The final sitting of federal parliament last week lacked no drama, ending with the sudden induction of Peter Slipper as speaker. It was also a mammoth week for health legislation, with the passing of the plain packaging bill for tobacco, movements in e-health and health reform, and the introduction of the Greens' private members bill to ban junk food advertising during children’s viewing hours.

The appointment of Slipper might just mean that Health Minster Nicola Roxon’s biggest failure this year – the inability to pass a bill to means test the private health insurance rebate – may not leave a hole in the health budget after all, with the government expecting its numbers to improve in the new year.

In a week where more health legislation has passed than in the rest of the year combined, it’s easy to loose track. Here’s a wrap up of how we ended the legislative year.

Plain packaging

This world-first legislation passed the lower house last Monday, after the Senate agreed to the legislation earlier this month. From December 2012, cigarettes will be sold in plain olive packs with graphic warning labels and a plain font to display the brand name and variant.

The removal of design features on cigarette packaging is likely to deter young people from taking up the habit and eventually cut youth smoking rates. It’s also seen as an important measure in reducing the long-term death toll from heart disease and cancer.

The plain packaging proposal won international acclaim when Minister Roxon presented the idea at the UN high-level meeting on non-communicable diseases in September. And the ferocity of the response from the tobacco industry suggests it could be in trouble if other countries follow suit.

Health reform legislation

The idea that governments should pay a uniform price to hospitals for treating patients is a central plank in the recent health reforms between the commonwealth and state governments. Now the Independent Hospital Pricing Authority – which would decide on how much to pay for procedures – has been endorsed by the lower house as a potential statutory authority.

Prices will be assigned for each type of surgical procedure and medical care, and hospitals will be paid directly for these services. The intention is to achieve greater equity in the distribution of the health dollar than the current arrangements, which give hospitals a block grant based on the previous year’s spend, regardless of what they did with the money and how far it stretched.

Means testing the private health insurance rebate

With the additional government numbers in the house following the change of speaker, we may expect to see the introduction of legislation in the next parliamentary session to cut the private health insurance rebate for those on higher incomes. The legislation would affect more than two million privately insured Australians – those earning over $80,000 per annum or families with an income of more than $160,000.

The government intended to introduce the legislation this year but had to retreat because it couldn’t get the support of the independents. This was predicted to return $2.9 billion to the public coffers and contribute to bringing the budget into surplus and easing the cost of other health reforms.

This legislative goal is now within reach and I bet Minister Roxon is breathing a sigh of relief.

Junk food advertising to kids

Greens leader Bob Brown introduced a private members bill last Monday to ban junk food advertising during children’s television viewing times of 6-9 am and 4-9 pm on weekdays, as recommended by the Obesity Policy Coalition. The bill would also prohibit the use of the internet, SMS and email to promote junk food to children.

Childhood obesity and excess weight is a major public health issue in Australia, affecting one in five children and increasing their risk of developing chronic diseases later in life. Comprehensive preventive approaches are needed to address this problem but one important measure is to limit the exposure of children to advertising of energy dense, nutrient poor food.

The bill is expected to be debated in the next parliamentary session and has the backing of the Australian Medical Association. But past attempts by the Greens to introduce bans on junk food advertising to kids have been unsuccessful so it’s unclear whether it will gain enough support to pass.

e-health

All Australians will eventually have access to an electronic medical record that stores all their health information and can be accessed by all of their treating health professionals. Minister Roxon introduced legislation to establish Australia’s e-health records system last Wednesday and it was then referred to the Senate’s Community Affairs Committee.

Internationally, e-health systems have improved the quality of care and led to cuts in health costs from reductions in duplication and repetitions between health services.

Locally, discussions have centred on privacy issues and it has been proposed that a national agency be establish to allow patients to control their own records and decides who sees what.

Current estimates suggest the system will cost a modest $500m but this is likely to be a gross underestimate if overseas experience is a guide. And the proposed start date of July 2012 may need to be shifted, pending legislative endorsement. The Senate Committee will canvass these issues and report back by the end of February 2012.

Coming up

When parliament resumes in 2012, it’s likely we’ll see some new additions to the legislative health agenda: gambling reform and alcohol warning labels.

Australians remain relatively blind to the health harms of gambling and alcohol. We are hardly at the point that we reached with tobacco sixty years ago, when our thinking slowly began to change and it was no longer seen as simply pleasurable but a killer in disguise.

Small legislative shifts to improve consumer information about alcohol and reduce problem gambling losses may serve to shake us out of our self-destructive indifference – 2012 may be the Year of the Awakening.