Nicolle Flint (Boothby, Liberal Party) Share this | Link to this | Hansard source

I support the Australian Immunisation Register and Other Legislation Amendment Bill 2017 today because it does two very important things: it creates a new framework to establish and manage our national immunisation registers and it expands the scope of the two existing registers. The bill also furthers the government's strong commitment to the No Jab, No Pay program, which has lifted immunisation rates right across Australia. The bill before us will strengthen and galvanise our whole society's protection against measles, mumps, rubella, shingles and the scourge of whooping cough. These are all diseases which attack our most vulnerable, by which we mean the young, the sick and the elderly. We must keep these people safe from disease and their health as secure as possible. I strongly support this bill for several reasons. First, it makes sense for medical practitioners and patients to be able to easily track their vaccination record so that they can make sure they're up to date with their immunisations and don't have additional vaccinations when it's not necessary to do so. We shouldn't waste money and precious medical resources. In this data-driven age it makes sense to have a register of immunisation so that we're not reliant on pieces of paper to record our vaccination history. This means those who have to move regularly for work, for example, will not be so reliant on transferring records between their doctors or healthcare professionals. Second, and more importantly, we must protect the most vulnerable in our community. Our most vulnerable, in this instance, are babies and very young children, people who are not able to be immunised because of serious illness, or the elderly who may have compromised immune systems.

Unfortunately, I have a firsthand and quite terrifying experience of how important it is to protect our most vulnerable and how easily they can be put at risk, no matter how diligent and well-immunised you are. Back in 2009, despite being fully immunised, I was diagnosed with whooping cough. That year, South Australia was suffering a whooping cough epidemic. I was one of the 5,831 people who contracted the disease, despite having a normal and up-to-date vaccination record. My experience with whooping cough was not terrifying because I had the classic cough and couldn't breathe—my symptoms were quite the opposite: all I had was a runny nose and a mild cough—it was terrifying because the week before I was diagnosed, and before my symptoms became really noticeable, I had visited my brother, sister-in-law and my week-old niece. My family spent a very nervous few weeks waiting to see if my niece, who of course was too young to be immunised, developed any symptoms; thankfully, she did not.

This very close call reiterated to me the absolute importance of vaccination, but it also reiterated the importance of staying up to date with medical advice, which includes that expectant mothers, fathers and grandparents, and anyone else who will be in close contact with brand-new babies, or people with compromised immune systems, should have a new whooping cough vaccination. It is a particularly nasty disease that has a habit of mutating, so up-to-date immunisation is very important. By not vaccinating ourselves or those in our care, we risk not only our lives and theirs but the lives of others in the community. We have to protect the vulnerable, the young and the elderly, and we cannot take for granted these vaccines, which are the result of over a century of public health management and medical research.

We are so privileged to live in a world where we have come so close to eradicating diseases that have plagued humanity for much of our history. It wasn't long ago that our ancestors did not enjoy such safety. It wasn't long ago that polio was still rife in so many parts of the world. Thanks to the work of Rotary International and their partners, they have reduced polio cases by 99.9 per cent worldwide since their first project to vaccinate children in the Philippines in 1979. Globally, there have been only eight reported cases of the wild poliovirus this year. It's a remarkable achievement.

As a proud member of the Rotary Club of Blackwood, I want to acknowledge the wonderful work of our president Garry Dolman, immediate past president Robyn Venus and all the work that the dedicated volunteers do week in, week out to raise money to eradicate this terrible and preventable disease globally. Their efforts are repeated by the 35,000-plus Rotary clubs around the world, and what a remarkable effort and achievement it has been to almost eradicate this terrible disease by immunisation.

It is not just whooping cough and polio that we need to protect against. It is other diseases like measles—a disease that, like polio, people of my generation don't really understand. If you do want to understand the devastating impact of measles, then read famous children's author Roald Dahl's 1986 essay on the death of his much-loved daughter, Olivia. She died at the age of seven in 1962, at a time when immunisations for measles were not reliable or readily available. He wrote:

Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn't do anything. 'Are you feeling all right?' I asked her. 'I feel all sleepy,' she said. In an hour, she was unconscious. In twelve hours she was dead.

Later in the essay, he went on to say:

It is almost a crime to allow your child to go unimmunised.

The coalition agrees with this sentiment. This is why, in 2015, we passed the Australian Immunisation Register Act, which created a new consolidated legislative framework for the establishment and ongoing maintenance of Australian immunisation.

The Immunisation Register, created by the coalition, complemented the policy by allowing parents and children over the age of 14 to see whether they meet their immunisation requirements. The register works in conjunction with the No Jab, No Pay policy, and is one of the mechanisms that has facilitated the climb of our vaccination rate from 90 per cent in September 2016 to 93 per cent now, and rates continue to climb. A rate of 95 per cent immunisation is considered the benchmark for stopping the spread of diseases, and that is what the government is working towards. For those with children covered by the No Jab, No Pay program, the vaccination rate sits just shy of this, at 94.5 per cent. It is a program of tough love, admittedly, but it is ultimately good public health policy that saves lives and protects lives. The coalition's No Jab, No Pay program has increased children's immunisations by an extra 200,000, making children's lives and those around them safer. Immunisation is the safest and most effective way of protecting against vaccine-preventable disease. In addition to creating a consolidated vaccination register and improving nationwide vaccination data capture, the Australian Immunisation Register, which came into effect on 1 January 2016, improved arrangements surrounding the medical exemption process, such that only general practitioners could assess for medical exemptions.

Since then, other specialists, including immunisation clinicians, have requested that other specialised medical professionals be allowed to conduct assessments for medical exemptions recognised under the act. Medical specialists have told of how sending patients back to general practitioners to get medical exemptions has unnecessarily added a burden for the time of both patients and practitioners, and unnecessary cost. This is why, in the interests of enhancing the effective No Jab, No Pay program, the government has introduced this bill, which will recognise other specialists as being able to provide medical exemptions. These specialists include paediatricians, public health physicians, infectious disease physicians and clinical immunologists. These changes will allow these specialists to provide a medical exemption through the Australian Immunisation Register. This will streamline the way individuals are assessed for a medical exemption, by including those medical practitioners. This will reduce the time taken for a small number of individuals who need to obtain this medical exemption from immunisation.

The willingness of the medical sector to consult and provide feedback on this vital policy shows they are primarily concerned with making this good policy work even better. Doctors, like the coalition government, understand the importance of a high vaccination rate in Australia. While the rate is climbing, we must keep working to see that those areas which lag behind catch up with the rest of the nation. A family's choice not to immunise their children is not supported by health, public health policy or medical research. If a dangerous disease is preventable, we must do all we can to reasonably stop it. The benefits to the broader community from high vaccination rates are too important to do nothing. We have to keep our most vulnerable, from babies through to the elderly, as safe and secure as possible.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

The Australian Immunisation Register and Other Legislation Amendment Bill 2017, which makes largely incontestable changes to the operation of the Australian Immunisation Register, is an important bill. On a recent parliamentary delegation to Myanmar—a very interesting trip, seeing the healthcare resources in a country that spends less than $20 per capita per year on health—I was struck by comments from a village leader—not a doctor—in one of the outlying villages some hours from Yangon. This village leader was very proud that there had not been a case of measles in his village for over four years and that the last case of tetanus in the village had been over two years ago. He said that he and the whole village were very proud of their record and they wanted to make sure that all the children in the village were protected against the common childhood diseases. He did mention also that he had lost one of his brothers to tetanus some years previously, and he was well aware of the dangers of such diseases, particularly to the children in the village.

In Australia, our overall childhood immunisation rates have crept up to over 92 per cent, but, unfortunately, as a public health policy, immunisation has been a victim of its own success. We now have a generation, including some of my children's generation, who have never seen measles or chicken pox or bacterial meningitis or epiglottitis. We actually now have several generations of doctors who have never seen tetanus or diphtheria or polio or smallpox or congenital rubella. It is very easy, therefore, for people to develop an anti-immunisation stance, as we have forgotten the terrible consequences of these previously common childhood diseases. Unless we are vigilant, however, it is quite possible for these illnesses to appear again. As a paediatrician, it absolutely infuriates me to see some people encouraging antivaccination organisations. These groups are highly irresponsible, antiscientific and vindictive. They demean our scientists, and, in many areas, significantly reduce our immunisation rates, and they endanger lives. For example, on the North Coast of Sydney recently, there was a case of childhood tetanus in an unimmunised child.

Let me tell you a little of what I have seen, because this is real life to me. As a medical student in 1974, I saw children in the Indian subcontinent with polio, tetanus and diphtheria with all its complications. Thankfully, these diseases have almost completely been eradicated in the subcontinent due to immunisation programs, often sponsored by non-government organisations, as we have heard, such as Rotary, which has done a fantastic job in the almost eradication of polio. As a paediatrician, I worked at the Sydney Children's Hospital in 1978 when we had the last great measles epidemic in Australia. Measles immunisation was included in the general immunisation schedule for children 12 months and older in 1975, so, in the late seventies, there was still a large cohort of children who were not immunised against measles.

We were completely inundated with children who had every complication of measles, from pneumonia to seizures, encephalitis and, unfortunately, death. I sat by the intensive care bed of a child with haemophilus influenzae meningitis—Hib meningitis. She was unwell at lunchtime, presented to hospital at dinner time and was dead by midnight. I sat by her bed and watched her die in spite of everything we did. I saw a child with epiglottitis have respiratory arrest—a complete respiratory obstruction—in front of me and require an urgent tracheostomy. These are real things for me.

The Hib vaccination was introduced to the child immunisation schedule in 1993 in Australia, and it was like the turning off of a tap. We no longer saw haemophilus meningitis; we no longer saw epiglottitis. In Campbelltown, in the paediatric ward where I worked, we were used to having, maybe, 15 or 20 cases of severe Hib infections, meningitis, epiglottitis and septicaemia per year. But, with the advent of immunisation, the tap was turned off, and these illnesses virtually disappeared. During the election campaign, on polling day I met, at one of the local polling booths, the mum of a girl who I looked after, who actually survived haemophilus meningitis but was left with a severe intellectual disability and a severe seizure disorder. Thankfully, we no longer see children like that. These illnesses disappeared thanks to immunisation.

I've seen children lose limbs and some die with meningococcal septicaemia. I've sat with a paediatric neurologist as he told the parents of one of my patients that their child had a condition called subacute sclerosing panencephalitis, or SSPE, which is a slow-virus encephalitis that occurs following a measles infection some years previously that leads to gradual cerebral deterioration and death. It is completely untreatable. People have forgotten about these illnesses, but, unless we improve our immunisation rates, they will still occur. I've witnessed the anguish of a mum on day 6 of treatment of her 11-month-old boy for pneumococcal meningitis. She realised on day 6 of treatment that he was completely deaf due to the meningitis.

I remember these children. They are etched in my mind. I've seen children with whooping cough cough themselves to death. I've seen a child recovering from leukaemia die from chickenpox pneumonia. Can you imagine what it's like having your child respond to treatment, start to get better and then die from chickenpox pneumonia? There are many more patients I'd like to talk about. Indeed, they all deserve my acknowledgement. They show that these illnesses are real and, to me, they've been part of my working life. We've come, indeed, a long way in our fight against these terrible diseases, but we must continue to improve our immunisation rate. In doing so, we will save lives and prevent the long-term sequelae in many people.

There is an increasingly strident anti-immunisation group who will use any means whatsoever to deliver their unscientific views. The recent comments by Senator Hanson will be used and, indeed, are being used by the antivaccination lobby as some sort of justification for their ideas. That's why I delivered to Senator Hanson's office copies of the Australian Academy of Science's literature on immunisation in an effort to explain the scientific basis of and success of our immunisation programs. On several occasions I've offered to meet her but, as yet, have had no response. I want to discuss with her her views on immunisation and the importance of maintaining trust in our scientists and repudiating the completely irresponsible statements that she has made regarding immunisation.

Recently in my electorate the anti-immunisation group arranged a screening of the unscientific, malicious and misleading film Vaxxed. I wrote to the cinema chain involved. Whenever they present this completely malicious film, I want to present the true immunisation science and explain why it has been so important to our public health in Australia. I have as yet had no response.

This bill also introduces some important improvements to our immunisation monitoring, such as the increased list of practitioners who can grant medical exemptions from vaccination requirements, to include people like paediatricians, like myself, infectious diseases physicians and immunologists. It increases the coverage of the register. However there is still much more that can be done. The change to the whole-of-life register is to be applauded but we must couple this with improved access to newer vaccinations, such as meningococcal type C vaccine, and improving availability of and knowledge of newer vaccines for things like herpes zoster, or shingles, in older Australians.

The overwhelming need for a new community-based education program about immunisation is fundamentally clear to me, and I wish the government had taken steps to make sure this happens. The government should strongly consider this on an ongoing basis, as we need to continue to improve everyone's knowledge about and understanding of the basis of immunisation and how important it is. The increasingly virulent, if I can describe it that way, attitude of the antivaccination groups, which ignore our scientists, portray themselves as experts and infiltrate social media with fanciful, unscientific information, is to be deplored. We need to make sure that, at every stage the antivaccination groups present their terribly false information, we counter it publicly and make sure people understand why immunisation is important to our children and also now to our older Australians. There's lots of evidence now that immunisation for influenza can be very important in our older Australians. Immunisation against bacterial infections such as pneumococcal disease in older Australians can be very important, particularly in those who have cardiovascular disease or peripheral vascular disease. We really need to encourage everyone to be up to date with their immunisations, and this includes adults as well as children.

We also need to increase funding for immunisation research. Australia has led the world. We have a very, very proud record in Australia in our immunological research and in our research into immunisation. People may not be aware, but congenital rubella syndrome, which still occasionally occurs, was discovered by an Australian ophthalmologist, Sir Norman Gregg, and he is famous around the world for his discovering of the congenital rubella syndrome. People like Sir Macfarlane Burnet, Professor Peter Doherty and, more recently, Professor Ian Frazer have been instrumental in improving access to and understanding the importance of immunisation. We have a very proud record and it is important that this continue and that we continue funding for institutions such as the Kirby Institute, the Walter and Eliza Hall Institute and the Children's Medical Research Institute at Westmead. It is very important that we fund these organisations properly. Australia can also help our overseas neighbours with funding to improve their immunisation rates and surveillance of infection diseases. We live in a global world. Many of the recent outbreaks of measles that have occurred in Australia have started with arrivals from infected people from overseas. If we can improve immunisation rates in our near and not-so-near neighbours that will improve our response to infectious diseases.

The future for immunisation is really a fascinating one. New immunisations are becoming available. I saw my aged father go through a terrible time with shingles towards the end of his life. It made the last 12 months of his life very, very uncomfortable. But we now have an immunisation available for herpes zoster, or shingles. In older Australians, it's very effective. Many people, however, are unaware of its availability. Again, we need to improve our knowledge and education about immunisation.

There are some recent surveys that show that older people who are vaccinated against pneumococcal disease—a bacteria which causes chest infections, and sometimes bronchitis and even septicaemia—have less cardiovascular disease. So it seems that that has a beneficial effect on cardiovascular health as well.

There's increasing investment around the world, by people like the Gates Foundation, in immunisation against diseases such as tuberculosis and malaria, and now there is a lot of research into immunisation against HIV. I went to a presentation yesterday by the peak HIV organisation in Australia, where they talked about the research into immunisation against HIV and the prospect that we will eventually be able to eradicate HIV. So this is very exciting and very important research.

The anti-immunisation groups are persistent, however, in their attacks. We must commit to better education about and explanation of immunisation and its benefits. I want all of us to be as proud of our immunisation rates and prevention of disease as the Burmese headman I met so recently.

I commend the bill to the House. I am extremely proud of the bipartisan nature of our response to improving immunisation rates. I think there is more to be done. I thank the House.

Joanne Ryan (Lalor, Australian Labor Party) Share this | Link to this | Hansard source

It is with great pleasure that I follow the member for Macarthur on such an important issue and after such an important contribution, as it is from a singular perspective in this House, I believe, in terms of his work in paediatrics and the insight he brings with him. I join him in commending the Australian Immunisation Register and Other Legislation Amendment Bill 2017, and I am pleased to speak in support of this bill. It is work that I think needs to be absolutely bipartisan because of its critical factors.

I want to speak particularly about the electorate that I represent, the electorate of Lalor. There's been much talk about immunisation rates, and a tendency to think that it is inner-city middle-class people turning away from immunisation. I speak from the other end of that perspective. I speak for a community where there are 5½ thousand people who have not had their childhood immunisation programs completed. I speak for a community where 30 per cent of our four-year-olds do not attend childcare or education. I speak for a community where many young families may not be connected to a general practitioner, one that they see repeatedly, and may not necessarily be connected to the kind of maternal and child healthcare opportunities that I had when my children were young in that community. These are really important matters. These children will get to the school gate, but No Jab, No Pay for childcare will not have an impact.

In a community like mine, we need to spend an enormous amount of money on education about immunisation. We need to ensure that this message is reaching everyone. So, while I celebrate today that we are here and we have a long speaking list—and that pleases me too because we are shining a light on this very important issue—and while the No Jab, No Pay regime in Victoria is improving outcomes and continually shining a light on this, I still feel that there is so much more to be done.

I have sat with the anti-vaxxers that the member for Macarthur referenced. They are more likely to be middle class and more likely to be educated, but more likely to be completely and utterly naive about this issue. They are unaware of Australia's great history in this space. And they are afraid because, through their self-education—through the internet—they tell me they believe that immunisation is some kind of campaign by big pharmacology, when in fact immunisation has come from the groundswell of generations past to prevent the kinds of losses that they saw.

I listened to the member for Boothby earlier about her coming in contact with whooping cough and then being a sufferer of whooping cough. I am a mother of a young family, with three sons under five. My eldest contracted whooping cough at school. My mother, who was then in her 70s, recognised the cough in its very early stages and immediately said, 'Joanne, your boy has whooping cough.' It is a communicable disease. He had picked it up at school. He had been vaccinated, but it had broken through his defences. In a large family, with seven siblings and lots of babies, this meant complete isolation for my family. It meant that my son, who was in his first year of school, missed eight weeks of school. The costs go beyond those things. I had the value of a mother who had lived through babes-in-arms dying from whooping cough and who could clearly explain to me the dangers for an infant who was not yet walking. I had a GP who could reassure me very quickly that, because he was on his feet and five years of age, whooping cough would not have a dramatic impact on him, but the danger was there for the tiny infant.

What I see in my community is some ignorance of those who are new arrivals to our country who do not have a history of immunisation; that is an education profile. Some middle-class people or people who have taken it upon themselves to determine that they don't want their child vaccinated ignore the statistics and the need for the herd levels of vaccination. I have sat with some of these people and spoken to them. My take, when I am in conversation with them, is that we have a generational disjoint here, because they haven't seen the deaths. They haven't seen the pain. They haven't seen the tragedies firsthand. I tell them about my son having whooping cough and what that might have meant. I tell them about a very good friend of mine who had been exposed to rubella while pregnant and her deaf child and the impact that this has had on their family. It was another child who was carrying the measles virus which led to that. I tell them about my father, who had polio as a child. I tell them about my Uncle John, who had tuberculosis. He spent many months in a sanatorium as a young man and was lucky to survive the ordeal.

If you share these stories about the past and what immunisation has done to change that situation, people do come on board. As a mother—and I note the member for Hotham has just joined us; I know that she will be going through this as a mother of young children—you do not wake up in the morning and say: 'Yippee, it's immunisation day. I can't wait to take my child for a vaccine injection.' Nobody feels like that. Everybody has some trepidation about this process. It's through our families, through our mothers—dare I say it, through our paediatricians and through our GPs that we do these things, because we are doing it for the good of all. Yes, we all feel some trepidation, but we must continue to immunise our children to protect them and other children; it is to protect one another. So I am a firm believer that this legislation not only is important but requires absolute support from people across the chamber. Like others, I was incredibly disappointed to see Senator Hanson's recent comments. I was also disappointed that they were not immediately condemned across this chamber. That's how important this issue is. Speaking as someone from an electorate where we have high rates of people who are not immunising, I understand the risk, because the risk is there for all of the children in my community. I call on the federal government to do more. I have sat with health stakeholders who have harked back to the past, to the Victorian model, when we had the child maternal healthcare units—the old caravan at the kindergarten. This was where we went to get support and have our children immunised. This was where mums were supported through the feeding process and where our babies were weighed monthly. I was someone who had their children while those things were available. I was given support through food and allergy grading. We heard again in the news this week about the allergy rates of children in Australia and the importance of going through the processes in a carefully staged way in order to get those numbers down. So I see the importance of a stick and carrot.

I am concerned that we are not doing enough in education and on how we might rebuild an educative process that supports parents through these processes and ensures that there are good health outcomes for our children. I think it is a space where we could hear a lot from older generations. We could hear stories from paediatricians. We could hear stories from people like my mother who held babes in arms who were lost to whooping cough a long, long time ago. They could share those stories in our new technologically enhanced ways and make sure that everybody is hearing this message about vaccination.

I would stress, as did the member for Macarthur, the importance of carrying the message to the community that this is an area where Australia has led the way—to de-Americanise, if you like, this debate that's going on to ensure that people understand that this work is something where we have led and where we have trusted our scientists for several generations to see us through.

Having sat with people who are very concerned and are acting from a position of concern for their child that they perceive already has immunological difficulties, I welcome the extension to other professionals in providing exemptions. I encourage all those who feel trepidation in these spaces to ensure that they connect with their general practitioners and be talked through the issues and to please listen to the science.

This is a very important piece of legislation. It adds to what is happening in some states and, I am very proud to say, in the state of Victoria, where much of this work is being done. I can say here that I know there are 5,500 unvaccinated people in my electorate because of some of the work in Victoria where we are doing a much better job of monitoring vaccination processes. I think that is really important. This legislation does some important things.

I will take a moment to acknowledge the member for Melbourne, Adam Bandt, and his very high-profile stance on this in an electorate that, like mine, has high rates of people not immunising. I was really pleased to see him on the front page of our Melbourne newspapers, carrying that very strong message with his small infant and his partner, encouraging people to ensure they have their immunisations completed.

I will share in closing that when I was a member of a school community as an assistant principal at a school in Melbourne's west I took the phone call at our school that said that we had a case of meningococcal in a student. I would take this opportunity to say that if you are the person who has to tell 1,200 families that there is a communicable disease within your cohort of young people, aged between 11 and 18, watching parents' faces absolutely brings home to you the importance of immunisation like nothing else does. I would say to anyone who is worrying about immunisation, if you were in that school that day, if you'd received that letter, you would've been with every other family lining up at a doctor to get immunised and get immunised quickly. It is a terrifying thing to think that you have been close to a disease that can be as tragic as that. We had a very positive outcome in our school. The student that had come into contact with and contracted that illness rejoined us in the classroom in a fairly short time after receiving treatment, but I know as a whole community how lucky we felt for his family and how lucky we felt that there was only one incident and that there were no other children affected. I know after that incident in my community that there were a lot of families who then began to talk about immunisation, and I hope that that single circumstance may have led to others going to be immunised.

But with 5,500 people in my community who have not been immunised and children not attending kindergarten or childcare centres necessarily—30 per cent of our four-year-olds—this is a critical matter. I would urge government, both federal and state, to think about what we are going to do as a next step for those families when they reach the school gate and how we are going to reverse that. I do not suggest in any way that that's part of an anti-vaccination movement. It is more a matter of education and education around public health: connecting people with general practitioners and ensuring that all of the adults in our community are well and truly aware of both the processes and the vaccinations and their importance, and that they understand vaccination processes and the good they do for public health.

Clare O'Neil (Hotham, Australian Labor Party) Share this | Link to this | Hansard source

I want to note the really outstanding contributions that have preceded me in this debate. We all come at the question of childhood vaccinations from a slightly different perspective. We've heard some really powerful stories from the member for Lalor in her capacity both as a mum of some wonderful boys, but also as a school principal who has had to deal with communicable diseases in that context. The experience of having to call families and tell them that such a disease is present in their community must have been utterly terrifying, and I really appreciate you sharing that story with us. Thank you so much.

The member for Lalor was preceded by the member for Macarthur, who we know is a paediatrician with decades of experience. I know that particularly for doctors in the medical community it's incredibly painful to participate in the current debate about the effectiveness of vaccinations, especially for doctors who have been around for a long time and have seen some of the horrific diseases that we have been able to virtually eradicate from our country through vaccinations. I will speak a little bit about the broader context for the discussion here today, but I do want to make mention of some of the specifics of the legislation before us.

Labor is very pleased to support the Australian Immunisation Register and Other Legislation Amendment Bill 2017. I might note that it's part of a relatively consistent legislative history of both major political parties in Australia trying to push this incredibly important issue forward. The bill before us makes two relatively minor changes to what are called the No Jab, No Pay arrangements. These are arrangements that, as I say, successive governments have pushed forward which restrict the entitlement of families in this country to certain government payments unless they can show that their children have been appropriately immunised. When those provisions were first put in place—they started around 1998—they included a number of exemptions. Families could say they were conscientious objectors to vaccinations, and of course there are some medical reasons why children can't be vaccinated. But over time governments have removed the various exemptions, because we are trying to make a very clear statement as community leaders—as the nation's parliament—that the expectation is that Australian families will vaccinate their children. That is incredibly important for the health of their child and for the health of the community more generally.

The legislation before us continues that history. It makes some requirements about the types of medical professionals who can provide evidence of vaccinations, and, indeed, it restricts the types of medical professionals who can provide evidence that exemptions have been allowed for various reasons on a medical basis. As I mentioned, the bill makes these relatively minor changes, but it does so in the context of a much broader and incredibly important community health issue to Australia. What we know is that despite incredibly voluminous amounts of evidence that tell us vaccinations are not only safe for use but also essential for the safety of our population here in Australia, immunisation rates in our country are lower than they need to be. It's a difficult conversation for those of us who have some perspective on what a powerful thing immunisations have been in improving the health of the community around the globe to have. Most people think that immunisations were, in fact, probably the biggest medical advance that we made in the 20th century. One of the studies that looked at the impact this has had on the lives of people around the world estimates that vaccinations save 2½ million lives every single year.

Now, in countries like Australia, we have seen horrible diseases affect, in particular, children. I know that people who are my parents' age and my grandparents' age can remember a time when, if a child started to contract flu-like symptoms—getting fevers and lethargy and other symptoms like this—parents would be awake all night wondering if their children had polio. And if they did have polio, they would know that a lot of the children who contracted this disease ended up without the use of their legs. Many of them died.

When we look to countries similar to Australia, in the US it was a peak—polio was contracted by something like 55,000 children a year. Many of those children died. And here, after years and years of research, brilliant medical scientists found a way to prevent this horrible illness from occurring. Now we are having a debate in the community about whether people should take access to that medicine. As a parent—I am sure you feel the same, Deputy Speaker—it's very hard to understand why it is that there are communities of people who are turning against such an extraordinary advancement, such a huge step forward, for us.

It's not just polio, it's things like diphtheria, tetanus and whooping cough, which we have seen virtually wiped out. In some instances it has been completely wiped out but in others we see the odd case here or there. This is incredibly important. Nothing matters more than the health of the young people in a community. We need to continue to explain this to the Australian people; we need to continue to enforce this message. In part, it's legislation like that before us today which helps us do this.

Another critical point to understand about vaccinations— and I do hope that Australians are spreading the word about this—is that it is not just about the children who are vaccinated. When we vaccinate all of the children or the vast majority of children in a community we develop something called herd immunity in a population. That means that when the diseases we are working so hard to eradicate do pop up, from time-to-time, they are not able to spread very far. So if there is a case, just one case, it does not immediately fan out, as it used to, in the thirties, forties and fifties.

We know that to get herd immunity rates—this is the great goal of public health professionals in Australia—we need something like 95 per cent of the population immunised. We are not seeing that today. We see relatively high rates when we look at the nation as a whole. It is something like 93 per cent. But in some communities immunisation rates are quite a bit lower. Unfortunately, there are sections of my community which fit into this category. I represent areas like Springvale, in south-east Melbourne, which has something around an 88 per cent immunisation rate. It does not sound like a terribly big difference between 88 and 95 per cent, but it is. We need to hit this herd immunity rate. That shows me as a community leader, as a local representative, I need to be working harder to explain to my constituents why it is so crucially important that they go through this process of properly immunising their children.

There are a lot of reasons for people not going through this proper process of immunising their children. I know in the case by Springvale, which, by some authorities, is the most multicultural suburb in the whole of Australia, a lot of this is about parents who bring children from overseas as migrants and, perhaps, in the country they came from there were not clear requirements to immunise children from a very early age. We need to do more work to help migrant families understand the benefits of immunisation and to practically help those families bring their children back up to a catch-up schedule, as they say, when we immunise children later in life.

There is a lack of focus sometimes for parents. As we heard from some of the previous speakers, among older Australians there's a very clear recollection of children they know who contracted horrible diseases that, generally, don't exist in our country anymore. That's the generation of people who do not need to be educated about the benefits of vaccinations. But there are younger people in this country who have not observed that type of illness before and who do not have crystallised, in their minds, the crucial importance of protecting their children in the way we know they can. So, we need to do some more work there.

There is also a section of the population who have not immunised their children because they are concerned about completely scurrilous claims that there are things to be worried about in immunising their children. One of the most commonly held beliefs—a total falsehood—is that there is a link between immunisation and autism among children. In fact, the Royal Children's Hospital did a poll recently that showed that one in 11 Australian parents still believe that vaccination is connected to autism and a further 30 per cent of Australian parents are unsure. I think those utterly terrifying statistics give us the push that we need in this parliament to be utterly clear about this.

Immunisations do not cause autism. Study after study has shown that the scurrilous claims that were initially made about this were wrong. They are wrong, and we need to be clear with Australian parents that they should not just jump onto Google and have a little look around and see what they can find, because, I can tell you, the first thing you will find when you google is that some of the common search terms about immunisations will land you on the pages of groups of antivaxxers, as they're called—people who are spreading this information about this crucial medical requirement to help our Australian population be safe and healthy. So we need to be absolutely clear that a lot of the claims that are being made on these sites, on these Facebook pages, are wrong. It is not appropriate, as Senator Pauline Hanson done, to suggest to parents that they do their own research about this. The medical community is united in saying that vaccinations are crucial, that they are important for the health of your child and that they are important for the children around them, and it's not appropriate to encourage doubts in the minds of Australians about the impacts of this.

So I think we, as community leaders, have a very clear role here in making sure that we're clear and united and we speak with one voice about the importance of this crucial aspect of our medical system. Part of that is continuing to strengthen legislation, as we are seeing in a bipartisan manner today. Part of it, though, is also standing up to people who are fomenting this sense of unease in the minds of some Australian parents about the impact of vaccinations. And that's why I was very disappointed to see that unfortunately the government was unwilling to come out and make a very strong statement against Senator Hanson's very damaging comments. The last thing we need in this country is to have members of parliament coming out and stoking the fears of Australian parents in regard to something as crucial as vaccinations.

We know vaccinations work. We know they do not lead to autism. We don't want people in this parliament who are community leaders creating confusion and concern among Australian parents. And I think it is also incumbent on people who perhaps take a more sensible approach, take a more evidence based approach to these things, to make a strong statement when other people are stoking those fears. So, I would like to see the government be stronger in its stance against silly comments that might lead to a less-healthy community. I think that's a very basic test of leadership that was a big missed opportunity for the government.

It's also important that we continue the crucial work that's been done on national health campaigns around vaccinations. I say that again as a member of parliament representing a community in which pockets of that community are clearly not hearing the message about how crucial it is that we continue to vaccinate our children. We've seen some pretty concerning things recently. We have to remember in this chamber that we are, in a sense, fighting with this group of people online who are trying to spread misinformation. It was not long ago that there was a major screening of another scurrilous anti-immunisation film in Melbourne. We have to fight back against that with a strong public health campaign, and that's something we want to see properly funded. It's important that we take the legislative approach but that we also take this education approach, because we want Australian parents to be as fulsomely supportive and pleased to take their children to a vaccination session as those of us are who can understand what a world where we did not have vaccinations at all could look like.

In closing, I will say that we want to see some more action on the No Jab, No Play policy. That's one that restricts access to child care for young people who have not been vaccinated—again, making this very clear statement on behalf of this parliament that our expectation is that Australian parents will take this incredible gift of vaccination and make sure that their children around them are safe.

The member for Lalor closed her comments by talking about how none of us get excited about taking our kids for a vaccination. That's true. I wrote some of this speech while I had an 11-month-old baby on my lap. I don't enjoy taking him to the doctor, because he does get upset when he gets those needless. But I am so grateful that I live in a country where my child has the opportunity to protect himself and to protect the children around him. I want other parents to understand that it is a great gift that we have the opportunity to protect our children from diseases that have wreaked havoc on previous generations.

Julian Hill (Bruce, Australian Labor Party) Share this | Link to this | Hansard source

In some respects, I think some of what I am going to say and put on the record may be a bit superfluous, having listened in my office to some of the incredible contributions of the member for Macarthur and also the member for Lalor and my colleague, neighbour and friend the member for Hotham. But I do think, for some of the reasons outlined, it is important that as many of us in this place as possible stand up and put on the public record our support for vaccination, for evidence based public policy. I know it is an old-fashioned concept at the moment—particularly for many opposite, when you talk about climate change and things like that—that public policy should be based on the best available scientific evidence and accumulated knowledge. But, as someone who studied a science degree many years ago—not that I was the greatest science student; I was otherwise occupied at university at times—and as someone who trained in the scientific method and firmly believes that our policy must be based on evidence and reason, I think that needs to be said.

We're fortunate to live in a society and a country where, through the impact of an effective national immunisation program, we have either largely forgotten or have never known the impact of mass death and disability caused by vaccine-preventable communicable diseases. As the member for Hotham said though, if we reach back not too far in our family histories, we can discover those stories. For instance, my daughter's grandfather still, in his 70s, suffers the effects of polio from many years ago. So it is important to remember the enormous public health benefits of vaccinations and indeed the millions of lives saved every year. But societies that forget and ignore science can all too easily slip into complacency, where the validity of immunisation is questioned. As it turns out, off-the-cuff comments by ill-informed internet conspiracy theorists are not a great basis for public health policy or life-changing decisions for individuals with regard to their families and children.

To their shame, the government did recently, as the member for Hotham said, let this tired and damaging debate swirl around again by not rebuking Senator Hanson in speaking strongly and failed to comprehensively shut down this misinformation. There was, as I saw in the paper this morning, a form of redemption, if you like, perhaps subject to verification, in that Polly Tommey, the antivaxxer activist from the UK, has been banned by the immigration department. Perhaps I could almost say the first positive thing I have ever said about the minister for immigration. That sounds like a good decision, a wise decision, should it be true. The shameful claim which was made by this individual that doctors were murderers was rebutted this morning in the paper by Dr John Cunningham, who said simply, 'Babies will die if not vaccinated.' So I think we would focus on that rather than the ridiculous claim that doctors are murderers.

The nature of the bill, as has been noted, provides for a couple of minor, sensible technical amendments to the Australian Immunisation Register Act, aka the No Jab, No Pay arrangements, which will allow for four other types of medical specialists—paediatricians, public health physicians, infectious diseases physicians and clinical immunologists—to grant exemptions to vaccination requirements. Currently, somewhat surprisingly actually, only GPs can do that. So it does seem sensible. You can't imagine that a paediatrician or a medical specialist couldn't also do this work. The amendments will make explicit in the legislation that the provision of vaccination information to the register must be by registered vaccination providers. Labor of course supports this bill. But, as ever, this government has a tendency to fiddle around the edges of legislation and call it reform when wider issues remain.

As has been outlined, but to briefly record, our immunisation program has been incredibly effective. Deaths from vaccine-preventable diseases have reportedly fallen by 99 per cent since the introduction of childhood vaccines 85 years ago. Vaccination rates are currently a little over 90 per cent, but, as the member for Hotham teased out, we do need to make sure the vaccination rates are as high as possible. We actually share the suburb of Springvale, and I know the issues you are talking about, particularly with newly arrived migrants and so on—the difficulty and the import of having these programs reach out and also the importance of having the programs available for temporary migrants, illegal arrivals or whatever, because it's a population-level impact to make sure that our public health programs don't discriminate by visa status and so on.

But for highly infectious diseases, and I will use the example of measles, we need much higher vaccination rates—at least 95 per cent—to provide that herd immunity. This complacency and refusal to vaccinate without medical justification is dangerous to the wider community as well as to individuals, particularly our kids. There are very few approved exemptions to immunisation requirements. The primary one is medical contraindication—things like anaphylaxis, compromised immunity and so on. So it is critical that only medical practitioners can grant such exemptions and provide advice to government as to whether vaccination requirements have been met.

Now, I will just turn, because it is important to record them, to the ridiculous statements this year by Senator Hanson, presumably advised by—currently—Senator Roberts; we'll see how that plays out. He is well known for his rejection of science, evidence and reason. Senator Hanson questioned the validity and safety of vaccines and encouraged parents to get their children nonexistent tests—tests that actually don't exist—for allergic reactions. I want to record in the Hansard the comment from AMA President Dr Michael Gannon, who said:

… it is the lament of doctors and scientists across Australia that evidence-based treatments do get called into question …

He said that nearly 10 per cent of Australian parents 'are so-called vaccine-hesitant' and 'can be swayed very easily by any message which might be seen to question the validity of the science'. In another interview he said it is essential that there is accurate information and that this idea that parents can spend 30 minutes on Wikipedia and come to a greater understanding of the issues than their doctor and the accumulated wisdom of all the world's medical scientists is ludicrous. That is what the member for Hughes did, I think, with his climate change comments in that wonderful speech. And I have to grant it to him: it is quite an art to be able to make a speech on any bill and bring it back to why burning coal is good. Nevertheless.

I do confess to be someone who occasionally is guilty of a bit of late-night Dr Google myself. I've diagnosed myself, after a couple of wines, with a range of dreadful cancers. So I do recommend going to the doctor and staying away from Dr Google.

An honourable member: No self-examination!

No self-examination! But the government's response to its dear friend Senator Hanson in the Senate was somewhat more measured. For those listening at home—although I don't think anyone actually listens to the Fed Chamber at home, but it is in HansardI will say that I wonder why the government wouldn't just quickly speak out against such unscientific nonsense, when the evidence is clear and the answer a mix of politics and substance. Politics: the Prime Minister's brilliant move to call a double dissolution election means that his government—and I use the word 'government' in the formal sense, not because there is a lot of actual governing going on this week—are hostage to nutters and fringe dwellers. But you do have to have a listen to government MPs debating climate change and you'll quickly learn the depth of the irrationality and the disregard for science and evidence—why this bill and the support shown for immunisation programs as represented by this bill is welcomed. It contrasts, of course, with what I would say is an old-fashioned respect for science and evidence on the immunisation program on our side, with any antivaxxer stuff being quickly rebutted. But we're listening and are of course aware of the growing risk to the community from ill-informed antivaccination campaigners.

Importantly, we've been calling for some time for an appropriately resourced public awareness campaign on the importance of vaccinations. Indeed this bill, by formalising the ability of other providers, may give us other agents and channels to through which to promulgate such a campaign. So we were pleased that the government belatedly but finally agreed with us and announced a national immunisation awareness campaign in April. It's fair to say that $5.5 million over three years may not quite cut it in terms of delivering an effective public health message for such an important topic, and it's disappointing, particularly after allowing such myths and misconceptions to flourish. But countering this information and providing parents with this information is important, and I hope there's transparent monitoring, to be fair, of the impacts of the campaign on immunisation rates, public education and so on so that if additional resources are warranted they can be provided swiftly. We have always offered our support to the government on the sorts of measures that will lead to increased immunisation rates and a more efficient system, as this bill does, and a little more integrity in the system, but we expect more when it comes to public safety.

In the time remaining, I would echo the member for Hotham's comments. It is directly related to this system. There is an overdue measure of the No Jab, No Play state and territory laws to allow childcare centres to turn away children who are not immunised. If that sounds familiar, if you think you've heard it before perhaps—that's right—it was promised by former Prime Minister Abbott when opposition leader. Perhaps it was one of those non-core promises! There are core and non-core promises. Four years on, there has been no action. But, still, I was pleased to see that the new Minister for Health announced in March 2017 that the government will be proceeding with these laws. We have not heard anything since. It doesn't seem to have been on the COAG agenda. But, nevertheless, we will remain hopeful that, if the government can stop stand spending their time obsessing about marriage equality and other people's relationships, they may get back to governing and actually follow through on this.

The other thing I would say with respect to public health, because this of course sits in a broader context, is that the member for Gilmore, the member for Brand, some other members of this House and I were privileged to spend the last week of June after the last sitting week in Thailand and Myanmar with the Pacific Friends of the Global Fund. We were looking particularly on that trip at Australia's work and contribution in preventing, stopping and stamping out malaria and stopping the transmission of HIV and tuberculosis in South-East Asia. There is a very close link to vaccinations.

What really came home to me were a couple of things. Firstly, Australia has an enormous national interest in this. In our work in Australia on reaching 90 to 95 per cent immunity it is so critically important that we don't live in a bubble and we don't live in isolation from the world around us. As part of things like our immunisation register in this bill to strengthen and improve its integrity, we must also continue to invest in our work with our neighbours overseas. There is a feel-good aspect to that. There is a moral contribution as a good citizen, a developed country and a good global citizen to work with our neighbours. But there is also a direct national self-interest in this. When we have a look at communicable diseases we can think it's fine to have our herd immunity. But with increasing amounts of travel, with such a migrant compromised society travelling to these countries, with Australian tourists and so on we have an enormous national interest in accelerating the efforts to stamp out these diseases, both vaccine-preventable communicable diseases and also tuberculosis, malaria, HIV and so on. Indeed, the rise in Papua New Guinea, for instance—only a few hundred metres from Queensland—of drug-resistant tuberculosis and drug-resistant malaria has potentially devastating consequences for Australia.

So the link with the vaccinations, particularly, is that investment in building capability to stamp out these diseases is actually very much the other side of the coin of investment in rolling out vaccine programs, because both rely on strengthening the capability of the public health systems and the ministries of policymakers. But also when the members for Gilmore, Brand and I were traipsing around we met with the Thai royal princess. We met with government ministers—

Ann Sudmalis (Gilmore, Liberal Party) Share this | Link to this | Hansard source

I didn't.

Julian Hill (Bruce, Australian Labor Party) Share this | Link to this | Hansard source

You actually didn't have a skirt on, so you were left outside. No wearing black pants to meet the Thai royal princess, as it turns out. But that's a story for another day!

This is where the link with vaccinations comes in. We were traipsing around in the mud in Myanmar villages. From rural Myanmar right through to the regional level health centres, this is all part of the same chain. So our work in Australia to maintain our levels of immunisation is intimately linked to our work in Asia if we are to really eradicate these diseases from the world.

In closing, I will read a comment around controlling the incidence of vaccine-presentable diseases in the Australian community and how it's a critical health issue from the Australian Family Physician. It says:

Ideally, governments formulate their health policies and regulations more broadly, and are concerned with the national interest. They take into account the risks to individuals, including vulnerable groups such as children. Parents, on the other hand, are primarily concerned with the wellbeing of their child.

…   …   …

In accordance with legislation and case law, it is in a child’s best interest to be protected against vaccine-preventable disease. It is also in the community’s best interest that children are protected against outbreak and spread of disease. To date, this is best achieved through programs that are accessible, well communicated and supported by law …

In closing, it's the responsibility of each of us in this chamber, perhaps as parents but certainly as parliamentarians, to reinforce, at every opportunity, now and in the coming time in our roles, the validity of vaccination science to the Australian public and to promote the public health benefits of achieving full immunisation.

Madeleine King (Brand, Australian Labor Party) Share this | Link to this | Hansard source

I rise today to give wholehearted support to the federal government's Australian Immunisation Register and Other Legislation Amendment Bill 2017. While the bill only makes minor technical changes to the No Jab, No Play arrangements, it is important to note the significance of ensuring this legislation remains effective and up to date to help safeguard the health of everyday Australians and sustain the nation's high level of immunity to many of the planet's worst infectious diseases.

While we fully support the continuing vaccination of Australian children, under this bill we understand and acknowledge the number of Australians with medical conditions who require exemptions to current arrangements. As the legislation currently stands, only GPs can grant these exemptions, which unduly affects and inconveniences this small group of people. The amendments to the bill will now allow four other medical specialists to grant these exemptions—paediatricians, public health physicians, infectious disease physicians and clinical immunologists. This not only continues to safeguard these regulations within the hands of those with the appropriate expertise but it makes common sense. In addition, the federal government will clarify the acceptance of evidence of vaccination, which can only occur through recognised vaccination providers and not through parents or the public, by amending the health and social services act to make sure it's explicit in the legislation and, therefore, very clear to the public.

This bill is a welcome addition to the immunisation program of Australia and a ringing endorsement of the benefits and positive results of immunisation in Australia and, indeed, around the world. The scientific evidence supporting the use of vaccines is overwhelming, yet this issue still refuses to be put to bed. The heat refuses to go out of it, and, if anything, at times, the temperature has increased exponentially, fuelled by many irresponsible commentators and, more locally in this country, by reckless and ridiculous commentary from One Nation, which has been spearheaded by Senator Hanson. In early March of this year, on the campaign trail for the Western Australian state election, Senator Hanson spoke on ABC's Insiders to question the safety of vaccinations generally, which many social commentators attributed to a renewed push on the issue by those against vaccinations—the antivaxxers, if you will. Those antivaxxers put the health of children in the wider community at risk through their irresponsible and unjustifiable campaigns that seek to discourage immunisation of children.

Senator Hanson has backed down from those comments, suggesting parents use a non-existent test for vaccine allergies—it's not very helpful to recommend a test that does not exist. But she has not apologised for the dangerous comments she made linking vaccines to cancer and autism. This is not only desperately irresponsible but a slap in the face of the medical profession as well as victims of both diseases and science itself.

What's even worse is the fact that the Prime Minister refused to directly condemn these comments for fear of upsetting the Liberal Party's new preference deal partner. Well, we all saw how that deal with One Nation went in the WA election. It must be remembered that these comments the Prime Minister refused to repudiate are comments that medical experts have described as dangerous and ignorant. These comments and attitudes are lifted directly from the political playbook of the alt-right and conspiracy theorists that seek, with determination and ignorance, to denigrate scientific research and denigrate the benefits that flow from it.

In this digital age, misinformation on immunisation and vaccines is rife. It's rife across the internet and easily accessible to those who are vulnerable to misleading and persuasive arguments. This boils down to a lack of solid, consistent education on the topic to combat this rise in negative attitudes. Australia must start providing a clear, thorough and well thought out message that Australia's strong immunisation program is critical to ensuring that the chances of contracting a life-threatening disease remain low. I welcome the government's commitment to a national strategy in this regard.

I and the rest of the Labor Party call on the Turnbull government to properly fund and resource the national education campaign for vaccines and immunisation, and to raise awareness of the critical importance they have to the health and wellbeing of everyday Australians. I believe the best way to refute these recent negative and misleading claims and commentary is through this national education program, which will provide irrefutable and overwhelming medical evidence and help provide a strong case to convince those Australian parents who perhaps think twice before vaccinating their child. However, I won't be holding my breath to see if any education program or, indeed, any facts will convince Senator Hanson to revoke her views.

The last thing any of us would want is a significant decline in the vaccination rate in Australia or, indeed, anything that would undermine confidence in the Immunise Australia Program. The President of the Australian Medical Association, Dr Michael Gannon, said recently:

… about 8 per cent of the population are so-called vaccine hesitant, and they're looking for any information that might lead them away from what is, with the exception of clean water, probably the most significant health measure we've got.

It is absolutely essential that we have accurate information …

I agree with this, the Labor Party agrees with this and the overwhelming majority of the parliament agrees with this. Oddly enough, that's similar to the views on marriage equality. Why then does the Prime Minister refuse to outright condemn Senator Hanson and her ignorance of the issue? A slap on the wrist is hardly an adequate response.

In 2015-16, the Australian rate of immunisation averaged around 93 per cent among five year olds. My own electorate of Brand in Western Australia has similar rates, with Kwinana and Rockingham at 93.3 per cent and 92.5 per cent respectively. This is up from a 90 per cent immunisation rate of children in 2012 but still short of the desired target of 95 per cent. Those that challenge that target are ignoring the basic scientific data which requires effective immunity—herd immunity, if you like—to be maintained with consistently high levels of vaccination rates amongst population centres. It's very pleasing to me that families in my electorate are making the very positive step for the health care of their children by ensuring they are vaccinated against diseases that can kill, that can harm a child's development and that are entirely preventable. I urge all parents in my community of Brand, Rockingham and Kwinana to follow the lead of the caring community around you, take part in the excellent and critically important immunisation program and have your children vaccinated.

Right now, in Perth, we are sadly witnessing an entirely preventable measles scare. I was very sad to read that there is a young student from a Perth school who travelled to Italy—she was an unvaccinated student—and has brought back, to her school in Bibra Lake, measles. She has measles herself and, before she was diagnosed, she was in the school population spreading this disease. It is sad enough that a modern, First World country in Europe—Italy—is itself in the grip of a measles epidemic but even sadder still that an unvaccinated child from Australia should go on holiday and bring back measles to her school, where it turns out that only half of its 400 students might be vaccinated. I think it's very concerning that the Perth school at the centre of this measles scare has not taken up the offer of a special immunisation clinic to ensure that all of its students are vaccinated immediately. This was an offer put to them by the WA health department. I hope the school reconsiders. If it doesn't, I sincerely hope the parents of children in that school act quickly to ensure their children do not suffer from measles in the future. In addition to this, the school has a very wide metropolitan catchment area, so it is difficult to know what suburbs the children are from. So this measles scare could spread through the metropolitan area of Perth rather quickly if not looked at immediately.

We know that the vast majority of parents are only interested in doing what is best for their children. Having a proper, clear and well-resourced national education campaign, which I spoke of earlier, will greatly counteract the slow tide of misinformation that is seeping into the public discourse and perhaps is what leads to schools such as this one only having nearly half of their students immunised. This type of campaign has the full backing of many of Australia's peak medical and scientific bodies, such as the AMA, the Australian Academy of Science, the Public Health Association of Australia and all of Australia's medical colleges. The government has been slow to act on this idea, but we are grateful that they have finally jumped on board. However, this education program still requires further resources and attention. There should be no debate on the issue of immunisation, only more education and proactive policies to ensure higher vaccination rates. The undoubted global health benefits of immunisation deserve no less.

While I have the opportunity, I have to reflect on the fact that introducing improved education programs in vaccination is not the only thing this government has been slow to act on. Nearly four years ago the coalition was elected to government on a platform consisting of a number of policies. I won't go through them all, but one is particularly relevant. The former Prime Minister in May 2014 as opposition leader, at the moment the member for Warringah, committed:

If childcare centres want to implement 'no jab, no play' then they should be free to do so, and we will work with the states and territories to make it happen.

Nearly four years later, what has happened? Virtually nothing. While we welcome the renewed interest in and commitment to important health policy, we can add this to the tally of broken promises and failed objectives, notwithstanding the government's sudden compulsion to keep another election promise—a non-compulsory, nonbinding postal plebiscite on marriage equality.

Members opposite, when reflecting on broken promises and promises they have made in elections, could do worse than listen to or watch Emma Alberici's interview with the Minister for Finance, Senator Cormann, earlier this week. She points out the government's sudden obsession with keeping its election promises. To paraphrase her, she says: 'You didn't keep the promise when it came to health and education. No new taxes is what you said before the 2013 election, and you introduced a three per cent budget repair tax. You, the government, promised no cuts to the ABC and then took $44 million away from the ABC. The member for Warringah promised you would not shut any Medicare Locals. All of them are now gone. The foreign minister, Julie Bishop, promised no cuts to foreign aid and that it would grow in line with inflation. Instead it was frozen, and that represents a $7.6 billion real cut. Then there was the member for Warringah's signature policy on paid parental leave, which has also been abandoned.' The clincher was that the interviewer asked, and it is what most Australians ask, 'Why is the promise on marriage equality and the need for a plebiscite of whatever order so important to keep?' It's no wonder the Australian people are understandably confused about exactly what this government is on about with its mixed up and whacky priorities that are of no help to Australia and its people.

Returning to the No Jab, No Play policy, we will continue to give the government's commitment to this issue today the attention it deserves and we will continue to watch closely and hold them to account as this progresses.

I want, before I conclude, to reflect on a very sad story, and many of you will have heard of it. In Western Australia there's a young family who became unexpected champions of the vaccination cause of promoting immunisation. Catherine and Greg Hughes experienced the preventable tragedy of losing their son, Riley, to whooping cough. It was utterly preventable but sequences of events led to the tragedy of losing their son. I am sure that on the day their son was born they could never have imagined firstly that 32 days later he would have died from a preventable disease which the community should be immunised against but that also they would become champions of the cause of immunisation amongst pregnant women and young children across Australia. So they have set up the Immunisation Foundation of Australia, and if there are parents around Western Australia, and the country for that matter, who feel confused about immunisation I really do encourage them to look to this family, Catherine and Greg Hughes, and their cause. Their Light for Riley website can direct them to some very trustworthy information on immunisation. What happened to young Riley should not have had to happen. He was too young to be vaccinated; he came in contact at some point in his life with someone who was not vaccinated against whooping cough and that ended in tragic circumstances. His parents have since had another young daughter, and they continue to fight for what we all should fight for, to ensure that the immunisation rates in Australia, of Australian children and adults, only continue to climb.

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

I want to commend the member for Brand on particularly those last comments about that family and the tragic death of their child from whooping cough. As she said, this is an entirely preventable disease. Imagine the despair, the horror and the trauma that that family went through in witnessing the death of their child from such a hideous disease and what we know is a preventable disease. I commend the member for Brand on that very powerful speech.

Whenever I speak on immunisation my thoughts always go to the book titled I Can Jump Puddlesby Alan Marshall. It is a fabulous book. I read it in primary school. I said to my team when preparing for this today: 'Can you get some quotes out of the book for me so that I can relay the firsthand experience of someone who had polio, what it was like for them and how they overcame the challenges of that disability.' It was interesting that drawing quotes from the book was very, very difficult. Some members of my team had not heard of the book or, if they had, hadn't read it. So I send a message out to schools. I know that at the moment there are a lot of challenges with school curriculums. Schools are having to juggle a lot. But, given that this issue is so contentious—and constantly so; it is back in the news now, with recent films being shown and discussions being had by some in the other chamber on the value of immunisation—I think it would be worthwhile for parents of a certain age to dust off their copies of the book I Can Jump Puddlesand give it to their children or grandchildren to read. For those in their 20s and 30s who are not aware of this really powerful novel, I suggest they go to their local library, get on Amazon or go to their local bookshop and get a copy of it and read it. If nothing has convinced you that immunisation is a vitally important protective mechanism for our community then that book will convince you. It's incredibly powerful.

As I said, this young man overcame significant adversity. He caught polio at a very young age in country Victoria, yet he achieved his dreams. I did find one quote. He writes:

It amazed me that they would imagine I would never walk again.

Imagine a child with a preventable disease being faced with the prospect of never being able to walk again. The fact is that this disease is preventable. So, do we want a recurrence of this disease? This young child, from country Victoria, was told that he would not be able to walk again. He writes:

I knew what I was going to do. I was going to break in wild horses and yell 'Ho! Ho!' and wave my hat in the air, and I was going to write a book like The Coral Island.

That was Alan Marshall's response to the hideous disease that is polio—a disease that has been eradicated from the world, thanks to immunisation. But, if we are not careful, it could rear its ugly head again and we could be facing the same scenario that children in the thirties, forties and fifties faced.

My mum, who grew up in a housing commission house in Melbourne, Victoria. She went to the local primary school and then she briefly went on to secondary school. When I was a child in the sixties and seventies, I remember my mum telling these stories about her classmates and what Melbourne looked like in a polio epidemic. This is what a city looks like when there is a polio epidemic: the city baths are shut down; all the swimming pools are shut down; and the schools are shut down. When you go back to school some of the school mates that you had before the school was shut down are not there anymore. Some have died and some have become paralysed as a result of polio; they can't come back to school. That is what it looks like to have a community with polio.

Is this the future we want for the country as a result of the resistance among some communities to be immunised?

Do we want our public places shut down? Theatres were shut down. Because it's a highly communicable disease, any place where people could catch the disease was shut down. As I said, the baths, the cinemas, the theatres, schools—all shut down. Can you imagine the trauma for young children of having your school shut down and then coming back to school with some of your classmates not there because they are dead or they are significantly paralysed and dealing with the challenges of trying to live with this significant disability?

So this is the sort of future that some of these antivaxxer people are proposing for our country. Do we want this, given the fact that this is an entirely preventable disease? Do we want this for our young people? Do we want this for our community? Do we want this for our city? Do we want this for our nation? Do we want this for our world? The ignorance of it is breathtaking. It really is. These whooping cough stories—the trauma. Can you imagine it? Particularly when you have done everything you can to protect your child, can you imagine that, through no fault of your own, you lose your child through that tragic, hideous disease?

In returning to this legislation in the time that I have left, as we know the government announced it would pursue this No Jab, No Pay laws. These allow childcare centres to turn away children who are not immunised. While some states and territories have put these laws in place, there still isn't a national approach, as my colleagues have mentioned. The ACT is one of the states and territories that are holding back in implementing any arrangements in the absence of a national approach. One of the reasons the ACT is holding out is because a national approach would ensure that the interests of some of our most vulnerable groups are taken into account. Whether it's through disadvantage, newness to Australia or unfamiliarity with the English language, some in our community may not have access to, or won't be aware about, these immunisation programs. Therefore, the ACT government's concern is there would be further disadvantage.

The benefits of a national approach will ensure that information can be communicated widely and that information will be consistent over all states and territories. It is vitally important—harmonisation of legislation, harmonisation of communication and harmonisation of implementation. There's nothing more frustrating, particularly for Defence families that move around the country every two or three years than having these incredible inconsistencies between states and territories.

We welcome the government's renewed commitment. Since they've been in office, they've done nothing on this policy. The more people who are vaccinated, the fewer opportunities a disease has to spread. The National Immunisation Program Schedule includes vaccines against a total of 16 diseases. These include the routine child vaccinations against diseases that were once incredibly fatal—measles, diphtheria and whooping cough, as have been mentioned. Included in the 16 new vaccines are the HPV and meningococcal C vaccine. That is a terrific development.

Any misinformation around the science behind vaccines is dangerous and irresponsible. It's a public health risk. Labor welcomes the government finally funding a public campaign to combat this dangerous misinformation on vaccinations. It's something we've been calling on for some time. We have written to the Prime Minister to encourage urgent action on this. Only last week we saw a screening of an antivaxx film at a large cinema in central Melbourne. This is a democracy. People are entitled to screen shows that have a different view, a different opinion. They are dangerous in the fact that they are potentially putting lives at risk with this whooping cough and, potentially, polio in the future. They are dangerous, but the thing is: this is a democracy.

We need to empower people, to put the scientific information at their fingertips so that they can counter these views that are being disseminated through these films and through other campaigns. We seem to have been seeing a resurgence in these over recent years. We must ensure that our people are well armed with information to protect themselves against these uninformed comments about vaccination. We have a strong immunisation program and it's critical to eradicating life-threatening diseases. A failure to vaccinate is a threat to public health.

What is concerning, as my colleague the member for Brand has mentioned, are the comments made earlier this year by Senator Hanson when she questioned the safety of vaccinations. This sparked renewed discussion on the value of vaccination, of immunising against preventable diseases. I understand Senator Hanson later backed down on her suggestion that parents should use a, non-existent, test for vaccine allergies, but, unfortunately, what she hasn't backed down on are her outrageous comments on children with autism and her outrageous comments linking vaccines to cancer and autism. Even though she has in some way backed down on some of those comments, she has not backed down fully. Medical experts have highlighted that her comments were ignorant and dangerous. Unfortunately, showing once again his lack of leadership, the Prime Minister could not bring himself to directly criticise and counter Senator Hanson's comments.

Our leaders need to do everything possible to ensure parents know about the deadly risks of failing to vaccinate their children—as we are doing here today—not spreading misinformation. Most importantly, they should not confuse things by making broad, misinformed statements based on ill advised scientific evidence and assumptions, and then withdrawing, partially, but not entirely, those comments so that these grey interpretations of what is actually happening in this space are still out there for people to be completely confused by.

The AMA has regularly paid tribute to the role played by family doctors in safely and effectively immunising generations of Australians against potentially deadly diseases. This is vitally important, because at is usually the first port of call for most families, particularly when they have little ones moving from the infant welfare centre, and the nurse there, up to the doctor and the local GP. There is that very early engagement, and that's why the role of the general practitioner is so vital in combating these preventable diseases.

The AMA accepts that there is still a small majority of the population that won't accept the science behind vaccinations. The AMA's president recently told Radio National that about eight per cent of the population are so-called vaccine-hesitant and are looking for any information that might lead them away from what is, with the exception of clean water, probably the most significant health mechanism we have got. That is a pretty powerful message: the most significant health measures we've got are clean water and vaccination. The facts are that vaccination plays an important role in protecting us from potentially deadly diseases like polio, whooping cough, and meningococcal disease. Polio is a highly infectious disease caused by a virus that invades the nervous system. It can cause total paralysis in a matter of hours and also death. Until the 1950s it crippled thousands and thousands of children every year in industrialised countries. But soon after the introduction of effective vaccines in the fifties and sixties polio was under control and practically eliminated as a public health problem in these countries.

The polio immunisation program is the best example of the transformative power of immunisation against preventable diseases. The polio immunisation program is absolutely the most powerful campaign and powerful education program in terms of talking to people about polio and about how, thanks to immunisation, it has been eradicated from our world. I ask anyone who in any way doubts this to go out—go to your library, bookshop, Amazon—and get out a copy of I Can Jump Puddles by Alan Marshall and see what it's like to live with polio, see the tragedy of polio and the challenges of polio and see that you can overcome in the end.

Matt Keogh (Burt, Australian Labor Party) Share this | Link to this | Hansard source

I am the proud parent of Nicholas, who last week turned one year old—a very enthusiastic one-year-old, just finding his feet and taking his first tentative steps. At this age, it is normal for parents to be concerned with things like choking hazards and them falling flat on their faces. What I shouldn't be worrying about is whether or not Nicholas will be at risk of contracting preventable diseases when he goes to day care or starts school. I am deeply concerned about the wave of parents choosing not to vaccinate their children and the implications this can have on families like mine and so many others in my electorate and across the nation.

Just this week the WA health department has had to step in and stop the spread of measles in a Perth school, where up to 200 unvaccinated children are now at risk of contracting the virus. In fact, Perth has one of the worst childhood immunisation rates in the country, according to a report recently released by the Australian Institute of Health and Welfare. The report states that some suburbs in Perth have vaccination rates as low as 80 per cent compared to the national average of 93 per cent. We are, indeed, at risk of losing our herd protection in some places in my state.

While I can appreciate the recent commentary around the supposed side effects of vaccines, which may have some parents thinking twice before booking their kids in for routine jabs, the overwhelming scientific evidence shows that vaccines save lives. The theory that forms the crux of this antivaxxer movement is that vaccines cause autism. This is based on a 1998 study published in a medical journal that 'found' a link between vaccines and autism, saying one in 100 were at risk. That journal later retracted that information because it was found to have been falsified. The author of the study was reportedly set to benefit from lawsuits that relied on the data he had published. But the damage had already been done, and the antivaxxer movement is, alas, in full swing. Even if vaccines did cause autism—which they don't—they still massively reduce the risk of other diseases, like diphtheria, polio, meningitis, hepatitis A, hepatitis B, mumps, whooping cough, pneumonia, retrovirus, rubella, smallpox, tinnitus and chicken pox, all of which can be fatal.

It must be said that the approach of No Jab, No Pay is a compulsion by the state to take a risk. It is, overall, a harm-minimisation approach where side effects may, in a very small proportion of the population, occur. But it is for the greater good. Importantly, to not do so would result in much greater harm not only to the population at large but also it is more likely to result in harm to those that may be susceptible to those side effects from vaccination. This balancing act is a difficult one but, after much consideration, I believe we have landed in the right place.

Amanda Young was a young and talented 18-year-old, living in my electorate of Burt, who died tragically after contracting meningococcal septicaemia. She was an inspiring young woman possessing many skills and passions and was a much-loved daughter of Barry and Lorraine. She was talented, hardworking in sports, academics and music, and throughout her life excelled in competitive sport as well as many other areas in her school life and at university. Amanda attended an intervarsity rowing competition regatta in Penrith, in October 1997, where she, tragically, contracted meningococcal disease and died at the age of 18. She was only a year or so older than I was.

Amanda's legacy lives on because her parents established the Amanda Young Foundation, with the aim of reducing deaths in WA from meningococcal disease and supporting survivors of the disease. They are, of course, big promoters of these vaccines. I mention this because it makes clear how important it is that we make sure we have a strong national education campaign to support the No Jab, No Pay policy and the importance of vaccination. With so much misinformation making its way into our mainstream discussion, it is incredibly important that the government assumes leadership on the role and presents Australian parents with the clear facts.

I am hopeful that our discussion of this bill in this place today may encourage the government to commit more to a national education campaign—a campaign that can learn from the work that's been done by organisations like the Amanda Young Foundation, which serve as such a sobering reminder of what can happen when people do not have access to necessary vaccines. In particular, I hope that this debate will serve to dispel some of the myths and misinformation that have been propagated—indeed, by some of the elected representatives in this parliament.

But, as well as promoting vaccination, it's also important that parents have access to vaccinations. Last year we were confronted with a shortage of meningococcal B vaccination. The Labor Party took issue with this and wrote to the government to express its concerns and urged it to make sure that we didn't find ourselves with this shortage again and that it be resolved. While more meningococcal B vaccinations have now been made available to the Australian public, there are still concerns that the amount available to the public is not enough to meet demand that may arise in the course of the coming year or so. That should be resolved.

I support this bill because it clarifies some of the detail around No Jab, No Pay arrangements. But I think it is important that we use this opportunity to shine a light on the issues related to childhood vaccination and the misinformation about it that is propagated. I hope the government does more to restore public confidence in our vaccination regimes and that it restores confidence in the science behind vaccination and the integrity of the vaccination program more broadly.

Greg Hunt (Flinders, Liberal Party, Minister for Health) Share this | Link to this | Hansard source

I thank all of the members who have spoken in this chamber on the Australian Immunisation Register and Other Legislation Amendment Bill 2017. It has the support of the House on a bipartisan basis, and, indeed, I believe, by all members of the House. In particular, I want to thank the opposition. It's unusual to say this, but I think the opposition spokesperson gave a wonderful, powerful and moving speech about her own family circumstances, and it deserves to be acknowledged as one of the motivations behind her, and the opposition's, support for stronger immunisation. She had a major loss, and I want to acknowledge and appreciate that. Hopefully, the work we've done with Polio Australia will also provide a way forward for others who have been victims of polio.

I want to address this bill in three phases: firstly, the overarching task in relation to immunisation and vaccination in Australia; secondly, what we will be doing with awareness; and, thirdly, where the bill fits in. We know that we currently have a 93 per cent rate of immunisation in Australia. That has increased significantly. It's the work of consecutive governments. But perhaps our signature effort in that space has been the No Jab, No Pay program. It is in many ways a tough measure, but unapologetically so. I want to acknowledge my predecessor, the member for Farrer, who has really been the pioneer in this space. It may be that, in 10 or 20 years time, she looks back on this as the most important thing from her time in parliament, because, in the end, it will have saved a lot of lives. So I thank and acknowledge her work.

We know that, since the introduction of No Jab, No Pay, the government has seen an extra 210,000 children vaccinated. Those vaccination rates have gone up to 93 per cent, as I said. We have an interim target—because, in the end, it's got to be 100 per cent, minus anybody with a medical exemption—of 95 per cent. We have to keep pushing towards that. Interestingly, some of the highest rates of vaccination in the country are in Indigenous communities, where there has been very strong support for the No Jab, No Pay program, which is a real tribute to the Indigenous community health leaders.

We then move on to what we are doing with awareness. We will shortly be launching the major component of the $5½ million awareness campaign. That awareness is built around the principle that it's not just safe but it saves lives—that your child or somebody else's child could be at risk. We have seen the outbreak of measles in Western Australia at the moment. I have to say to the school involved: please rethink your philosophy on this, because there are 200 kids who are at risk right now.

At a broader level, I want to categorically denounce, in a way that I do not usually do, the antivaccination movement. Unfortunately, this is not a science-based movement. Their comments and approach threaten the lives of young children and people of all ages—but particularly the young and the elderly—whose immune systems are not robust. There is a bipartisan approach to rejecting the antivaccination movement. There was a unanimous response to a Commonwealth initiative at last Friday's Council of Australian Governments health ministers meeting to denounce and reject the antivaccination movement and their material. Our campaign will commence shortly, giving confidence to parents but also telling the stories of families who have suffered from the lack of vaccination by those around them. Think of whooping cough. The Prime Minister and I have met, tragically, with family sufferers where a beautiful little baby was lost because, prior to the ability to vaccinate a very young child, that child was brought within a care situation where others had not vaccinated their children. A mother held her little baby as it literally choked to death in the first few weeks of life. These are strong, powerful reminders to all of us that you don't play with vaccinations.

That then brings me to the bill. There has been strong support through the House, and, again, I thank all members who've spoken and all sides of the House for their support. This bill makes minor amendments to the Australian Immunisation Register Act. In addition to general practitioners, it allows paediatricians, public health physicians, infectious disease physicians and clinical immunologists to assess that a young individual has a contraindication to a vaccine or a natural immunity to a disease. It actually provides some of the protections that some of the critics want. It makes the system even more robust, so it saves time and cost. But, above all else, it protects those patients who might be in the absolute minority. The bill also makes a minor amendment to paragraph 9(b) of the Australian Immunisation Register Act to make it explicit in the legislation that the Australian Immunisation Register can only accept vaccination information provided by recognised vaccination providers and not that provided by members of the public. Again, that's about protecting the integrity of the system.

Ultimately, I want to commend the bill to the House. I want to thank our extraordinary medical researchers. I want to thank all of those who are on the front line helping to issue the vaccinations, whether it's our doctors, our nurses or our maternal healthcare workers who work right across the state. The ultimate message here is that vaccinations save lives. Our national goal is a 95 per cent interim target and, subject to any medical exemptions, 100 per cent national vaccination coverage.

Question agreed to.

Bill read a second time.

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

Sitting suspended from 12:38 to 16:00