Simon Birmingham (SA, Liberal Party) Share this | Hansard source

Indeed. There is no shortage of public servants. What we have seen in state Labor government after state Labor government around the country is a ballooning of public service numbers. They do not even know, half the time, how many extra they are getting. In South Australia they have thousands more public servants than even the Labor government ever budgeted for. They just woke up one day and had all these extra public servants. Quite clearly, this federal Labor government is going to go down the same path. Numbers will slowly creep up in all of the existing agencies and, on quite a regular basis, we will have new agencies coming into power. The Australian National Preventive Health Agency will of course be one of them.

What we need is health outcomes, not health bureaucrats. What we need are actions, funds and policies on the ground and in communities around Australia that provide real, tangible health benefits, not more health bureaucrats sitting in Canberra trying to tell people how to live their lives. This agency is going to have a $133 million budget. It will spend $2 million this year on marketing campaigns—and I will come in a moment to some of those ideas of marketing campaigns and agencies telling us how to live our lives. That figure will balloon out to $33.8 million in 2010-11. So there will be nearly $34 million that year in marketing campaigns by this new government agency, with all of its bloated bureaucrats and so on adding to the great Canberra bureaucracy.

Thirteen million dollars over four years will go into what is euphemistically described as ‘translating research into practice’. It would be interesting to see just what that actually meant. It may well mean yet more research, or it may mean—and this is the great fear out of this—that the government will hand over policy powers, some level of arbitrary decision making, to an unelected body. We believe that the government should respond to the Preventative Health Taskforce report in its entirety. That is what the second reading amendment to this bill, sensibly moved by Senator Cormann, calls for, and I hope that this chamber will support it. The second reading amendment would ensure that the government actually gave a response to all of the recommendations in the Preventative Health Taskforce report and that the government set the policy and did not handball the policy decision making off to unelected health bureaucrats. That is the risk in establishing these types of new agencies—that is, that the government takes decision making out of the hands of this parliament, out of its own hands, and gives it away because it finds it easier to let other people make decisions and finds it easier then not to have to front up for the blame for the types of actions and decisions that these agencies might follow through with.

This whole agenda around preventative health is an interesting one, because it is an area where, with too many powers, agencies such as this one could have very profound impacts on the way people choose—quite knowingly—to live their lives. It is not a news flash, it is not some earth-shattering, groundbreaking news, to tell Australians that smoking is bad for them. It is not earth-shattering news to tell Australians that drinking to excess is bad for them. Equally, it is not earth-shattering news to tell Australians that gorging themselves on fatty foods is no good for their ongoing health. These are not groundbreaking bits of news—far from it. These are facts that the overwhelming majority of Australians already understand.

I would hazard a guess that, if you asked that question—whether smoking was good or bad for them, drinking to excess was good or bad for them or eating an unhealthy diet was good or bad for them—of 99 per cent of Australians, they would all know that each of those things was bad for them. Yet they continue in some instances to do it. That is not to say that it is good that they do it but it is to say that no number of marketing campaigns, no number of budgets in these areas will enable you to convince or stop people from making what in the end to some extent are free choices to be able to actually decide how they lead their lives. Unhealthy lives we would all like to discourage, but there are limits to how much government should interfere in people’s lives to discourage them from leading unhealthy lives. Government is not some nanny state that is there to hold the hand of everybody each time they go to the supermarket, to tell you, ‘No, you should not put that in your shopping trolley.’ That is not the role of government and that is not what we should be seeing out of these types of preventive health agendas.

Preventive health is far wider an issue than the government has chosen to pursue in this particular taskforce report and indeed the working of this agency. Preventive health relates to the overall avoidance of disease development, supporting early diagnosis and reducing negative impacts or complications of established diseases—all very worthy aims. Using condoms, washing hands, cleaning areas of food preparation and providing immunisations are all quite worthy aspects of preventive health. These are things that seem to be overlooked in the remit for this agency and seem to be overlooked in the approach of the task force. Yet early screening, testing for a range of diseases and more work on family history are all important things that the government should be putting high on the priority list. But no, it chooses to go for the sensationalist aspects that get good, cheap headlines: those things to do with smoking, drinking and fatty foods. The media lap up the stories on clamping down on these things. They love to hear the stories of inflated estimates of just how much these types of activities might actually cost.

Let us look at how much some of these things cost, not in terms of overall economic loss that takes in a whole range of extraneous factors that those who like to sensationalise put together but let us actually look at cost to hospitals. We will pick on smoking because everybody else picks on smoking. I do not see why I should not as well. A federal government report in 2005 found that the cost of smoking to the hospital system was some $670 million. That is a significant cost of smoking to the hospital system, and I acknowledge there would be other direct costs to the health system from smoking that would add to that very significant price tag. But what do we collect in tobacco excise? It is $5.5 billion, with GST on top of that. There is $5.5 billion in tobacco excise collected every year. We are already taxing smokers and drinkers quite significantly to pay for their sins of smoking or drinking to excess, to make sure that they pay for the additional cost that they put on the health system and our health services, to make sure that there is a financial disincentive as well. A financial disincentive is welcome and is an important part of the types of measures the government has pursued over the years. These are reasonable measures that have been built up over a long period of time.

Taxes on tobacco and alcohol have their place. They have been growing over many years to the level we have today and they act as a deterrent. There comes a point where you push beyond that deterrence level and you start to encourage, in the case of tobacco, the use of chop chop, illegal activities, activities by bikie gangs or others. You end up with government policies that encourage the types of underground businesses that prohibition for time immemorial has been seen to foster that society should not encourage. That is why getting the right balance in these policies is so important.

It seems that very little of this debate has actually focused on when we cross the line of unnecessarily telling people how they should live their lives or unnecessarily instructing businesses on how they should run their businesses. There is no way that in those types of interference we should be handing power over to an unelected body like the Australian National Preventive Health Agency. We should be ensuring as a parliament that we set the policies in these areas; that we make sure that the tax rate applied to these areas is correct, not too much, not too little; that we make sure that the public education campaigns applied to not smoking, not drinking to excess and having a healthy diet are not too much, not too little; that we make sure that the parliament and the government and the elected officials are actually the ones who have the total control over these very important policy areas that impact directly on how people choose to live their lives. It is not up to unelected bureaucrats, and indeed we as elected officials should be very mindful that we do not cross that line of unnecessarily impinging on people’s freedom of choice to be able to live their lives as they reasonably see fit so long as they do not cause harm to others. That needs to be the prerequisite. We of course need to pursue the types of policies that have been pursued over the years in relation to smoking and in relation to drinking that minimise the harm caused to others, that seek to eliminate the harm caused to others. But in the end people’s choice to do these things for their own selves, in their own body, needs to remain their own choice.

There are some reasonable ideas contained in the Preventative Health Taskforce report. Increasing the provision of fresh food to remote Indigenous communities is something government should be actively addressing. Working to reduce tobacco and alcohol abuse, particularly in those communities, is something government should be addressing. Tackling obesity and diabetes and providing for better sports and encouraging active, healthy lifestyles in schools is something government should be addressing. But government should be addressing those things before they ask us to vote on this bill. We should be expecting that this government and this Senate defer consideration of this bill rather than handballing another report off to another agency that will probably undertake another review. Let us hear your comprehensive responses to the Preventative Health Taskforce. When we hear your comprehensive responses, we will happily debate this bill. When we know what the agency may or may not be undertaking on a policy basis, we can make a considered decision. Until then, this bill should lie on the table or be defeated.