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House of Assembly - Fifty-Fourth Parliament, Second Session (54-2)
2020-04-29 Daily Xml
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South Australian Public Health (Early Childhood Services and Immunisation) Amendment Bill

Second Reading

The Hon. S.K. KNOLL (Schubert—Minister for Transport, Infrastructure and Local Government, Minister for Planning) (15:53): I move:

That this bill be now read a second time.

Immunisation is one of the most cost-effective health interventions and is supported by the World Health Organization and all levels of the government in Australia. Although immunisation coverage in South Australia is very good, despite free vaccines, adequate vaccine supplies for all children and ready access to immunisation services, the latest available data shows that 5 to 12 per cent of children in South Australia still do not get timely or complete routine vaccinations scheduled for the early years of life. Outbreaks of vaccine-preventable diseases continue to occur, such as the large ongoing outbreak of measles in New Zealand, which has recently spread to the Pacific Islands, including Samoa, where around 6,000 people have been infected and 83, mostly children, have died.

In 2019, the first phase of changes to the South Australian Public Health Act were made to strengthen the ability of public health officials to respond to outbreaks of vaccine preventable disease in early childhood services. From the beginning of this year, parents have been required to provide immunisation records to staff at early childhood services when they enrol a child and at ongoing and specified times, and the early childhood services are required to keep these and provide them to the Chief Public Health Officer on request.

The Chief Public Health Officer can exclude susceptible children during an outbreak of a vaccine preventable disease. This amendment bill, the second phase of measures to strengthen immunisation requirements, was developed after extensive public consultation. This bill prohibits enrolment of children who are not up to date with their vaccinations or provision of those services if the child does not remain up to date, unless they meet certain specified exemption criteria. I commend the bill to the house.

The DEPUTY SPEAKER: Do you have any clauses you wish to insert, minister?

The Hon. S.K. KNOLL: I can.

The DEPUTY SPEAKER: Only if you have them.

The Hon. S.K. KNOLL: Maybe I won't.

The SPEAKER: That is fine.

Mr PICTON (Kaurna) (15:55): If there has ever been a time to recognise the importance of vaccinations, this is the time. We currently have the whole world turned on its head by one disease that we do not have a vaccine for.

The DEPUTY SPEAKER: I am sorry to interrupt, member for Kaurna, but you will need to indicate that you are the lead speaker.

Mr PICTON: I was just getting on a roll.

The DEPUTY SPEAKER: Yes, but you are the lead speaker; we need to identify that.

Mr PICTON: I am the lead speaker. We currently have a world upended by a disease that we do not have a vaccine for. There are many, many other very deadly diseases that we do have vaccines for and that we do have the ability to protect ourselves from. While we are encouraging, supporting and hoping that the medical researchers from around the world are able to make very dramatic progress towards a vaccine for SARS-CoV-2, we have a whole range of other diseases that are not on the front page of the paper or the top story on the nightly news because of vaccines that are available.

We need to do everything we possibly can to make sure that people do not contract those diseases where they are preventable. The vast majority of South Australians do the right thing. The vast majority of South Australians get their children vaccinated, take them to the doctor or take them to the local council clinic and fulfil the requirements of their national Immunisation Register. My wife recently took my two children to get their next step of vaccines. They were not particularly thrilled about it, but it is very important that all children get their vaccines.

But, sadly, there are some people who do not do that. Sadly, there are some people who do not, either through choice where they have decided that they do not want to vaccinate their children or they have been remiss in doing it. What that means is that other children are potentially at risk, particularly those children who cannot get vaccinated because they have a medical condition that prevents them from being able to be vaccinated. They are the children who need herd immunity in our community to ensure that they are protected. This legislation seeks to ensure that we provide that herd immunity and that these vaccines are being used.

This is a piece of legislation that is not new this year and was not new last year or even the year before, but stems back to 2017 when it was first introduced into the Legislative Council. It was introduced in the Legislative Council by the now Leader of the Opposition before the last election. Ever since then we have been advocating and pushing very hard that this legislation should be enacted here in South Australia. We are delighted that we have finally got here, but we are very disappointed that it has been over two years since this legislation was first introduced in the parliament and that it is now at the stage where it is hopefully going to be passing through both houses today.

After the election, when the bill lapsed, I reintroduced the legislation. We tried Wednesday morning after Wednesday morning of sitting in this house to get the legislation considered and every single time it was put off and deferred by the government. We then had the minister eventually say that he thought that something should be done, but he was reluctant to introduce legislation in the form that we have here.

He introduced another bill, which he called his stage 1 bill, which dealt with information requirements that children in childcare facilities and preschools should have to provide, but it did not mandate vaccination, as is the case in this piece of legislation and as was the case in the legislation from 2017—a wholly inadequate response to the situation. It did not introduce no jab no play, as had been proposed originally here in South Australia and as had been proposed originally by former prime minister Malcolm Turnbull and as has been in place and legislated in New South Wales and in Victoria for a number of years and in Western Australia over the past year. It did not meet that threshold whatsoever.

We had the minister raising concerns about this back then. He pointed to concerns raised by one of the medical colleges but was not willing to get to this point. We then tried to amend his inferior bill to put in these provisions. They were voted against by the government and by the crossbench in the Legislative Council as well. So time after time we have been pushing for this legislation and time after time the Liberal government has been either blocking it from being discussed or voting against those provisions in the Legislative Council.

That is very disappointing because, if this legislation had been in place a year or two years ago, it would mean that more children would be protected right now. It would mean that we would have the protections that are in place in Western Australia, in Victoria and in New South Wales. We would have them right here in South Australia because this is all about protecting those children. This is all about protecting those kids particularly who cannot get vaccinated because of their medical conditions.

This is a bill where we get people emailing us with their views against it. We had a petition against it tabled today by the member for Finniss. This is something where a lot of people will find things on the internet where they disagree with this proposal. But we have been steadfast in our support of this measure over the past 2½ years, or even longer since it was first promoted while the consultation was originally happening, and it is disappointing that it has had to get to this point.

I remember that when the original bill the minister proposed, which was just the information requirements, we tried to insert these provisions in this house and had a debate in this house. I remember very clearly last year the member for Waite, who is no longer with the government benches, questioning significantly why the opposition would seek to do this and how we had not consulted enough, etc. It was disappointing that this would not be supported back then.

This has been knocked down by the government more than 30 times, and there is nothing particularly new in here whatsoever that could have caused that delay over the past two years. Ultimately, they have landed on the same piece of legislation. Ultimately, the government's consultation, which finished last year, produced almost exactly the same piece of legislation that happened out of the consultation in early to mid-2017, so we had two years of delay, two years of obfuscation, but the same result—the same piece of legislation.

As was the case with the bill 2½ years ago, this bill requires children to be appropriately immunised to attend early childhood care. There is a maximum penalty of $30,000 for any person who provides an early childhood service or enrols a child without the appropriate exemption or immunisation history required, with a good faith defence to protect providers who are necessarily relying on the statements provided to them by parents and guardians.

These immunisations are the same ones on the national schedule: hepatitis B, whooping cough, polio, measles, mumps, rubella and those strains of meningococcal that are currently on the national schedule. Hopefully, the national schedule will one day include meningococcal B as well, which we have had a lot of discussion over the past few years about in South Australia.

This is a piece of legislation that has our wholehearted support because it is essentially the same piece of legislation we have been trying to get passed by the parliament for the past 2½ years. It will lead to higher rates of immunisation and it will lead to higher rates of protection for our community. There is no doubt that scientifically proven vaccines are good for our society and that people should be vaccinated unless they have a medical condition that says they otherwise cannot.

There is a lot of pseudoscience on the internet that says differently, but we on our side back the science, we back our medical professionals, we back our scientists, who say very clearly that these vaccines save lives. We have no better example of that than what is happening around the world right now, where we have a disease for which we desperately hope there will be a vaccine soon. We desperately hope that vaccine could be added to this register within months—hopefully, not years—and people will have protection against that in the same way they have protection against all these other vaccines. This bill has the opposition's support.

The Hon. V.A. CHAPMAN (Bragg—Deputy Premier, Attorney-General) (16:07): I rise to speak on the South Australian Public Health (Early Childhood Services and Immunisation) Amendment Bill 2020 and indicate my appreciation to the Minister for Health for progressing this matter in the parliament. Whilst there appears to be some criticism from the opposition as to the pace with which this has been developed, advanced and now presented for the final part of stage 2, I do note that the member for Kaurna was part of a government that had 16 years to develop this. Really, in the dying days of that government—

Mr Picton: Since I was at uni?

The Hon. V.A. CHAPMAN: —yes—they advanced this as an important initiative. I can recall minister Portolesi making comment in this house about how important it was to have no jab no play and, as usual, there were lots of promises in that regard and no delivery. Nevertheless, I agree with the member for Kaurna on two things: one is that this is an important piece of legislation and it is an important issue to be resolved and, furthermore, I appreciate and am very pleased to hear that, as a parent himself, he endorses the benefits available for immunisation generally.

Can I firstly address the bill itself, which is really part 2 of the legislative program of reform. What has been in the first stage is the passage of the first amendment to permit the Chief Public Health Officer to exclude children who are at material risk during an outbreak of a vaccine-preventable disease and to obtain immunisation records from early childhood services during an outbreak or risk of an outbreak.

The second stage—which is what we are dealing with now, phase 2 of the bill—proposes financial penalties of up to $30,000, as has been indicated, for someone who breaches the obligations there. In particular, it allows a child to fail to be up to date with immunisations in order to continue to attend at an early childhood service, obviously with the usual regulation powers to be able to be effected and enabling a penalty to be applicable also to a childhood service provider who does not comply with the exemption requirements.

Some commentary has been made about the need to ensure that, while we value and applaud the benefits of immunisation and COVID-19 is a contemporary example of exactly why it is so important, nevertheless there are children who are unable to be safely immunised. They may have a respiratory condition or some other medical circumstance that would place them at risk in relation to that. Parents need to be able to have oversight in respect of their child's health, and that includes immunisation in those circumstances. They need to be able to have some exemption, and provision has been made for that, as it should be.

As to the conscientious objectors generally, can I say this: whilst there are very strongly held views by some that there should be no population health immunisation and that there should be a capacity to dissent from the benefits of this and therefore have some exclusion, I appreciate that they are passionate about that, but if I could just recount the situation. As the shadow minister for health, about 15 years ago I attended the World Health Organization in Switzerland, and I was briefed on a number of matters.

The thing that surprised me more than anything was the urgency of those who were providing advice as to the two things they saw as the 21st century problems in respect of health. I expected them to talk to me about poverty-stricken countries, cholera in water and all sorts of things of that nature. In fact, they described to me the problems of infectious disease—in countries where we would expect it to be, perhaps in Africa and those less fortunate economically, but also in our own communities—and, secondly obesity, which was at a pandemic stage from their description. I found it a very enlightening period of meetings on that day.

Two things were very passionately put within this envelope. Firstly, they wanted to know about the Institute of Medical and Veterinary Science because they knew that it was headquartered in Adelaide at the time. Of course, what was left of it after the previous government stripped it down and took pathology in-house is now our SA Pathology entity, which members are quite familiar with. They wanted to commend the IMVS because of the work that it was doing and had done over a number of years with polio and smallpox. I think they also suggested that they were quite active in both the testing and treatment of tuberculosis.

This work was having international benefits. They wanted me to be very proud—I was—but also to be aware of how much they appreciated, in the World Health Organization public health arena, the importance of the work that the institute was doing here in South Australia and the significance of its testing and advancements, its published activity that it had presented over the years and the extraordinary gift that it was giving to the world in relation to communicable disease.

Bear in mind that, certainly in my time in the eighties and nineties, we came through what I think was also a really difficult period, which was the transmission of HIV. In the 1980s, if contracted it was likely to be a death sentence. As a transmission through bodily fluids, it was something that resulted in the death of a very large number of adults. Often there were practices of unprotected sex between consenting adults, who were either same sex or opposite sex.

I recall there was a terrible period in South Australia when blood was being provided for transfusions, often for newborn babies, and the blood was contaminated in the donation system that used to operate in those days and a number of babies died when they contracted the disease and, of course, it developed into AIDS. As I say, it was a death sentence.

From time to time we are faced with these really difficult periods and real challenges and we are in one at the moment. The World Health Organization were very keen to say that this issue of infectious disease is something that is a plague across the world and we ought to be aware of it because it was a big challenge still for the 21st century, even though, at first blush, I thought we had got through all that. I had not personally lived through polio epidemics, but my parents' generation did.

Recently, but not that recently now, I launched a book in relation to the John Martin's pageant and the author provided pictures of children wheeled down from the Royal Adelaide Hospital and what was then the children's hospital. They were in beds, having been sentenced to bed rest as a result of polio being contracted, and there were rows and rows of them lined up along Rundle Street to watch the John Martin's pageant.

Sometimes it brings home these really tragic periods during which whole generations of our children, and sometimes into adulthood if they have not had measles or chicken pox as children, contract these diseases and to have these conditions as adults can be very difficult and sometimes fatal. The World Health Organization were very keen to recognise the IMVS, but reinforced to me the importance of us being really vigilant in this area and that it really is a very serious situation in parts of the world. We might episodically find out about it, but it is really a killer across the globe.

I agree with the member for Kaurna that it is important that those who are having children now consider this matter seriously and not only think carefully about the future of their children, their education and their own advancement but make sure that in the health space they seriously look at this question of immunisation. I am very pleased that my own children and their wives have made decisions to immunise their children.

I think I said to one daughter-in-law at one stage that this would probably be the one issue when I would have to suppress my otherwise genteel approach to relationships like that and have to have something to say about it if they made the decision that their children would not be immunised. Fortunately, I was spared that. So, in my usual mild way, I was quietly able to compliment them on making that decision and not express how I really felt about it. That was pleasing in itself.

Probably, sometime in May, I would have been lining up with my eldest granddaughter, Adelaide, to have all our immunisation shots for Africa. COVID-19 has put that trip on the backburner and hopefully we can do it next year. There are meningococcal and other conditions, which again we are largely isolated from, in the regions that we would be visiting. I had trips with my late husband to regions on the African continent, and we had to be really vigilant.

Sometimes, looking outside the comfort of our own little area like Adelaide, we realise how much the world relies on us doing the responsible thing, especially when we have access to vaccines and funding to be able to support that—a lot of this is publicly funded—and that we need to make sure we do everything we can to ensure that as many of our community as possible are immunised.

I also remember that minister Portolesi at the time raised this question about what she might do in relation to childcare centres and the obligation for children to either be immunised or not be able to have access to these facilities, and it was a bit of a challenge. Obviously, there was a concern about having something mandatory. Everyone gets a bit unnerved about that, but overwhelmingly the parents that I spoke to, who also had children at childcare centres at that time when my grandchildren were at childcare centres, were very clear about having immunisation. They did not want their children to be attending a centre where other children were not immunised. They did not want the risk of that, and they wanted that to be very clear.

Of course there are occasional exceptions to that, but the sentiment was very strong, and I think that it is one that we need to respect and, of course, keep ourselves up-to-date with to make sure that we understand how our parents of today are making decisions in relation to that for their children and to make sure that we give them every support possible, including through this legislation, to protect those children and to give them a future.

I thank the minister for bringing the matter to the parliament's attention, that is, the Minister for Health, and of course my colleague the Minister for Transport for ably presenting it to this house.

Mr TEAGUE (Heysen) (16:21): I rise briefly to commend the bill to the house and to make, perhaps, brief observations about the current global pandemic that we are living through and to emphasise that South Australia is leading the world in living through it. We have just heard in the last hour or so that we have achieved now seven days in a row with zero cases here in South Australia, and it is tremendous news and a source of confidence, I hope, for all the people in South Australia for the fantastic efforts that everyone has been making in the face of this pandemic.

If ever there was a time when people are daily reminded of the importance of the great work of public health authorities in making available to the public vaccines that can prevent the spread of disease then it ought to be now. I think that one of the things that might come out of this current emergency is a greater consciousness and appreciation of the risks to health that exist when available vaccines are not taken and the benefits to the public—to all of us—when we have widespread vaccination.

This bill now comes along and imposes quite serious penalty provisions, along with prohibitions. It introduces penalty provisions to apply of up to $30,000 for enrolment or for the provision of childcare services where vaccination has not happened. It makes it very, very clear that the provision of services absent vaccination is simply not on in South Australia, and that is a very welcome development in my view.

I might say that I am thoughtful in this debate about the smart one in our household. My wife, Dr Maria Teague, is an immunologist and knows all about this area, and we have discussions at home with her and among our children—perhaps Maria is Bridgewater's answer to Professor Nicola Spurrier. We have the opportunity to hear in the household about the importance of vaccination where it is available as well as the insidious capacity of these microorganisms, viruses, to come along and cause such destruction, as we have seen with the COVID-19 virus.

I welcome the imposition of these new prohibitions and serious penalties. I hope it augers towards an outcome where in South Australia we aspire to not only be world leaders in finding vaccines but world leaders in responding to circumstances in which public health is challenged by the lack of them and, where they are available, that we universally take the opportunity to vaccinate our children and remain as healthy as we can possibly be in this state. I commend the bill.

The Hon. S.K. KNOLL (Schubert—Minister for Transport, Infrastructure and Local Government, Minister for Planning) (16:26): I would like to thank all members who spoke on this bill. I look forward to its passage through this chamber this afternoon.

Bill read a second time.

Committee Stage

Clause 1.

Mr PICTON: I welcome Dr Koehler from the Communicable Disease Control Branch. I am sure he has been very busy. Thank you for your assistance here and thank you for your hard work through the pandemic. I do have a few questions; the first one is in relation to clause 1. Given that the consultation on the revised legislation—not the 2017 consultation but the new consultation—closed in June 2019, what happened between the close of consultation and the introduction of the bill, given that the bill is ostensibly a replication of the original legislation that has been around since 2017?

The Hon. S.K. KNOLL: As I outlined in my second reading explanation, this is phase 2, essentially CDCB. We are implementing phase 1 and obviously setting up the protocols and everything needed to make sure that early childhood education centres that are involved in this act have in place what they need to comply with the record-keeping provisions. Given that phase 1 was already legislated, that work took precedence.

Ms BEDFORD: Can the minister indicate what consultation has been undertaken in preparing this bill? By way of explanation, I have been approached by a constituent whose child has a medical contraindication for vaccination that the federal department has refused to register on the Australian immunisation register.

The Hon. S.K. KNOLL: I thank the member for Florey for her question and say that there was a month-long consultation process that was undertaken with a discussion paper that was released. There were three options put—(a) (b) and (c)—in that discussion paper, and 600 responses to the consultation were received over the course of that period.

Clause passed.

Clause 2.

Mr PICTON: In the other place, the minister referenced a potential start date of 1 July for the legislation. Is this still the government's intention, or has this been postponed under the current pandemic circumstances?

The Hon. S.K. KNOLL: Essentially, we are now saying three months after assent, provided it passes here in the coming weeks, and so we are looking at an August start date. The reason for the slippage is that the Communicable Diseases Control Branch has been dealing with a global pandemic that has caused the slippage.

Ms BEDFORD: What was the date you said, minister?

The Hon. S.K. KNOLL: August.

Ms BEDFORD: Can the minister advise why the bill does not include a grandfathering provision for children already enrolled, on a similar basis to all other jurisdictions? By way of explanation, I am advised that in other jurisdictions no jab no play legislation does not apply to children who are enrolled in a childcare centre, kindy or school prior to the commencement of the legislation, and that means those children can complete their schooling or enrolment. Whereas it is my understanding that with this bill, in effect children who are not immunised by the commencement date are expelled.

The Hon. S.K. KNOLL: I have been advised, member for Florey, and I thank you very much again for this question, that not all jurisdictions have grandfathering provisions in relation to them. This is phase 2. A phase 1 process has already been in place, so obviously there would be a heightened awareness amongst the parents of this cohort of children that this applies to as to what their obligations are.

If we were to put a grandfathering provision in place, it would mean that it would be a further six years before the intent of this bill would become fully operational. In terms of the issues we are having at the moment, where again we have between 5 and 12 per cent of students not completing their vaccinations, we believe that it is important to have this in place as soon as possible to provide the impetus as soon as possible and provide the benefits that come with high rates of vaccination and herd immunity as soon as possible.

Ms BEDFORD: If it is not in all other jurisdictions, which ones is it not present in?

The Hon. S.K. KNOLL: That is information I do not have to hand at the moment.

Ms BEDFORD: I do not understand how you can dismiss automatically that it is not in all jurisdictions if you do not have that information to hand; that is all. I am just surprised.

The Hon. S.K. KNOLL: I can only refer to my previous answer and also say that in this instance our understanding and our response to vaccination rates and using vaccines in our community are evolving. We can see this year, for instance, the way we have evolved our use of the influenza vaccination in response to COVID and a whole series of measures have been undertaken; and last year, for instance, where we had to try and bring forward the flu vaccine because our flu season started a little bit early.

This is an evolving space especially in relation to the COVID pandemic, where we see on a daily basis that our understanding of vaccines evolves. The opportunity here for us as a jurisdiction to evolve and move further than other jurisdictions have I do not think is a negative step, especially when what we are seeking to do here is for those children who cannot get vaccinated. They are the ones we need to protect. We are likely talking about children with cancer.

If this means that there is a little bit of an impost upon other children to be able to provide that herd immunity to those immunocompromised children, I think that is a very worthy goal and one that this bill seeks to have implemented as soon as possible.

Clause passed.

Clause 3 passed.

Clause 4.

Mr PICTON: I wonder if the minister can outline the requirements for children who are already enrolled in early childhood education. By when will they need to meet the vaccination requirements?

The Hon. S.K. KNOLL: I will answer this in two ways. I will answer the easy bit first, and that is that it will come into place as children age. Obviously, there are immunisation requirements at various ages. Essentially, as I am advised, the threshold falls due a couple of months after the time when those vaccinations should have taken place. There is a couple of months' grace period. For those children, as they age, that is essentially the operable date after which these measures come into force, and at that time they will start to be excluded.

In relation to what I think is the intent of the question, when this comes alive in August there will be a cohort of children who have not been vaccinated and who will in August immediately fall foul of these provisions and then be excluded. Between here and when these measures come into effect, there will obviously be a strong community communications plan, but again under phase 1 of the measures that we have previously undertaken the records being held by early childhood facilities will help to gather the information necessary to know which children will potentially be affected by this.

Essentially, it is the job between assent and when this goes live for that communication to occur so that we do give every opportunity for those children who will be excluded as a result of these measures we are debating today to fix those vaccination records and get the injections they need so that they can continue to take part in early childhood education.

Mr PICTON: Let me clarify that because this is an important point that I think a lot of people will be paying attention to and be interested in. I have already outlined that my children are vaccinated, but let's say hypothetically that I have a child in child care who is not vaccinated. This legislation comes in from 1 August. At what point would that child be told that they could no longer go to that child care? Is it immediately? Is it upon the next date of their vaccine schedule that they miss? Or is it in the next year of enrolment when they start their enrolment next year and they check the records?

The Hon. S.K. KNOLL: I refer to my previous answer. Again, it will be different. The two-month grace period comes in, but I think you are talking about the cohort of children who are not vaccinated now and are already beyond two months behind. For that cohort, it is August that they will start to be excluded.

Ms BEDFORD: Does the bill rely upon the provisions of the A New Tax System (Family Assistance) Act 1999 of the commonwealth, which in turn relies upon the Australian Immunisation Register Act of the commonwealth?

The Hon. S.K. KNOLL: The answer is yes. The reason that it is yes is that the federal government obviously has their own no jab no play provisions in place. We wanted to make sure that there was no added complexity by diverting from the criteria that they defined, so we essentially mirrored those federal acts to make sure there is no confusion or a different cohort or for whatever reason there is further complexity. So, yes, we are essentially mirroring those acts.

Ms BEDFORD: Is the minister aware the form issued by the federal health department providing for certification of medical contraindications by medical practitioners limits the contraindications to a preset list which appears to be unsupported by the provisions of section 6(3)(a) of the A New Tax System (Family Assistance) Act or the Australian Immunisation Handbook, which that act refers to as the authoritative clinical document? Will the minister undertake to draw this potentially improper administrative practice to the attention of the federal minister for his action?

The Hon. S.K. KNOLL: Yes, this form and that preset list of contraindications are the first port of call. In relation to that, that form and that list were compiled by experts and that is why that list has been put together, but there is a special immunisation service that is run out of the Women's and Children's Hospital where parents can seek an expert opinion and it is staffed by paediatric immunologists.

Failing that, as a provision in here, there is the ability for the Chief Public Health Officer to make a determination as well. I assume we are talking about a child who has some sort of medical condition and parents who believe that their child should be exempt from vaccinations but their contraindication is not on the preset list. So there is, ultimately, a pathway via the Chief Public Health Officer for that to be considered and the first port of call would be the special immunisation service run by the Women's and Children's Hospital.

Ms BEDFORD: In relation to the exemptions, can the minister advise why exemptions under this bill are made by the Chief Public Health Officer rather than by regulation, as are similar laws in other states? Does the minister think proper public scrutiny required the potential for parliamentary disallowance, as is provided, for example, elsewhere in the South Australian Public Health Act in relation to notifiable conditions?

The Hon. S.K. KNOLL: The reason it is the Chief Public Health Officer is precisely for the situation that your question implies, in that we have a preset list that will deal with almost everybody. We will then have a very small number of cases where a child is immunocompromised and somebody believes they should have an exemption but cannot according to the preset list.

We need to have a flexible arrangement where somebody can make that decision. In this case, the Chief Public Health Officer is the highest authority on this in the land and I think Associate Professor Nicola Spurrier is somebody whom all of South Australia respects very deeply and whose opinion I think everybody respects very deeply.

Essentially, it is about having a flexible arrangement. If we were to put a set of regulations in place, that would need to be prescriptive. Anytime we create prescription, we would then need some sort of specific process outside of that prescriptive list to be able to provide flexibility to deal with cases that crop up and occur from time to time.

Clause passed.

Clause 5.

Mr PICTON: In relation to the compliance requirements, the minister in the other place was asked if there had been any issues with noncompliance in relation to the so-called first phase of these reforms, the requirement on education providers to collect immunisation records. The minister said, 'I would assume that, if there was noncompliance, we would be aware of it.' I am just wondering if there is any update on that. Has there been any information provided in relation to noncompliance? Has this assumption by the minister been investigated and confirmed?

The Hon. S.K. KNOLL: Essentially, the mechanism is that the Education Standards Board are the people who audit the early childhood education centres on whether or not they are holding that information. If there is a breach or some sort of issue, as you point out, that then gets escalated to the Communicable Disease Control Branch. To date, I am advised that there has not been any notification of any breach or difficulty in that regard.

Mr PICTON: What penalties would a parent or guardian face if they forged an immunisation history statement or otherwise were misleading regarding their child's immunisation history statement?

The Hon. S.K. KNOLL: A $30,000 fine.

Clause passed.

Remaining clause (6) and title passed.

Bill reported without amendment.

Third Reading

The Hon. S.K. KNOLL (Schubert—Minister for Transport, Infrastructure and Local Government, Minister for Planning) (16:48): I move:

That this bill be now read a third time.

Bill read a third time and passed.

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