Penny Wong (SA, Australian Labor Party, Minister for Climate Change and Water) Share this | Link to this | Hansard source

I table a correction to the explanatory memorandum relating to the bill and I move:

That this bill be now read a second time.

I seek leave to have the second reading speech incorporated in Hansard.

Leave granted.

The speech read as follows—

Preventive health measures work.

This has been demonstrated by our experience in smoking, the impact of HIV/AIDS, the road toll, seat belts, heart disease and even bicycle helmets.

But in some areas we are facing many challenges that could put these successes at risk unless we take effective action now.

This is why today I rise to introduce a measure to focus and revitalise Australia’s preventive health capacity - the Australian National Preventive Health Agency Bill 2009.

The establishment of the ANPHA has been recommended by both the Health and Hospitals Reform Commission, and the National Preventative Health Taskforce. In fact, the creation of a national preventive health agency was proposed at the 2020 summit. So we have listened and we are now acting.

These reviews confirm for us that the rising incidence of chronic illness, combined with the ageing profile of the population, mean that sitting on our hands is not an option in terms of both the cost to our health system, and more importantly in terms of the human cost of illness and lost productivity.

This Bill establishes a national infrastructure to help drive major change in the way we behave and how we look after (or don’t look after) our own health.

It is widely appreciated that the ageing of our population is one of the major challenges to our health and prosperity. But there are also major pressures arising from our changing lifestyles and consumption patterns.

Between 1950 and 2008, more than 900,000 Australians died because they smoked - despite the fact that there was from about 1950 clear evidence on the dangers of smoking.

Thanks to preventive health measures we now have one of the lowest smoking levels in the world, and yet nearly three million Australians continue to smoke.

Of all cancers lung cancer remains our biggest killer of both men and women.

While less people are smoking than ever before, thousands of young people continue to take up the habit each year and tobacco remains the single-biggest preventable cause of death and disease in Australia.

In fact, 25 per cent of cancer deaths are attributable to tobacco and alcohol, and as such are avoidable, and a key job of the new Agency established by the Bill before us will be to ensure that we reduce this burden.

The Preventative Health Taskforce set a target of reducing smoking rates to less than 10 per cent. This would mean approximately one million fewer smokers in Australia, and according to the Taskforce would prevent the premature deaths of almost 300,000 Australians.

Similarly, with alcohol, barely a day goes by without newspapers outlining the severe impact of alcohol abuse in our community.

In contrast to tobacco, our overall per capita consumption of alcohol is high by world standards. One in four Australians drink at a level that puts them at risk of short-term harm at least once a month. Around 10 per cent of Australians drink at levels that put them at risk of long term harm.

And on top of that, we are now among the most obese nations in the world.

The National Preventative Health Taskforce stated that if obesity trends are left unchecked, the life expectancy for Australian children alive today will fall two years by the time they are 20 years old. This would represent the life expectancy levels we saw for males in 2001 and for females in 1997.

The Taskforce Chair is right when he says this is not a legacy we should be leaving for our kids.

These examples illustrate why the Government has made prevention a key focus of our reform agenda.

We must ensure that Australia does not go backwards in health status.

And we have to make our health system sustainable in the long term.

We need to reduce the burden preventable health problems are already placing on an ageing workforce, and ensure Australia’s productive capacity is maintained.

In the past the prevention effort has been neglected. We currently spend less than two per cent of the health budget on preventive health, and to make matters worse in many respects, current arrangements are fragmented, lack cohesion and focus.

Success in changing lifestyles takes a long term, systematic approach informed by the latest evidence and ongoing evaluation of results.

In part this is because the skills and efforts required go beyond the capacity of any single sector, government or portfolio.

It cannot be about Governments imposing solutions on the community. It needs engagement, action and responsibility to be taken by individuals, families, communities, industries and businesses.

But as a national government, we can play a leadership role by gathering and analysing and disseminating the best available evidence, and the best evidence-based programs.

We need to bring together the best expertise in the country, and we need to engage employers, businesses, other sectors and the wider community in prevention.

A new approach is needed, and the new Australian National Preventive Health Agency will play a key role in achieving this ambition through the deployment of a skilled and dedicated team which can work flexibly and responsively.

The Rudd Government takes preventive health seriously. Under the auspices of COAG we reached agreement with the states and territories in November last year to a National Partnership Agreement on Preventive Health, which will reform how the Commonwealth and the states work together on preventive health. This Agreement, funded by the Government at $872 million, provides the largest single investment in health promotion in Australia’s history.

A key initiative of that Prevention Partnership is establishing the Agency today.

The Agency’s staff will include population health and other experts. It will have responsibility for providing evidence-based policy advice to health and other ministers interested in preventive health and will administer social marketing programs and other national preventive health programs which it may be tasked with by Health Ministers. It will have responsibility for stakeholder consultation, and overseeing surveillance and research activities.

Initially it will have $133 million allocated, including funds to assist with the establishment and operation of the Agency ($17.6 million), social marketing targeting obesity and tobacco ($102 million) and to support preventive health research, especially the translation of research into practice ($13.1 million).

It will also form partnerships with industry, as well as the community and non-government sectors.

I am therefore pleased to present the Australian National Preventive Health Agency Bill 2009 to establish the Australian National Preventive Health Agency.

The Bill establishes the Agency as a statutory authority under the Financial Management and Accountability Act 1997, or FMA Act, and specifies its functions, governance and structure.

Health Ministers have agreed to the Agency being established under the FMA Act and were consulted about the broad provisions in the Bill. The Australian Local Government Association was consulted in relation to it being a named entity in the Bill.

Provisions have been made to allow the Agency to manage pooled funds through a Special Account if other organisations, including states and territories, choose to contribute financially to its operations. This provision reflects the Government’s commitment to work with the states and also with other interested groups to achieve the preventive health outcomes this country needs.

A Chief Executive Officer will manage the Australian National Preventive Health Agency and will be directly accountable to the Federal Health Minister for the financial management of the Agency and to the Australian Health Minister’s Conference, via the Minister for Health and Ageing, for the Agency’s performance. This provision reflects that the Agency is a COAG mandated body and that it has been established to support all Health Ministers in tackling the complex challenge posed by preventable chronic disease.

The Australian National Preventive Health Agency will have an Advisory Council which will consist of state, territory and Commonwealth government representatives and other individuals with expertise relating to preventive health.

Both the CEO and Advisory Council members will be appointed by the Minister, consulting with the Australian Health Ministers’ Conference.

Preventive health is a policy area which the Government has given the highest priority. The establishment of the Australian National Preventive Health Agency is a key component of this Government’s health reform agenda.

It is important that the Bill is passed in the Spring sittings to allow the Agency to commence operations on 1 January 2010.

Once established it will mean that for the first time, Australia will have a dedicated organisation to help us combat the complex challenges of preventable chronic disease.

It will benefit all Australians, now and into the future, and will play a significant role in putting Australia on the path to becoming the healthiest country in the world.

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

The Australian National Preventive Health Agency Bill 2009 is a piece of legislation that is being introduced now so that the government can look busy in the health portfolio. The reason they want to look busy in the health portfolio is so that they can make people believe that they are actually doing something. We have to remember that in the health portfolio the Rudd Labor government promised the world before the last election, and they have delivered next to nothing. They have been a great disappointment in the health portfolio. All we have had is a series of reviews followed by more reviews and followed now by reviews into those same reviews, and photo opportunities around Australia for the Prime Minister and the Minister for Health and Ageing, all with the single purpose of making it look as if the government are doing something when in fact they are doing nothing. It reminds us of an episode in Yes, Minister. Remember that episode of the hospital without patients. There were 500 bureaucrats—500 people typing away, writing reports, shuffling papers and being very busy—but no patients. Nothing was actually being done.

Before the election there were many promises made by Labor. Labor had a plan to fix public hospitals. They were going to fix public hospitals by the middle of 2009. The buck was going to stop with the Prime Minister. We were going to have a new era of cooperative federalism. The government was no longer going to prosecute this ideological crusade against people with private health insurance. Preventive health was going to be a high priority. Instead all we have had is reviews, reviews and more reviews—and the occasional lazy budget cut, usually targeted at those Australians who access their healthcare services through the private system.

One of those many reviews which the government commissioned was a review into the very important area of preventive health with the national Preventative Health Taskforce. The minister commissioned it in April 2008. For 15 months they worked very thoroughly through all the issues. They came up with a whole series of recommendations on how they thought the government should proceed in the preventative health area. The government received that report on 30 June. That is four months ago. Since then the government have been sitting on that report. They have not come out and made any response whatsoever in terms of which measures they will support and which measures they will oppose. We are none the wiser. And here we have this bill proposing to set up another layer of bureaucracy before we actually know what direction the government are intending to take in the preventive health area. We have a lot of talk and no action.

Mr Acting Deputy President, I will draw your attention to a few of the recommendations, because at the core of our concern is that we are faced with a government which has been absolutely unable to make a single hard decision in the health portfolio. They have not been able to make a single hard decision. Whenever they are faced with a difficult decision they set up another committee, they set up another review or they set up another consultation round, or they set up a propaganda tour around Australia where the Prime Minister and the Minister for Health and Ageing appear at a hospital near you for a nice little photo opportunity. They are trying to look as if they are doing something by being busy.

We on this side of the chamber are very supportive of effective preventive health measures. But we are not in favour of setting up another bureaucracy without a clear purpose. This is exactly why we will be moving a second reading amendment, which I hope will be supported by the Senate, which calls on the government to table forthwith its response to all of the recommendations of the Preventative Health Taskforce. The government has been sitting on those recommendations for the last four months. We in this Senate had to shame the government into releasing the report in the first place. It took them two months before they were prepared to release it publicly—all the while leaking it bit by bit whenever they needed instruction out there in the media. We want to know what the government are proposing to do in relation to the recommendation—for example, to make tobacco products more expensive by raising the average price of a packet of 30 cigarettes to at least $20 within three years. Is the government supporting that or is it opposed to that?

Eric Abetz (Tasmania, Liberal Party, Deputy Leader of the Opposition in the Senate) Share this | Link to this | Hansard source

Who would know?

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

Exactly, who would know? What is the government proposing to do with the recommendations in relation to changes to alcohol taxation? Is the government supporting them or is it opposed to them? Is the government supporting them in part? If yes, to what extent?

Eric Abetz (Tasmania, Liberal Party, Deputy Leader of the Opposition in the Senate) Share this | Link to this | Hansard source

They’ll go to Indonesia for the solution.

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

Exactly, they will go and find an Indonesian solution. Then there is the issue of the restriction of alcohol promotion and marketing—

Debate interrupted.