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Thursday, 23 March 2017
Page: 2963


Mr HUNT (FlindersMinister for Health and Minister for Sport) (09:31): I move:

That this bill be now read a second time.

I am pleased to introduce the Australian Immunisation Register and Other Legislation Amendment Bill 2017. It is part of the government's firm, clear and absolute commitment to a No Jab, No Pay program, which is ultimately about encouraging immunisation and vaccination to lift the rates of safety for our children and for the children of others with whom each of our offspring play.

This is about ensuring safety against measles and mumps. It is about rubella, it is about shingles and it is about the tragic outcomes that we have seen from whooping cough.

Only a week ago, the Prime Minister and I met with a magnificent mother, Toni McCaffery. She lost her little daughter Dana some years ago to whooping cough, almost certainly acquired through a childcare centre at a drop-off. That little girl was only a few weeks old, and the courage, the dignity and the decency of Toni struck both the Prime Minister and me.

Although we were already committed to further strengthening vaccination levels in Australia, the degree of galvanisation which came out of it was shared by both of us. I look across the table and acknowledge the bipartisan approach to vaccination for young children from both sides of this parliament.

Against that background, the Australian Immunisation Register Act 2015 (AIR Act) was created as a new, consolidated legislative framework for the establishment and ongoing management of Australian immunisation registers.

This bill implemented measures to improve immunisation rates across Australia and complemented other government initiatives, including No Jab, No Pay and new catch-up incentives to GPs and other immunisation providers.

As I said at the outset, immunisation is critical to maintaining public health and preventing the outbreak of infectious diseases. The advice to me and to the Prime Minister from the Chief Medical Officer, the extraordinarily capable Professor Brendan Murphy, could not be clearer: vaccination saves lives, vaccination protects children and vaccination protects our elderly.

It is something which is a fundamental achievement of the 20th century and the 21st century, and the evidence of those who come from a different perspective is simply unfounded, unsubstantiated and antiscience, and cannot and will not be tolerated by this government.

The Turnbull government is therefore committed to further improving vaccination rates.

Since the introduction of the No Jab, No Pay policy, the government has seen 200,000 extra children vaccinated in just over a year.

That has meant that vaccination rates have increased to 93 per cent for the general childhood population and to 94.5 per cent for those covered by the particular measures which would withhold benefits to those who would otherwise receive benefits under the No Jab, No Pay program.

It is a tough program, but it is fundamentally good public policy to ensure good public health and, at the most important level—the level of individual families—it is good policy that saves and protects lives.

Implemented on 1 January 2016, the AIR Act improved the arrangements surrounding the medical exemption process such that only general practitioners could assess for medical exemptions.

Since the introduction of the AIR Act, immunisation clinicians have requested that other specialised medical professionals have their assessments for medical exemptions recognised under the act, in addition to general practitioners.

This is a fair, reasonable and sensible proposal put forward by the medical profession to further advance the objectives of No Jab, No Pay. These additional practitioners include paediatricians, public health physicians, infectious diseases physicians and clinical immunologists.

Specialists have advised that having to send patients back to general practitioners to get medical exemptions has added an unnecessary burden of time for patients and, in some cases, may risk the correct recognition of those families that have done the right thing.

The four specialist groups identified in the legislation today, therefore, provide care to the most vulnerable children in the country, including those with complex illnesses and healthcare requirements. This is a humane and sensible response put forward by the profession, which we welcome and thank them for. I particularly want to acknowledge the work of the AMA and the Royal Australian College of General Practitioners, as well as the other specialist disciplines. They include, therefore, paediatricians working in specialist immunisation clinics who GPs call for advice on whether medical exemptions are warranted.

This legislation enables these highly qualified specialists, who are often best placed to assess children for immunisation, the opportunity to provide comprehensive care for their patients.

Allowing these specialists to notify medical exemption to the Australian Immunisation Register will maintain and enhance the integrity of the No Jab, No Pay policy because it ensures that the most qualified clinicians are able to make this assessment. That is right, proper, sensible and an important advancement.

Based on this feedback, the bill will make minor amendments to paragraph 9(c) and subparagraph 9(d)(iii) of the AIR Act to allow paediatricians, public health physicians, infectious diseases physicians and clinical immunologists to assess that a young person should not have a vaccine for medical reasons or natural immunity to a disease.

The inclusion of these immunisation specialists will reduce the number of referrals and appointments that patients currently need. This will save time, cost and effort for health providers and patients.

In conjunction with the amendment to the AIR Act, the A New Tax System (Family Assistance) Act 1999 (FA act) is also being amended.

Schedule 2 of this bill includes provisions to amend the FA act for consistency. The amendments will expand the medical practitioners who can certify medical exemptions in line with the amendments to the AIR Act.

The bill also makes a minor amendment to paragraph 9(b) of the AIR Act to make it explicit that the Australian Immunisation Register can only accept vaccination information provided by recognised vaccination providers, and not members of the public. This removes any uncertainty associated with who can provide vaccination information and removes the opportunity for the very small number of parents who may seek to do the wrong thing.

Through the bill, the AIR will continue to operate to support the continued efforts of health professionals to improve the health of individuals. The bill will reduce the burden on those professionals and also the individuals that require medical exemptions from immunisation.

I want to thank the medical profession for their cooperation in not just the amendments which we are proposing at their suggestion today: again, the AMA, under the very impressive and august leadership of Dr Michael Gannon; the Royal Australian College of GPs, who are equally well and ably led by Dr Bastian Seidel; the Australian College of Rural and Remote Medicine, which has been a very forceful activist in this space; and the other colleges involved.

I also want to acknowledge the bipartisan support lent by the opposition. They have been a constructive partner in the push to ensure that vaccination becomes a universal outcome for Australian children other than those with a genuine medical exemption. I thank all of those in the department and within my office. In particular, I want to acknowledge the work of the extraordinary Alex Best in advancing this legislation.

Above all else, I acknowledge that the Prime Minister has made this a signature, personal area of investigation and action in terms of preventive health, public health and protecting children. For those reasons, I commend the No Jab, No Pay policy and the Australian Immunisation Register and Other Legislation Amendment Bill 2017 to the parliament.

Debate adjourned.