ACON has condemned the introduction of legislation by the NSW Government that will enforce mandatory testing of individuals whose bodily fluids come into contact with frontline workers. On 11 November, the NSW Government introduced the Mandatory Disease Testing Bill (2020) into NSW Parliament.
ACON, along with many other expert and qualified stakeholders strongly oppose mandatory testing as it is ineffective in reducing harm or risk to people involved in potential exposure incidents. Further, such policy will cause different actual harm – particularly to marginalised communities – cost money and add to system pressures.
“We strongly believe in the importance of wellbeing and safety of frontline workers in NSW. We agree they must be protected as much as is reasonably possible in a high-level occupational risk environment,” said ACON CEO Nicolas Parkhill.
“We believe that those putting forward this Bill to mandatorily test people are doing so as a well-meaning but misguided gesture of care for emergency services personnel. The concern for frontline workers is commendable and shared by all of us.”
“However, this Bill does not afford real protections for our frontline workers – our current policies and procedures do, as evidenced by the fact that there has not been an incidence of occupational transmission of HIV for emergency service workers in more than 15 years.”
“This Bill is not in line with evidence, not consistent with multiple state, national and international policies and guidelines, it exacerbates unfounded fear and it does nothing to educate and inform our workers about the real risks associated with bodily fluids.”
“Our existing laws, policies and procedures work: there are other ways to reduce fear, risk and concern about this issue among frontline workers. We did not resort to mandatory testing in the height of the HIV/AIDS pandemic in the 1980s and 1990s, we certainly don’t need to now, noting the excellent progress we are making in driving down transmissions, and irrefutable evidence that effective treatment prevents onward transmission.”
“NSW has every reason to feel incredibly proud of its efforts to contain epidemics and pandemics. We have seen this in NSW’s world-leading HIV response and, more recently, in the way NSW has responded to COVID-19.”
“And we have done this by following the evidence, trusting people with information, and supporting frontline workers while they did their job – not by ignoring science, inciting fear and enacting policy that marginalises already vulnerable people.”
“This Bill is the antithesis of evidence-based policy, and counter to our experience with pandemics and epidemics long brought under control by NSW using evidence, education, and a supportive approach. Force, criminalisation, misinformation, and fear is not the answer,” said Mr Parkhill.
Parkhill said the Bill, in its current form, presents significant concerns such as the lack of clarity in key areas and definitions, inappropriate age of application, and ambiguity around grounds for refusal or review.
“The Bill does not provide clarity on when the transfer of fluids from a third party is a ‘deliberate action’,” said Mr Parkhill. “Medical procedures against the will of the person should not occur on the subjective opinion of a frontline worker and their senior officer, who are unlikely to understand the contemporary evidence around blood borne virus transmission.
“Extraordinarily, this Bill does not require medical advice of an infectious disease expert to be included in the application for a mandatory test,” added Mr Parkhill.
Under the proposed legislation, a person who has appealed a decision made by a senior officer must still undergo venepuncture under threat of a fine or gaol. A person who is detained can have force used against them to ensure this occurs. “This is a denial natural justice, a violation of civil liberties and is unacceptable,” said MrParkhill
The Bill will also apply to children aged between 14 and 18, which Parkhill labelled as “extremely worrying”. “NSW reported only three infections among children in this age group in the previous year. On any assessment of risk, that minors are included in the Bill is an overreach and unconscionable,” said Mr Parkhill.
“Mandatory testing orders for young people will further increase pressures on the Children’s Court and increase the distress of this vulnerable group of people. The handful of people likely to have any risk of HIV infections in this age group – and the likelihood these young people will be on treatment – represents perhaps the most egregious aspect of this Bill.”
“We believe that this Bill is based on fear and ignorance, and flies in the face of decades of evidence-based practice and policy in relation to HIV and other blood borne virus transmission.”
“The Bill will increase stigma and discrimination experienced by people living with HIV and other blood borne viruses. It also presents risks and harms for many thousands of marginalised people in this state – the overwhelming majority of whom pose no blood borne virus risk to our emergency workforce.”
“Homeless people, people who experience mental illness, people struggling with addiction issues, Aboriginal and Torres Strait Islander people and others who are more likely to come into contact with frontline workers, particularly police officers – they also deserve our care and protection.”
“Fundamentally this Bill is an inappropriate criminalisation of a health issue, one which has been dealt with through world-leading, evidence-based, bipartisan policy. Further work is needed on this Bill, and we strongly recommend that an Inquiry is formed to investigate the potential harm of the Bill before its passage through the Parliament,” said Mr Parkhill.