Thursday, 5 March 2020

Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020

Second reading

Debate resumed on motion of Mr FOLEY:

That this bill be now read a second time.

Ms KEALY (Lowan) (10:10): It is a great pleasure to rise today to contribute to the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. This is of course a topical bill when we are talking about vaccinations, and particularly when we are talking about exposure to viruses and various other illnesses, when we look at our supermarket shelves and are not able to buy a roll of toilet paper because of concerns around the spread and impact of coronavirus.

I have heard from back in my fabulous electorate of Lowan—the biggest and best electorate in the state—around what will happen in terms of not just people who are at risk of coronavirus, not just the supplies if we do need to bunker down for a fortnight or more if we are going into quarantine, but also the impact for small business, which I think is a very fascinating area to look at. I know of a local small business that has been told that 25 per cent of its supply lines have been held up because they are sourced from China and it will not be until around June or July before we see flow of those supplies again. So we know the retail sector is hurting. We know that certainly there is a lot of pressure from big businesses coming in. Our locally owned smaller businesses are really struggling, and I do fear for the future of a number of small businesses, whether they are retail or whether they are in the restaurant scene. When you look down Chinatown—I had dinner down in Chinatown on Monday night—there is barely anybody down there.

We are going to have a lot of Victorians who are really going to struggle over this period. It is not just about the health impacts but certainly about how we can support the valuable people who run our small businesses and keep our state running. I do hope this government does prioritise support for these groups, because without them Victoria will certainly be floundering and will go backwards, which is not something that anybody wants to see.

The purpose of the mandatory vaccination of healthcare workers bill is, as it states in its long title, to amend the Health Services Act 1988 and the Ambulance Services Act 1986 to allow the secretary to direct public health providers—which includes hospitals, ambulance workers and community health services—to require vaccinations for all staff, subject to some exclusions. Those exclusions, from my reading of the bill, are specifically medical exclusions.

We have heard from many people over the past few weeks since this bill was tabled who have raised concerns around vaccinations and particularly mandatory vaccinations. Some of those have been on conscientious grounds, and I do note that is specifically excluded from this bill as a reason not to get vaccinated. But there is also concern from people who have legitimate medical reasons to not be vaccinated. In addition to that we have people who object to vaccination on religious grounds. Again, that is specifically excluded from this bill.

But I would like to speak to the issue of people who cannot have a vaccination for medical reasons. I have seen this firsthand in the medical sector. There are some individuals who, for example, have an egg allergy. Many vaccines are based on albumin as the carrier for the vaccine, and so obviously there would be significant complications and reactions within that individual and they simply cannot have that vaccine; it is not compatible with their own health and safety.

There is not a lot of detail around what is acceptable as a reason for a medical exemption under this legislation, and I would seek further information from the minister and her office around the specifics of that because I think when we are talking about medical exemptions we can be quite specific in terms of the conditions that would be compatible with an exemption from the mandatory vaccination requirement.

In regard to other elements of the bill or concerns that have been raised with me, they are around what the impacts will be for employees or those engaged by health services should they refuse vaccination, but they have built a career and are important contributors to Victoria’s healthcare sector. We know now that even though there have been different rates put in place—minimum rates and expectations upon health services and other health providers that they reach a certain level of vaccination rates—we have not been able to improve upon about an 84 per cent coverage of relevant employees, which leaves 16 per cent of the medical workforce impacted by this bill in a way that they will have to change what they have been doing. It may be that they have to now get vaccinated. It may be that they are now directed by the secretary that their employment will be terminated and their career will be over.

This is something that I completely understand as somebody who studied immunology and as a biomedical scientist. We do need to do all we can to achieve herd immunity, for healthcare workers in particular because they are more exposed to people who have otherwise preventable diseases—vaccine-preventable diseases. They also because of the nature of their work go from patient to patient providing amazing care and support for individuals who are unwell. Because of that and because they work with people who are immunocompromised, often there is a situation where they could act as the vector. So even though they are young, healthy, fantastic individuals who may just have a sniffle, they may carry that inadvertently from one patient to another, putting others at risk. So it is important that where we can we do achieve herd immunity within our healthcare worker population and across our entire population, not just in Australia but across the world.

It is difficult to achieve herd immunity, and I think we have experienced that when we look at polio. The aim a number of decades ago now was that we would be able to eliminate polio in the community, but it has remained at that stubborn level where we have not been able to provide herd immunity which has sufficiently halted the disease and allowed it to die out. Unfortunately, and to great shock in some countries that simply cannot afford vaccinations or cannot access those vaccines, we have situations where now people are refusing to vaccinate even though they can afford to do so. I think that for some people, particularly those who cannot afford it and those who are in areas where they cannot access it, they find that quite a contradiction—that their people are dying while others are choosing not to be vaccinated.

But it is a question when it comes to employment, and I hark back to my time when I was at university and I studied an elective of morals and ethics of today. There was a similar question posed to us: what happens if the rules change when you are in the midst of employment? Specifically for nurses, what happens if the rules change where you are against vaccination for yourself, particularly if it is on religious grounds; however, part of your employment requires you to do so? So for future nurses and all healthcare workers I think there certainly will be an expectation that you are vaccinated, and some religious groups will choose therefore not to enter the sector. For others who already work in the sector, this will be a very, very confronting time for them.

The consequence may be inadvertent and perhaps it does not have the overall weight of carriage rather than providing herd immunity and protecting other healthcare workers and their patients from vaccine-preventable diseases, but it certainly does raise that question over whether somebody should have their employment terminated when they entered into an employment agreement where it was not a requirement to have a vaccination—they could do so and live through their religious beliefs in doing that—and then there is a change in legislation which means that they could be sacked.

There is not a lot of information around what the consequences will be for employees or those engaged by health services if they choose not to get vaccinated or if they have a medical exemption for vaccination. In terms of that there is conflicting information between the statement of compatibility and the minister’s second-reading speech and the legislation in terms of whether that requirement is a directive straight from the secretary to the employee or whether it is the health service employer’s requirement to provide those directives. I think there is some conflict in there, and it would be good to seek some clarification from the minister’s office around that.

I do note that there is the opportunity for the secretary to revoke or suspend the registration of a health service if they fail to achieve the mandatory vaccination targets, which will be rolled out in 2021—next year. For some areas I think this needs to be balanced in terms of the provision of health services themselves. While there are plenty of alternatives and different options for health service providers in metropolitan areas, in some of the more rural and remote areas of Victoria there are significant shortages of particularly nursing staff, doctors and also allied health providers. If a significant number of these workers are told in a very short time frame that they cannot have any patient contact, I do fear that those positions will be unable to be filled. We find them very, very difficult to fill currently. It may mean that there will be a significant reduction in health services because the employees or engaged staff are not available.

Secondary to that, if the hospital are working hard to recruit to those positions but they cannot, they therefore will have a choice: do they run the risk of deregistration or suspension or revocation of their registration to provide any services at all or do they just close a specific service to the community? Where there is not an option—the option may be 100 kilometres away—there will be significant impacts from that.

Now, there is limited detail on how those directives from the secretary in terms of suspension or revocation of the registration of a health service would be implemented. There is very limited information in terms of the time frames that would be involved in that or the consideration of how that may impact on the general population being able to access the health services that they deserve. I do believe that a great amount of security needs to be given to particularly our smaller communities, who have no other option but to go to their local hospital, their bush nursing centre or their community health centre when there are no other options around. I do seek that reassurance and clear information to be provided to not just the health services in those regions but the people who rely on those very, very important health services, where people are doing an amazing job. It is more than just a job, it is more than just a shift that people go to work; it is part of their community. It means a lot to them, and that is why they live in those communities.

We have seen many, many times that rural communities do slow down and shut down because they start to lose their access to key services, whether it be their local school, whether it be healthcare services or whether it be a police station that has closed down. We do need to make sure that we do not inadvertently progress the demise of some of our smaller rural communities by creating an expectation which is unachievable when we have got such a significant staffing shortage around our health workers in rural and remote Victoria.

There are also other elements. We know that vaccinations do cost a lot of money to deliver for health services. While I believe that generally health services would be supportive of achieving 100 per cent vaccination rates if they possibly could, their only barrier would be that they may not have the funds available to do that without cutting other services within the hospital.

Always—I think we see this through many pieces of legislation, and it is something I have spoken about on a number of occasions—if we are going to make legislative changes that mandate a requirement on a health service or any public body, we need to ensure that there is a similar amount of funding that is provided to these organisations to achieve that goal. We also need to ensure that there is adequate support from the department to implement these types of policies and also for the provision and monitoring of staff.

Again, we need a little bit more information when it comes to vaccinations in terms of the schedule of vaccinations or the specified diseases that staff will need to show immunity to. We need to understand how this will be measured across the year. Putting a sort of audit date at the end of the financial year, which I could see could be the concept, may not be compatible with certain viral illnesses, such as the flu, as the flu season covers that June–July period and crosses over between two financial years.

There are other concerns around the supply of vaccines, and we have certainly seen that over past years. It happens with most vaccines that at some point in time there is a shortage and it becomes very, very difficult for one reason or another to access those vaccines. If you cannot access the flu vaccination before flu season and it only becomes available right at the very end of flu season, when the risk is extremely low, will the mandated vaccine schedule still apply? Will it mean that hospitals may be at risk of having their registration revoked or suspended because they simply could not vaccinate their staff because the vaccine was not available?

Then we have the other complex issue, which is around new diseases such as coronavirus. We know that there are many, many research scientists who are working exceptionally hard to create and develop a vaccine against coronavirus. We need to understand from the government where the priority will lie. When we have the mandated vaccination legislation, will the priority lie with the healthcare workers or will it lie with the most vulnerable people in Victoria who are most at risk of mortality as a result of having coronavirus?

I think that is an interesting question as we know there will be a very, very high demand for the coronavirus vaccine when it becomes available on the market. There is no doubt there will have to be priorities given, whether they are given to those that are immunocompromised or to elderly residents, who seem to be more at risk of mortality in relation to coronavirus, or whether the priority will be to vaccinate healthcare workers who will be mandated, in accordance with the legislation that is before us today, to receive the vaccine. We just need to make sure that there is good planning around that and that all care is taken to make sure at the end of the day we are providing the best supports for our greater population to achieve herd immunity and also protect our population from otherwise preventable or vaccine-preventable diseases.

I raised earlier the issue around bush nursing centres, and they do a fabulous job. They deliver healthcare services in areas of Victoria that do not have access to any other public health services. It is extremely concerning that their funding future is on the line. I have received a number of concerns from my local constituents who rely on bush nursing centres but also may be employees of bush nursing centres as to what the future might look like. These are fantastic little organisations, and they are the frontline healthcare workers for many of our communities. They do make me smile because they do such a great amount of work. Sometimes they are the ambulance officers; sometimes they are the only nursing staff who are available to help someone who has been in a car accident, who has had a heart attack, who has broken their arm. They are sometimes the people who are pushing the exercise programs and pleading that people start to do a bit more exercise and eat healthier foods. They do fantastic fundraisers for the community to ensure that they have got the best possible equipment and infrastructure available.

They rely on a pittance of funding from the state. Without that funding though these organisations will close. For many of our towns—I think of Harrow, Balmoral, Lake Bolac and Dartmoor in my electorate—without bush nursing centres these communities would have to travel 100 kilometres to get to their nearest hospital or GP. We simply cannot have that scenario where because you live a long way from a major centre you do not have access to health services, so I do plead with this government: budget time is coming up—please secure the future of bush nursing centres because they are so important to our rural communities. As I said earlier, if bush nursing centres and access to health services do not exist in some of these towns, these towns do not exist—people will not live there. Please support our bush nursing centres.

Again, thank you so much to our fantastic bush nursing centres, whether you are an employee or whether you are a volunteer. They run on the smell of an oily rag, and the volunteers really do prop them up. Thank you for all your work and for making a difference in your community. That is what we are all here for. It is what drives each and every one of us. Whether you are a parliamentarian, a business owner or anybody in the community—a volunteer—all you ever want to do is to make a difference, and I know that bush nursing centres are certainly achieving that.

I had the great privilege to attend the Wimmera Machinery Field Days yesterday, and I was speaking to the local primary care partnership (PCP) manager, Geoff Witmitz, who is an absolute superstar, is extraordinarily humble and has done so much great work around filling the gaps in our healthcare system or pulling together all those little dribbles of money to deliver amazing health services in our region. One of those is the rural outreach worker. We have extraordinarily low access to mental health supports in my local area, and the results speak to that. We have certainly issues around whether you see a social worker. We do not have a lot of visiting psychiatrists; I do not think there is any visiting psychiatrist at all at the moment. When it comes to youth mental health there is nothing available, so this is the first port of call and the only support available for many people in our rural regions. Without the PCPs I do not think the rural outreach workers would be there, and I know firsthand that there would be many residents in our community who simply would not be with us today. These people save lives. They do a fantastic job.

PCP funding is on the line. It is really, really sad to see that the work of so many fantastic individuals could just disappear at the end of June because of a small amount of government funding. PCPs will be celebrating their 20th anniversary later in this month. It is next sitting week. I do invite all MPs to come along and hear about the great work they do. I think sometimes there is a lack of understanding or a misunderstanding that they are not delivering front-of-line healthcare services and therefore they are not important. But that is simply not the case. Having been on the board of the local PCP in the past, having seen firsthand the difference these organisations make, I know they cannot be replaced by primary health networks; they cannot be replaced by any other existing organisation. We need them. So, please, again I urge this government to provide that funding and make sure that PCPs can celebrate their 21st next year and their 50th in future years, because they are amazing and without them our people would not be nearly as well as they are now.

Going through the concerns that I have, it is really about the information that has been provided by the government—or the lack of information. Whether it is around what diseases and the vaccine schedule, when that will be audited and how it will be reported, whether it is around the funding available to hospitals and health services to achieve the goals of this legislation or whether it is around support for hospitals and other health services to implement this legislation and to monitor the processes, I think this information should be forthcoming before we go ahead.

Most importantly, there needs to be better information provided to those 16 per cent of healthcare workers who are currently unvaccinated in terms of what their options are. Will their medical exemption fit the secretary’s directives and therefore be acceptable? If it is for other reasons, what options will be available to them in terms of redeployment or moving outside of those frontline services? We know that for some that will not be possible. Lastly, if an employee is terminated on the basis of not being vaccinated, what supports will they get to seek and be trained up for alternative employment? We simply cannot turn our back on people because they have been terminated under legislation that they did not see coming in the future.

We do need to support all Victorians, and certainly the priority should be herd immunity and stopping the passage of viruses and viral diseases, particularly those that are preventable by a vaccination. But we do need to make sure that we look after those employees and do not leave them high and dry if they are unable to be vaccinated or, for other reasons such as religious reasons, do not wish to be vaccinated. So with that, we wish a good passage of the bill through this house and the other house, but we do seek that additional information, which I hope will be forthcoming from the minister in the other place.

Mr McGUIRE (Broadmeadows) (10:34): This bill is timely and pertinent, especially as the coronavirus becomes a pandemic. The Andrews Labor government is stepping up the fight against the flu and making vaccinations compulsory for frontline doctors and nurses in our hospitals and for paramedics caring for Victoria’s most vulnerable patients.

Last year’s unprecedented flu season put enormous strain on our hospitals, with more than 69 000 laboratory-confirmed flu cases. Victoria’s dedicated health workforce rose to the challenge and continued to deliver world-class care, and that needs to be underlined. The Labor government already makes the flu shot free for healthcare workers. These new laws will mean that healthcare workers must be fully immunised to protect themselves and patients against the flu each year, as well as whooping cough, measles, chickenpox and hepatitis B. All healthcare workers in public and private hospitals and ambulance services with direct patient contact will be required to be vaccinated, including doctors, nurses, paramedics, dentists, orderlies, cleaners and staff working in public sector residential aged-care services. Workers who refuse to be vaccinated may face restrictions or be redeployed to other parts of the health service.

The intent of these laws is to protect healthcare workers from preventable diseases while also reducing the risk of transmission to the most vulnerable in our communities, such as children, the elderly, pregnant women and people with chronic diseases. This is why this is important. I want to emphasise that last year the Labor government set a target of an 84 per cent flu vaccination rate among healthcare workers, which was well exceeded. It reached 88 per cent across the state; that is an incredible take-up rate and should be applauded.

Victoria’s landmark no jab, no play laws are also making a real difference in protecting children against preventable diseases, with Victoria’s immunisation rates still the best in Australia. Again, that was landmark legislation. that was important and that has proven its success. The Labor government is also making it easier for busy families to get the flu jab by reducing the age at which Victorians can receive it at a pharmacy to 10. This is another part of a raft of legislation and reform on prevention and how we actually address these critical matters. I think that is the important context to know and understand.

The member for Lowan has raised the issue of people who refuse vaccines on religious grounds. I have been informed and advised that the only exemption will be for medical contraindications. As the government has said publicly, workers who refuse to be vaccinated may face work restrictions or be redeployed to other parts of the health service. That is how that issue is going to be addressed. There will be exemptions for people with medical contraindications as defined in the Australian Immunisation Handbook. Healthcare workers who are unable to be vaccinated due to temporary or permanent medical contraindications should provide documented evidence of this to their employer. I hope that that addresses that issue.

I think that we really need to look at Victoria’s international leadership. We are world leading in medical research. We keep building on our incredible institutional clout that has been built up over decades. I had the privilege, as the Parliamentary Secretary for Medical Research, to join the Premier and the Minister for Health, Jenny Mikakos, earlier this week when the Victorian government provided another $6 million to the consortium led by the Peter Doherty Institute for Infection and Immunity. As people would know and understand, this is built around Nobel Prize winner Peter Doherty, and the elegance of the science that comes out of Victoria is world leading. Just to underscore that, the Doherty Institute was the first laboratory outside of China to grow and share the coronavirus. It is now working with other laboratories to increase Victoria’s capacity to rapidly diagnose infected people and to also develop better diagnostic tests to understand who has been exposed and how we can clear the virus without symptoms.

This is world-leading research. This is getting the collaboration that counts and having the institutional clout. And it is bringing together the Doherty Institute with Professor Sharon Lewin, one of our most eminent leaders. She said that it is a tremendous contribution from Victorian state government, and it will support Victoria’s frontline diagnostic laboratories and also bring together leading expertise in Victoria to tackle this global health issue.

COVID-19 is spreading fast around the world and it demands a global response …

is the way that she put it, and:

This funding will go a long way towards Australia’s ability to build capacity to prevent, detect and control this new virus.

And this is a collaboration also with the Burnet Institute, and Professor Brendan Crabb said:

… an urgent and highly collaborative research component is essential to an effective COVID-19 response.

With this support from the Victorian Government, Burnet Institute will extend its already close partnership with the Doherty Institute and other key partners to accelerate the generation of knowledge and new tools that will help minimise the impact of this new infection to our community. Research goes hand in hand with front line responses, one cannot be effective without the other, and Victoria is an international powerhouse when it comes to health and medical research.

That is another important proposition with the University of Melbourne. I just want to use this opportunity to call on the Australian government to actually look at establishing a centre for disease control based in Melbourne and anchored on this collaboration that has already been formed and well established with the Doherty Institute, the Burnet Institute and the University of Melbourne.

The other critical proposition to know and understand is that what is happening is these viruses are transferring from animals to humans. What we need then to have is the connection with the CSIRO down at Geelong, with the Australian Animal Health Laboratory. That is a facility worth hundreds of millions of dollars that has already been established, so Victoria has the institutional clout and it has the internationally regarded expertise, and this should be the critical centre. When you are in a pandemic you do not go parochial, you go for the world’s leaders and you go for the best.

I would argue that this should be one of the missions out of the Medical Research Future Fund rising to $20 billion. It looks like it was tailor-made to actually bring these institutions together—and I know that from Nobel laureate Professor Sharon Lewin to Professor Brendan Crabb and the dean of health at the University of Melbourne, they are all concerned to actually make this happen so that we have a critical mass of expertise to inform government responses. Of course we would obviously reach out and maximise our resources, so never forget Monash University and CSIRO; that they have connected in what I would call the great southern hub there, connected by Innovation Walk. I think that this is the time to bring these resources to the fore; for the Australian government to step up on the leadership. We have got the mechanism with the Medical Research Future Fund to establish a centre for disease control right here in Melbourne and to make sure that this becomes the centralised centre of excellence for emergency response to these issues as well.

Now is the time to act. This is an issue that is of international significance. It has already become a pandemic. In Victoria, by virtue of what it has already achieved—its leadership and excellence—now is the time to recognise this. Do not go parochial; be big picture, deliver on the vision and this will be the area that is the stand-out nationally. In the past this has become a bit of an issue between Melbourne and Sydney. Put that to one side, go with the world’s leaders, deliver the best result and help improve and save lives.

Ms BRITNELL (South-West Coast) (10:44): I rise today to speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. This is an interesting bill, because when you think about the duty of care that a health worker has you would instantly imagine that people would actually understand the importance of being immunised. As a nurse for many, many years I would never have dreamt of not being vaccinated if I was looking after neonates or infants. On a children’s ward of course you would make sure you had your pertussis up to date or every year the flu vaccinations. That was just part and parcel of the role.

I am pleased to see this bill, but I do have some concerns about how the bill will play out. I see that this was introduced in other parliaments—some four years ago I think is the time line on that—and I am disappointed to see that there is a lack of detail in this bill of how it will actually be implemented. Some of the questions I have got are: what vaccines are going to be included as mandatory? There are a number of vaccines—I think 192 vaccines are actually available—so what vaccines does this cover? You would hope it would be measles, mumps and rubella, your standard ones—but there is probably no need for some of the more exotic ones, and that is not explained in detail.

How will this be audited? It is often hard to get enough vaccines. In particular, out in the country we find it quite difficult to have the vaccines available when the season starts, and there is really no point if you are just ticking a box and you cannot get vaccinated until, say, August because the vaccine was not available for the amount of people requiring it—and that we have seen happen many times. What happens in this situation where the health professionals and the support staff are actually not vaccinated? Are they stood down until that vaccination takes place? Of course with the coronavirus in play at the moment and everyone most concerned about this disease, what will we see happen when that comes out? Will we have people that are vulnerable being prioritised, as you would hope to see, or would we be prioritising the health professionals?

There is no doubt that we need to have an improved herd immunity to actually get the results we are after. It is quite disappointing to see that we are only at 84 per cent of health professionals vaccinated. I think it will be a good thing, because we know that vaccinations work. In fact I am quite horrified to be receiving some emails from health professionals who are saying the science is not there to say that vaccinations work. It is absolutely ridiculous to say that when we see diseases like polio, which has been almost eradicated from the planet because of the great work that the Rotary clubs do—and a big shout-out to my Rotary clubs in Warrnambool, Portland and Port Fairy. They do a lot of work, and I recently attended the breakfast they had for raising money for polio around the world. We are so close to being able to get there like we have done with smallpox, so there is absolutely no reason why as a community we cannot do better. As someone who was a nurse, I am actually horrified that we would have health professionals that do not have that sense of duty of care that I think should be mandatory.

I want to take the time also to talk about the hardworking health workers around my electorate. We have got the hospital at Portland which is doing an extraordinary job for a hospital that is very isolated in terms of closeness to capital cities. It has a large amount of people coming through its doors and has to provide services when it is so far away from the Melbourne hospitals. There needs to be an understanding of those challenges. There is the Heywood hospital, which is doing a fantastic job and which I love to visit. It is always great to visit—I like the old folks section of the hospitals because you can talk about who is related to whom, and we like to know who is who in the country. I love to go and have lunch with the community at Heywood and must do that again soon. The Port Fairy hospital has currently got its issues with the urgent care centre and trying to meet the demands of the community, and of course there is Macarthur with its small health facility there, but no less very important to the community of Macarthur. And that leads me of course to the Warrnambool base hospital, which is the hospital that services the region and has an enormous need for an upgrade at the moment.

I am desperately hoping that the government understand the many, many times I have put to them the importance of funding this hospital. As I keep saying, it is not a want, it is an absolute need. The accident and emergency and theatre areas particularly are desperate for an upgrade. There is no way I would believe that we will not get funding in this budget in May. I would just be horrified if that is not the case. But these people are all going to work every day worried about their own health, obviously, and looking after others before themselves. So a big shout-out to all the health workers—the doctors and nurses—particularly in places like Warrnambool, where they are under enormous pressure in the accident and emergency department and theatres.

The concern I have got is: how will this be run out? When you talk about the smaller health services, like Heywood and Port Fairy, how will this be funded? There also needs to be funding for this. If the government keep saying to hospitals, ‘You’ve just got to fund it out of your global budget’, then the pressure at some point will be unbearable. Their electricity costs have gone up enormously, and they are just being told they have to cater for that out of the budget. The reality is that something else has to go. We have seen the elective surgery wait blow out by 46 per cent at the Warrnambool Base Hospital. Extra pressures that are not having the extra funding allocated to deal with them are much harder in small hospitals. When you have got a larger facility you actually have people who are delegated to certain administrative roles that can deal with that. In small hospitals you do not. It is often the administration staff and the CEO and the director of nursing who are the front line trying to do the extra administrative roles that will accommodate the new changes. So we hope that we actually see some funding around this as well.

It is really just a matter of saying that this is a bill that will, I think, improve the situation but there are some challenges around conscientious grounds being excluded. I think that is absolutely fair—as I said, there is a lot of science around immunisation and we need herd immunity to make this effective—and I am pleased to see that is actually excluded. However, some of the more challenging areas are religious grounds. That has been excluded, and I think that is absolutely right as well. But when you have got people who are allergic to eggs, for example—because the vaccines are sometimes carried in an albumin base and that can result in allergies or anaphylaxis—how are we going to deal with those sorts of situations? Will it just be a doctor’s certificate that will certify that somebody does not need to be vaccinated? If a pregnant woman, for example, says, ‘I’m not comfortable with being vaccinated while I’m pregnant’, will she get an exemption, or is this going to be much more clearly itemised somewhere where the doctors can have some guidelines around that? At this point in time I am not sure there is clarification around things like what medical exemptions there are.

I recently had a new granddaughter, born on 27 December, little Fleur.

Mr Pakula interjected.

Ms BRITNELL: This is grandchild number two. Archie is four. We make sure we all get immunised. We do not want to put any risks around our children and our grandchildren. I would be horrified to think that anybody would go onto a ward—as a nurse I certainly would not have—if they did not have their immunisations up to speed. Let us just remember that we want to make sure that parents, families and patients are protected. I absolutely endorse the fact that there will be a big improvement in healthcare workers to get it up from 84 per cent so we have better herd immunity in our community.

Mr J BULL (Sunbury) (10:54): I am really pleased this morning to have the opportunity to contribute to debate on this important bill, the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. As you know, a good government’s number one priority should always be the safety, security and wellbeing of the citizens that it represents. We know that safety, security and wellbeing within our respective communities come in many shapes and in many forms. Communities that we all represent are of course entitled to be free from harm and to be free from violence in its many dark and varied forms. The communities that we all represent are entitled to a safe and clean environment, clean air, clean water and a climate that does not threaten their very existence and that of their families. We know that the communities we all represent are entitled to safe and reliable systems of transport, whether it is road, rail, bike, foot or air. But importantly, and at the heart of this bill, the communities that we all represent are entitled to the very best health care and the very best health system that we can provide—world-class health care, supporting you, supporting your family when they are sick and providing an opportunity to get that care where and when you need it. That is primarily important for all communities right across the state.

You only need to look at the current situation that has played out over the last couple of months in relation to the coronavirus to see the importance of public health. Like other members have done, I put on record my thanks to and appreciation of our incredible healthcare workers and agencies that are doing everything they can to provide factual, clear and concise advice to the Victorian community. And can I also put on record my thanks to those at the Doherty and Burnet institutes, alongside many others, that are working very hard together to develop treatments and to develop vaccines in the face of a significant challenge.

This government and indeed all members of the house should support that critical investment in science, in research and in development in this area at a challenging time not just for our community but right across the world. What is of course most important is that we focus on facts and we focus on listening to those agencies that are experts in the field, heeding their message and following their advice calmly and accordingly. We all know of course that this bill goes to the health and wellbeing of our respective communities.

Like many other members of the house, I have received a number of emails in relation to this bill. Those emails have contained a number of statements around why this bill should not be supported. The emails relate to fundamental rights around bodily integrity and autonomy. They express figures from searches of the Australian Database of Adverse Event Notifications, and concerns have been raised regarding the little or no evidence they suggest has been provided to show that healthy, unvaccinated healthcare workers are any more risk than their fully vaccinated peers.

Like other members I have received a range of emails. I respect and appreciate these views and I thank these members of our community for writing to me, but I certainly do not agree with the points that have been put forward. I do not agree that the science should be in question and I do not agree along the lines of many of the assertions that are made within these emails. This is an important bill because we of course know that vaccinations are safe and they save lives, and they are one of the most effective ways of preventing diseases worldwide.

A number of years ago when we in this place looked at the no jab, no play legislation there were some statistics in the contribution that I made around the rates of death through centuries that have gone by. When you look at some of those statistics compared to some of the statistics that are currently in play, what is clear is that we know that vaccinations save lives. Without the very sound, very rigorous, well-funded, well-supported series of vaccines that are available today we would certainly not be anywhere near as healthy a community as we are. That does not mean to say that there are not challenges, and there are challenges right now, as I have mentioned, but this is a fundamentally important bill, a bill that goes to ensuring that our healthcare workers are protected to the best of our ability, that our healthcare workers are supported, that our healthcare workers have the best protections against many of these harmful diseases that they can. I know that this government will continue to support our healthcare workers in all the important work that they do. I commend the bill to the house.

Business interrupted under sessional orders.