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Thursday, 30 March 2006
Page: 149

Senator McLUCAS (6:39 PM) —It is ironic that here we are on the last day of the autumn sitting scrabbling to pass the Cancer Australia Bill 2006, a bill that we have been waiting for for more than 12 months. It was in September 2004 when the Howard government, pushed into action by the success of Labor’s cancer policy announcements, finally put out their cancer policy with the establishment of Cancer Australia as its centre. But, since then, nothing has happened except for the announcement last year that Dr Bill Glasson has been selected to chair Cancer Australia and, finally and belatedly, the far more recent announcement of the remainder of the advisory committee members. Even now with the final enactment of this piece of legislation we will not see this body up and running inside two years since it was first promised. That means that many other election commitments on cancer made at that time have not been fully implemented because they are contingent on the establishment of this authority.

Labor’s inquiries at Senate estimates, through the Parliamentary Library and questions on notice have failed to elicit any real information about the state of implementation and the reason for the delays. In fact I asked through questions on notice, on 10 October last year, a series of very straightforward questions about cancer, including: where is the establishment of Cancer Australia up to; when will this body be set up—very straightforward questions—how many additional undergraduate places for radiation therapists were provided in 2005-06; and what is the current state of development and implementation of the continuing professional education modules for cancer professionals? They were extremely straightforward questions. Why has it taken since 10 October last year to the end of March to answer these very simple questions?

In the lead-up to making this contribution this evening, I thought it would be timely to ring the minister’s office to actually find out and advise him, as I did this morning, that I would make mention of this fact today. I can report to the Senate that earlier this afternoon my office received a call from Minister Abbott’s office to say that he has apparently signed the answer to that question, for which I am pleased, but I continue to wait to receive a copy of the answer. We need more than non responses to questions to understand why it has been so slow for the minister for health to enact, firstly, Cancer Australia and, secondly, the commitments that are attached to it.

This bill is to establish, as I said, Cancer Australia as a statutory agency. Cancer Australia will provide national leadership and coordination of cancer control in Australia, guide improvements to cancer prevention and care, and ensure treatment is scientifically based. It will coordinate and liaise between the wide range of groups and providers with an interest in cancer, make recommendations to the Australian government about a cancer policy and priorities, and oversee a dedicated budget for research into cancer. It will assist with the implementation of Australian government policies and programs in cancer control and 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 people living with cancer and strengthened palliative care services and better support for cancer professionals. The bill outlines the responsibilities and conditions of employment of the CEO and allows for the appointment of a chair and up to 12 other members of an advisory council. I must say that it is intriguing to note that the bill provides no criteria for the expertise of these members. This is surely a surprising oversight, given the important and sometimes technical work which Cancer Australia will have to perform and the imperative that a range of perspectives, including those of cancer patients, are represented on the council.

While it is hard to fault the qualifications of the people who have ultimately been named to the initial advisory council, we are entitled to expect that there is some prescription about the qualifications of those who have been appointed. In particular it is, in our view, a serious oversight that there is no specific requirement that cancer patients and consumers are represented. That is why I indicate at this point that Labor will be supporting amendment (3) of the tranche of amendments which are being proposed by the Democrats to resolve that issue.

The government initially committed a total of $13.7 million over four years to 2007-08 to establish this new agency. Due to delays, this funding has been rephased over four years to 2008-09. However, it is unlikely that the $4.546 million allocated to 2005-06 will actually be spent this financial year. I should comment also that there is some concern about this statement in the minister’s second reading speech:

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

Does this mean that the Howard government is not going to provide Cancer Australia with all the funds needed for this important policy work? Does it mean that a national government agency will be engaged in fundraising activities, using government funds to compete against not-for-profit community groups and non-government bodies for donations to cancer work? I hope the minister will use his response to clarify that position.

During the 2004 election campaign, two days after the release of Labor’s well-received cancer policy, the Howard government announced their Strengthening Cancer Care policy. Cancer Australia is a key plank of that policy. Cancer groups around Australia greeted this with reserved enthusiasm, which has diminished with the increasing delays in its implementation. The Cancer Council Australia, the National Cancer Control Initiative and the Clinical Oncological Society of Australia said in their joint submission to the recent Senate Community Affairs References Committee inquiry into cancer services:

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.

The mismanagement and absolute incompetence dashes the hopes of cancer patients, researchers, policy makers, health care professionals and the cancer councils and community groups for a coordinated and reinvigorated approach to cancer policy and funding priorities. It has also meant the untimely demise of the National Cancer Control Initiative.

The NCCI was the key expert reference group on cancer, set up to advise the federal government on all aspects of prevention, detection, treatment and palliation. It was proposed that the NCCI would be subsumed into the new Cancer Australia, and the NCCI had begun the essential task of developing initial priorities for the new body. However, the NCCI was provided with no further funds, and the last head of it, Professor Mark Elwood, was forced to send a letter to key constituents and supporters outlining the dilemma confronting the organisation and its staff. Many have left and all will leave in May.

Along with failing to deliver on Cancer Australia, Minister Abbott has retreated on the promise of a national screening program for bowel cancer. At election time the minister was promising that all older Australians—that is, over 55—would be screened every two years for bowel cancer and acknowledging that, every week, 90 people die from bowel cancer. That promise was dumped at budget time, and what was billed as ‘a major priority for the next term’ became a continuation of the current trials, not due to start until July 2006. But even this date is in doubt, as the states and territories are expressing concerns about the fact that significant funding, management and operational issues are still to be resolved.

The Australian Health Ministers Advisory Council met in February and they wanted answers about a whole host of issues. Unfortunately they found those answers were not forthcoming. 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 and will add additional cost burdens to the states. They are concerned that it has not addressed the need for affordable access to colonoscopy and it has no information and database management systems. Their concerns include that it has no clear funding arrangements between the states and the federal government and has no communication program to educate health professionals and consumers. They claim the whole program, a very important program for the health of all Australians, is at significant risk of failure.

But unfortunately there is more. Parliamentary Secretary Pyne’s only effort to deliver the promised program to help pregnant women quit smoking, which was also an election commitment, has been a media statement issued in June last year about an advisory group, which has yet to be announced and has yet to meet. About 20 per cent of pregnant women smoke, and babies of smoking mothers are more likely to be smaller, are three to four times more likely to die of sudden infant death syndrome and are more likely to suffer respiratory disorders and intellectual impairment. With such a large body of research showing that parental smoking has a serious impact on the health of babies, there can be no justification for delay on implementing this commitment.

I note that the second reading speech states:

… Cancer Australia will have a role in the implementation of the following initiatives as part of Strengthening Cancer Care:

  • New approaches to mentoring regional cancer services;
  • A grants process targeted at building cancer support groups;
  • A national awareness campaign for skin cancer …
  • A new dedicated budget for research into cancer … and
  • Funding for Clinical Trials infrastructure …

I think we can be pretty sure that these election commitments are not up and running yet. The Howard government’s election commitments on cancer have been exposed as a sham. Mr Abbott has broken yet another election commitment in health. Australian cancer patients, their families and their treatment deserve better than this delay and incompetence.

In December of last year we all mourned the sad and untimely death from cancer of our friend former Senator Peter Cook. We all acknowledged his important last legacy in the recommendations contained in the Senate committee report, Cancer journey: informing choice. This report contained a raft of recommendations which, if implemented, could improve cancer care. The report deserves not just a detailed response but an expeditious one. In particular, the recommendation that requires us to establish a new Medicare item so that every cancer patient can have a multidisciplinary plan developed for them is a crucially important thing to do. This was Peter’s lesson to us, this was his experience and he was in a position to push it, unlike many others, and he has acknowledged that. We need to ensure that all Australians benefit from this, that doctors and health professionals work together and that we get a team approach.

Unfortunately, we are still waiting for the response to that report. Minister Abbot regularly pats himself on the back about his commitment to cancer but it seems that his commitment and enthusiasm do not extend to releasing the government’s response to that report, which has been on his desk since last July.

Labor supports this bill to establish Cancer Australia and in doing so we will also highlight the government’s failure to fully implement a raft of election commitments to prevent cancer and to improve cancer care. This is not a government which can lay claim to any real commitment to improving cancer care in Australia, and thousands of Australians will suffer unnecessarily as a result.