Abbott Government give up on preventative health

04 June 2014

Mr STEPHEN JONES (Throsby) (18:45): I rise to speak on the Australian National Preventive Health Agency (Abolition) Bill 2014, the sole purpose of which is to abolish the only agency dedicated to preventative health policy at the Commonwealth level, the only Commonwealth agency capable of delivering the sorts of programs that my friend the member for Fremantle and my predecessor in the role as assistant shadow minister for health outlined so eloquently in her address on this bill. I think if you want to understand the disposition of those who move such legislation in the House, it is instructive to look at what they have said on the matters in the past, and I did exactly that. I had the opportunity of availing myself of the second reading speeches of the then Minister for Health, former member for Gellibrand, Nicola Roxon. Some excellent speeches were made in the introduction of the original bill which founded this agency. She talked about the fact that it arose out of discussions and consultations through the National Health and Hospitals Reform Commission. There were consultations at the COAG level, and it received expert advice. The tenor of that advice was that we needed a stand-alone expert agency to focus on the issue of preventative health. We needed to do that because the existing department, as good as it was, did not have the sole focus on preventative health measures. That is the tenor of the second reading speech of the then Minister for Health.

I then pulled down a copy of the second reading speech of the now Minister for Health, who sponsors this bill that is before the House. I think the attitude in that speech is very revealing of why we are now debating a bill to effectively dissolve the Preventive Health Agency. I will concede this: it is always very dangerous to pick up a speech from a member of parliament and focus in on one or two sentences and say, 'This is the ratio of the argument.' Nothing bespeaks the attitude of the Minister for Health more than this contribution in his second reading speech on the National Preventive Health Agency bill, where he had this to say:

The issue is complex. As unpalatable as it may be, the taxpayers should pick up the bill through the health system for someone who lives their life with reckless disregard for the health consequences. Government intrusion into an individuals life and lifestyle should always be closely scrutinised.

I think that says it in a nutshell. Before he has already started, the minister has thrown his hands up and said: 'There is nothing that we can do in this space that is going to make a difference. The only thing we can do is pick up the bill at the end of the day.' It really is an extraordinary admission from the same minister who is introducing proposals into this place which are going to massively slash Commonwealth expenditure in the health areaover $80 billion of cuts in health and education funding to states and massive cuts to expenditure in other areas of the health portfolio. So it is really extraordinary that you have the minister before he even gets going saying, 'The only role as the Commonwealth is to pick up the bill at the end of the day. We have no role in saying anything about the lifestyle choices or the consumption behaviours of consumers.'

You do not have to go back to 2009 to see those sorts of attitudes when it comes to preventative health. I have the great benefit of sitting in front of gorgeous George Christensen, the member for Dawson, in the House of Representatives. I am often amused by his contributions. We can share a joke but we do not share many opinions on many things. When I listened to his contribution in this debate, I formed the view that he represents the extreme libertarian view on this particular matter. The member for Dawson was essentially saying that there is no role for government in preventative health, that individuals should be able to eat what they like, smoke what they like and drink what they like in complete disregard of the consequences, and there is no role for government in this space.

I agree in part with the member for Dawson. It is not the role of the government to stand by the pantry door and tell people what they can and cannot eat. It is not the role of government to stand by the bar and say, 'Do you really need that extra middy?' It is not the role of government to be standing outside the building, except in the planning sense, and telling people, 'Really, you should put that cigarette away.' But it is the role of government to be engaged in education, to be engaged in research and to be informing the public debate. It is certainly the role of government to be informing the public debate about the consequences of our lifestyle choices. I have said at this dispatch box before, if we were to just leave it to business and if we were to just leave it to civil society, we would not know a hell of a lot that we now know about the negative health consequences of many products that are on the market. I have used the example of asbestos in the past. Had it not been for the research organisations funded by government and ultimately the regulations by government, the health consequences of that building product would not be known. And we could, without dragging the analogy too far at all, make the same observation about so many other things.

I do not agree that it is the role of the government to be some sort of statutory fat-controller, but it certainly is the role of government to engage in education, research and dissemination of advice. It is simply not good enough for either the member for Dawson or the minister to be saying, effectively: 'The role of government is to pick up the bill. We've got no say about what's on the menu; in fact, we should remain completely silent about what's on the menu. We just pick up the bill at the end of the meal.' I think most Australians would find that view completely unsatisfactory.

There are a number of medical practitioners within this House, and you would normally rely upon them, in a debate such as this, to shine some light upon the issues before the House. That is why I tuned in to the contribution of the member for Lyne, who is a medical practitioner. I thought, 'This is a bloke who's going to be able to shine a bit of light on this debate and add a bit of sense to it.' I thought he might have something to say. So I listened very carefully to what he had to say in this debate, and I have got to say: never this evening was I more disappointed. His stunning contribution to the debate in the current environment was: 'We don't need a preventive health agency because we've got doctors and dieticians out there who can provide this sort of advice.' Knock, knock, Dr Gillespieyour side of the House is trying to stop people going to doctors and dieticians by putting in place a GP tax to make it more expensive because you think people are going too often. So to suggest that the answer to having a Commonwealth-funded preventive health agency is available through our GPs and dieticians shows that the good doctor is just not with the program.

The member for Lyne also suggested that the agency was somehow redundant because we had cooking shows and TV ads which filled the space. Well, the good doctor from Lyne simply has not been following the public debate on this issue. And there are a lot of things that I see advertised on TV that I am sure, when he was in private practice, he would not have been recommending to many of his patients.

The most stinging criticism that he made of the agency, and the reason he gave for it needing to be abolished, was that it had too many experts advising it. I can say to the good doctor: if there had been a few more experts advising the minister and the Treasurer over the last couple of months, they would not have made some of the stunning mistakes that they have made. A few experts might have been able to tell their Commission of Audit, and then the Treasurer and then the Minister for Health and the Minister for Social Services, that in fact Australians are not visiting a doctor on average 11 times a year, as they have built their whole health policy upon; it is actually less than half of that. If they had listened to the experts, they may have not built a health policy, the GP tax, on this terrible mistake.

If they had listened to the experts before they introduced these proposals into the House, they probably would not have had a string of experts from here to Hobart lining up to bash down their doors, saying: 'You've got it terribly, terribly wrong. Your GP tax is going to have a terrible impact on public health outcomes in this country. Your proposals to hike the PBS payments are going to have a terrible impact on public health in this country. And your cuts to health and hospital funding are simply unconscionable.' If they had listened to the health experts, they might have listened to advice such as this.

The work of this agency is too important to be glossed over. It focuses on some things that really ought to be at the centre of the public health debate in this country. Many other speakers have talked about the importance of having strategies around alcohol abuse and obesity, and 'Quit smoking' and antitobacco messages. I think these are all critical strategies.

But I would like to say a few things about the important work that the agency is doing when it comes to men's health. I am very pleased to see the member for Port Adelaide at the table as I make this contribution, because I know that he was very involved last year in the launching of a men's health strategy, and was particularly focused on the importance of having a mental health strategy for men. But he would recallas I recall and as other members on this side of the House would recallthat, when we launched those policies, we had bipartisan support. We had former Liberal Party premiers up there as guest speakers at the event; we had former Liberal Party chief ministers backing the initiative; and we had a front rowyou may even have been there yourself, Mr Deputy Speaker Vastafull of Liberal Party and National Party MPs standing there saying: 'It is critically important that we have preventive health strategies addressing the issue of men's health.'

We know that there are particular issues when it comes to men's health. Men are four times more likely than women to commit suicideit is five men a day, on average. Men are more likely to suffer from chronic diseases, cancer, heart disease, and a whole range of other issues. And if we are going to address the issues associated with men's health then we need a preventive health strategy.

We do not have a preventive health strategy. What we have in its stead is a wrecking ball. Instead of having a proactive strategy for dealing with preventable health issues, what we have is the GP tax. We have slashing of funding for hospitals in the states' health systems. We have the tearing up of the National Health Reform Agreement; we have the tearing up of the National Partnership Agreement on Preventive Health; we have the tearing up of the National Partnership Agreement on Improving Public Hospitals. The list goes on and on: the National Preventive Health Agency, which we are debating today; Health Workforce Australia; Medicare Locals, which are having their role downgraded; the Private Health Insurance Ombudsman and council; the Australian Institute of Health and Welfare; the National Blood Authority; General Practice Education and Training; the Medicare Safety Net, which is going to be altered; the Pharmaceutical Benefits Scheme, which is going to be alteredin fact, everything that we have built up, not only over this term of government but over the last 30 or 40 years, is standing in front of their wrecking ball. They do not have a policy for preventive health; they do not have a policy for public health. They have got a wrecking ball, and the people of Australia are being asked to pay the consequences.