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Tuesday, 8 August 2017
Page: 7709


Ms CATHERINE KING (Ballarat) (18:32): I rise today to speak on the Australian Immunisation Register and Other Legislation Amendment Bill 2017. This bill makes two minor changes to the No Jab No Pay arrangements. First, it adds four medical specialties to the list of providers who can grant medical exemptions for vaccination requirements—paediatricians, public health physicians, infection disease physicians and immunologists. Second, it clarifies that only recognised vaccination providers and these four specialties can tell the government whether children and families have actually met the vaccination requirements.

Labor supports this bill and the practical benefits which will arise from its passage. Ensuring vaccination rates are as high as possible is one of the most important health responsibilities of a government. While this bill makes minor changes, the issue at hand is not minor. Having this legislation in front of us is a good reminder of the importance of vaccination and a reminder of the role of everyone in this place to ensure we spread the message about protecting our society. Because despite all of the scientific evidence, Australia is in the midst of a renewed debate about vaccination, a debate that ended long ago, since the scientific evidence that vaccines save lives is overwhelming.

In early March, Senator Hanson questioned the safety of vaccinations on national TV, sparking renewed discussion on the issue. Senator Hanson later backed down from her suggestion that parents should use a non-existent test for vaccine allergies but she has not apologised for her earlier comments linking vaccines to cancer and to autism. Medical experts said Senator Hanson's comments were ignorant and dangerous. Disappointingly, the Prime Minister could not bring himself to directly criticise Senator Hanson on this issue.

One of the most naive things I hear from people talking about vaccination is because there are not any current outbreaks of diseases commonplace 100 years ago that their kids will be safe. That attitude completely threatens the ongoing success of our vaccine program. Professor Clem Boughton was once the senior physician at the Division of Infection Diseases at Prince Henry Hospital in Sydney—in other words, he was at the front line of treating these diseases. He hit the nail on the head about the reason complacency is creeping in on vaccines when he said: 'As a result of the effectiveness of immunisation programs, most young parents have not seen any of these conditions once so common in the community, and do not realise how dangerous they are.'

The result of such complacency? According to official statistics, there were 340 cases of measles in 2014, almost double the 158 measles cases in 2013. So when I hear leaders questioning the validity of vaccines, anger does not even come close. There will always be misinformed opinions, with proponents clustering on hidden Facebook groups and sharing discredited research. Do a quick search of Google and you will find uninformed and dangerous views flooding the results. But it is completely unacceptable for a politician, a national leader, to use their public platform to put a shadow of a doubt in one person's mind about something as critical as vaccination. Vaccination isn't just about protecting personal health; it's a social responsibility. Herd immunity is critical to protecting Australians who simply cannot be immunised for medical reasons.

The reason that most of us cannot fathom the devastation that diseases such as rubella, measles, diphtheria and polio cause is because of our successful immunisation programs. Australia's strong immunisation program is critical to eradicating life-threatening diseases, and failure to vaccinate is a threat to public health. Our leaders need to be doing everything possible to ensure that parents know about the deadly risks of failing to vaccinate their children, not spreading misinformation.

Only last week we saw a screening of a dangerous anti-vaccination film at a large cinema in central Melbourne by an active anti-vaccination group. And while activities such as this are taking place there is a risk that uninformed views are introduced into the mainstream discussion. We cannot afford a single shadow of a doubt to be put into anyone's mind about vaccination. Accordingly, we need to refute the uninformed discussion in order to protect population health.

In line with this, Labor welcomes the government finally funding a public campaign to combat the dangerous misinformation being spread on vaccinations. This is something we have been calling on the government to act on, writing to the Prime Minister back in March to encourage urgent action. However, I will note that Labor is disappointed the government has not allocated more resources to this critical initiative. The government should not drag their feet to act on this. They dragged their feet to act on this and then failed to put enough money behind it to seriously combat the level of misinformation circulating in the community. For months Labor has been calling on the government to fund a public campaign to combat the dangerous misinformation on vaccinations.

This is a really important issue—an incredibly important issue. Health experts have consistently reiterated the importance of getting accurate information to parents, and have been calling on the government to act. Michael Moore, the president of the Public Health Association of Australia said:

We need ... to maintain accurate information in the face of the misinformation that tends to be circulated.

The president of the Australian Medical Association, Michael Gannon, makes it clear:

It is absolutely essential that we have accurate information, and this fatuous idea that parents can spend half an hour on Wikipedia and come to a greater understanding of the issues than their doctor and the accumulated wisdom of all the world's medical scientists is ludicrous.

I ask: does the Turnbull government seriously think that the small amount of funding allocated will be enough to fight against what has become widespread misinformation on vaccinations? Dangerous misinformation peddled by anti-vaccination proponents should never take the place of proven scientific advice. We welcome a step to ensure parents are equipped with the right information, and we hope that parents now take the responsible step and protect their and other people's children.

Of course, there are clear consequences if parents do not protect their children, with the No jab, No pay arrangements establishing a clear financial link. Since 1 January 2016, only families who fully immunise their children, who are on a recognised immunisation schedule or who have an approved medical exemption can receive family assistance payments linked to immunisation status, such as childcare assistance and family tax benefit part A supplement.

These reforms build on Labor's track record to use every lever possible to boost immunisation rates and to protect our children. In government, Labor made important changes to family payments to lift immunisation rates, including linking the family tax benefit end-of-year supplement to immunisation. Ahead of the 2013 election, Labor committed to further tightening immunisation requirements within the family payments system, so we were very pleased to support the No Jab, No Pay legislation, having built on our reforms. We are pleased to support the changes in this bill today.

As the shadow health minister, I am particularly pleased to see the increase in immunisation rates. I am aware that since the No Jab, No Pay measures commenced, more than 210,000 families have taken action to ensure they now meet the immunisation requirements. This means increased immunisation rates for our children. As one example, I am aware from December 2015 to March 2017 the immunisation rate for one-year-olds increased 1.35 percentage points to 93.63 per cent. Of course, it will continue to be important to support people in vulnerable communities to catch up with their vaccination requirements and to make sure they understand the consequences of failing to make sure all vaccinations are up to date.

As it stands, the Australian Immunisation Register is only able to recognise medical exemptions to vaccination assessed by general practitioners. Whilst this tightly restricted approach was appropriate when the original legislation was introduced, it is appropriate to revisit it at this time to ensure the legislation is working as well as it possibly can. As noted in the explanatory memorandum, the restriction to general practitioners was taken to prevent medical practitioners not specialising in immunisation from conducting assessments and also to protect individuals' privacy in moving from the Australian Childhood Immunisation Register to a whole-of-life register, the Australian Immunisation Register. The explanatory memorandum notes the Department of Health has received feedback from some specialists requesting the ability to have their assessments of medical exemptions recognised in the Australian Immunisation Register. These clinicians have advised that having to send patients to a general practitioner to get medical exemptions has added a burden of time for patients. Passage of this bill will allow paediatricians, public health physicians, infectious disease physicians and clinical immunologists to have their assessments of medical exemptions to immunisation recognised by the Australian Immunisation Register in addition to general practitioners.

This bill also makes a minor amendment to make it explicit that vaccination information can only be provided by recognised vaccination providers and not by members of the public. Labor thinks these are sensible amendments in line with feedback from experts. We note these changes are likely to see a reduction in the number of referrals and appointments, creating efficiencies for both patients and for our health systems.

But of course there is more work to be done. In March 2017 the government announced to pursue No Jab, No Play laws. These are state and territory laws that allow childcare centres to turn away children who are not immunised. Whilst some states and territories have them in place, there is not a not a national approach. If the announcement sounded familiar, it is of course because the Abbott-Turnbull government already announced this policy almost four years ago. In May 2013 the member for Warringah and then-Opposition Leader committed, 'If childcare centres want to implement "no jab, no play" then they should be free to do so, and we will work with the states and territories to make it happen.' This government has been in office for 3½ years and, frankly, they have not worked with the states to implement No Jab, No Play, so we welcome the government's renewed commitment on the issue. Labor will certainly be holding them to account on this promise.

The other issue I want to note in this debate is the availability of vaccines and the government's failure to do more on this issue. Since last year, Australian parents have been grappling with ongoing shortages of the meningococcal vaccine, Bexsero. In February the minister boasted he had acted on the shortage and had a firm conversation with the manufacturer to restore supply in Australia. Despite this, nothing changed and parents were still being turned away when they tried to obtain the vaccine. The minister's comments misled parents into the false hope that they would be able to protect their children immediately. I am now pleased that the manufacturer advised the shortage was resolved in June, finally. But we are now seeing similar issues with the Menveo vaccine. Australian teenagers are caught in a state-by-state lottery when it comes to being protected against meningococcal W, with the Turnbull government failing to progress a national response to the growing threat of this disease. State governments in Victoria, Queensland, Western Australia and New South Wales currently fund immunisation programs, with the Victorian government confirming in June that 51,000 doses of the vaccine for meningococcal W have been distributed across the state. But with ongoing shortages of the vaccine and a lack of national leadership, teenagers in other states and territories will continue to miss out on this critical vaccine. The Therapeutic Goods Administration confirmed that shortages of vaccine to protect against meningococcal W are expected to continue until September. While shortages continue, states with funded immunisation programs are prioritised for supply.

At a time when there has been increased incidence of the disease, the Turnbull government must do more to protect our children. The federal government should make it a priority to work with the manufacturer of the vaccine, address shortages and make sure parents have the most up-to-date information. In the long term, Labor urges the government to work with the manufacturer and the Pharmaceutical Benefits Advisory Committee to negotiate a way forward, including whether this vaccine should be accessible for all children on the Australian Immunisation Register, because access to life-saving vaccines shouldn't depend on which side of the border a child lives on.

In conclusion, I'd like to revisit the comment made by Professor Boughton, who said it is the result of the effectiveness of immunisation programs that most young parents do not realise how dangerous some conditions are. I would like to finish today by sharing a story of a Western Australian family who I met a number of years ago and who continue to be huge champions for vaccination. They have had very personal and deep experience of just how dangerous vaccine-preventable diseases are. I refer particularly to Catherine and Greg Hughes, who've experienced what no parent should have go through, losing their baby boy to whooping cough. At three weeks of age, Riley started displaying a mild, cough-like symptom and developed an occasional cough. The doctors began treating him for pertussis, commonly known as whooping cough, but on his fourth day in hospital he was taken to the paediatric intensive care unit with pneumonia. These are Catherine's own words about what happened:

His heart was failing, his lungs were filled with thick mucus, as the toxins from the pertussis and the subsequent pneumonia had ravaged his body. My whole world was crumbling, and while I don’t think I was a total mess, inside my heart was breaking. We mentioned that when it was time for him to go, we’d like to be holding and cuddling him, not have him lying alone on the bed. The rest of the morning was spent crying, texting family and friends about what was happening, spending time with Riley, and asking my brother to bring in our three year old daughter so she could say goodbye.

This is the heartbreaking reality of these diseases and the reason that we cannot be complacent about the importance of vaccination. If that wasn't enough for the Hughes family, they were then subject and continue to be subject to a targeted campaign of online abuse and harassment from the antivaccination movement. But they have kept up their public campaign, because they know better than anyone else the devastating consequences of these diseases.

There is a generation of Australians who remember growing up facing the threat of vaccine-preventable diseases. Some of them live with the impacts even now. As an example, in 1953 Australia had just come through its worst ever polio epidemic. At its peak about 10,000 people a year, mostly children and teenagers, were coming down with polio. One of them was my mum, who died around this time last year. She spent a year in Fairfield Infectious Diseases Hospital at the age of 17, having contracted polio. She described the absolute terror that swept through communities and families when a polio diagnosis occurred and when polio was within communities. We have been very lucky in Australia that we don't have polio anymore. Australia started using the vaccine two or three years later, and by the end of the 1950s the disease had almost been eliminated in this country. That is the power of vaccines, and that is why we need to do everything in our power to ensure that the importance of vaccination is not forgotten by society.