New South Wales Cancer Council Amendment Bill

The Hon. R. D. DYER (Minister for Community Services, Minister for Aged Services, and Minister for Disability Services) [2.05 p.m.]: I move:

That this bill be now read a second time.

I seek leave to have the second reading speech incorporated in Hansard.

Leave granted.

I am pleased to introduce a Bill for an Act to amend the New South Wales Cancer Council Act of 1995.

The Cancer Council was established over 40 years ago with the passage of the then New South Wales State Cancer Council Act 1955. That Act was amended by the New South Wales Cancer Council Act 1995, which had as one of its principal objects, the reconstitution of the Board of the Cancer Council to reflect the Cancer Council’s community base.

I would like to remind the House that the proposal to vary the composition of the Board was initiated by the Cancer Council itself and adopted by the previous Government. The 1995 Act was passed with bipartisan support.

However not long after the commencement of the 1995 Act, problems arose in implementing its objects. This Government has sought to expedite the resolution of these problems through the amendments before the House.

The Bill before you retains the principle of representing on the Board, the constituents of the Cancer Council, namely patients and carers, health care professionals and scientists. The proposed composition of the Board also provides for the involvement of persons drawn from the spectrum of expertise to be found in business, finance and the law, which expertise is needed for the effective administration of an important community organisation. The expertise and special knowledge of Cancer Council staff is recognised through the inclusion on the Board of an elected staff member.

The proposed amendments were developed in consultation with a wide range of community and professional groups and individuals, including cancer patient carers and the staff of the Cancer Council. The perspectives of both groups are represented in the composition of the Board.

In considering this Bill, I would like you to take account of the very important role of the Cancer Council in New South Wales. The Cancer Council provides information to the public and supports education for health professionals who care for cancer patients. It supports the work of outstanding clinicians and researchers. It also provides direct support for cancer patients and their families, by ensuring, for example, that patients in country areas have personal transport from their homes to treatment facilities.

To achieve its objectives, the Cancer Council works in partnership with professional societies, research groups, universities, and patient support groups. It also works through harnessing the goodwill and generosity of the people of New South Wales. The strength of the Cancer Council is enhanced by its affiliated community-based Cancer Action Groups and Special Interest Groups. Volunteers in these groups give time, money and expertise to amplify the efforts of the Cancer Council - and the whole health system - in cancer related education, health promotion, information distribution, and fundraising.

The major part of the Cancer Council’s funding comes from donations large and small, given generously by the people of New South Wales. These donations attest to the importance of the Cancer Council and its activities for everyone in this State.

The New South Wales Cancer Council is truly a unique and vital organisation in the society of this State. It is a resource of the people of New South Wales, and must be managed with a collective wisdom, arising from the participation on its Board of experts in cancer and other fields and community representatives.

The Board described in the Bill is a relatively large one, comprising 14 part-time members and the chief executive officer of the Council. However its size is a strength, because it embraces a broad range of expertise and community interest. The Bill signals a greater involvement of the health care and scientific communities in the directions of the Cancer Council.

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The timely passage of this Bill will ensure that the work of the Cancer Council can proceed without impediment. The new Board will help to ensure that the Cancer Council has a bright future, meets the needs and wishes of the people of New South Wales, and has their full confidence. I commend the Bill to the House.

The Hon. Dr B. P. V. PEZZUTTI [2.05 p.m.]: I strongly support the changes made to the New South Wales Cancer Council Act by this bill. It is worth the House taking a little time to consider the history of the bill.

Reverend the Hon. F. J. Nile: There isn’t a lot of time.

The Hon. Dr B. P. V. PEZZUTTI: I understand that perfectly well, but, especially given that honourable members were able to spend 1½ hours in Committee on the previous legislation, I consider that we should be able to spend at least 10 minutes on this bill. I go back to the second reading speech made by the Minister in 1995 for the legislation that is now being amended. At that time the Minister said that the Cancer Council was an independent statutory corporation run as a non-profit charitable institution. He came unstuck, however, when he said that until 1995 the Act had retained a medico-scientific bias in both its objectives and its management structure until it had become anachronistic to the point of hindering the proper operation and current purposes of the organisation. He said that he was rectifying the situation by repealing the previous Act.

Surely there must be a word such as "derectification" or "rerectification", because this move by the Minister makes me belong to the anti-disrectification committee, and I will fight the Minister all the way on a number of other issues. The Minister said that it was anachronistic to have a medico-scientific organisation, but that is what the people wanted - that is what they put their money into. In 1995 the Minister for Health became the person responsible for recommendations and acceptance of appointments. The Minister said that the main aim of the amended New South Wales Cancer Council Act, which the Parliament is now changing, was to allow the Cancer Council to manage some projects. That is perfectly true; that is something the previous Government was planning to do.

As the Minister said in 1995, the previous Government would have amended the New South Wales Cancer Council Act had it won the most recent election. However, there is a vast difference in what the present Government and the previous Government had in mind for the Cancer Council board. The coalition considered that there would be bipartisan support for legislation governing an important organisation in this State. The coalition had a bill on the books in 1995, but it was subsumed and the Parliament enacted the legislation of the present Minister for Health, which he is now amending. The previous Government had planned to appoint a committee made up of a vice-chancellor, the New South Wales Bar Association, the New South Wales Division of the Australian Institute of Company Directors, the President of the Clinical Oncological Society of Australia, the President of the New South Wales Chamber of Commerce and others.

That committee was to nominate to the Governor people who should be appointed to the Cancer Council. Appointments to this organisation, which is for the people of New South Wales, would be at arm’s length from the Minister for Health. The Parliament is now coming back to that proposal. The previous Government was concerned that the best people available serve on the board. The experts in their field should judge whether a person is suitable for appointment to the board. That was the proposal of the previous Government, but the present Minister for Health made the change to the awful situation that the Parliament now has to amend. The Hon. Elisabeth Kirkby made four important points during her speech on the old bill. She said:

. . . certain members of the medical profession may be concerned about the proposed change to the council, particularly as the emphasis now appears to be away from medical research.

How right they were, which is why we are now dealing with this legislation. The Hon. Elisabeth Kirkby was concerned that only one doctor was to be appointed to the board of the Cancer Council. How right she was, but nine members of the medical profession will be appointed to the new board. She also said:

I am certain that the public will want proper representation from the medical profession on the board of the New South Wales Cancer Council. I am advised that the current New South Wales Cancer Council supports this bill . . .

And they did. What else could they do? The honourable member made another important statement. She said:

Substantial donations of money have been made by the public on the basis of real or perceived medical-scientific bias within the council, and in the belief that a donation was a contribution to cancer research in the broad sense of that term.

She was concerned about that issue. She also said:

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For many years I have been supporting the New South Wales Cancer Council by a yearly donation. Quite frankly, I thought all of that money was going into cancer research. I will not continue my donation if I discover that the money is not going into cancer research but into an administrative organisation which will employ a fund-raiser to raise money for the New South Wales Cancer Council.

The honourable member noted that she was part of a parliamentary team that was raising money for cancer research. I was proud to be the token male on that committee, which met again today.

The Hon. B. H. Vaughan: Were you there?

The Hon. Dr B. P. V. PEZZUTTI: No, I was not able to attend. The Hon. Jennifer Gardiner and Beryl Evans, a former member of the Legislative Council, today donated $10,000 to the Westmead breast screening program. The Hon. Elaine Nile made an important point in her contribution. She assumed that women would be appointed on merit, but she was very concerned about that. She said:

The consumer representative should be chosen by the Cancer Council because it is aware of the most appropriate people for appointment. The board should not be politicised.

The honourable member quoted the Minister on that issue and said that he was going to rectify the failings of the old board. In his rectification he almost killed it. The Minister in fact politicised the board, and it is perfectly clear how he did it: he simply called up his mates and asked if they wanted to be appointed to the board. In an important, major article headed "Sickening politics of cancer" in the Australian, journalist Miranda Devine pointed out that Professor Saltman was a friend of the Minister, that many members of the board were from the Australian Labor Party, including Wayne Burns, who is the press secretary of former Federal Labor Minister Dawkins, the future ALP candidate of the inner Sydney electorate of Bligh, and the convener of the first gay and lesbian credit union.

Janelle Saffin, a left-wing Labor MLC, was also a member, and I thought she probably did a good job representing country women. Ian Robertson, Secretary of the Environmental Health and Building Surveyors Association, was another Refshauge appointee. The board’s first decision was to cancel the advisory committee on medical research. Professor Saltman wrote an article at the time headed "There is no free lunch in research. Investigation is built on conflicting needs and interests". On the basis of that article I wrote a letter to the publishers in the following terms:

Prof Saltman’s diatribe on research funding and accountability is a thinly veiled public explanation of her extraordinary behaviour as Chairman of the NSW Cancer Council Board.

Her brazen assault on cancer research grant allocation by that body has resulted in the resignation of the advisory committee and a member of the board.

Without warning she and the majority of the newly appointed board did not allocate grants this year and called for a review, in spite of that body having ‘clear, relevant and disseminated policies’ on grant allocation.

She just wanted to change the policies without any consultation or personal expertise in the area.

It is a little rich for Prof Saltman to describe empirical researchers as learning more and more about less and less.

Empirical research is derided, laboratory-based research is expensive, applied researchers are misquoted and we are encouraged to look at newer ways of thinking: where politics, class issues, gender and the environment are to be satisfied before we even look at the scientific value of a project.

That is what I wrote at the time and that is what I believe now. As a result of that and the brouhaha that followed, the newspapers and television stations went wild. Cancer experts from some 35 affiliate organisations in the State bashed up the Cancer Council comprehensively, so much so that funding to the Cancer Council on a yearly basis dropped. The Cancer Council was wounded terribly, and Professor Peter Baume was appointed by the board to try to work out what could be done. His first recommendation was:

Effective immediately, the Research Advisory Committee should be confirmed as the main source of research policy advice for the Cancer Council.

He said it should be reformed. His second recommendation was:

Those persons who have assisted the research activities of the Cancer Council over several years be thanked for the help they gave.

Professor Saltman and the board sacked them and did not even thank them for the work they had done. The Minister did not thank the previous board, which had worked for nothing. The third recommendation was:

All those who contributed to this Review be thanked by the Cancer Council.

The fourth recommendation was:

By Feb 28th 1997 all research Committees of the Cancer Council should be reconstituted with an attempt to continue the membership of many of the distinguished former committee members.

Professor Baume, the independent arbiter, said that the process had to be reinstituted with the same quality people - which must have rung alarm bells for Professor Saltman and her motley crew. But they
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were going to tough it out; they were not going to let those whingeing people get the better of them. Then something awful happened. The Minister ordered a review into environmental smoking and its impact on people’s health. About 30 different New South Wales bodies recommended that there should be no smoking in restaurants or where food and beverages are served. The Minister said, "No way Jose," and the Heart Foundation and many other health bodies came out screaming on 4 or 5 April and condemned the Minister.

Where was Elaine Henry of the Cancer Council, who was always pushing the Opposition when it was in office? Wayne Burns issued a statement to the effect that the board had not seen the report yet but they would make some judgment about it. He sent a brief to Ms Henry asking her to please prepare statements supportive of the direction recommended by the committee but consistent with the policy of the Minister. So here was an independent body having its policy directed by the Minister. But the representative of the board had to come unstuck, because they were wrong. The whole process was short of being corrupt. It was hurting this body that people looked to in New South Wales, which Elaine Henry built from almost nothing to a substantial organisation running a vast number of programs and raising huge amounts of money - because that is what drives research.

The sacking of this remarkable woman, Elaine Henry, has outraged not only the cancer research community but the community in general. Following the media reports, the Minister realised that he had fallen into the biggest black hole of his career. He instantly dumped the board, including Professor Saltman, and told the members that they were not to meet again. The Minister then agreed to reconstitute a new board of 14 part-time members, not 10. The members are mainly to be appointed by the Minister on the nomination of various relevant bodies.

The appointed part-time members of the board are to comprise: one person who has expertise and experience in conducting medical research with relevance to cancer, nominated by the Australian Society for Medical Research - the group made up of 35 Australian big research groups; two persons who have expertise and experience in the care of cancer patients, one nominated by the Clinical Oncological Society of Australia and the other nominated by the Australian Medical Association; one person who has expertise and experience in disease prevention, health promotion or public education, nominated by the Public Health Association of Australia; three persons who have expertise and experience in training undergraduates, nominated by the vice-chancellors of the universities of Newcastle, Sydney and New South Wales; two persons who have knowledge of the needs of cancer patients or other users of health services, at least one of whom has a knowledge of those needs in the rural community, nominated by the Australian Consumers Association or the Consumer’s Health Forum, or both; one person who is a legal practitioner, nominated by the Law Society of New South Wales or the New South Wales Bar Association, or both.

Other part-time members will be a person who is prominent in the business community and a person who has expertise and experience in the practice of accountancy. For the appointment of those two members the Minister may seek nominations from any relevant person or body, including, in the case of the business person, the State Chamber of Commerce - New South Wales - the Australian Institute of Company Directors or the Business Council of Australia; and, in the case of the accountant, the Institute of Chartered Accountants in Australia or the Australian Society of Certified Practising Accountants.

One part-time member is to be an elected staff member - and I am sure that the staff will not elect Dr Refshauge again. The Minister does not get much say in the appointments. He can nominate only one person for appointment as a part-time member, and it is that one person that the Opposition and the Hon. Elisabeth Kirkby are concerned about. To a board that has a heavy reliance on experts in research, treatment, the care of people, consumer interests, a legal practitioner, a business expert and an accountant, the Minister can appoint only one person. The Opposition is concerned that the new board, as distinct from the old board, will not include a person of Aboriginal descent.

The Opposition will not move an amendment on this matter, but I raise that concern. It is important, but difficult, to gain access to Aboriginal communities to encourage them to seek treatment, including the early treatment of cancer. The early detection and treatment of cancer is important, and in that respect the Minister has the opportunity to nominate an Aboriginal person to the board. A further concern is the representation on the board of the vast array of older, non-English speaking people. To accommodate their concerns I ask the Minister to consult with a relevant person from the Australian Consumers Association or the Consumer’s Health Forum who may have a non-English speaking background.

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The Opposition was aware of what was happening to the Cancer Council, but did not interfere; although on one occasion in the Parliament the Opposition asked about the waste of money, and about money not being expended on the research team. At the end of the day, the Opposition is concerned to see the Cancer Council make a fresh start with the support of all members of this Parliament, so that it can get on with the business of re-establishing the community’s trust. Once that trust is re-established the Hon. Elisabeth Kirkby and the Hon. Elaine Nile and other honourable members, together with the broader community, will approve the funding that the council deserves. Most importantly the Cancer Council will then receive corporate donations.

With those few words, I commend the bill to the House. I ask honourable members to carefully consider the value of an Aboriginal person being chosen as the Minister’s one nominee on the board. I ask the Minister to request the consumer groups to be sensitive to the advantage of having a person of non-English speaking background, particularly a woman, as one of their nominations to the Minister. Of course, they cannot be forced to do that, which is good, but I hope that the consumer groups will be sensitive to that suggestion.

The Hon. ELISABETH KIRKBY [2.26 p.m.]: The Australian Democrats support the New South Wales Cancer Council Amendment Bill, and support the views of the Hon. Dr B. P. V. Pezzutti. I have read in the media the problems that the Cancer Council encountered and I re-read the speech I made to the House on 11 October 1995. At that time I placed too much faith in the Government’s assurance that the reorganisation of the Cancer Council 1995 was for the better, not for the worse. Of course, I have been proved wrong. At that time I said:

Certainly I would be very concerned if I thought the council was to become merely a fundraising charity. I am assured, however, that the range of persons, who would possess commonsense and specialist expertise, able to be nominated to serve on both a committee and to select board members and the board itself, will ensure that that does not eventuate.

Unfortunately, I was wrong. Concern had been expressed in certain quarters of the medical profession that section 6 of the Act required only one member of the board to be a medical practitioner. That has proved to be a disaster. If the Cancer Council is to improve incidence of cancer in society, it is quite obvious that the majority of its members must be medical practitioners. One medical practitioner member would represent only token representation from that profession. The Hon. Dr B. P. V. Pezzutti detailed the 14 part-time members of the new board. At least six must have medical qualifications, and three must have expertise and experience in the training of undergraduate and postgraduate experience in cancer control.

The whole focus of the new council has been moved from purely fundraising to the knowledge of medicine, medical research, medical training. The Hon. Dr B. P. V. Pezzutti placed on record concerns that have also been brought to my attention about the omission of the previous Aboriginal community representative. That was one of the important provisions in the Act. I am at a loss to understand why the Government has changed that. As the bill provides for a person to be nominated by the Minister, I seek an assurance that the responsible Minister, who is also the Minister for Aboriginal Affairs, will allow an Aboriginal representative to be included. I do not have to repeat in this House that the health of the Aboriginal population in New South Wales is the worst of any section of the community. Aboriginals also suffer severely from many forms of cancer, particularly breast, colon and liver cancer. Their concerns need to be addressed more directly than those of any other group in the community.

The previous Aboriginal representative on the board represented the needs and desires of her people, and that representation should not be allowed to die merely because the composition of the Cancer Council has been changed. I hope that the Government will take on board the concern I have, a concern that has been brought to the attention of other women members on both the Government and Opposition benches. The Cancer Council undertakes continuing active mainstream research into cervical, colon, breast, and liver cancer and, most particularly in Australia, skin cancer. I believe it must now also undertake more detailed research into cancers caused by the use of chemicals in agriculture, particularly those that are used widely in cotton-growing areas of New South Wales.

In recent weeks I have received a great deal of correspondence from people living in the Gunnedah area. Apparently the records of the Cancer Council show that since cotton was introduced to the Gunnedah area in 1983 there has been an increase in prostate cancer in that part of New South Wales. When the newly formed Cancer Council starts its work, it is important that it undertake a special project into the influence of agricultural chemicals, particularly in areas where cotton is the main crop. In those areas the chemicals are being spread through the air in exactly the same way that Agent Orange was spread during the Vietnam war. The chemicals can spread by wind drift for many
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kilometres. Bearing in mind the amount of research that has been done and continues to be done on a variety of other cancers, the council should now undertake as a priority research into cancers caused by the use of chemicals in agriculture.

The DEPUTY-PRESIDENT (The Hon. Helen Sham-Ho): Order! I remind members of previous rulings concerning the use of mobile phones in the Chamber.

The Hon. ELISABETH KIRKBY: With those remarks, I am happy to support the bill. I hope to receive the assurance about an Aboriginal representative when the Minister speaks in reply.

Reverend the Hon. F. J. NILE [2.34 p.m.]: Call to Australia supports the New South Wales Cancer Council Amendment Bill. The object of the bill is to reconstitute the board of the New South Wales Cancer Council and expand its membership, which now is 10 part-time members, to 14 part-time members appointed by the Governor on the nomination of various relevant bodies or with appropriate experience and expertise, including a staff-elected member. As other speakers have said, the bill will hopefully bring to a close a sorry stage in the history of the Cancer Council that I am sure everyone regrets.

The way in which the former Executive Director of the Cancer Council, Mrs Elaine Henry, was sacked was certainly controversial and led to a great deal of community concern about the attitude of the Government to the council and its treatment of her. Apparently Mrs Henry’s dismissal, which she was not advised of officially, became a type of backdoor resignation. She found out about her dismissal from a press release to the media. That is not the way to treat the person who spent 12 years building up the council into an efficient and effective organisation that is respected both in Australia and internationally. As honourable members know, Mrs Henry received a great deal of community support.

The Hon. Dr B. P. V. Pezzutti: And from Call to Australia too.

Reverend the Hon. F. J. NILE: Yes, we certainly supported her in the same way as many other groups. The underlying suggestion is that part of the tension between Mrs Henry and the Government developed over the effects of passive smoking and the Smoking Regulation Bill that I introduced into this House. The bill finally received the support of this House and has now passed through both Houses. The details may be hard to prove but there is a strong suspicion that the Cancer Council was told that it was not to be regarded as strongly supporting the bill because that would have been in opposition to the position taken by the Minister for Health at that time. That may have led to the breakdown of the relationship and finally to Mrs Henry being sacked from her position. The bill now provides for the reconstitution of the New South Wales Cancer Council.

The Hon. Dr B. P. V. Pezzutti: I hope she comes back again.

Reverend the Hon. F. J. NILE: That is my desire. I have made a note that the Government should apologise for its treatment of Mrs Elaine Henry and reappoint her as the chief executive officer of the council board, or at least issue the invitation. If she declines, she probably has good reason, having regard to the way she was treated. I do not know whether she would take up the position. If an apology were made and an invitation issued to return to the board, that may undo some of the wrongs of the past. Call to Australia supports the bill.

The Hon. R. D. DYER (Minister for Community Services, Minister for Aged Services, and Minister for Disability Services) [2.38 p.m.], in reply: I thank honourable members who have spoken during this debate for their support for the provisions of the bill. Some concern was expressed by both the Hon. Dr B. P. V. Pezzutti and the Hon. Elisabeth Kirkby about Aboriginal representation on the board. I have some advice in that regard from the Minister for Health that I would like to place on the record. The composition of the board was proposed following extensive discussions in a working group comprising a wide spectrum of interests and expertise. The working group considered and discussed Aboriginal and Torres Strait Islander representation on the board. On the basis of that discussion, members of the working group recommended that the board should not contain representation from any specific subgroup of the population. That recommendation was made after considering not only the interests of Aboriginal and Torres Strait Islander peoples but also the interests people from non-English speaking backgrounds and, indeed, specific representation of women’s and men’s health interests.

The reasons for that were twofold. First, board members should be encouraged to take a comprehensive approach to the cancer control needs of the people of New South Wales, including the needs of such population subgroups. Of course, a case could be made for numerous population
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subgroups to be represented on the board, and that would lead to fragmentation rather than appropriate policy. Second, while the Aboriginal and Torres Strait Islander community has many serious health problems, cancer is not as prominent among that community as it is in the community as a whole. The Cancer Council has several programs which address the needs of the Aboriginal and Torres Strait Islander community. For the types of cancers that are more prominent in the Aboriginal community, such as cancer of the cervix, the Cancer Council has specific mechanisms to target the Aboriginal community and has Aboriginal representation in its working parties. I commend the bill to the House.

Motion agreed to.

Bill read a second time and passed through remaining stages.