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

Introduction and First Reading

The Hon. S.G. WADE (Minister for Health and Wellbeing) (16:05): Obtained leave and introduced a bill for an act to amend the South Australian Public Health Act 2011.

Second Reading

The Hon. S.G. WADE (Minister for Health and Wellbeing) (16:06): I move:

That this bill be now read a second time.

The South Australian Public Health (Early Childhood Services and Immunisation) Amendment Bill 2019 that I introduce to parliament today is the first of two no jab no play bills that will be introduced to state parliament.

The first phase of the government's no jab no play policy aims to improve the ability to prevent and control outbreaks of vaccine preventable diseases in early childhood services. The bill requires parents and guardians to provide immunisation records to their child's early childhood service, and gives the Chief Public Health Officer the power to request those records. In the event of an outbreak of a vaccine preventable disease at an early childhood centre, the bill will allow the Chief Public Health Officer the power to exclude a child from the centre. This will provide our public health officers with more support to prevent and contain a dangerous outbreak.

Most other states have the ability to exclude unimmunised children from an early childhood service when an outbreak is occurring. While these measures will help reduce cases of vaccine preventable disease and improve our ability to respond, we are continuing to consult on further measures to improve overall vaccination rates. Immunisation is one of the most effective strategies to protect children and adults against serious diseases. Immunisation is also one of the most cost-effective health interventions and is supported by the World Health Organization and all levels of government in Australia. Immunisation saves lives and protects lives.

Although immunisation coverage in South Australia is very good, in most areas it falls short of the national aspirational immunisation coverage target set at 95 per cent. State-wide immunisation coverage in South Australia in the assessed age groups is between 86.83 per cent and 95.83 per cent, depending on the group.

Increasing immunisation rates for children under five to as close to 100 per cent as possible is critical to ensure herd immunity and protect children and adults from highly infectious diseases. Some children are unable to be immunised for medical reasons, such as immunosuppression or severe allergy. These potentially vulnerable children are provided with a circle of protection against most vaccine preventable diseases if other children are fully vaccinated.

The commonwealth enacted no jab no play legislation in 2015 to improve vaccination coverage. The no jab no play act directly impacts parents who receive the Family Tax Benefit Part A supplement, and the Child Care Subsidy. Under the no jab no play act, parents are still able to send incompletely immunised children to early childhood services, but they are unable to receive the usual government benefits.

New South Wales, Victoria and Queensland have enacted no jab no play legislation. Both New South Wales and Victoria require parents or caregivers to provide evidence that the child is fully vaccinated for age prior to enrolment in early childhood services. Queensland legislation permits early childhood education and care services discretion regarding whether or not they will allow attendance of undervaccinated children.

Western Australia has recently commenced regulations to require caregivers to provide their child's Australian Immunisation Register statement upon enrolment in child care, kindergarten and school. This is the first step of Western Australia's proposed three-part process. The second part, which will require children to be fully vaccinated for age to be eligible for enrolment in child care and kindergarten, is currently undergoing consultation. The third part of the proposal will involve policy initiatives aimed at improving childhood vaccination coverage.

The Marshall Liberal government is committed to improving South Australia's overall immunisation coverage and reducing pockets of underimmunisation. The government is going to consult on the best model for South Australia. Our starting point is to legislate to exclude children from early childhood services if they are not vaccinated. We are not considering the Queensland model.

The other two models, New South Wales and Victoria, differ. Victoria provides a greater range of exemptions, for example, if the child is descended from an Aboriginal or Torres Strait Islander or the child is in the care of a parent who is the holder of a health care card, pensioner concession card, gold card or white card or the child was a multiple birth.

An issue that will need to be considered is if the role of preschool childhood education in maximising beneficial health and development outcomes for children during their school years is supported by strong evidence. The Royal Australian College of Physicians highlights the importance of affordable and accessible early childhood education, raising concerns that lack of access to early childhood education is highly detrimental, especially from 3 to 4 years of age and especially if compounded by financial vulnerability.

The South Australian Child Development Council has provided in principle support for the measures, which focus on improving immunisation coverage rates, recognising the complexity of the issues around no jab no play legislation and the potential impact on human rights such as the child's right to health and education. The council cautioned against the blunt nature of such a policy instrument, which might violate some of the core principles of the United Nations Convention on the Rights of the Child.

Given the complexities of the issues, this government has determined to adopt a two-step approach. This bill is the first step. The government bill seeks to take the opportunity to facilitate a swift public health response to vaccine-preventable disease outbreaks ahead of full implementation of a no jab no play policy, pending further evaluation and consultation.

Under the second phase of no jab no play, it is proposed that children must be appropriately immunised on an immunisation catch-up program or be exempt for medical reasons in order to enrol or attend early childhood care services. The government will now go to community consultation on a further South Australian bill on that aspect.

The government will shortly release a discussion paper which will draw on input received and assessments of the impact of interstate legislation. We want to ensure we get our laws right. We are committed to protecting children and believe that South Australia should have the best childhood immunisation rates in the nation. I commend the bill to members and seek leave to have the explanation of clauses inserted in Hansard without my reading it.

Leave granted.

Explanation of Clauses

Part 1—Preliminary

1—Short title

2—Commencement

3—Amendment provisions

These clauses are formal.

Part 2—Amendment of South Australian Public Health Act 2011

4—Insertion of Part 12A

This clause inserts new Part 12A into the South Australian Public Health Act 2011 as follows:

Part 12A—Immunisation and Early Childhood Services

96A—Interpretation

This clause defines key terms used in the measure. For the purposes of the measure, an early childhood service is defined as a service for the education or care (or both) of a child under the age of 6 years but does not include the following services:

(a) the provision of primary education provided at or in connection with a primary school;

(b) a service comprising a person engaged by a parent or guardian of a child to babysit the child in the child's home;

(c) a babysitting, playgroup or childminding service that is organised informally by the parents of the children concerned;

(d) a service provided for a child by a family member of the child or friend of the family of the child personally under an informal arrangement where no offer to provide that service was advertised;

(e) a service principally conducted to provide tuition to 1 child or a number of children who ordinarily reside together;

(f) a service principally conducted to provide instruction in a particular activity (such as sport, dance and music);

(g) a service where a parent or guardian of each child remains on site and is available to care for their child if required;

(h) a service comprising out of school care;

(i) care provided to a child by a person in accordance with a parenting order under the Family Law Act 1975 or Family Court Act 1997 of the Commonwealth;

(j) care provided to a child under the Children and Young People (Safety) Act 2017;

(k) any other service, or service of a kind, prescribed by the regulations.

Immunisation record is defined as any of the following:

(a) an extract, or extracts, from the Australian Immunisation Register under the Australian Immunisation Register Act 2015 of the Commonwealth;

(b) a document of a kind approved by the Chief Public Health Officer;

(c) a certificate in writing issued by the Chief Public Health Officer.

96B—Requirement to provide immunisation records to service provider

This clause provides that the parent or guardian of a child that is enrolled or attends at premises for the purposes of the provision of an early childhood service must provide immunisation records relating to the child to the provider of the service in accordance with the requirements of the Chief Public Health Officer.

The clause further provides that a provider of an early childhood service must take reasonable steps to ensure that the parent or guardian of a child complies with the requirements to provide the records and must also keep a copy of all records provided to the provider under the clause.

96C—Provision of information to Chief Public Health Officer on outbreak of vaccine preventable disease

This clause provides that the Chief Public Health Officer may, if satisfied that there is an outbreak, or a risk of an outbreak, of a vaccine preventable disease at premises at which early childhood services are provided, require the person with responsibility for providing the service at the premises to provide to the Chief Public Health Officer—

(a) the name and date of birth of each child that is enrolled, or routinely attends, at the premises for the provision of an early childhood service; and

(b) immunisation records relating to each child referred to in paragraph (a) provided pursuant to clause 96B(1); and South Australian Public Health (Early Childhood Services and Immunisation) Amendment Bill 2019

(c) the contact details for a parent or guardian of each child referred to in paragraph (a); and

(d) any other prescribed information.

If the Chief Public Health Officer requires the provision of information under the clause then the information must be provided within 24 hours and a maximum penalty of $30,000 applies for a failure to comply.

96D—Exclusion of children from premises on outbreak of vaccine preventable disease

This clause provides that the Chief Public Health Officer may, by notice in writing, direct that a specified child is excluded from attending at specified premises at which early childhood services are provided if satisfied that—

(a) the child has been diagnosed with a vaccine preventable disease; or

(b) there is an outbreak of a specified vaccine preventable disease at the premises and the child would, if the child attended at the premises, be at a material risk of contracting the vaccine preventable disease.

The clause provides for service of a direction of the Chief Public Health Officer on the person responsible for the provision of an education or care service at the specified premises and also on the parents of a child specified in the direction.

The clause provides that a person must not provide an early childhood service to a child at premises from which the child is excluded pursuant to a direction under the clause and a maximum penalty of $30,000 applies.

96E—Exemptions

This clause provides that the Chief Public Health Officer may, by notice in writing, grant an exemption from this Part or specified provisions of this Part—

(a) in relation to a specified child or children of a specified class; or

(b) to specified persons or persons of a specified class; or

(c) in relation to specified early childhood services or early childhood services of a specified class.

An exemption under this clause may—

(a) be subject to such conditions as the Chief Public Health Officer thinks fit; and

(b) apply for a specified period, until further notice or indefinitely; and

(c) vary according to the circumstances to which it is expressed to apply.

A person who contravenes or fails to comply with a condition of an exemption imposed under this section is guilty of an offence and a maximum penalty of $2,500 applies.

Debate adjourned on motion of Hon. E.S. Bourke.