Thursday, 5 March 2020

Bills

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

Second reading

Debate resumed.

Mr J BULL (Sunbury) (11:49): I am delighted to resume my contribution on this very important bill, the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. Just before we broke for question time I was discussing the importance of making sure that we as a government are doing everything we can to ensure the health of Victorians and, in this bill’s context, the health of healthcare workers who each and every day do such a terrific job in local communities to support the health and wellbeing of individuals, their families and their communities.

Speaker, as you will know, last year was an unprecedented flu season which put enormous strain on our hospitals, with more than 69 000 laboratory-confirmed flu cases. It started earlier than usual. It hit a lot of people hard. There was significant coverage in the media about the flu season, and what we know is this has devastating impact right through the community. We saw more than double the number of measles cases in 2019 compared to 2018, and we know this also was a significant issue within our community.

My point just before question time was around making sure that any decisions made about community health—any decisions made about the health care of individuals and their families—are based on the latest and most up-to-date science. Of course the government and, I imagine, all members of the house will agree on the importance of making sure that we are continually advancing our technology, continuing to invest money in all of the medical research areas right across the state, working with our interstate counterparts and collaborating right across the board to make sure that we are doing everything we can to ensure the best health for our local communities.

This bill is such an important one because it goes to the care of those people that work in our healthcare system but also to the care of patients. I certainly know within my community that each and every agency, whether it is Sunbury Community Health, whether it is those at the Sunbury Day Hospital or whether it is those within local clinics, is working very hard to support the local community and ensure that people have the best vaccination program possible.

What we also recognise as part of this bill—and I mentioned no jab, no play earlier in my contribution—is that we need to continually rely on that science to deliver the very best outcomes. This is about protecting those people who do such terrific work within their particular community, but it is also about making sure that the people they treat are given the best possible protection.

This is a very important bill. There are a whole range of statistics that I mentioned earlier, as well as statistics that you can track back through decades; those vaccination rates have improved over time. If you particularly look at the 17th century, the 18th century, some of the data there around the lives that were lost because people did not have access to vaccinations is absolutely staggering. So whether you are just looking into this space for the first time or you are absolutely wedded to your views around vaccinations not working, what I encourage you to do is go and have a look at those statistics and make sure that you are right across this important science, because this government will always make decisions on the basis of the very best available research, member for Oakleigh—

Mr Dimopoulos: Hear, hear!

Mr J BULL: and the very best available data. I commended the bill to the house earlier in my contribution, and I am delighted to be able to commend the bill to the house for a second time.

Ms STALEY (Ripon) (11:53): I rise to speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. As the lead speaker on the Liberal-Nationals side, the member for Lowan, has already said, we do not oppose this bill. We do think there are some issues around some of the lack of clarity in the bill, and it fails to explain some of the consequences of not being vaccinated. But the thrust of the contribution I want to make today is to address the underlying philosophy of this bill, which I strongly support, and that is that herd immunity is vital. I am a strong supporter of vaccination, because it works. The science is clear, and we should be doing everything we can to increase vaccination rates because it protects those who cannot be vaccinated.

Now, I will be referring a bit in my contribution today to a paper that was published in the Journal of Medical Ethics in 2018. It is a paper by Jason Brennan and it is entitled ‘A libertarian case for mandatory vaccination’. The author, Jason Brennan, said:

Anti-vaxxers are not in general people who have failed to put in epistemic effort in determining that vaccines are safe. A person who simply does not pay much attention to medicine would normally just following the vaccination schedule her physician suggests. Rather, anti-vaxxers nearly always put in active epistemic effort to reason about vaccines in an irrational way … individual anti-vaxxers are in general people who actively chose to behave in certain reckless ways, rather than, say, people who simply failed to choose to behave in certain publicly beneficial ways.

I am not going to read into Hansard the names of those behind the correspondence that we have all received on this bill, but I do think that the comments in that paper, in the Journal of Medical Ethics, are borne out in some of the letters that we have received in relation to opposing this bill. For example, I had someone who said:

I am vehemently opposed to the bill based on the extensive research regarding human physiology, immune systems and vaccinations that I have undertaken … Obviously this does not make me an immunologist however, it does make me well informed …

Well, no, it does not. It does not make you well informed. Similarly:

I have completed both undergraduate and postgraduate studies and obtained my nursing registration … I started researching about vaccines … what I found was …

Well, no, you did not research. You went looking to redo your preconceived notions that we see in this movement. And finally:

I have read widely on the subject of vaccines due to ongoing health issues in myself and my family.

Well, if that person had read widely, they would know that vaccines are overwhelmingly safe and overwhelmingly deliver benefits to the community.

I do want to take up some arguments that are seen a little bit in the libertarian or classical liberal positions, that somehow mandating vaccines violates the classical liberal or libertarian goals of enhancing freedom. I would push back very, very strongly against that as a justification not to mandate vaccination, because the key point in a libertarian philosophy is that you cannot force on someone else. Well, it is forcing on children and on the immunosuppressed for them to get a disease that they did not ask for because you did not get vaccinated. That is a force far greater than your getting vaccinated. The non-aggression principle found within libertarian thought fails entirely when you are talking about getting life-threatening and very serious diseases just because someone chooses not to get vaccinated. I am now quoting an article by Tiana Lowe that appeared in the Washington Examiner on 5 March 2019, a year ago:

… libertarianism absolutely does not condone involuntary association, which is exactly what sending your unvaccinated child—

in this case, unvaccinated health service worker—

out in public constitutes.

There is simply no classical liberal, libertarian basis for saying that this is in some way violating a freedom principle, because—and I go back to the whole point about vaccination—vaccination relies on a herd immunity. It just is not about you or me as an individual. It is about us as a community standing together, vaccinated for those who cannot be vaccinated.

Going unvaccinated constitutes a contribution to collective risk imposition. You are imposing, so it does violate the non-aggression principle of libertarianism because you are imposing something on others by your lack of action. I was very, very interested to read the arguments put forward by Jason Brennan in the paper ‘A libertarian case for mandatory vaccination’, and I commend this paper to the house and to anyone who is interested in various philosophies and how they may play out in different policy areas. This is someone who has gone through a whole lot of arguments, this time within libertarianism, and applied them to mandatory vaccination. The clear conclusion that Jason Brennan comes to is that no matter which way you cut this, no matter which libertarian principle you attempt to apply to this problem, you come out with a situation where you cannot argue against herd immunity. You cannot argue against the principle of violating non-aggression when your actions can give life-threatening diseases to others.

So I say on the fallacious arguments put forward both by the anti-vaxxers, which of course we have all received in spades, and by any of those who would regard themselves as libertarians or classical liberals who somehow think that this is an infringement on freedom that this is neither. This bill seeks to increase herd immunity and, I would argue, in a place we perhaps we should have thought to start with. When people are in hospital they are often immune suppressed. It is the last place that you want to see people around them who have not been vaccinated.

I am strongly of the view that health professionals should be vaccinated. They should be leading society’s vaccination rates, not lagging them. I understand that in certain regions of Victoria this bill if implemented by stepping off a cliff with a straight date may cause labour force shortages, but I think we as a Parliament should be exposing people who will not get vaccinated but think it is okay to work in a hospital or a health service where there are people who are immune suppressed. That is just not okay. I have no time at all for these people, even those who say they have some sort of conscientious objection. I have got to say herd immunity. At the moment we are talking about the flu, but the flu kills millions of people every year worldwide, and now we have coronavirus coming.

I do not want to be in hospital when we have got coronavirus out there, and we do not quite know what to do with it, with people who could be vaccinated but are not vaccinated. I also do not want a very nasty flu outbreak to come across our health services when they are trying to deal with coronavirus because people did not go and get immunised against the flu epidemic that could come. So I have got to say I strongly support the underlying philosophy of this bill. I do think that there are some mechanical parts of it that are not quite right, but fundamentally people who work in hospitals and health services, whether they be medical professionals, whether they be cleaners or whether they be in administration, should be vaccinated, and I urge them all to embrace the principle behind this bill and get themselves vaccinated.

Mr TAK (Clarinda) (12:03): I am delighted to rise today to speak in support of the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. In summary, this is an important bill. Its major objective is to introduce mandatory vaccination for healthcare workers. Vaccinations for healthcare workers are important to reduce the risks of vaccine-preventable diseases for frontline healthcare workers, mitigate the risk of transmission of vaccine-preventable diseases to patients and, most importantly, maximise compliance with recommended vaccination policy.

Currently in Victoria, as we know, the department has guidelines for healthcare worker vaccination; however, there is no legislative mandate to enforce these guidelines. It is important to note that Victoria is one of the few Australian jurisdictions that does not have a mandatory vaccination requirement for healthcare workers. This new law will see healthcare workers fully immunised to protect themselves and patients against the flu as well as whooping cough, measles, chickenpox and hepatitis B.

As context, it was in 2016 that the Duckett review into hospital safety and quality assurance in Victoria found that the department should have stronger oversight of the health system and provide greater support to hospitals to discharge their quality and safety improvement responsibilities. The review recommended ensuring that legislative powers of oversight or intervention can be exercised to identify and respond to quality and safety risk. Mandatory vaccination of healthcare workers has clear quality and occupational health and safety implications that are consistent with that review.

The government is also undertaking comprehensive consultations on this amendment. Stakeholder engagement has commenced and an extensive stakeholder engagement plan has been developed. A round table with chief health officers was held in December 2019 as part of the stakeholder engagement process. Key stakeholders attended the round table including health services, professional bodies, clinical experts and union and healthcare representatives. Further stakeholder engagement will continue through the policy development phase after the passing of the bill, so there is broad consultation that has gone into these amendments. I would like to take this opportunity to commend the healthcare workforce on their commitment to this issue.

In 2019 the government set a target of an 84 per cent flu vaccination rate amongst healthcare workers, which was well exceeded, reaching 88 per cent across the state. I would like to commend the honourable Minister for Health for this bill. I have had the pleasure of joining the minister for lunch on several occasions over the past weeks in the wake of the novel coronavirus, COVID-19. She has shown fantastic leadership during this difficult time for the Chinese Victorian community in our state. During those lunches with my parliamentary colleagues I was shocked to hear some of the false assumptions being made about people of Asian appearance and assumptions that for some reason Chinese people and Chinese restaurants are unsafe. Again, we should be embracing and supporting our Chinese and broader Asian community members and showing solidarity with our Chinese community during this difficult time. Thank you, again, to the honourable Minister for Health. I would also like to take this opportunity to thank the Premier and the Minister for Multicultural Affairs as well as the Minister for Jobs, Innovation and Trade for the community briefing with the Chinese community leaders and the media in this difficult time.

The bill makes amendments to the Victorian Health Services Act 1988 and the Ambulance Services Act 1986 which will allow the Secretary of the Department of Health and Human Services to direct employers of healthcare workers in public health services and ambulance services in Victoria to require healthcare workers to be vaccinated against specified vaccine-preventable diseases. The bill makes amendments to the Health Services Act 1988 to permit the secretary to give directions also to private health service establishments, requiring them to ensure that specified persons are vaccinated against specified vaccine-preventable diseases. The bill provides that the secretary may suspend, in part or in full, or revoke the registration of a healthcare service establishment that does not comply with the secretarial direction. So this is relevant to all healthcare workers in public and private hospitals and ambulance services with direct patient contact. They will be required to be vaccinated, including doctors, nurses, paramedics, dentists, orderlies, cleaners and staff working in public sector residential aged-care services, which are also very important.

In my electorate of Clarinda we are extremely lucky to have Monash Medical Centre and Monash Children’s Hospital. I am so proud of the amazing job that all of the healthcare workers do at these facilities and across our state. Monash Health is a premier metropolitan health service in Melbourne with more than 18 000 employees. They provide care to south-eastern metropolitan and rural Victoria from over 40 locations via telehealth and in people’s communities and homes. Eighteen thousand employees is a huge number, and that between 80 and 90 per cent of these workers are vaccinated already is a fantastic achievement which shows the commitment and dedication of these workers and professionals.

I am also extremely proud that in partnership with Monash Health soon we will have MonashHeart, Victoria’s first standalone heart hospital. The Andrews Labor government is extremely proud to support the $564 million Victorian Heart Hospital at Monash University’s Clayton campus, and extensive works are already in full swing at the site. The state-of-the-art hospital will provide the latest in cutting-edge cardiac treatment, world-leading education, training and groundbreaking research. When it opens the hospital will have capacity for up to 206 beds. It will also have the capacity to provide 2150 cardiac surgeries, up to 13 500 cardiac laboratory procedures and thousands of consultations. That is extremely important given that heart disease is the leading cause of death in Australia, with recent statistics showing one Australian dies every 12 minutes from heart disease.

The hospital is being delivered in partnership with Monash Health and Monash University and is expected to be completed in 2022. It is just one of the projects the Labor government has delivered or will deliver as part of its unprecedented $7 billion health infrastructure build program. Other investments in the Clarinda electorate include the $76.3 million project to create a new emergency department with a devoted area for the treatment of children and a new mental health and drug and alcohol hub at Monash Medical Centre. That project is going to make a huge difference to my constituents, especially those struggling with mental health conditions. The emergency department will now also include a separate 24-hour short-stay unit to treat more people with mental health or drug and alcohol problems in times of urgent need.

This government is committed to improving the health of our state. We can see that through the investment in our healthcare system and the investment in our healthcare workforce. We can see that commitment again in this bill here today. It will make a huge difference and improvement in our lives and the lives of our citizens. I commend this bill to the house.

Dr READ (Brunswick) (12:13): The Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020 empowers the Secretary of the Department of Health and Human Services to direct public hospitals and other health services to require staff be vaccinated or demonstrate immunity to specified infections. This will likely apply to several infections, including hepatitis B, measles and pertussis, but the subject of most debate and concern is influenza. Influenza outbreaks in hospitals make everything in hospitals a whole lot more difficult. They increase mortality, particularly in the elderly—and this applies to all healthcare institutions, particularly nursing homes—but also for people with specified illnesses that make them more vulnerable to influenza, in particular bone marrow transplant patients, people with emphysema, people with chronic obstructive lung disease or very low birth weight babies. For those who survive, their hospital stay is often prolonged. In one paediatric hospital where they studied this, patients with influenza stayed an average of eight days longer, which is a big cost to the hospital—not just financially. It means that the hospital is blocked up and people needing a hospital bed cannot get it.

It causes diagnostic confusion when people come into hospital for one reason and then acquire influenza and have all the symptoms and signs. I can remember one very distressing case personally where someone’s headache was misattributed to influenza and they died of something that was missed. It causes staff absenteeism. People become ill and cannot get work. It can be so bad that wards and even entire hospitals—or more commonly nursing homes—can be closed as a result of influenza outbreaks in healthcare institutions. So much so that purely on managing staff time, providing influenza vaccinations to all staff has been demonstrated to be cost saving.

If we look at peer-reviewed studies of the impact of influenza vaccination on healthcare institutions, there is very strong observational evidence. There is weaker trial evidence, but in both cases vaccination protects healthcare institution patients. But experience is often more persuasive than data, so I will just tell you about one outbreak in the Greek city of Thessaloniki in 2009 in the haematology/oncology unit that does bone marrow transplants. Eight leukaemia patients were infected by the H1N1 pandemic flu and three of the eight died. In order to prevent things like this the healthcare professions have come generally to the position now that everybody needs to be vaccinated. The problem with the influenza vaccine is that it is not that good. The efficacy is around 70 per cent and the real-world effectiveness is often lower than that. So to get the best protection you need the highest proportion of the population vaccinated. A lot of the observational trials I mentioned earlier compared staff in institutions with high vaccination uptake of around 50 per cent to other institutions where uptake was around 5 per cent. Compare that to what we have achieved here in Victoria with a lot of hard work by public hospitals in recent years trying to get as many staff vaccinated as possible. They have got it up to 88 per cent—that is very good. In fact in going from 88 per cent to perhaps 98 per cent as a result of this legislation we may not see much additional benefit. Nevertheless it seems worth doing to protect our patients.

There are two concerns I want to raise. First of all, this 88 per cent refers to the percentage of staff for whom there is a record of vaccination. I know from personal experience that many health workers work part time at more than one institution, and it is often very difficult to convince institution B that you were vaccinated at institution A, so much so in fact that staff have told me that it is often just easier to roll up your sleeve and get the jab twice. That is not necessarily a good idea, so I urge public hospitals instituting this policy to pay attention to that concern.

The other one is more serious. Many current health workers have emailed me—I think they have emailed all the MPs here—to voice their opposition to this bill partly for spurious reasons about vaccine safety but also for the very valid reason that all medical treatment. including the vaccination of a staff member, has to be carried out with valid consent. It is hard to argue that consent is valid if it is being obtained with the spectre of potentially losing your job hanging over you, so it is a legitimate concern. But population health often brings the public good into conflict with individual rights and freedoms. This particularly applies in infectious diseases, and nowhere more so than when there is an outbreak.

We are seeing echoes of this now in our preparation for a likely epidemic of the SARS-CoV-2 virus, or the COVID-19 disease. We are reading about mass screening, restrictions of movement and closure of businesses, all of which is essentially a trade-off of public good versus private liberty. Vaccination is a case where the interests of the population require nearly everyone to agree to subject themselves to the inconvenience, the discomfort, the small risk of side effects and sometimes the expense of vaccination. It is interesting to reflect that the first successful vaccine, smallpox, was made compulsory in England in the 1850s, punishable by a fine for non-compliance. This was also adopted in the early 20th century in the United States, and I believe there were fines applied in Australia 100 years ago during the Spanish flu pandemic. Ironically some people believe that it was the over-zealous implementation of these public health policies that led to the emergence of the anti-vaccine movement that continues to this day.

For us in deciding whether to support the bill we have to weigh the concerns about a group of people who do not want to be vaccinated against a community desire for high levels of population immunity, particularly in healthcare institutions. The Greens will certainly support this bill because it may help to protect the health of the population and because of the limited risks, the very low risks, of vaccination.

However, I note from the bill’s explanatory memorandum that the Secretary of the Department of Health and Human Services may be able to give directions that may include consequences for non-compliance such as the worker is redeployed to a different area of the hospital or even that the health worker’s employment is terminated. While I understand that such powers may be necessary to create the compulsory aspect of this regime, I am concerned that the bill does not actually define and limit the mechanism for this. It could result in serious consequences for non-compliant health workers, and I am particularly concerned about the very small number with a genuine medical contraindication. The bill’s statement of compatibility assures us that when making such a direction the secretary must give ‘proper consideration’ to relevant human rights, and we are further told that:

Undertaking proper consideration involves a reasoning process that includes the Secretary seriously turning his or her mind to the possible impact of the direction on a person’s human rights and balancing competing private and public interests …

The description of this process is, I believe, far too vague to guarantee that all non-compliant workers are always going to be treated fairly and consistently. I think that the process needs to be a little more prescriptive. Anaphylaxis in response to a previous dose of a vaccine or a vaccine component is an absolute contraindication to vaccination. Pregnancy is a contraindication to measles vaccination. We are told in the statement of compatibility that where such a contraindication exists the secretary will be required under section 38 of the charter to:

… consider the implications of any direction for such an affected person and balance it against the public interest, including considering whether any less restrictive means are available such as granting the affected person an exemption from a direction if to do so would not compromise the overall efficacy of the direction.

That seems very sensible, but there is a practical issue here. As a doctor I would not vaccinate anyone with an absolute contraindication to a vaccine, or I certainly would not do it knowingly, nor I think would any other health worker. So in practice no-one with an absolute contraindication is going to be knowingly vaccinated, or it would put potentially junior nursing staff who are administering vaccines in a very difficult professional situation. I think that these processes and protections should be more explicitly defined in the bill, and I think the government should be open to scrutiny of potential amendments in the other place to improve on this. But to conclude, the Greens do support the bill.

Mr PEARSON (Essendon) (12:23): I have been in the chamber listening to contributions for the last 45 minutes, and I listened to both the member for Ripon’s contribution and the member for Brunswick’s contribution. Both were quite thought-provoking and somewhat quizzical.

I think the member for Brunswick probably drew the short straw. Obviously given his medical training I think that the determination from the Greens political party would be that he would be the only person speaking on this bill. While he did indicate that the Greens would be voting for the bill—I think, as Sir Humphrey Appleby would say, member for Brunswick, that it is indeed courageous when you go and front your Greens branches, particularly the Darebin branch—he also made sure that he had enough carve-out at the back end of his speech to be able to point to these concerns with the bill, so I think he was having a bet each way, to be honest with you.

The member for Ripon’s contribution I did find quite interesting. I thought that as a devotee of Ayn Rand and as the poster child of the Institute of Public Affairs she would have been arguing a very strong libertarian view in relation to this bill.

Ms Staley: I was.

Mr PEARSON: Well, I would have thought a libertarian would be more likely to object to the imposition of a state law on the rights of an individual. But nonetheless the member weaved around that and talked about a higher good in terms of the benefit of herd immunity. Nonetheless, it was a thoughtful and interesting contribution from the member for Ripon. It is always interesting to see a very different view being put by members in this place in the spirit of debate in this great chamber and then to listen to that and to see how that argument unfolds.

I also want to acknowledge the great contribution from my good friend the member for Clarinda, who has made a fantastic contribution in this place in the brief time that he has been here, particularly in times of crisis. There are real challenges confronting the Chinese diaspora in our community at the moment. He has made a really strong contribution in supporting Chinese Australians in what is a very challenging and difficult time.

This bill is a fairly straightforward bill, but I think it also recognises some of the challenges that we are confronting as a society at the moment. Who would have heard of coronavirus three months ago or six months ago? It is something that we have had to try and respond to fairly quickly. I do want to acknowledge the great work of Professor Sharon Lewin of the Doherty Institute as well as the workers and the researchers at the Burnet Institute.

This is a new disease. The impact of this disease is going to be quite profound, and I guess we are fortunate as a state and as a nation that we have got world-class medical researchers here in our community and that we have got some degree of separation from some of the more challenging aspects of the disease in the sense that we are at least going to have a little bit more time to try and combat and respond to this disease. When you look at it, I think we have been fortunate in the way in which China has dealt with it and the way in which this disease has played out in terms of having these interventions to try and prevent the spread of the disease. Yes, the disease has spread, but imagine if those measures had not been put in place in a city like Wuhan and you had a population of 5 million people just going about their business without that sort of rapid state intervention and the imposition of martial law—which I appreciate for the people in the communities involved would be very challenging. But imagine if you had 5 million people who were in Wuhan for Chinese New Year and those 5 million people spread—they went to Beijing, they went to Shanghai, they came to Melbourne or they came to Sydney—and China had not responded in the way in which it has. How much worse would it be? What China has done has given us time to be able to invest money in the Doherty Institute, and I am really pleased that the Premier and the Minister for Health were able to provide significant funding to the Doherty to help us try and find a way through this.

Over the passage of time these sorts of diseases appear from out of nowhere. I think the earliest discovery of whooping cough was by Giovanni Filippo in the 16th century. Filippo was quite interesting actually. He wrote extensively on these matters, and he was the first medical person to start to introduce appropriate public health controls. He recognised the correlation between the rise of malaria and mosquitoes and swamps—I think it might have been in Naples. He ordered that the swamps be drained to try and remove the mosquitoes, and when plague struck Sicily in 1575–76 he started to introduce public health controls in terms of segregating and separating people with the disease. Again, if you are looking at whooping cough, it is a relatively recent phenomenon. If you look at chickenpox and you compare chickenpox to smallpox, that was not really separated as a disease from a research perspective until the late 19th century, so that is also relatively recent. These diseases come along periodically, and from time to time there is a need to try and respond appropriately to address them.

Previous speakers have talked about the benefits of having an appropriate level of herd immunity and the fact that you have to have something like 95 or 96 per cent immunised in order to achieve that outcome. With our health workers we do want to make sure our health workers are protected, are safe and are able to have the protections they need to do their work. I think if you look at what has happened with coronavirus in China, when medical workers start to fall ill themselves it has a huge impact on the system’s ability to cope with and respond to some of those challenges. So finding ways in which we can ensure that healthcare workers have the support that they need and are protected I think is really important.

As others have mentioned, I have received a number of emails from health workers who have expressed some concerns about this. I respect the rights of those individuals to hold a view that is contrary and counter to my own, but I think at the end of the day we have to follow the science. We have to follow the evidence, and the evidence is that if you have a strong herd immunity to protect the broader community from measles and chickenpox and pertussis then that indeed is a higher social purpose and a greater benefit, and it should be something that we do look at ensuring that we foster and facilitate.

These are very challenging times we are experiencing. We had a really bad flu season last year; I think something like half a million people presented to accident and emergency in one quarter alone last year. I think where we stand now with the emergence of a new flu season, if we are not fortunate enough to stop the arrival of coronavirus in a large way—we have had isolated instances of the coronavirus, but if we are not fortunate enough to be able to prevent the wide spread of that disease—then these will be really challenging times. We really need to try and find ways in which our health workers have the ability to be able to do the things they need to do as best they can, so they can operate at their highest level of efficiency, and a bill like this I think is really important.

It has been an interesting debate. When I was starting to prepare for this bill I thought that it would be in one respect a fairly straightforward bill, but it is nonetheless interesting to sit here for a while and listen to the different views and opinions that people put forward who have a different lived experience than I and who come at this from a different angle than I do but who nonetheless at least come in here and are prepared to argue their position. We will get to the right outcome at the end. We will probably find different ways of getting there, particularly in relation to this bill, but nonetheless it is illuminating. I commend the bill to the house.

Mr McGHIE (Melton) (12:33): I rise today to speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. I am pleased to follow the member for Essendon and the contributions of other members in this chamber, and I am pleased that there is no opposition to this bill.

The introduction of this bill comes at a time when the community has a great awareness of the need for vaccinations and the benefits that vaccinations provide to keep our population safe. The last few flu seasons here in Victoria have seen an increased severity in the symptoms of the flu and a devastating effect on particularly vulnerable members of our society. Aged-care facilities, where the transmission of the flu can easily occur, saw a particularly concerning amount of cases in the 2019 flu season. There were 268 outbreaks, 3611 resident cases, 357 hospitalisations and 138 deaths as a result of influenza hitting our aged-care facilities in 2019.

In 2017 there was another horrific flu season that saw increased deaths in the community. Children and young infants in particular are another demographic that are vulnerable to a severe flu outbreak. Once upon a time the flu was seen as not much worse than a cold and something that you could just shake off. The last few flu seasons and recent events have shown us that the severity of symptoms can be a real concern for Victorians. Often at the peak of the community being exposed to an outbreak it coincides with naturally an increased rate of people seeking medical help.

Victoria is served by amazing healthcare workers. I had the privilege to lead many of them heading up the Victorian Ambulance Union and serving as a paramedic. Victorians should be proud of the many healthcare professionals and frontline staff that work hard each and every day to provide Victorians with high-quality health care. I want to thank all our healthcare workers for the jobs that they do. These hard workers constantly put the needs of others ahead of themselves. They care for those who seek their help at a time in their lives when they feel very vulnerable. In the height of an outbreak when people are seeking help it is important that our healthcare system is protecting people and the community as a whole by not inadvertently passing on vaccine-preventable diseases. Of course with vaccines we know that a herd immunity is an effective way of helping protect that community, especially those who are unable to receive vaccines due to allergies or a weakened immune system. We all have a part to play in protecting the community. The Andrews Labor government has a solid track record in promoting and encouraging vaccines. The no jab, no play policy that has seen more Victorian families immunising their loved ones and protecting children whilst learning has been a success.

Victorian immunisation rates are still the highest of Australian states. The Andrews Labor government stands up for healthcare workers in Victoria. Protecting frontline staff from preventable diseases is a priority for this government. Currently the influenza vaccination is funded for staff working in health services, and healthcare worker influenza vaccination rates have risen in the last few years, peaking at 84 per cent last year. One of the reasons healthcare workers choose to work in the sector is that they care for the people that they come into contact with doing their day-to-day tasks. Vaccinating to ensure that they are not passing on an infection to the people that they care for is an important measure to protect Victorians. Currently Victoria is one of the few jurisdictions in Australia that does not yet have a mandatory vaccination requirement for healthcare workers. The overwhelming majority of healthcare workers in Victoria do the right thing to protect the people around them by vaccinating themselves from preventable disease. However, not having a mandated policy leaves open the potential for risk to those who cannot be vaccinated for a particular reason. It is essential that the healthcare system in Victoria not only protects its staff but of course all Victorians by ensuring that healthcare staff are not inadvertently passing on preventable diseases. The science is undeniable: vaccines save lives.

It is unfortunate that saving lives is hijacked by misinformation and deceit by some claiming to provide accurate information but spreading dangerous misunderstandings of the science and the facts. This is no mere misdemeanour. The consequences of this deceit and misinformation can have devastating consequences. There can be no greater example of this than recent events with the devastating measles outbreak to inflict Samoa last year. Misinformation around vaccines in Samoa had led to a drop in vaccination rates to around 31 per cent. When measles broke out the catastrophe that followed ended with at least 20 per cent of babies aged six to 11 months contracting the preventable disease. One in every 150 babies in Samoa died. Out of a population of just over 200 000 there were 79 deaths. Every single person in the tight-knit community was affected in some way. Everyone knew a family member that had lost someone. No doubt that in the rush to vaccinate and protect their families during the outbreak many may have been exposed to measles whilst trying to access medical treatment. Those seeking medical assistance unrelated to the outbreak could have been exposed at that time, and there is no doubt that during an outbreak an important protection to the vulnerable is a healthcare workforce that is immune. A workforce that is able to turn up to work during an emergency, a workforce that is protected from harm and a workforce that protects the people that they are caring for is essential.

It is important to note that mandated vaccination would not occur unless the Secretary of the Department of Health and Human Services makes a declaration to health services under this bill. It is intended that that declaration to do this will not occur until early 2021. This time will allow appropriate consultation and implementation with those who this bill affects.

I would like to acknowledge that in the lead-up to this legislation being discussed here in this place my office has been contacted by a number of individuals concerned with this legislation. Some of these have been from genuine healthcare workers. Some, I suspect, are part of the usual suspects that tend to get involved with any announcement that this government makes when it sets to protect vulnerable Victorians from easily preventable diseases. In much the same way that we have protections in other areas, it is essential that protections in our health sector are in place too. Working with children checks are now mandated in Victorian schools, child care centres and sporting clubs to protect children. This is similar in that it sets out a requirement to protect patients. In my experience as a paramedic and an ambulance union official representing paramedics, the overwhelming amount of healthcare sector workers do the right thing by protecting their patients and themselves by using scientifically proven vaccines. The entire reason for the healthcare system to exist is to provide care to those who need it. Patient safety and care is the reason people make the decision to seek a career in health care. Putting others at unnecessary risk is not acceptable.

Protecting Victorians is something that this Andrews Labor government makes no apology for. A recommendation of the 2016 Duckett review of hospital safety and quality assurance in Victoria found that the Department of Health and Human Services should have stronger oversight of the health system and provide greater support to hospitals. The report recommended that legislative powers of oversight or intervention can be exercised to identify and respond to quality and safety risk. This legislation is clearly in line with this review. This protects workers and this protects patients.

Last year’s flu season was like no other. There was an enormous strain on our hospitals and ambulances, with more than 69 000 laboratory-confirmed flu cases. Many more cases of course would have gone unreported. We also saw more than double the number of measles cases in 2019 than what we did in 2018. As I mentioned earlier, this had devastating and tragic consequences in Samoa and our Pacific neighbours, and many families in my electorate of Melton with Samoan heritage know the hurt and pain from losing family members in Samoa last year due to the measles outbreak.

We had a large year for whooping cough. There were 2210 notifications compared to 1700 in 2018. Some good news we have seen recently is that our healthcare workers protecting themselves and the people they care for in 2019 resulted in an 88 per cent flu vaccination rate in our public health services.

The government is committed to making sure our healthcare workers are among the first to be immunised each year by making the flu and other vaccines mandatory for healthcare workers. This health minister and the minister before her have a strong track record when it comes to immunisations and vaccines, advocating with the federal government to ensure supplies in Victoria are available and putting in polices to protect our children and the vulnerable in society. I congratulate them on their strong track record and their continued commitment to vaccinations and immunisations in Victoria.

There is no question about it, vaccination is one of the most effective ways of preventing disease worldwide. Reducing morbidity and mortality from many infectious diseases by means of vaccination has been described as one of the most significant public health achievements of the past century. It is clear that vaccinations are safe and save lives. I commend this bill to the house.

Ms BLANDTHORN (Pascoe Vale) (12:43): It is with great pleasure that I also stand to commend this bill, the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020, to the house. I am very pleased that this bill is receiving endorsement from all quarters of this chamber and commend each of those who have spoken on their contributions. Indeed the member for Brunswick certainly made a very valid contribution from his perspective as a doctor in our community, as the member for Melton just did as a paramedic in our community.

Hearing from our frontline health workers on this issue is of course important. It continues to amaze me that vaccination is at all a controversial issue in our community. Perhaps it is from the luxury of the privileged position that we are in that we are able to protect ourselves from these diseases. Indeed, as has been said in a number of forums, including theconversation.com:

The fact we can protect individuals and communities against some of the deadliest diseases by a simple and safe injection is one of the miracles of modern medicine.

But it does continue to amaze me that we continue to find that whilst we might be in agreement here in this chamber, in our community this is an issue that does attract its fair share of opposition. As the member for Brunswick said, some of the claims are spurious, some come with potentially a valid argument about the nature of informed consent and the like, but at the end of the day we have an opportunity in this place to protect the health of our entire population, and for some that might mean there is a cost or an imposition that they are not entirely happy to wear, but certainly from a whole community perspective this is a very important bill.

This bill is about ensuring the best standard of health and safety for our valued health professionals and it is about supporting and protecting our vulnerable patients across healthcare settings. As the mum of a toddler, protecting vulnerable patients against infectious diseases is something that I am acutely aware of.

Our Victorian health professionals deliver world-class health care in our community. From our paramedics on the front line to our nurses and doctors inside our hospitals, Victorians benefit day in and day out from the dedication, the compassion and the expertise that these workers bring to our public and our private health systems—often at some of the toughest times of a patient’s life. Healthcare workers perform an integral role in treating illness and disease, and they also perform an equally important role in the prevention of disease.

We are to be so thankful to medical science, which has been at the forefront of developing vaccines which can prevent and at times completely wipe out the existence of harmful and at times fatal diseases amongst our population. There is no doubt that vaccination prevents disease and saves lives. This is why we are mandating vaccination for health workers, protecting both workplace occupational health and the safety of patients from the harms associated with preventable disease.

This bill will make amendments to the Health Services Act 1988 and to the Ambulance Services Act 1986. These amendments will mean the Department of Health and Human Services secretary is allowed to direct employers of healthcare workers in public health and ambulance services to require those workers to be vaccinated against specified vaccine-preventable diseases.

The bill also makes amendments to the Health Services Act 1988 that will mean that the Department of Health and Human Services secretary is permitted to give directions to private health service establishments, including private hospitals, to require them to ensure specified persons are vaccinated against specified vaccine-preventable diseases

The bill puts Victoria into line with other Australian jurisdictions that already have mandatory vaccination for healthcare workers. Healthcare workers applicable to mandatory vaccination include all healthcare workers in public and private hospitals and ambulance services that have direct contact with patients. This includes doctors, nurses, paramedics, dentists, orderlies, cleaners and staff working in public sector residential aged care.

Through this bill we will boost the occupational safety of workers in these areas. We will protect them from vaccine-preventable diseases. Workers will be vaccinated against these diseases, preventing the possibility of them contracting such illnesses and their associated harms. By mandating vaccinations for the health workers, this bill has a dual effect whereby it works to protect patients as well who are at a particularly vulnerable stage in their lives.

The 2019 flu season was unprecedented. There were 69 000 laboratory-confirmed cases of flu. The season started earlier than usual, and we expect that again this year. Many Victorians and their families were hit hard by the impact of the illness. We had Victorians who lost their lives from the flu and many who lost their loved ones in Victoria, across the country and indeed beyond.

We know of the strain that the flu places on our healthcare workers. However, we are to be incredibly thankful for the way that our dedicated health professionals rose to the challenges of last year’s outbreak. Amongst the stress and the strain of many more patients arriving at healthcare settings, our paramedics, nurses, doctors, orderlies and cleaners continued to deliver world-class care, support and guidance to thousands of Victorians who fell foul of this illness.

It is so important in these times of outbreak that our health workers are well and fit to work. We need to ensure these workers are protected as much as possible from illness and disease. Our hospitals need to be places where people come to get better and places where our dedicated healthcare workforce is safe. If these workers are unwell at work, the occupational risks for their colleagues and for their patients are increased and the transmission of disease is more likely.

This is why our Andrews Labor government already makes the flu vaccine free for our healthcare workers. And now, through this bill, we are mandating vaccination for healthcare workers. To quote the Minister for Health in the other place when speaking about these laws last year:

There’s no doubt about it—vaccinations are safe, effective and save lives. That’s why we’re taking action to make sure health workers and patients are protected against dangerous diseases.

Unfortunately last year was also a difficult year for the number of cases of other preventable diseases. We had 2210 notifications of pertussis—whooping cough—in 2019 in comparison to 1700 in 2018. In addition, in 2019 we saw more than double the number of measles cases than in 2018. And certainly across parts of the inner north those numbers were high.

These preventable diseases, like the flu, can be fatal. These diseases are preventable with vaccination. We as a community have the responsibility to get vaccinated against these diseases to protect vulnerable Victorians who need the immunity of the herd in order for them also to be protected. We know that babies under six weeks cannot be vaccinated against a disease like whooping cough. Their protection from these harmful and sometimes fatal diseases comes from the community around them. If they are exposed to an infected person, they are at huge risk of contracting the disease.

The community rightfully expects that those who cannot be vaccinated will be protected by the mass prevention that immunisation provides our society. Likewise when people with young babies, the parents of children that cannot be immunised or people who cannot be immunised enter our healthcare settings they are again relying on this protection. These groups of people rely on our health workers being vaccinated.

When individuals get vaccinated against preventable diseases, not only are they protecting themselves, they are contributing to the health of the wider community through herd immunity. To quote authors Nic Geard, James Wood and Jodie McVernon in their article titled ‘Explainer: what is herd immunity?’ for The Conversation:

When a high proportion of a community is immune it becomes hard for diseases to spread from person to person. This phenomenon is known as herd immunity …

By decreasing the number of people who are susceptible to infection, vaccination can starve an infectious disease outbreak in the same way that firebreaks can starve a bushfire: by reducing the fuel it needs to keep spreading. If the immune proportion is high enough, outbreaks can be prevented and a disease can even be eliminated locally.

Herd immunity is defined as ‘vaccine efficacy among unvaccinated contacts’. Importantly, herd immunity is crucial for protecting those who for various reasons, whether that be illness or age, cannot be vaccinated. If more people who can be immunised do get vaccinated against preventable diseases, it is ultimately a win for herd immunity and it is therefore a win for the health of our community.

We know that herd immunity will protect those people who are most vulnerable. The Andrews Labor government has worked hard to boost levels of vaccination in our community for the benefit of all Victorians. Our achievements in vaccination initiatives form an important part of our overall commitment to the highest standard of health care for all Victorians and include building a hospital system that our community can rely on and ensuring that our dedicated health workers—from the paramedics to the doctors, the nurses, the orderlies and the people who volunteer in our hospitals—have herd immunity and that there are supports and resources for those who deliver the best health care across our great state. Nothing matters more than the health of the vulnerable people in our community. Thanks to the great developments and innovation that medical science engages in day in, day out we can consider certain illnesses and diseases preventable, some of which are preventable through vaccines.

We have seen this sort of innovation in our own state recently at the Doherty Institute, where Melbourne scientists were responsible for growing the first coronavirus cell culture. On the back of this significant achievement by the Doherty Institute our government has acted swiftly, announcing yesterday that there will be over $6 million for the Peter Doherty Institute for Infection and Immunity. The institute will be working with the Burnet Institute and other experts in an effort to fast-track the development of new treatments and vaccines for the coronavirus outbreak that people anticipate. This is a very important bill, and I am very pleased to commend it to the house.

Mr FOWLES (Burwood) (12:53): I rise today to make a contribution around this very important matter, this very important initiative to improve the health of Victorians, to take seriously the challenges we face within the health system and to shine a light, I guess, in my contribution today on the fallacy of the logic sometimes put by opponents of measures like this, because opponents of measures like these tend to rely on arguments that centre on those of personal freedoms.

It calls to mind the debates going back to the 1950s or 60s—and unlike the minister at the table, the Minister for Disability, Ageing and Carers, I was not alive then—around seatbelts. Among the opponents of the compulsory wearing of seatbelts there was some feeling at the time that the wearing of seatbelts was a self-regarding matter—that is, it was a behaviour that affected only themselves and ought be considered through that personal freedom matrix. Quite obviously we as a society—and I think I can safely say there is bipartisanship on this matter—have arrived at a position where we say, ‘Well, no. The wearing of seatbelts is not just a matter of personal choice. By failing to wear a seatbelt you ultimately put yourself at risk of serious injury, and there is a public good in not having that serious injury. There is a public good in terms of the impact on the health system, there is a public good in terms of the impact on the economy and there is a public good in terms of your contribution to society more broadly’. So we say that these public health matters ought be taken into consideration and that in the balancing of the personal freedoms versus the public good we ought to take on board and be prepared to constrain personal freedoms for the public good.

There are some schools of thought that have a different view about those alleged personal freedoms. I refer to Mr Tim Quilty and Mr David Limbrick in the other place, both of whom I think frankly hold their seats by dint of their party name, not because of any particular genuine public support. Just like the Democratic Labor Party on our side of politics, they really owe their political existence to nothing more than coat-tailing on the brand of the Liberal Party. It is the same piece of neat deception that resulted in David Leyonhjelm entering the federal Senate so he could just tee off and launch disgraceful campaigns of harassment against people like Greens senator Sarah Hanson-Young.

I say that they are not even proper libertarians, because proper libertarians would run a reasoned argument against compulsory vaccinations. They would say that they are a violation of personal and bodily freedoms. Proper libertarians would oppose with every fibre of their being the state mandating a medicine being injected into their bodies as a condition of employment or as a condition of accessing early childhood education or anything else. But not these libertarians. No. Despite the fact that they would transfer ownership of public hospitals to non-government organisations, despite the fact that they would abolish government involvement in the delivery of health services, despite the fact that they want to abolish government funding of health research and despite the fact that they would even privatise blood and organ donation and supply—despite all of that—they argue that we should maintain government involvement in the management of infectious diseases, including through vaccination.

Well, that is a sensible position, unlike the positions that preceded it, and it is perhaps because it is not a truly libertarian position that it is the only one with which I might agree, because on this side of the chamber we say that the public interest in a healthy population far outweighs those private freedoms, not least because that private behaviour does in fact have a very clear public consequence. By refusing vaccinations, particularly where the refusal is by a parent, the welfare of the child and of the community is put at risk. It is, we say, a profoundly selfish act—a profoundly selfish act to put not just yourself at risk but your child at risk.

These days when teenagers sneak out to get some shots, it is not of alcohol; it is to defy the anti-vaccine wishes of their parents. It is to sensibly defy the anti-vaccine wishes of the parents. Even the ANMF—the Australian Nursing & Midwifery Federation—believe that nurses and midwives have a professional responsibility to lead by example and maintain their own immunisation status through routine vaccination and boosters. That is a sensible position—a position I will expand on a little further when we return from lunch.

Sitting suspended 12.59 pm until 2.04 pm.

Mr FOWLES: Acting Speaker Fregon, tempted as I am to raise a highly complicated point of order, I will continue with my submission on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. Just before the luncheon break I was talking of the ANMF’s view about the compulsory vaccination of their members. Their view is that nurses and midwives have a professional responsibility to lead by example, maintain their own immunisation status through routine vaccination and boosters and not to engage in ill-informed fearmongering on social media. I agree. A tiny fraction of the Victorian nursing workforce, however, disagree, and they have corresponded in willing terms sometimes with me on the topic. Their arguments have ranged from the reasoned to the irrational to the ludicrous. At their core, though, is a refusal to accept by that very tiny group of people the premise that those working with the medically vulnerable ought be subject to a higher standard of care in relation to their own infectiousness.

In my view the anti-vaxxers belong in the same camp as the climate change deniers and the flat-earthers. These are people who would rather install antivirus software on their computers than give antivirus medicine to their children. I know, Acting Speaker Fregon, with your particular experience that sentiment will make enormous sense, but it is madness. By denying the science in favour of alarmist rhetoric they threaten not just their own health but the health of others.

So I say to the anti-vaxxers: if you are really longing for the good old days of polio, mumps and measles, then I urge you to take some other retro medical strategies and bring them into your life. So I say to the anti-vaxxers: when you go to the dentist, do not use anaesthetic. In fact do not go to the dentist at all; just go to the blacksmith and get your teeth pulled there. And you will be doing a lot of teeth pulling, because you will not be drinking fluoridated water, you anti-vaxxers—you will not. And always make sure that your cough syrup comes with a goodly amount of heroin in it—that is another one. Stock up on the leeches. Stocking up on leeches is important. If you are going to put the science to one side, surgery to remove gangrenous flesh will not cut it—you have got to get the leeches going. And if you are feeling a bit down, things are not quite running your way—frontal lobotomy. That is the way to go. It will do the trick for sure. Or just drill a hole in your head to release some evil spirits; that is another tried and true strategy. If you are going to set the science to one side, do not ever wash your hands; washing hands is unnecessary. Do not, frankly, exercise any personal hygiene. If you are suffering from syphilis as an anti-vaxxer, God help you, but go and get some malaria. That is apparently the way to knock syphilis on the head—if you contract malaria. If you feel a headache coming on, arsenic is the way to go; arsenic is the tried and true measure for the headache.

These points might be jocular but the serious point behind them is anything but. Evidence matters. Superstition and hysteria have no place in modern health policy. Science and evidence are the way we on the government side of the chamber will always legislate, by referring to the science and by offering due respect to the scientists, to the practitioners who live with these matters every single day and to the research that is peer reviewed, academically rigorous, and tested and understood by the broader scientific community to have the appropriate level of rigour in it. These are the things we ought rely upon when making public policy. These are the things we ought pay heed to when determining the future direction of health policy in this state. This is a very strong bill, and I commend the minister for bringing it forward to the house. I wish it a speedy passage.

Mr STAIKOS (Bentleigh) (14:08): I rise to speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. At the outset I congratulate you, Acting Speaker Fregon, on being appointed to the speakers panel, and I feel a great sense of honour that I am one of the first members of Parliament to be contributing to a bill under your acting speakership. I want to also say that it has been a good week for science in this Parliament, because of course yesterday we were debating a bill that would unlock renewable energy in this state by making it easier for our Minister for Energy, Environment and Climate Change to ensure that transmission lines are upgraded and that we can get renewable energy across the state where it needs to go and make it more reliable, and today we are debating this important bill on ensuring that health workers are vaccinated.

It is, as I said, a good week for science. Yesterday I did say the opposition were anti-science in opposing the bill on renewable energy. Today I am pleased to see that the opposition are nearly wholeheartedly supporting this bill. I did enjoy listening to the contribution by the member for Ripon, particularly because I know that she is a moderate in the Liberal Party. She is probably a small-l liberal as opposed to a hard-right conservative, and she did give a libertarian’s perspective to vaccinations. I thought that was particularly thought-provoking, and perhaps if I have time, I will come back to that in a moment.

When I was first briefed on this bill—we attend as members of the government regular bills briefings, and I believe you were there as well, Acting Speaker—I did think it was an important step, absolutely. I actually in fact thought it perhaps did not go far enough, and I might come to that later as well. That is why I was a little bit surprised when we received that avalanche of emails from members of the public—not necessarily members of my electorate but members of the public—opposing this bill. If I can just go through a few without naming those members of the public, one here has said that:

… no evidence has been provided to show that healthy, unvaccinated healthcare workers are any more of a risk than their fully-vaccinated peers.

It is a bit of a redundant statement because of course a healthy, unvaccinated healthcare worker is one thing, but such a person of course has the potential, particularly without vaccination, to become unhealthy and to put their patients at risk.

Of course another one that I received is one of the old conspiracy theories linking vaccinations with autism and Alzheimer’s, and I think that is pretty offensive to families of people who live with autism and Alzheimer’s. Then this is one of my personal favourites. This person says that:

… we do know that every puncture into the body compromises the immune system …

and it is signed after the name: ‘Bachelor of Arts’. Now, I have a bachelor of arts, like many, many members of this house. When I studied arts at Monash University, it broadened my mind, it gave me a qualification to put on a CV but it did not give me the requisite credentials to then give out medical advice to other people.

And then this one caught my eye for some personal reasons, but I will first quote from it. It says:

We have a right to make informed choices over our own bodies to enable us to live our lives without unnecessary risks imposed on us by others.

And we have heard from people about freedom of choice. We all have freedom of choice. We do not have a bill of rights in our constitution, but we still enjoy freedom of choice. But with the greater freedom we have comes greater responsibility, and we all in exercising our freedom of choice also have a responsibility to our fellow citizens to keep them safe as well. That is herd immunity. There are some people who cannot be immunised for all sorts of reasons, and we owe it to them to make sure that we are getting our vaccinations, like we get our flu shots every year, to keep them safe. That is what it means to be in a society.

I was alarmed by how many people got in touch with us who are nurses and also midwives, and I was particularly alarmed because I have a close family member at the moment who is in her second trimester of pregnancy. It was a long road getting pregnant. She had to undergo some treatments in order to get pregnant that I would imagine most women would not have to undertake. That has meant that her immune system has been somewhat compromised, and I get a shiver down my spine when I think that a nurse or midwife treating her in hospital might be unvaccinated. I think we owe it to our fellow citizens to ensure that we are not putting them at risk, as I said earlier. That is what it means to be part of a society.

Earlier this week of course the Premier and the Minister for Health announced important funding of $6 million for the Peter Doherty Institute for Infection and Immunity in an effort to combat coronavirus. It was $6 million to work with the Burnet Institute and other experts to fast-track new treatments and a vaccine. I would imagine a lot of these anti-vaxxers, who are very active—very few in number but very active in the community—no doubt will be thinking very carefully while they are stockpiling toilet paper about whether they actually need this new vaccine, which is still some months away—that is the latest advice. Vaccinations keep people healthy, keep people safe. As I said earlier, we owe it to the broader community that we keep ourselves healthy in order to keep the rest of the community healthy.

In terms of how this particular bill will actually work, it makes amendments to the Health Services Act 1988 and the Ambulance Services Act 1986 to allow the Secretary of the Department of Health and Human Services to direct employers of healthcare workers in public health services and ambulance services in Victoria to require healthcare workers to be vaccinated against specified vaccine-preventable disease. In addition, the bill makes amendments to the Health Services Act 1988 to permit the secretary to give directions to the private health services establishments, including private hospitals, requiring them to ensure that specified persons are vaccinated against specified vaccine-preventable diseases. This will include ambulance staff, private hospitals, public aged-care staff and others. It will include cleaners, orderlies and administrative staff who have day-to-day contact with patients, and currently Victoria is one of few jurisdictions that do not have a law like this in place. The amendments proposed by this bill will ensure that Victoria is in line with other jurisdictions. We are taking the fight against the flu. Last year of course we had the worst record of flu in Victoria on record.

We need to take this ever more seriously. It is in line with other changes that we have made—no jab, no play, for instance. I chair a community house which runs a childcare centre and a kindergarten. We have enthusiastically enforced no jab, no play where issues have come up from time to time with people seeking enrolments for children who have not been vaccinated.

In the 1½ minutes that I have left to me, I do want to point out a bit of a regret that this bill, I believe, does not cover local government. While it is not so common anymore, a very small number of residential aged-care facilities in fact are still owned by local councils. Most of them have divested, but the City of Glen Eira in my electorate still has three, Warrawee, Rosstown and Spurway, which are of course high-care facilities. I think that it would be worth at some point revisiting this legislation and looking at how we can broaden the scope of it, because it is not just residential aged-care facilities that are owned and run by local councils. Local councils are still involved in the delivery of home and community care services. Many who receive those services are older, are unwell or are vulnerable, and I think it would be a good idea to look at how we can broaden the scope of this bill, which is very well intentioned.

With those few words I commend this bill because it is in line with this government’s agenda of keeping Victorians safe and healthy, and I wish it a speedy passage.

Mr EDBROOKE (Frankston) (14:18): I rise today to speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. Of course we have heard some very good contributions from other speakers this morning and this afternoon. I would have to say that in many of those contributions there have been people citing some great foundations of evidence for this bill but also some emails have that have been sent to their offices. People have said some absolutely ridiculous things. And we all know that group of people as anti-vaxxers.

I would like to share some of those messages today as well, because I think when you see a bill like this and you choose to believe someone whose blog you read on social media or while you are sitting on the toilet reading their Facebook page or something like that over millions of GPs and millions of scientists involved in the immune area and you refuse to take their information on board or cannot even understand it, I think we have got a huge problem. I used to have a bit of fun arguing with those people, to be honest, but it does get tiresome, because when you argue with stupid people you run the risk of looking stupid yourself. This is a great bill, and this will save lives.

As we have heard previous speakers say, the mandatory vaccination bill for healthcare workers will reduce the risks of vaccine-preventable diseases for frontline healthcare workers, mitigate the risk of transmission of vaccine-preventable disease to patients and maximise compliance with recommended vaccination policy. And why are we doing this? It is pretty simple: because the facts and figures add up, the evidence is there and vaccinations save lives.

I have heard, throughout five years in this role, from many, many people from all over the state, all over the nation and also in my electorate who have come to tell me absolute furphies about vaccinations, and we have had some about this bill as well. These days I do not even bother to pay them attention. The evidence is there. It is like trying to convince people that day is night and night is day; they just stand there and they will not have it.

I, like the member for Bentleigh, anticipate there will be a rapid change of heart when an inoculation or immunisation comes out eventually for coronavirus. We have seen some pretty bizarre reactions to news stories. People are stocking up on things—toilet paper et cetera. I think there will be a huge change of heart when it is not just your child that you are making a decision for but it is yourself. I think we will see many, many people who might have been on these Facebook pages, who might have been propagating this absolute rubbish, go to the GP and say, ‘How can I be healthy? How can I avoid contracting coronavirus?’. And when the GP says, ‘Take this shot’, I reckon they will do it.

To go through and put this proposal in place, the bill makes amendments to the Health Services Act 1988 and the Ambulance Services Act 1986, which allow the Secretary of the Department of Health and Human Services to direct employers of healthcare workers in public health services and ambulance services to require healthcare workers to be vaccinated against specified vaccine-preventable diseases. The bill makes amendments to the Health Services Act 1988 to permit the secretary to give directions to private health service establishments, including private hospitals, requiring them to ensure that specific persons are vaccinated against specified vaccine-preventable diseases.

The context of this of course is that our healthcare workers meet and greet and treat many thousands of people every week. They do not know where these people are coming from or going to, and we need to first protect our healthcare workers—but our healthcare workers could be putting patients at risk, especially elderly patients when we are talking in the frame of coronavirus and some other preventable diseases that have been around for a long time, if they are not actually vaccinated themselves. We have heard people talk about the herd as well, which is a fairly well-known theory. It is a theory to some people, and they would think it is actually false; I think the facts prove that that theory is correct.

You only need to take the example of Samoa. The member for Melton, who is well learned in this space, was talking about the outbreak of measles. We have got a community where immunisation is at one of the lowest levels internationally—31 per cent, I believe. Fifty kids died in Samoa as measles ravaged the country—sadly, totally preventable. That is one in every 150 babies as well. What we saw was a low rate of vaccinations at about 31 per cent but a really high rate of anti-vaxxer advocacy. There was one well-known advocate in that country that was telling people to take a vitamin A instead of going to get a vaccination. The Samoan PM even recently suggested that maybe we should jail anti-vaxxers because of the uneducated advice they are giving to people. I would say this to the people that are calling me and giving letters to MPs: get off social media, stop buying toilet paper and actually read some peer-reviewed literature by experts in this field. I have, in Frankston, even had someone talk to me about the link between phrenology and immunisations.

For those who do not know what phrenology is, it is the ancient art of grabbing someone’s head and having a bit of a feel and checking out the lumps and bumps, and you can tell if they are of good character or if they are going to have genetic diseases or something like that—absolute rubbish. We have had people that have had children infected with measles on social media pages sharing infected lollipops with other people in the community to perhaps successfully or unsuccessfully immunise their kids. But they will not believe the data.

We have had Kat Von D, who is a well-known tattooist, who works with needles, but we have had people in my office telling me, ‘But Kat Von D is not going to immunise her kids’ and ‘So-and-so is not going to immunise her kids’. Well, it is not exactly the evidence I think you should be bringing to the table. Just because she works with needles does not mean that she knows anything about immunisation.

We have even heard one person in my office who was a well-educated person come out with the phrase, ‘We don’t need vaccinations, because the plague went away by itself’. I was very quick to remind this person that the plague also killed millions upon millions of people—and yes, it is still around today. So we have an argument in the background, but many of us no longer choose this argument. We choose to introduce legislation and pass that legislation that will certainly save lives.

We saw in the last year an unprecedented flu season that put enormous strain on our hospitals, and kudos to the health minister at the time and the leadership of the Andrews Labor government for handling that, but there were more than 69 900 scientifically proven, laboratory-confirmed flu cases. It started a lot earlier; it hit a lot of people very, very hard. Last year we saw almost double the number of measles cases in 2018. We also had a very large year for whooping cough, with 2210 notifications compared to 1700 in 2018.

I was brought up in a household with two nurses, and I remember when this conversation first started happening when I was a young teenager. I remember one of my parents saying to a young mum, ‘You’re welcome to come to the local hospital with me, and we will go to the emergency section and you can make your mind up then and there once you see a kid struggling for breath, struggling to survive with whooping cough’. I am not sure whether that person took up the offer or just decided to be smart and actually immunise their child, but I have actually heard that cough. If you are ever in doubt about the successfulness of immunisations and if they work, type that into your Google search bar, have a look at whooping cough and consider that levels are so low, polio levels are low, these diseases are still in the background but they are at low levels and they are manageable because we actually vaccinate in this country. We are not Samoa, and we do actually take up that fight against people who are disseminating false truth based on nothing but Facebook and whatnot.

This bill will save lives. It will protect our healthcare and emergency service workers. It is reasonable, and the people that disagree with it would want to come up with a better argument than they have been for the past 10 years, because they have been absolutely ridiculous.

Also just in the few seconds that I have got left I would ask those people too: should not healthcare workers be safe in their workplace? I would say yes, and this bill goes a long way to ensuring that as well. With that, Acting Speaker Fregon, I think you have done a good job listening to me this afternoon—off to a good start, I think. I commend this bill to the house.

Mr CARBINES (Ivanhoe) (14:28): Thanks very much, Acting Speaker Fregon, and welcome to the big chair. Can I say at the outset that the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020 is really important legislation that seeks to protect health service workers. That is what in part—a very significant part—this is about. It goes back to, really, a record our government has of workplace safety, a record our government has of investing in and protecting and advancing the interests of working Victorians, particularly those in our service industries, our healthcare workers—particularly across ambulance services, disability, ageing, carers and health. Can I say that from the outset what we understand we are seeking to do here with this bill is to introduce mandatory vaccination for healthcare workers in order to reduce the risk of vaccine-preventable disease for frontline healthcare workers, to mitigate the risk of transmission of vaccine-preventable diseases to patients and to maximise the compliance with recommended vaccination policy.

Most Victorians know and know well the value and the critical importance of vaccination policies and programs across the state. It is something that we have all become very familiar with both as parents as we work our way through those early years with our registration books to make sure that our kids have got the protection that they need and deserve and through the responsibility we take as members of society to ensure that we are playing our part to advance and protect the interests of those in the community in which we live. It is a societal responsibility. We have seen great success with that work across our state. Certainly across Australia we are recognised as having very significant vaccination rates.

For someone of my era who had to endure chickenpox and had to endure the mumps—illnesses these days for which young people can be vaccinated and which they do not have to endure—I can say that I have had firsthand experience when perhaps those vaccinations were not available en masse for young people. But the lasting memories of those illnesses are a stark reminder of the effect it has on you even in later years to recall just how unpleasant some diseases can be—such as the mumps, let me tell you.

So again, I suppose this is just drawing attention to the fact that nobody wants people who cannot look after themselves—our children—to have that responsibility. We make sure that is a parental responsibility, a responsibility we take in our society—and we have seen the great gains in that vaccination work to eradicate a range of diseases in our community.

Who are those frontline workers though? Not only just today have we seen across the world in relation to the coronavirus people like our healthcare workers and our doctors and our nurses who have found themselves fatally ill. And of course while we do not have vaccination arrangements in place yet, what is really important, as we have heard from many of the speakers on the government side, is the significant research at the Doherty Institute and others to work towards those vaccination measures.

Can I say that what is also important is an understanding that where we can take advantage of safeguards put in place to protect our healthcare workers, the Andrews government is one that has demonstrated time and again that whether you are a healthcare worker, whether you are working as a paramedic, whether you are a teacher in our schools or whether you are working on construction sites, our government seeks to advance and protect your interests in the workplace and make sure that you are safe and make sure that you return home at the end of a day’s or a night’s work. This legislation, again, is about drawing on the fact that currently in Victoria, while the department has guidelines for healthcare worker vaccination, there is no legislative mandate to enforce these guidelines. We are one of the few Australian jurisdictions that does not have mandatory vaccination requirements for healthcare workers. This legislation seeks to lay the groundwork very clearly not only to protect individual health workers but also, across our Fair Work legislation and laws, to make sure we are meeting our obligations to the state as to how we seek to legislate and put in place the right framework to support healthcare workers, who of course are on the front line protecting and looking after the vulnerable people in our community.

Vaccinations, we know, are safe and save lives. The influenza vaccination was funded for staff working in health services, and the introduction of targets has seen a rise in healthcare worker influenza vaccination rates in recent years, peaking at 84 per cent in 2019. Certainly that is collegial, the way in which we have seen across the Department of Health and Human Services that when the call goes out you can get your vaccination done. There are arrangements in place to provide those services, and people take them up. It is a further opportunity, I think, for people to walk the walk—whether they are people who are healthcare workers or people who are working in policy or working in practice or whether they are clinicians. If you are prepared to be out there advocating for what is best for the patient, it is also about walking that walk yourself and making sure that you are able to be vaccinated and that there are some clear regulations and authority in government to be able to deliver those outcomes.

Mandatory vaccination will not be implemented until early 2021 to allow time to consult appropriately with other stakeholders on the implementation process and to enable the development of appropriate supporting resources, including methods to monitor vaccination updates, as outlined in the minister’s second-reading speech. Again can I say that what is particularly important here is that there were some comments made by those opposite in relation to rural communities. If you look at the healthcare outcomes in rural communities, we know and understand that for rural and remote communities across the country healthcare outcomes related to things like age are not as high as of course in metropolitan centres. What that also means is that the risks too are also significant. So what we want to make sure of in rural and remote communities as well is that there are opportunities to provide them with every support. Part of that is about making sure that the vaccination programs that we are able to offer reach deep across the breadth of Victoria to communities where health outcomes are not as high as they should be, despite all of our investment, our hard work and our continued commitment to that. Those opposite also need to understand the significance of this program. Many of the electorates that are represented in this place include those rural and remote communities where people’s health outcomes are not as good as they should be and where the effects of not having a significant and high uptake of vaccination programs can have a very deleterious effect on people.

Last year of course, as further evidence of that, was an unprecedented flu season that put an enormous strain on our hospitals—some 69 000 laboratory-confirmed flu cases. We saw more than double the number of measles cases in 2019 than in 2018. If you take these sorts of figures and you overlay them in vulnerable communities where health outcomes are not as high, you can see where the risk really lies in our community for those who do not have the protection of vaccinations themselves or that herd immunity that results from making sure that there are sufficient vaccination rates and uptake. We also know that 2017 was a particularly bad flu season, with hundreds of Victorians unfortunately passing away with comorbidity issues. Particularly targeted were people who were elderly or who were vulnerable in their own health.

We know this legislation is particularly about not only protecting and advancing the interests of our healthcare workers but providing some very significant advances in what we need to be doing across the community to keep people safe and to send a very clear message, picking up again on the desire to lift our vaccination rates wherever we can. There is a broad acceptance and understanding of that in the community. I would not spend very much time on some of the comments and views that have been put to me and other members of Parliament from keyboard warriors out there, but can I say that in past roles, where I have been involved in health policy and prevention, particularly in relation to the fluoridation of water supplies in rural and regional Victoria where we have expanded and broadened out those prevention and public health matters, we have seen significant improvements in people’s health and wellbeing, giving young people in particular—new generations of Victorians—every chance to lead long, successful, healthy and prosperous lives. Some of those silly arguments that we hear and see out there should be ignored, really, and discounted and held to account on occasion. Again, we hear those on the vaccination front. But what we know is that there is strong support for this bill and strong support for vaccination policy in our state, and I commend the bill.

Mr CHEESEMAN (South Barwon) (14:38): Thank you, Acting Speaker Fregon, and congratulations on accessing such a high office. I would like to speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. I find it interesting that today as we debate this bill the likelihood we are hearing, certainly from the global health authorities, including of course our commonwealth government and indeed senior health officers within the Victorian government, is that we are right now as a community potentially experiencing a global pandemic with respect to the coronavirus. In reflecting on the elements of this bill and indeed in looking at some of the historic pandemics that humanity has experienced over the last several hundred years, we are now as a global community fortunate in comparison to past generations that our medical science has these days advanced to an extent that we are able to develop vaccinations that help us as a global community, us as a country and us as a state over time to overcome these global pandemics.

Historically if you look at the spread of these viruses, not only often is it healthcare workers that help in our recovery but it is often those healthcare workers who, because they are dealing with those that are unwell and that are experiencing various diseases, ultimately put their own occupational health and safety at risk. Clearly perhaps for a period of time after they have been exposed but before they become unwell they may be passing the virus from their hospitals and the places in which they are treating people back into their own communities. As a consequence of that I think this legislation has been thoughtfully developed to ensure that the healthcare workers in our public health system in the first instance are protected from an occupational health and safety perspective—that they can go to their workplaces, care for those that are sick or injured and protect their own health but then ultimately protect the health of their loved ones, making sure that they do not take a disease or illness that they have contracted from their workplace back into their own homes and back into their own communities.

As I say, we are fortunate in comparison to previous generations that we have made massive advances in medical science and we have been able to develop vaccinations which enable us to protect those workers and to ultimately protect their families and the communities in which they reside. Over the last 20 or 30 years throughout Australia we have had a very active immunisation program, and many diseases that people experienced prior to that are no longer found in this country to the extent that they used to be.

It is with some pleasure that I identify the CSIRO Australian Animal Health Laboratory in Geelong, who are world leaders in terms of identifying viruses, particularly those that are transmitted from animals to humans. They are global leaders, and they have partnered with many of our other research entities in this state to be at the forefront of developing these vaccinations which go to keeping us and our communities profoundly safe.

The importance of this initiative really does need to be considered not necessarily in terms of global pandemics, which I have spoken about, but really more from the perspective of more common diseases, more common viruses that our communities are subjected to—things such as the common flu virus. My limited understanding of the way viruses transmit is that people can become unwell but before they actually start experiencing those symptoms they can spend anywhere up to several weeks in their communities passing on that contagion, passing on that virus in their communities. If we look at the flu season, particularly over the last couple of years—we of course know that not every flu season is the same; I think in the 2017 flu season that particular strain of that virus was more contagious—we certainly know that in any one particular year we can have somewhere between 700 and 1000 Victorians who will succumb to that virus and pass it on. Often those people are the more vulnerable in our communities, whether that be young people or whether that be our elderly and the like.

This legislation, I think, is a very well considered piece of legislation that will, if you like, almost create a bit of a barrier around our public health system to ensure that our healthcare workers in the first instance do not get sick themselves but, importantly, do not carry those diseases that they may come into contact with back into their families and back into their communities. I think the legislation is very well informed by the science. I think it is very well thought through public policy that will ultimately lead to a much greater level of protection for all of our communities. Ultimately we want to see with these diseases wherever possible that we eliminate them. We want to see that instead of getting perhaps 95 per cent herd protection that we take it to as close to 100 per cent as we can.

Like most others in this chamber I have received quite a number of emails, particularly from people claiming to be nurses. Certainly all of the nurses that I have ever spoken to very much want to see their own occupational health and safety protected. They want to see protections for their families and the like. All of the nurses that I have ever interacted with as far as I know very much would be supportive of these measures being put in place because it is good for their health, it is good for the health of those that live in their homes and of course it is good for their communities. The more we vaccinate against these particular viruses, these particular contagions, I think the better we will be and the more healthy we will be as a society. I commend the bill.

Mr HAMER (Box Hill) (14:48): Thank you, Acting Speaker Fregon, and it is a real pleasure to see you in your elevated position today. May I just say, you are doing a fabulous job and you have controlled this session absolutely wonderfully. I also want to thank the member for South Barwon. I always do learn a lot from his contributions, so it is a pleasure to follow him.

I also really want to thank the Minister for Health for bringing this important public policy to the house and all her staff, not just in terms of the legislation that is before us today but particularly all the work that they have been doing in the last six weeks as the coronavirus has been developing. I know that the minister and her staff have been working very long hours over this entire time to get information out certainly to my community and to your community as well, Acting Speaker Fregon.

As has been discussed, the purpose of this bill is to provide the secretary with the power to direct health services to vaccinate certain members of staff with particular vaccines. To me it really comes down to a simple proposition—that is, if you are a frontline healthcare worker, you are more at risk than many other members of the community. This policy is in line with how the Andrews government thinks in terms of health and safety, particularly the health and safety of workers. We were on the steps of Parliament earlier in the week celebrating the passage late last year of the amendment to the WorkSafe legislation and realising how important it is to be safe in your workplace, particularly in the construction industry. You would not be allowed to turn up to a construction job and say, ‘Oh, well, if I don’t want to wear a hard hat, I don’t have to wear a hard hat, because I just oppose philosophically wearing something on my head’. That is the standard. All those standards have been introduced over a number of years because of the deaths that have been caused.

In the health sector we have seen that in a number of other areas of government policy, particularly in the no jab, no play initiative that we have for kindergarten children in terms of going into kinder and making sure that their immunisations are up to speed. I was listening to the lead speaker for the opposition, the member for Lowan, in her contribution, and I appreciate her long employment history in this area. I think she did refer to the concept of herd immunity, and I think it is really important that we are able to increase the vaccination rate and immunisation rate as greatly as possible.

I do want to go specifically into a bit more detail about the coronavirus and particularly how that relates to this bill and cite a number of cases. One of the more publicised, high-profile cases concerns a doctor from Wuhan, Dr Li Wenliang, who was one of the first to identify the existence of an unknown virus in the area. The reports are that he was detained and censured at the time but he continued to see patients and treat patients. Sadly, he contracted the coronavirus and has since died—a man in his 30s, a doctor, well qualified, who would have had many, many more years to give to his profession.

Just this week we have seen in New South Wales two health service workers have contracted the coronavirus. I wish them both a very speedy recovery. I understand that they are the first two cases of human-to-human transition that have occurred in Australia. It really just illustrates the point and I guess the risks that healthcare workers face every day dealing with, in many cases, the sickest people and the people who present with the most symptoms. For their own health, for the health of their families and for the health of other patients who they will go on to treat it is really critical that healthcare workers are vaccinated when a vaccine is available.

I was really pleased to see the Premier and the Minister for Health out at the Doherty Institute this week announcing $6 million for further research towards the development of vaccines and protections in relation to the coronavirus. We do have world-class medical research facilities here in Melbourne, and it really was great kudos to the Doherty Institute that I think in January or maybe early February they were the first institute in the world to actually recreate the virus and then be able to send that to research labs across the world. The experts suggest that the vaccine is some months away, possibly even next year, but based on not only the particular health scares that have been documented and the individuals that have died but the community angst that exists I am sure that a vaccination will be very much sought after, particularly by those in the most at-risk groups but also for those healthcare workers.

Can I make my last point on the coronavirus. I have not had many opportunities in this chamber to talk about the coronavirus, but can I pay tribute to the local Chinese community in the electorate of Box Hill, who have had an anxious time over the last few weeks. There have been some reports of racist attitudes that have been directed towards members of the Chinese community, and we saw an episode, I think last week, in the children’s hospital where a patient refused to be treated by a Chinese doctor. I just want to call that out—that has no place in our society—and I want to use this opportunity to again show solidarity with our local community.

In my final couple of minutes I want to go back to the vaccines that are actually available. I know a number of other members in this place have talked about the terrible flu season that we had last year. Last year was the worst flu season for many years. I think in total across Australia there were more than 300 000 people who presented to health services with symptoms of influenza and approximately 900 flu-related deaths across the country. Obviously there is a vaccination available, but it is not compulsory and it needs to be updated every year and changed. There are various reasons why there was a longer season and a more impactful season, but clearly this is a big health issue and anything that we can do to help try and prevent the spread of viruses and of diseases is something that as a community and as a society we should be adopting.

In closing I would just like to touch on some of the emails. Unlike the member for Bentleigh, I did not read most of my emails. When a couple of them started talking about the Nuremberg laws and drawing parallels to the Nazis and the medical procedures that went on, I just tuned out. In any language that is not acceptable—you cannot compare the vaccination that occurs in Australia in terms of health and safety with Nazis. It is just not on.

Ms EDWARDS (Bendigo West) (14:58): It is a pleasure to speak on this bill because I think once again by introducing legislation such as this the Andrews Labor government is showing how much it is prepared for and wants to place an emphasis on ensuring that our community is protected from any number of diseases and illnesses that could permeate our society. From the outset can I say how much I appreciate, thank and show some gratitude to our healthcare workers who are on the front line constantly in our hospitals, our aged-care facilities and our ambulance services and of course who are on the front line in protecting our communities every single day. We should never undervalue the work that they do because without them who knows where we would be.

However, it is really important that our hospitals, health services, ambulance services and indeed all of the other services that protect us do not have frontline staff who are off ill, particularly at times of peak demand. With the current climate that we are in, we may see that peak demand double in the coming months as the flu season approaches once again but also because of the potential spread of COVID-19. As we know, health facilities are a place people go to get better, not to get sick.

It is important also that our healthcare workers are safe—very safe—in their workplaces. In 2017 the Andrews Labor government announced a staged target of reaching 90 per cent flu vaccination rates for our health services staff by 2022, and it is well on track to reach that target. Just last year we reached an 88 per cent flu vaccination rate in our public health services. Of course this bill will enable us to mandate the flu vaccine and indeed other vaccines for our frontline health workers. This will include our ambulance staff, our private hospitals and our public aged-care staff. It will include cleaners, orderlies and administrative staff who have day-to-day contact with patients and who also do amazing work in our healthcare system.

I was reading an article by the Immunisation Coalition in support of mandatory vaccination for healthcare workers, and I would just like to refer to an article that they produced, where they have said that currently about 83 per cent of hospital staff across Victoria have been vaccinated against the flu, while at the Royal Children’s Hospital the number was believed to be hovering at around 88 per cent. The Immunisation Coalition calls for healthcare workers and allied health and ancillary staff members and their employers to recognise their duty and responsibility to protect themselves, their contacts and their patients from influenza and indeed from other illnesses.

As has been mentioned by other speakers, seasonal influenza remains the leading cause of the annual vaccine-preventable diseases associated with hospitalisation and death in Australia, and the immunisation of healthcare workers plays a significant role in preventing transmission within the health system and healthcare settings, so it is really important. Some voluntary healthcare worker vaccination programs have been effective when combined with strong institutional leadership and robust educational campaigns. The rates of influenza vaccination amongst healthcare workers in Australia remain suboptimal.

I just wanted to refer to that article because I think it is important to note that there are health professionals right across Australia who are already doing this, particularly in other states, and that the call is that every single healthcare worker have this kind of protection. While I was looking at this legislation, and in light of the COVID-19 virus, it occurred to me, ‘What would our world be like if we had no vaccines, if the vaccine stocks disappeared overnight?’. Can I say, as a parent and a grandparent it terrified me, because I think the consequences would be millions of women and millions of children and adults suffering needlessly from preventable diseases. As we know, one of the things that vaccines make possible is of course the eradication of disease. Smallpox has been eradicated, and polio is close to being eradicated. They are just two. But it requires everybody in the world to use them, and unfortunately there are people in the world who do not have access to these particular vaccines. In fact most people in developed countries like Australia have never really seen the impact of infectious diseases like measles, diphtheria, meningitis and whooping cough. We have vaccinations now that prevent the majority of our population from getting those diseases, and so we do not fear them, because we really have not seen them firsthand. And it is because of vaccines. Illnesses have disappeared as a consequence of the Hib vaccine that young children get—the bacterial meningitis vaccine. We do not see children presenting with swollen windpipes and the inability to breathe because of that vaccine, and some of those classic diseases are gone now because we vaccinate people.

We know that a disease that appears to be under control can suddenly return, because we have seen it happen. In Japan in 1974 about 80 per cent of Japanese children were getting the whooping cough vaccine. That year there were only 393 cases of whooping cough in the entire country and not a single death. Then immunisation rates began to drop until only about 10 per cent of children were being vaccinated, and in 1979 more than 13 000 people got whooping cough and 41 died. So when routine vaccination was resumed the disease numbers dropped again. That is just one example of how failure to immunise can actually create significant, ongoing problems in the community, where more and more people get sick and more and more people die. Of course since vaccines were first developed in the late-18th century they have been used to combat and even, as I said, eradicate many deadly illnesses.

Sadly there are some sceptics out there—people that we know as anti-vaxxers. Like many members of Parliament I have received a number of emails that I really have not read. Some of them appeared to me to be not quite genuine and potentially a campaign by an anti-vax movement to send on standard emails from people claiming to be healthcare workers. I clearly was curious and sceptical about the genuineness of those particular emails, particularly when I looked at some of the names on those emails. One of the things we need to remember is that anti-vaxxers are conspiracy theorists, for want of a better word, and they like to spread fear around vaccines. I was looking at a Forbes online article back in February of this year titled ‘How anti-vax activists use conspiracy theories to spread fear of vaccines’.

Indeed the World Health Organization recently declared that vaccine hesitancy, anti-vaxxers—that is what the World Health Organization refers to as vaccine hesitancy—was one of the top 10 threats to global health. That is right, it was up there with air pollution, climate change, influenza, Ebola and other threats. For the WHO vaccine hesitancy is a polite phrase designed to engage the public and highlight how serious the problem is without angering those who indeed are guilty of peddling the anti-vax message.

I look at my grandchildren. I had the whooping cough vaccine myself just before the first one was born, with no hesitancy at all. My children were saying, ‘You have to have the whooping cough vaccination. No-one can see my babies until they have been immunised if you have not been immunised’. That is the kind of message that we want people to have. We do not want people saying, ‘Your child is going to get sick if they have a whooping cough vaccination’. It is just ridiculous. We would be reprehensible as individuals if we allowed children to get sick when there is no reason for them to get sick. It is simply going and getting a vaccination. It just makes me so angry that there are people out there peddling this kind of nonsense. As we know, it is the conspiracy theories that are the background to many of these arguments. It is important for everyone to be vaccinated and more important for our healthcare workers.

Ms ADDISON (Wendouree) (15:08): I rise today to speak in support of the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020 because I firmly believe that we need strive to provide excellent healthcare that is of the highest quality and that is as safe as possible to all Victorians. This is what Victorians deserve.

Further, I strongly believe that this bill is in the best interests of all Victorians. As a responsible government, we have an obligation and a duty of care to all workers in our public hospitals, denominational hospitals, private hospitals and ambulance services to provide them with a safe workplace, which includes being protected from specific vaccine-preventable diseases. For the Victorian government to deliver quality and safe health care to the communities we serve it is essential that we minimise risk to patient safety, which will result in positive outcomes and better health.

At the heart of this bill is this government’s commitment to the occupational health and safety for Victoria’s frontline healthcare workers. I wish to thank the Minister for Health in the other place for the work she has put into this bill since she announced the policy for the introduction of a mandatory vaccination program for health workers in acute settings on 1 August 2019. I would also like to acknowledge the work of her office and the department in the preparation of this bill.

I welcome the widespread consultation about the bill that has occurred with key stakeholders. I would particularly like to thank the chief health officer, who has considered best practice in other jurisdictions and relied on evidence to inform his decision-making before making the determination that maximising the coverage of health workers is the optimal option. I would also like to thank all of those who contributed to the round table and provided their expert insights and recommendations, including health services, unions, professional bodies, clinical experts and healthcare representatives, to ensure that we get this right.

This is another example of the Andrews Labor government showing its commitment to the people of Victoria by reducing the risk of vaccine-preventable diseases for frontline healthcare workers and mitigating the risk of transmission of vaccine-preventable diseases to patients by amending two of our important acts, the Health Services Act 1988 and the Ambulance Services Act 1986.

I would like to take this opportunity to congratulate the Minister for Ambulance Services in the other place, Ambulance Victoria and the Victorian Ambulance Union, ably led by general secretary Danny Hill, on reaching an enterprise bargaining agreement for paramedics which will provide better pay and conditions and additional paramedics to better care for all Victorians. I want to thank all paramedics and show my respect for the work they do day in, day out.

I am proud that this new agreement will not only provide ongoing professional development but will make our paramedics amongst the best paid in the country. I would like to put on record that this was achieved without any industrial action. Compare this outcome to that of the Baillieu-Napthine governments that disrespected our paramedics: the difference could not be starker.

The changes that will be introduced by this amendment bill will allow the Secretary of the Department of Health and Human Services to direct employers of healthcare workers in public health services and ambulance services to be vaccinated against specific vaccine-preventable diseases. 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. The proposed new laws will mean our healthcare workforce must be fully immunised to protect themselves and patients against not only the flu each year but other diseases such as whooping cough, measles, chickenpox and hepatitis B. This bill will maximise compliance with recommended vaccination policy. It is important that our community is aware that Victoria is one of only a few jurisdictions in Australia that does not have this mandatory vaccination for healthcare workers. This amendment bill will address this.

Let me be very clear: I disagree with members of our community who are anti-vaxxers, those who oppose the science of vaccinations. The evidence is in and the benefits to our society are great. Vaccinations are safe and save lives. That is why the Andrews Labor government already makes the flu shot free for healthcare workers. By mandating vaccinations for healthcare workers, thousands of patients have not had their healthcare and treatment compromised and our hospitals have minimised their absenteeism rates.

Locally, in Ballarat the number of flu cases put pressure on our emergency departments and health services, but our dedicated health workforce rose to the challenge and continued to deliver world-class care for my community. In my electorate we are so fortunate to have two world-class hospitals in Ballarat: the base hospital and St John of God. I care about the health and wellbeing of all of our healthcare workers. Healthcare frontline workers and paramedics across Ballarat do an outstanding job in caring for our community.

Recently my dad has required the services of paramedics and healthcare workers at St John of God, and I would like to thank the dedicated staff who provided exceptional care for him. Ballarat Health Services is the largest employer in the region with over 4500 staff, including thousands of dedicated nurses and health professionals, orderlies, cleaners and catering staff. Ballarat Health Services is the main public referral hospital for Ballarat and the Grampians region, and it has been providing quality care for over 160 years. It is Victoria’s second largest regional health service and provides a comprehensive range of general and specialist care.

I support this bill not only as the member for Wendouree because it is important public health policy but also as the former chair of the Ballarat Health Services quality and safety committee and the Ballarat Health Services consumer advisory committee. From my experience from my three-year term on the board of directors of Ballarat Health Services I know firsthand that this bill will deliver positive outcomes for the workforce, patients and the broader Ballarat community.

Ballarat Health Services has been very busy, with nearly 61 000 emergency department presentations, 47 000 inpatient treatments, 10 000 surgeries, 2265 people treated in the mental health services and over 1400 babies born. I am very pleased that these numbers will continue to grow as my community does. And with the Andrews Labor government’s investment of $461.8 million to redevelop Ballarat Health Services, the future of health in Ballarat is looking very good.

Whether patients are receiving care at the base hospital or at St John of God or from Ambulance Victoria, we need to reduce the risk of exposure. This bill will help them achieve this. If health carers are not immune, they pose increased risks of disease transmission to other staff and patients, particularly those who are vulnerable.

My dad is commencing cancer treatment at the Ballarat Regional Integrated Cancer Centre this week, and I do not want his health and wellbeing threatened by contracting a vaccine-preventable disease. I believe that we have a duty to the workforce, patients and their families, as well as the community, to do what we can to protect people like my dad and other people’s family members and friends from disease transmission when they are attending hospital.

In 2010 our eldest child experienced a severe health episode that resulted in her spending an extended period in intensive care at Monash hospital. It was a terrifying time for Mike and me, living in Ballarat and having our child transferred to Monash, and we were unsure what the outcome would be for our daughter, who was only 18 months old at the time.

While she was in an induced coma our very sick little girl received 24-hour-a-day care in a world-class hospital. She was incredibly vulnerable and immunocompromised as her tiny body fought off the numerous health challenges. I would not wish this experience on anyone. It was the most difficult time in our lives. Fortunately our daughter pulled through and is a very active and happy 11-year-old. For my daughter and every other sick child, and other families who have lived through having a sick child in hospital, I am supporting this amendment.

I am committed to ensuring a safe and healthy working environment for our doctors, nurses, dentists, paramedics and orderlies, which will also reduce the risks for patients, residents, visitors, volunteers, and contractors at all health services and hospitals.

To conclude, I thank the minister, I thank this government, and I am very, very proud to support the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020, because it is another example of the Andrews Labor government living its values and improving the lives of all Victorians. I am confident that by introducing this bill we will enhance the occupational health and safety and working environment of our health services, our hospital employees and our paramedics, whilst very importantly strengthening and embedding patient safety, because it is patient safety that we should all be fighting for every day in our hospitals. I cannot commend this bill to the house more strongly.

Ms GREEN (Yan Yean) (15:18): I take great pleasure in joining the debate on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. I say at the outset that one of the reasons that I got off Twitter was the anti-vaxxers. That might have meant that I wanted to hang back from speaking on this bill, but I am not going to. From hearing the member for Melton before, I know that we are so fortunate to have him speak so knowledgeably from his experience of being a frontline paramedic. When he spoke in particular about the horrific measles outbreak in the Pacific last year I found quite shocking the rate of infection of babies there, and indeed the rate of death—one in 150 babies in that country.

It is things like that that really underscore why we need vaccination, particularly for our workforce. A number of us have received emails from people claiming to be health workers who are very concerned. I wish that when people email you about matters of concern they would identify where they live so you can hone your response to them. I say to people who send emails constantly—the keyboard warriors—that you are more likely to get our attention if you say where you live and give greater detail about yourself. It probably helps us to understand a bit more.

We see a lot of hysteria around this. I think some in the house might have been concerned about whether I was going to miss my call for this bill, but I was actually with the whip and my northern colleagues having a meeting with Northern Health, as we do periodically. They are a fabulous health service that really perform above expectations. They are not a very large hospital and they have a huge catchment. In particular their emergency department is outstanding in its performance and in overachieving its targets.

They of course in their briefing were talking about their preparations for the coronavirus. In this pandemic many of us really want to thank the Minister for Health for organising an all-Parliament briefing early this week, the second one that she has done, with the chief health officer. We heard about things in great detail. One of the things that Northern Health were saying to us was that they are really concerned about the impact that this virus could have on their workforce if this thing takes off in Melbourne’s north. It will not be about just managing the sick that come through the building, but having large numbers of the health workforce in quarantine—hopefully not too sick in home quarantine—could mean that there will be great difficulty in being able to offer their service. I think it really has focused the mind.

As yet the virus does not have a vaccine for it. I get a flu vaccination every year. A number of years ago I said, ‘Do I need to have it?’. My GP said, ‘Look, for your health and your age you probably don’t need to, but the flu is a really, really serious disease for vulnerable categories—for older people, for babies, for people with compromised immune systems’. He said, ‘It’s actually your contribution to other people’s health by ensuring that you get the flu shot each year’. I think it does not have as good a coverage as some other vaccines, but I was pretty rapt last year. I did not have a cold or flu. Touch wood, I will not get extra ones this year.

We had quite a diabolical flu season last year. That, combined with coronavirus, is going to be an amazing challenge for our workforce. I think one of the best things we can do is to contribute to that herd immunity and reduce the risks of vaccine-preventable disease for our frontline healthcare workers. It mitigates the risk of transmission of vaccine-preventable diseases to patients and it maximises compliance with recommended vaccination policy. I think in terms of being a responsible employer it is the best thing that we can do. I want to thank the Parliament, because each year the Parliament reimburses our staff, all the parliamentary officers and MPs so that we get our flu shots.

The bill makes amendments to the Health Services Act 1988 and the Ambulance Services Act 1986, which will allow the Secretary to the Department of Health and Human Services to direct employers of healthcare workers in public health services and ambulance services in Victoria to require healthcare workers to be vaccinated against specified vaccine-preventable diseases.

From the briefing we just had with Northern Health we know that our healthcare workers are at increased risk of vaccine-preventable diseases if they are not vaccinated. They come into contact with sick people, and if they are not protected they may pose risks to their colleagues but also to patients. With the planning that is going on for coronavirus there is a concern that if you do not have enough coverage of people who have been vaccinated you have got a higher risk of staff absences. We see that in the flu season. Our public hospital system was under enormous pressure last year. The flu season lasted for about nine months—it was a particularly difficult winter—and our hospitals performed very well, but they are going to be able to do even better when they have got a workforce that is protected.

I spoke about the member for Melton and his contribution earlier and about the measles cases in the South Pacific, but even here in Victoria we saw more than double the number of measles cases in 2019 than in 2018, and we had a large year for pertussis, or whooping cough. My children have had whooping cough, and that is such a scary, scary disease. One of them was already at school. It is not something that you think about, but he had it, and it is very scary. Last year there were 2210 notifications compared to 1700 in 2018. These diseases are not just a bad cough or an itch; they are potentially deadly diseases, and they do kill people every year, including in Victoria.

We owe a debt of gratitude to our healthcare workforce. I have had the pleasure, when I have been out doorknocking, at street stalls and things like that, to meet a number of nurses and particularly paramedics; there is a really high number of paramedics and other first responders that live in the Yan Yean electorate. I really want to express my thanks to them during the debate on this bill.

I also want to commend the minister and her department. I cannot imagine what their workload is like at the moment. I want to commend her advisers and the staff of the Department of Health and Human Services. They have also got a workload to deliver the capital projects that we have promised as election commitments. They are doing a very good job in a difficult environment, and I wish them well in the coming months. I commend this bill to the house.

Ms RICHARDS (Cranbourne) (15:28): I rise today to contribute to the debate on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020 with great pleasure and pride. It is a bill which makes amendments to the Health Services Act 1988 and the Ambulance Services Act 1986 and which will provide the Secretary of the Department of Health and Human Services with powers to give directions to public hospitals—including public health services, denominational hospitals, health service establishments and ambulance services—and to be able to specify requirements for employees and workers to be vaccinated or prove immunity to specified diseases.

I would like to reflect on the contributions to the debate that I have just heard. I think it has been very important for people who have done the journey with other vaccination bills to be able to provide those insights, and I am very grateful to have heard that wisdom and also the passion that comes from having a parent who is unwell or having had a child who was unwell, and to have heard of the effect that the stress of a sick child or a sick parent has on somebody without worrying about additional burdens of disease. I would also like to pay credit to the member for Melton. As always with health-related bills, to be able to hear firsthand from somebody who had a long and very important career servicing our community as an emergency services worker in the health sector—to have somebody of the calibre of the member for Melton—is something that is a great credit to Labor. I am very proud to be able to share this side of the house with people who have that sort of background.

Like the speaker before me, I am a very enthusiastic supporter of the science of vaccination. I see this as fundamental to our collective responsibility to live in a society where the well have themselves vaccinated so that those who are too young or for other reasons unable to be vaccinated are protected. I see this as part of the collective, because of course herd or community immunity is essential if you believe that a society must function well and put the needs of those who are not able to be vaccinated ahead of the needs of those who are unsure and have not taken the time to read the credible scientific literature.

Herd immunity happens when enough people are immunised against an infectious disease and there is less of the disease in the community, making it harder for the disease to spread. Victoria is one of only a few Australian jurisdictions that do not have a mandatory immunisation requirement for frontline health workers. We know that healthcare workers are at increased risk of vaccine-preventable diseases if they are not vaccinated. Importantly we know that healthcare workers may pose increased risk of disease transmission to other staff and patients, especially those who are vulnerable.

This government is once again taking action and bringing this state into line with other jurisdictions on the mandatory vaccination of healthcare workers. Our dedicated frontline workforce is under ever-growing demand to provide world-class care, continually rising to the challenges of the horror flu season we have seen and disease outbreaks that we are looking to face potentially in the future. To ensure that our healthcare workers are safe in their work environment and that the risk of illness being spread to them and vulnerable patients is minimised—and the risk to their families is also reduced—we are making sure that our healthcare workers are among the first to be immunised each year by making the flu vaccine and other vaccines mandatory. This will include ambulance staff, private hospital staff, public aged-care staff, cleaners, orderlies and administrative staff who have day-to-day contact with patients.

We know that those people who have day-to-day contact with patients are vital to the care of those in our community who are unwell and those in our community who are perhaps well but are going to have babies in hospitals. The people who often serve our food or make sure that the environment is clean and healthy are also those who take the time to stop and talk to patients, and the role that they have is recognised in this legislation. Not only will this ensure our front line is protected and there when we need them the most, it will also ensure that those being cared for, including those vulnerable, as the member for Wendouree talked about, because of age or illness; those who are pregnant; those who have chronic diseases; and those who are immunodeficient have significantly reduced risks of disease transmission.

Modern vaccines provide high levels of protection against vaccine-preventable diseases. Make no mistake, these diseases can be fatal. Vaccinations are one of the most effective ways of preventing disease worldwide. Reducing morbidity and mortality from many infectious diseases by means of vaccination has been described as one of the most significant public health achievements of the past century. Last year we had an unprecedented flu season, and that put enormous strain on our hospitals, but our dedicated health workforce—again I pay credit to them at every opportunity, as we all do on this side—rose to the challenge and continued to deliver the world-class care that Victoria is known for. The Labor government has made the flu shot free for healthcare workers, and the new law will ensure healthcare workers are fully immunised to protect themselves and patients against the flu, whooping cough, measles, chickenpox and hepatitis B.

In 2019 the Labor government set a target of 84 per cent flu vaccination rates amongst healthcare workers, and we exceeded that. We reached 88 per cent across the state. With the Attorney-General now in this place, it is a credit to her that we introduced the no jab, no play legislation that made a huge difference in protecting children against preventable diseases, with Victorian immunisation rates still the best in Australia.

We have the latest hospital performance data, and it shows our paramedics and our hospitals are rising to the challenge of record demand caused by a busy flu season. Despite this flu spike elective surgery patients are receiving their operations quicker than ever before and patients are being treated within a record median of 28 days compared to up to 42-day blowouts under the Liberals.

Ambulance Victoria recorded the best ever code 1 response times for the quarter despite more than 8500 additional code 1 emergency patients in the same quarter a year prior. This latest data shows that hospitals have driven down elective surgery waiting lists to 40 210, 2845 patients fewer than the last quarter and below the 50 000 barrier broken by the Liberals before they lost office.

Like many, I have been receiving emails from people who oppose vaccinations, and I was interested to note, and relieved at, how few of those people who contacted me actually lived in the area I represent—incredibly reassuring. I actually agreed with the member for South-West Coast when she said earlier today that she was horrified to see the number of healthcare workers who emailed in opposition to vaccinations, and of course the member for Yan Yean has articulated very clearly and strongly the outrageous hypocrisy of people who are opposed to vaccinations.

So I would like to take the opportunity to respond to the antics of the anti-vaccination movement and embed some science into our discussion about vaccinations, because we know there are people who are peddling misinformation and mistrust, and this makes me so angry. Of course we must use credible sources in this debate. In Australia the source of credibility is the CSIRO, because it is our premier science agency, and in Victoria I always send people to the Better Health Channel. If you spend some time in the CSIRO, you will see they use humour and clear language. I feel angry, but I am delighted to see the way that they are busting myths, and of course the most contentious of those myths is the one that vaccines cause autism.

Twenty years ago a former British doctor had an article published that falsely linked the measles, mumps and rubella vaccine to autism. Since then a high number of quality studies have compared the health of a large number of vaccinated and unvaccinated children, and the largest of these included thousands of children born in Denmark. There are some really terrific insights on the CSIRO website, and I implore people to use credible sources.

I am going to take a moment to reflect on those who are anti-vaxxers and reflect that I have some friends who are hesitant. I reminded them that they are in the company of Donald Trump, Pauline Hanson and a group of celebrities whose health expertise is non-existent. So I will take the opportunity to thank Minister Mikakos for bringing this and the minister’s staff and also take a moment to thank those who are working very hard to keep us safe. I thank our nurses, our paramedics, our doctors, our ancillary workers, our personal care attendants and all who bring us this care.

Ms HENNESSY (Altona—Attorney-General, Minister for Workplace Safety) (15:38): What a delight it is to come after the member for Cranbourne, a well-known public health advocate. I would also enthusiastically join her expression of appreciation and admiration to the Minister for Health for bringing this very important bill before the Parliament—and a very important bill it is indeed.

We have seen the world of public health change over the last 50 years, and it is beyond contest that the innovation of vaccinations and immunisations has fundamentally changed the public health outlook for the world, not only in developed countries but particularly in developing countries. We no longer live predominantly in a world where polio exists and where we see things like babies dying from whooping cough and pertussis. We have great opportunities to protect pregnant women—things like blindness and deafness because of an exposure to measles, mumps and rubella occur. We know that, now, we can better protect particularly women but also men from the scourge of things like cervical cancer with wonderful innovations such as immunisations. They are without doubt one of the greatest public health innovations that we have seen occur over the last 50 years. That has really been led by the people that have done the fabulous scientific research to that end, but it has also been by relying on those who have served at the front line around public health to ensure that we have been able to roll out immunisations and vaccination programs.

Why is this bill important? We have seen really significant movement in how we build what is called herd immunity, and I heard the member for Cranbourne give a very accessible explanation of what herd immunity is. What it is scientifically of course is the threshold we have to get to, of about 95 per cent, to ensure that we are all protected against vaccine-preventable illnesses.

There is also what it means socially and, I would certainly argue, morally—herd immunity is our responsibility to each other. It is our responsibility to reflect upon how our decisions, particularly our decisions to get vaccinated or not, impact upon other people in the community. And in ensuring that we are able to do things like protect those who are immunocompromised—whether that is because they have got a chronic illness or disease, whether that is because they are having chemotherapy or whether that is because they are a baby in utero or a baby just born—it is our responsibility to make sure that we are doing our best to protect them from vaccine-preventable illnesses, because we can. And that means that we have got to use every front we possibly can, every lever we possibly can, to make that occur.

This government has made such significant strides in ensuring that occurs. We have introduced no jab, no play. For the first time we have got children under five to 95 per cent herd immunity; that will save lives. We have got significant investment around access to meningococcal vaccines, particularly targeting those 15- to 16-year-olds where again a simple intervention can save lives. We have got vaccination occurring in schools to ensure that we are doing our best to protect young women and young men in the future against certain cancers that we know are potentially vaccine preventable. But where we still continue to have work to do is of course in our health system. Our frontline health workers do an extraordinary job. Many of them are vaccinated, but certainly what we know is that for those that are working around the very ill and the very vulnerable—whether they be visitors or healthcare workers—we have got more opportunities to try and strengthen the level of vaccination and the penetration of vaccination in the health system.

This is a fantastic bill that seeks to make sure that we are using the levers to achieve good public health outcomes and good public policy. In doing so we will be protecting those that are vulnerable. We have seen in winters gone by horrific influenza seasons that have genuinely resulted in the death of people where perhaps if we had higher rates of vaccination we could have avoided that outcome. So this is a bill that is fundamentally motivated by making sure that we are exercising our public responsibility to ensure that the vulnerable are protected and that we are finding and utilising every lever. I commend the Minister for Health for her absolute passion and commitment to that end.

I, too, would like to make a couple of brief comments in respect of the vaccine hesitant as well. We know that the anti-vaccination movement is a very, very well organised movement and that there are those that have jumped on the bandwagon that are anti-science and that have utilised one misconceived article that was published decades ago that falsely claimed a link between the measles, mumps and rubella vaccine and autism—a connection that has been comprehensively debunked, a myth that is dangerous and a myth that essentially puts the life and wellbeing of vulnerable people at risk. It is absolutely rejected by every scientist. This is a platform where we should be calling out these people who are effectively flat-earthers for what they are: people that peddle dangerous myths. That is one cohort, and we should not underestimate their resolve. They get very organised. They are very organised internationally. I have got good firsthand experience of the tactics that they use in respect of their advocacy.

But there is another group of people that perhaps are what we might call vaccine hesitant, that are not necessarily starting from the position that they think that there is a worldwide conspiracy against the world in the form of vaccinations. What happens, however, is the myths and misinformation get out there and when the vaccine hesitant do things like google information about whether it is safe or not safe to vaccinate their children some of the claptrap from the anti-vaccination movement appears on their computer screens. We have to continue to make sure we engage with the vaccine hesitant. We have got to make sure that we are encouraging people to get their advice from their maternal and child health nurses, to get their advice from their general practitioners and to take their advice from those that are clinically trained, not the nutters on the internet who try and perpetuate ongoing myths about the safety or lack thereof of vaccination.

We have also got to recognise that we have got to make vaccination available for people. Being a parent, and being a young parent, is really tough work, and it can be one of those things where parents say, ‘Oh, I’ve just got to get around to it’. We have got to make sure access is as porous as possible. We do that by making sure people can get access to affordable public health services, whether that is nurses or whether that is pharmacists, who in some circumstances are legally able to vaccinate people, and by making sure that our private and our primary healthcare system is not so unaffordable to parents that they cannot afford it or do not have the time to get there.

We have got to make sure that we keep putting out the pro-science, the pro-public health message that vaccination works, that it has changed the face of our earth when it comes to preventable illnesses and diseases, that we will not stand back in our health facilities and refuse to use every tool in our arsenal when it comes to making sure that vulnerable patients are protected from things like influenza—again, potentially preventable through vaccination—and that we are actually going to put in place proper plans and processes to make sure that people are protected from avoidable, preventable illnesses.

I know that the vast majority of those that work in the health system are great advocates of vaccination. I know that they will feel enthusiastic about a culture that says everyone has got to do their bit, and I know that families and friends will absolutely take very, very seriously our mutual obligation to each other to ensure that we are all kept very, very safe.

Congratulations to the minister, as I said. I wish all of those that work in the health sector the very best in making sure that they are able to efficiently and effectively roll out this program. Long live the great scientists who have saved lives through their innovations and interventions when it comes to vaccinations. And may the anti-vax movement curl up into the anti-science ball that they deserve to be in.

Ms WILLIAMS (Dandenong—Minister for Prevention of Family Violence, Minister for Women, Minister for Youth) (15:49): It is always difficult to follow on from the Attorney-General in any contribution in this place, but it is particularly difficult to follow her in a contribution that pertains to anything in the health portfolio given she formerly occupied that portfolio and did so with a forensic attention to detail. I think she demonstrated that in her contribution just then.

But as other speakers have done, I stand here in support of the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. I understand why it has attracted so much commentary around the anti-vaccination movement, which we have seen over recent years gain some prominence, particularly at different points in time of government reform and in particular around that no jab, no play policy which we have heard others speak of.

It is hard to think about that period of time without also thinking of some of the vitriol that sadly came as a part of the debate, and I know the Attorney-General, as the then Minister for Health, was a target of a lot of that vitriol. Who could forget her confronting that and reading out some of the nastier messages that she received during that time, which apart from putting on show and highlighting some exceptionally bad behaviour I think also went to highlighting how misguided some of the assumptions that underpinned those comments were and just how dangerous is some of the misinformation that has been circulated around vaccinations.

Most of us need only look at our own extended families to understand how significant and positive an impact vaccinations have made to our own health and wellbeing and the health and wellbeing of those that we love. I know in my extended family we have people who experienced polio and TB—tuberculosis—things now that would be virtually unheard of. In older generations of my family people still live with the impact of diseases like polio. The very fact that we now have generations who would only read about such things in historical accounts goes to show the value of vaccination and just what a significant role it has played not only in keeping us more healthy but in changing our community and society as a result.

To that end the bill that is being introduced today is another step forward in a suite of reforms that has gone towards making our community more healthy and safer in that frame of increasing vaccination rates across our community. Vaccinations, as we know, are safe, despite some of the misinformation that is circulated, and without doubt they save lives. We know that vaccinations are one of the most effective ways of preventing disease, not just here in Victoria or Australia but worldwide. We know that they provide very high levels of protection against vaccine-preventable diseases. Many of these diseases we must understand can be fatal, and reducing morbidity and mortality from many infectious diseases by means of vaccination has been described rightly as one of the most significant public health achievements of the past century—and I think I demonstrated that by pointing to the fact that many of us can see that impact within our own family lineage.

I referenced before that Victoria had already embarked upon its no jab, no play laws, which we know are also making a significant difference in protecting children against preventable diseases, with Victorian immunisation rates still the highest of all Australian states. We should be very proud of that here in Victoria.

But what of our healthcare workforce—those people that keep us safe when we most need it and those people who put themselves in sometimes extraordinary danger in the process of doing that? The beauty of this bill for me in the scheme that it introduces—which is a mandatory vaccination scheme for our frontline healthcare workers—is that not only does it seek to keep our most vulnerable patients healthy and well and safe but it also obviously delivers significant benefits for those healthcare workers who themselves are coming into contact with a range of different diseases and illnesses which make them obviously more predisposed to getting ill themselves. We need these people healthy and well, because they are there when we need them most. So I think this bill has a range of benefits that we should all in this place be very firmly on board with.

The government is committed to making sure our healthcare workers are among the first to be immunised each year by making the flu vaccine and other vaccines mandatory. This bill makes amendments to a couple of acts—to the Health Services Act 1988 and also to the Ambulance Services Act 1986—which effectively allows the Secretary of the Department of Health and Human Services to direct employers of healthcare workers in public health services and also ambulance services across Victoria to require their workforce to be vaccinated against specified vaccine-preventable disease.

In addition, though, the bill makes amendments to the Health Services Act to permit the secretary to give directions to private health service establishments, which may include, for example, private hospitals, requiring them to ensure that specified persons are vaccinated against specified vaccine-preventable diseases. This will include ambulance staff, private hospitals, public aged-care staff and more. It will also include cleaners, orderlies and administrative staff who have day-to-day contact with patients. So it covers that part of the workforce that we would logically expect it to—those who most frequently come into contact with some of the most vulnerable patients in our health system and those who themselves are vulnerable by virtue of their contact with or exposure to certain illnesses and diseases.

Victoria, interestingly, is one of the few Australian jurisdictions that does not have a mandatory immunisation requirement for healthcare workers, and the amendments proposed by this bill will ensure that Victoria is in line with other jurisdictions on the mandatory vaccination of healthcare workers. We are taking the fight against the flu and other preventable diseases further by making this vaccination regime compulsory for this part of the workforce, and this is, as I have said, ultimately about ensuring that our front line is protected and there and available to us when we need them the most and that our healthcare workers who are in positions of caring for our most vulnerable—and the cause of that vulnerability may be on many grounds, whether it be age, pregnancy, chronic disease or some level of immunodeficiency—are in a position to be, through their own safety and security, also keeping those patients safe as well.

We have heard others speak about the toll that the flu takes on us each and every year, and we know that last year in particular was a particularly bad flu season. Sometimes we can be a little bit flippant about the flu, particularly because we have become so accustomed to it being regarded as not a particularly severe kind of illness. But what we do know is that if you are in that vulnerable cohort, whether by age or by immunodeficiency, influenza can have very catastrophic consequences, and sadly when we see a spike in flu rates or strains that have crept in, we can see that the consequences of that are dire in some cases. I know last year’s unprecedented flu season saw more than 69 000 laboratory-confirmed flu cases. We know it also started earlier and hit a lot of people very hard. Last year we also saw more than double the number of measles cases than the year prior, and we had a large year for whooping cough as well, with 2210 notifications compared to just 1700 in 2018.

These diseases are very serious and are very significant, and we cannot afford to be too flippant about them or about the impact that they can have on our community, and particularly on the most vulnerable in our community. We know that in 2017 hundreds of Victorians unfortunately passed away as a consequence of flu, and we also know—and in closing I want to draw attention to this—that our healthcare workforce has done an incredible job in rising to the occasion in these difficult times and has done an incredible job in treating patients and in being there when people have needed them the most and when people have been in some of the worst health conditions of their lives. So I want to end this by thanking our health workforce, and I commend this bill to the house.

Ms WARD (Eltham) (15:59): I also rise in support of this bill. It has been quite interesting actually to, along with other MPs in this place, talk about the kinds of emails that we have received from some in the community who are concerned about this legislation and what it means for what they refer to as their personal freedoms. When I was younger I spent some time in the Royal Children’s Hospital. I had blood poisoning and osteomyelitis, and I was pretty unwell. You can only imagine how concerned my parents were. As you would expect at the Royal Children’s, I had exceptional care; I had great care. But when you look at statistics like there having been 69 000 laboratory-confirmed flu cases last year, you think about the vulnerability of children and you think about children like me who were incredibly ill, you think about the vulnerability of older people and you think about people who do need to have caregivers who are healthy. I do respect and pay credit to all of the healthcare workers that we have in our community. I know that they take health care very, very seriously, but sometimes you do not always know when you are sick and you do not always know when you are carrying something. This idea that some who have emailed us have put forward that there is a lack of respect from the Minister for Health, from the Department of Health and Human Services and from people in this place for healthcare workers because of this legislation is, I think, wrong.

I think we do have an obligation to ensure that we have a healthy healthcare workforce, not just for patients but also for other healthcare workers. I think this is especially pertinent when we are in an environment where we know that there is a virus heading our way. We know that there is a virus that has already started to seep into our shores and we know that there will be more and more people who will be on the receiving end of this virus and will become ill in a variety of ways, some, sadly, worse than others. So when we are going to have so much pressure put on our healthcare system and we are going to need our healthcare workers more than ever before, it is very important that they are actually vaccinated and protected as much as possible against any other viruses that could infect them. We need them to be in perfect health but we also need them to not by mistake infect anybody else who is vulnerable, and that includes people who may contract coronavirus.

I do find it quite—I am not sure what the word for it is—hurtful in a way to think that there are people in our community who would rather not vaccinate their child, who would rather have their child contract something like polio or like whooping cough—

Mr Wynne: Measles.

Ms WARD: That is right, member for Richmond, like measles. They would rather that than their child, in this bizarre conspiracy theory, have autism. As an aunt of someone with autism who is the most beautiful person, who is someone I love dearly, to think that there are people in our community who think that autism is such a terrible thing that they would rather their child contract one of these contagious viruses or diseases just astonishes me. We know that there is no scientific evidence—in fact we know that the study was falsified—around any connection between autism and immunisation. But to think that people would put their own children at risk because they are afraid that their kids by some amazing transformation would become autistic I find unconscionable, I find it incredible and I do find it quite hurtful.

I think this is something where again the science must prevail, and just as we talk about climate change, just as we talk about anything to do with science, the facts need to be the ones that are discussed. This is not an emotive discussion. This is not a discussion around belief, this is a discussion around the facts, and the facts are that having immunisation—having our herds—actually does save lives. This is an undisputed fact. When herd immunity is decreased, when we do not have enough of us around us who are immunised, people get sicker and, sadly, more people die. We do not want that. We want people to be as healthy as possible, and we do need to encourage the immunisation herd. Whether that is in your school communities, whether that is in your sporting communities and indeed whether that it is in your health practitioner communities, we need to have those herds. We need to have people who are immunised and who will not contract these diseases and viruses so that they can protect those people who are unable to be immunised. And there are people in our community who would love to be immunised, who would love to be protected, but who, through their own health needs, are unable to be. In fact there are people who are immunised but who have had their immunisation reduced because they are receiving medical treatment, such as cancer treatment. I have a young boy in my community whose parents were incredibly worried for him because he was having cancer treatment and yet there were parents at his school who were not immunising their kids, so they were actually risking the life of this child, who was doing everything he could to preserve his life. They were risking his life through their fear around immunisation.

Immunisation is not something to be fearful of. It is not about a belief system, it is about respecting and understanding the science. And the science is if you allow yourself to be immunised, the likelihood of you contracting, falling ill due to or even dying from a whole variety of illnesses is substantially reduced, if not removed. We have seen this with the craziness around whooping cough where we had a whooping cough epidemic a couple of years ago because people were not immunising their kids. Whooping cough had all but disappeared and suddenly came back, scaring people senseless. These images of little babies coughing their poor hearts out—why would you do that? Babies are our most vulnerable. When they are so small they cannot be immunised and they cannot be protected, so it is up to us to recognise our social responsibility to protect the most vulnerable in our community. We all need to do that and we all have a role to play in that.

Our health practitioners have the same responsibility, and I know that many of them understand that. While I acknowledge that everybody has got the right to put forward their view, everybody has got the right to express their fears and everybody has got the right to express those fears with respect—and I am sure that everybody in this place who has received those emails has done exactly that, responding to them with respect—the thing is that we have actually got to legislate for the greater good. The science tells us that what we are doing is the right thing to do, and the science tells us that your fears around immunisation are wrong. They are wrong. You need to listen to the science. So I would encourage those to open up their minds. I would encourage those who are afraid of immunisation, those who think that being immunised is going to harm them in some way to look at the science. This is not a conspiracy by big pharma. This is something that scientists, that doctors, that medical practitioners have devoted decades of their lives to perfecting. There is so much investment by good people that goes into research to help preserve life, not damage life.

So this is good legislation and I commend the Minister for Health, who, might I say, is doing an exceptional job, including the work she is doing around coronavirus, on the way she is calmly keeping this community abreast of what is going on, with regular updates delivered to us in a calm way. She is doing fantastic work, as are her staff and as is the department, not just with coronavirus but also with legislation such as this. While I do hope that everybody’s demand for toilet paper slows down, I do encourage this legislation and I support the bill.

Ms HORNE (Williamstown—Minister for Ports and Freight, Minister for Public Transport) (16:09): I rise today to make a contribution to the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. I join my colleagues in congratulating the Minister for Health in the other place on proposing amendments that will improve the occupational health and safety of Victoria’s frontline healthcare workers, who provide such vital services in hospitals and also to protect vulnerable Victorians who are in hospital from the risk of transmission of vaccine-preventable diseases.

This bill amends the Health Services Act 1988 and the Ambulance Services Act 1986, enabling the Secretary of the Department of Health and Human Services to direct a range of healthcare settings, including public, denominational and private hospitals, and ambulance services to require employees to be vaccinated against specified diseases. This bill will mean that all healthcare workers in public and private hospitals and ambulance services with direct patient contact must be fully immunised to protect themselves and patients against the flu each year as well as whooping cough, measles, chickenpox and hepatitis B.

Victoria is currently one of the few Australian jurisdictions that does not have a mandatory immunisation requirement for its healthcare workers. These amendments will ensure that Victoria is now in line with other jurisdictions on such important occupational health and safety and patient safety risks. Last year’s unprecedented flu season put enormous strain on our hospitals, with more than 69 000 laboratory-confirmed cases. It also started earlier than usual and hit people with greater severity. We also saw more than double the number of measles cases in 2019 than in 2018, while whooping cough notifications rose to more than 2200 last year compared to 1700 in the previous year. These are potentially deadly diseases. They do kill people every year, including in Victoria. The figures highlight why it is so important that our dedicated healthcare workers, who continually rise to the challenges of horror flu seasons and outbreaks of disease and continue to deliver world-class care, are protected against preventable infectious diseases. Through this bill the Andrews Labor government is taking up the fight against flu and other preventable diseases while ensuring that our dedicated healthcare workers have a greater level of personal protection, while also reducing the spread of diseases to vulnerable patients. I want to express my thanks to our hardworking doctors, nurses and other healthcare workers here and across Victoria who do an amazing job every single day caring for patients when they need it most.

This bill is about good public health policy. We know that the use of vaccinations has reduced morbidity and mortality from many infectious diseases and is considered to be the most significant public health achievement of the past century. Vaccinations are safe and effective and provide a wideranging public health benefit, and the mandatory vaccination of healthcare workers will improve the protection of both healthcare workers and their vulnerable patients from vaccine-preventable diseases, leading to clear public health benefits.

Those who work in public health are highly aware of the importance of promoting herd immunity in acute healthcare settings to protect those who cannot receive vaccines or for whom vaccinations do not work. A poorly vaccinated workforce presents a risk to occupational health and safety, patient safety and health services operations. However, despite the huge gains made in tackling infectious diseases they remain a significant cause of death worldwide, threatening public health and contributing significantly to the escalating costs of health care. This has been highlighted in the worldwide outbreak of the coronavirus. Healthcare workers are at an increased risk of vaccine-preventable diseases and may pose a risk of transmission to other staff and patients, particularly those who are at risk because of age, chronic disease, immunosuppression or pregnancy. Mandatory vaccination has, through irrefutable medical and scientific evidence, been demonstrated to be the least restrictive option for achieving the public health benefit made possible by widespread immunisation and that herd immunity.

These laws will protect healthcare workers from preventable diseases and also the risk of transmission to the most vulnerable, including children, the elderly, pregnant women and people with chronic diseases. We have all had someone close to us or someone we know who falls within those groups, and we all want the best for our loved ones and friends when they are receiving medical care for whatever reason. This bill gives me an opportunity too to give a special shout-out to part of my family who were healthcare workers. My late uncle who was an anaesthetist, my aunt who was a nurse and my cousin who was an emergency nurse registrar, all were healthcare workers and know the importance of providing that frontline service and being able to not only put yourself on the front line but also, too, keep yourself safe. That is at the heart of what this bill is about.

The Andrews Labor government already makes the flu shot free for healthcare workers, and in 2019 it set a target for an 84 per cent flu vaccination rate amongst healthcare workers, which was well exceeded, reaching 88 per cent. Our landmark no jab, no play laws are making a real difference in protecting children against preventable diseases, with Victorian immunisation rates still the best in Australia. I am really proud to be a member of a government that is committed not only to the wellbeing and safety of Victorians but also to that of its healthcare workers.

This bill has a strong quality and occupational health and safety impetus that is consistent with the 2016 Duckett review of hospital safety and quality assurance in Victoria, which defined quality in its report as ‘care that is safe, effective and patient centred’. It defined safety as ‘freedom from harm when receiving medical care’ and stated that safety ‘is the most critical aspect of quality, and is the main focus of this review’.

The amendments proposed in the bill will build on the reforms and significant work that flowed from the review already undertaken by the Andrews Labor government to strengthen quality and safety across the health system. They will ensure the better use of existing resources by way of legislative and organisational change. Mandatory vaccination of healthcare workers will provide greater support to hospitals to discharge their quality and safety improvement responsibilities and improve the protection of both healthcare workers and their vulnerable patients from vaccine-preventable diseases, leading to clear public health benefits.

The amendments will mean that 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. Those who refuse to be vaccinated may face work restrictions or be deployed to other parts of the health services. I appreciate this may raise concerns for some people, but these laws have been designed to protect healthcare workers from preventable diseases while also reducing the risk of transmission to the most vulnerable, such as children, the elderly, pregnant women and people with chronic diseases. The statement of compatibility with the Charter of Human Rights and Responsibilities Act 2006 addresses any limits imposed on human rights by these amendments in careful detail.

In developing the policies to support the amendments the chief health officer has consulted with many stakeholders, and further consultation with all stakeholders on the implementation process and development of appropriate supporting resources, including methods to monitor vaccination uptake, will be undertaken prior to implementation, which is not expected to be until early 2021. This will allow the time needed to thoroughly examine the most effective way to achieve success.

In conclusion, as we face new health challenges such as the coronavirus it is imperative that our healthcare workers are protected from contracting and transmitting preventable infectious diseases. I commend this bill to the house.

Mr RICHARDSON (Mordialloc) (16:19): It is a pleasure to rise and speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020 and follow some of my colleagues, who have given a good account of the importance of this bill. I want to talk in a few contexts on the importance of this, including the prevention of infectious diseases; the demonisation that we see across various areas in our community of science, with science somehow being the prism of belief rather than fact and evidence; and also the great contribution of our health workers more broadly.

We have seen in recent times fear and concern around infectious diseases, particularly with what we have seen from communities with coronavirus. As we see with the funding that has been provided this week to the Doherty Institute and the work that has been done, we have been on the front foot on this, not to create panic in our community but really, as Victorians do well and our medical research community does so well, to lead by example. We are at the forefront of international research and development, and that investment of $6 million by the Andrews Labor government will further fast-track that work as well. As the Premier, the Minister for Health and others have said, this is a very concerning disease, and we are on the edge of where we might find ourselves facing more infections and how we manage that and support our community.

The notion that people would not support vaccinations based on the overwhelming evidence that we find in our communities about the impacts of infectious diseases is something that sits really uncomfortably with me for two reasons. One is as a parent of a three-and-a-half-year-old, Paisley. You go through that first eight weeks when they cannot be vaccinated, and they cannot have some of those vaccinations at critical junctures at year two and year four, and you have got to wait for those to happen as well. The notion that we would as a herd, as a community and no less as humanity itself put others at risk really troubles me. There is not a perfect number you can get to, of course, with immunisation. As the former health minister and now Attorney-General outlined eloquently, there are people that will not be able to be immunised through circumstances that they cannot control, and we would expose them to horrific risk if we were to drop that herd immunity down below those critical junctures. That is what has underpinned our no jab, no play policy as well, the landmark policy that was taken up by the commonwealth, and we have seen that really lift the immunisation rate substantially and save lives. That is the critical thing—we do not want the return of diseases from previous centuries that we have eradicated through medical advancements in the treatment of those infectious diseases. Tens of thousands of lives would have been lost had we not had those innovations and those research developments. The notion that we would move away from that with all the information that we have in our communities is unconscionable—we would be putting communities and putting children’s lives at risk.

It is a very vexed position we find ourselves in as a community when across a number of different sectors and a number of different examples science, evidence-based theory, critical analysis, the testing of critical hypothesis, getting to conclusions and outcomes that then underpin our actions as government, as policymakers and indeed as people, particularly in the medical space and in how we treat those that are at risk, are things to be debated or up for conjecture. It is dangerous when we demonise those institutions, and it is dangerous when we undermine empirical evidence and scientific advancement, and sometimes it is hard to determine where the agenda or where the theory might be coming from.

One of the really deeply troubling things about the fear campaign and misinformation that the member for Eltham eloquently touched on is around falsehoods about the impacts of vaccinations and choosing various subcategories and neurological conditions like autism to then demonise vaccinations and also demonise those communities living with autism. That is a horrific mistruth that has proliferated over a number of years. It has damaging consequences and has been debunked time and time and time again, yet we see that that continues to permeate some of that debate and some of that culture as well. It is a dangerous position that we find ourselves in when propaganda overruns sound empirical evidence and scientific rigour. We cannot let our community and our societies get anywhere near that prism, and we need to call it out for what it is: it is false, it is mistruth, it is absolutely wrong and it does not stack up to evidence.

I was in the chair as acting speaker at the time of the member for Melton’s incredible speech in this place. It was amazing. He is someone who for decades has been front and centre, supporting communities as a paramedic and then representing a workforce of paramedics as well. That was the summation of everything we need to be working on: one, to protect frontline health workers with this policy to make sure their health, safety and wellbeing is maintained into the future; but then also to protect those that are vulnerable that we are supporting and caring for into the future, which is critical.

The stats are troubling. Last flu season did not get the coverage that we are now seeing with coronavirus, but the casualties from that were extraordinary. When we see more than 69 000 laboratory-confirmed flu cases and when we see the disproportionate impact on those with health conditions—our older Victorians and the impacts that it has on them and our younger Victorians as well—we need to do all we can to make sure that we are supporting our communities and protecting them into the future. We have seen time and time again the horrific impact of whooping cough on little ones. When I was a new parent with Lozzie, that was a thing we absolutely were worried about with the warnings you get about that. Last year there were 2210 notifications, compared to 1700 in 2018. That is a worrying trend when you think of the growth of population in Victoria and that exponential growth in whooping cough cases beyond that. That is a really worrying trend in terms of what we need to do to better inform the community, challenge the rhetoric of people who are undermining the science in this space and support people into the future as well.

This is yet another example of the Andrews Labor government being bold in their agenda and working towards the protection and support of our community as well. There were many, many criticisms of the no jab, no play policy from certain sections of the community. We heard that in email form and in rhetoric as well. But we all have a collective obligation as Victorians and indeed in the humanity that we show each other. So much of society these days we see as individualised, with people putting themselves first before community in so many elements—in terms of media, in terms of shock jocks—‘What’s in it for me? What’s it about for me?’. We need to get back to talking about community. Our media has a role to play as well in promoting the interests of the community and promoting the obligation that we all have to our fellow Victorians to care for and support one another and the obligation that we have to make sure that we support these policies and support science in the future. Those that undermine those critical institutions should be vigorously and in a bipartisan manner challenged and prosecuted at every available junction. What do we see in the no jab, no play policy? We see better outcomes for kids. We see safer outcomes for kids, and we make sure that the diseases of the past—through humanity’s development and advancement year on year, decade on decade—that we eradicated are not returned based on fear and misinformation.

I also want to knowledge that I have had correspondence from people, and I know others have referred to that as well. But we have an obligation as Victorians to each other to make sure that we support and protect our broader communities as well. This is what this bill is about: frontline health workers and making sure they are safe and making sure that those with critical illnesses who cannot be vaccinated—not through choice or anything else but who are just at great risk—are safe. I think it is unconscionable to put those people at an even greater risk when they are already going through so much with their health and wellbeing challenges. To then go and exponentially increase the risk to them by refusing to have those vaccinations undertaken is a huge risk that Victorians just cannot allow.

This bill going through the Parliament is a critical element in our support for health workers but also in our support for the health of our communities and Victorians more generally. In the final moments I would like to commend the bill to the house and thank the minister for her work in this space. I wish it a speedy passage through to the upper house.

Ms THOMAS (Macedon) (16:29): I am very pleased to rise this afternoon to speak on this important bill, the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. In doing so I would like to take this opportunity to commend many of the speakers this afternoon. I have had a good opportunity to listen to many contributions from Labor MPs who were in the house this afternoon. There has been a common thread through what I have heard, and that is that public health relies on us having a strong vision for community health, thinking outside ourselves and thinking about the best interests of the community in which we live. In times when it feels that we are becoming an increasingly selfish society in some ways or that people are putting their own interests ahead of the best interests of the common good, I think it is timely to remind ourselves that when it comes to public health challenges we have to stick together as a community.

I did want to talk briefly about the challenges that we are facing now with the coronavirus and to commend the Minister for Health on the work that she is doing in ensuring that as a community we have clear advice from health professionals. I really want to use this opportunity. We have talked about the anti-vaxxers and the way they infiltrate the internet and spread mistruths with abandon, not concerned about the impact that their lies will have on vulnerable people in our community—not concerned about that at all. I am a little bit concerned also about people relying on advice from Facebook when it comes to coronavirus. I really want to encourage people in my community to ensure that they are listening to the experts. Here in Victoria we are very well served by our chief medical officer, Dr Brett Sutton, who has been very clear in his communication about what we need to do in order to keep ourselves safe while we see how this virus unfolds around the world. We need to be sensible.

When thinking about the common good, I also want to use this opportunity to put out a plea to people to stop stockpiling, stop ransacking our supermarkets. I was very happy to listen to one of my former colleagues and good friend Emma King, who is now the CEO of the Victorian Council of Social Service. She was on the radio this morning talking about the real experiences of some of the most disadvantaged members of our community, who can only do their grocery shopping either on payday or when they receive their pension, heading along to the supermarket and the shelves are empty because people who have got lots more money and resources than them have come in and bought the place out. I mean, this panicking is irresponsible. As I have said, it is a little bit about people thinking only of themselves and not of the wider community in which we live. Here on the Labor side of the house we believe in the power of community, we believe in the power of society and we fight every day for the common good. That is what we will keep doing. That is why this bill is so important.

As the Attorney-General, the former Minister for Health, said—now I will talk a little bit about vaccinations—there is a moral imperative to get vaccinated, because of herd immunity. We need to all take the opportunity that science presents to us to vaccinate or inoculate ourselves against diseases that have killed many millions of people over generations. We have available to us vaccines that can prevent disease. We need, if we are able to, to get vaccinated in order to protect those who cannot.

I have a personal experience of this, like my good friend the member for Eltham, in that when my fully vaccinated daughter was 16 she was infected with whooping cough and as a consequence of that was unwell. We have just had a little text exchange because I had forgotten exactly how unwell she was and for how long, and she informed me that it was for four months. It impacted her capacity to play sport. It impacted her ability to do her schoolwork. It was a wholly preventable disease, but because we no longer had the herd immunity in the community in which we were living at the time she was exposed to this terrible virus.

This bill expands on the many great things that this government has done when it comes to encouraging vaccination across our state. I am so proud of the work that was done on the no jab, no play legislation that we introduced, because when we look at the outcome of that now we see that 95.68 per cent of five-year-olds are fully vaccinated. Now, that is something worth celebrating. That means that we have the highest vaccination rates of any of the states.

There are many, many children and older adults who for various health reasons cannot receive vaccinations or maintain their vaccination regime, so it is important, as I said before, that those of us who can do. That is what this bill is about. This is about ensuring that our healthcare workers, who of course are exposed to the sick and the vulnerable, are vaccinated because they can be and because they work each day with people whose health is vulnerable.

I fully support this bill because I support the common good—it is as simple as that for me. We all need to act in the best interests of the communities in which we live and that we are members of and do all that we can in our own power and within our own ability to ensure that we do not put others at risk. That is what this bill is about. It is saying to healthcare workers, ‘We need you to do all you can to ensure that the people you care for are kept as safe as they possibly can be’. To me it is very timely that this bill is being introduced at a time when we are waiting to see the full impact of coronavirus.

Can I take this opportunity to congratulate medical researchers in Victoria at the Doherty Institute for the work that they have done and to congratulate the Minister for Health and the Premier on the announcement of $6 million for the Peter Doherty Institute for Infection and Immunity, which is working with the Burnet Institute and other experts to fast-track new treatments and vaccines for COVID-19. We have some of the best medical research facilities in the world. We have some of the best medical scientists in the world. They all deserve our appreciation and support. These are the people who work hard every day on these pandemic diseases to ensure that we do all that we can to create vaccines to prevent them.

It is coming up to that time—we are a way off it really—of the year when I would encourage everyone to get their flu vaccination. The fact that it is raining outside at the moment and quite cool in here makes me think it is almost flu season, but in fact it is still a way off. But it is an important reminder to my constituents and to everyone in this place to get their flu vaccination, check their own vaccinations and make sure their children’s vaccinations are up to date. Of course we created a really nice little app back in 2015 to remind parents when their children’s vaccines are due. We are doing all we can to ensure the population health of our state, and this bill is a very important part of that.

Ms CONNOLLY (Tarneit) (16:39): I rise with great pleasure to follow my colleague the member for Macedon to speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. Before I begin I do want to give a really big shout-out to our incredibly hardworking Minister for Health in the other place. She has been working extremely hard over the past couple of weeks and months dealing with the health and wellbeing of Victorians in relation to the outbreak of coronavirus.

This is a commonsense bill that has been brought to the floor of Parliament with very practical measures to help protect our healthcare workers, staff and patients at a time when so many people within our community are seriously concerned about the outbreak of coronavirus. And let us remember, as the member for Macedon has just pointed out, we are also coming towards the beginning of flu season, so I thank the Minister for Health for her actions to protect the health and wellbeing of all Victorians, including me and my family.

Getting to this bill, this is a significant and important bill that makes amendments to our Health Services Act 1988 and the Ambulance Services Act 1986, amendments that are going to allow the Secretary of the Department of Health and Human Services to direct employers of healthcare workers in public health services and ambulance services across Victoria to require healthcare workers to be vaccinated against very specific vaccine-preventable diseases. These include settings such as public hospitals, denominational hospitals, private hospitals and ambulance services. It is a bill that makes amendments to the Health Services Act to permit the secretary to also give directions to private health service establishments, including private hospitals, requiring them to ensure that specified persons—their workers—are vaccinated against these diseases. The bill also provides that the secretary can suspend in full or part the registration of a health service establishment if it is not complying with his or her direction.

Upon reading this bill and really thinking about what is at the heart of it, the heart of it is our healthcare workers, who are very, very special people, across Victoria. They are at the very heart of our communities, and what we know is that they are at increased risk of vaccine-preventable diseases if they are not vaccinated. With our dedicated healthcare workers being protected through vaccination, we ourselves, our families and our loved ones are also protected because some of us are also the staff that work within the sector and some of us will be that sector’s patients, and many of us are likely to be more vulnerable than others.

A poorly vaccinated workforce creates both an occupational health and safety risk and a patient safety risk. Our health services are also at increased risk of disruption due to staff absences either from illness or exclusion as a quarantine measure. Vaccinations are safe and vaccinations save lives. As we start to approach flu season it is no surprise that the influenza vaccination is currently funded for staff working in health services and that the introduction of targets has seen a rise in healthcare worker influenza vaccination rates in recent years, peaking at 84 per cent in 2019. By mandating influenza vaccination for healthcare workers, along with vaccination for other important diseases such as whooping cough, measles and chickenpox, healthcare workers and their patients can be protected from these preventable diseases.

My mum works in the aged-care industry and she is currently looking after very elderly, vulnerable patients in local nursing homes. Every flu season she is a woman that rolls up her sleeve, grits her teeth and welcomes that little jab of goodness that will protect not only her from the flu but also the vulnerable locals she looks after. Year after year she tells me stories about how bad things can get inside those nursing homes when you have got elderly vulnerable people in close proximity to each other and someone there catches the flu. For those people it is a matter of life and it is a matter of death.

Having talked about my mum, I will say my dad is the local milkman back home. I do not get to talk about him a lot besides him being a big Labor man that delivers milk to all the local coffee shops, so he is basically what you would call an essential service. The milk run is a small business. And like many small business owners, Dad cannot afford to get sick because there is no-one else who can deliver the milk. Now this will not be footage that I will be putting up on Facebook, so I can say that Dad completely freaks out when it comes to needles. I am pretty sure that back in his younger days he was even known to get a bit woozy at the doctor’s surgery after being jabbed with a tetanus shot, usually after being bitten by other people’s household pets—most likely the dog—which you could say was always a hazard for any milkman that did the house run back in those days. So Dad is a man who basically baulks at any needles coming his way, but before every single flu season, every year, he gets his flu shot, and he does this because he knows the risk to the milk run—his small business and his livelihood—and he knows what happens if he does not look after his health.

In talking about this bill down in my office this afternoon one of my staff—and I am sure he is watching right now—told me about his mum. His mum became extremely ill with a lung disease and ended up needing a double lung transplant. He told me that every year he gets a flu shot, because with having a mother who was so sick and who has had that double lung transplant the risk of him catching the flu and passing it on to her would be absolutely deadly.

As a parent I am absolutely resolute on the need to immunise our kids. I come from an area in northern New South Wales where there have been so many outbreaks or re-emergences of preventable, almost dormant or non-existent diseases that have suddenly caught the community off guard. There have been years of anti-vaccination campaign messages, disgusting messages, and parents—and I hate saying this—had stopped immunising their kids. Next thing we know, low and behold, newborn babies and the vulnerable are suddenly at risk of having terrible, terrible diseases and illnesses. As the member for Macedon pointed out, it really is about protecting the herd, and unless the herd is fully vaccinated there is no protection. I can only hope that the anti-vax movement, that still seems to absurdly and strangely exist within the very fringes of our community, does hear the contributions made to this bill here in Parliament today, particularly the one made by the member for Eltham. It is a reality and a fact-checking exercise indeed.

I was certainly shocked to learn that currently in Victoria the department has guidelines for healthcare worker vaccinations, but there is no legislative mandate to enforce these guidelines. So when I think of vulnerable patients I think of newborn babies. From memory—and it has been a while—the first round of immunisations come at around six weeks of age. I will never forget watching a video of a newborn baby struggling to breathe because that child had contracted whooping cough. That image has stayed with me for the past nine and a half years, since my Emily was born. I remember that the video affected me so much that I stayed very close to home with my newborn bub for the first six weeks of her life.

Victoria is one of the few Australian jurisdictions that does not have a mandatory vaccination requirement for healthcare workers, so essentially the amendments in this bill will maximise compliance with already existing recommended vaccination policy, and it will improve the effectiveness of the program in protecting Victorian healthcare workers and patients. As I have said, healthcare workers are at the very heart of our communities. They are very special people. We know that they are at increased risk of vaccine-preventable diseases if they are not vaccinated. This is not a bill about us versus them. We are all better protected if all of us are vaccinated and immunised against terrible diseases and illnesses. We all have a role to play in our community in protecting those who are most at risk and most vulnerable, because we can never be sure if that person whose life is put at risk will be us, our child, a family member or a friend. I commend the bill to the house.

Mr WYNNE (Richmond—Minister for Housing, Minister for Multicultural Affairs, Minister for Planning) (16:49): I rise to make a contribution on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. We debate this very important bill against the backdrop of what we are confronting internationally in terms of the pandemic of the coronavirus.

We commend of course the work that has been undertaken on a bipartisan basis by both the federal government and indeed our state government. I particularly want to call out my colleague in the other house the Honourable Jenny Mikakos, who has done a magnificent job representing the interests of Victorians at this very, very challenging time. I can indicate that the cabinet has been briefed by the chief medical officer in relation to all of the strategies that have been put in place to address this pandemic, and I know that the minister continues, not on a daily basis but three, four, five times a day, to have hook-ups with her federal colleagues to make sure that we have a coordinated response right across the country as we seek to address this particularly challenging environment that we find ourselves in now. Obviously we are aware of the potential for this virus to spread rapidly, and I think many of the measures that are recommended to us by the chief medical officer and others are very sensible matters, but I do note that it is quite a dynamic and changing environment. I notice that just in the last short while the federal government, I think today, is seeking to consider further travel bans on some countries.

Mr Angus interjected.

Mr WYNNE: I will not respond to that interjection.

It was in 2017 that our government announced a staged target of reaching 90 per cent flu vaccinations of health services staff by 2022, and indeed we are well on track. In 2019 we reached 88 per cent of flu vaccination rates in our public health system, and the bill will enable us to mandate the flu vaccine and other vaccines for frontline health workers.

Obviously people are working furiously to find a vaccine to address the pandemic that we are confronting at the moment. The Premier announced the very important initiative at the Peter Doherty Institute for Infection and Immunity; I think it was $6 million to support the magnificent work of the Doherty Institute to work in collaboration, as I understand it, with researchers at one of the Queensland universities who have been able to now grow the culture itself. That has been a really significant breakthrough. It is not absolutely clear at this stage when a vaccine may be available, but the work that has gone on to date I think is extraordinarily promising and, can I say, world leading.

It just speaks yet again to the investment that our government has made in that incredible Parkville precinct, when you think about the Doherty, you think about the extraordinary Peter MacCallum Cancer Centre, you think about the Walter and Eliza Hall Institute, you think about Melbourne University, the Royal Melbourne Hospital—which for other reasons I know intimately—and all the others. These are world-leading institutions. We are thrilled with the work that our medical researchers have done, and we hope that we get to a vaccine as soon as is possible.

This bill is important because it introduces a mandatory vaccination scheme for frontline health workers. We are committed to make sure that our health workers are among the first to be immunised every year by making the flu and other vaccines mandatory for healthcare workers. It is self-evident at one level. You say, ‘Well, of course this should be the case’, but the truth of the matter is that this has not been the case, and we are one of the states that has not made this mandatory to date. It is important that we fix up this anomaly because when people go to hospital they expect that they will be in a healthy and safe environment and of course on the road to recovery. That is why this bill is so important.

The bill makes amendments to the Health Services Act 1988 and the Ambulance Services Act 1986 which will allow the Secretary of the Department of Health and Human Services to direct employers of healthcare workers in public health services and ambulance services in Victoria to require healthcare workers to be vaccinated against specific vaccine-preventable diseases. In addition, the bill makes amendments to the Health Services Act to permit the secretary to give directions to private health service establishments, including obviously private hospitals, requiring them to ensure that specific persons are vaccinated against specific vaccine-preventable diseases. This will include obviously ambulance staff, private hospitals, public aged-care staff and more. It will also include cleaners, orderlies and administrative staff who have day-to-day contact with patients. As I indicated, Victoria is one of the few Australian jurisdictions that does not have a mandatory immunisation requirement for healthcare workers, and we are making that right here today. This will ensure that our frontline services are protected when we need them most.

I have to say, there is no greater time for us to implement this program, as I indicated in my earlier contribution, than now given that coronavirus is part of our environment here in Victoria and indeed Australia more generally. I am very conscious of just how important this particular initiative is from a personal point of view as someone who has had to interact with the health services at a very critical time and was provided with absolutely expert care at the Royal Melbourne Hospital. Again I take every opportunity to call them out for the magnificent work they did for me as a punter coming in off the street with an acute health crisis, and here I am today. I will be eternally grateful to them for what they have done for me, and I will do anything I can to support them, to pay back to them and acknowledge them.

I am also conscious of that because my wife is an employee at the Peter MacCallum Cancer Centre and she, as much as anybody else, would say to me that when people are going to the Peter MacCallum Cancer Centre—again, an absolutely world-leading facility both for treatment and research—they are going there with very serious and confronting illnesses that need to be addressed. In that context, particularly for people who are suffering from acute illnesses such as some of the cancers they so successfully have treated over such a long time, it is important that people who are employed in those organisations are immunised to ensure that there is no infection or indeed cross-infection. I know just how important this is, as she has reinforced to me the critical importance of these sorts of initiatives that will in the long term obviously protect people in what is often their most vulnerable time.

In that context this is an important bill. I think this is a bill that does enjoy bipartisan support. I want to acknowledge obviously the wonderful contributions from many of my colleagues who have spoken here today on this bill—

Members interjecting.

Mr WYNNE: particularly the member for Mordialloc—a beautiful piece of work there.

In commending this bill to the house we do wish that our researchers find a vaccine to this virus as soon as possible.

Ms HALFPENNY (Thomastown) (16:59): I am also rising to speak on the Health Services Amendment (Mandatory Vaccination of Healthcare Workers) Bill 2020. I know that we have received some correspondence from various health workers about this, expressing their concern at the mandatory nature of the vaccinations. However, I think this legislation is very balanced and fair. We need to protect the public, so I support the bill.

The DEPUTY SPEAKER: The time set down for consideration of items on the government business program has arrived, and I am required to interrupt business.

Motion agreed to.

Read second time.

Third reading

Motion agreed to.

Read third time.

The DEPUTY SPEAKER: The bill will now be sent to the Legislative Council and their agreement requested.