28 November 2024

The Hon. R.A. SIMMS (17:11): I rise to speak in favour of the bill on behalf of the Greens. The Greens know that prevention is better than cure, not to mention being cheaper and more cost effective. We know we must find ways to keep people healthier throughout their lives rather than just treating illnesses once people get sick.

Successive reviews, both internationally and in Australia, have recommended that governments reorient their health systems towards primary and preventive health care. I think that is particularly important in the context of the debate that we are having around ramping in our state. We know that when you prevent people from being ill that also reduces the pressure that our hospital system is under. It is essential to ensure we have a healthy community and to reduce the strain of our emergency departments and hospitals.

The health of South Australians can be turned around with the right care, support and interventions early on. Primary health care is crucial to the provision of a responsive, effective and high-quality health system. Indeed, it is better to build a fence at the top of the cliff than to simply have an ambulance waiting at the bottom. Unfortunately, preventive health care has not always received the attention that it deserves in our state, but we do welcome this move by the government.

I want to acknowledge, as I have often in this place, the leadership of Minister Picton. He is someone who is passionate about preventive health, and I think he has a very strong track record. If you look at the legislation that he has explored during his time as minister, he has a very strong track record of trying to move our state further in the prevention space, and we certainly welcome that.

The Greens hope the Preventive Health SA agency will receive the funding it needs to carry out its essential work. We look forward to reading the strategic plan that Preventive Health SA will release in 2026, and we look forward to seeing the priorities and measures the agency will identify as key to improving the health and wellbeing of South Australians. Indeed, for my part, I will continue to push for action on childhood obesity.

Members will be aware that I have a bill that I plan to introduce into parliament in the new year, which is currently being drafted, that will prevent fast-food restaurants from popping up near schools. I have another bill to prevent junk food being advertised on public assets and within 500 metres of schools, and I intend to continue to advance that in the new year.

For now, it is important to note that the Greens support the passage of this bill. We do hope it leads to a more comprehensive approach to promoting the health of South Australians, and ultimately we hope it leads to a greater focus on primary healthcare services and preventive health because we know that this will benefit everybody in our community.

27 November 2024

The Hon. R.A. SIMMS (17:21): I move:

That this council—

1. Recognises that 1 December is World AIDS Day.

2. Notes that the Australian theme for 2024 is It Starts With Me.

3. Notes that approximately 1,400 people are estimated to be living with HIV in South Australia.

4. Acknowledges the success of South Australia’s public health response to HIV, and that new infections have been declining over the last 10 years with people living with HIV now able to live a long, healthy life as a result of:

(a) antiretroviral therapy medication;

(b) community-led initiatives through grassroots organisations;

(c) peer education by including priority populations in responses;

(d) harm reduction through needle and syringe programs; and

(e) prevention through regular testing and interventions such as PrEP and condom use.

5. Calls on the Malinauskas government to continue the commitment to virtually eliminate HIV transmission by 2030 and reduce the impact of HIV on those living with the virus in the community by committing to the full implementation of the Ninth National HIV Strategy:

(a) empowering communities to educate, raise awareness and combat stigma and discrimination;

(b) allocating sufficient funding for high-quality HIV testing, care and treatment, prevention, advocacy and research; and

(c) expanding access to high-quality support services to affected and at-risk communities.

This motion is recognising that 1 December is World AIDS Day. It notes the Australian theme for 2024 is It Starts With Me, and it notes that there are approximately 1,400 people living with HIV in our state. It also acknowledges the success of South Australia's public health response to HIV and notes that new infections have been declining over the last 10 years, with people living with HIV able to live long and healthy lives.

It also calls on the Malinauskas government to continue its commitment to virtually eliminate HIV transmission by 2030 and reduce the impact of HIV on those living with the virus in the community by committing to the full implementation of the Ninth National HIV Strategy. Some of the elements of the strategy are outlined in the motion.

World AIDS Day is an international day that began in 1988. It is held on 1 December each year to help raise awareness about HIV and AIDS. The human immunodeficiency virus (HIV) is a virus that affects the immune system. It gradually destroys cells called CD4 cells, which usually help the body stay healthy by fighting off disease. While there is no vaccine or cure for HIV infection, there are effective treatments that can prevent the transmission of HIV and the progression to AIDS, and help ensure a near-normal life expectancy for people who are HIV positive. These treatments are known as antiretroviral therapy. They stop the virus from reproducing itself, which can lead to a lower viral load. The treatment involves a combination of drugs being used together.

HIV positive people who take antiretrovirals daily, as prescribed, and achieve and maintain an undetectable viral load are not able to sexually transmit the virus to a partner who is HIV negative. That is one of the really great innovations that we have seen in HIV prevention in this country over the last few years, and it is one of the reasons why it is so important that people who are at risk of acquiring the virus, in particular men who have sex with men, should ensure that they are being tested regularly for HIV. If they are considered to be at high risk of acquiring the virus, in consultation with their doctor they should get access to PrEP, the medication that can be taken daily which reduces the risk of HIV significantly.

Thanks to the improvement in HIV treatments, infection is now a manageable chronic disease for many people in countries like Australia. Globally, there has been a 60 per cent reduction in the number of new HIV infections since the peak of the virus in 1995. According to the Kirby Institute at the University of New South Wales, Australia is tracking well towards the elimination of HIV transmission in our country, with just 555 new diagnoses in 2022. This represents a decline of 48 per cent over the last 10 years. That is really significant.

Australia is also leading the world in HIV reductions in gay and bisexual men, achieving a remarkable 57 per cent reduction in new HIV diagnoses since 2013. This really demonstrates the success of comprehensive approaches to HIV prevention that have been made within the LGBTI community. I think it is worth noting what some of these approaches are. They include:

• community-led health promotion strategies, such as those run in SA by SAMESH;
• regular sexual health testing and treatment through facilities like the O'Brien Street Practice and the Adelaide Sexual Health Centre;
• treatment as a prevention, and by that I mean the finding that an HIV positive partner on effective HIV treatment cannot transmit the virus to a negative partner; and
• the rollout of PrEP.

I have spoken a bit about PrEP. Indeed, I was proud, during my time in federal parliament, to advocate for PrEP to be listed on the PBS, and I certainly welcomed the decision of the Turnbull government to do so. That has been carried on by the successive Labor government. Other effective preventative measures more broadly include increased condom use and harm reduction through a needle and syringe program, such as the Clean Needle Program that is run by SA Health.

In South Australia there are estimated to be 1,400 people who live with the HIV virus. Worldwide, though, there are still estimated to be 39.9 million cases. Whilst we have made huge strides here in our own country, and indeed here in South Australia, in tackling the AIDS virus and preventing transmission, sadly this is still a prevalent virus around the world. There are many people who are continuing to die from AIDS because they do not have access to treatment, particularly in developing countries.

World AIDS Day is also a time to reflect on the huge social effect of HIV and AIDS and the terrible loss of life that has occurred over the last 40 years. Indeed, more than 42.3 million people have died as a result of AIDS-related illnesses throughout the world. Of course, we honour them on World AIDS Day and we grieve for the loss of life.

I think it is worth noting, when talking about World AIDS Day, that such was the stigma associated with HIV at the height of the AIDS virus that many people, particularly gay men, were forced to die in isolation, separated from family and friends at this tragic time in their lives. I think one of the great changes that we have seen in Australia over the last several decades is that the campaign to end stigma around HIV has been very effective, and there is a broader understanding of the HIV virus and, in particular, a broader understanding of how this virus is transmitted and what can be done to reduce the transmission. That understanding has meant that people who are HIV positive are able to live happy and fulfilling lives and are able to be members of the community that can live their lives free from discrimination.

The theme of the 2024 World AIDS Day event in Australia is It Starts With Me, which highlights that the fight against HIV is still far from over and calls on everyone to take the actions they can to raise awareness, challenge stigma and support people living with HIV.

In closing, in the lead-up to World AIDS Day on 1 December, people may be asking what they can do. This is a time for members of the South Australian community to show their support for people living with HIV, to raise awareness about HIV prevention, treatment and care within their communities, to do what they can to eliminate stigma and discrimination around HIV and to remember people who have died of AIDS-related illnesses.

It is also a time for governments to continue the commitment that has been a multiparty commitment in Australia over many years now to reduce the prevalence of HIV in the community. This includes adopting initiatives such as empowering communities to educate, raise awareness and combat stigma and discrimination, and allocating sufficient for high-quality HIV testing. I note the Malinauskas government recently made rapid HIV testing available at some key sites in South Australia. I welcome that, I think it is an excellent innovation. It is excellent that people are able to get their results in a timely manner and are able to access support from healthcare professionals when they deal with those results.

It is vital that we continue care, treatment, prevention, advocacy and research in this area, and we need to expand access to high-quality support services to affected and at-risk communities. I believe that it is possible for us to end the transmission of the HIV virus in Australia. We need to do what we can to combat this virus internationally as well and support people, particularly in developing countries, to access the treatment and support they need. With that, I conclude my remarks.

13 November 2024

The Hon. R.A. SIMMS (16:10): I move:

That this council—

1. Notes that not-for-profit hospitals such as Burnside Hospital, Glenelg Community Hospital, North Eastern Community Hospital and the Stirling Hospital play a pivotal role in providing health care for local communities.

2. Recognises that these hospitals partner with local health networks to deliver critical services, playing an important role in reducing the patient load burden on public hospitals.

3. Notes that the new national standards introduced by the Australian Commission on Safety and Quality in Health Care, in particular standard AS4187 (now AS5369):

(a) imposes tighter minimum requirements for health service organisations’ compliance with reprocessing of reusable medical devices in health service organisations; and

(b) will necessitate major multimillion-dollar infrastructure upgrades at some health service organisations to remain compliant.

4. Calls on the Malinauskas government to make available no-interest loans to community hospitals to allow them to undertake the necessary infrastructure upgrades to remain operational.

On 14 December 2023, the Australian Commission on Safety and Quality in Health Care introduced new standards aimed at better protecting patients undergoing surgery. The commission was tasked with reviewing licensing standards around hospitals, day procedure centres and clinics where cosmetic procedures were being performed. This followed a joint investigation between Four Corners and Nine newspapers, which found that doctors without specialist qualifications were operating on patients in privately funded facilities with serious hygiene and safety breaches.

The Greens, of course, welcome the more stringent standards that have been put in place; it is appropriate that that occur. But this does mean that many not-for-profit community hospitals will need to undertake extensive infrastructure upgrades in order to meet these standards, and that is going to put a significant cost burden on those hospitals.

The Glenelg Community Hospital, for instance, I understand requires $8 million to upgrade their sterilisation department to meet these new requirements. I understand that the Stirling Hospital would require in excess of $50 million to undertake major infrastructure upgrades, including resizing operating theatres and replacing the building's water filtration system. Their most pressing challenge is upgrading the ventilation system in their theatre and procedure rooms, which is estimated to cost half a million dollars.

As not-for-profit community hospitals, any surpluses made by these hospitals are automatically reinvested back into the hospital infrastructure, the equipment and staff, so these major infrastructure upgrades are beyond their normal annual expenditure, and they do not have the capital reserves required to provide for these infrastructure upgrades.

The private health sector in South Australia is facing increased pressure. It is not my role to advocate for the private health system, but what we are talking about here is a community hospital that provides a very important community service. The closure of local hospitals at a community level has put increased strain on the public system. Indeed, over the last decade rising costs for consumables, wages and services have compounded the challenges that these small hospitals face. Furthermore, revenue from health insurance has not kept pace with the true cost of care delivery.

Despite these challenges not-for-profit community hospitals play an important role in not only providing health care delivery to their respective communities but also in reducing the patient loan burden. I understand, for instance, that the Stirling Hospital partners with the Southern Adelaide Local Health Network to deliver critical services such as ear, nose and throat care, and this is a really important partnership.

I also note that in the last financial year, ending June 2024, the Stirling Hospital had a total of 4,212 patient admissions, including 3,315 day surgeries and 595 overnight stays. The Glenelg Community Hospital in the same period treated over 7,000 patients and works with SA Health on waiting list initiatives and care for special needs children for dental surgery.

These are hospitals that provide a vital community service, particularly, might I say, the hospital in Stirling. It operates in an area where there are not local hospitals. It is a critical service for that community, and its future hangs in the balance as a result of this new regulatory regime. The Greens are calling on the Malinauskas Labor government to make interest-free loans available to these not-for-profit hospitals so that they can undertake the necessary upgrades so that they can do the work that is required so that they can remain operational.

We are not saying 'give private hospitals a blank cheque'; we are talking about only three small community hospitals. This is a bespoke solution for those community not-for-profit hospitals so that they can remain operational. It would be easy for the government to make an interest-free loan available and to work with those hospitals to develop a repayment plan down the track, and so I do urge the government to consider this as an option.

29 October 2024

The Hon. R.A. SIMMS (17:26): I rise to indicate support of this legislation on behalf of the Greens. The Greens have always supported a health approach to substance use. We believe that harm minimisation is the most appropriate way to reduce the adverse health, social and economic consequences of alcohol and the use of other drugs. We want to see a reduction in high-risk uses of nicotine and tobacco, as we acknowledge that they are substances that can cause significant harm. Of course, one of the risks around vaping and access to e-cigarettes is that if young people and children get access to these drugs from a very young age, they are going to be using them potentially throughout the life cycle.

It is important for us that there are supports in place to help young people under the age of 15 to move away from nicotine. This is an argument that the Greens have consistently made in the federal parliament and, indeed, in July when the federal government moved to ban the importation, manufacture, sale, supply and commercial possession of vapes in Australia, the Greens made that point.

In the vaping reforms passed by the federal parliament in June, the Greens negotiated with the Albanese government in Canberra to secure some positive measures to support a health approach in relation to e-cigarettes and vapes. Under this new agreement, GPs can continue to prescribe therapeutic vapes. Possession of quantities for personal use will not be subject to criminal charge. There will be a review of the legislation after three years and additional funding will be provided to support young people quitting vaping. I note that this will be of benefit to young people in South Australia as well.

We know that this proposed bill will bring South Australia into line with changes made at the federal level. Some of the changes include increasing penalties for the sale to children, of selling tobacco without a licence, advertising tobacco or cigarette products, or smoking in a smoke-free area. We also welcome the establishment of a five-metre smoke-free and vape-free buffer at public transport stops to support the health of people who are waiting for public transport.

I might take this opportunity to recognise the leadership of Minister Picton. I think he has been a real national leader in this space. Indeed, I recognise his work as a political staffer when he worked for the Hon. Nicola Roxon when she was federal health minister on world-leading legislation to ban tobacco advertising, in effect, on tobacco packets and to implement plain cigarette packaging.

That was a world-leading piece of legislation and I know that before he was a minister Chris Picton worked on that. Here in this parliament the minister has taken up the fight against the big tobacco companies, so I commend him for that. I also echo the statements made by the Hon. Frank Pangallo that the next step here is surely to phase out the use of cigarettes over time, and the Greens are certainly supportive of the Hon. Frank Pangallo's bill.

I also thank the minister for the collegial way in which he has worked with the Greens in approaching this bill. When the legislation came forward, one of the issues we were concerned about was the potential for young people to be involved in controlled purchase operations or, in effect, sting operations. Our concern was that you could see very young people being involved in these operations, potentially being put at risk, and that appropriate safeguards were not in place. I understand that issue was also of concern to the opposition.

We did not want to go down the path of entirely banning this practice, because we have had advice from the government that the involvement of young people in these operations is of benefit to the broader scheme, because it acts as a potential deterrent. My amendment strikes an appropriate balance between protecting the young people involved and ensuring their safety, whilst also protecting the integrity of the government's scheme. To save time I will talk the chamber through those amendments now during the second reading stage, so that I do not have to do so in committee.

The Greens are proposing that a designated person—that is, a person who can participate in a controlled purchase operation—means a child who is or above the age of 16 years, so in effect it restricts the participation in these activities to 16 and 17 year olds. It makes clear that the minister cannot authorise a designated person to be a controlled purchase officer unless the parent or legal guardian of the person has consented in writing.

The third very important element, which I think points to the issue the Hon. Frank Pangallo raised, is that the authorised officer responsible for supervising any controlled purchase operation involving a designated person—that is, someone who is 16 or 17—will be required to undertake an assessment of the operation and must ensure that appropriate measures are in place to ensure the safety of the designated person during that operation.

I think that should allay some of the concerns honourable members have. It certainly allays the concerns the Greens had when we heard about the involvement of young people in these potential sting operations. I am encouraged by the comments made at the second reading stage that indicate there is broad support in this chamber for that approach.

16 October 2024

The Hon. R.A. SIMMS (20:26): I rise to speak against this bill. As noted by my colleague, the Hon. Tammy Franks, this is not simply a matter of conscience for the Greens, it is actually a matter of party policy for us. Our party has a very clear policy position in favour of recognising abortion as fundamental to health care.

I do want to say that it is always been a frustration for me that the two old parties approach issues of women's reproductive rights as conscience votes. It creates the impression that these issues are opt-in luxury items and it seems that whenever we are dealing with issues of gay rights or women's rights these become conscience votes of the old parties. I do find that a very frustrating state of affairs, particularly when they bind on so many other policy issues in this place that have a significant moral dimension.

I want to take a moment to reflect some of the Greens' policy and read that into Hansard. Our policy that we took to the last federal election was very clear:

The Greens will continue to support giving people choices over their bodies by ensuring access to safe and affordable sexual and reproductive healthcare.

We are committed to making access to abortion safe, accessible, legal and affordable across Australia.

As the Hon. Tammy Franks has stated, no matter who represents our party in the parliament, there is a clear commitment that we will defend women's reproductive rights in this place. It is very clear to me that this is going to be an important issue at the next state election, as it is over in Queensland, given the broad support for the radical proposition that the Hon. Mr Hood has put before the parliament from the Liberal side of politics, and so the Greens will be doing everything we can to resist this assault on women's reproductive rights in the days and months ahead.

I also want to acknowledge the leadership of my colleague, the Hon. Tammy Franks, over many years in this space. The Hon. Ms Franks has been a strong and tireless voice for the rights of women, in particular defending women's reproductive rights, and I really want to acknowledge her leadership. I know that it is valued by many, many people in the community and, indeed, it is an issue that has been raised with me many, many times when people reflect on the great work that the honourable member has done in this place. She has been a really staunch advocate, so I want to recognise her for her work on that.

I am opposed to this bill not only because it is Greens policy to stand for women's reproductive rights but also because I consider this bill to be morally reprehensible. There are already significant safeguards in place when it comes to women accessing late-term abortions. One of the things that has really upset me about this debate is the highly emotive and I think disrespectful language that has been used in relation to those women who have had to make that incredibly difficult decision, a decision that they are making in consultation with healthcare professionals, not politicians. These decisions should be made by women in consultation with healthcare professionals, not by members of parliament who seek to regulate what people do in their personal lives.

I want to reference some points made here by Professor Warren Jones. Professor Jones has had more than 45 years' experience working in the women's health field. This is a letter that he wrote to The Advertiser when this issue came on the agenda just a few weeks ago. He said:

It is clear that some have no knowledge of the emotional or physical trauma experienced by women with unplanned and unwanted pregnancies…

In Sydney in the early 1960s, I worked in a 24-bed hospital ward dedicated to the acute care of women who were recovering or dying from infection and haemorrhage after illegal abortions.

I then had similar experiences in England and campaigned for abortion law reform leading up to the passage of the enlightened UK Abortion Act in 1967.

Legalised and safe termination of pregnancy is now well established in SA. It is not in the purvey of community bias. It is solely a matter of a woman's rights and her choice.

The currently proposed, and politically motivated, private member's Bill is dangerous to women.

Severe mental illness and critical medical disorders usually do not manifest until pregnancy is well advanced when a late but life-saving decision for termination must be taken by the woman and two doctors.

To make this decision conditional on the baby being adopted out is unethical and medically reprehensible.

I agree with Professor Warren Jones and, indeed, this appears to be the view of the overwhelming majority of healthcare professionals who work in this space and provide advice and support to women in these circumstances.

I also want to reference one of the other elements of this debate that I found really disturbing, and that is this kind of flippant way in which adoption has been talked about as a solution: 'Oh, well, these women should be forced to have the baby and then just put the baby up for adoption.' Again, I think the Liberal speakers who are offering that, and those in this debate outside who have put that solution forward, are being blind to history.

Back in 2012, there was a comprehensive Senate inquiry into forced adoption practices here in our country, looking at the significant effect that this practice had for women. It led to a national apology, recognising the long-term trauma that those practices did to those women. This parliament, here in South Australia, also provided an apology to those women. So, to simply dismiss their experience, and to sort of suggest that this is some kind of easy solution and easy pathway, again, I find demonstrates that the Liberals just do not get it.

This brings me to my next point, and that is what I see as being the far right's takeover of the South Australian Liberal Party, something that I see to be very disturbing here in this parliament. I think it is worth reflecting that this is the second private members' Wednesday, or second week in a row, when we have dealt with these thorny issues where we have seen Liberal speakers presenting world views that I think are wildly out of step with the broader South Australian community.

What we are seeing, I think, is an importation of the far-right politics of Donald Trump in the United States, and it is being brought into a South Australian context. That is really concerning, I think, in terms of what that means for this kind of debate here in South Australia. I know some people might find that shocking, but it is very clear that these tactics are being adopted and deployed here in South Australia, and I urge the Liberal Party not to go down this path because I see it as being very divisive and it is very dangerous.

If you look at what has unfolded over in the United States, where there has been a gradual erosion of women's rights, and in particular their right to access abortion, that is resulting in very dangerous health outcomes for women, and I do not want to see that kind of environment being created here in South Australia.

This is a matter of health care. It should not be a matter for politicians and, indeed, this was resolved some time ago. It is now being reopened in the context of a Liberal Party preselection that is coming down the line, and I think that is really regrettable. I hope that we are not going to see this sort of culture war politics being played out in the months and years ahead by the South Australian Liberal Party. In closing, I oppose this bill, and I urge all members to vote it down and to stand firm in standing up for women's reproductive rights.

15 October 2024

The Hon. R.A. SIMMS (15:48): I rise to speak in favour of the Automated External Defibrillators (Public Access) (Miscellaneous) Amendment Bill 2024 on behalf of the Greens. The Greens supported the automated external defibrillators public access bill twice: firstly in 2020 when the Hon. Frank Pangallo first introduced a private member's bill, which was opposed by the former Marshall government, and again when this bill came into law in 2022 with the support of the Malinauskas Labor government.

Again, we support this bill. We consider that it will aid in the implementation and rollout of defibrillators across the state in line with the intent of the original bill that was brought forward by the Hon. Frank Pangallo. I do want to acknowledge the work of the Hon. Frank Pangallo in this regard. The honourable member has been a long-term advocate in this space and I think really led the way on this. It is an exciting thing to see South Australia become the first state in the country to actually take action on this, so I commend the Hon. Mr Frank Pangallo for his leadership and of course I acknowledge the work of the minister, the Hon. Chris Picton, as well.

We know that defibrillators save lives when they are accessible. They are simple, they are easy to use and they are highly effective. The implementation of defibrillators in public access spaces is the result of advocacy from the Heart Foundation and the Ambulance Employees Association and a range of others as well. Indeed, I remember having a look at this debate years ago when I was on the Adelaide City Council when my then colleague Councillor Philip Martin moved for the city council to install some defibrillators, and I know that that has been a success at a council level.

The changes in this bill are sensible to ensure that these devices are publicly accessible without creating unnecessary burdens. They draw a distinction between the owner and the tenant of the building and this ensures that there will be greater clarity around the responsibility for maintaining these devices. There are also changes being made to the floor area definitions that will make it easier for organisations to provide access to defibrillators.

The bill also removes the annual testing requirement. I think that is an important change because we understand that annual testing has been found to diminish the life cycle of the product, which obviously was not what was intended. I note that the opposition have indicated that they will be moving amendments to this bill in response to the concerns that have been raised by the local government sector. I had the opportunity to meet with the Local Government Association yesterday to discuss their request for a new statutory immunity to protect councils from civil lawsuits that may arise where a defibrillator might have been stolen or vandalised and then a person has a heart attack and sues for damages.

In my second reading speech in relation to the Hon. Frank Pangallo's bill back in 2022, I highlighted the problem potentially being faced by councils with respect to batteries being stolen from these devices, particularly in rural areas. While I understand the intent of the opposition's amendments, and I do respect the advocacy work of the local government sector, I am concerned that these amendments could be seen as a watering down of the honourable member's bill and could potentially move us away from building owners taking responsibility for defibrillators, which I understand could rob the bill of its veracity, and that is of concern for me.

I also note that carve-outs are not being given to smaller organisations, such as sporting clubs or not-for-profit organisations, that will also have responsibility for the installation and maintenance of these devices. I also understand from some advice that has been provided to my office from the government that some of the legal concerns that have been flagged are potentially already addressed. I think the government will no doubt talk to that when they reflect on the opposition's amendments. I will listen closely to the debate but at this stage it is not the Greens' intention to support the Liberal amendments.

25 September 2024

The Hon. R.A. SIMMS (21:22): I rise to indicate that the Greens will be supporting the bill. The Hon. Mr Pangallo and I have disagreed on a few issues over the last few days but we do agree on this issue. I certainly support his efforts to tackle cigarette use, particularly among young people. I think this is a bold step in terms of taking a phased approach to stopping the sale of tobacco products to young people, initially, but of course what this bill does is phase out cigarette use among a whole new generation coming through. I think that is a worthy public policy initiative.

The bill prohibits the sale of tobacco products to anyone born after 1 January 2009, or people who are currently 15 years or younger. I do note that there is an amendment filed by the Hon. Frank Pangallo that changes that date to the year 2007, which would impact anyone who is 17 years or younger. I am happy to entertain that amendment should it be required to secure the passage of the bill through this place.

The Greens have always supported a health approach to substance use. We believe that harm minimisation is the most appropriate way to reduce the adverse health, social and economic consequences of alcohol and other drug use. We want a reduction in high-risk uses of nicotine and tobacco, as we acknowledge that they are substances that cause serious harm.

It is important for us to note that there are supports put in place to help young people under the age of 15 move away from nicotine; however, we note that this is a private member's bill, and those services would need to be provided by the government. I look forward to hearing from the government down the track around what they might do in that regard should this bill become law.

This is an argument that the Greens have made at a federal level. During the time when vaping reforms were passed by the federal parliament in June, the Greens argued that the increase in nicotine dependence is a significant public health problem. We want to keep tobacco and nicotine products out of the hands of kids, but we also want to ensure that people can access support to address their addiction when they need it.

We are pleased that this bill does not take a punitive approach to the possession of tobacco products but instead prohibits the sale of such products to young people. New Zealand was the first jurisdiction to ban smoking for future generations. It was accompanied by other measures to make smoking less affordable and accessible and included dramatically reducing the legal amount of nicotine in tobacco products. At the same time, they increased funding for health services and rolled out additional quitting services.

This was a comprehensive package of reforms and supports that was due to see health benefits at a significant level for people in New Zealand. Unfortunately, the new right-wing government in New Zealand has scrapped these reforms before they were due to be implemented in July this year. I think that is very disappointing. I also notice that the Tory government announced a plan to move down this path but never achieved that. I do hope, though, that governments in other jurisdictions take action on this.

The Greens will therefore be supporting the bill by the Hon. Frank Pangallo as we consider it to be consistent with promoting better health outcomes for people born after the year 2009, but I do want to use this opportunity to call on the government to provide additional services to support people using tobacco products.

In considering this bill, I would urge elected members to consider whether, if we had our time again, we would choose to make tobacco a product available to young people and adults here in our state. The reality is there are significant health risks that flow from tobacco use. We know that it has been linked with cancer. We also know that cigarette butts are terrible for our environment, and I will talk a little bit about that later. Really, if we had our time again, would we go down this path? What this bill does is take a staged approach to phasing out cigarettes and tobacco products in our state, and I commend it.

24 September 2024

The Hon. R.A. SIMMS (17:51): I rise to speak in favour of this bill. The Greens believe that our laws need to ensure everybody can live a life where their human rights are respected and where they are safe from harm. We have a long-term commitment to championing the rights of the queer community in this state and we welcome this bill finally coming to this parliament.

This bill to ban conversion practices is the culmination of a long campaign by the LGBTI community. It is a campaign that has been nation wide. New South Wales, Victoria and the ACT have already banned these harmful practices. Queensland has banned them within healthcare environments, Western Australia and Tasmania have committed to reform, and it was a promise of the Malinauskas government that they would tackle this issue if elected. There is no secret about that. It was part of the Labor Party's election platform and they were elected to form government. So, much to the relief of many, they have acted upon that election commitment.

I want to acknowledge the leadership of some of my colleagues in this place over many years on this issue: The Hon. Tammy Franks, who has been a staunch ally and voice for LGBTI South Australians; the Hon. Ian Hunter, who has been a tireless warrior for LGBTI rights and a loud and consistent voice for our community; and the Hon. Michelle Lensink, who has long championed this reform and always supported the LGBTI community in this place. I also acknowledge members in the other place—the Hon. Nat Cook and the Hon. Susan Close—as well as the work of the Attorney-General, Kyam Maher, and his team in preparing this bill for us.

As is so often the case when it comes to LGBTI law reform in South Australia, it has taken cooperation from across the parliament and voices from all sides of politics to get movement on this. It is my hope that members of the Liberal opposition will seize this opportunity to continue our state's proud tradition of achieving LGBTI law reform in a multipartisan way and support this bill. I note the statements made by many on the opposition benches, but I do hope that more members will join the Hon. Michelle Lensink in coming on board and embracing this opportunity.

I also want to acknowledge the survivors of conversion practices, and I thank them for sharing their stories with us. I want to thank the groups that have amplified their voices and advocate for this change: Equality Australia, SARAA, the Sexual Orientation and Gender Identity Change Efforts survivors, and the Brave Network, amongst many others.

As an out and proud gay man, one of only two in this parliament, I do want to take a little bit of time to reflect on the significance of this bill and what it means for the LGBTI community. Fundamental to conversion practices is a belief that there is something shameful about differences in human sexuality and gender identity. Indeed, being part of the LGBTI community is so shameful that you need to repress and alter your own identity.

Despite the far-right conspiracy theories about LGBTI people trying to recruit others to the cause, it is the virtues of heterosexuality that are being promoted actively by conversion practices. It is that world view that is being imposed on LGBTI people.

In moving to ban these practices in this state, this parliament will be sending a clear message to LGBTI South Australians that we do not need to change. That is a vital message for LGBTI people to hear. I know that many LGBTI young people in particular struggle with feelings of fear and shame and that is one of the reasons why conversion practices are so damaging because they feed into those feelings. They reinforce them by forcing young people to deny their true selves and so the consequences of those practices can be lifelong.

I should make it very clear that I never endured conversion practices as a young person, but I do remember how challenging it was grappling with those feelings of shame growing up and so I hate to imagine what it would have been like to have those fears and anxieties being reinforced under the guise of therapy.

I was about 12 when I first realised that I was gay, but for me the bullying started much earlier, well before I actually understood that I was a gay person. I think I would have been about eight or nine when I first started being called a 'poof' and a range of other things I will not repeat on Hansard. Most of the bullying for me centred around the way I walked and the way I talked. It continued on and off throughout my high school years. As a result, I really dreaded what it would be like to try to live a gay life and I certainly never imagined that I would have the opportunities that I have had in my life—the opportunity to stand for parliament, let alone have anybody actually vote for me.

Through the leadership of LGBTI activists who have come before, those opportunities did come for me and for other gay men of my generation. I do salute the work of people like the Hon. Ian Hunter and many others who have been carrying that fight for so many years. Indeed, today I have a happy and a healthy life. When I came out in my early 20s, I was fortunate enough to be supported by friends and family, but I know that everybody is not so lucky and that is why these conversion practices are so dangerous because they prey on young people in particular when they are going through such a challenging, vulnerable period in their lives.

When I gave my first speech in the federal parliament back in 2015, I remarked then that things really do get better and again I do want to use this opportunity to say to any young people who are struggling with their own journeys that this is still the case—things do get better. Stay brave, stay strong and know that things are continuing to change.

This bill is powerful not just because it stamps out conversion practices—and that is a very worthy aim—but because it strikes at the heart of the shame that has been part of the LGBTI experience for far too long.

One of the great things I have observed during my time in politics is the tremendous advances that we have seen in the rights of gay men. Marriage equality is an example of laws that have had a really transformative effect. Indeed, over the last few years since we have seen those amazing changes and the changes that have flowed in community attitude, I have had the courage to do things I never thought I would be able to do here in Adelaide—holding a partner's hand or kissing them on the street without fear of being bashed or verbally abused.

The experiences of younger gay men today are so different to my own experiences and those of other gay men in my generation and that is a truly wonderful thing to observe. It gives me hope that, just as we have seen some really amazing advances in our rights and freedoms, these opportunities will flow through to the rest of the LGBTI community.

Indeed, the big challenge for gay men like myself is to continue the fight for other members of our LGBTI community who need our help. We cannot leave our trans friends behind and today it seems that, like the gay men of the eighties and the nineties and the noughties, trans people are the new targets of right-wing ideologues and the right-wing culture warriors who seek to demonise difference and impose their world views on others. They are now targeting trans kids and I see this bill as being an important way of standing up for those young people.

I will make a few remarks about some of the statements that have been made in the debate. It does strike me as very odd that so many of those who profess to be liberal would seek to impose their morality on others and to exercise control over the personal lives of other people. Surely exercising that kind of control over others or trying to change them is the antithesis of liberalism.

I have also noticed there have been some bizarre falsehoods that have featured during this debate. I will not address all of them, but I think it is often the feature of LGBTI law reform, not only here in South Australia but across the country, that whenever there is an attempt to try to enhance the rights of LGBTI people we are told the sky will fall in. I remember, during the debate about marriage equality, that people suggested that people like the Hon. Mr Hunter and I would seek to marry our pets if marriage equality became part of our law.

I remember when I was on the Adelaide City Council and proposed a rainbow walk for Light Square that we had evidence to the council—a deputation was made from some opponents—that young children would throw themselves down the rainbow walk and into the traffic, and that this project was a safety hazard. These are the sorts of ridiculous claims so often made when we are trying to advance the rights of LGBTI people.

Today, we have heard that this bill will simultaneously do nothing whilst also being a threat to our way of life and undermining the role of the family unit. Opponents of this bill cannot have it both ways; you cannot walk both sides of the street. This bill is worthy of support because it continues to move us in the right direction.

It is important to note this is not just a matter that concerns the LGBTI community and that many other groups have opposed conversion practices. The Australian Medical Association has called for all state and territory governments to impose a ban. In a media release coinciding with the release of a position statement back in 2021, their president, Dr Omar Khorshid, said:

Conversion practices are a blatant example of the discrimination faced by LGBTIA+ people in Australia and have no place in our society.

The AMA noted the fact that conversion practices have no medical basis, and states:

There is strong agreement in the medical profession in Australia that conversion practices have no medical benefit or scientific basis, and that there is evidence of significant harms resulting from such practices.

I note the statement made in her contribution by the Hon. Nicola Centofanti, where she said she had been contacted by a counsellor who said they would not practice should this ban on conversion practices be put in place. I think that is good news, because anybody who would seek to operate as a counsellor and deploy conversion practices should not be working in that field. That is one less troublesome person in that profession.

Some people might believe these arcane practices are a thing of the past. Sadly, these practices do still take place in South Australia. I have heard, as have other members in this place, from survivors who have shared their experiences with us, and I commend them for their bravery in talking about challenging and traumatic events.

Up to one in 10 LGBTI Australians remain vulnerable to conversion practices, with about 4 per cent of all Australians aged 14 to 21 having experienced some form of conversion practice. There is significant harm that comes with these practices, including acute distress, ongoing mental health issues, severe anxiety, depression, symptoms of chronic trauma and PTSD. Some organisations and communities disguise their attempts to suppress someone's sexuality or gender identity as counselling or care. Often these activities are not undertaken by anybody with any formal training in counselling, and they can cause irrevocable harm to people who are convinced or forced to go through such a process.

Sometimes these things are labelled therapy, but therapeutic attempts to alter sexual orientation and gender identity have been discredited by the psychological community for years. In 2015 a report by the Office of the United Nations High Commissioner for Human Rights included conversion therapy in its list of practices that are categorised as torture and ill treatment. Many conversion programs have claimed they only exist to help those who express a desire to change. However, survivors have reported they were coerced by parents or community figures as a result of the ideologies within their religious beliefs.

Many survivors have expressed they were driven by fear of rejection from their family and their community, and therefore they were considered willing, when in fact it was much more complex than that. As I have detailed earlier, so many LGBTI young people confront the circumstances that I faced, where they desperately want to change because they fear what the future might hold. I think it is morally wrong for people to prey on young people in those circumstances.

Any activity that seeks to suppress a person's sexual orientation or gender identity is based on the false premise that queer people are broken and need to be fixed. These practices are steeped in bigotry and discrimination. Rather than recognising and supporting someone in an affirming way, they deny someone the understanding of their true identity.

As stated by my colleague the Hon. Tammy Franks, the Greens firmly believe conversion practices must be banned. We also want to ensure that the government is going to provide services and support to survivors. It is important that we do not just have a legislative approach but that we also provide ongoing support for these people.

My colleague the Hon. Tammy Franks has been engaging with stakeholders and has prepared a series of amendments to improve the bill. She has outlined the basis of these within her second reading speech. Additionally, I will move one amendment, should the Hon. Tammy Franks' amendment not be successful, which will extend the reporting period to six years, and I will speak a little bit more about that in the committee stage.

I do understand that some members of the LGBTI community will look at this bill and say that it does not go far enough. I understand that. The Greens hear you and that is why we are advancing these amendments, but if these amendments fail we will of course be voting in favour of this bill. While the bill is not perfect, it represents another important milestone in the journey for LGBTI rights in our state, and of course the fight continues. Those who seek to change LGBTI people or to bully us into denying our identities must know this: we are here, we are queer, we are going to keep up the fight; out of the closet, into the streets and into the parliament.

24 September 2024

The Hon. R.A. SIMMS (15:08): I seek leave to make a brief explanation before addressing a question without notice to the Minister for Industrial Relations and Public Sector on the topic of health workers.

Leave granted.

The Hon. R.A. SIMMS: Today, it has been reported that in Victoria an agreement has been reached between the government and the union to increase paramedic wages. It comes after negotiations have been ongoing since February 2023 and resulted in industrial action in March. Under the four-year agreement, paramedics will now receive wage increases ranging from just under 17 per cent to 33 per cent over four years. Victorian Ambulance Union secretary, Danny Hill, has said that senior paramedics will soon become some of the most well compensated in the country.

My question to the Minister for Industrial Relations and Public Sector is: what is the government doing to ensure that South Australia can compete for qualified health workers with other states that are willing to pay much higher wages than here in South Australia, and will the government commit to matching the pay increases we have seen in other jurisdictions to stop paramedics from leaving South Australia and potentially compounding the ramping crisis that Labor promised to fix?

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector) (15:09): I thank the honourable member for his question and his interest in these areas and his slightly, as always, provocative questions. If his question is will I make a commitment here in question time to match the very highest offer that occurs anywhere around Australia for every aspect of an enterprise bargaining agreement, no I won't. What I will commit to is what we said before the election and we have continued to do: enter each round of bargaining for an industrial agreement in good faith with their representatives in a particular union.

The honourable member mentioned paramedics. I haven't seen the details of exactly what was negotiated, what reforms went with pay increases which might be efficiency reforms within the EB and what parts of the workforce and paramedics different pay rises might apply to, but what I will say is that genuine desire to bargain in good faith was on display very soon after we came to government. Members will recall that for the four long years of a Liberal government under the former minister, the Hon. Rob Lucas, who would stand up and very proudly demonise union leaders, there was not a pay rise in the whole four years for ambulance workers in South Australia.

I am very proud that as a new Labor government we were able to come to an agreement with the union that represents ambulance workers, voted on by the members of that union, not just for a pay rise for the years going forward over the three years of that industrial agreement but for back pay in each year that they missed.

Members interjecting:

The Hon. K.J. MAHER: For the back pay in each year that they missed. So we will continue to negotiate in good faith with each industrial agreement that comes up for discussion.

The Hon. R.A. SIMMS (15:11): Supplementary: given the minister has ruled out matching the pay offer made in Victoria, is he concerned that South Australia is at risk of losing health workers to other states?

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector) (15:11): I will reiterate again what I think I answered—what the honourable member's question is: will I here and now agree to the highest settlement that occurs in every area in the health system in EBs right around the country? No, I won't do that, but it's not just pay that makes South Australia a particularly attractive place to live. I think the honourable member will agree that this city and this state have many natural benefits, over and above many other cities and states around Australia, that contribute to so many people wanting to call Adelaide home.

27 June 2024

The Hon. R.A. SIMMS (14:54): I seek leave to make a brief explanation before addressing a question without notice to the Minister for Industrial Relations and Public Sector on the topic of a pay rise for nurses.

Leave granted.

The Hon. R.A. SIMMS: Yesterday, the Victorian government and the Australian Nursing and Midwifery Federation agreed to a 28.4 per cent pay rise for nurses and midwives over the next four years. The agreement includes allowances for a change of ward and being on call. There is also a right-to-disconnect clause and a change to night shift penalties. The Victorian Premier, Jacinta Allan, told The Age, and I quote:

This is absolutely backing in our nurses and midwives. They are the backbone of our health and hospitals system.

My question, therefore, to the Minister for Industrial Relations and Public Sector is:

1. Will the Malinauskas government match the Victorian pay rise for South Australian nurses and midwives, and if not, why not?

2. What is the government doing to ensure that our nurses don't simply pack up and move over to Victoria?

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector) (14:55): I thank the honourable member for his question. In relation to whether we will immediately institute the results of an interstate jurisdiction's enterprise bargaining into industrial instruments in South Australia after having gone through a bargaining process, the short answer to that is, no, we won't—and I am not sure the honourable member would have expected much different from an answer in relation to that.

What we will do, though, as I have said in this chamber a number of times before, is bargain in good faith with public sector unions, which represent employees in a whole range of areas, including the Australian Nursing and Midwifery Federation, which represents nurses in South Australia and around the country. I don't have the date in front of me, but I think it was sometime in mid to late 2022 when the last industrial agreement was negotiated and signed with the union representing nurses in South Australia. Sometime in the next couple of years that will be up for renegotiation.

What I will say and can commit to is: unlike the last government, we don't come to the table in bad faith with preconceived notions about what is or isn't on the table. We will come to the negotiating table in good faith and are happy to negotiate terms and conditions that are fair for nurses, also recognising the needs of South Australia.

The Hon. R.A. SIMMS (14:56): Supplementary: given the government won't commit to matching Victoria's offer, is the minister concerned that these nurses and midwives are going to leave South Australia and move interstate, where they can get a better offer?

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector) (14:57): I thank the honourable member for his question. I do not have a jurisdictional comparison of the base that this has been taken from, and pay rates and the exact matching of various conditions—and that is one element of where someone decides to work. A very important element is the quality of life you get while you are working as well. I might be accused of being biased, but I think that living in South Australia, and Adelaide in particular, affords you a quality of life that you can't find in many other places in this country.

The Hon. R.A. SIMMS (14:57): Supplementary: in light of the government's failure to match the offer in Victoria and the significant crisis that is gripping our health system—

The PRESIDENT: The Hon. Mr Simms, did you start with—I missed the first words. If you haven't started with a question, you can't have a preamble.

The Hon. R.A. SIMMS: Is it not the case, given the crisis that is befalling our health system and the fact that the government is not going to actually match the offer that has been put on the table over in Victoria, that people are going to simply move interstate and cause further problems in our health system?

The Hon. B.R. Hood: I will allow it.

The PRESIDENT: The Hon. Ben Hood will allow it. If that is the case, then we had better allow it.

The Hon. K.J. MAHER (Minister for Aboriginal Affairs, Attorney-General, Minister for Industrial Relations and Public Sector) (14:58): I thank the Hon. Ben Hood for allowing it. I think the honourable member is taking some liberties. He well knows that is not how the industrial relations system works. It doesn't happen, when there is one agreement in one jurisdiction somewhere, that it automatically becomes something that every jurisdiction then gets too.

I was going to suggest that if there were a parliament somewhere else around the world that paid more than here would the honourable immediately move to that parliament because it has better wages? Then I remembered that the honourable member has been in almost every form of government—every single form of government, including local government, that we have in this country—so maybe he is working his way up in that respect.

I think what that does indicate is that it is certainly a factor but there are a lot of other factors that determine where someone chooses to live, where someone chooses to raise their family, and I think South Australia has a lot of advantages in that respect.