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House of Assembly - Fifty-First Parliament, Third Session (51-3)
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STATUTES AMENDMENT (PUBLIC HEALTH INCIDENTS AND EMERGENCIES) BILL

Second Reading

Adjourned debate on second reading (resumed on motion).

(Continued from page 2623.)

Ms CHAPMAN (Bragg—Deputy Leader of the Opposition) (15:50): Earlier, I was referring to the broad—probably too broad—proposal to grant power during a declared period in relation to a public health incident essentially to circumvent the provisions of the Controlled Substances Act 1984. During the luncheon adjournment, I briefly perused the second reading explanation, which for reasons explained this morning, was tabled but not read. I have yet to identify any explanation as to why it is necessary for this to be so broad. The second reading explanation states:

The other 'health' power that is included is proposed section 26A which enables the minister to modify the operation of the Controlled Substances Act 1984 during the period of a declared emergency for the purposes of response or recovery operations. This can only be after consultation with the minister responsible for the administration of the Controlled Substances Act 1984.

I cannot identify anywhere else where this is detailed other than on page 11 of the second reading explanation (I am not sure what page it will end up in Hansard), where it states:

The rationale for the inclusion of new clause 26A, which allows for the Controlled Substances Act 1984 to be modified, was primarily to cover situations that may arise with the distribution and supply of medication during a pandemic where there may not be a formal prescription and nurses or other health professions may need to assist with supply;

There are checks and balances built in—

it is the minister who would issue the notice;

the minister must form the opinion that it is necessary and desirable to do so;

it could only be done for the purposes of the response or recovery operations;

the minister is obliged to first consult with the minister responsible for the administration of the Controlled Substances Act;

the notice can only be for the duration of a declaration.

Some of that is obvious because, quite clearly, for a public health incident we are talking about a period of up to 14 days and, for a general major incident, disaster or emergency, up to 30 days. I again make the point that, as that is all that is disclosed in the second reading explanation, it seems inappropriate simply to have a general remit and power to modify this act and not specify what it is for.

The example that is referred to was briefly discussed at the briefing I had. One can imagine, for example, a vaccine being developed and packaged, presumably in some kind of a vial or capsule containing the prescribed dose for an adult or child (maybe in different doses) and that someone may need to inject it. As it is a drug that would be available only when prescribed by a medical practitioner or some other authorised medical person nominated in the legislation, in an emergency there may not be enough doctors around to do that, especially if there was a mass invasion of the virus and a need for the vaccine to be distributed quickly to a huge number of people.

If that is the case, surely that modification should be included in the provisions of the act to allow for prescription, distribution and even injection to be carried out by persons other than those who are qualified to do so in an emergency, as determined by the minister.

It seems to me that it is quite open for that provision, which I can see may be necessary. It would be reasonable for that to be included with the appropriate checks and balances as indicated. I ask that, between houses at the very least, some careful consideration be given to how that could be provided for without having this blanket notice in the Government Gazette to modify the operation.

If there were such a disaster and we suddenly had to distribute a vaccine or medication to a mass number of people, it seems bizarre that we would have to put a notice in the Government Gazette. One assumes the place would be falling apart around us and that we would need to make this very much a priority, so it seems incongruous to have to arrange for something to be published in the Gazette.

Other than in bushfire situations, I have not been in an active war zone or a major health pandemic where there may be hundreds or thousands of people who are either contaminated or exposed to some kind of risk—radiation, for example. I have not been in that sort of emergency or disaster situation, but it seems to me that there is an opportunity for us not to rush into legislation such as this. Again, I make the point that there is plenty of time to do this because cabinet, as I understand it, has already endorsed regulations that have been issued by the minister to cover these powers in any event, and they are currently in operation.

I turn now to the amendments to the Public and Environmental Health Act, which essentially bring in a whole new regime of emergency/incident response by health officials when there is a public health emergency or incident. They are to receive a process of declarations made by the Chief Medical Officer and, essentially, the Chief Executive of the Department of Health will be the person who has control of this new regime.

We would be obliged to have a public health emergency management plan and that would form part of the State Emergency Plan, so somebody would have to prepare that. Emergency officers would be appointed by the chief executive, with or without conditions, and, in some ways, they would have similar obligations including now this specifically legislated confidentiality requirement. They would have to carry a badge to show that they are authorised and all the things that relate to officers under the state emergency legislation.

We have the definitions for 'public health incident' and 'public health emergency'. New section 37E will set out that, when a declaration has to be made, almost all the powers under section 25 of the Emergency Management Act, with the exception of section 25(1) and section 25(2)(n), will be the same. I have read through those at some length in this debate to make it absolutely clear how extensive they are.

I think the first question is: why do we need to have part 8 at all? Why do we need to repeat a whole structure, plan and process with the health department in order to deal with a public incident or emergency when we have the state emergency act powers that are statewide? Again, I refer to the minister's contribution and, whilst the scheme maintains the Emergency Management Act process as an overarching act, he explains that:

It provides an additional mechanism to respond to public health incidents or emergencies under the P&EH act—

that is, the Public and Environmental Health Act—

without needing to seek a declaration under the EM act until such time as that may be required. This better reflects the Department of Health's responsibility for identifying and managing the response to a human disease incident...In the initial stages, Health, with its expertise to manage a health issue, will manage the response. If the situation warranted it, the Chief Executive, Department of Health...could declare a public health incident or emergency after consultation with the Chief Medical Officer and the State Coordinator under the EM act. If that occurred, once a public health incident or emergency is declared, most of the EM act powers 'come across'—

and that is as I have explained—

and the CE Health can exercise them under a public health incident or emergency declaration.

If the situation escalated in magnitude, such that a whole-of-government state emergency response was necessary, the State Coordinator under the EM act would be approached, seeking a declaration under the EM act.

It also says the scheme allows for an easy transition between the P&EH act structure and the EM act. Reading that, I assume that the government has in mind that when there is the need for management of a normal disease incident (there is a notification, for example, of a disease that has the potential for problems, particularly with contamination), the Department of Health, under the Public and Environmental Health Act, would carry out its usual responsibility. It does that now and it is vested with that direct responsibility.

If it gets to a really serious stage, at the moment we can go straight across to the Emergency Management Act and call in the people involved in that structure—which includes the Department of Health, because obviously it would be a health issue, and that is provided for in the Emergency Management Act. The department would, as I explained before, as a committee make decisions and declarations, if necessary, and then these extraordinary powers come into effect.

This bill gives a step in between, where the Department of Health and its emergency officers, who will be appointed—its own health police or health army will be identified—will have all those emergency powers to do what is necessary under their declaration periods which, as I have explained, are for slightly shorter but still extended periods. Then, if it gets really bad, we move into stage three, which is where we bring in the police and other emergency services and the EM act kicks in.

It raises the question, first, about whether or not there is an easy transition or power, once the state coordinator (the head of police) says to the Department of Health, 'Your efforts have not worked,' or, 'It is simply not contained and we now need to move to the next level so I am going to rescind your declaration and implement my own.'

What we say is that it is possible that this is a structure that could work. However, we want the government to have a very good look at why it would introduce a stage in the middle where all these powers are with the department. I think we need to have a clear indication from the government about whether it is planning to divest all these responsibilities, depending on the nature of the incident, disaster or emergency, to each of the relevant authorities. Is the Minister for Emergency Services going to take over all floods, earthquakes and disasters? Are all terrorist acts going to be taken over by the police department?

One of the reasons we have these draconian powers—at first blush—is that they are justified in a very, very serious situation and, in a very, very serious situation, the logical expectation is that all the services are likely to be involved and may be called upon.

If we have a bushfire, we call in the police for the management of public and traffic (this is just some of their duties), we call in the SES (which deals with, very often, chemical spills, motor vehicle accidents, clearances and access for the public to get in and out of hospitals and along roads, and all sorts of things like that), and we use the MFS and CFS (who are experienced in the management of fire and the containment thereof and, of course, the protection of life and property, and they obviously have special skills in dealing with that type of risk).

So, when we do have an emergency, whether it is a public health emergency or a flood, fire or terrorist attack, very often we are going to need all of those services together. Implicit in there being a state disaster or emergency, it is likely that the reserves and expertise of all these people need to be called on. One of the comforts I have as a member of parliament is in knowing that when these sorts of powers are out there (even for a matter of hours but, in this case, proposed for days or up to a month), there is a breadth of people who are actually going to have control of it and be able to make those decisions.

So, personally, I am far from convinced that establishing a new hierarchy, a new army of obligation, a new training requirement and a new plan, because we are dealing with very extensive powers, is the right way to go. I am not convinced of that from the material contributed to the parliament by the minister. Page 9 of the second reading explanation states:

Turning to the amendments to the P&EH Act, it is clear that there is a need to have a modern public health law that can respond not only to 'traditional' public health issues, but also has the flexibility to deal with emerging public health concerns of the 21st century. New and emerging dangers—including emergent and resurgent infectious diseases and incidents resulting in mass casualties—have focused attention on the adequacy of legislative frameworks. As was observed in the Exercise Cumpston 06 Report, the community expects government to provide leadership in preventing disease outbreaks and, in the event of an outbreak, to respond and assist recovery quickly and effectively. Public health legislation therefore needs to be flexible enough to respond to a variety of emergency situations and integrate with our emergency responses.

I agree with all that. Arguably, it is a bit motherhood but it states the bleeding obvious; that is, the public expects, quite reasonably, that we have both the legislative framework and a process that can be flexible enough to be activated promptly to deal with mass breakouts—in this case, preventing disease outbreaks.

I hasten to add that even at a time when we have an international contamination—swine flu—on a number of continents, with all the existing legislation we still contained it. It again raises the question of the need for this interim layer of armed officials to have this responsibility and be given this power. The second reading explanation continues:

Some communicable diseases can be infectious before an individual produces symptoms that would lead to diagnosis. As a result it may be necessary to quarantine asymptomatic (well) people who have made contact with a case or a suspected case to prevent them unwittingly passing on infection before they themselves become symptomatic.

We agree with that—and we do not need the Emergency Management Act powers to be able to deal with that. We do not need that. We can make provision in the Public and Environmental Health Act to deal with the quarantine requirements, if necessary. They are quite significant. For the record I will refer to the Public and Environmental Health Act for the purposes of understanding the fullness of the existing powers. In division 3 of the Public and Environmental Health Act, section 36 provides:

(1) Where there is danger to public health from the possible spread of a notifiable disease, the Chief Executive or an authorised officer authorised by the Chief Executive for the purposes of this section may give directions and take such action as may be appropriate to avert that danger.

Again, similar to the Emergency Management Act, it provides:

(2) Without limiting the generality…the Chief Executive or authorised officer may—

(a) direct that any premises, vehicle or article be cleansed or disinfected;

b) direct the destruction of any article, substance or food;

(c) seize any vehicle, article, substance or food;

(d) impose areas of quarantine or close premises;

(e) restrict movement into or out of any place or premises;

(f) take such other action as may be prescribed.

Admittedly, it does not say that you can blow up a building, but it is far reaching. Those in the Department of Health, in dealing with the containment of a disease in the first instance, have significant powers. No-one is challenging that. What I am simply saying is that if that fails, those in the health department—in relation to swine influenza or, indeed, any other influenza virus that may be added to the list in the schedule or provided for in regulation—have significant capacity to be able to deal with it. If it fails and we are hit from all sides, or we have a mass invasion of the virus across the country and we need to declare a state of emergency or a disaster—which is even worse in those categories—then we have the power to do that.

I am still at a loss to understand why we need an interim regime in order for that to be effective. While the minister says that the existing powers under the P&EH act do not provide a clear power in relation to dealing with suspects, we have indicated already we are happy to support that aspect of it and expand it for that purpose. The second reading explanation continues:

While people tend to be cooperative if the reasons for doing so are explained to them and it is made as easy as possible to do so, there also needs to be powers available to deal with non-compliance. It could be expected that in a situation of rapidly escalating magnitude, such as an influenza pandemic, compliance could become an issue.

Again, the opposition agrees with that sentiment; and that is exactly why I raised the point that a mother might be required to be separated from a child who is a suspected contaminated case and a highly stressful situation might arise. I gave an example of a child having asthma and a mother wanting to remain with the child, even at risk to herself. People can make decisions, which may not necessarily be to the benefit of others, in order to protect those around them so an external decision needs to be made.

Surely, that is exactly the situation where you want to have the benefit and support of other services, including the police department, so those people can have support and intervention, if necessary, to manage it, and then let our public health officials get on with the job they are there to do; that is, identify, test, contain and heal.

I raise those matters. Again, we are a long way from moving from a few hours to cover a couple of days or three or four days to weeks or months. I would feel much more comfortable if that situation were to apply under ministerial declaration in the first instance. As it is not—it is only for the extension that the minister becomes involved—I have some concerns about that.

I have referred to the amendments to the Electricity Act, but there are also amendments to the Essential Services Act, the Fire and Emergency Services Act, the Gas Act and the Health Care Act (in relation to the ambulance service and how it might apply to it in the latter). A number of these others are consequential, as I understand it. I have had a look through them and they appear to be so, although I have not checked them off against the principal acts. For the purposes of this debate, I am accepting that they are consequential and that again they simply flow through to cover powers that will apply under those acts and apply to their authorised officers.

Finally, I have indicated our support to swine influenza being added to the schedule of controlled notifiable diseases. We already have other influenza infection on that list. It is designed to cover the pretty serious ones, I think it is fair to say, and for the reasons which are clearly in the public domain—the seriousness and the rapidity of which influenza viruses are developing and spreading. Of course, some of that is due to mobility of population. On the other side, we have a very changed hygiene situation since the distressing events of 1918 or 1957, when we had extraordinary loss of life as a result of what today we call pandemics.

The circumstances are such that we need to be ready. I think the public has a very high expectation that we are prepared. Interestingly, the issue of bird flu was quite a popular topic at the time I visited the World Health Organisation in Switzerland a few years ago. They wanted to impress upon me some public health legislation which was being considered at the federal arena at that time and which had been introduced by former minister Abbott—and I note had been followed through and supported post the new election by minister Roxon. They were keen to know about that, but they were also keen to tell me, 'Look, Vickie, you can talk about cholera, malaria or other contagious diseases—AIDS—but the truth is the biggest problem we now have in the world is the diseases that are not in these lists at all. They are the epidemics we have in obesity, diabetes, etc.'

I know that the minister is well aware of these. I place them on the record, though, as a way of highlighting that we need to keep in perspective what we are dealing with. These types of conditions—that is, when we have a contagious disease—do require a rapid response. It needs to be effective and commensurate with what is necessary in powers that are implemented at the time. All we are saying as an opposition is: let us be clear about who should be responsible to implement that and let us not just add another layer of structure that, potentially, will slow down providing a rapid and effective response in these circumstances.

With those few comments, I indicate the opposition's support at the second reading stage. Again, because we are yet to receive a number of responses from other parties with whom we are busily trying to consult, I will not be asking for the bill to move to the committee stage because I think there is little point at this stage. We will have a very good look at this between the houses.

The Hon. R.B. SUCH (Fisher) (16:19): I would like to make a brief contribution. I support this bill. I think it is a necessary provision in order to deal with what could be at any time a serious issue confronting the people of this state in terms of their health. I want to focus just quickly on some of the underlying and related aspects. This particular bill is designed (I guess) to look at the macro type issues, but I would like to focus attention on the fundamentals, that is, basic hygiene.

This current outbreak of flu has the unfortunate title of swine flu, which is unfortunate because it suggests something untoward about cooked pig meat, which is unfortunate and inaccurate. I am not an expert, but as I understand it, pigs—and they cannot take legal action—in their natural situation, are very clean animals, but if they are artificially confined and restricted, then that can change. Likewise, with poultry and other birds. They are not in their own practices what we would call dirty. However, we know that, in countries like Indonesia, people often have their chooks sleeping near them, sometimes with them.

I understand that, in the case of this outbreak of so-called swine flu in Mexico, children in particular were in close proximity to effluent coming from piggeries. I think it does highlight the importance of practising basic hygiene. Obviously, we do not want people living with their poultry. I do not think we have quite reached that situation where people need to live and sleep next to their chooks or get involved in effluent from piggeries. However, what I do notice (and, once again, we use the term unfairly) is that we talk about people being 'dirty pigs', which is unfortunate. We have a high percentage of people who do not practise basic hygiene. I do not make a habit of standing in or near toilets to observe people, but we would all be aware that there are people—

Members interjecting:

The Hon. R.B. SUCH: I try not to practise that sort of behaviour. I think we have all observed people from time to time who go into a toilet area and do not wash their hands afterwards. We also see people who do not practise basic hygiene—and, at the gross level, one example is people spitting in the street. We also see people in the street coughing into their hand, and the next minute their hand is on the escalator rail or some other area where people will touch it.

If you watch a surgeon prepare for an operation (if you are still with it), you will notice that they wash their hands very thoroughly—in fact, one would hope that they all do so. They do not just quickly put their hands together with a bit of soap or cleaning agent and that is it; they scrub their hands and wash them thoroughly. We are not going to be doing that every time; that would be unrealistic.

However, what would help to reduce the spread of some of these infectious diseases would be the simple practice of daily hygiene. I have mentioned before that my young brother works at St Vincent's Hospital in Sydney (where he is, I think, well loved and respected), and he said the other day that the dirtiest part of your body is your hands, the second dirtiest part is your mouth and the third is the region around your anus. Contrary to what people might think, their hands are, in general, much dirtier and less hygienic than the area around their anus. This may not be popular talk at a dinner party, but the reality is that some simple, basic hygiene would go a long way towards reducing the risk of cross-infection. I have said this before (I sound like a record, I know), but if you watch people going into fast food outlets, you will see that in come the kids, and they have had their fingers up their nose, or maybe elsewhere—

Mrs Geraghty: Oh, please—

The Hon. R.B. SUCH: No, this is the reality.

Mrs Geraghty: We don't need to know—

The DEPUTY SPEAKER: Order! The member for Fisher, I remind you that the chair is meant to maintain decorum in this place!

The Hon. R.B. SUCH: Thank you for your protection, Madam Deputy Speaker. I am a small, timid person and I do tremble when the Government Whip lets fly. I challenge members, next time they go to a fast food outlet (and I know the Minister for Health probably does not want us to), to have a look. People come straight in from their cars, the playground or school and eat food with their hands. That is what you do in those places: you do not use utensils.

In my view, there should be places (and more progressive establishments are now doing it) where you can use waterless disinfecting agent on your hands. It might seem a bit over the top, but it is quite a simple thing to do. In fact, I know of people who go to gymnasiums, and so on, who are now disinfecting their hands. They carry a little bottle of disinfecting waterless fluid so that they can disinfect their hands before they get on some of the machines. Normally, in a restaurant people use cutlery (one would hope), but they will be touching their bread roll with their hands.

The point is (and it sounds unnecessary to even have to say it), for goodness sake, in our society in this day and age, let us have people practising basic hygiene and washing their hands after toileting and before they eat and generally avoiding the basic risk that comes from poor hygiene.

This bill is trying to deal with situations that arise because basic hygiene has not been practised. People should take the time and make the effort to think not only about themselves but also about others, as they do in countries such as Japan, where they wear a face mask (we are not quite to the point where we consider others enough to wear a face mask if we have some possibly infectious condition). Let us ensure that we practise basic hygiene. I commend the government and the minister for trying to get the message out. I am appalled that people I see in prominent positions still do not seem to understand that basic hygiene is the way to go.

Mr VENNING (Schubert) (16:27): This bill comes about as a result of the swine flu epidemic, as we know, which has claimed many lives around the world. Fortunately, both here in South Australia and across the whole country we have not been greatly impacted, and we certainly hope that that will not be the case. As of today, the state government's swine flu website states that there is still only one confirmed case of swine flu in Australia, and there are currently three suspected but no confirmed or probable cases here in South Australia. The three people are undergoing testing.

The government has announced that, as part of the state's preparation for a potential flu pandemic, it proposes to strengthen the existing laws to manage medical emergencies. The bill would: amend the Public and Environmental Health Act 1987 and have swine flu declared as a controlled notifiable disease (as it was declared last week under the commonwealth quarantine legislation); possibly amend the Emergency Management Act 2004 or introduce regulations to add powers to order medical assessments and mandatory isolation (home detention) in the event of an outbreak reaching the level of a state emergency; and amend the Emergency Management Act to include new powers for senior health officials in a state emergency, including directing a person to remain in isolation or oblige them to undergo a medical observation, examination or treatment.

It seems that the measures contained in this bill are already covered, to a large extent, in existing legislation, particularly in the Emergency Management Act. However, I understand that there are provisions contained in this bill, such as declaring swine flu a notifiable disease, which will ensure that our legislation is consistent with commonwealth legislation, which makes sense. However, we on this side of the house do have a couple of concerns.

The first matter relates to clause 11, which concerns power to the minister to modify the operation of the Controlled Substances Act 1994. It seems a little extreme that, even in the event of a pandemic or notifiable disease outbreak, the Emergency Services and Management Act should override completely the Controlled Substances Act.

I also have concerns regarding the power that will be invested in the chief medical officer in the case of a public health emergency. They seem to be rather extraordinary. I think that perhaps it would be better to retain the current structure under the operation of the Commissioner of Police under the Emergency Management Act 2004.

The current act gives powers including the power to enter, break into, take possession of or assume control of any land, building or vehicle, take possession, direct or prohibit the movement of people or animals, direct a person to undergo decontamination procedures, direct a person to stop work or operation, the power to shut off a water supply, among many others. This list is quite extensive.

It would seem that the measures already included in the current act would be sufficient. So, I do have concerns about the chief medical officer having far-reaching powers in the case of a public health emergency. Whilst I do have a couple of concerns, I support the bill, but hope that we do not have reason to implement it.

I commend all those involved in preparing us all in the case of an outbreak and also those undertaking actions to minimise the risks, especially airlines, etc. Yes, we support the bill, but highlight concerns with two areas of it. First, under clause 11 there is power to the minister to 'modify the operation of the Controlled Substances Act 1984'. There are the usual roles for qualified people to prescribe medication, i.e., issue vaccines, which could be exempt with conditions. The whole operation of the act is far too broad.

Secondly, part 8 inserts an emergency management regime for a public health emergency providing extraordinary powers to the chief medical officer—Dr Tony Sherbon in this instance, I believe—rather than retaining the structure under the operation of the Commissioner of Police under the Emergency Management Act 2004.

People are very aware of the threat of the swine flu pandemic. Without spooking the population, we need to be ever vigilant. We have to be ready in case, if not this time, or even the next. The shadow minister mentioned foot and mouth disease. I am not sure that other animals can be infected, but I believe that swine can catch this disease from humans, so we need to be very vigilant about that. People going into pig sheds have to be careful that they are healthy.

Having owned pigs myself in the past—and I will not relate the story of Bertha because that is already in the Hansard—I know how vigilant we were about bringing people in in relation to Erysipelas and other diseases of pigs. I think they have to be more careful of humans going in who may be infected with this. So, certainly it is very important.

We are lucky in Australia that we have a natural border. In other words, we have sea all around us. It is easier not having a common border with other countries. If we watch our entry points we can, hopefully, keep these things in check. Certainly, we need to watch our airports.

I was very interested to hear the speech from the member for Fisher a moment ago. He highlights a favourite topic of mine, from when I served on the Public Works Committee, relating to public buildings and, more importantly, public toilets. We spent many hours looking at them. I believe that public hygiene and the risk of cross-infection is extremely high.

This is one place where Australia performs very poorly. I believe that our public bathrooms do not rate when you travel overseas. In many countries of the world now in public toilets you do not touch the taps. You put your hand under the spout and out comes the water. Why is it that we do not have these in Australia? They are no longer rocket science. They are common and they are not expensive. So, why do we not have them?

I believe it is a very common sense thing. When you go in a public toilet you should not have to, or want to, touch anything, because you do not know what the people who were there before you were doing with their hands. As the member for Fisher rightly said, the hands are probably the dirtiest part of your body, you put them on everything.

Mr Goldsworthy interjecting:

Mr VENNING: The member for Kavel asked me: what about the door handle? Exactly right. Why is it that in public toilets we have doors that open inwards? If they opened outwards you would not have to touch the knob, you could just push it out with your knee. You should not have to touch the knob. I am very conscious of grabbing hold of the doorknob after I have washed my hands. You have just wasted the exercise.

What I do is grab a paper towel, open the door and then throw it into the bin. Hopefully, you can reach it, but it often goes on the floor. It is a basic thing. Why do we not have toilet doors that open outwards, without having to undo the latch, just with a clip retainer on the door? Common sense, you would say, but we do not seem to do it, do we?

So, when you go into that public toilet next time, and we all have to at times, you do not know who was there before you and I think it is important that we give it a little bit more thought. I want to challenge those people in charge, particularly Adelaide City Council, and others, when you are designing and building public toilets have this in mind. Hygiene is a huge area that has been very much overlooked.

Disinfecting hands is a very important matter in public. Having returned from Canada last year, every time you got on a bus the bus conductor would be there with a bottle of detergent and you would put it on your hands. Every time you go into a restaurant, the lady would say, 'Would you like some detergent on your hands?' Even though you have just washed your hands here is some germicide for your hands. It is common practice everywhere. It is sold everywhere. Do we do that in Australia? No. Why not? Are we resting on our laurels? Do we need to have a pandemic to smarten us up? All I can say is, just look at what is happening around the world.

I think we should have a good look at these things. It is all very well at home, you know what your standards of hygiene are in your own home, but when you are out in a public place, when in some of these places the seats are hardly even cold, they are continually warm, these are places of high cross-infection risk. So, maybe this is the time to take a good look at that and at speeches such as this one and that of the member for Fisher and, as I said, look at this issue in the Public Works Committee.

Mr Goldsworthy interjecting:

Mr VENNING: That is exactly right. Men are lucky because we do not have to sit on the seat. When I visit a public toilet and observe the number of people who go out the door without washing their hands, I am quite shocked. Irrespective of a minor or major operation, you should always wash your hands. I think this is a good opportunity for us to brush up on our public hygiene. With those provisos, we support the bill.

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts) (16:38): I thank the house for giving me authority to allow me to deal with this legislation today. I know that it is an unusual arrangement for a bill to be introduced without the appropriate notice and pass through all the stages on one sitting day. I appreciate the house's indulgence, and I particularly thank the opposition for agreeing to do that.

Before I get into the substance of the bill, the member for Schubert wondered what the collective noun was for swine. I can inform him that, in the Macquarie Dictionary, the collective noun for swine is a drift of swine; if one is talking about swine in the wild, it is a sounder of swine and, if one is talking about tame swine, it is a trip of swine. So, there is a bit of trivia for the house.

The Deputy Leader of the Opposition raised a number of matters of substance, which I will attempt to deal with. I think it is correct that she indicated her intention not to seek to go into committee but, rather, let the bill pass today and, if necessary, deal with matters of substance via her colleagues in the other place. I give an undertaking to both her and the house that I will look at those issues more substantially between now and when the other place considers the bill. It would be good to have consensus on this legislation because the matters that are being proposed are serious and I expect will last for a long time. They will probably not be used very frequently (hopefully, never), but it is important that we have the right balance.

Before I begin, I want to say a couple of things about this measure. We have been working on this issue as a health department for a number of years, as I understand it. The planning has been going on for several years, and it emerged after health officials right across Australia became concerned about our state of preparedness when concerns were raised about the potential threat of avian flu.

Avian flu has not disappeared as a threat. Potentially, at some stage it could become a flu that is passed from human to human; at the moment, it is only from birds to humans. If it were to pass from human to human, it would be a very dangerous flu indeed. The planning we have done is based on a pandemic of avian flu occurring and many thousands of deaths and probably millions of people ill across Australia, with a potential breakdown of civil society. So, we are planning on the basis of that event occurring, unlikely as it might be. A lot of work has been happening.

In the normal course of events, I would have brought this legislation before the house in the spring session but, because of the emergence of swine flu and the lack of knowledge, particularly when it first emerged, about where it was going and the risks of its becoming a pandemic (and those risks were being assessed on a regular basis by the World Health Organisation, amongst others), we felt it was important to bring the legislation forward.

Some of the consultation processes we otherwise would have carried out, particularly with external to government organisations, such as the AMA and the Nurses Federation and so on to which the member referred, have yet to occur on the basis we normally undertake them with those organisations. For the sake of the house, and anybody reading Hansard, I indicate that that is why this has occurred.

Another issue I point out to the house is that much was made of the fact that we have emergency powers and emergency legislation that can come into effect and that many of the powers that exist in the bill we propose for a health emergency exist in the current emergency powers. This is true, but the proclamation of emergency under the emergency legislation is a matter that is outside the health department's control and applies at a higher level of concern than perhaps a medical emergency might.

I understand that the police strongly support the establishment of this new regime because they do not believe that they have the skills to deal with medical emergencies and prefer the health system to deal with them. Based on the advice I have, I will go through some of the responses to some of the issues raised by the deputy leader.

She referred to amendments being sought to the bill, and she said that they had already been brought into effect through regulation; however, that is not quite the case. The regulations, which I took to the Executive Council last Thursday, make changes to powers only under the Emergency Management Act, whereas the bill proposes that these powers are also available to health, under the Public and Environmental Health Act, to address health emergencies that do not require a full emergency management declaration.

The regulation that makes swine flu a controlled, notifiable disease will allow the Department of Health to act only against persons who have that disease, not those who might be at risk of having it. This is the key issue which the regulations do not cover. As it would be obvious to anyone thinking about this for just a few minutes, if the health system can manage an individual who has a notifiable illness (that is, swine flu or some other flu) and they can deal with that person, it is not going to help the spread of that disease very much if their immediate family and people with whom they have been in close contact at work or in transport cannot also be dealt with. At the moment, we rely on goodwill to deal with those people.

However, if we are talking about something that is breaking out on lots of fronts at once, goodwill is not necessarily going to be sufficient to control the spread of that illness. So, the health system really does need to be able to control those who have been in close contact but have shown no symptoms, so that they can be tested and provided with treatment, if necessary, sometimes against their will.

The deputy leader has listed all the powers currently provided for in the Emergency Management Act. However, the bill provides greater clarity. For example, 'to remove or destroy any animal' is in the bill, not just 'injured animals'. So, in the case of an avian flu outbreak or some other outbreak where the animals potentially are passing on the disease to humans, it would be a necessary power to be able to destroy those animals, even if they do not show immediate symptoms themselves but they have been in proximity with animals which have shown those symptoms.

In relation to wider powers, for example, requiring persons to remain in isolation or quarantine, which are new powers, and requiring treatment and assessment, I have already addressed both those issues. The bill also provides for those to be applied by Health during a health emergency which does not justify using the whole of government emergency management arrangements. These two provisions—the amendments to the health legislation and the emergency powers legislation—will relate to each other in a sensible and integrated way. A health emergency might be called while we are in the process of stopping a disease spreading. However, if it got to the stage where civil society was starting to break down, you would bring in the Emergency Management Act, because you would be dealing not just with health matters but also a whole range of other issues that are really outside the purview of the health department.

The deputy leader talked about the expansion of authorised officers. In fact, the expression 'authorised officers' already exists in the Emergency Management Act. They will now be able to exercise powers, subject to conditions imposed by the State Controller. The ability to put conditions on the powers of individual authorised officers allows the State Coordinator to limit powers to those necessary for the function they need to perform during an emergency.

In relation to consultations, as I have indicated, because we brought this forward, some of the niceties of our consultation process have yet to occur. We have made contact with the AMA and, I understand, the Nursing Federation as well, and we have discussed the amendments with those organisations. We have certainly been dealing with government agencies in the preparation of this legislation. As I have said, the police, in particular, support the direction that is proposed in the legislation.

In relation to extension of initial maximum timing for major emergencies and disasters, these amendments are being sought as a result of the experience from the Eyre Peninsula bushfires and pandemic planning. Ninety-six hours is seen as insufficient to deal with emergencies that warrant the highest level of declaration. For example, if you were dealing with a fully blown pandemic situation, where hundreds of thousands of people were affected, you would want to have the powers to last longer than 96 hours. In fact, I think it would be questionable whether you would want to bring the parliament back to consider granting even greater powers if we were worrying about people transferring infectious diseases one to the other.

So, I think the extension to 30 days makes a lot of sense—it was recommended by the State Emergency Management Committee that a disaster declaration could be made for up to 30 days—and this would make our legislation consistent with both Victoria and New South Wales. I understand that these proposals have the support of SAPOL.

I return now to the issue of the demand for medical goods and services (clause 9(5)) and the Controlled Substances Act (clause 11). The deputy leader indicated her concern that these clauses could be used to authorise any actions at any time (or I took her words to indicate that). In relation to medical goods and services, this power could be used only in relation to medical goods and services, not, as she exampled, to authorise jaywalking and criminal breaking and entering. So, it is not a broad power where you can break any law. It is really in relation to medical goods and services.

The ability of the relevant minister to exempt persons from any provision of the Controlled Substances Act already exists in that such exemptions can be made by regulation under the Controlled Substances Act at any time. This amendment merely allows the exemptions to happen directly without consulting the Advisory Council during an emergency. These are powers that need to be exercised during an emergency and, in both cases, these authorisations apply only during a period when an emergency declaration is in place, not, of course, at any other time.

Examples of such actions could include the following. In the event of workforce shortages and if interstate health professionals were available and were brought urgently to assist, and if there was not time for them to go through the registration process with the relevant professional board, the provision could be used to authorise them to provide specified goods or services on specified conditions. Secondly, in the event that flu clinics were established (and this is certainly part of our planning for a pandemic), perhaps with only one senior doctor in charge of that flu clinic (this would be the case, of course, if the workforce were stretched or many members of the workforce were ill themselves) and it was necessary for paraprofessionals to assist, they may be authorised to do so under this provision.

A clinical governance framework is being developed for flu clinics, with various sets of clinical guidelines to which staff will have to adhere. The conditions attached to the authorisation could explicitly require such compliance. I understand the deputy leader and other opposition members have some concerns about these provisions. I am happy to look at ways that we can strengthen the safeguards, but I do not want to see a weakening of the capacity of the health system to deal with such issues in an emergency. We do not want to put paperwork or red tape in the way. However, if there are ways—and it could be after-the-event reporting or something else—I am happy to have a look at it and, if the deputy leader or her colleagues have any suggestions, I am happy to consider them.

I turn now to final points. Regulation, which increases powers under the Emergency Management Act, does not include either the power to operate outside the provisions of the Controlled Substances Act or the ability to direct the provision of medical goods and services. A series of plans forming the Public Health Emergency Management Plan does already exist and is part of the broader State Emergency Management Plan. It is a living document and it is regularly updated. When the bill is passed by parliament, it will need to be further amended to take into account the provisions of this bill, including provision for emergency officers and their identity cards, conditions for emergency officers and governance arrangements when it is necessary for health services to operate outside existing laws during an emergency.

Section 36 of the Public and Environmental Health Act refers to what the department can do in relation to persons with a notifiable disease, not those who are at risk of getting the disease but who at the moment appear to be well persons. It also is restricted to—

The Hon. M.J. Atkinson: Well-personed?

The Hon. J.D. HILL: Well persons—people who are not ill.

The Hon. M.J. Atkinson: Well persons—I was about to say!

The Hon. J.D. HILL: Not somebody who is well-personed. It is also restricted to notifiable diseases, not other forms of public health incidents or emergencies. We are really talking about having legislative framework in place which we can rely on if we are in a set of circumstances where things happen quickly and our community is threatened. That could be by a pandemic or some other disease which is likely to spread and affect numbers of our citizens, if not all. It could also be brought into play if there were an accident and a spillage of something which might have a health impact.

The framework would be applied to medical circumstances which would be best dealt with by the health system if those circumstances were to change rapidly and a full-blown emergency situation where civil disobedience systems were breaking down, schools had to be closed and the like. Of course, then, you start using the emergency management powers. So, there is an overlap, if you like, between the sets of powers in the two provisions so that there is consistency in the field if and when we went through that transition from a health emergency to a broader emergency. That is why the powers have been transported into each other's legislation so that there would be a seamless transition from one level of emergency to another.

However, the understanding I have is that the emergency powers within government believe that this is the best way of setting up a set of protocols to deal with something like the potential threat of a pandemic associated with, say, swine flu. We are dealing with it very well, and I pay tribute to the work of the health officials in South Australia and Australia generally. We have powers that are exercised through the commonwealth government under the Quarantine Act, but they are really limited to border control; they do not really spill into the broader community. We have powers that can exist under the emergency legislation, and there are some powers within health. This legislation really provides the health system with the missing bits to allow it properly to manage a health outbreak which threatens our community and to do it quickly with the appropriate checks and balances put in place.

I commend the legislation to the house. I sincerely thank the Department of Health officers who have been working on this for a very long period of time—including David Filby and Maxine Menadue, who are here assisting me today, but there are many others as well—and I also thank parliamentary counsel. I am not sure which part of parliamentary counsel did this, so I cannot thank the officer by name, but I do thank them for their assistance.

As I said, I hope we can get consensus across the parliament about these provisions. I am happy to consider any reasonable request from the opposition or from any of the other parties and, if they have some suggestions, I recommend they bring them forward as soon as possible so that we can consider how to incorporate them if they have merit.

Bill read a second time and taken through its remaining stages.

Mrs REDMOND: Mr Speaker, I draw your attention to the state of the house.

A quorum having been formed:

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