03 May 2016

NSW Public Health Act Review

The NSW Government has released a Discussion Paper [PDF] regarding the  Public Health Act 2010 Statutory Review.

The Review covers
  • The Role of Local Government 
  • Safe supply of drinking water 
  • Environment health premises – regulated systems, public swimming pools and spa pools and skin penetration 
  • Premises undertaking skin penetration procedures .
  • Legionella control 
  • Public swimming pools and spa pools 
  • Scheduled medical conditions and other disease control measures and notifications, including notification of scheduled medical conditions and notifiable diseases, the requirement to notify and obtaining further information,  notification of HIV and AIDS, and disclosure of STI status 
  • Extension of existing provisions relating to vaccine preventable diseases to high schools 
  • Actions undertaken during an outbreak of a vaccine preventable disease 
  •  Public Health Registers
  •  Public Health Inquiries 
  •  Nursing homes 
  •  Regulation of the disposal of bodies 
The Public Health Act is aimed at protecting public health, primarily through the monitoring and control of diseases and conditions that can adversely affect public health. Section 3 of the Act sets out the objects -
a) To promote, protect and improve public health,   
b) To control the risks to public health,   
c) To promote the control of infectious diseases, 
d) To prevent the spread of infectious diseases, and 
e) To recognise the role of local government in protecting public health. 
Section 136 of the Act requires that it be reviewed 5 years after assent  to determine whether the policy objectives remain valid and whether the terms of the Act remain appropriate for securing those objectives. Preliminary submissions from key stakeholders were reflected in the Discussion Paper. .

The discussion paper accordingly asks
 1) Are the objectives of the Public Health Act valid and appropriate? 
2) Should s3 include a new objective relating to monitoring by NSW Health of diseases and conditions affecting the people of NSW? 
3) Do sections 3 and 4 adequately recognise the role of local government in the Public Health Act? 
4) Should a compliance regime be established in the Act in relation to s25 (which requires suppliers of drinking water to establish and adhere to a quality assurance program)? 
5) If so, should this compliance regime involve a penalty for non-compliance and/or the ability to issue improvement notices for non-compliance? 
6) Should the Act be amended to recognise a role of local government authorities in relation to the regulation of private water suppliers and water carters? ? 
7) Should the definition of skin penetration include all procedures that penetrate a mucous membrane? 
8) Should there be additional regulation to limit people who can perform high risk procedures such as eyeball tattooing to relevant registered health practitioners? 
9) Should the Act be amended to ensure that the owner of a tenanted building, or the person that the owner has arranged to manage the building, is considered the occupier for the purposes of the provisions relating to regulated systems? 
10) Should the Act be amended to clarify that the definition of public swimming pool applies to a pool in a residential premises where the pool in question is used by members of the public as part of a commercial undertaking by the occupier of the premises? 
11) Should the Act be amended to give the Secretary an express power to arrange for another person or body to undertake specified public health actions in respect of notifications of a particular scheduled medical condition or notifiable disease? 
12) Should the requirement on pathology laboratories to notify results be extended to chemical testing facilities or other facilities carrying out biological testing? 
13) Should s55 be amended to require laboratories to notify the Secretary whenever a pathology test is carried out for the purpose of indicating that a person has a Category 3 condition and indicates a positive result, regardless of who requested the test? 
14) Should the existing provisions in s54, which require a medical practitioner involved in the treatment of the person to provide the Secretary with further information in order to complete the notification report or provide information concerning the person’s medical condition and transmission and risk factors as is available to the medical practitioner be extended to all provisions of the Act where a disease or condition is notified by the Secretary? 
15) Should HIV notifications to the Secretary include the person’s name and address? 
16) Should any additional protections be included in the Public Health Act relating to information held by the Secretary, and if so what are they? 
17) Should the prohibition on including a person’s identifying details in a pathology request form for HIV with specific consent of the person be removed from the Act? 
18) Should s56(4)(b) be amended to allow for information about a person’s HIV status to be disclosed for the purpose of providing medical or health care (with such information being subject to the Health Records and Information Privacy Act) 
19) Should s79 be removed from the Act? 
20) Should the Act contain a new section setting out the principles that should apply to the management and control of infectious diseases? 
21) Should the current powers for public health orders be extended to include high risk contacts of a person with a Category 4 condition? 
22) If so, should additional protection be included in the Act to appropriately protect the rights of persons who have been in contact with a person suffering from a Category 4 condition? 
23) Should the Act be amended to allow a public health order to be made requiring a person with a Category 4 condition to be detained while infectious and/or in order to receive treatment?   
24) Should there be greater transparency requirements in the Act relating to public health orders that have been made? 
25) Should the current provisions in the Act relating to vaccine preventable diseases be extended to apply to high schools? 
26) Should the Act be amended to allow a public health officer to direct an unvaccinated child whom the officer reasonably believes has been in contact with a case of a vaccine preventable disease be excluded from child care or school, regardless of whether there is an outbreak at the school or child care the child attends? 
27) Subject to feedback on issue 25, should this amendment also apply to students of high schools? 
28) Should the Public Health Act be amended to remove the conscientious objector exemption to enrolment in a childcare facility from the Act, such that children who are not vaccinated due to their parents’ conscientious objection cannot enrol in child care? 
29) If the exemption is not removed from the Act, should other options be pursued to strengthen the requirements to obtain a conscientious objection exemption for enrolment in child care in NSW? 
30) Should the Act be amended to clarify that s97 and s98 does not limit the creation of other registers or databases relating to scheduled medical conditions or notifiable conditions under the Act? 
31) Are any other changes to s97 and s98 required? 
32) Should s106 the Act be amended to give the Secretary a power, following a public health inquiry, to direct a person or organisation take action to mitigate the risk to the public? 
33) If so, what limits, and in what circumstances should such a power be exercised, should there be such a power? 
34) Is it still appropriate for the Public Health Act 2010 to continue to regulate the work, health and safety aspects of the disposal of bodies and the regulation of cremations, internment and exhumation, preparation rooms, equipment and apparatus in mortuaries, crematories and cemeteries (where these are unconnected to public health)?