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Monday, 23 November 2015
Page: 8547


Senator MOORE (Queensland) (10:01): Labor will be supporting this bill, the Social Services Legislation Amendment (No Jab, No Pay) Bill 2015. I reviewed the comments I made when we were talking in the last process and I saw that, at that stage in the debate, I pointed out a number of the concerns that I have with the legislation. I continue to have the concerns that I raised—about the need for education, the need for certainty, and the need to ensure that people and their views are respected effectively in our community—but it is very clear that Labor supports the legislation. We believe that there is a need to have strong immunisation policies in Australia. The evidence that we as a committee have received indicated that that was important and that it was real.

However, I also want to talk about some of the things that we need to get right in introducing this legislation because, as I said in the previous contribution, there will be a group of people in our community who reject immunisation, who do not believe in its effectiveness, and who are actually quite fearful about the processes. Those people will not change their views. Many people have spoken to parliamentarians about their concerns. The people who genuinely reject vaccination have strong views and will not change these. But we need to listen to the questions that are being asked, to respond effectively, and to ensure that the information process is accurate. I have spoken about my concern that I do not believe that the department was able to convince us effectively during the committee process that the education campaign which must go with this legislation is fully developed and effectively funded. In fact, to this day we still have not got the full budget to discuss in this place.

I know that there have been effective processes in Australia looking at the need for immunisation, and we pointed in the discussion to what had happened with some of the then Medicare Locals, where there was intensive effort put into particular regions to make sure that people knew about the value of immunisation, to talk about the safety issues, and to acknowledge that there was a need for people to make decisions and also to find out about the processes. That worked, Mr Deputy President—for the Medicare Locals which had this as a priority, we know that there were changes in the vaccination rates in those regions. Where this was not a priority, there continued to be a lack of effective information, and also fear—people were not certain about how the process worked, and about how it should work.

So, when you are introducing legislation as decisive as what is before the chamber today, what must go with that is the education and engagement program—well funded, well targeted and also done with respect so that people who have differing views are not excluded, demonised or ridiculed but have their views acknowledged with acceptance that there will not be agreement. That is important in ensuring that any program of change is effectively brought forward.

Another element is the Australian Childhood Immunisation Register. One of the parts of this legislation which has not been discussed as fully as others is the fact that now the registry vaccination program is there not just for early childhood but through until the late teens. We need to have an effective registration process for the whole of our lifetime of vaccinations. That has not been in place in the past. In fact there was considerable discussion around the way the current Australian Child Immunisation Register operates and there was a recent ANAO report which looked at the operations of that register and made suggestions for how the process could be improved.

Evidence that we received at our inquiry talked about some real concerns that the data was not always accurate, that there could have been multiple registrations made to this register and that by the evidence we received it was felt that perhaps it was not seen as a priority by the people who were putting this data into the system. We know this is an issue across the board in our systems with data collection and maintenance. If we are going to be sure that there is going to be real knowledge of what is happening with vaccinations across our nation, we have to have confidence that the data is accurate and that we will be able to use the Australian Childhood Immunisation Register effectively and with confidence.

That was part of the discussion we had during the committee process. We needed to ensure that the work which was done by the ANAO, which was looking at how the register was working now and also at the operations of the register into the future, would be accepted by the departments and by government and that there would be confidence that the register would be accurate. We did not at the inquiry because, naturally, the department that was in charge of the register was not there to provide evidence to our committee, but subsequent to the inquiry we did get evidence back from the Department of Human Services that said that they were meeting the time line of change, that they were confident that they had the resources and the skills to ensure that the register would be accurate and that we would be able to know that this register, which is kind of the infrastructure of vaccination, would be accurate. People would be able to have confidence that their details were accurate and that, when we have a system which is actually saying that you are not going to be able to receive payment unless you are up to date with your vaccinations, there is knowledge about what the vaccinations are, what is needed and what is required. The register would be able to confirm that you have received that process.

We accept the evidence provided by the department that they are aware of the needs, that they are working to cleanse the data and that they are ensuring that the site will be functional and secure by September 2017. There does seem to be a reasonable expectation that, if we bring the changes in on 1 January, it will take time to make sure that the system catches up and the register will be accurate.

In terms of ensuring that we actually know where there is genuine conscientious objection to using vaccines, the new system needs to have some consideration. This is something we discussed and put back to the department. We need to know where there is conscientious objection to vaccination so that we know where there are areas that may well have a lower vaccination protection rate. The department took that on board, and at this stage that is part of ongoing discussion to ensure that we do not lose contact, that we do not lose information about where there are and are not effective vaccination rates in the nation.

We know that this debate will continue. As I have said, there are people in our community who will not accept vaccination, and that is their right. Nothing in this legislation actually says that not taking up vaccination is illegal. What it does is change the family payment regime and the childcare benefit regime around having vaccination up to date. This is actually an extension of existing legislation, and we know that there have already been processes where we link access to family payments with vaccination, so this is not new, but it is wider and takes up more people. We need to ensure that we are working with the community to explain the reasons and to point out to them what the background to this process is and how it is going to operate.

During the committee process, the Labor Party recommended—and the committee took up this recommendation—that there would be reviews of how this legislation is operating after a year and after five years, with very intensive scrutiny of how this legislation operates—making sure the register process and the public campaigns of education and awareness are in place—and also of the impact of these changes on the childcare area, as I said. We do not think this is something that should just wait for the standard review process that is natural in departmental processes. I would be very interested to hear from the minister about whether there has been any agreement to the recommendations that the committee made about this concept of having a very intensive review, almost from the start, of how the legislation is impacting, who is affected and whether we get changes to ensure that the vaccination rates increase. It would be useless to introduce such a significant piece of legislation and not know how it is going and how it is working from the very start.

So I would be interested if in the minister's concluding comments and in committee, if it should go to committee, we can get some clear indication that the department will be taking up a very intensive review process which is linked to the necessary engagement with the community, with people who do not agree with vaccinations and, most importantly, with the almost seven per cent of people and families in our community who are non-vaccinators, who have not registered as conscientious objectors but have not vaccinated their children. That is the group that I believe will be most benefited by this change, but it will not happen if we do not work with them, if we do not have the engagement campaigns and public awareness campaigns targeted clearly, and if we do not get effective information out of the department about where the people are.

I think I have shown my frustration on a number of occasions during my contribution about the lack of information that we were able to extract from the various departments who have a role to play in this process. We need to have the data. We need to know where vaccinations are occurring and where they are not. Only then, when we find out where people are choosing not to vaccinate and why and we work in a targeted way with that group, will we be able to reach the kinds of results that this legislation is designed to do.