Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Mental Health) Share this | Link to this | Hansard source

I rise to speak on the Australian Immunisation Register Bill 2015 and the Australian Immunisation Register (Consequential and Transitional Provisions) Bill 2015. In doing so, I want to indicate at the outset that Labor strongly supports these bills and in particular their purpose, which is to give us for the first time a truly comprehensive national vaccination register. We are pleased at the opportunity to be able to vote in this place for all-too-rare moves to actually improve health outcomes in Australia from a government that has spent the last two years attacking health.

The existing Australian Childhood Immunisation Register, which was established in 1996, provides accurate data on the immunisation status of all registered children under the age of seven. This, of course, matches the period when children are receiving the intensive schedule of vaccinations so essential for children in their early years. But, clearly, the need for vaccinations does not end at the age of seven.

Medical experts, for example, recommend that whooping cough, tetanus and diphtheria be updated every 10 years. Then there are the ever-increasing numbers of vaccines now recommended for adolescents and adults in Australia, such as influenza, pneumococcal, whooping cough for pregnant mothers, shingles for older Australians and HPV for adolescents and young adults.

Against this background, clinicians and public health workers have long advocated the need for much better information on the vaccination status of all Australians, and this bill, therefore, makes two very big changes. The legislation proposes that from 1 January 2016, the Australian Childhood Immunisation Register will expand to collect and record vaccinations given to young adults under the age of 20. Then from September 2016 it will be expanded further to become the national immunisation register, covering all vaccinations given from birth to death through general practice and community clinics.

This will accommodate the addition of Zostavax shingles vaccine to the national immunisation program for persons aged 70. And if unexpected disease outbreaks occur, as there have been recently for whooping cough, with tragic consequences for newborns, or in the event of measles returning to Australia, as has occurred in the US, immunisation registers will be able to help us determine whether they are due to low vaccination coverage and enable better targeted responses.

The bill also replaces the HPV register with the Australian School Vaccination Register. Whereas the HPV register, as its name suggests, only captures administration of the HPV vaccine, the school vaccination register will record other adolescent vaccinations administered through the school. Programs include chickenpox and the diphtheria, tetanus and pertussis—whooping cough—booster.

A comprehensive immunisation register is a vital component of any efficient vaccination scheme. Registers are a key tool in improving the performance of immunisation programs. They do this by collecting data on the vaccinations that have been given; generating notices and prompting people to have their next vaccination, booster shots and the like; providing certificates of vaccination; and, importantly, monitoring vaccine coverage, including hotspots across the entire population. Registers allow us to identify deficiencies and to adapt and respond to new and emerging threats.

So, how will this help health experts stay on top of the diseases that threaten the health and welfare of all Australians? The answer is that unexpected disease outbreaks still occur. There is the prospect of measles returning to Australia, as has occurred recently in the United States. Comprehensive immunisation registers will help determine whether it is due to low vaccine coverage and will enable a better and more targeted response.

We know that parents lead busy and complicated lives these days, and in many cases missed vaccinations are due to oversight rather than to a specific objection. The establishment of a national immunisation register of school-based vaccinations will assist all parents to keep their children's immunisations up to date.

This national register will also enable adults to have the information they need to ensure the protection they received as children continues long after their schooling ceases. Diseases like tetanus, diphtheria and, of course, whooping cough are not confined to children. Adults who travel or come into contact with others who do not keep their immunisations up-to-date are just as much at risk as those who have refused to be vaccinated.

Importantly, this bill enables the transfer of data to Centrelink that is necessary to enable the government to effect the No Jab, No Pay measure that encourages parents to have their children immunised. Labor believes that parents should have the final say in making health decisions about their child. But when it comes to immunisation there is a strong public interest in ensuring that children are immunised.

Like many in this place I have been lobbied strongly by opponents of this measure who argue that it is an attack on their rights, and that this amounts to compulsory vaccination. I have no sympathy with that argument. Firstly, parents still have the right not to vaccinate their children; it is just that now if they choose this path, this nation is also now choosing to make its position clear on that decision by no longer paying these parents family tax benefits. So there is no compulsion to vaccinate, just a clear signal that parents should vaccinate. And those who do not will face a financial penalty for choosing not to protect their children, and the people they come into contact with, from the consequences of that decision.

It is not going to be popular with everyone, but it is a necessary initiative. In fact, it is an initiative that Labor took to the last election. We did that for the very simple reason that we believe it is unreasonable for those people to expect the collective benefits of family support payments if they are not themselves contributing to the collective wellbeing of the population as a whole by having themselves and their children vaccinated against preventable diseases. It is for this reason that Labor wholeheartedly supports these changes.

It is important that we continue to improve vaccination rates across the country. We know that passage of the legislation we are debating here today will not end the campaign of misinformation, or suddenly lead to parents who have refused to vaccinate their children racing down to the clinic to get them up to date. But the early figures are promising.

In September last year just over 40,000 Australian children were listed as claiming exemption on the grounds of conscientious objection. That figure has fallen for three consecutive quarters, and at the end of June stood at 34,000—a drop of 15 per cent in just nine months. And this is even before No Jab, No Pay comes into effect. Clearly, even talk of this measure has been enough to persuade some parents, perhaps undecided about immunisation, to end their claim to be conscientious objectors and do the right thing by their children and their community. As a result, the proportion of eligible children claiming exemption has fallen from 1.8 per cent to 1.5 per cent and, once the new regulations come into effect, we expect this trend to continue.

Vaccination rates in Australia have been amongst the best in the world, but we cannot rest on our laurels. Vaccinations are vital to the welfare of all citizens. It is not just about protecting yourself or your child; herd immunity relies on everyone doing the right thing. Labor will work to ensure these changes are implemented in a way that not only increases immunisation rates across the entire community but also targets vulnerable children and does not lead to these children being excluded from early education and care as a result of their parents' decisions. We must also ensure that this is not the be-all and end-all of the work we do to educate and inform the public about the benefits of immunisation. Before they were abolished, Medicare Locals were doing good work to increase immunisation rates in local communities, and I urge the government to ensure that this continues through the Primary Health Networks.

So Labor is pleased to support this all-too-rare move by the government to strengthen our health system and promote, rather than cut, preventative health care. For two years, Labor has stood firm against this government's repeated attempts to place a barrier between patients and primary care through its now four attempts to introduce a GP tax. We have repeatedly called on the government to abandon its disastrous attacks on public hospitals, its cuts to preventative health programs, its cuts to dental programs and its cuts to drug and alcohol services. There are so many other areas of health policy that are now in drastic need of repair, but on this measure, which is clearly a measure that will advance the cause of public health in Australia, Labor is proud to stand and declare our support for improving vaccination in our country.

Helen Polley (Tasmania, Australian Labor Party, Shadow Parliamentary Secretary for Aged Care) Share this | Link to this | Hansard source

I rise to speak on the Australian Immunisation Register Bill 2015 and the Australian Immunisation Register (Consequential and Transitional Provisions) Bill 2015. Labor strongly supports these bills and, in particular, their purpose, which is to give us a truly comprehensive national vaccination register. These bills achieve this by establishing a new consolidated legislative framework to manage and expand the two existing immunisation registers. These bills also broaden their scope to capture all vaccinations given, from birth to death, through general practices and community clinics.

Labor is committed to strengthening immunisation rates so that all Australian children have the best chance at growing up strong and healthy. The establishment of a national immunisation register of school-based vaccinations will assist all parents to do the right thing by their own children and, very importantly, their community's children. It will also send a very strong message to those who are refusing to vaccinate their children that we, as a society, reject that approach. Whilst Australia does have good immunisation rates, with about 92 per cent of all five-year-olds fully vaccinated, immunisation rates must continue to improve, because all too often we hear of outbreaks amongst the most vulnerable people and, tragically, totally avoidable deaths due to a small number of Australians who are not vaccinated. We have seen this most recently with the outbreak of measles in the USA and, tragically, here in Australia with the outbreaks of whooping cough.

I have a personal interest in this as my sister fell victim to the polio outbreak when she was a very young child. I have seen the consequences of the medical procedures that she had to go through. She is now a woman in her late 60s, and the consequences of that polio are still borne by her every single day. That is why my family have always been strong supporters of immunisation. As parents, my husband and I never questioned it when our children were immunised. And, when our third grandchild was being born, before we flew to WA, because of the concerns over there with whooping cough we made sure that our vaccinations were updated. So I am a very strong supporter of vaccination, as are my colleagues here. As Senator McLucas said, it is unusual, unfortunately, when it comes to health that we are able to support the legislative frameworks that the government have implemented since they have been in government. They do not normally have a good track record when it comes to health, but on this occasion we stand with them because this will be a great benefit to the entire community.

Labor believes that parents, of course, should have the final say in making health decisions about their child. But, when it comes to immunisation, there is strong public interest to ensure that children are immunised, and that cannot and should not be ignored. There are strong arguments against this measure from those claiming that it is an attack on their rights. I do not have any sympathy for those arguments, because parents still have the right to not vaccinate their children. But to me this is a no-brainer. This is something that will be beneficial to all children and, most importantly, to the wider community.

There is no compulsion to vaccinate and no attack on parental rights here—just a clear signal that parents should vaccinate, and, if they do not, there is a financial penalty. The science on immunisation is clear and there is strong evidence that this legislation will lead to greater outcomes for the entire community. The changes being made by this legislation are not just about ensuring that children are up to date with their shots and that we have an accurate register. They are also about making sure that adults have the information they need to ensure that their protection continues after they leave school, because parents, as we all know, come into contact with others who do not keep their immunisation up to date and are at just as much of a risk as our children are when it comes to vaccination.

So this bill actually makes more than one change. From 1 January 2016 the existing Australian Childhood Immunisation Register will expand to collect and record vaccinations given to young individuals under the age of 20 years, and then, from September 2016, it will be expanded to cover all vaccinations from birth to death.    The bill also replaces the HPV register with the Australian School Vaccination Register, which will record other adolescent vaccinations administered through the school programs. Finally, the Health Insurance Act 1973 and the National Health Act 1953 will be combined to provide the ongoing data management for both registers.

Labor definitely welcomes these bills and supports the opportunity to act and improve the outcomes for all Australians. But because this government has not had the best record for improving health outcomes in Australia over the last two years, which has been spoken about in this chamber very often, we will work to ensure these changes are implemented in a way that will increase immunisation rates among vulnerable children and for the greater good of the community. We know that Prime Minister Abbott, when he was minister for health in the Howard government, had a terrible record. In fact, we know that he gutted health by a billion dollars, and unfortunately when he became Prime Minister of this country he continued with that very poor record in providing world-class health for this country. That has continued, along with all the other bad policies of the Abbott government, although they have a new captain of their ship. It is a good step in the right direction to be able to join with the government and say, 'Congratulations,' but we will be working to ensure this legislation brings the best outcomes for the Australian community.

Scott Ryan (Victoria, Liberal Party, Assistant Cabinet Secretary) Share this | Link to this | Hansard source

I probably should declare at this point, in a personal sense, that I used to work for a company that makes vaccines. I agree with some of the things said by those opposite on the Australian Immunisation Register Bill 2015 and the Australian Immunisation Register (Consequential and Transitional Provisions) Bill 2015. Mass immunisation has been one of the great public health measures of the 20th century, although it started earlier. In particular, it has removed the scourge of preventable disease, which my generation, luckily, in many ways was the first to avoid. Subsequent to that, there has also been a substantial expansion of the immunisation register to cover conditions which even for me, as a 42-year-old, were not prevented.

I must say that there have in fact been few more damaging campaigns in public health than that of the anti-vaxxers and the completely and utterly discredited allegations regarding the MMR vaccine that came out of a now-withdrawn alleged study in the UK, which has seen the person responsible for that struck off the medical register. Tragically, there are probably deaths attributable to that particular campaign, which has scared the uninformed and provided alleged evidence to those who wish to mislead.

In Australia today we have one of the world's most effective mass immunisation campaigns, and as a parent of a young child I can attest to how effective that is. In my own home city of Melbourne, it is run primarily by local councils, and it very effectively reaches into those communities that have varying levels of socioeconomic access and information, and we have achieved very high rates of penetration, as we have right around the country, albeit with constant challenges in some areas—in particular, access to these services for Indigenous groups. I might say, though, that one of the more disturbing things about the declines in some immunisation rates in Australia is that they tend to come in highly educated and high-income-earning areas—people who, quite frankly, should know better. Some of the most misleading things about immunisation are no longer done by people who do not have access to information and who we seek to educate; they are done by people who seem to wilfully misuse information.

One of the aspects of this register that was commented upon before by Senator McLucas is that it will allow us to study outbreaks, look at immunisation rates and understand why outbreaks happen. I have family experience of this too. Without going into great detail, one of the challenges is that we now have adults getting whooping cough, particularly some of those who work with children, because of lack of immunisation and the falling herd immunity amongst young Australians. In fact, I know of a situation where grandparents were not allowed to see grandchildren because of their exposure to whooping cough, which is a sad moment for any family. It also poses health risks to older Australians, because whooping cough is not something nice to get when you are in your 60s. But, again, this is not happening in areas that do not have access to services. I think most of us will be very interested to see where some of the immunisation rates are falling, because tragically that is happening in areas where it should not be and where, quite frankly, we have not had to have extra efforts at health service delivery because of the education and income level of those involved. Disturbingly, I think that will become more apparent over time.

I must say, however, that I am a bit disappointed in the efforts of a couple of speakers among those opposite to politicise this debate, and I am going to rehash here Labor's record on mass immunisation. It needs to be said that, when the Howard government came to office, it was only through the passion and the dedication of Dr Michael Wooldridge as health minister that our immunisation rates were picked up from levels that were the lowest in the developed world and in some cases approached Third World levels. The Liberal government, from 1996 to 2001 under Dr Wooldridge, made it a significant national health priority to increase immunisation rates to levels above 90 per cent, where herd immunity was rebuilt, because in some parts of metropolitan cities in this country they were collapsing into the 50 per cent range, where herd immunity had completely collapsed. The record of the Labor government under Hawke and Keating on immunisation stood condemned by statistics. So, if those opposite want to talk politics, we will point to the history.

I will also point out that the most substantial expansion in the immunisation register for young Australians—particularly children but also with reference to vaccines for older children, particularly the HPV vaccine, which of course Dr Ian Frazer had such a role in discovering—was undertaken under the Howard government. The most substantial expansion in the vaccines register and the free vaccines register in this country's history were undertaken under the Howard government, and this is a record which the Liberal-National coalition proudly stand by.

With those comments, I commend the bills to the Senate.

Question agreed to.

Bills read a second time.