Andrew Laming (Bowman, Liberal Party) Share this | Hansard source

It is always a pleasure to speak on health related matters in this chamber. We need to remember the health sector is now the largest employer in the country, the fastest growing area of social spending and in particular, as we start to recognise diseases such GIT-related conditions—something that has not been a health priority—we need to look more carefully at whether we are giving appropriate emphasis to them. Of course speaking after a gastrointestinal surgeon is a bit of a challenge, but the eye surgeon will give it a red-hot go. I should say that through my medical training I missed a couple of days of lectures, and I probably missed the lecture on gut and that may have left a permanent scar on my medical training. But I do not think I would ever swap my profession for Mr Gillespie's—nonetheless, adding to his speech will be challenging.

In essence, of course we support issues like those raised in this motion, but we are also mindful that we do have, in the end, to rely on a research system that is based on merit and we need to be able to assess the quality of research and fund it accordingly. Any move where we begin to carve out money and commit it to particular disease groups does have some effect by redirecting money from potentially more productive causes. In the end we can only rely on experts to tell us the research that has been proposed by those who have the highest impact in the field, those who have the strongest records in the area and those who are doing the most promising research. That is one area. The other one, of course, is just looking after patients. Gastrointestinal disease is something no-one wants to talk about. Self-evidently, there are 120,000 people suffering functional gut motility disorders in this country but how many people have you met in the street who have come up and told you exactly what their symptoms are? It is very hard to get men, in particular, and older men, to talk about this area of medicine.

My training from the 1980s was predominantly about deciphering whether gastrointestinal disorders were just functional problems—sometimes we are born with a gut that causes us problems—but increasingly we understand the role of diet, we understand the role of behaviour, we understand the role of genetics and we understand the specific immunological impacts of gastrointestinal disease. Let us not forget that we have already seen a Nobel Prize won by an Australian who identified that one of the most severe gastrointestinal concerns was related to a bacteria, after decades of our simply trying to treat it with neutralising compounds and antacids. We have not talked about gastric reflux yet, but an even larger cohort of Australians suffer that and they have been offered very few options either through cutting edge research or investment in patient support. Traditionally this parliament has said that patient support is very much a state-related issue. Well, times are changing and previous governments have seen a greater focus on federal preventative health care. Now the reality is that the feds are in the game, and once you are there you cannot get out of it. We do need to be able to have a specific discussion with leading teaching hospitals around the country about what support we are giving to patients with chronic disease.

I do believe that 10 years from now we will look back on the way we have supported people with gastrointestinal conditions and say that we did not do well enough and that providing just a small amount of additional support would have had an incredible impact. The question of impact is a matter for local providers. With a sense of subsidiary, I want to see those decisions made by the primary health care networks. I want to see their performance in managing gastrointestinal disease measured. How can we reduce the recurrent admission of people with gastrointestinal disease, save hospitals money, liberate some resources and refund preventive health care? I do not want to state the obvious, but to fund our health system, like the rest of our social system, we do not just rely on tax—we borrow from overseas, from China and the Middle East, to fund our hospital system. We know that is not sustainable and that has been the core of intense debate in this place. To get the health system right we have to have every lever pushing towards the most efficient hospital and public health system we can build, and we do not have that yet. We are not even close to that yet. Before we start proposing additional spending, I want those who think about public health to confine their thoughts to how we save the money to invest in this area. When a motion like this comes to this chamber I ask where is the money going to come from. The answer has to be more efficient acute care—not paying ridiculous amounts of money to have people in public hospitals when they can be perfectly managed by highly skilled general practitioners. Let us come right back to that GP-centred system. They need to be given all the power they can have to look after their gastrointestinal patients with the resources, the money and the time that that they deserve.

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