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Wednesday, 29 March 2006
Page: 44


Ms GILLARD (11:52 AM) —The government should be hanging its head in shame, bringing the Cancer Australia Bill 2006 to the House at this time. Mr Deputy Speaker, I am sure you would be astonished to find out that it has taken since the Howard government’s commitment was made during the 2004 election campaign to bring this bill to the House to deliver on one of its major election promises in the area of cancer care. You may recall that in September 2004 the Howard government was finally pushed into making an announcement on cancer policy as a response to Labor’s cancer policy announcements. When it finally and belatedly put that policy out, its cancer policy had at its centre the establishment of Cancer Australia.

Here we are in 2006 and nothing has happened since the announcement of that cancer policy except for the appointment of Dr Bill Glasson as chair of the advisory council of Cancer Australia, with that appointment being announced late last year. Even now, with this bill so shamefully and belatedly having been brought to the House, we will not see this body up and running inside two years since it was first promised. This is an act of gross incompetence. It is an act of inexplicable delay. The Howard government should make it clear to Australians at election time that its promises, if they are to be honoured at all—and we know that so many of them are not honoured at all, most spectacularly with the minister for health’s rock solid, ironclad guarantee about the Medicare safety net—will be honoured in this tardy fashion. It is not good enough that the Howard government goes out to Australians and gives its word that something will be done, only to do it as slowly and as incompetently as this.

If it were just a delay then perhaps you might forgive that. Perhaps you might say, ‘Well, delays sometimes happen in public administration,’ but this is a delay that has cost Australians. It has cost Australians because it means that many other election commitments on cancer, made at the same time as Cancer Australia was announced in the Howard government’s cancer policy, have not been fully implemented. The degree of the lack of implementation of the other cancer policies made during the federal election still has not been made transparent to the Australian public.

Obviously, when the Howard government incompetently does not deliver on its promises, it wants to cover that up. This is a government for which cover-up is no strange or unusual activity. It is a government that often engages in cover-up—indeed, one of the most spectacular cover-ups has been the ongoing focal point of question time in this House for many weeks now. But in this area of cancer policy we have also seen a cover-up where, despite Labor’s inquiries via questions on notice, through the Parliamentary Library and at Senate estimates, we have failed to elicit any real information about the state of implementation of the government’s other cancer policies from the 2004 election campaign and the reasons for the delay.

We have seen a spectacular delay in bringing this bill forward to create Cancer Australia, we will see more delay before the body is up and running and the other cancer promises that were made at the time of the election appear to have been grossly delayed as well. Standing here today, the Australian public has never been told the truth about what is happening with the implementation of all of those other policies. That is simply not good enough. I would hope that in summing up on this bill the Minister for Health and Ageing will finally come clean about these matters and explain to this House, and through this House to the Australian people, the inordinate delay in implementing these policies and promises and the true state of implementation today of the various cancer policy promises that were made at the time of the last election.

We also want the minister for health to confirm whether or not the involvement of the Prime Minister’s office, as has been speculated in the media, has led to part of the hold-up, particularly with bringing this bill for the establishment of Cancer Australia to the House. The minister for health ought to be giving that explanation to the House as well, or perhaps the Prime Minister might choose at some point to intervene in this debate and to explain his conduct and whether or not his office has played any role in the delay in this bill coming before the House and in the incredible delay in the establishment of Cancer Australia.

The purpose of this bill, as we know, is to establish Cancer Australia as a new statutory agency. The role of Cancer Australia is to provide national leadership and coordination of cancer control in Australia, to guide improvements in cancer prevention and care and to ensure that treatment is scientifically based. Cancer Australia will coordinate and liaise between the wide range of groups and providers with an interest in cancer. Cancer Australia will make recommendations to the Australian government about cancer policy and priorities. It will oversee a dedicated budget for research into cancer, it will assist with the implementation of Australian government policies and programs for cancer control and it will undertake any functions that the minister, by writing, directs the chief executive officer to perform. The stated aim is to provide a national voice with more research funding for cancer care, better support for those living with cancer, strengthened palliative care services and better support for cancer professionals.

The bill outlines the responsibilities and conditions of employment of the chief executive officer and allows for the appointment of a chair and up to 12 other members to an advisory council. I must say that I am intrigued to find that the bill provides no criteria for the expertise of these members, which seems to me an enormous and somewhat surprising oversight given the important and sometimes technical work which Cancer Australia must perform. One would have thought that in structuring the advisory council it would be transparently clear on the face of this bill the sort of person or the various types of people the government wants to have on the advisory council. Are they to represent consumers? Are they to be people with particular scientific expertise? Are they to be professionals involved in the treatment of cancer? Are they to be people in training in terms of being involved in cancer? Are they to be geographically dispersed across the country? All of those things need to be answered. They are not answered in the bill and they ought to have been. As you would know, Mr Deputy Speaker, it is very common practice when one is legislating for a structure to provide advice that is crystal clear on the qualifications that one is seeking in those who will be appointed to the body.

I specifically note the importance of consumer representation on any of these bodies. This is a continuing theme that the opposition raises when dealing with legislation in this House. It is always very important when we are creating structures in health, including advisory councils of this nature, to ensure that there is a structure so that the voice of Australians generally can be heard, as well as the voice of our very able health professionals and health researchers.

The government originally committed a total of $13.7 million over four years to 2007-08 to establish this new agency Cancer Australia. However, due to delays, this funding has been rephased over four years to 2008-09. It is highly unlikely, given the government’s incompetent delay, that the $4.5 million or $4.6 million allocated to 2005-06 will be spent in this financial year. So here again we see a consequence of delay. I have already spoken about the consequence where other cancer policies have not been delivered in a timely fashion. Now a second consequence of the Howard government’s incompetent delay in this matter is that resources that were budgeted and available to assist with cancer policy in Australia languish unspent in consolidated revenue because of the way in which the government has gone about this process and the huge delay in which it has engaged.

I should also note that there was a comment by the Minister for Health and Ageing by way of his second reading speech which should send a shiver of concern through every member of this House. That comment was:

In addition to government funding, it is expected that Cancer Australia will seek funding from other sources, particularly from the private sector.

This is a comment weaved into the minister’s second reading speech. The meaning of it is not at all clear in the bill. Indeed, the area is not dealt with within the bill. I think Australians have a right to know whether it is the intention of this government to underfund the work of Cancer Australia with a view to sending it out to fundraise for itself from the private sector or indeed, one would suppose, from members of the public. They have a right to know whether Cancer Australia is going to be in the field looking for donations in competition with many other cancer bodies which are out there doing extraordinary work, as we know, raising money for cancer and, most particularly, cancer research.

Mr Deputy Speaker, as a local member of parliament like me, I am sure you would be aware—as I am sure other members of this House, as local members of parliament, would be aware—that there are many localised events for fundraising for cancer research. Many women in this country wear the pink ribbon for breast cancer. Many women in this country attend fundraising events for breast cancer research. Many of them buy specific products that are associated with the pink ribbon fundraising campaign because they want to do their bit by putting money into breast cancer research. Many Australians involve themselves in the World’s Biggest Morning Tea, which we have annually. Right around this country, indeed including in this Parliament House, in schools, in community centres, in retirement villages and in other community places right around the country, we see Australians coming together at the World’s Biggest Morning Tea to raise money for cancer research.

Is it really intended that the Howard government is going to underfund Cancer Australia and send it out into the field seeking to get donations to supplement its work? I anticipate one answer to that might be, ‘Really, we’re just going to be looking for corporate donations.’ We all know in this House that fundraising for breast cancer, the World’s Biggest Morning Tea and all of the other fundraising events that we have for cancer research across the country work, in part, because corporate Australia enters into a genuine partnership with local communities to enable those moneys to be raised. If you divert corporate Australia from fundraising and assisting with those events and making its discretionary money—the money that it marks for community donations—available to support Cancer Australia it will inevitably undermine the work of those very well-known fundraising events for cancer.

It is very important that, in his summing up of this bill, the Minister for Health and Ageing—I trust, but do not know, that the minister will find this bill important enough to donate some of his time to it; he did not do the second reading speech, but, at some point, hopefully, he will deal with this bill personally—clarify whether it is the intention of this government to systematically underfund Cancer Australia and send it out into the fundraising arena with the inevitable result, in my view, that it will be competing with other agencies that are well established in the area of cancer fundraising.

As I have said, the policy to create Cancer Australia came out in the 2004 election campaign and we are just seeing its delivery now. It should be remembered that, apart from the fact that the policy was only released because Labor had released a cancer policy which was very well received, when this policy was announced it was greeted with reserved enthusiasm by agencies and cancer groups around the country—and even that reserved enthusiasm has leached away, over time, given the delays in implementation. In their joint submission to the recent Senate Community Affairs References Committee inquiry into cancer services, the Cancer Council of Australia, the National Cancer Control Initiative and the Clinical Oncology Society of Australia said:

There is great potential for reforming cancer services in Australia to better meet the needs of the individual patient, their carer and family … the forthcoming establishment of the Federal Government’s new national cancer agency, Cancer Australia, could provide an authority for its implementation; and existing clinical practice guidelines, if adopted nationally, provide best practice protocols.

Unfortunately, the incompetence and mismanagement with which this has been dealt have dashed the hopes of cancer patients, researchers, policy makers, health care professionals, cancer councils and community groups for a coordinated and reinvigorated approach to cancer policy and fundraising priorities. It has also meant—and this is one of the most tragic results of the government’s delay—the untimely demise of the National Cancer Control Initiative.

Mr Deputy Speaker, I am sure that you are very aware of the work of this important body. The National Cancer Control Initiative, as we all know, was the key expert reference group on cancer. It was set up to advise the federal government on all aspects of prevention, detection, treatment and palliation. When the policy to create Cancer Australia came out, it was proposed that the work that was then being performed by the National Cancer Control Initiative would be rolled into the new body, Cancer Australia—that is, that the National Cancer Control Initiative would seamlessly move into and be subsumed by Cancer Australia. That would have been a way of making sure that the valuable work that had been done by the National Cancer Control Initiative was not lost. Even more importantly, it would have been a way of ensuring that the staff who had worked for the National Cancer Control Initiative—who in doing that work had, over time, inevitably developed expertise, skills, abilities and contacts—could have been made available to Cancer Australia.

The National Cancer Control Initiative could have gone out of business one day, with Cancer Australia starting up the next day. The work and the staff could have moved seamlessly across, with no work lost and no expertise lost. But, because of the incompetence of this government and the delay in the creation of the new body, Cancer Australia, we ended up with a situation where the National Cancer Control Initiative was provided with no further funds. The last head of the National Cancer Control Initiative, Professor Mark Elwood, was forced to send a letter to key constituents and supporters outlining the dilemma confronting the National Cancer Control Initiative and its staff, which was that, with the delay in the creation of Cancer Australia, the National Cancer Control Initiative was going to go out of business, with its work dropped into a black hole and its staff lost and dispersed to wherever they could get jobs, and there would be many months of nothingness before the creation of Cancer Australia. And that is exactly what is going to happen.

As I said, Mark Elwood is the last head of the National Cancer Control Initiative. Many of the staff have already left. With all the financial obligations they necessarily have in supporting themselves and members of their family, what are these working people supposed to do when the money that is going to fund them is clearly going to run out? They cannot end up in a situation where, for many months, they do not have a job. Of course, skilled staff look for new jobs. Many of these skilled staff have new jobs, and the ones that do not have new jobs will leave in May. So we end up with a situation where, because of the Howard government’s incompetence, the work being done by the National Cancer Control Initiative will be lost, the staff employed by the National Cancer Control Initiative will be gone and, sometime in the future, Cancer Australia will start up on day one with a blank page instead of having access to all of that work and all of those staff with all of their skills, expertise and track record in this area.

If you were a senior executive in the private sector and conducting yourself like this, I am sure the CEO or chair of the board would say to you: ‘Why on earth are you conducting yourself so incompetently? You are costing the business any amount of time, money and inefficiency. Don’t behave like this.’ But the Howard government seems to think this is an adequate way to behave in the area of cancer policy when we know, of course, that so much of the burden of disease in this country falls on people who have cancer. This incompetence is unexplained and unapologised for.

The very least it could do, given this gross act of incompetence, is apologise to Australians and send a letter of apology to the National Cancer Control Initiative and to every staff member who has left or is about to leave. It could acknowledge its failings and at least make some transitional arrangements to try to ensure that it does not lose all the work of the  National Cancer Control Initiative or access to those staff. This is a truly disgraceful performance.

If the bad news stopped there that would be a black enough picture, but of course the bad news does not stop there. Because of the delays in implementing this and other aspects of the government’s cancer policy, we have crystallised before us a clear broken promise. One of the things that Minister Abbott and the government promised to do when they announced the government’s cancer policy in the 2004 election was deal with the question of a national screening program for bowel cancer. At election time, the minister promised that all older Australians, people over 55—whether that is the definition of older Australians, Mr Deputy Speaker Lindsay, I will leave to one side—


The DEPUTY SPEAKER (Mr Lindsay)—I think you are reflecting on the chair, aren’t you?


Ms GILLARD —I apologise for that. There was a promise that youthful, vigorous Australians who may be over the chronological age of 55 would be screened every two years for bowel cancer, acknowledging that every week 90 people die of bowel cancer. So this is a very serious disease. This promise was dumped at budget time. It was billed as a ‘major priority for the next term’, but it will not be delivered in this term. We know, because of a continuation of current trials, that it is not due to start until July 2006. So a promise on bowel cancer screening has been dumped. Even if there is delivery at the later date, there is significant doubt by the states and territories that the funding, management and operational issues that need to be resolved will be resolved.

The Australian Health Ministers Advisory Council is meeting today, and they want answers on a whole host of issues around this much delayed, looking like it is going to be dumped policy. The states and territories are concerned that the bowel cancer screening program has no clear set of objectives and strategies, has no clear specification of roles, will add additional cost burdens to the states, has not addressed the need for affordable access to colonoscopy, has no information and database management systems, has no clear funding arrangements between the states and the federal government, and has no communication program to educate health professionals and consumers. That is, everything that would need to be done to support this policy in any effective way remains undone. There is not one thing that one would need to do to get this policy up and running effectively that has actually been done by this government. In view of this incompetent performance, the states and territories claim that the whole program, a very important program for the health of all Australians—I remind you, Mr Deputy Speaker, that 90 Australians die every week because of bowel cancer—is incompetent. Here we have a national screening program—promise made, promise delayed—and incompetence is surrounding what could be its ultimate delivery.

And there is more. We know through the Parliamentary Secretary to the Minister for Health and Ageing, Christopher Pyne, that there was a promise to help pregnant women quit smoking. That was also an election commitment. There was a media statement issued in June last year about an advisory group for this program, but the composition of the advisory group has yet to be announced and is yet to meet. We know that about 20 per cent of pregnant women smoke. We know that babies of smoking mothers are more likely to be smaller, are three to four times more likely to die of SIDS and are more likely to suffer respiratory disorders and intellectual impairment. So this is not a marginal issue. This is not an unimportant issue for Australia’s future and the future of Australian children. This is an issue front and centre that we should be dealing with. But, yet again, we have unexplained delay and continuing incompetence.

This is something that really does need to be addressed by this government, and it ought to be addressed during the course of this debate. I note that the second reading speech stated that ‘Cancer Australia will have a role in the implementation of the following initiatives’, which were once again part of the Howard government’s election policies. These initiatives are

  • new approaches to mentoring regional cancer services;
  • a grants process targeted at building cancer support groups;
  • a national awareness campaign for skin cancer, to be developed in conjunction with state and territory governments;
  • a new dedicated budget for research into cancer, to be administered in conjunction with the National Health and Medical Research Council; and
  • funding for clinical trials infrastructure for cancer patients.

I am pretty sure that we can say today that these election commitments are not up and running yet. So Strengthening Cancer Care, the policy taken by the Howard government to the last election, has been awash with incompetence, awash with delay and awash with promises made and not delivered on. I have raised a number of them in the course of this speech, such as the creation of Cancer Australia itself, as well as bowel cancer and smoking and pregnant mothers. These things have not been done. They ought to have been done, and an explanation is required. We also need an explanation of what this body will be doing in relation to private sector fundraising.

While I am on the case of delay and incompetence of this government, there is another very important case of delay. We all know that in December last year this parliament mourned the sad and untimely death of former senator Peter Cook from cancer. We all acknowledged his important last legacy in the recommendations contained in a Senate Community Affairs References Committee report entitled The cancer journey: informing choice. This was a committee he chaired and inspired, despite his personal battle with cancer at the time. In my memory never has someone made such a commitment in this parliament, never have they dedicated the last remaining months of their life so clearly to the development of a better policy for the rest of the nation. Despite that historic work by former senator Peter Cook, as of today the Howard government has not responded to that report. What could explain that act of cruelty? That ought to be done. May I conclude by moving a second reading amendment that deals with these issues:

That all words after “That” be omitted with a view to substituting the following words:

“whilst not declining to give the bill a second reading, the House condemns the Government for:

(1)   the unreasonable delay in implementing this 2004 election commitment;

(2)   the consequent demise of the National Cancer Control Initiative and the loss of NCCI expertise;

(3)   failure to respond to the Senate Committee Report The Cancer Journey: Informing Choice; and

(4)   lack of any substantial commitment to improving cancer care in Australia”.


The DEPUTY SPEAKER (Mr Lindsay)—Is the amendment seconded?


Mr Burke —I second the amendment and reserve my right to speak.