Mathias Cormann (WA, Liberal Party, Shadow Parliamentary Secretary for Health Administration) Share this | Hansard source

Before question time, when we started this debate, I was pointing out the absolute failure of the Rudd Labor government in the health portfolio. Senators would remember my comments before question time about how, before the election, the Rudd Labor government promised the world on health but have delivered next to nothing. All we have had is a whole series of reviews, followed now by reviews into those same reviews; a return to the bad, old-fashioned crusade against private health; and the occasional lazy, ill-thought-out, short-sighted budget cut, usually targeted at those Australians who access services through the private health system.

One of the reviews commissioned by the government upon coming into office was the National Preventative Health Taskforce. That review went for 15 months. It considered all of the issues. It considered the best way forward from its point of view. It made a whole series of recommendations. The minister received the report of the National Preventative Health Taskforce on 30 June and we were led to believe at the time that the report would be released. At the last minute, the release of that report was canned because somebody in government, and I can only guess who, made a judgement that it was too hot to handle—some tough decisions would have had to be made and there may well have been some consequences in terms of public opinion. The government then sat on it for two months. It was only an order of this Senate which forced the government to publicly release the National Preventative Health Taskforce report on 1 September. It was a disgrace that we had to wait for those two months.

Since then, have the government done anything? Have the government made any announcements in relation to any of the recommendations: what should happen to the tobacco excise, what should happen to alcohol taxation, what should happen to alcohol advertising and what should happen to a whole series of other recommendations? No, they have not. In fact, when the Leader of the Opposition, in his budget reply speech, made the very sensible and constructive suggestion that we should increase the excise on tobacco by 12½ per cent, the government came out and opposed it. They pooh-poohed it. It was an eminently sensible suggestion. What is the minister scared of? What are the government scared of? Why are they not prepared to take on the tobacco companies? Why are they not prepared to make some tough decisions in the health portfolio about alcohol taxation or about a whole series of other issues?

The minister has been out there saying that the opposition want to delay or block this bill. We do not want to do anything of the sort. I cannot believe that the government would make such an incredibly unbelievable suggestion. If you look at the second reading amendment we have put forward, you can see that what we are saying is that this bill should be considered only after the government has tabled its response to all of the recommendations of its own National Preventative Health Taskforce review. That is eminently sensible. What it means is that, if the government were to come into this place today and tell us which recommendations they support and which ones they do not, we would be able to deal with it in very good time—before 1 January 2010, which is when this agency is supposed to come into effect.

We support effective preventative health measures, but we do not support just setting up another agency without a clearly articulated purpose. This government uses bureaucratic processes—it uses reviews, task forces, committees of inquiry, further reviews and new agencies—to avoid making decisions. This is a strategy to create the impression of a government that is busy—busyness instead of a focus on outcomes.

One of the real problems we have in the health portfolio and one of the things that any future Australian government will have to address is duplication in management of the health system. This is yet another bill which is going to create duplication. I would be very interested to hear the response from the government to the points I am about raise. We are here being asked to support legislation to set up the National Preventative Health Agency which will be funded at a total cost of $133.2 million over four years. This includes establishment costs of $17.6 million. It will oversee spending of $102 million on a national social marketing campaign targeting obesity and smoking and a total of $13.2 million in research spending to support policy development.

The federal Department of Health and Ageing, Nicola Roxon’s own department, already spends $31 million per year in departmental expenses for two programs that administer $204 million in funding for disease prevention and strategy. Both those programs already include national-level social marketing campaigns targeting obesity and smoking. This figure includes—and this comes straight out of the budget papers—$152 million that has already been allocated for the existing drug strategy program in 2009-10, with $24 million of that total having been allocated for departmental expenses. In 2009-10, the department will continue a social marketing campaign aimed at raising awareness about the risks of overweight/obesity. In total, $52 million has been allocated, including the promotion of healthy lifestyles, reducing and preventing diabetes, and the detection and prevention of cancer. Of the total, $7 million has been allocated for departmental expenses. And the list goes on.

We support effective preventative health measures, but one of the other measures in the budget is going directly counter to that. Cataract surgery is a very effective and a very cost-effective preventative health measure. It helps to prevent falls, fractures and the mental distress from going blind. It helps to improve quality of life. It helps to prevent social isolation and early institutionalisation. It is one of the most effective and cost effective preventative health measures currently being funded by the Commonwealth, yet this government wants to cut it in half.

Our main criticism with this legislation is that the government is putting the cart before the horse. It came with all these promises about what it was going to do in preventative health. In two years as Minister for Health and Ageing, Nicola Roxon has not been prepared to make one single hard decision. We understand that there are some difficult decisions to be made in some of the areas this preventative health strategy focuses on, such as tobacco, alcohol, obesity and food, but the minister has not made them. The Rudd government has not made them. It had a 15-month review and nothing has happened since then. The minister has ducked for cover. She has refused to release the report for two months. She has been sitting on it for four months without making a decision. This minister is unable to make decisions right across her portfolio. We had her inability to make a decision on the ill-considered chemotherapy budget cut. She has been unable to make a decision on clinical treatment guidelines for ADHD, she has been unable to make a decision on any of the recommendations out of the National Health and Hospitals Reform Commission and she has been unable to make a decision on any of the recommendations in her own National Preventative Health Taskforce report.

We have got report after report piling up and we have got the minister ducking for cover. Instead of telling the Australian people how she proposes to move forward on the price of tobacco, alcohol taxation arrangements and various other issues such as advertising et cetera, she is ducking for cover and just going to set up another agency. We acknowledge that this agency can do some good work as long as it is well targeted and as long as it is targeted on tangible, effective outcomes. But with this minister we are worried that this is just part of another delaying tactic and making people believe that she is doing something when she is doing nothing.

This is a very serious concern. The objectives of preventative health are obviously shared by all. We all agree that we should encourage healthier lifestyles and thereby reduce pressure on an already overburdened health system. I have already mentioned that the government’s decision on cataract rebates will actually put more pressure on our health system, particularly on our public health system. It will put more pressure on elderly Australians, which will result in more falls, more fractures, mental distress and early institutionalisation. We support strong preventative health measures, including on tobacco, alcohol, food et cetera. However, there is a very fine line between giving people the information they need to make informed decisions and a nanny state telling people how to live their lives. We do not believe that preventative health should be about social engineering. We believe that preventative health should be focused on achieving serious, tangible and positive practical health outcomes. On any of these counts, this minister has failed. She has failed to make tough decisions. She has failed to look the vested interests in the eyes and say, ‘This is the way forward.’ All we have got from this minister—