House of Assembly - Fifty-Second Parliament, First Session (52-1)
2010-11-24 Daily Xml

Contents

SOUTH AUSTRALIAN PUBLIC HEALTH BILL

Second Reading

Adjourned debate on second reading.

(Continued from 29 September 2010.)

Dr McFETRIDGE (Morphett) (12:16): It gives me great pleasure to rise in the house today to support the Public Health Bill 2010. This bill has had a long gestation. It was started by the Hon. Dean Brown back in the year 2000—

The Hon. J.D. Hill: You can't rush these things.

Dr McFETRIDGE: As the minister says, you can't rush these things. Well, we certainly did not on this one, and I agree with the minister there. I congratulate the people who have spent many hours putting this bill together and doing the work. There has been good consultation on this piece of legislation, and what we see today is a bill that is quite comprehensive. There are still a few issues that people have raised with me, and I will be talking about those in my contribution today. I do indicate that I am the lead speaker for the opposition and the opposition does support this bill.

The history of the bill not only had a seven-year gestation to get to where we are today, but it is going to replace the South Australian Public and Environmental Health Act 1987. It is interesting to note that the bill took quite a while—there were some amendments and some updates—to replace the Health Act 1935, the Noxious Trades Act 1934 and the Venereal Diseases Act 1947. All of those various acts and the issues that were recovered in those acts have now been incorporated into the previous Public and Environmental Health Act, and now we see a more comprehensive treatment of those in the bill we have with us today.

The Public and Environmental Health Act 1987, like the previous acts, had a very traditional focus on sanitation, nuisance, vermin and infectious disease. Today, we are facing many issues, many diseases, many public health problems, such as lifestyle diseases and conditions that were not around 20 years ago, certainly not 50 years ago and certainly not in the early part of last century. So, public health is changing, and changing dramatically, and I hope it is not going to be another 10 years before we review this act.

I do have an amendment that I have had drafted that looks at reviewing this act in three years' time under the auspices of the Social Development Committee. I will not be moving that amendment today, but certainly I will seek the government's input and opinion as to how we treat this act in the future so that there is not such a long time between upgrades and amendments.

Moving away from the traditional focus, as I say, we are having to look at pandemics, and I suppose the most relevant one is the swine flu pandemic which was predicted but which turned out to be a fizzer, thank goodness. Certainly, I was very concerned that, had the H1N1 swine flu (which had components of swine flu and human flu viruses) combined with a bird virus, such as the avian flu virus that we saw in South-East Asia, we could have had a very serious world pandemic on our hands, and millions of people could have been infected and come down with the disease.

As we see now, I think about 3,000 Australians and 80,000 Americans die every year just from the ordinary flu. The millions who would have died had that pandemic eventuated is a good enough reason to be alert—but not alarmed. I suppose we should be afraid of those sorts of viruses, but we certainly should not be taking them for granted because the latest example turned out to be a bit of a fizzer. Having said that, a number of people did die from it, so I should not say it was a fizzer because it was extremely serious. I hope people do not think I am being flippant.

The South Australian Public Health Bill 2010 seeks to review public health laws to strengthen the state's capacity to deal with public health emergencies such as global pandemics and the impacts of terrorism, particularly bioterrorism. There is mention in the legislation of psychological harm, and I will have a bit more to say about that later. Just watch the 6.30 news and, if that does not cause anxiety and stress in people, I do not know what does. I remember the old Skyhooks song Horror Movie about the 6.30 news.

The Hon. J.D. Hill interjecting:

Dr McFETRIDGE: I think Master Chef causes enough stress. So, there is a number of issues that we need to cope with nowadays in this modern legislation, and I will be talking about that, but, as I said, we support this legislation.

Powers to prevent, control and manage infectious diseases that pose a serious risk to public health are streamlined and strengthened in the bill. The regulatory regime has been strengthened, allowing for authorised public health officials to take early and decisive action to prevent and control disease outbreaks. The bill seeks to recognise public health orders in other jurisdictions and allows for the exchange of public health information required to manage outbreaks.

The bill, in part, seeks to provide a South Australian response to the work of the World Health Organisation, which called for government and community action at all levels to address the social determinants of health. I am very pleased to have been part of the research for the statement (which I will read from later) which is the work of public health officers in South Australia that is used all over the world to point governments and communities towards being aware of public health in all the areas of their lives.

As I say, this bill is responding to some of the calls by the World Health Organisation for action on the social determinants of health, and there is also emphasis on the chronic non-communicable diseases which are attributable to lifestyle choices, as I mentioned previously. These lifestyle diseases are becoming more and more prevalent and will become a real burden on society if we do not encourage changes to lifestyle and preventative health. That is not to say we should become a nanny state and tell everybody what to eat, what to do, what time to get up and what to wear, but I think we should encourage people to ensure that they have some responsibility for their own outcomes. That is an issue that I have: when do you stop being responsible for your own outcomes?

The provisions within the bill are in accordance with the WHO revised International Health Regulations (2005). Yesterday I spoke about our adopting legislation and agreements from outside this jurisdiction but, in this particular case, it is in accordance with the WHO regulations. We are not binding ourselves to any particular legislation or regulation, but we are acknowledging the fact that there are some covenants and international agreements that assist in directing us in providing a public health agenda in this state.

The legislation has also been framed with the Public Health Partnership Agreement signed in Quebec in 2008. Our own Professor Fran Baum from Flinders University was appointed a commissioner on the WHO's Commission on Social Determinants of Health and played a primary role. I spoke to Professor Fran Baum a number of months ago about this bill, and I am very pleased to say that she did play a primary role in ensuring that this bill does meet the requirements as set out by the WHO.

New features of the bill establish clear objectives and principles to cover prevention, promotion and protection. The bill provides clear definitions, particularly for public health and risk to health. The definition of 'public health' within the bill has been widened to mean the health of individuals in the context of the wider health of the community. I will go back to the definition in a moment because there are some variations in the definition across the states.

It is interesting to see in some of the submissions on the bill some discussion about the definition of 'public health'. Also, there is a policy on public health in all areas, which really broadens that definition of 'public health'. As I said, it has been widened to mean the health of individuals in the context of the wider health of the community.

The bill defines the role of the minister and local councils. The minister will be charged with the overall responsibility for administering the legislation and for protecting and promoting public health. The bill establishes a framework for the minister to provide advice and to consult with other state government agencies about public health in line with the government's Health in All Policies approach, as I have just said. It requires that the minister work collaboratively with local government to protect and promote public health in South Australia and gives the minister the power to intervene where a council may be failing in its duty to protect the public's health.

I certainly have a couple of concerns, and we need to talk about those as I get into the various clauses in the bill, because there is some concern that there may be some cost shifting going on there between the state and local government. I might be wrong, and I look forward to responses from the government.

The bill establishes the statutory position of the chief public health officer. The chief public health officer will be given a statutory position. The position will provide a single point of reference and the power to give directions and make orders, including detention orders as a last resort. However, detention orders beyond 30 days must be authorised by the Supreme Court, and mandated reviews by the Supreme Court must occur for an order extending beyond six months.

There is some fairly—what some people might call—draconian legislation here, in as much as you could really, in effect, shut the state down with this type of legislation. I have worked in the veterinarian profession, and I know that there is a real need for veterinarians to be encouraged to go country because veterinarians will be at the forefront of biosecurity in this country; and, should we get an outbreak of rabies, foot and mouth or one of those really nasty diseases, we may have to shut down the state. I do not have any objections to those powers because, if I am fortunate to be the minister, I would like to have those powers to be able to shut down the state to control an outbreak that is potentially going to wreak havoc and have long-term consequences for the people of South Australia.

There would be some short-term pain for long-term gain hopefully under that position. Some interesting clauses are in this bill, but no more than could be or should be expected with this type of legislation where we are looking after the health of the public of South Australia. The Public and Environmental Health Council will be replaced by the South Australian public health council and will comprise members appointed by the Governor, as is the current case.

This body will have responsibility to provide strategic advice and monitor South Australia's public health, as well as provide advice to the chief public health officer. The bill also establishes the public health review panel to hear appeals on matters relating to part 6 of the legislation. The review panel membership will consist of the chief public health officer, two members or deputies from the public health council and other members with expertise as considered appropriate by the chief public health officer.

The District Court can appeal decisions made by the review panel. The bill also requires public health planning and reporting against plans, which is a terrific move. We do need to plan for future outbreaks. You need to have response plans in many areas, whether it is in the emergency services or, as in this particular case, in the public health area. Public health planning must be undertaken under the general direction of the minister, so statewide public health goals and priorities can be incorporated at a local and regional level. Unincorporated areas of the state, including Aboriginal lands, will also be incorporated into planning requirements.

Public health planning requirements will be introduced in a phased implementation process so that all parties can become familiar with the provisions. Development of a state public health policy will also be a requirement under the bill. Those policies will obviously be open for review, open for consultation, because the policies will then have a direct influence on the development of plans.

There is an establishment of a general duty preventing harm to public health for individuals whose behaviour may be placing others at risk. This bill provides for a compulsory scheme of clinical examination, counselling, direction, treatment orders and isolation or detention orders, and can be applied in a graded manner over the next few years; but, as anybody who is reading this legislation or is concerned about this legislation will see, detention really is a measure of last resort.

As I have said, as a veterinarian, I am aware of many of the serious diseases that are out there that we do not have quick cures for, where isolation or detention may be the immediate control method. That is something that I will strongly support, with oversight, and with some regard for the rights of individuals. It is not just a draconian lock them up for 40-odd days with no right to contact anybody at all, as you see with some terrorism legislation.

The bill provides for cooperation and consultation between state and local governments. Councils will be given more explicit guidance and clearly defined responsibilities regarding their public health functions. The Department of Health will continue to provide ongoing support to councils for the provision of immunisation services. If the council has failed to discharge its duty under the act, the bill still gives the minister the power to take over a function of council subject to certain stated procedural requirements. Enforcement will occur through mediation notices, and penalties for causing a risk to health have been increased, some of them quite substantially, and quite rightly so.

The bill incorporates provisions for emergency incidents. All changes from the Statutes Amendment (Public Health Incidents and Emergencies) Act 2009 are incorporated into this bill. The public health incidents or emergencies can be declared by the South Australian health chief executive, and the chief executive may appoint emergency officers under part 3, division 6 of the bill.

The bill identifies notifiable microorganisms, and includes codes of practices that will be developed on certain diseases and conditions, including injuries, so that incidence of diseases can be prevented, monitored, reduced, managed and controlled at an underlying social and environmental level. Notifiable diseases and controlled notifiable disease declaration, including those in emergency situations, by regulation will be retained. A new category of notifiable contamination will be introduced, which will require the reporting of prescribed contaminants and testing measures as required by the chief public health officer.

Contaminants can include prescribed chemical agents, heavy metals or other substances known to be a risk to health. The provision mirrors the Victorian public health legislation. Interestingly, we are mirroring the legislation there, not just adopting it. That is just another little plug for my views.

The bill has been out there for quite a while. Consultation occurred with Dean Brown in 2000 and there were many submissions back then. That was in 2000. We have obviously moved on since then and now we have this latest bill. There were, if not hundreds, many submissions again, and all those submissions were given consideration, because when you go back over the submissions on the draft bill and see what is in the current legislation, not all of them, but many of them, have been taken notice of and incorporated into the legislation we see before us today.

The South Australian public health bill was released for public comment in September 2009 and the submissions were received. The bill has been revised following the consultations and the key groups include the Local Government Association of South Australia, the Environmental Health Association (Australia), and the environmental health officers working within the public health system. The Public Health Association of Australia has put in an extensive submission as well. I know groups such as the EPA and SACOSS, others like that, have also put in; and some of the food producing groups also put in submissions.

It was interesting to see some of the submissions from the pork industry and the chicken meat industry. Their submissions were about prescribed microorganisms and they explained the fact that any handling of meat or animal products involves the unfortunate contamination with microorganisms. However, that contamination is reduced during processing of the creatures into the products and, hopefully, does not continue onto the supermarket shelves. As I mentioned yesterday, my wife and I ate some cheese manufactured from unpasteurised milk, which was listed the next day as having listeria contamination. Fortunately, neither of us had any clinical signs from that and I am past the point of having to worry about it now because my system has coped.

As a matter of fact, I was reading in this morning's paper about how we should be encouraging little kids to get out in the dirt and eat it. Now, I am not so sure about eating dirt, but I think we need to be aware of what we are doing with the handwashes and disinfectants that we are using on surfaces now. They kill 99.9 per cent of germs, but it is that 0.1 per cent of the germs that they do not kill that I am worried about because they are obviously the really tough ones. There is no need to wrap our kids up in cottonwool, because that means their immune systems are not challenged.

Personally, I think that the number of children nowadays who have allergies and suffer from asthma have not had the challenges to their immune systems that people particularly of my age had when we were kids. We used to be out and about and getting in the dirt and having great fun. We certainly did not wash our hands as much as we now like our children to do. However, having said that, we want our children to have great immune systems and, as a general rule, washing hands should not ever be overlooked, particularly before handling food or being around people who have illnesses or allergies.

I will now look at the definitions in the bill. The Public Health Act 1987 contains no definition of 'public health'. There are definitions for 'public health emergencies', 'public health incident', 'premises', 'the public health emergency plan', 'a public place', but there is no definition of 'public health'. It defines 'pollution', 'places of public assemblies', 'vermin', 'waste control systems' and 'water supply', which is interesting, because there is no definition of 'potable water' in this current bill but there is a definition of 'wastewater'. In the current bill, 'public health' is defined as 'the health of individuals in the context of the wider health of the community'.

In New South Wales legislation, there is a definition of 'public health order', 'public health risk' and 'public hospital' but there is no definition of 'public health', so they have a way to go. In Western Australia there is a definition of 'public health' which is different from ours. It means 'the physical, mental and social wellbeing of the community'. The thing I like about the Western Australian definition of 'public health' is that it emphasises the mental health of society. I think our public health plans are going to have to incorporate more and more the need to involve communities and community groups in the promotion of good mental health.

I have been involved with some teachers at Victor Harbor High School who have a program called Doctors on Campus (DOC) where local practitioners and social workers come to the school and talk to the kids (with their parents and school staff members) to make sure that they are not only physically well but also mentally well. Mental health prevention and first aid plans are something that we are aware of on this side of the house, and I hope the government is also, because we do need to make sure that we are getting in early with mental health.

I was staggered when I heard this figure: anxiety and depression cost the Australian economy $20 billion every year. That is just anxiety and depression, so if we can make sure that our friends, family and children are not being caught up in depression and becoming anxious, whether through watching the news or because they do not have the latest style phone or something as simple as that, right through to the constant threat of terrorism as you walk through the airport scanners in America, where they are having some fun at the moment with people being very stressed.

Mental health issues really do need to be emphasised more, and I do not think that they have been emphasised that much in this bill, other than in the definition. On page 9, as part of the definition, it states, 'For the purposes of this act, harm includes physical or psychological harm.' That is an area that we will need to look at.

The great thing we are seeing in public health nowadays is that at last, rather than having the Venereal Diseases Act and the Noxious Trades Act and various other acts like that, we are seeing a recognition of health in all policies. I am pleased to see that the current government has been going ahead with this policy and promoting it. The government's website, Health in All Policies: The South Australian Approach, states:

Health in All Policies (HiAP) is an approach which emphasises the fact that health and wellbeing are largely influenced by measures that are often managed by government sectors other than health.

HiAP seeks to highlight the connections and interactions between health and policies from other sectors. HiAP explores policy options that contribute to the goals of non-health sectors and will improve health outcomes.

By considering health impacts across all policy domains such as agriculture, education, the environment, fiscal policies, housing and transport, population health can be improved and the growing economic burden of the health care system can be reduced.

The health sector’s role is to support other sectors to achieve their goals in a way which also improves health and wellbeing.

The question is asked: why do we need Health in All Policies?

Despite major developments in the management and prevention of acute illness, chronic conditions are emerging as a significant ongoing cost to the community.

The majority of these chronic conditions are preventable and are closely linked with living conditions or the determinants of health which tend to be influenced by policies outside the health sector. For example, it has been shown that transport has well recognised effects on health and inequalities.

The determinants of health highlight the need for policy makers in all sectors to be aware of the impact of their decisions on population health and to act to incorporate considerations of health into their policies.

I look forward to seeing Health in All Policies being put into all policy areas. We see a lot of money being spent on superways, but I would love to see more money spent on public transport. There have been improvements, but we certainly need a lot more because we do not want people in any way to have their health affected by lack of access to public transport and any other inequalities across the government sector. The website continues:

Implementation of HiAP provides a system which enables governments to respond in a coordinated way to the health and wellbeing needs of the population. HiAP also aims to bridge the gap in health inequalities, especially those seen within Aboriginal and Torres Strait Islander populations.

A couple of weeks ago, I had the pleasure of co-signing, with the Minister for Health, the Treasurer, the shadow minister for Aboriginal affairs (Hon. Terry Stephens), and other members of parliament, the Closing the Gap letter of intent. We all agreed to work in a collaborative and multipartisan way to make sure that Aboriginal and Torres Strait Islanders were seen as a disadvantaged group and that we are closing the gaps between their outcomes and those we are seeing in non-Aboriginal and Torres Strait Islander communities.

That is so important. If you want to see the inequalities that exist in South Australia, just go to the APY lands. On my first visit there, I think in 2003—or it might have been 2004—I was gobsmacked at the conditions I saw. There were facilities but, given the conditions they were living in, you certainly would not think they were taking any advantage of the existing opportunities. We need to make sure that we encourage particularly disadvantaged groups in rural and remote communities to get the best benefit they possibly can from living in South Australia and to have opportunities presented to them.

The Health in All Policies agenda was partly the result of a meeting with the World Health Organisation and a number of governments, particularly the South Australian government, in Adelaide earlier this year. From that, the Adelaide Statement on Health in All Policies was developed in April this year. In my reading in preparation for this debate, it became obvious that this is quite a powerful statement. It is not that long: it is four pages, which probably would not take me long to read, but for Hansard's sake I will not read it all in.

I encourage people to google it or go on to the health website and download the Adelaide Statement on Health in All Policies, because it is a very good document. I congratulate the government on collaborating with the World Health Organisation on this policy. I will read the start of it:

The Adelaide Statement on Health in All Policies is to engage leaders and policy makers at all levels of government—local, regional, national and international. It emphasises that government objectives are best achieved when all sectors include health and well-being as a key component of policy development. This is because the causes of health and well-being lie outside the health sector and are socially and economically formed. Although many sectors already contribute to better health, significant gaps still exist.

The Adelaide Statement outlines the need for a new social contract between all sectors to advance human development, sustainability and equity, as well as to improve health outcomes. This requires a new form of governance where there is a joined-up leadership within governments, across all sectors and between levels of government. The statement highlights the contribution of the health sector in resolving complex problems across government.

It then goes onto how we are going to achieve social, economic and environmental development, the need for joined-up government, the Health in All Policies approach, the drivers for achieving Health in All Policies and the new role for the health sector. In fact, I will read this, because it is quite interesting:

New role for the health sector

To advance Health in All Policies the health sector must learn to work in partnership with other sectors. Jointly exploring policy innovation, novel mechanisms and instruments, as well as better regulatory frameworks, will be imperative. This requires a health sector that is outward oriented, open to others, and equipped with the necessary knowledge, skills and mandate. This also means improving coordination and supporting champions within the health sector itself.

I just wish that the Menadue report on the Generational Health Review saw more light than it did. I had a look at that not long ago, actually, and there is some terrific stuff in there. I know that some of it has been picked up by this government, but I think there is a lot more that could have been picked up. The Adelaide statement, under 'New role for the health sector', continues:

New responsibilities of health departments in support of a Health in All Policies approach will need to include:

understanding the political agendas and administrative imperatives of other sectors;

building the knowledge and evidence base of policy options and strategies;

assessing comparative health consequences of options within the policy development process;

creating regular platforms for dialogue and problem-solving with other sectors;

evaluating the effectiveness of intersectoral work and integrated policy-making;

building capacity through better mechanisms, resources, agency support and skilled and dedicated staff;

working with other arms of government to achieve their goals and in so doing advance health and well-being.

The statement then goes on to talk about the next steps in the development process, and that is working with member states and regions of the world and taking note of other global conferences. The next global conference on health promotion will be in Brazil in 2011 followed by Finland in 2013, and then there is a Millennium Development Goals conference, which is to be held post-2015. So, it is going to continue on not just a local basis but a worldwide basis, and I am glad that Adelaide and South Australians were a part of that driving force to advance 'health in all areas' policies with the Adelaide statement.

The Public Health Association of Australia put in a number of submissions on this bill. From those submissions, it is interesting to see the areas of policy that it is involved in. The association is certainly covering health in all areas. For a start, the categories that are listed on its website are quite extensive and include: Aboriginal and Torres Strait Islander health, health promotion, environmental health, health services development, infectious and transmissible diseases, international health and international trade, obesity, political economy of health, prisoners' health, research, women's health, child health, drugs and alcohol, food in health, immunisations, injury, mental health, oral health, primary health care, weapons in war—and we go back to our 6:30 news there and the fear of terrorism. Workforce training and development is another area, because in order to have a healthy workforce, occupational health and safety are very important, and the Public Health Association has looked at policies in that area.

It is worth looking at some of the areas within policies that the association has developed. I will not go through all of those again, but under 'Aboriginal and Torres Strait Islander health', the association is looking at Aboriginal and Torres Strait Islander people's substance abuse and that has certainly been a serious issue here in South Australia. We have seen a shift away from petrol sniffing, which is terrific, but unfortunately there has been a rise in the use of marijuana and other drugs. That is a real issue, and we are all working with Aboriginal communities to reduce that.

Under 'Indigenous health', the continuing consequences of colonisation is an interesting thing for the Public Health Association to be involved in. Once again, that comes back to mental health, anxieties, stresses and depressions and our views on where we come from and where we should be going. Prevention of violence and sexual abuse in Aboriginal and Torres Strait Islander communities is so important. We have seen that with the Mullighan inquiries, and I look forward to some further reporting on that fairly shortly in this place.

Incarceration of Aboriginal and Torres Strait Islander people is also a very important issue in terms of prisoner health. We spoke about that a few moments ago in the debate on the motion regarding the Port Augusta Prison upgrade. Our children are our future as many people say, and child health is so important. The Public Health Association of Australia is concerned with improving the health of school-age children and young people. Peri-conceptual folate and the prevention of neural tube defects is very important. We have seen how a simple food supplement such as folate can prevent lifelong deformities and disabilities. This is a very important area to look at, and it is good to see that the Public Health Association actually lists it under its child health policies.

The marketing of food and beverages to children is certainly a controversial area and there is some concern that we are going to become a nanny state, but at the same time we do want our consumers to be informed. We do want food to be labelled accurately; we do want people to know what they are eating. We talked about 'scores on doors' yesterday and about knowing whether the eatery you are going into is serving food to the high standards we should expect. That is something which, as I said yesterday, I strongly support.

I do not have an app on my iPhone that would enable me to point at the door with the radar to tell me what a restaurant is serving, because I do not know how to use the thing properly yet; I am still learning. In England, you can load up an appropriate app and point the radar at the restaurant and it will give you the 'score on the door', the menus and a whole lot of information. That is the sort of information that we look forward to being able to access. Certainly, under the Public Health Association of Australia's child health policies, the marketing of food and beverages is a very important policy.

One issue about which I have had discussions with the various community groups, and one which is a terrible tragedy for any parent, is Sudden Unexpected Deaths in Infancy and Sudden Infant Death Syndrome. It is great to see that the policies and the research being done is advancing our knowledge and that sudden infant death has reduced significantly, from my understanding. It is very important that we foster those sorts of policies and assist where we can.

Health promotion is listed under the Public Health Association of Australia's policies, and that to me is something we need to work on more. I see in one of the submissions (and I will read it a little later) that there is a concern that there is not enough emphasis on prevention and education in some areas of notifiable diseases.

Another area, of course, we are all very aware of is drugs and alcohol. The Public Health Association has policies on illicit and pharmaceutical drug misuse, alcohol and tobacco control and passive smoking. One of my pet hates is walking down the street behind someone who is smoking. You just cannot avoid it. It really gets up my nose—no pun intended. It is just disgraceful.

If people knew what they were inhaling and what they are doing to themselves and others—and then you see these young mothers, with babies in pushers, and they are smoking—you feel like going up to them and ripping the cigarettes out of their hands, but that is the society we live in. It is a democracy, and it is not illegal yet.

I say 'yet' in the rhetorical sense. I would not be surprised if at some stage somebody tries it on, but how do you enforce that? It is like alcohol, isn't it? Certainly, educating people in lifestyle changes is such an issue for people developing whole health. How the heck you get people to change their lifestyle is a real issue. I love a glass of red at night—not every night, but just every now and again—

The Hon. J.D. Hill: It's a balance.

Dr McFETRIDGE: It is about balance, as the minister says. However, with cigarettes one puff is too many. I will have more to say about passive smoking. In terms of environmental health, the EPA put in a submission (and I will read from that a little bit later on) about some of their concerns that the environmental impacts of public health incidents are not being emphasised. However, under its environmental health policies the Public Health Association of Australia is looking at ecologically sustainable development. That is an issue that I will read in SACOSS's submission too, because they are very concerned about development, housing and community development.

Other concerns include: ecologically sustainable development, environmental health, justice (an interesting area), climate change (and there are certainly some issues there), and nanotechnology. There are some wonderful advances in nanotechnology, but there are also some concerns with some of the nanoparticles going through your skin inadvertently with, say, sunscreens—

The Hon. J.D. Hill interjecting:

Dr McFETRIDGE: No, minister, we are not going to become a 'nano state'. Another concern is uranium munitions, which was linked to their policies on weapons and war because depleted uranium weapons certainly cause massive long-term effects for the communities involved. Nuclear energy as a response to global warming is an interesting policy. I have not read that yet; I must read it. Sustainable population for Australia is another topical area that the Public Health of Association of Australia is looking at. I seek leave to continue my remarks.

Leave granted; debate adjourned.


[Sitting suspended from 13:00 to 14:00]