Preventive Health SA Bill

Second Reading

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector) (16:41): I move:

That this bill be now read a second time.

I seek leave to have the second reading explanation and explanation of clauses inserted in Hansard without my reading them.

Leave granted.

I rise today to introduce the Preventive Health SA Bill 2024.

Whilst many South Australians experience good health, rates of chronic conditions are increasing, with some population groups and communities experiencing poorer health outcomes compared to others.

Combined with an ageing population this is having an impact on escalating demand and costs on our health care system and more importantly the impact in terms of the human cost of illness and lost productivity.

According to recent research:

8.7% of South Australians aged 15 years and over currently smoke;

68% of adults and 27.5% of children across South Australia are currently overweight or obese; and

more than 29% of South Australian adults consume alcohol that puts them at risk of harm from alcohol related disease or injury.

When you consider population growth, projections indicate that without intervention the number of people experiencing these risk factors will increase.

It is expected that by 2029 an additional 1,900 children and 48,000 adults will be overweight or obese.

For adults aged 18 years and older it is projected that an additional:

9,800 females and 15,000 males will be exceeding alcohol consumption guidelines;

7,800 females and 4,900 males will report high to very high levels of psychological distress; and

2,600 females and 3,300 males will report suicidal ideation.

We all know the adage 'prevention is better than cure' and we must ensure attention is given to taking comprehensive action to reduce this growing burden of ill-health and disease.

We must ensure preventive health effort is a key component of our overall health response because we know its proven impact on reducing health risk factors such as smoking tobacco and UV sun exposure, and how such changes reduce rates of chronic disease and improve the health and wellbeing of individuals, families and the community as a whole.

We know that targeted preventive health action must occur to improve the health and wellbeing of priority population groups, especially Aboriginal and Torres Strait Islander persons who experience a burden of disease that is 2.3 times greater than other Australians.

Under previous South Australian Governments, reviews of non-hospital-based services have led to reductions in primary prevention funding and uncertainty in relation to resourcing and priorities for prevention work in South Australia.

Such changes have resulted in South Australia not sustaining preventive health infrastructure that can deliver coordinated and comprehensive strategies to prevent ill-health and downstream costs to the South Australian health system.

Despite this, good work has continued to take place to promote preventive health initiatives in South Australia.

In 2020 Wellbeing SA was established to support the physical, mental and social wellbeing of South Australians, using a population health approach to improve the health of the entire population.

While this agency included many important priorities and functions that have continued to be delivered today, it was also responsible for other integrated care services that supported public hospitals with system-wide demand activities.

Preventive health functions relating to smoking, vaping and alcohol also sat separately as part of Drug and Alcohol Services South Australia.

Earlier this year, Preventive Health SA was established, strengthening the prevention agenda in South Australia through the consolidation of these key prevention functions into a single agency.

The Preventive Health SA Bill 2024 is the first of its kind in South Australia, formally recognising preventive health as an important area of health policy and ensuring it becomes a permanent part of the infrastructure of the health system in South Australia.

The Preventive Health SA Bill 2024 demonstrates the South Australian Government's commitment to embedding systems and structures in legislation for long term, sustainable health system enhancements to support positive health and wellbeing outcomes which, over time, will reduce pressure on the acute health system.

The Bill provides the legislative infrastructure required in South Australia to build a sustainable prevention system for the future and help drive long-lasting, positive health and wellbeing change for current and future generations.

Over the past 40 years legislation has been critical to taking action on complex public health challenges, playing a key role in reducing fatalities and injuries on roads and reducing smoking prevalence.

We have been fortunate in South Australia to lead the way with contemporary preventive health legislation over the past couple of decades.

The South Australian Public Health Act 2011 which replaced the Public and Environmental Health Act 1987 provided the State with a modernised, flexible legislative framework, supporting a better response to emerging and traditional public health challenges.

The Suicide Prevention Act 2021 is another example of unique and nation leading preventive health legislation, the first of its kind for any jurisdiction in Australia which aims to reduce the incidence of suicide in the State.

The Preventive Health SA Bill 2024 strengthens and compliments the South Australian Public Health Act 2011 and other key prevention legislation in South Australia relating to suicide prevention, controlled substances, alcohol and tobacco.

In February this year the Preventive Health SA Establishment Advisory Council was established to provide expert advice on the drafting of this Bill.

Chaired by the Honourable Nicole Roxon, members of the Council had expertise in epidemiology, public health policy, Aboriginal health and health equity, preventive health strategy, Government policy making and business.

The Council sought community and stakeholder input into the drafting of this Bill, with a range of individuals and organisations providing feedback through public consultation held earlier this year.

There were high levels of support for enshrining preventive health policy and action in legislation and the Bill was further strengthened following consultation feedback.

The Preventive Health SA Bill 2024 contains a number of Objects which outline the intent of the Bill to:

ensure a dedicated focus on improving the health and wellbeing of South Australians by preventing and reducing the burden of non-communicable health conditions through addressing preventable risk factors and the associated determinants of health;

improve health equity for Aboriginal and Torres Strait Islander persons as well as other priority population groups;

lead preventive health action and strengthens collaboration across government, non-government and other key sectors; and

embed the prevention agenda for long term and sustainable outcomes.

Within 18 months of the legislation being assented to, the Chief Executive will ensure a strategic plan for preventive health action in South Australia is available, identifying preventive health policies, priorities and measures in order to further the Objects of the legislation.

The Preventive Health SA Council will also be established under this legislation and will include members with diverse preventive health knowledge, expertise and experience.

I am very pleased that this legislation is one of the first to be considered by the South Australian Voice to Parliament and has been strengthened following their feedback.

The Objects include a focus on improving health equity for priority population groups, but of note is the specific Object focussing on healing and wellbeing for Aboriginal and Torres Strait Islander persons through preventive health action.

The Council established under this legislation will have strong representation with at least two Aboriginal and Torres Strait Islander persons as members.

The Bill also enshrines the strong commitment to working together with Aboriginal and Torres Strait Islander communities through the requirement for the Chief Executive to consult and collaborate with Aboriginal and Torres Strait Islander persons and their representative bodies in performing their functions.

There are a number of provisions in the Bill that support the Government's commitment to create an independent prevention agency, ensuring the ability to lead and engage across government agencies on preventive health action, while providing impartial, evidence-informed advice and information.

Independence of the Chief Executive and the Council is essential for transparency and influencing and driving positive change in decision making and action.

The challenge ahead of us is great and Government cannot do it alone.

I would like to thank and acknowledge the work of partners that have supported the prevention agenda.

Organisations such as the

South Australian Health and Medical Research Institute

Cancer Council SA

Heart Foundation

Diabetes SA

University of South Australia

Flinders University

Adelaide University

Public Health Association of Australia

Australian Health Promotion Association

South Australian Council of Social Service

Local Government and

The South Australian Aboriginal Community Controlled Organisation Network

are just a few of the organisations who share our commitment towards improving the health of all South Australians.

I would also like to thank members of the Establishment Advisory Council who have provided advice to help draft this important Bill including:

Hon Nicola Roxon, Chair;

Dr Michelle Atchison;

Todd Harper;

David Pearson;

Professor Caroline Miller;

Associate Professor Odette Pearson;

Kim Morey;

Dr Rhiannon Pilkington;

Andrew Culley; and

Dr Alison Edwards

I would also like to acknowledge and thank all the staff of Preventive Health SA for their continued work since the establishment of this agency earlier this year, including Marina Bowshall, who has recently been appointed Chief Executive of Preventive Health SA.

This is an important and much needed piece of legislation. I believe the Bill will play a significant role in South Australia becoming an even healthier State through strengthening collaborative and evidence-informed preventive health policy and action.

I commend this Bill to members.

Explanation of Clauses

Part 1—Preliminary

1—Short title

2—Commencement

These clauses are formal.

3—Objects and key principle

The objects and key principles of the measure are set out.

4—Interpretation

Certain terms are defined for the purposes of the measure.

5—Interaction with other Acts

The measure is in addition to, and does not derogate from, any other Act or law.

Part 2—Office for Preventive Health SA

6—Office for Preventive Health SA

The Minister is required to designate an administrative unit of the Public Service as the Office for Preventive Health SA.

Consultation with the Preventive Health SA Council under the measure is required before the engagement, transfer or termination of the employment of the Chief Executive of that administrative unit under the Public Sector Act 2009.

7—Functions

The functions of the Chief Executive of the Office for Preventive Health SA are set out.

8—Exercise of functions

The Chief Executive is required to act independently, impartially and in the public interest in performing their functions. The Minister is authorised to give the Chief Executive a direction in relation to the performance of the Chief Executive's functions, except in relation to certain specified functions.

9—Strategic plan

The Chief Executive is required to prepare a strategic plan for preventive health action in South Australia and review it at least once in every 4 years. Other provisions relate to preparing, reviewing and publishing the plan.

10—Annual report

An annual report on the performance of the Chief Executive's functions under the measure is required to be prepared and tabled in Parliament.

11—Delegation

Provision is made for the Chief Executive to delegate their functions.

Part 3—Preventive Health SA Council

12—Establishment of Preventive Health SA Council

The Preventive Health SA Council is established. The Council consists of the Chief Executive and at least 8 other members appointed by the Minister on the recommendation of the Chief Executive, of whom at least 2 must be Aboriginal or Torres Strait Islander persons.

The collective knowledge, expertise or experience required of members of the Council is set out.

13—Terms and conditions of membership

The terms and conditions of appointment of members of the Council are to be determined by the Minister.

14—Vacancies or defects in appointment of members

This clause is technical.

15—Remuneration

The remuneration of a member of the Council is to be determined by the Minister.

16—Functions

The functions of the Council are provided for.

17—Committees

The Council is authorised to establish committees.

18—Delegations

Provision is made for the Council to delegate its functions.

19—Procedures

Procedures of Council meetings are provided for.

Part 4—Miscellaneous

20—Resources for preventive health

This clause makes provision in relation to the Minister determining the resourcing that the Chief Executive reasonably needs to carry out the Chief Executive's functions under the measure.

21—Regulations

A regulation-making power is set out for the purposes of the measure.

Schedule 1—Transitional provision

1—Transitional provision

A transitional provision relating to the first strategic plan is provided for.

Debate adjourned on motion of Hon. L.A. Henderson.