The “No Jab No Pay” legislation came into force in Australia on January 1. 2016. Under this legislation, families in which children are not vaccinated in accordance with the requirements in the legislation (see below) will be financially penalised – unless their children are eligible for a medical exemption from vaccination. (Until January 1 2016, Australian parents who did not want their children to have some or any vaccines were able to register as a Conscientious Objector and retain eligibility for childcare subsidies and a family tax rebate (FTB Part A supplement.)
Under the new No Jab No Pay regime, children who are not vaccinated in accordance with the legislation will no longer be eligible for the The Child Care Rebate and Child Care Benefit and (CCB). Their parents will also lose eligibility for the Family Tax Benefit Part A end‐of‐year supplement (FTB Part A supplement).
If you may be affected by the No Jab No Pay legislation, it is important to note that there is a sixty-three day grace period for The Child Care Rebate and Child Care Benefit and (CCB) for children whose parents have already registered as Conscientious Objectors to vaccination. There is a six months grace period before the FTB Part A supplement is affected.
The website www.avn.org.au is calling for pledges for support for a legal challenge to No Jab No Pay.
This link suggests one way to handle the situation:
Other Australian-based websites that support parents freedom of choice are:
http://www.vaccinationawareness.com.au/
http://vaccinationdecisions.net/
Bronwyn Hancock (who runs the website http://www.vaccination.inoz.com/ ) wrote a letter to the Chief Medical Officer of Health relating to the vaccinations that are covered by the new No Jab, No Pay legislation. Her reason for writing was because some of the information that is publicly available about which vaccinations that are necessary to meet the No Jab No Pay requirements (including information that was supplied by Centrelink) was incorrect.
You can read the text of this letter below. (Italics have been added for emphasis.)
Letter from Bronwyn Hanock
Dear Sir,
NOTICE of False and Misleading Correspondence re “No Jab, No Pay” legislation.
A very important matter is in need of your urgent attention.
TAKE NOTICE that false and misleading information of a significant nature has been recently published online, and apparently widely distributed to Immunisation Providers (IPs) and to other bodies, regarding the effect of this legislation.
All or some of this correspondence has evidently originated from your office (the CMO).
This constitutes a serious breach of the legal duty of care of the CMO.
The false and misleading information includes the following:
1. The vaccinations that are relevant to “No Jab, No Pay”
1.1 FACT: The Child Care Rebate and Child Care Benefit and (CCB) and the Family Tax Benefit Part A end‐of‐year supplement (FTB Part A supplement) are not linked to the vaccinations in the National Immunisation Program (NIP) schedule, but to different smaller schedules, which are set independently by the Minister, by way of legislative instruments, pursuant to Section 4 of A New Tax System (Family Assistance) Act 1999 (“the Act”).1
The current legislative instrument for the CCB is:
Child Care Benefit (Vaccination Schedules) (DEEWR) Determination 20132.
Fewer vaccines and doses are listed in these benefits‐linked schedules than in the NIP.
For example, vaccines not included in the benefits‐linked schedules are as
follows:
– no birth dose of hepatitis B vaccine
– none of the 2 or 3 doses of the rotavirus vaccine
– no pneumococcal vaccine for children born before 1 July 2013, and
– no meningococcal C or varicella vaccines for children born before 1 July 2012.
In the case of the CCB (only), the correct benefits‐linked schedules are
presently provided on the Department of Social Services web site.3
The current legislative instrument for the FTB Part A supplement is:
Family Assistance (Vaccination Schedules) (DSS) Determination 20154
(registered on Friday 4th December 2015). The same principle can be seen to apply in these schedules as with the CCB benefits‐linked schedules.
In the case of the FTB Part A, the Department of Social Services web site does not presently provide the benefits‐linked schedules.
1.2 FALSE INFORMATION:
(a) The correspondence to IPs from the CMO which is at this link:
Click to access CMO‐letter‐toimmunisation‐providers.pdf
falsely states:
“The relevant vaccinations are those under the National Immunisation
Program (NIP) childhood schedule, which covers vaccines normally
administered by age five.”
(b) A “Fact Sheet for vaccination providers” published by the DoH here:
http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Conte
nt/375B788BBCB7EC0FCA257F110017177E/$File/No‐Jab‐No‐Pay.pdf
also falsely states:
“Children overdue for vaccines on the NIP should be commenced on a catchup schedule covering the vaccines usually administered by 5 years of age, using the funded vaccines available on an on‐going basis through the NIP.”
The Fact Sheet does include Table 1 which provides the information that those aged over 10, i.e. born before 2006, do not need all of those vaccines to get the benefits. However, that doesn’t correct the false information with respect to the younger children.
3
(c) Centrelink:
The same incorrect information appears to have been given to Centrelink, with the result that Centrelink have been distributing letters (attached) to
thousands of parents containing this same false information. Specifically, after this sentence in the Centrelink letter:
“All children have to be fully immunised to be eligible to receive child care
fee assistance (Child Care Benefit and Child Care Rebate) and Family Tax
Benefit Part A supplement… or have an approved medical exemption”
the letter falsely proceeds to state the following:
“Fully immunised means that your child is immunised according to the
National Immunisation Program early childhood vaccination schedule, on
an approved catch‐up schedule, or has an approved medical exemption”
2. The 63‐day grace period
2.1 FACT: Those who are presently registered as Conscientious Objectors will have a 63‐day grace period to resolve the situation before any of linked child care benefits are discontinued, or 6 months before the FTB Part A supplement is affected.
(The “No Jab, No Pay” legislation wipes the 63‐day grace period for new claims but not for already existing ones such as this situation.)
2.2 MISLEADING INFORMATION: The letter from your office (and that received by parents from Centrelink) fails to explain this. It merely states:
“As a part of the Government’s commitment to improving immunisation
coverage in Australia, the No Jab, No Pay measure will commence on 1 January 2016.
Only parents of children (less than 20 years), who are fully immunised, or are on a recognised immunisation catch‐up schedule or have an approved medical exemption, can receive the family assistance payments…”
By omitting any mention of the 63‐day grace period, the letter is misleading, as it falsely implies that compliance is necessary from 1 January 2016 for the linked benefits to be continued.
3. New medical exemption form
3.1 FACT: An amendment made by the “No Jab, No Pay” to the Act is that “a general practitioner, not a recognised immunisation provider, would now be required to make the certification in relation to medical contraindication” 5
The reason for this is that proper assessment of medical contraindication for any individual is not a definitive process. Accordingly,
(a) The Explanatory Notes accompanying the Bill state:5
“Following consultation with medical experts, it has been identified that the
assessment of medical contraindication can be complex. It is therefore
appropriate that this assessment is made by a general practitioner.”
(b) The Senate stated in a Notice of Motion in relation to the Bill (attached), which
it passed just before it passed the Bill on 23 November 2015:
“the Senate: (1) recognises that it is of critical importance that GPs remain
able to use their clinical judgement in assessing children who are eligible for
medical exemption”6
(c) The Australian Immunisation Handbook 10th edition (“the Handbook”), to
which general practitioners are referred by the legislation for assessing medical
contraindications, is not definitive in a number of areas,
e.g. the Handbook states in 3.3.1 Vaccination of persons who have had an
adverse event following immunisation:
“… It is usually not possible to predict which individuals may have a mild or a
rare, serious reaction to a vaccine… It is important that persons who
experience an allergic reaction associated with a vaccine dose are fully
investigated appropriately to ascertain the possible causal relationship to
vaccination, and determine if… repeat doses of vaccine can be provided.
Specialist advice should be sought where appropriate (refer above).”7
To any extent it that the Handbook appears definitive, the Australian
Government publishes associated disclaimers, that the Handbook:
– is only “a general guide, subject to clinician’s judgement in each individual
case”8 and
– “reflects the views of the authors and not necessarily the views of the
Australian Government”9 and
– that “it is possible that errors have been missed” in relation to “dosage
recommendations”, which “are continually being revised and new adverse
events recognised.”8
Accordingly, the Australian Government refuses “liability for any injury, loss or damage incurred by use of or reliance on the information” in the Handbook.8
Unless you are able to inform to the contrary, it appears that the intention of
the Australian Government is to continue to refuse said liability, after 31
December 2015.
Accordingly the legal responsibility that duly falls upon the GP, and carries
liability with it, must take precedence over any pressure to follow any mere
“general guide”.
Hence, to said extent to which responsibility and liability rests with the
individual IP and/or the patient, the IP’s judgment must ultimately, at law, be
made independently of the Handbook or any other external entity.
3.2 MISLEADING MEDICAL EXEMPTION FORM:
The new medical exemption form, which is here: http://www.humanservices.gov.au/spw/healthprofessionals/
forms/resources/im011‐1512en.pdf, fails to take into account, indeed is directly at odds with, the medical and legislative considerations, principles and disclaimers in paragraph 3.1 above. Hence it is misleading to general practitioners.
The new form provides for only a few alternatives as being applicable. Indeed it lists even fewer alternatives than are listed than in the older form
(IMMU11.1310). It does not include a box for “Other reason”.
The form also explicitly states (on page 3):
“A comprehensive list of false contraindications to vaccination is provided in
The Australian Immunisation Handbook”
This statement is expressly at variance with the Handbook’s lack of definitiveness and acknowledged fallibility, for which reason(s) it is regularly reviewed and the Australian Government refuses “liability for any injury, loss or damage incurred by use of or reliance on the information” therein.
Similarly, general practitioners are informing parents also that in practice they do not consider themselves free to “use their clinical judgement in assessing children who are eligible for medical exemption” (see paragraph 3.1(b) above). They state that, whilst they and many other “independent thinking well educated healthcare workers across the board” “are well aware of the shortfalls in the vaccination programme (especially the blatant omission of a sensitivity testing schedule)” and accordingly “understand (parents’) concerns”, they are “no longer able to fall back on our own knowledge and experience for opinion”, but are instead constrained by higher authorities.
Hence the Australian Government is double‐minded with respect to whether the issue of medical contraindications is:
(a) a definitive one, in relation to which GPs power and responsibility is restricted to a selection from a predefined limited and small set of alternative
6 contraindications set by the Australian Government, and to the extent of which
restriction, liability must be borne by the Australian Government, or
(b) a “complex” one, that is subject to clinician’s judgement in each individual case, which leaves the power and responsibility in the hands of the GP with the corresponding refusal by the Australian Government to accept “liability for any injury, loss or damage incurred by use of or reliance on the information” in the Handbook.
If the Australian Government wishes to continue to refuse to accept any such
liability, and hence (b) is the case, then the Australian Government has a legal duty of care to ensure that such forms and directions to clinicians reflect this and make it clear that it is the clinician who ultimately bears the responsibility to make the judgment without being subjected to any “undue pressure, coercion or manipulation”, just as it is the case that clinicians themselves are prohibited from subjecting patients to any such pressure.10
Please respond as soon as possible in relation to the action that you intend to take in order to address these issues.
Yours faithfully,
Bronwyn Hancock
Ed note: The NZ Journal of Natural Medicine frequently features articles about various aspects of vaccination. Issue 19 (November 2015 – February 2016) features an article by the late Dr. Nicholas Gonzalez as well as a feature story about NZ girls who became seriously ill following vaccination with the HPV vaccine Gardasil. To purchase a copy or to download a free sample of any of our issues, please visit our online shop at this link: https://naturalmedicine.net.nz/shop/
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