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ABC News Breakfast -

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(generated from captions) Next week, the biggest

immunisation scheme in

Australian history will begin.

The government has announced

the national roll-out of the swine flu

more, the Federal Health

Minister Nicola Roxon joins us

now . Good morning, thanks for

joining us. Good morning. What's the evidence

that we have at the moment that

this is such a massive health

problem still that we even need

to engage in this immunisation

program? I think it's very

clear that it does pose a

significant risk. What we've

seen is a very high number of

higher than usual number of people hospitalised. A much

higher than usual number of

people in intensive care. And

particularly the impact of this

disease on those who have other

underlying conditions has been

pretty significant. So our

message is although the disease

is mild for most people, vulnerable people can really

experience the hard edge of

this disease, and the World

Health Organisation and all our

team of experts say the best

protection is the vaccination protection is the vaccination

program, where I think a

fortunate country that we can

afford to buy the vaccine for

the communal, we've done that

and it starts rolling out from

next Wednesday. It will be

available to everyone who wants

it, aged 10 and over. But we

are trying to particularly urge

those who are most vulnerable,

or in families contact with

those who are vulnerable, to

prioritise getting the vaccine.

But the community at large has

to remember that the best way to protect to protect those vulnerable

people is for to us have

significant immunity across the country. So even though you

might not particularly feel

vulnerable from the flu, it is

a good way of protecting others

'cause if you're vaccinated you

can't spread it to the next

person. It helps close down the

disease if it comes back in a

more virulent form. You are recommending then that everyone

get the vaccine? We are

recommending that everyone

consider getting the vaccine,

aged 10 and over. We don't aged 10 and over. We don't have

the data yet from the

paediatric trials, so children

aged under 10 will need to wait

a bit longer till we get that

data and know what an effective

dose is and check there are no

complications for children. But

what do we do when the next flu

wave comes along, and we've

been told again and again this

is only going to continue to

happen, do we mass vaccinate

again for the next flu? Well,

what was different about what was different about this

flu is that because it was a

totally new strain, there was

no immunity in the community.

It looked like there potentially was for the very

elderly who might've been

exposed to something similar a long time ago. With other types

of flu we usually have some

people who have some immunity,

so you're able to help stop the

spreading. Because of the novel

nature of this disease, the

risk is much higher. We've seen the

the consequences, 177 people

have already died,

unfortunately, with this disease, not necessarily

because of it. And we are in a

position that we can protect

the community, we've got a good

network of GPs who are able to

recommend to their patients,

particularly those with chronic

diseases, that they get the

vaccine and we believe it's a

sensible way to protect

people. But my question was

whether you'd do it again. We

expect new flus, would you expect new flus, would you mass

vaccinate each time there was

another flu? It will depend on

nature of the flu. It will

depend if it's a different

strain of something that we've

previously had, so that people

will have some immunity, even although it's taking on a

different form. This is an

entirely novel flu. That's why the World Health Organisation

has recommended this approach.

I don't think we can answer

what we'll do in each new

the capacity to situation, we certainly have

the capacity to respond, we're

manufacturing facilities here very well placed. We have

to make the vaccine. I think

that puts Australia in a good

position and we will be one of

the first countries to be

vaccinating. Whether we do that

in the future will depend on

the severity of the disease,

but of course we do vaccinate

people every flu season for

what is the current flu that

year, so we do take on different changes with the different changes with the

normal flu vaccination program.

But this is about getting

immunity across the community

for an entirely novel disease

that will give us protection

well into the future. Do you

concede there were serious

flaws in the response - in the

effort to contain the flu? It's

come under a lot of criticism?

I don't think that's right. I

think there has been healthy

debate about things cow do

differently. I think by and

strong large there has been very

strong support for the approach

that's been taken but anyone

would be foolish not to say

you've got to learn from the

way you respond to each of

these diseases. But I think the

response was good. We were able

to delay the entry of the

disease for a significant

period of time. We were able to

contain it with some of the

school closure programs, we had

very good use of our

anti-virals which treated

people who otherwise would've

had a negative - much more serious and adverse serious and adverse response if

we hadn't had those anti-virals

in the stockpile and now we're

ready to vaccinate as one of

the first countries around the

world. I think that's a pretty

good record but of course we'll

look at how we can do things

differently in the future. Everyone needs to do that to

keep improving for the next

time we have some sort of

disease that's like this. On

another subject, you've been

critical of some doctors' rush

to embrace expensive and

technologies. You sometimes untried medical

technologies. You want to

reform that sector. What's your

particular criticism there? My

real issue is just that we

don't have an unlimited amount

of money for health Budget. We

want and the community expects

we're able to pay for new medicines and new technologies

when there are breakthroughs.

When there's a new vaccine, for

example. But to do that, we

have to make sure that every

bit of our health expenditure

now is being used well. And I

don't think we can be satisfied of that

of that yet. We don't have the

strong enough assessment

processes for some new

technologies. We see clinicians

sometimes using the new US and flashiest equipment rather than

using what is a proven

effective intervention. They're

getting some sort of wealth

support for that? Absolutely.

I've been saying I want

clinicians to help play a role

in using the most effective and

the most cost effective

treatments. That's why we're

having a few arguments with

having a few arguments with the opthalmologists and others

about when technology delivers

a benefit, taxpayers should be

able to reap that. Just how

much money do you think is

being wasted in that way? I

think it's very hard to tell,

because I think the vast

majority of clinicians are

absolutely trying to do the

right thing by their patient

and by taxpayers. Really the

point I'm making is we've got

enormous and exciting new

horizons that will cost a lot horizons that will cost a lot of money in health, to make

sure we've got the money to do that, we have to make sure

we're getting value for our

current dollar and I'm not

always convinced we do But that's something you can't

anticipate. You run the risk

here of potentially talking

down and dismissing new technologies and new developments by taking that

approach. Sometimes it has to

be tried, tested, found not to

be as good as someone hopeed in

the first place. That's about the first place. That's about blue-sky investment, that's

about getting some result in

the end. You can't anticipate

that. No, what we need to do,

though, is make sure that we

have good and clear processes

for assessing when something 's

safe to start with, so that it

should only be on the market if it's safe, having a different

test, which is more rigorous

for whether it should be

publicly funded, having good

post-market surveillance to see

if that

if that promise of change is

being most. That sounds like a

very bureaucratised process?

No, our health system will not be sustainable in the future if

we aren't rigorous about what

we're currently paying for and

we're not very good at taking

off the MBS or the PBS things

nor longer effective. We seem

to add off and never take off to add off and never take off

when new technologies and

advances mean we can do that.

It would be great if you could

give us a yes or no on this

question. Will you ban ban

doctors from receiving freebies

from pharmaceutical companies

like lunches, trips? I don't

think there is any defence for getting World Cup tickets and

flying off to Germany or Italy

as part of an educational

program for doctors. I don't

think that's good for the

companies that are doing it and I don't think I don't think it's good for

clinicians. Can you ban it?

There are some steps before we have to take that very

heavy-handed approach. I've

made clear my view that if a

code of conduct process is not

working f these sorts of circumstances are falling

through the gaps we will

consider it. Isn't it clear

that's not working now? No, I

think there has been massive

change over a fairly short

period. I don't think there's been enough as these been enough as these sorts of

examples show but I think we

need to make sure there is the

potential for innovators to be

able to show their - whether

it's a drug or whether it's a

new device to clinicians, I

just want it to be transparent,

I want it to be appropriate,

and we certainly are prepared

to take action if we don't see

that happening, from the industry themselves taking

responsibility to do that. Now,

when it comes to your stalled

legislation in the Senate, I know that

know that the federal Treasurer

has said pretty much we'll do

whatever it takes to try to get

our legislative agenda back on

track and it will be

represented in three months'

time. When it comes to whatever

it takes, in your particular

portfolio, is there room for

more negotiation with the -

those senator who is are not

coming on board? Could you

amend your legislation again? Well of course, until anything's actually gone through the Senate, there's the

potential to be able to amend it You're open

it You're open minded to that?

As I've made clear before, the

range of senators who don't

support this private health

insurance measure all disagree

with it for fundamentally

opposite reasons. It's quite

hard for us to see how that

will ever come to a landing

point that has sufficient

people to agree with it and

ultimately we are convinced

that this is a good policy. We

don't think that low and middle

income earners should be paying

a rebate for high income

earners to have private health

insurance. There's no need to

rush this, is there? The reason

you're putting it up, you say

Parliament may have to be

recalled, it's just political?

No, we're trying to get this

measure through. It's meant to

come into place on 1 July next year. Quite a big Budget hole

I guess? Yes, but also there

is a lot of administrative

changes that are required but

we want to make sure it's through in sufficient time for

those who are insured and the health insurance companies themselves ... Do it when

Parliament resumes next year,

first thing. We could do that

we're not keen to bring it back

before we have the Productivity

Commission's report, because

Senator Xenophon has made it

clear he won't for this until

we have that report. We're not

trying to get a double

dissolution trigger. What we're

trying to do is get a sensible

strategic health measure

through the Parliament. And

we'll use whatever steps we can

to make sure that

happens. Nicola Roxon, good to