Sue Boyce (Queensland, Liberal Party) Share this | Hansard source

I was quite interested to note that the Australian National Preventive Health Agency Bill 2010 is not only on the Notice Paper but is actually being debated—and I think it is a very exciting occasion. I was looking back at some speech notes that I had which were dated 21 February 2010 and they said the bill was listed for debate on 18 March 2010. I noticed that the first thing I was going to talk about back then was the fact that, on 22 October 2009, the Minister for Health and Ageing, Nicola Roxon, told the House of Representatives that it was important that the Australian Preventive Health Agency be up and running on 1 January 2010. She said it was ‘essential that the legislation be passed without delay’. Unfortunately, like so many of the wonderful reforms of the Labor government, this has come to nought and has been delayed and delayed and delayed.

The opposition have no basic objection to this bill but we do have some very strong reservations around the achievability of the great promises that were made by Minister Roxon and the government. I think it is worth noting that the Australian National Preventive Health Agency was an election promise of the Rudd Labor government in December 2007. But it is now almost December 2010, so Minister Roxon’s definition of ‘without delay’ must be slightly different from mine. I guess that when the government have so much mess to clean up, so much waste to try to spin their way out of, it is not surprising that they have had neither the time nor the inclination to do something which from 2007 to 2009 they regarded as essential and urgent.

I was recently very pleased to get an email from the Bushwalking Society of Australia. Very much along the lines of the coalition’s view on the subject, they suggested that walking is very good exercise. They also pointed out that you do not need an awful lot of bureaucracy to undertake walking, that you do not need to spend $133 million on awareness and promotion programs and social marketing programs to get walking happening and that walking could be a cheap and easy answer to improving the health of Australians. It is not simply about telling people what is good for them; it is about encouraging them to understand why it is good for them and why making healthy choices in their lifestyle and diet is worth while for them. If it were simply about saying, ‘Eat your veggies,’ everyone in Australia would at some stage have become a healthy person. We have concerns now that a generation who have not been told to eat their veggies is developing.

But let us have a look at why that is happening. Education around nutrition is not happening. That is because people are so much busier and because there is a food market—sometimes pejoratively referred to as ‘the fast-food market’—that simply meets the needs of busy consumers. There is no problem, in my view, with food marketers who meet the needs of consumers. But we need to unpick that a little more and make the point that it is about meeting the ‘needs’ of consumers. If consumers want chips with an extra dollop of fat on the side, that is what the market will give them. If consumers ask for salads and other healthier options, that is also what the market will give them.

I am very concerned that, with this bureaucracy, we might end up with a move towards a nanny state. The agency that is established by the bill will advise the minister on matters related to preventive health; gather, analyse and disseminate information; conduct awareness campaigns; make financial assistance grants; develop national standards and codes of practice; manage schemes rewarding best practice; and any other function as determined by the minister. To say the least, that is a very open-ended list of functions—and some of the amendments that have been suggested are aimed at ensuring that there is transparency and oversight of exactly what the agency does.

The bill also creates the Australian National Preventive Health Agency Advisory Council, which will advise the CEO. Back in October last year Minister Roxon said the agency would be receiving $133 million over four years to undertake its activities. I wonder whether the government intends to index that money, given that it has taken so long for this body to get off the ground.

The agency arose from the 30 June 2009 report of the National Preventative Health Taskforce, Australia: the healthiest country by 2020, which seemed both ambitious and somewhat ambiguous in its title. I wondered whether it was suggesting that the agency would make Australia the healthiest country in the world within 10 years—a laudable aim, but I suggest that it is as unlikely to be recognised and achieved as Prime Minister Hawke’s promise back in the 1980s that no child would be living in poverty by 1990. We need to do far more than we have done in assisting disadvantaged people, Indigenous Australians and people with disabilities before we can begin to boast about looking like the healthiest country in the world.

The response to Australia: the healthiest country by 2020 became, like so many other things that this government started but did not quite finish, tied up in the recommendations of the National Health and Hospitals Reform Commission, which is still wending its tortuous way through many different procedures. I think the government is now up to something that is alleged to be action around the review of the review of the review of the ministerial advisory council’s advice to the COAG meeting on the review!—and so it goes.

Again we have the issue of the structure of this body being such that it will suffer from the same fragmentation and the same problems that other attempts to reform hospital funding and health funding in Australia have suffered from. Right now we have a situation where the Queensland government does not, or cannot or will not—the answer is a bit hard to know—provide data in certain health areas to the Australian Institute of Health and Welfare in a way that allows it to be compared to other states’ data. There are consistent problems in getting data that is nationally comparable in Australia. Of course, the issue here is that the federal government cannot compel the states to provide comparable data. Why, in fact, would a state provide data if their current record on health and hospital funding was about subterfuge and hiding funding in hollow logs wherever they could so that they were away from scrutiny by the state oppositions and by this parliament?

The government seems to think that it is good public policy to set up this preventive health agency in what is still a very uncertain situation—something of a policy and procedural vacuum—around what happens in health. There are also currently moves to set up a safety and quality authority to oversight the safety of the delivery of hospital services throughout Australia. Once again, of course, there is no standardised data from all the states. There is just the hope that—perhaps, maybe!—sooner or later everyone at COAG will see their way clear to do it all the same way.

There is a suggestion not only of setting up an agency to oversight health and welfare but of having other authorities to look at pricing and the like. You can see that in health we are building agency and authority after agency and authority—a massive brick wall of bureaucracy. And there is no guarantee whatsoever that these new agencies will improve the delivery of services or the types of services being delivered, given the failures that this government has had, not only in negotiating coherent agreements in the area of health and hospital funding, but also in delivering any of their projects which involve serious and complex implementation. I could go on for ever and ever on that issue. So we remain concerned about what this will all mean.

In the explanatory memorandum that Ms Roxon circulated this time around—it has ‘2010’ on it so it must be one of her later efforts—you see that she talks about the functions of the CEO in terms of what the agency will do. Dot point number six of 10—more than halfway down the list—it says that the CEO will  manage national-level preventive health promotional activities, including education promotional and community awareness programs relating to preventive health, including but not limited to the promotion of a healthy lifestyle and good nutrition, reducing tobacco use, minimising the harmful drinking of alcohol, discouraging substance abuse and reducing the incidence of obesity amongst Australians. For example, the national program provides funding to the National Preventative Health Authority for national level social-marketing campaigns on obesity and tobacco.

As I said, that is No. 6 out of 10 tasks or criteria for the CEO of this new organisation. It seems to me that it should be far, far higher up the list. What is a preventative health agency for? If it is going to be collecting data and providing evidence based recommendations, either at the minister’s request or on the CEO’s own initiative, I think we need to get the data collection right first—and, as I already pointed out, this is just not happening. The data collection and the standardisation of the data collection is as difficult for the Australian Institute of Health and Welfare as it has been for a number of years because the state governments—primarily the state Labor governments, particularly the government of my own state of Queensland—simply do not cooperate or see the necessity of properly cooperating.

Collecting and analysing information relating to preventative health is actually seen as a more important task for this agency than undertaking preventative health promotional activities. I do not think there is any exaggeration in the concerns that the opposition has about this potentially being a great, big bureaucracy not doing very much. We are not going to improve the health of Australians by collecting data, by looking at the data that has already been collected or by replacing, presumably, in some ways the work of the Australian Institute of Health and Welfare, which already collects data. It is fine to collect data, but collecting data is only one task, and by no means the major task, that you would expect a new body that is costing millions and millions of dollars to undertake. You would expect this to be an active body that would actually be doing something. Terms such as ‘promotional activities’ and ‘community awareness programs’ do not sound as pointy as one might hope if we are talking about educating people about how to be healthy, why they should want to be healthy and the dangers of not being healthy.

Senator Barnett has already discussed the epidemic of obesity and diabetes in Australia. This can only get worse as the population ages. We have bodies already collecting whatever data is available. We do not need this body to reinvent the wheel; we need this body to get on with doing some real work on educating the public on the topic of what constitutes good health and a healthy lifestyle.

We should also look at some of the other areas in which this government has behaved somewhat oddly when it comes to the health of Australians. I was interested to note in today’s media that, for the first time since the Fraser government, there are now more than 10 million Australians with private health insurance. I am pleased about that. Judging by the legislative measures that those opposite are attempting to undertake, they are not pleased about that. A lot of their activities are about trying to decrease, cap and stop moves towards private health insurance.