SOUTH AUSTRALIAN PUBLIC HEALTH BILL

Second Reading

Adjourned debate on second reading (resumed on motion).

Dr McFETRIDGE (Morphett) (16:13): I continue my remarks on the South Australian Public Health Bill. I was talking about the position of the chief public health officer, which is a new position that is being created. It is a position that will be held by a member of the Public Service, which I have some concerns over in relation to independence. They are, obviously, going to be giving advice to the minister, and I hope that advice is without fear or favour.

The functions of the chief public health officer are vital. Clause 21(1)(b) provides that they are ‘to ensure this act and any designated health legislation are complied with’, and it is so important that the chief public health officer is able to do that. What I am concerned about (and I have had an amendment drawn up to have this act reviewed in a more timely fashion) is clause 21(1)(c); that is, that the chief public health officer can look at proposed legislative or administrative changes related to public health and so, hopefully, set a review of the act.

The role of the chief public health officer cannot be overestimated because it will be vital in coordinating (particularly in emergencies) the rollout of services to the people of the state. Why does the chief public health officer report on a biennial basis (every two years) and why not annually? I would like to hear about that, because the South Australian public health council will be reporting every 12 months. There may be a reason for that and I would like to hear more about it.

The South Australian public health council is being established to replace another council that has been around for many years. The South Australian public health council is going to consist of the chief public health officer and nine other members. There was a comment by members of the Aboriginal health community that there is nobody on the council who has an Aboriginal or Torres Strait Islander background. I am sure that can be incorporated and if the council has to sit on particular issues they can seek advice from people with expertise in those areas.

The important thing we have emphasised is the across-government role of public health policy—federal, state and local. On page 20, division 4 talks about the functions of local government and the functions of councils and the series of functions that are conferred on councils. I just hope there is no cost shifting in here and it is just an expansion of their responsibilities without an expansion of their costs. Ratepayers of South Australia think that they pay far too many rates as it is.

Immunisation services are a very important part of public health delivered by councils and that is an area where they are still going to have a vital role. Under clause 38(3) it states:

The minister must take reasonable steps to enter into and maintain a memorandum of understanding with the LGA about the provision of immunisation services and support.

I hope that is financial support as well as logistical and other professional support. The power of the chief public health officer is such that it can take over the role of the council if necessary. I hope that never becomes necessary but it is in there, and I think if a council is unable, for some reason, to do the job it has been given to do then somebody has to do it for the sake of public health in South Australia.

The council should remember, though, that when it is giving or having its powers taken by the state government it will still have to pay any costs that may be associated with the delivery of a particular service or outcome that is being handed over. I hope that is a negotiable thing because, obviously, we would not like to see councils put into a position where they are financially embarrassed.

The other very important part of this bill, which I talked about briefly before, is the introduction of a state public health plan and regional public health plans. Regional public health plans can involve either one council or groups of councils together. It is important to put down plans and protocols and have them in place so that if something does happen you can act immediately without having to sit down and discuss where we are, where we want to go and how we are going to get there. It is a good thing that these are in there and I look forward to seeing them being developed. The public health plan is reviewed every five years. That may be a short enough term—perhaps every three years could be considered. However, it is every five years in the bill and is the same as councils that are expected to review their regional public health plans every five years.

The development of public health plans obviously relies on public health policies. On page 32 of the bill, section 53, it states:

The minister may prepare and maintain policies under this part that relate to any area of public health in the state.

I assume 'any area of public health' means not country or city but as in the various areas of policy that we talked about with the Public Health Association of Australia, in that vast list of policy development that it has.

Procedures for policy making, preparing of drafts and making those drafts available for comment are included, so there is good provision for feedback. The development of those plans and policies is something I look forward to being able to participate in by providing submissions and feedback, because it is vital we develop good quality plans. I am sure, with the calibre of people working in the health services in South Australia, they will be good plans.

Part 6—General duty is on page 34. There is a general duty that:

A person must take all reasonable steps to prevent or minimise any harm to public health caused by, or likely to be caused by, anything done or omitted to be done by the person.

It sounds pretty broad; it is pretty broad, but you need to make people aware that they do have responsibility for not only their own outcomes but also putting those around them at risk, particularly if there is a material risk to the public, which is covered in clause 57. Serious risk to public health is covered in clause 58. Subclause (1) provides:

A person who causes a serious risk to public health intentionally or recklessly and with the knowledge that harm to public health will result is guilty of an offence.

To show how seriously we are taking this offence, there is a $1 million fine or imprisonment for 10 years, or both. Serious risk to public health is something that we should not tolerate.

Part 8 of the bill talks about prevention of non-communicable conditions. I would like to see a list of these non-communicable conditions. Obviously, the first ones that spring to mind are obesity and diabetes, but there is a long list of them. We do not want to become the nanny state, though, with clause 62 where we are issuing codes of practice. We do want to give some indication of what is acceptable, but I do not think we need to be overly prescriptive in that area.

Notifiable conditions and contaminants are interesting. There is a range of contaminants that we are seeing nowadays. PCBs are spreading across the world and we are seeing ever-increasing reports on their effects, so we need to be vigilant in watching out for contaminants in the food we are importing and in the general environment around us. I think the Environment Protection Authority was concerned that there was not much of a mention here about environmental consequences of offences against the act.

There is the ability to declare a notifiable condition. I cannot find the word 'microorganism' in here, but I know there were some concerns about declaring particular microorganisms in the legislation from some of the food-producing groups. I have no particular issue about prescribing individual microorganisms. Some of those I listed before are particularly nasty and I think we should be prescribing some of those.

There are a number of clauses in the bill which, on the surface, are quite broad in their initial interpretation. Having considered the bill, I do not have any particular issues with the range of powers, but I do have a couple of issues with clause 75, which relates to detention and the power to give directions. Clause 75 provides:

(1) If—

(a) the chief public health officer has reasonable grounds to believe that a person has, or has been exposed to, a controlled notifiable condition…

the chief public health officer can then direct various actions to be taken, particularly relating to an individual. The directions that may be imposed by an order under this section include the following: that the person remain isolated, refrain from carrying out specified activities, refrain from visiting specified places, and refrain from associating with specified persons or specified classes of persons. The person can be ordered to take specified action, attend meetings, and place him or herself under the supervision of a member of the staff of the department or a medical practitioner or other health professional. That is okay under particular circumstances, and I look forward to seeing how that is all going to be applied. The concern, when you have all those things that can be done by the chief public health officer, is that clause 75(5)(a), on page 47, provides:

The Chief Public Health Officer—

(a) must not impose a direction under subsection (4)(h) or (i) if the Chief Public Health Officer is satisfied that the person has a conscientious objection to the relevant examination of treatment (as the case may be) due to a religious, cultural or other similar ground;

I question how we are going to balance that with the outcomes for public health because, surely, a person cannot refuse to be confined, to undertake tests, to participate in treatments, or other actions, on religious or conscientious grounds if there is a risk to the health of the public, so I do question that. On page 48, clause 75(6) provides:

However, if a direction under subsection(4)(h) or (i) would relate to a child, the Chief Public Health Officer may make a direction under either (or both) paragraphs despite a conscientious objection of a parent or guardian of the child if the Chief Public Health Officer considers that the relevant examination or treatment (as the case may be) is in the best interests of the child (and reasonably necessary in the interests of public health).

So, if it is okay to do that for a child, why is it not okay to do that for an adult? I see that as a bit strange if it is in the best interests of public health. It states 'and reasonably necessary in the interests of public health', so you can do it with kids, but you cannot do it with adults, and I do have some issues with that. I think it should be both. I am not going to try to take the kids out of the picture, because we should be acting in the interests of the children, but we should also be acting in the interests of public health.

I will finish by skipping to the powers of detention. There are two forms, and I thank the Hon. Stephen Wade, the shadow attorney-general in the upper house, for some advice on this. The background is that there are two forms of detention available under the South Australian Public Health Bill 2010. One form is in clauses 77 to 79, the detention of a person with a controlled notifiable condition by the chief public health officer. That is initially for up to 30 days and is subject to review by the Supreme Court at any time.

The second form of detention is the detention of a person in the course of a public health incident or emergency (clause 90) by the Chief Executive Officer of the Department of Health. There are no time limits, although detention could only continue while an incident or an emergency is running. A declaration of an emergency beyond the initial 14 days can only be made by the Governor, but there are no appeal provisions. I would have thought that there should be an appeal provision in there somewhere, and I will be interested to hear what the minister has to say about that.

I find it interesting that you cannot exhume a body if you need to investigate a public health incident of some sort but, other than that, I think this bill is very comprehensive, and I congratulate all those who were involved in its development. As I said, it was started in 2000 with Dean Brown, and we have seen it develop from there. We have seen public health issues develop rapidly. Let us hope that it is not another 10 years before we have this bill back before the house for a complete review and update. We are way past the Health Act of 1935, the Noxious Trades Act of 1934 and Venereal Diseases Act of 1947, and we have to keep looking at the ever-expanding areas of public health in South Australia. I commend the bill to the house and repeat that the opposition supports the bill.

Mr GRIFFITHS (Goyder) (16:29): Far be it from me to think that I could ever try to compare in any way with the member for Morphett (the shadow minister) and the contribution that he has made on this South Australian Public Health Bill 2010, so I will be brief.

The Hon. J.D. Hill interjecting:

Mr GRIFFITHS: No, when I say that, I mean that because the shadow minister has certainly given a very detailed response to the issues that have been raised with the opposition. He has demonstrated his intimate knowledge of this area and the consultation that he has undertaken, and he has expressed quite well the concerns and the issues the opposition has had. There is no doubt, though—and reading the briefing paper that the member for Morphett has prepared really does highlight it to me—that this is a key point and a key bit of legislation for consideration by the chamber.

Health is essential to everything in our community and it is important that we ensure that the processes will support whatever level of community government response needs to occur when situations arise and that it has the powers that it requires to do that. We certainly live in a very different world. September 11, 2001 really highlighted that, no matter where you live in the world, no matter how safe you may be, there are issues that can occur that you have no control over and that there needs to be an immediate response to.

We live in a world in which disease can spread so quickly with the global travel that occurs. It is important that governments have the opportunity to respond very quickly to issues and to ensure that the right decisions are made from an informed position to ensure the safety and wellbeing of others around us. This bill goes into so many different areas, but for me it comes back to highlighting the fact that, after some 10 years of review, and extensive consultation over the last six months—and certainly the ability that the minister provided to all members of parliament to be briefed on this bill—the government has made every effort to get it right. It does have its genesis from when the Hon. Dean Brown was the minister for health so it has been some 10 years in its formation, but we are about trying to get a system in place that will ensure that South Australians live in the safest possible community.

It does obviously have an effect on the Public and Environmental Health Act 1997 with which local government—which I previously worked for before coming into this chamber—has a close involvement. I know when the briefing was provided by the minister, I posed a question to him and it refers to a closer working relationship between state and local government and the consultation and the cooperation that will occur: indeed is that going to translate into more responsibilities upon local government and if those responsibilities come at a cost, is there an expectation of some level of financial contribution and support from the state towards those costs?

Local government is a primary driver in this. It is well connected to the community and it has the ability to get the message out to the community about issues that it needs to be prepared on and it has the ability to put programs in place to ensure that the level of not only education but also health prevention actually is occurring out there. I know that each council tries to employ very skilled people. It is quite hard to find public and environmental health officers, but I hope that from this there can be a stimulation of great career opportunities for people who want to go into those areas too.

Education, as I said, is the key thing for me here too, because a community that is aware of what can occur knows how to react. It makes our awareness far better. We are alert to issues as they arise. There is a level of knowledge within a family structure or a business or corporate structure on the way in which an appropriate response has to be developed, and it ensures that indeed we are able to get things moving properly.

The briefing paper prepared by the shadow minister talks about so many things. Certainly he has identified the key issues and established the objectives. It talks about the definition of the role between minister and local government; it talks about establishing a statutory position of a chief public health officer. He refers to the requirement for public health planning and reporting against those plans, and I think that is a very good move. We have to ensure that plans are in place, that training takes place, that reports against those yearly objectives are published and where deficiencies occur, that the objectives are actually met in future times.

It talks about the development of state public health policy. It talks about the general duty of preventing harm to the public health and, again, the consultation and cooperation between state and local governments. It talks about incorporating provisions for emergency incidents. That is a key one, too: there will be situations that arise that you just cannot plan for. As much as a community thinks they are prepared for that, we need to make sure that the flexibility exists in these emergency service providers to make sure that they are actually skilled in what they need to be to make sure that we actually cover that.

It talks about identifying notifiable microorganisms. Again, that is part of the global world in which we live, where there is an ability for those microorganisms to be transported so very quickly. There are amazing movies and television programs sometimes about pandemics and epidemics, how quickly they are transported and the number of people who can be affected by them in a very short time.

Having that planning in place will ensure the ability to control that. It may mean, as the shadow minister said, having the ability to detain people from time to time in the interests of the public good. Getting that right without inconveniencing the freedom that people have is also important, but we have to have that flexibility.

I am aware that consultation on this bill has been quite extensive. Any bill that has taken some 10 years before it is presented to the parliament does rely on the fact that consultation has been extensive. I am sure that the minister will ensure that he has done everything possible. I note that there have been 59 submissions. To me, that certainly indicates that there has been a wide variety of views canvassed and that efforts have been made to ensure that those views will be incorporated in any changes that might have been made to the draft.

Agriculture is really important to South Australia. For our export potential and our economic opportunities we want to make sure that controls are in place to ensure that there is no risk. That is where the ability to control disease outbreaks is very important. I know that, in this state, the agriculture industry goes to an immense degree of effort to ensure that it minimises that risk as much as possible, but let us hope that the support provided by this bill will ensure that it is only going to be easier for our farmers to undertake that.

We all want to see the swift passage of this bill. It has been something that has been talked about. The shadow minister gave a very detailed response to the joint party meeting and any questions that were posed. The small number of speakers from the opposition is not reflective of the support and the concern that we have for this. We hope that the swift passage of the bill will allow for improvement in the health and wellbeing of South Australians now and into the future and that surety will exist for our economic wellbeing by ensuring that our export opportunities are not harmed in any way.

Mr PICCOLO (Light) (16:37): I rise in support of this bill. I would just like to make some general comments regarding the bill and provide some background, given that this bill seeks to overhaul an act dating back to 1873.

Ms Bedford interjecting:

Mr PICCOLO: It was a good year, 1873. While public health legislation is important, it sometimes appears that it is not always reviewed as urgent and perhaps it does not always command the legislative attention it deserves. South Australia passed its first public health legislation, as I mentioned, in 1873. This basic act provided the model for several further pieces of legislation.

Further public health acts of 1876, 1884, 1898, and 1935 simply restated and refined the basic provisions of the 1873 act. Even the 1987 act, which this bill is designed to replace, can trace a clear and linear connection back to 1873. While this shows the continuity of sound public health measures, it is also important for this house to consider the significant changes that have taken place in public understanding and expectations about health and the significant changes that have developed in public health practice and knowledge since 1873.

The 1873 act and many of the subsequent pieces of public health legislation were developed at a time when the principal public health threats came from infectious diseases often caused or made worse by poor living conditions and a lack of proper sanitary systems and infrastructure. Also, for most of human history and well into the 19^th century we had very little scientific certainty about what caused the spread of illness in the community, and this lack of knowledge was reflected in our laws. For example, throughout much of the 19^th century, the miasma theory was dominant, and I will explain what this theory is. It holds that disease was spread through noxious odours.

Today, however, often as a result of successful public health initiatives, many of these 19^th century health risks have been largely eliminated or controlled. These initiatives have led to cleaner air, safer drinking water, efficient waste disposal, safer and higher quality food and food storage systems, and generally better living conditions, such as better housing and safer products.

While these traditional health challenges are now well controlled through sound environmental health measures and modern medical practices, we now realise that, since the latter part of the 20^th century and into this century, new public health risks have emerged. Risks that confront our public health authorities today include issues such as:

the epidemic spread of chronic conditions and conditions related to obesity;

illnesses caused through what the World Health Organisation refers to as the 'social determinants of health';

the public health impacts of climate change;

new or recurring diseases resistant to modern drugs; and

pathogens, chemicals and other contaminants which may find their way into our environment or into our food and the food chain and potentially damage our health.

We must ensure our public health authorities have sufficient powers to deal with these issues and continue the historic task of preserving and improving health. While our understanding of public health has changed markedly since 1873, the basic mission of public health remains the same. The 1873 act was 'to make provision for the preservation and improvement of public health'.

The other great core of the 1873 act, which has been reflected in all subsequent acts and continues in this bill, is the strong partnership between state and local governments. Local governments in earlier acts were constituted as local boards of health. In fact, in an earlier life, I think I was a member of the local board of health when I was a member of the district council of Munno Para.

This new bill continues the recognition of the role of councils by making it clear that they are local public health authorities. It is a clear recognition that, while our health can be impacted by many global factors and wide-scale social and economic circumstances, much of what also impacts on our health is very local. Having local government as an equal partner in public health means that South Australians can rely on their elected representatives and public health officials to work closely to make sure that public health strategies are both effective and accountable to the community—and accountability is very important.

What the bill does is allow these powers and provisions to be applied to today's and tomorrow's public health concerns. Many lessons have been learnt in the last century about the best way to develop and deliver sound public health strategies. Advances in science, medicine, toxicology, environmental health, and other social sciences and biochemistry mean that we can now have a far wider range of tools available to combat public health threats.

But the greatest lesson of the last century has been the recognition that public health is everyone's business. We all have a role to play and the best way to mobilise against public health problems is to work with people (particularly those most affected by the risks), encourage their participation and work in partnership to preserve and promote health.

Australia's success in stemming the HIV/AIDS epidemic in this country was due to the determined efforts of public health experts to work collaboratively with those communities most affected by this disease. Without this full cooperation and genuine partnership, this success would not have occurred. These lessons have been well learnt and have been incorporated into this bill. Not only are there strong powers to ensure the protection of the public's health, but also these powers are balanced by strong guarantees and safeguards in the bill. I will now canvass some of these guarantees and safeguards which will ensure that public health in this state remains sensible, accountable and effective.

First, there is a set of principles spelt out at the beginning of the bill which will be used to guide the administration and practice of the legislation. They must be used to inform the decisions made and the powers exercised under the law. For example, the precautionary principle (clause 6) ensures that action can be taken to deal with an assessed public health risk, even though there may not be full scientific certainty. Nevertheless, those actions must be undertaken only after careful evaluation and assessment, and then only with minimal disruption to individuals, communities or commercial activities as are necessary to protect against identified risks.

Secondly, clause 7—Principle of Proportionate Regulation ensures that regulatory measures contemplated under this legislation should take into account ways to minimise adverse impacts on business and members of the community. There are also principles which ensure participation and partnership (namely, clauses 11 and 12). These principles make it clear that individuals and communities will be encouraged to take responsibility for their own health and participate in decisions and planning for their own health and the health of their communities.

Where strong powers are required (for example, in the case of highly-infectious diseases where it may be necessary to exercise controls over certain individual's behaviour), there are a range of protective safeguards. Strong public health powers to order a person to conduct themselves in certain ways, to be under supervision, to undergo examinations and even to be detained have always been part of public health's legal capabilities here and around the world.

For the first time, however, these powers were exercised within the context of a clear statement of rights for the affected person. These rights are described in clause 14 and must be applied to parts 10 and 11 of the bill. These rights include:

the right of the individual to have his or her privacy respected and to have the benefit of patient confidentiality;

the right to appropriate care and treatment which respects the individual's dignity and which is provided without unnecessary discrimination;

the right to be involved in decisions about themselves where practicable and to be given reasons for decision made about them; and

the right, where they are subject to restrictions on their liberty, to have those restrictions be proportionate to the risks.

These clear statements of rights are consistent with the requirements of the World Health Organisation's International Health Regulations, which were last revised in 2005. These rights will be adhered to, but the most important of all rights is the right for the community to be protected from harm, and this bill makes this very clear.

The system of control orders is also subject to appeals to the District Court, and where a person is detained it is subject to regular judicial oversight by the Supreme Court. There are several provisions within this bill which require the minister and the chief public health officer to consult before taking action or to consult about how they might formulate policies, guidelines, regulations and other codes of practice or plans.

For example, where regulations are contemplated in order to make certain contaminants notifiable, the chief public health officer, under clause 67(13), is required to consult with representatives from those industries and groups that will be directly affected. Also, under clause 62(4), where the minister is developing a code of practice for an industry or sector to help prevent or reduce the incidence of non-communicable conditions, the minister, again, must take reasonable steps to consult with affected persons or organisations.

These are some of the examples of how this bill balances the need for strong and clear public health powers and action with the equally important need to ensure that people's rights are protected, of how impositions are kept to the minimum necessary and that participation and partnerships are supported and encouraged, and consultation mandated in many instances.

In conclusion, this bill continues the great and historic task of public health to preserve, protect and improve the public's health as it was set out in 1873. It continues a strong and historic partnership between state and local government. It recognises and provides powers to respond to 21^st century public health challenges, and it secures good, contemporary public health values and practices of working with people and communities, respecting their rights and encouraging their participation.

Ms BEDFORD (Florey) (16:48): The South Australian Public Health Bill has been the result of an extensive review and consultation process. This review was initiated by the former minister for human services, the Hon. Dean Brown. This review builds on the global renewal of public health legislation that began around the turn of the century—as the member for Light said, 1873, that fine year.

Here in Australia, most other states and territories have either recently renewed their legislation or are in the process of reviewing it. Some, such as New South Wales and Western Australia, commenced their reviews before South Australia and are yet to conclude. Taking all this experience of legislative reform into account means that South Australia can learn from the best of national and international approaches, but it can also build and extend them to make sure that they meet our local needs and challenges and reflect our local experiences.

The contribution of local government and the contribution of environmental health officers to this review have been exemplary. Those working on the front line of enforcement know best how the current legislation works and, more particularly, how it can be improved. I join with the minister in expressing my thanks to local government, the Local Government Association, Environmental Health Australia and all those locally based environmental health officers who contributed their time, energy and insights to this review.

This bill not only allows us to look backwards to make sure that we deal with perennial public health problems and ensure we retain those tried-and-true public health powers that we need to deal with known public health risks, but it allows us to push forward, to anticipate new public health challenges and to prepare for the unexpected. The experience of those who have worked with the current legislation, combined with national and international reform experience and blended with the contribution of public health law experts, has given this state a bill which I am sure will help us preserve, protect and promote our people’s health well into this century.

I particularly wish to highlight the range of provisions within the bill which clearly strengthen South Australia's public health effort and provide the basis for ensuring that our community’s health is protected and promoted. Firstly, I wish to draw the house’s attention to the establishment of the state's first statutory position of chief public health officer. Clauses 20 through to 25 are the operative clauses. For the first time in South Australia's history, this parliament will establish, through this bill, an independent officer who will have public health expertise and experience and whose charter is to be a clear voice to advise the minister, the health system, the government, the parliament and the people of South Australia on matters which affect their health.

The chief public health officer also has powers to intervene and act where there is a clear public health danger or breakdown in usual functioning. This leadership role will have the force and the strength of law to ensure that it can be undertaken. Most other similar jurisdictions around the world have such a position. It is time for South Australia to catch up.

This bill also continues a high-level consultative and advisory body. Under the current Public and Environmental Health Act, the Public and Environmental Health Council provides this role. In many ways this body reproduced the leadership functions of the Central Board of Health, which was established under the earlier public health legislation. This bill also establishes such a body at clauses 26 through to 36, but with clearer and more strategic terms of reference and a broader membership which reflects the scope and diversity of public health stakeholders in this century.

For example, included in the membership of this new council are persons with expertise in health promotion, persons from the non-government sector, and persons with expertise in communicable diseases. This body will ensure that the minister, as well as the chief public health officer, has formal access to the best public health advice.

Further to this, clauses 37 and 38 make it far clearer that local councils need to sustain their historic and continuing role as the local public health authorities. These provisions do not extend the responsibilities of local councils; what they do is clarify and codify the broad range of tasks that councils have always had to undertake in order to protect and advance the health of their communities.

I most particularly note that authorised officers appointed by this legislation have identical powers as under the current act, congruent with the powers similarly provided by this parliament in other acts that establish a scheme for authorised officers. This is appropriate and proper. It is important that when public health is threatened, those charged with its protection have the full authority that the law can provide in order for them to do their job to protect our health.

There are also several key innovations in this bill which strengthen our community's capacity to secure an advanced public health. Clause 56 establishes a general duty not to harm public health. This provision mirrors similar statutory general duties established under other legislation, for example, the Environment Protection Act establishes a general duty not to cause environmental harm. This provides for a generally applied community standard and reinforces that we all have a role to play when it comes to protecting public health. As such, it is a significant educational opportunity to reinforce our joint responsibilities.

More particularly, as with most statutory general duties, whilst breaches do not constitute an offence, failure to comply with a properly constituted notice under this provision may give rise to an offence. This provision in many ways replaces and improves sections 15 to 17 of the current act. The bill improves this area of public health by providing a clear scheme for how harm, as well as risks to health, can be systematically assessed. This provides clear guidance to authorised officers to undertake consistent assessments prior to taking necessary action.

I am informed that the current sections of the act are so antiquated that they reflect pre-germ theory understanding of what may cause risks to health. Section 17 of the current act speaks of the emissions of offensive material or odours. This is pure miasma theory; the view that disease was spread through noxious odours is long since outdated.

The bill also establishes two specific offences of material risk and serious risks to public health at clauses 57 and 58. These are general offences which can be applied to any situation of public health risk. Using a well-established risk assessment framework, authorised officers will now have the capacity to consistently assess any situation that might cause a risk to health and take whatever appropriate and proportionate action is necessary to remedy the situation. Some examples of what may constitute an offence of a risk to health include:

operating a tattoo parlour in such a way as to risk the spread of disease to clients—a prosecution might occur if there is a repeated failure to comply with a notice under the general duty or an immediate case for prosecution can be made if there are cases of infection that can be traced back to the parlour and the procedures used;

failure to maintain a system to prevent overflow of potentially hazardous effluent—a prosecution might occur if effluent has overflowed in circumstances where persons have been exposed to toxic or infectious material which may result in actual or potential harm; and

a therapeutic health or lifestyle procedure (for example, colonic irrigation) presents a risk—a prosecution might occur if, despite orders being issues or statements made about the inherent danger of the procedure, a person continues to provide the procedure in a manner likely to cause harm or there are actual cases where persons have been physically harmed as a result of undergoing this procedure.

Over and above providing strong and clear measures for dealing with public health offences, the bill also provides for measures which can help prevent harm from occurring in the first place. Members will note that the bill in part 4 provides for a scheme for state and regional public health planning. This has been a feature of legislation interstate for some time but not in South Australia.

Again, it is time for South Australia to catch up. Such planning will allow both state and local government agencies to coordinate their activities, plan for public health protection and improvement strategies based on a local assessment of needs and set an overarching framework of priorities for public health action in our state.

The bill also establishes a scheme for the notification of prescribed contaminants which may cause risk to health. This occurs at clauses 67 and 68. For example, with the cooperation of food processors, if certain contaminants—such as a microorganism or other contaminant such as a heavy metal—are detected at a certain stage of processing, notifying public health officials will ensure that immediate action can be taken by both the company working in concert with public health well before any harm is done and well before the contaminated product can enter the retail market. This is the essence of prevention—taking action to prevent a clear potential harm.

There are several other provisions in the bill, such as in part 8, the development of codes of practice for the prevention of non-communicable conditions, which is designed to get ahead of the public health risk and designed to enlist the cooperation of industry and other sectors of the community. Taken together, the bill provides a set of provisions to take quick action where harm or potential harm is occurring or imminent, as well as a set of measures which will allow us to get ahead of potential problems, assess public health needs, jointly plan for coordinated action and prevent harm from occurring in the first place.

These are the very things that our community rightly expects when it comes to public health law. The community rightly expects where damage or harm is occurring that we can take immediate action, and the community rightly expects that if we can prevent harm we should not hesitate to act. The community rightly expects that if we can develop the conditions which will keep us healthy, then that is precisely what we should do. The bill provides for such a suite of approaches, and I commend the bill to the house.

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for Mental Health and Substance Abuse, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (16:57): I thank members on both sides of the house for their contributions to the debate. I particularly thank the opposition for its expression of support for the legislation. I want to briefly turn to some of the issues the member for Morphett raised and try to address them if I can. I am grateful for the notes I have been provided to do this.

The member raised the issue of the precautionary principle, clause 6. I am advised that it is balanced by two clauses in clause 6; that is, there has to be careful evaluation, assessment of risk and minimum disruption. Also, principle 7, proportionate regulation means regulations must minimise adverse impacts on businesses and community. So, it is true that there is a precautionary principle that is balanced by other principles, and I guess that is the point. The minister also issues guidelines as to how principles are to be used, and guidelines are prepared in conjunction with local government.

The second point was in relation to clause 23, biennial reports of the CPHO (chief public health officer). The advice I have is that it is a two-yearly report because it is meant to identify trends, activities and indications and the implementation of the public health plans, and so it is supposed to have a longer time frame. There are a longer-term issues, and two years is considered to be an appropriate period to identify changing trends, and the Southern Australian public health council will report on activities on a yearly basis anyway. So, there is a yearly report but this is above that report.

Thirdly, direction powers under clause 75, I am advised that these powers are exactly the same as in the current act. Adults who have a conscientious objection to treatment or examination can exercise that but can still be supervised or detained, so the other provisions of clause 75 would apply. Fourthly, detention in emergencies, clause 90. This is the same as amendments to the Public and Environmental Health Act last year, already passed by the parliament, and will only apply in declared emergencies, so I hope that covers it.

The member also mentioned the possibility of a review after a few years by the Social Development Committee. I am not opposed to that; I am happy to get some advice. It might be that we have a review. I gather there is a five-year plan that is required under this legislation. It might be appropriate that we link the review to the planning process. Without being specific about the time frame, I am not opposed to the idea that we should have a review by the Social Development Committee, so perhaps we can do some work between the houses. I am happy to agree to something, I just do not quite know yet what it would be.

I take the point the member for Morphett made that this legislation has been a long time in the making. It is a very complex bit of legislation, as members would have heard from the description by the member for Morphett and from their own reading of the legislation. It does cover the field. It is really a seismic shift in the way we approach these kinds of issues, from a very traditional method of rules and regulations and what you can and cannot do to a broader approach, I suppose similar to the way we manage environmental legislation. I commend the legislation to the house. I am glad it has bipartisan support because these kinds of measures do need that level of support from the political leadership.

In these last few minutes, I thank the departmental officers. I do not know if they have all been working on this for 10 years, but some of them have been working on it for a very long time. The principal contributors are Danny Broderick, Kevin Buckett and Kay Anastassiadis, and they have certainly been working on this for as long as I have been Health Minister. They are here in the chamber—I am not supposed to draw attention to the chamber, but I do thank them. I know they have been helped by an extensive team.

I would also like to thank Dr Chris Reynolds, who until recently was at Flinders University. He has made a very significant contribution to the drafting of the bill and, of course, parliamentary counsel Richard Dennis who, as usual, does a mighty job. I particularly thank the Local Government Association, with whom we have a strong partnership in relation to this, obviously, for their forbearance as we have gone through this very long process.

I understand the LGA is seeking some assurance in relation to resources identified for the implementation of the legislation and I give them that undertaking. I understand that the department is working with the LGA and Environmental Health Australia, SA Branch, to develop specific implementation plans. This planning will be carried out by a joint implementation steering committee, which includes representations from both the LGA and Environmental Health Australia.

A plan needs to be developed in the first instance so that costings can be determined and the plan funded accordingly, so I certainly look forward to receiving the business case which will support the plan once it is developed. In saying this, I wish to assure the LGA and EHA that the department and I are committed to making sure the legislation is properly implemented and identifying reasonable and appropriate resources to support its implementation. I also understand the department has already identified some resources in advance of the legislation passing to assist the LGA in developing capacity to support councils to undertake regional public health planning.

This is a new way of approaching this. It has been consulted on and thought through in great depth over a long period of time. I am very pleased it has now reached the stage where this parliament can consider it. Once again, I thank the opposition and particularly the member for Morphett for his expression of support, and my own colleagues for their support as well. I commend the legislation to the house.

Bill read a second time.

Third Reading

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for Mental Health and Substance Abuse, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (17:04): I move:

That this bill be now read a third time.

Bill read a third time and passed.