Attachment A

 

Details of the Financial Framework (Supplementary Powers) Amendment
(Health and Aged Care Measures No. 3) Regulations 2023

 

Section 1 - Name

 

This section provides that the title of the Regulations is the Financial Framework (Supplementary Powers) Amendment (Health and Aged Care Measures No. 3) Regulations 2023.

 

Section 2 - Commencement

 

This section provides that the Regulations commence on the day after registration on the Federal Register of Legislation.

 

Section 3 - Authority

 

This section provides that the Regulations are made under the Financial Framework (Supplementary Powers) Act 1997.

 

Section 4 - Schedules

 

This section provides that the Financial Framework (Supplementary Powers) Regulations 1997 are amended as set out in the Schedule to the Regulations.

 

Schedule 1 - Amendments

 

Financial Framework (Supplementary Powers) Regulations 1997

 

Item 1 - In the appropriate position in Part 4 of Schedule 1AB (table)

 

This item adds two new table items to Part 4 of Schedule 1AB to establish legislative authority for government spending on certain activities to be administered by the Department of Health and Aged Care (the department).

 

New table item 621 establishes legislative authority for government spending on the Smoking and Vaping Cessation program (the program) to support people to quit smoking and vaping.

 

Tobacco use remains the leading cause of preventable death and disability in Australia and the use of e-cigarettes including nicotine vaping products (vapes) is rapidly increasing. Nicotine is highly addictive and poses serious health risks, and medical experts have serious concerns about the health effects of other harmful substances in vaping products. There is strong and consistent evidence that young people who vape are three times as likely to take up smoking, compared to those who do not vape. In addition, e-cigarette use among young people is leading to nicotine addiction for a cohort that would otherwise have a low risk of tobacco use.

 

The Government is committed to reducing rates of tobacco, e-cigarettes and nicotine vaping product uses as outlined by the Minister for Health and Aged Care, the Hon Mark Butler MP in a media release on 2 May 2023 (https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/taking-action-on-smoking-and-vaping), and through the Vaping Regulation Reform and Smoking Cessation Package announced in the 2023-24 Budget.

 

The commitment aligns with the goals, objectives and targets of the National Tobacco Strategy 2023-2030 (the Strategy), which aims to improve the health of all Australians by reducing the prevalence of tobacco use and its associated, health, social, environmental and economic costs and the inequalities it causes.

 

The Strategy includes the following objectives:

• prevent uptake of e-cigarettes by young people and those who have never smoked;
• prevent and reduce nicotine addiction;
• denormalise and limit the marketing and use of e-cigarettes;
• encourage and assist as many people as possible who use tobacco and e-cigarettes to quit as soon as possible, and prevent relapse;
• prevent and reduce tobacco use among:

o   groups at higher risk from tobacco use; and

o   other populations with a high prevalence of tobacco use; and

• prevent and reduce the marketing and harms associated with use of novel and emerging products.

 

The Strategy includes targets to reduce daily smoking prevalence in Australia to below 10 per cent by 2025, and to 5 per cent or less by 2030 and reduce the daily smoking rate among First Nations people to 27 per cent or less by 2030. It also includes a number of actions to address e-cigarette use and vaping.

 

Further, Australia has obligations as a Party to the World Health Organization Framework Convention on Tobacco Control to prevent and reduce tobacco use and nicotine addiction. The program also aligns with the National Preventive Health Strategy 2021-2030 and will help support the National Agreement on Closing the Gap.

 

The Government, through the Vaping Regulation Reform and Smoking Cessation Package in the 2023-24 Budget is proposing stronger regulation and enforcement of all e-cigarettes, with and without nicotine. The Government will provide $92.9 million over four years from
2023-24 to fund a program of work to reduce smoking and vaping rates, with a particular focus on young people and high risk groups, such as First Nations, LGBTIQA+ and culturally and linguistically diverse (CALD) communities. The program comprises of public health information campaigns on vaping and tobacco controls and smoking and vaping cessation activities.

 

Public health information campaigns (the campaigns)

 

The campaigns are a key initiative of the Strategy, which will receive funding of $63.4 million over four years from 2023-24 to:

• drive and support tobacco and e-cigarette quit attempts;
• denormalise smoking and vaping;
• increase support in the community for quitting; and
• reduce the likelihood of people substituting smoking for vaping (or vice versa) instead of quitting.

 

The campaigns will be delivered in line with the Australian Government campaign guidelines and the department will procure services from suppliers on the Government Communications Campaign Panel, managed by the Department of Finance for:

*         research;

*         creative development;

*         public relations;

*         First Nations communication; and

*         multicultural communication.

 

The campaigns will also work with the whole-of-government suppliers for evaluation research and media buying.

 

The campaigns will be comprised of two activities: a national targeted smoking and vaping public health campaign; and a national youth vaping education campaign cost-shared subject to the agreement of states and territories.

 

National targeted smoking and vaping public health campaign

 

$46.6 million will be provided over four years from 2023-24 for the implementation of a national targeted smoking and vaping public health campaign to reduce smoking and vaping prevalence among priority and at-risk populations aged 18-40. The approach would include engagement and delivery with First Nations peoples, LGBTIQA+ people and people from CALD backgrounds.

 

National youth vaping education campaign, cost-shared subject to the agreement of states and territories

 

$11.3 million will be provided over four years from 2023-24 for the implementation of a youth vaping education national campaign to educate and support young people, their parents and carers and the community about the harms of vaping. The campaign aims to stop young people vaping, through reducing uptake and supporting cessation.

 

Both campaigns will be implemented and delivered by the department in accordance with whole-of-government arrangements for Australian Government communication campaigns. Activities and communication channels will be informed by comprehensive developmental research, however will include a combination of paid advertising and below-the-line activities such as public relations and stakeholder outreach. The campaign will be adapted and translated for First Nations and multicultural audiences, where appropriate.

 

The department will lead the development and implementation of the public health campaigns, including adhering to the Australian Government campaign approvals process. The department will also manage all contracts for the above components in line with the Public Governance, Performance and Accountability Act 2013 (PGPA Act).

 

Smoking and vaping cessation activities

 

Funding of $29.5 million over four years from 2023-24 is available to smoking and vaping cessation activities through specialised programs and health services to support Australians to quit smoking and vaping. This consists of five activities:

 

Activity 1: national consumer digital cessation hub

 

$9.0 million will be provided over four years from 2023-24 to fund the development of an externally hosted national consumer digital cessation hub to provide equitable access to evidence-based smoking and vaping cessation information, resources and support, with opportunities for collaboration with states and territories and the public health sector.

 

A closed tender procurement will be conducted for this activity due to the specialised nature of cessation services and the need for existing knowledge and experience with tobacco initiatives and evidence.

 

Activity 2: redevelopment of My Quit Buddy mobile application

 

$3.0 million will be provided over four years from 2023-24 to redevelop the existing My Quit Buddy mobile app to enable its expansion and provision of evidence-based cessation supports, including for vaping cessation. It also includes transition to an externally hosted platform run by cessation experts.

 

An external service provider will be engaged through an open tender procurement process to deliver this activity.

 

Activity 3: funding to scale up state and territory Quitlines

 

$15.0 million will be provided over four years from 2023-24 to support additional workforce capacity and training of state and territory Quitlines and other Quit services to support increased demand through additional workforce, training for Quitline counsellors, and enhanced use of technology to drive efficiencies and complement phone services.

 

Funding will be provided through the Federal Financial Relations funding arrangement, subject to negotiation with state and territory governments. The department will lead negotiations with states and territories to ensure funds are targeted to improve equitable access to services and extended hours of operation to remedy disparities in areas of greatest need.

 

Activity 4: updating evidence-based clinical guidance to ensure best practice vaping cessation is available to the health workforce

 

$0.4 million will be provided over two years from 2023-24 to update clinical guidelines and supporting materials for health professionals (provided by the Royal Australian College of General Practitioners Limited (RACGP) and Pharmaceutical Society of Australia Limited (PSA)) to include a focus on people who need support to quit vaping.

 

Pending negotiation and agreement by the providers, the department will engage with the current owners of the relevant guidelines, the RACGP and the PSA to deliver this activity.

Activity 5: targeted workforce education strategy to equip and train health professionals.

 

$0.4 million will be provided over two years from 2023-24 to develop a targeted workforce education strategy to equip and train health professionals in evidence-based practices to best support their patients to quit smoking and vaping.

 

An external service provider will be engaged through a closed tender process, given the specialised nature of this activity.

 

The department will procure a number of services to deliver the five activities as outlined above. The procurements will be undertaken in accordance with applicable legislative requirements under the PGPA Act, the Commonwealth Procurement Rules (CPRs) and the department's Accountable Authority Instructions. A range of procurement methods may be used such as open and limited tenders or procurements under existing arrangements. The selection of which procurement method to use will depend on the activity.

 

Final spending decisions will be made by the Secretary of the department or an appropriate delegate in line with the relevant Instrument of Delegation provisions in line with the PGPA Act and the Financial Framework (Supplementary Powers) Act 1997. The financial delegate will have the relevant skills, qualifications and experience to perform this administrative function.

 

Procurement decisions will be made in accordance with the Commonwealth resource management framework, including the PGPA Act and the CPRs. The department will provide an opportunity for suppliers and tenderers to make complaints if they wish, and to receive feedback. These complaints and inquiries can be made at any time during the procurement process, and will be handled in accordance with probity requirements. Information about the tender and the resultant contracts will be made available on AusTender (www.tenders.gov.au) once the contracts are signed. Procurement decisions will be based on value for money, including capability and capacity to deliver, and price and risk considerations.

 

Funding decisions made in relation to the program will not be subject to independent merits review as they are decisions relating to the allocation of a finite resource, from which all potential claims for a share of the resource cannot be met. In addition, any funding that has already been allocated would be affected if the original decision was overturned. The Administrative Review Council (ARC) has recognised that it is justifiable to exclude merits review in relation to decisions of this nature (see paragraphs 4.11 to 4.19 of the guide, What decisions should be subject to merit review? (ARC guide)).

 

The remaking of a procurement decision after entry into a contractual arrangement with a successful provider is legally complex, impractical, and could result in delays to providing services to platform users. The Government Procurement (Judicial Review) Act 2018 enables suppliers to challenge some procurement processes for alleged breaches of certain procurement rules. This legislation might provide an additional avenue of redress (compensation or injunction) for dissatisfied providers or potential providers, depending on the circumstances.

 

Extensive consultation has occurred for tobacco and e-cigarette control, including to develop the Strategy and for e-cigarette regulatory reform via the Therapeutic Goods Administration (TGA). Public consultation for the Strategy occurred in 2018 and 2022. The TGA undertook public consultation from November 2022 to January 2023 on e-cigarette regulation. Proposed investment aligns with feedback received as part of these consultations.

 

In addition, two roundtable consultation events with tobacco and e-cigarette control experts were hosted by the Minister for Health and Aged Care in September 2022 and April 2023. These events also indicated broad support for the need for campaign activity and improved cessation supports in conjunction with regulatory reforms.

 

Further information on the nature of consultation that has occurred, or will occur, on the specific elements of the investment is outlined below:

 

The Government will lead collaborative action across all levels of government and the public health sector to optimise campaign delivery and avoid duplication of efforts. Support for collaborative campaign action aimed at youth has been expressed through the Education Ministers Meeting and through the Health Ministers Meeting.

 

In relation to the Smoking and vaping cessation activities, the department will consult with the Digital Transformation Agency, as well as stakeholders listed below.

• Activity 1: the department consulted with Cancer Council Victoria on the functionality and activities of the online hub. Cancer Council Victoria's advice was also informed by members of the National Quitline Advisory Committee, of which Cancer Council Victoria is chair and the department an observer.
• Activity 2: the department consulted internally and with the current provider as to the possible updates required to the hub to bring in line with modern technology.
• Activity 3: the department has engaged with the National Quitline Advisory Committee to understand issues faced. Negotiations with states and territories in respect to best use of funding will commence shortly.
• Activity 4: consultations with RACGP and PSA in respect to this activity will commence shortly. The proposal is in line with recommendations of the National Quit Centre Advisory Committee.
• Activity 5: the department consulted with the National Quit Centre in the development of this measure.

 

Total funding of $92.9 million for the program was included in the 2023-24 Budget under the measure 'Vaping Regulation Reform and Smoking Cessation Package' for a period of four years commencing in 2023-24. Details are set out in Budget 2023-24, Budget Measures, Budget Paper No. 2 at page 154.

 

Funding for this item will come from Program 1.5: Preventing Health and Chronic Disease Support, which is part of Outcome 1. Details are set out in the Portfolio Budget Statements 2023-24, Budget Related Paper No. 1.9, Health and Aged Care Portfolio at page 36.

 

Noting that it is not a comprehensive statement of relevant constitutional considerations, the objective of the item references the external affairs power (section 51(xxix)) of the Constitution.

 

External affairs power

 

Section 51(xxix) of the Constitution empowers the Parliament to make laws with respect to 'external affairs'. The external affairs power supports legislation implementing Australia's international obligations under treaties to which it is a party.

 

World Health Organisation Framework Convention on Tobacco Control [2005] ATS 7

 

Australia has the following international obligations under Articles 5, 12 and 14 of the World Health Organisation Framework Convention on Tobacco Control [2005] ATS 7 (the Convention).

 

Article 5 of the Convention obliges parties to develop, implement, periodically update and review comprehensive multisectoral national tobacco control strategies, plans and programmes in accordance with the Convention.

 

Article 12 of the Convention obliges parties to promote and strengthen public awareness of tobacco control issues, using all available communication tools, as appropriate.

 

Article 14 of the Convention obliges each party to develop and disseminate appropriate, comprehensive and integrated guidelines based on scientific evidence and best practices, taking into account national circumstances and priorities, and to take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence.

 

Expenditure under the national public health campaigns, especially to target at-risk population groups and young people, is a key initiative of the Strategy as well as expanding smoking and vaping cessation activities through specialised programs and health services to support Australians to quit smoking and vaping. 

 

New table item 622 establishes legislative authority for government spending on the Youth Suicide, Self-Harm and Waitlist Management Strategy (collectively known as two initiatives).

 

The two initiatives commenced in 2019-20 and are delivered by headspace Newcastle, as commissioned by the Hunter New England and Central Coast (HNECC) Primary Health Network (PHN). Since commencement, the initiatives have supported more than 4,800 young people, supported by the commissioning and use of a second building at the original location. The initiatives have previously been extended, with additional funding provided through the 2022-23 October Budget to continue throughout 2022-23. Funding ceases on 30 June 2023.

 

The initiatives form part of the Extension of Terminating Mental Health Measures - Child and Youth Mental Health measure announced in the 2023-24 Budget, which include:

• $4.0 million in 2023-24 to continue operation of the headspace Digital Work and Study program to provide clinical integrated employment and education support to young Australians whose mental health is a barrier to work and study;
• $2.3 million over 2 years from 2023-24 to the Raise Foundation to continue its Student Mentoring Program; and
• $0.7 million in 2023-24 for headspace Newcastle to deliver the region's Youth Suicide, Self-Harm and Waitlist Management Strategy.

 

Legislative authority through table item 622 is required for the continuation of the initiatives for an additional year from 2023-24.

 

The initiatives are comprised of two activities: Youth Suicide and Self-Harm Program (the Program) and Waitlist Management Strategy (the Strategy).

 

The Program was proposed in recognition of the need to provide services for young people, aged 12-25 years presenting to headspace Newcastle who are assessed to be at risk of suicide or self-harm, and who would otherwise not be able to access timely and appropriate services. The Program will receive funding of $356,204 and aim to provide fast response psychological support for young people and their families who are at moderate to high risk of, or who have, attempted suicide or deliberate self-harm primarily in response to a situation crisis, with or without a diagnosed mental disorder. The Program would also support people bereaved of suicide.

 

The Strategy has seen the adoption of a comprehensive waitlist risk monitoring and review process, including regular contact with young people aged 12-25 years and their families who are on the waitlist to review and support their needs. In addition, digital mental health platforms and programs have been introduced where appropriate to assist young people commence basic psycho-education and low intensity interventions whilst waiting for a
face-to-face appointment with a clinician. As part of the Strategy, the HNECC PHN has undertaken recruitment of additional Mental Health Clinicians and Support Workers to deliver brief online intervention and address the increasing demand. Funding of $304,957 will be available to the Strategy.

 

The continuation of these initiatives will ensure headspace Newcastle has ongoing capacity to respond to the increasing demand and complexity of care required for vulnerable groups of young people, particularly those with increased self-harm, suicidal ideation or high levels of distress.

 

Funding for the initiatives will be provided to the HNECC PHN through a closed,
non-competitive grant process. This has been determined due to the HNECC PHN being responsible for commissioning headspace Newcastle to deliver the initiatives. This is in accordance with applicable legislative requirements under the PGPA Act and the Commonwealth Grants Rules and Guidelines 2017 (CGRGs).

 

Consistent with the requirements under the PGPA Act and the CGRGs, the delegate of the Minister for Aged Care, being a Senior Executive Officer of the department, with relevant expertise and skills, will make the final decision and approve funding. The Minister's delegate will consider whether the proposal represents an efficient, effective, ethical and economical use of Commonwealth resources, and whether any specific requirements need to be imposed as a condition of funding.

 

The decision of the Minister's delegate is final in all matters, including:

• the approval of the grant;
• the grant funding amount to be awarded; and
• the terms and conditions of the grant.

 

The grant guidelines, assessment criteria and information about the grant decision will be available at www.health.gov.au. Funding will be administered through the Commonwealth Grants Hub, noting the grant agreement will be managed by the department.

 

Funding will be provided to the HNECC PHN through a future Deed of Variation to its Primary Mental Health Care Schedule.

 

Funding decisions made in connection with the grant are not considered suitable for independent merits review because the scope is limited to one Primary Health Network, the expenditure is time-limited and the activity represents a locally-designed service offering. The ACR has acknowledged that it is justifiable to exclude merits review in relation to decisions of this nature (see paragraphs 4.16 to 4.19 of the ARC guide).

 

To reconsider this decision under merits review would substantially impact headspace Newcastle's ability to continue implementing the initiatives and would impede the policy intent of responding to the increasing demand and complexity of care required for vulnerable groups of young people.

 

The HNECC PHN and headspace National were consulted in developing and implementing the proposal following the suicide of a young person on the waitlist to access services through headspace Newcastle in 2019. The PHN has also continued consultations with the local community to ensure the initiatives remain appropriate and continue to meet their objectives. Letters of support were received from the PHN, Local Member and headspace Newcastle staff to support continuation of the program beyond its initial tenure
(beyond 30 June 2022).

 

The results of this consultation have validated the implementation of these initiatives. The PHN has a demonstrable track record of delivering locally-tailored youth mental health services that remain consistent with the existing headspace model.

 

Funding of $6.9 million, which includes $0.7 million for the initiatives was included in the 2023-24 Budget under the measure 'Mental Health' for a period of two years commencing in 2023-24. Details are set out in Budget 2023-24, Budget Measures, Budget Paper No. 2 at pages 139-140.

 

Funding for this item will come from Program 2.3: Pharmaceutical Benefits, which is part of Outcome 2. Details are set out in the Portfolio Budget Statements 2023-24, Budget Related paper No. 1.9, Health and Aged Care Portfolio at page 80.

 

Noting that it is not a comprehensive statement of relevant constitutional considerations, the objective of the item references the external affairs power (section 51(xxix)) of the Constitution.

 

External affairs power

 

Section 51(xxix) of the Constitution empowers the Parliament to make laws with respect to 'external affairs'. The external affairs power supports legislation implementing Australia's international obligations under treaties to which it is a party.

 

Australia has international obligations under Articles 2 and 12(2) of the International Covenant on Economic, Social and Cultural Rights (ICESCR).

 

Article 2 of the ICESCR obliges each State Party to take steps, to the maximum of its available resources, with a view to achieving progressively the full realisation of the rights recognised in the ICESCR by all appropriate means, including the adoption of legislative measures.

 

Article 12(2)(c) of the ICESCR obliges States Parties to achieve the full realisation of the right of everyone to the highest attainable standard of physical and mental health via the prevention, treatment and control of epidemic, endemic, occupational and other diseases and the creation of conditions which would assure to all medical service and medical attention in the event of sickness.

 

Expenditure under this item will ensure that headspace Newcastle has the resources required to continue to provide psychological support to young people and their families who are at risk of suicide, self-harm or suffering from poor mental health.

Attachment B

 

Statement of Compatibility with Human Rights

 

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

 

Financial Framework (Supplementary Powers) Amendment (Health and Aged Care Measures No. 3) Regulations 2023

 

This disallowable legislative instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

 

Overview of the legislative instrument

 

Section 32B of the Financial Framework (Supplementary Powers) Act 1997 (the FF(SP) Act) authorises the Commonwealth to make, vary and administer arrangements and grants specified in the Financial Framework (Supplementary Powers) Regulations 1997 (the FF(SP) Regulations) and to make, vary and administer arrangements and grants for the purposes of programs specified in the Regulations. Schedule 1AA and Schedule 1AB to the FF(SP) Regulations specify the arrangements, grants and programs. The powers in the FF(SP) Act to make, vary or administer arrangements or grants may be exercised on behalf of the Commonwealth by Ministers and the accountable authorities of non-corporate Commonwealth entities, as defined under section 12 of the Public Governance, Performance and Accountability Act 2013.

 

The Financial Framework (Supplementary Powers) Amendment (Health and Aged Care Measures No. 3) Regulations 2023 amend Schedule 1AB to the FF(SP) Regulations to establish legislative authority for government spending on certain activities administered by the Department of Health and Aged Care.

 

This disallowable legislative instrument adds the following table items to Part 4 of
Schedule 1AB:

*         table item 621 'Smoking and Vaping Cessation'; and

*         table item 622 'Youth Suicide, Self-Harm and Waitlist Management Strategy'.

 

Table item 621 - Smoking and Vaping Cessation

 

Table item 621 establishes legislative authority for government spending on the Smoking and Vaping Cessation program (the program) to support people to quit smoking and vaping.

 

Tobacco use remains the leading cause of preventable death and disability in Australia and use of e-cigarettes including nicotine vaping products (vapes) is rapidly increasing. Nicotine is highly addictive and poses serious health risks, and medical experts have serious concerns about the health effects of other harmful substances in vaping products. There is strong and consistent evidence that young people who vape are three times as likely to take up smoking compared to those who do not vape. In addition, e-cigarette use among young people is leading to nicotine addiction for a cohort that would otherwise have a low risk of tobacco use.

 

In response to these significant health concerns, the Australian Government will provide funding of $92.9 million over four from 2023-24 to fund action to reduce smoking and vaping rates, particularly among young Australians, through:

• public health information campaigns on vaping and tobacco controls - $63.4 million will fund a national targeted smoking and vaping public health campaign; and a youth vaping education national campaign to drive and support tobacco and e-cigarette cessation attempts, denormalise smoking and vaping, increase support in the community for quitting, and reduce the likelihood of people substituting smoking for vaping (or vice versa); and
• smoking and vaping cessation activities - $29.5 million will fund specialised programs and health services to support Australians to quit smoking and vaping. Activities will include establishing an online national quitting support hub; redeveloping and modernising the existing My Quit Buddy mobile app to include vaping; increasing the capacity of state and territory Quitline and Quit services; and updating clinical guidance to support the health workforce.

 

Human rights implications

 

Table item 621 engages the following human right:

*         the right of everyone to the enjoyment of the highest attainable standard of physical and mental health - Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR), read with Article 2.

 

Right of everyone to the enjoyment of the highest attainable standard of physical and mental health

 

Article 2 of the ICESCR requires each State Party to the Covenant to undertake to guarantee the rights recognised in the Covenant to be exercised without discrimination of any kind, including race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status.

 

Article 12 of the ICESCR provides for the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. The right to health includes, in Article 12(1)(c), the right to the prevention, treatment and control of diseases.

 

The United Nations Committee on Economic, Social and Cultural Rights states that health is a 'fundamental human right indispensable for the exercise of other human rights' and that the right to health is not to be understood as the right to be healthy, but includes the right to a system of health protection which provides equal opportunity for people to enjoy the highest attainable level of health.

 

In 2019, 2.5 per cent of Australians aged 14+ reported e-cigarette use (daily, weekly, monthly, or less than monthly). Findings from a Cancer Council Victoria report show that in 2022 in Australia, 7.7 per cent of people aged 14+ currently used e-cigarettes. While the prevalence of exclusive smoking is trending down, the report found the prevalence of vaping and dual product use (both vaping and smoking) trended up. Vaping prevalence was highest in the 14 to 17, 18 to 24, and 25 to 34 years age groups.

 

All e-cigarette users are exposed to chemicals and toxins that have the potential to cause adverse health effects. Importantly, there is evidence that e-cigarettes are a gateway to smoking and vaping by young people.

 

Tobacco use remains the leading cause of preventable death and disability in Australia, and is responsible for approximately 21,000 deaths each year.

 

Tobacco use causes more deaths than any other behavioural risk factor. Up to two-thirds of deaths in tobacco smokers can be attributed to smoking, and long-term smokers die an average of 10 years earlier than non-smokers. Exposure to second-hand smoke is also a cause of preventable death and disability in adults and children.

 

Tobacco use remains the biggest contributor to Australia's preventable health burden, contributing 8.6 per cent of the total burden of disease in 2018 and 12 per cent of the total preventable health burden for First Nations people. Tobacco use compounds health and social inequalities and is a major contributor to poorer health status in socioeconomically disadvantaged populations.

 

People who smoke and/or use vape products, including priority population groups, particularly young people, will be affected by these changes as they are the key audience for public health campaigns and cessation support services. Health workforces will also be impacted as the audience for targeted education and training. All Australians will benefit from the reduced burden on the health system as a result of reduced smoking and vaping prevalence.

 

Table item 621 is a positive step to promote the right to health by ensuring that a person who needs support to quit using tobacco or vaping products is able to access support and services required to assist them. It also informs people's knowledge about the harms caused by tobacco, nicotine and vaping products through the public health information campaign. The prevalence of e-cigarette use is rapidly increasing, particularly among young people, leading to nicotine addiction for a cohort that would otherwise have a low risk of tobacco use.

 

Reducing smoking prevalence and the associated disease burden will reduce pressure on the health system and increase productivity in the workforce.

 

Table item 621 is compatible with human rights because it advances the protection of human rights and to the extent that it may also limit human rights, those limitations are reasonable and proportionate. Table item 621 promotes the right to health by aiming to reduce smoking and vaping rates and thereby reduce the significant health and economic effects of tobacco and e-cigarette usage.

 

Conclusion

 

Table item 621 is compatible with human rights because it promotes the protection of human rights.

 

Table item 622 - Youth Suicide, Self-Harm and Waitlist Management Strategy

 

Table item 622 establishes legislative authority for government spending on the Youth Suicide, Self-Harm and Waitlist Management Strategy.

 

The Youth Suicide, Self-Harm and Waitlist Management Strategy commenced in 2019-20 and is delivered by headspace Newcastle, as commissioned by the Hunter New England and Central Coast (HNECC) Primary Health Network (PHN). Since commencement, it has supported more than 4,800 young people, supported by the commissioning and use of a second building at the original location. The Youth Suicide, Self-Harm and Waitlist Management Strategy has been extended, with additional funding of $0.7 million provided in the 2023-24 Budget for headspace Newcastle to continue the following two activities:

 

The Youth Suicide and Self-Harm Program - which was proposed in recognition of the need to provide services for young people (12-25) presenting to headspace Newcastle who are assessed to be at risk of suicide or self-harm, and who would otherwise not be able to access timely and appropriate services. The Program aims to provide fast response psychological support for young people and their families who are at moderate to high risk of, or who have, attempted suicide or deliberate self-harm primarily in response to a situation crisis, with or without a diagnosed mental disorder. The Program would also support young people bereaved of suicide.

 

The Waitlist Management Strategy - has seen the adoption of a comprehensive waitlist risk monitoring and review process, including regular contact with young people and their families who are on the waitlist to review and support their needs. In addition, digital mental health platforms and programs have been introduced where appropriate to assist young people commence basic psycho-education and low intensity interventions whilst waiting for a
face-to-face appointment with a clinician. As part of the Strategy, the HNECC PHN has undertaken recruitment of additional Mental Health Clinicians and Support.

 

The continuation of these activities will ensure headspace Newcastle has ongoing capacity to respond to the increasing demand and complexity of care required for vulnerable groups of young people, particularly those with increased self-harm, suicidal ideation or high levels of distress.

 

Human rights implications

 

Table item 622 engages the following human rights:

*         the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health - Article 24 of the Convention on the Rights of the Child (CRC), read with Article 4; and

*         the right of everyone to the enjoyment of the highest attainable standard of physical and mental health - Article 12 of the ICESCR, read with Article 2.

 

Right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health

 

Article 4 of the CRC requires each State Party to undertake all appropriate legislative, administrative, and other measures for the implementation of the rights recognised in the CRC.

 

Article 24 of the CRC requires that States Parties recognise the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties are required to strive to ensure that no child is deprived of his or her right of access to such health care services.

 

Right of everyone to the enjoyment of the highest attainable standard of physical and mental health

 

Article 2 of the ICESCR requires each State Party to undertake all necessary steps to achieve the full realisation of the rights recognised in the present Covenant.

 

Article 12 of the ICESCR requires that States Parties recognise the right to the highest attainable standard of physical and mental health. 

 

Funding for the Youth Suicide, Self-Harm and Waitlist Management Strategy promotes these human rights to health by providing increased support to vulnerable groups of young people, particularly those with increased self-harm, suicidal ideation or high levels of distress.

 

Conclusion

 

Table item 622 is compatible with human rights because it promotes the protection of human rights.

 

 

 

 

Senator the Hon Katy Gallagher

Minister for Finance