Speech on the Public Health Amendment (Review) Bill 2017

In Parliament | 13.09.17

The Hon. PENNY SHARPE (20:31): I make a contribution to the debate on the Public Health Amendment (Review) Bill 2017. I note that the bill makes a number of changes to the Public Health Act as part of the statutory review of that Act. The bill is an omnibus bill and it covers a range of different issues including vaccination in childcare centres, the supply of drinking water, eyeball tattooing, skin penetration procedures, measures to curb legionella, safeguards on the disclosure of HIV-AIDS, measures on persons engaging in sexual activity when they are aware they are infected with sexually transmitted infections, and public health orders in relation to some diseases and conditions such as severe acute respiratory syndrome [SARS], Middle East respiratory syndrome [MERS], Ebola and HIV-AIDS.

I will confine my remarks to the part of the bill relating to HIV. I start by congratulating the Government on the work it has done to try to end HIV in this State. I will talk briefly about the release put out by NSW Health on 23 August, which spoke about the recent testing regimes showing that HIV is a step closer to becoming eliminated in New South Wales following a rapid fall in diagnosis to record low levels, according to the latest NSW HIV Data Report. I note, however, how long it has taken New South Wales to be in this position. New South Wales is now the world leader in stopping the transmission of HIV-AIDS.

When the epidemic started and the disease came to light, New South Wales was prepared to take difficult, bipartisan decisions—decisions that ultimately saved thousands and thousands of lives. We did that not only because we had to, but also because we had a level of maturity in our politics where, even though we did not understand what was going on at the time, we decided to go with the best scientific evidence that we had. We should be congratulated on that because we have saved literally thousands of lives. I always take an interest in what is going on with HIV and the way that we deal with it in this State. The change to section 79 in relation to some of the disclosure laws is welcome. That is a really big step forward and it is long overdue.

Again, it follows the evidence of where we are at in relation to this disease and the way we are dealing with it in this State. I place on record my concern about the increased sanctions in new section 79—the $11,000 fine and the possible jail sentence. This is a major departure from the way in which we have dealt with HIV in the past. Yes, there have been previous criminal sanctions, which are in the bill, but they were targeted very specifically at sexual activity in public places. This bill introduces jail time for people in private settings, which is quite a change. I am glad that the Government took up the suggestion in the review, but it is important to note that this is a departure from the way we have dealt with this issue before.

I bring to the attention of the House the concerns that groups such as the AIDS Council of New South Wales, NSW Users and AIDS Association, Positive Life, Hepatitis NSW, Sex Workers Outreach Project, and the HIV/AIDS Legal Centre have raised in relation to this bill. Those organisations did not do this because they are trying to be tricky; they did this because they have been at the forefront of dealing with the transmission of HIV in this State since day dot. In the past we listened to them very closely and backed them—and they were right. They were big contributors to why we have achieved such a fantastic outcome in heading towards the virtual elimination of HIV transmission in this State. We need to stop and think about that: We are literally on track to stop the transmission of HIV in New South Wales. Nowhere else in the world is even close to that.

I cannot let this bill pass without commenting on the serious concerns that have been raised about this change. We have been successful because we have made long-term investments in educating communities, we have been prepared to be open about the way in which HIV is transmitted, and we have been willing to work with affected communities. We have worked hard to get the message across to people that it is okay to be tested and that we want them to be tested. At the moment in this State there is testing in nightclubs and in the streets. There were 33,000 new tests in the last quarter. That is what will stop the transmission of HIV/AIDS. Putting people in jail will not stop it; it will be stopped by people getting tested early and often so they know their status and can take reasonable precautions to make sure that no-one else contracts it.

We need to understand the way in which this disease operates and its changing nature. Some provisions in legislation were introduced in 1991, at the height of the epidemic. Back then I was fighting on campus to get sharps bins installed so that cleaners did not get needle-prick injuries. That is a long time ago, and things have changed. There have been some positive steps forward, but we need to keep a close eye on this development because putting people in jail is not going to help. We need to be very serious about that. In November 2016 a group of HIV/AIDS doctors and specialists who are some of the heroes of this epidemic—and who know more about this subject than we could ever pretend to want to know—put out a consensus statement. The group made two recommendations. It said:

Scientific evidence shows that the risk of HIV transmission during sex between partners of different HIV serostatus can be low, negligible or too low to quantify, even when the HIV-positive partner is not taking effective antiretroviral therapy, depending on the nature of the sexual act, the viral load of the partner with HIV, and whether a condom or pre-exposure prophylaxis is employed to reduce risk.

Given the limited risk of HIV transmission per sexual act and the limited long term harms experienced by most people recently diagnosed with HIV, appropriate care should be taken before HIV prosecutions are pursued. Careful attention should be paid to the best scientific evidence on HIV risk and harms, with consideration given to alternatives to prosecution, including public health management.

This is one of the things we can all claim as a really important win, and the bill takes us a little further forward. It contains lots of other great stuff, which other members have talked about. But we should be very wary. If I am here in two years time when the review is completed, we will look at it closely. The change is unnecessary. We should learn from history and what we have won already. We must keep moving forwards, rather than taking steps backwards.

HANSARD - NSW Legislative Council, 13 September 2017