Mrs ELIZABETH GRACE (10:51 PM) —I was very interested in the comments made by the previous speaker, the member for Reid (Mr Laurie Ferguson), about the veterans and what is happening to them. Since becoming the member for Lilley, I have had to advocate on behalf of many, many, many veterans whose cases, to get some sort of recognition from the Veterans Review Board, have been four, five and six years in the pipeline. I had one case where a veteran was 92 years of age and he had spent six years waiting for recognition. I am grateful to say that that gentleman's recognition has come through and he is feeling much more content.

I find it hypocritical that the opposition are making these comments about veterans. They had 13 years to attend to those veterans who had been suffering from nuclear exposure and those sorts of things, and they did absolutely nothing. They sat there and did absolutely nothing, and kept so many of these veterans waiting for their rightful rewards.

The 1998-99 budget meets the government's commitment to return the budget to surplus in its first term of office. The government can use this surplus and the prospective surpluses to pay off the debts left to the nation by Labor. In returning the budget to surplus, the government has focused on keeping spending under control. We have not resorted to increasing the tax burden on Australians and, for the third year in a row, the budget contains no increases in income tax, no increase in the company tax rate, no increase in wholesale sales tax and no increase in petrol excise.

Even though we have put the government's finances in order by being careful with spending, we are still able to target areas of need. One of those areas is health, and today I would like to address the issue of child immunisation in Australia. Over the past 10 weeks I have had a student from ANU, Janet Macnamara, in my office who compiled a report on this issue in response to the unacceptably low child immunisation levels currently recorded in Australia. In 1995 the ABS reported Australia's child immunisation levels as being 53 per cent, placing Australia third last among Western nations and well below many developing nations.

In recent years, much effort has been put into devising strategies which would successfully improve child immunisation levels in Australia. Immunisation is a public health issue and, as such, comes under our government's responsibility. The coalition government's `Immunise Australia: The seven point plan'—released in the 1997-98 budget and subsequently followed by further measures in the recent 1998-99 budget—is a coherent package which addresses the key problem areas of Australia's child immunisation system. The main focus of this government's initiatives is towards education—education of parents, providers and the community at large. The great need for education can be seen as a function of Australia's low child immunisation levels alone. However, a closer look at the issue highlights some alarming statistics.

The Immunisation Schedule recommended by the National Health and Medical Research Council begins a child on a series of vaccinations from the age of three months right through to school age. It has been found that, while a vast majority of infants begin the recommended schedule, less than 20 per cent are likely to complete it. This means that a majority of children are not fully immunised and that, of the 53 per cent who supposedly are, many are not completing the schedule on time.

Studies have revealed that parents are inadequately informed of the many aspects of immunisation, such as when immunisation is due, where the child can be immunised, the diseases vaccination prevents and the nature of the vaccines themselves. The provision of education through federal strategies—such as the mass media campaign and the public relations strategy begun last year and the immunisation awareness days—are invaluable in supporting parents who require more information. Much support has been indicated in the Canberra region for these strategies, in particular for the dramatic television commercials featuring a baby coughing violently with whooping cough.

Misconceptions of the safety of vaccines are also playing an increasing role in the attitude of parents towards immunisation. The most pertinent example is the whole cell pertussis vaccine administered in the trivalent DTP vaccine, which is associated with a minute percentage of adverse reactions. Around 20 per cent of infants who receive the DTP vaccine experience mild side effects, 0.1 per cent may experience convulsions and one in a million may develop encephalitis. While these statistics appear frightening to parents of young children, they are insignificant when compared to the severity of the whooping cough disease itself—where one in 200 infants six months and under suffering from the whooping cough infection die from pneumonia or brain damage.

Last year, New South Wales experienced a devastating whooping cough epidemic, where 2,500 children contracted the disease and six died. This epidemic can conceivably be attributed to the low levels of DTP vaccination that are well below other vaccine levels. The experience of the New South Wales epidemic obviously demonstrates the benefit of full child immunisation and the great need for educating parents.

In an effort to increase community awareness, this government has designated $6.6 million for an Internet `megahub' which will provide a two-way flow of information, communication and education on health issues, policies, services and research in Australia. Much importance has been placed on research, with an ongoing level of funding for the National Health and Medical Research Council of $165 million a year.

It is through education that many other aspects of Australia's immunisation system can be addressed. The most vulnerable groups in the community with respect to child immunisation are minority groups—Australia's indigenous and migrant populations. Whilst success has been reported for immunisation coverage in certain remote Aboriginal communities, indigenous people are nevertheless particularly susceptible to the transmission of diseases, such as Haemophilus Influenzae type b, or Hib. Special attention is therefore needed from us as a government and from the community to provide the necessary health programs. The recent 1998-99 budget acknowledges this by committing $72.6 million over four years towards combating the levels of infectious diseases in the indigenous population and providing free Hib and pneumonococcal vaccinations to all Aboriginal and Torres Strait Islander people over 50.

Unlike the apparent success of vaccine coverage among indigenous Australians, migrant groups remain particularly vulnerable to vaccine preventable diseases due to the practicalities of culture and language barriers. Migrants are also an at-risk group to vaccine preventable diseases, particularly rubella and Hib infection. In general, there is a lack of appropriate strategies that specifically address the needs of Australian migrants. Such strategies should be able to identify at-risk infants in the community, provide adequate education and service and monitor the resulting immuni sation levels. The widespread provision of multilingual community health nurses and other such providers could prove invaluable to the provision of services and a subsequent improvement to immunisation levels in our migrant communities. Not only is parental awareness of immunisation issues proving detrimental to Australia's immunisation levels, but more mundane practical difficulties have also been highlighted as preventing adequate immunisation. Effort needs to be put into providing out of hours services for working parents and mobile immunisation units for parents who have transport difficulties, for example. Provision for an on-the-spot immunisation service may also prove beneficial, as it has been said that 83 per cent of parents would support such a service.

Of particular concern to the government is the adequacy of health services for Australia's rural communities. A $2.3 million rural multipurpose health and family services network is currently being established in which the immunisation needs of each rural community can be addressed.

This government has focused its efforts not only on parents and the general community but very importantly on the GPs themselves. GPs are key providers, providing over 60 per cent of all immunisations and seeing 93 per cent of nought to six year olds on an average seven times in a year. This places them in a prime position to monitor the immunisation status of each child.

The 1998-99 budget outlined a new practices incentive program which is to replace the original better practices program. The new incentives, totalling $812 million over four years, will reward practices that make a commitment to providing high quality care for their patients. It has been established that providers themselves play a considerable role in Australia's low child immunisation coverage by not correctly administering and handling vaccines according to the NHMRC guidelines. In addition, the proper monitoring and evaluation of immunisation targets depends solely on the accurate reporting by the providers of the occurrence of disease, as well as the adverse reactions to vaccines. This government has addressed the issue of child immunisation by grasping the fundamental weaknesses in the system and implementing strategies and setting targets for much improved outcomes.

My speech has outlined the firm commitment of this government to protecting Australian children from many vaccine preventable diseases that exist in our society. The previous government painted itself as socially responsible, yet failed to achieve any improved outcomes in indigenous health. The previous government had an ad hoc approach to public health, while this government is backing its commitment to preventative health with the biggest funding package ever for public health. This government will not `tax and spend' indiscriminately. We are committed to improving health outcomes, not just committed to satisfying the consciences of inner city intellectuals. I congratulate the Treasurer (Mr Costello) on a budget that provides security, safety and stability for all of us.

Debate (on motion by Mr Stephen Smith) adjourned.