attacks across the health portfolio. Labor will oppose this bill. Labor will always be the party of health care. This bill, this budget and the actions of this health minister show that the government simply do not get it. They ignore the experts, they ignore the evidence and they ignore the needs of Australian families and pensioners who deserve a world-class health system.

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

I would like to congratulate the member for Newcastle on her fine contribution to this debate. She is a colleague of mine form the Hunter and I have been able to observe how active she has been in the community in advocating for strong preventive health action. She was very active when Newcastle led the way in addressing the issue of binge drinking and alcohol consumption. I congratulate the member for Newcastle and acknowledge her fine contribution in this area and the fact that she does get it. She does understand how important preventive health care is and how decisions of government can impact on people's health. She understands how the government ripping $80 billion out of health and education will impact on her constituents and how the GP co-payment will affect those people she represents in this parliament as much as the people I represent.

The Australian National Preventive Health Agency (Abolition) Bill 2014 is bad, short sighted legislation and the Abbott government needs to recognise that the abolition of the agency in combination with ripping money out of the health system and the GP tax will lead to poor health outcomes. In other words, Australians will become sicker and die younger. The agency was established in 2011, and I remember speaking in the original debate in 2010. At that time I implored the then shadow minister for health to support the legislation. I emphasised the importance of making sure we work hard to address on issues of preventable diseases. This is best done through a strong preventive health strategy. This government has always looked aversely on preventive health. It has never been supportive of actions to address obesity or drug and alcohol abuse and smoking. They were dragged kicking and screaming to stop accepting donations from tobacco companies.

We on this side of the House believe in a sustainable investment in public health because we believe that will benefit Australian people. It will lower the burden of disease; it will have enormous economic benefits for all Australians. The government's position is a false economy. It shows a total lack of understanding of health that any government would get rid of something like the National Preventive Health Agency. Labor recognises the need for long-term, sustained investment in preventive health and the benefits it achieves in leading to positive health outcomes.

This government is not interested in preventive health. It is more concerned with protecting its mates. The minister responsible for the area of preventive health has removed the food-labelling website. I would like to spend a little bit of time on this. Back in February this year, the minister, Senator Fiona Nash, failed to meet with major health bodies central to her portfolio, despite taking significant decisions, including the removal of the healthy food-rating website. In addition to that, this minister employed a lobbyist as her chief of staff—somebody who was involved in the fast-food industry. When this government has a minister who employs somebody who works in the junk-food industry, it has a total lack of commitment to preventive health and to the issues surrounding preventive health.

The Australian government has introduced in this budget a number of changes to the current preventive health arrangements. An essential function of the National Preventive Health Agency will be transferred to the Department of Health by 30 June 2014 with a view to closing the agency. Closing the agency will come to fruition with the passing of this bill through the parliament. As well, the National Partnership Agreement on Preventive Health will be terminated and programs transferred to the department will be integrated into the department's own work. That will handle issues like tobacco usage, obesity and the use of alcohol.

I have touched a little on the way the government has related to tobacco and how it has a long history of being close to the tobacco industry. They finally supported the plain packaging legislation, but they did so reluctantly. It is interesting to see that they are moving away from money that has been invested in the national tobacco control campaign. It is also very interesting to note their approach to obesity. As everybody in this parliament knows, obesity is probably one of the major issues confronting our community. Australia has the second fastest growth rate, and this government, by getting rid of the Preventive Health Agency, is showing that it is not interested in putting in place a strategy to address obesity and to monitor that strategy. This lack of interest will lead to this generation's dying at a younger age. The generation being born now could be the first generation that dies at a younger age than their parents. It is interesting and important to note that the rate of childhood obesity has slowed down since the Preventive Health Agency has been in place. I can only say that with the abolition of the agency there is no guarantee that that will continue. The government has never been committed to addressing the issue of obesity.

In May 2009, a report entitled 'Weighing it up' was tabled in the parliament. In that report a number of recommendations were made. I remember that the member for Mayo, the Assistant Minister for Infrastructure and Regional Development, who is at the table, spent some time on that committee, as did the member for Cook, the Minister for Immigration and Border Protection. On that committee we had some quite heated debates that tended to be about advertising, the promotion of junk food and putting in place proper strategies to address the obesity epidemic that was taking place in Australia. Some wonderful recommendations were made about diet, weight and physical exercise and about involving the states and territories in programs and negotiations so that there was a whole-of-government approach to addressing the issues of obesity and preventative health.

I do not think the government has moved on from the position that the member for Mayo and the member for Cook took when they were on that committee. They support the fast food industry. They support the tobacco companies. And of course they also support the alcohol industry. It is interesting to note that if there is an area that we as a government need to address it is alcohol consumption. There has been a lot of media interest in issues surrounding alcohol consumption and the fact of young people losing their lives. In the Kings Cross area of Sydney they have put in a curfew, a strategy similar to the one that has been put in place in Newcastle. It is really important to note a few facts about alcohol consumption. The AMA sees it is one of the biggest problems in our society. Not only can alcohol affect a person's health it can lead to road accidents, domestic violence, vandalism and chaos within our community. As I mentioned just a moment ago, alcohol has led to the death of many young people from one-punch attacks, which have taken place a number of times. I have looked at this very closely. There is evidence of a high level of alcohol use and abuse in Australia, showing that 90 per cent of people have tried alcohol and 83 per cent have consumed an alcoholic drink in the last 12 months. Only about 10 per cent of people have never tried alcohol. The AMA found that about eight per cent of Australians drink daily and about 41 per cent drink weekly. There is an enormous cost associated with alcohol abuse. Alcohol abuse, along with those over two factors—tobacco smoking and obesity—that I spoke about, is responsible for a large number of hospital beds being occupied in this country. Obesity leads to cardiovascular disease, diabetes and cancer. The way to address all these issues is through the Australian National Preventive Health Agency, which this government is seeking to abolish.

Currently, the House of Representatives Standing Committee on Health is looking at issues surrounding skin cancer. One of the issues that come up time and time again is the need for more research and for education programs. Educating the Australian people on the best way to prevent developing skin cancer, about the way to eat and about ensuring that they do not get sick from the consumption of alcohol and tobacco are very important roles played by the Preventive Health Agency. The agency actually tracks the progress of preventative health programs.

I have heard a number of people on the other side of this House talking about individual responsibility and individual choice. Yes, an individual does have responsibility for their actions, but they need education and they need to be able to develop the knowledge and skills to make the right decisions. Unfortunately, under this government that will not happen. There has been criticism about the My QuitBuddy app at Summernats. That app actually attracted 100,000 hits from 25- to 40-year-olds. It is working to educate people. There has been talk about the fact that $200,000 was spent on a recipe book. If you can teach people how to eat properly, if that recipe book goes out and teaches people the exact kinds of food they need to eat, it has been successful.

This government is a failure in the area of health. It rips money out of basic services. It is going to tax Australians to go and see the doctor. It is going to rip money out of the health budgets of the states. It is going to ensure that Australians end up getting sicker and dying younger. At the same time it is not putting in place any strategies to address the gap that will be left by the removal of this agency. I condemn the government.

Gai Brodtmann (Canberra, Australian Labor Party, Shadow Parliamentary Secretary for Defence) Share this | Link to this | Hansard source

One would have been forgiven for thinking that a Prime Minister who had previously been a minister for health might have led a government that was passionate about health care—but, when it comes to the Abbott government, nothing could be further from the truth. Immediately after coming to power it was clear that this government cared nought about preventative health and was, in fact, determined to undo so much of the very good work that had been done in this space over the last six years.

In November last year, in one of its first acts since coming to power, the Abbott government inexplicably cut funding to the Alcohol and other Drugs Council of Australia. ADCA had operated since 1966 as the peak body for organisations working to minimise the harm caused by drugs and alcohol on an annual budget of just $1.6 million. ADCA was the non-government national peak body, representing the interests of the alcohol and other drugs sector and providing a voice for those who work to reduce the harm caused by alcohol and other drugs.

ADCA collaborated with government and non-government organisations, business and the community to promote evidence-informed, socially just approaches to confront the health, economic and social harm alcohol and other drugs cause individuals, families, communities and the nation. Members of ADCA included organisations, services, agencies and individuals engaged in alcohol and other drugs sector services nationwide. ADCA counted among its membership major university research centres, tertiary institutions offering courses in addiction studies and programs for alcohol and other drugs workers, officers of the law and the criminal justice system, policy analysts and administrators.

ADCA also offered a range of online services and resources to support the alcohol and other drugs sector in Australia, including the: National Drug Sector Information Service; the Register of Australian Drug and Alcohol Research; the National Inhalants Information Service; the Drug Database; Drugfields, which was a professional development, policy and practice information service for the alcohol and drug sector; Update, an alcohol and other drugs information bulletin board; and Drugtalk, an alcohol and other drugs discussion list. These services, like ADCA, have now all been abolished.

The decision to axe ADCA truly came out of the blue. Last year, under the Labor government, ADCA received an assurance of its ongoing funding. On 14 October last year, the new Prime Minister Abbott wrote to ADCA and said, 'I look forward to working with you in the years ahead.' Yet, just six weeks after the Prime Minister wrote these words, ADCA was axed. Understandably, ADCA has been wondering why. In 46 years this is the only government that has decided it can do without ADCA's advice.

The minister responsible for preventative health, Senator Nash, has failed to provide us with a reason. The AMA said closing ADCA was a bad idea. The National Alliance for Action on Alcohol said it was a bad idea. The Foundation for Alcohol Research and Education said it was a bad idea. But the Abbott government and the minister ignored them all.

In February of this year, the Abbott government's already poor track record in preventative health worsened substantially when Senator Nash, through her chief of staff, ordered the removal of the health star rating website within 24 hours of its launch. This health star rating system is a voluntary system for food manufacturers to display star ratings based on the nutritional quality of their food. Two years were spent developing this system. It was two years of research, trials and consultation to work out how to improve food labelling—and it was pulled down within 24 hours. The health star system would have allowed people to more easily compare different brands of packaged food to see which ones are higher in hidden salts, saturated fats and sugars. It is a much-needed step in our ongoing battle against obesity.

After the website was taken down, it was revealed that Senator Nash's chief of staff, who had also played an instrumental role in the axing of ADCA, is the co-owner of a lobbying firm that that has represented major food companies who were vocally opposed to the new health star labelling system. According to Fairfax, he also co-owns a company which, in turn, owns another that lobbied for the alcohol industry. This, to me, is the ultimate indicator of the Abbott government's attitude towards preventative health. The person hired by the Abbott government to be the key advisor to the minister responsible for preventative health had spent a considerable amount of their career working for, and still had a financial interest in, companies that actively and aggressively lobbied against the messages of preventative health.

It is no real surprise, then, that the next step in the Abbott government's war on preventative health was to abolish the Australian National Preventive Health Agency, which they seek to do through this legislation. Labor established the agency on 1 January 2011 to support the development and implementation of evidence based approaches to preventative health initiatives. The agency has a particular focus on the areas of obesity and harmful alcohol consumption. The establishment of a dedicated preventative health agency that could work across jurisdictions was widely supported. In November 2008, COAG had signed the National Partnership Agreement on Preventive Health, which included an agreement to establish a dedicated preventative health agency. The National Health and Hospitals Reform Commission's report of July 2009 and the final report of the National Preventative Health Taskforce of September 2009 had both also recommended the establishment of such an agency. Establishing the Preventive Health Agency also had the support of community organisations in the health sector, including the National Heart Foundation, the Public Health Association and the Royal Australasian College of Physicians—to name a few.

The Preventive Health Agency plays a leadership role in preventative health and health promotion, it coordinates, analyses and advises on key statistics and data in relation to chronic disease and prevention and it delivers and administers the Preventive Health Research Fund. One of the key benefits of the Preventive Health Agency is that it does work across jurisdictions. It supports all Australian health ministers in managing the complex challenges of preventable chronic disease. The agency has also worked with Medicare Locals to implement preventative health measures at the primary healthcare level.

I want to talk now about one of the recent initiatives of the Preventive Health Agency. As part of the National Binge Drinking Strategy, the agency ran the 'Be the influence—tackling binge drinking' campaign to help give young people the tools to cope with peer pressure and ensure every night out is a good one. The message of this campaign was that drinking responsibly and having a great night out can go together. In fact, a night out is always better when you are in control and do not put yourself at risk or risk being a burden on your mates. The campaign focuses on communicating with youth where youth are, and so the campaign centres around social media—Facebook, Twitter and Instagram—music festivals and sporting events.

Recently the Department of Finance, through the Cross Agency Social Media Forum—a group of social media users across the Public Service—tracked which government departments, agencies and campaigns attract the most Facebook 'likes' and the most Twitter followers. This research found that the Be the Influence—Tackling Binge Drinking campaign Facebook page is one of the most popular Australian government social media pages in history, with over 189,000 likes to date.

The reason I mentioned this is that so many of the government speakers on this legislation have lambasted the agency for using social media for campaigns and for thinking outside the box when it comes to delivering preventative health messages. But, I ask those opposite: what better way is there to communicate with young people—like you do, yourselves—than in the spaces that they use, such as Facebook, Twitter and Instagram? The fact is that an ad in a newspaper simply isn't going to cut it when it comes to sending a message about binge drinking to teenagers. Plus, it is expensive.

In their speeches on this legislation, some of those opposite have also spoken about preventative health as a luxury. They have said: 'Let's fix tertiary health first. Once we have done that we can consider looking at preventative health.' What those opposite fail to understand is that you will never 'fix' tertiary health unless you invest in preventative health.

The speeches of those opposite on this legislation have shown just how out of touch they are when it comes to preventative health. They just do not understand it and they do not support it. They think of it as easily dispensable, an overreach of government or an added extra. They fail to understand that preventative health is a crucial component of public health policy, pivotal in ensuring a strong and sustainable health care system.

Let us not forget that abolishing ADCA, pulling down the Health Star Rating website and abolishing the Preventative Health Agency are not the only attacks on preventative health from this government—far from it. The Abbott government's budget of broken also promises to: scrap the National Partnership Agreement on Preventative Health; scrap the National Partnership on Improving Public Hospital Services; cut hospital funding; increase the cost of prescriptions; significantly downgrade the role of Medicare Locals; rip $125 million out of Aboriginal health programs; and introduce the GP co-payment, a financial barrier that will deter people from accessing primary health care. That is just what we know about.

I would call this a sustained and brutal attack on our health system, not to mention a broken promise from a Prime Minister who said as recently as the day before the budget that there would be no cuts to health. The government calls this making our health system more sustainable. That is complete and a nonsense. It shows again just how little understanding the government has about the benefits of preventative health. Investing in preventative health is the best way—in fact the only way—to ensure we have a sustainable health system in the long term. Labor opposes this legislation because we recognise the need for long-term, sustained investment in preventative health. We recognise that preventive health is pivotal to ensuring a strong and sustainable health care system. Abolishing the Preventative Health Agency is short-sighted. The cost to future generations of Australians will be immeasurable.

Finally, I want to add that the Australian National Preventative Health Agency is located here in Canberra, and many of its hardworking, dedicated and specialised employees are my constituents. So tonight, I want to say to them: thank you. Thank you for all that you have done for the health of this country. It has not gone unnoticed. I know that many of you are now in a state of uncertainty, unsure if you will have a job at the end of the month, unsure if the work you have dedicated your lives to for the last three years will continue. I want to assure you that Labor will continue to fight for preventative health and oppose the Abbott government's reckless and damaging cuts to health.

Warren Snowdon (Lingiari, Australian Labor Party, Shadow Parliamentary Secretary for External Territories) Share this | Link to this | Hansard source

It gives me no pleasure to be participating in this debate. This is a debate we should not be having. To abolish this agency is, I think, a demonstration of how short-sighted the government's health policies are and how ill-conceived they are. The fact that they are ill-conceived should worry us all. They are ill-conceived because, clearly, they have decided that somehow or another advocating against obesity, looking at ways we can stop kids getting obese; making sure adults understand what they need to do to be healthy; and making sure that we look at the impact of alcohol and tobacco on the community, are things the government thinks are a luxury. Frankly, that is a great disservice to this nation of ours.

It is worth just contemplating from moment that COAG committed $932 million to the National Partnership Agreement on Preventative Health in 2008. That was extended by three years in 2012. Of course, the Australian National Preventative Health Agency, established as it was in 2011, is the mainstay of that agreement. This bill seeks to abolish that agency. It is worth just reminding ourselves what that the agency was established to do. It was a key element, as I said, of the COAG agreed National Partnership Agreement on Preventative Health and, from the department's website, it says:

The Agency assists in driving the prevention agenda, including by:

The Agency is responsible for a number of programs outlined in the Agreement including:

I would have thought they were eminently sensible objectives and functions for an organisation like this, and eminently sensible functions to be undertaken by an organisation like this at the request of a national government.

I have heard the contributions of many of those opposite in the government talking about people 'accepting personal responsibility for their health'—and a whole range of other fairly silly proposals, ideas and criticisms which really do not go to the substance of why you should abolish an organisation like this.

Why should you abolish an organisation like this? It is not as if it is a body which worked in isolation. It worked in conjunction with the department and with other agencies. It has a professional advisory council, whose membership included Professor Christine Bennett as the chair, Professor Rob Moodie as the deputy chair, Mr David Butt, Professor Michael Daube, Ms Judith Munro, Dr Lyn Roberts, Dr Roscoe Taylor, Ms Pat Turner, the Hon. Trish Worth, a former member of this place, and Dr Jeannette Young. These are eminently responsible Australians who have the capacity, foresight and knowledge to act as advisory council members for the agency. They did their job with competence and aplomb, and provided insights to government, to the health department and to other agencies about why it was important, and is important, to retain competence in prevention. It has had—and should still have, in my view—a national lead role in preventative health across this country.

Examining the agency's functions in some detail reveals its status as a necessary criterion in preventative health strategy and practice, including: to understand and use the link between lifestyle, behaviours and chronic disease risk; to address the rising prevalence of smoking related chronic disease; to collect essential population health data, including data specific to Aboriginal and Torres Strait Islander communities; to establish national preventative health guidelines and standards; to evaluate the effectiveness of preventative health interventions; to run social marketing programs relating to tobacco use and obesity; and of course, as I said earlier, to provide management of other things.

I spoke to someone just a day or so ago, someone who I regard as one of Australia's national experts in health prevention, public health policy and population health policy, someone who should be listened to by this government. When I spoke to him, he said: 'Cutting the agreement with the states is awful. Prevention is an essential service. This is as bad as stopping renal clinics or cardiac surgery.'

We need to put this in some sort of context. Why is it that it could be so difficult? Why is it that it is so important? I live in the Northern Territory, and we have some of the highest chronic disease management issues in the country. They revolve largely revolve around Aboriginal communities, who have diseases which relate to all the things that this organisation was set up to address, including a very high incidence of smoking, renal failure, diabetes, heart failure and a range of other diseases which need to be addressed and which are all preventable.

What this government says to those communities is effectively: 'We are not really interested in trying to prevent the disease. We will try and treat them'—although treatment will become more difficult and less attainable for many as a result of other decisions in this budget around co-payments and access. Nevertheless, the government is clearly saying that they are not interested in prevention: 'We do not care how much you smoke. We do not care what food you eat. We simply do not care. It is your responsibility to look after your own health. When you get crook and go to a clinic or a doctor, pay up front—if you can afford it—and you will get treatment.' That is so short-sighted and stupid that even the government should recognise the problems with it.

It is interesting because the previous speaker, the member for Canberra, spoke about cuts to Aboriginal and Torres Strait Islander health monies. As a result of the estimates process this week we learned that preventative health programs make up the bulk of cuts to Indigenous health, particularly the Tackling Smoking and Healthy Lifestyle programs. Why would you do this? Why would you go about cutting these programs?

Let me just remind you about ongoing measures in the budget which have now been cut substantially by this government: $106 million was made available over four years from 2009-10, an ongoing measure, so money was available for this, to tackle smoking in Aboriginal and Torres Strait Islander communities as part of the COAG agreement; $58.3 million for tackling Indigenous smoking workforce and on-costs; $18.8 million for regional tackling smoking funds; $10 million for training resources and programs, including brief interventions and so on.

Why is this important? Let's just comprehend why this is important. In 2003 smoking was responsible for one-fifth of the deaths of Aboriginal and Torres Strait Islander Australians. Tobacco smoking directly caused one-third of cancer and cardiovascular disease burden in that population.

It is important to understand that improvements have been achieved in smoking rates for Aboriginal and Torres Strait Islander Australians, with a decline in smoking from 51 per cent in 2002 to 47 per cent in 2008—and I believe there has been a subsequent decline as well. Compare this to the smoking rate for all people in Australia, which was 23.2 per cent in 2001, 19.4 per cent in 2007 and 18.1 per cent in 2010, and it has come down significantly since. What would you have in your mind that you would say to the community, 'Smoking rates are okay; we don't need to have healthy lifestyle workers or tobacco action workers in Aboriginal communities anymore because really only half of them smoke'?

When you make that sort of statement, do you then ask what diseases have resulted from this use of tobacco? As I have just explained, one-fifth of the deaths of Aboriginal and Torres Strait Islander Australians are attributed to tobacco smoking—and we are told that there is no need for the preventive health agency that the government is seeking to get rid of! You will not stop people smoking unless you educate them, work with them, understand what their needs are and try to make sure that they appreciate what smoking does to their health and then provide them with the services that are available.

We learnt this week why it is important to have prevention measures in place. A very timely paper was released by the Australian Medical Journal, which talks about solid evidence that better access to primary health care in remote Northern Territory communities saves money by preventing costly hospitalisation and improves health for Aboriginal and Torres Strait Islander people—in this case Aboriginal patients with diabetes. What is important about this particular study is that it tells us that primary health care is an effective and efficient way of providing basic health services that promote health and prevent illness. It tells us how important primary health care is in delivering services. It also tells us that if you deliver these primary healthcare services in a proper way, and in conjunction with the other things that are happening in remote communities, you can actually improve the health outcomes for these populations.

What it tells us is something the government does not seem to want to hear—because, if you are going to achieve these outcomes, a co-payment ain't going to help you. The importance of the co-payment in this sense is that we will have these preventative health measures and educative programs—developed by organisations such as this agency the government is trying to knock off tonight—to educate people about the importance of taking particular actions in their lives being delivered by primary care organisations. I say to the minister: I am not sure why you would want to do this. I appreciate that you are the government and I appreciate that you have every right to determine your own budgets, but this particular budget measure is short-sighted and will, in the longer term, be something which you will regret and the Australian community will regret, because it will mean, ultimately, that many of the measures we want people to understand are important to them and their own health—and which are therefore a cost to the community–so they understand what they should do ameliorate the impacts on them and their community will not be clearly understood and appreciated. Sadly, that is an indictment upon you and this government.

Peter Dutton (Dickson, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

I want to thank members for their contributions to the debate on the Australian National Preventive Health Agency (Abolition) Bill 2014. As has been acknowledged during the debate, it is essential that our health system supports the health needs and outcomes of all Australians. In this context there is a role for the Australian government to play in supporting effective preventative health efforts. Part of this role is providing leadership to streamline and better coordinate public health efforts that are currently spread across agencies and to ensure there is no unnecessary duplication or waste of taxpayer funds. This is particularly the case when such inefficiencies are not enhancing health policy or the health system.

Repealing the Australian National Preventive Health Agency Act 2010 and thereby abolishing the Australian National Preventive Health Agency—otherwise known as ANPHA—will reduce unnecessary duplication, red tape and regulation and enable the Australian government's focus on preventative health to be more cohesive, holistic and efficient. For Labor, this agency was always about symbolism over substance. The current arrangements create inefficiency, duplication and confusion. They add another layer of red tape and regulation which are not needed to support preventative health policies and improved health outcomes for Australians.

Abolishing ANPHA through this bill demonstrates our commitment to getting money away from bureaucratic structures and back to frontline services, including in the area of preventative health. A separately established Commonwealth funded agency is not needed for a focus to be given to this area within the health portfolio. The necessary work in this area will be continued under more efficient arrangements in the Department of Health. This bill will enable efficiency and effectiveness in terms of the delivery of functions, the most efficient use of government funding and an ongoing national focus on preventative health priorities.

It is understandable that this issue is contentious, but it goes to the heart of the choice about how we govern. On one side of the debate we have those who favour symbolism and bureaucracy over clinical outcomes and patient improvement. ANPHA has spent its time and, more importantly, taxpayers' money examining fat taxes, sponsoring burnouts at Summernats and on fake music festivals. It has been supported by those who mistake programs for outcomes. On this side of the House we believe a good government is judged by what it achieves, not by what it spends. We believe that health outcomes are best delivered through frontline services, through doctors and nurses who care for patients, through the vaccines that prevent disease and through medical research.

We recognise that people need to take responsibility for the choices they make that impact on their health, and this includes supporting their efforts to address alcohol, tobacco and obesity by ensuring that information is available for the public to inform these choices. The Commonwealth's work with stakeholders, seeking expert advice or forming productive working relationships with other bodies, will continue—just without the significant overhead costs of another agency.

I am pleased to have introduced the Australian National Preventive Health Agency (Abolition) Bill 2014 as one of many steps required to achieve much needed efficiencies, given the waste of the last six years, within the Commonwealth health portfolio. It will in turn benefit the public health sector and the Australian population more broadly. I want to thank all of those who have supported the bill and recognise the immediate and longer term benefits that it will produce.

Ross Vasta (Bonner, Liberal Party) Share this | Link to this | Hansard source

The question is that this bill be now read a second time.

The House divided. [20:19]

(The Deputy Speaker—Mr Vasta)

Bill read a second time.