South Australian Public Health (Early Childhood Services and Immunisation) Amendment Bill

Second Reading

I rise to speak on the South Australian Public Health (Early Childhood Services and Immunisation) Amendment Bill 2020 and indicate my appreciation to the Minister for Health for progressing this matter in the parliament. Whilst there appears to be some criticism from the opposition as to the pace with which this has been developed, advanced and now presented for the final part of stage 2, I do note that the member for Kaurna was part of a government that had 16 years to develop this. Really, in the dying days of that government—

Mr Picton: Since I was at uni?

The Hon. V.A. CHAPMAN: —yes—they advanced this as an important initiative. I can recall minister Portolesi making comment in this house about how important it was to have no jab no play and, as usual, there were lots of promises in that regard and no delivery. Nevertheless, I agree with the member for Kaurna on two things: one is that this is an important piece of legislation and it is an important issue to be resolved and, furthermore, I appreciate and am very pleased to hear that, as a parent himself, he endorses the benefits available for immunisation generally.

Can I firstly address the bill itself, which is really part 2 of the legislative program of reform. What has been in the first stage is the passage of the first amendment to permit the Chief Public Health Officer to exclude children who are at material risk during an outbreak of a vaccine-preventable disease and to obtain immunisation records from early childhood services during an outbreak or risk of an outbreak.

The second stage—which is what we are dealing with now, phase 2 of the bill—proposes financial penalties of up to $30,000, as has been indicated, for someone who breaches the obligations there. In particular, it allows a child to fail to be up to date with immunisations in order to continue to attend at an early childhood service, obviously with the usual regulation powers to be able to be effected and enabling a penalty to be applicable also to a childhood service provider who does not comply with the exemption requirements.

Some commentary has been made about the need to ensure that, while we value and applaud the benefits of immunisation and COVID-19 is a contemporary example of exactly why it is so important, nevertheless there are children who are unable to be safely immunised. They may have a respiratory condition or some other medical circumstance that would place them at risk in relation to that. Parents need to be able to have oversight in respect of their child's health, and that includes immunisation in those circumstances. They need to be able to have some exemption, and provision has been made for that, as it should be.

As to the conscientious objectors generally, can I say this: whilst there are very strongly held views by some that there should be no population health immunisation and that there should be a capacity to dissent from the benefits of this and therefore have some exclusion, I appreciate that they are passionate about that, but if I could just recount the situation. As the shadow minister for health, about 15 years ago I attended the World Health Organization in Switzerland, and I was briefed on a number of matters.

The thing that surprised me more than anything was the urgency of those who were providing advice as to the two things they saw as the 21st century problems in respect of health. I expected them to talk to me about poverty-stricken countries, cholera in water and all sorts of things of that nature. In fact, they described to me the problems of infectious disease—in countries where we would expect it to be, perhaps in Africa and those less fortunate economically, but also in our own communities—and, secondly obesity, which was at a pandemic stage from their description. I found it a very enlightening period of meetings on that day.

Two things were very passionately put within this envelope. Firstly, they wanted to know about the Institute of Medical and Veterinary Science because they knew that it was headquartered in Adelaide at the time. Of course, what was left of it after the previous government stripped it down and took pathology in-house is now our SA Pathology entity, which members are quite familiar with. They wanted to commend the IMVS because of the work that it was doing and had done over a number of years with polio and smallpox. I think they also suggested that they were quite active in both the testing and treatment of tuberculosis.

This work was having international benefits. They wanted me to be very proud—I was—but also to be aware of how much they appreciated, in the World Health Organization public health arena, the importance of the work that the institute was doing here in South Australia and the significance of its testing and advancements, its published activity that it had presented over the years and the extraordinary gift that it was giving to the world in relation to communicable disease.

Bear in mind that, certainly in my time in the eighties and nineties, we came through what I think was also a really difficult period, which was the transmission of HIV. In the 1980s, if contracted it was likely to be a death sentence. As a transmission through bodily fluids, it was something that resulted in the death of a very large number of adults. Often there were practices of unprotected sex between consenting adults, who were either same sex or opposite sex.

I recall there was a terrible period in South Australia when blood was being provided for transfusions, often for newborn babies, and the blood was contaminated in the donation system that used to operate in those days and a number of babies died when they contracted the disease and, of course, it developed into AIDS. As I say, it was a death sentence.

From time to time we are faced with these really difficult periods and real challenges and we are in one at the moment. The World Health Organization were very keen to say that this issue of infectious disease is something that is a plague across the world and we ought to be aware of it because it was a big challenge still for the 21st century, even though, at first blush, I thought we had got through all that. I had not personally lived through polio epidemics, but my parents' generation did.

Recently, but not that recently now, I launched a book in relation to the John Martin's pageant and the author provided pictures of children wheeled down from the Royal Adelaide Hospital and what was then the children's hospital. They were in beds, having been sentenced to bed rest as a result of polio being contracted, and there were rows and rows of them lined up along Rundle Street to watch the John Martin's pageant.

Sometimes it brings home these really tragic periods during which whole generations of our children, and sometimes into adulthood if they have not had measles or chicken pox as children, contract these diseases and to have these conditions as adults can be very difficult and sometimes fatal. The World Health Organization were very keen to recognise the IMVS, but reinforced to me the importance of us being really vigilant in this area and that it really is a very serious situation in parts of the world. We might episodically find out about it, but it is really a killer across the globe.

I agree with the member for Kaurna that it is important that those who are having children now consider this matter seriously and not only think carefully about the future of their children, their education and their own advancement but make sure that in the health space they seriously look at this question of immunisation. I am very pleased that my own children and their wives have made decisions to immunise their children.

I think I said to one daughter-in-law at one stage that this would probably be the one issue when I would have to suppress my otherwise genteel approach to relationships like that and have to have something to say about it if they made the decision that their children would not be immunised. Fortunately, I was spared that. So, in my usual mild way, I was quietly able to compliment them on making that decision and not express how I really felt about it. That was pleasing in itself.

Probably, sometime in May, I would have been lining up with my eldest granddaughter, Adelaide, to have all our immunisation shots for Africa. COVID-19 has put that trip on the backburner and hopefully we can do it next year. There are meningococcal and other conditions, which again we are largely isolated from, in the regions that we would be visiting. I had trips with my late husband to regions on the African continent, and we had to be really vigilant.

Sometimes, looking outside the comfort of our own little area like Adelaide, we realise how much the world relies on us doing the responsible thing, especially when we have access to vaccines and funding to be able to support that—a lot of this is publicly funded—and that we need to make sure we do everything we can to ensure that as many of our community as possible are immunised.

I also remember that minister Portolesi at the time raised this question about what she might do in relation to childcare centres and the obligation for children to either be immunised or not be able to have access to these facilities, and it was a bit of a challenge. Obviously, there was a concern about having something mandatory. Everyone gets a bit unnerved about that, but overwhelmingly the parents that I spoke to, who also had children at childcare centres at that time when my grandchildren were at childcare centres, were very clear about having immunisation. They did not want their children to be attending a centre where other children were not immunised. They did not want the risk of that, and they wanted that to be very clear.

Of course there are occasional exceptions to that, but the sentiment was very strong, and I think that it is one that we need to respect and, of course, keep ourselves up-to-date with to make sure that we understand how our parents of today are making decisions in relation to that for their children and to make sure that we give them every support possible, including through this legislation, to protect those children and to give them a future.

I thank the minister for bringing the matter to the parliament's attention, that is, the Minister for Health, and of course my colleague the Minister for Transport for ably presenting it to this house.