Bernie Ripoll (Oxley, Australian Labor Party) Share this | Link to this | Hansard source

I move:

That the House:

(1)

notes that:

(a)

chronic disease is one of the country’s most critical health challenges;

(b)

more than 50 per cent of the Australian population already suffers from a chronic or long term condition of some form; and

(c)

the rise of these diseases poses both a major risk to the long term health of millions of Australians and a frontline economic challenge; and

(2)

supports:

(a)

the Government’s continued commitment to preventative health strategies and closing the gap in indigenous life expectancy;

(b)

initiatives to support the role of the primary care system on our local communities; and

(c)

the increased role the private sector currently plays in delivering health and medical services.

One of the most widely debated and, it seems, unresolved issues facing all Australians in some form is chronic disease. This country is revered for its outdoor lifestyle, sporting endeavours and the image of the lean, bronzed Aussie, but it must come as no surprise that chronic disease is a very real and urgent issue that needs addressing. Australia is a healthy country by international standards, but we need to understand the consequences of the fact that around 32 per cent of the population’s illnesses are caused by tobacco, obesity, harmful and high use of alcohol, physical inactivity, poor diet and the associated risk factors of high blood pressure and high blood cholesterol. We tend to refer to these epidemics in an almost glib fashion, with little regard to their individual complexity, cultural pervasiveness or the ultimate social and economic cost.

Some startling facts that will no doubt put this into perspective are as follows. It is estimated that three million people alone will have diabetes by 2030. Cardiovascular diseases including heart disease, stroke and blood vessel disease are the leading cause of death in Australia, for almost 50,000 people died as a result of cardiovascular disease in 2004. Skin cancer accounts for around 81 per cent of all new cancers diagnosed each year in Australia. Around 380,000 people are treated for skin cancer each year and approximately 1,400 people die from it. There are around 10,000 new cases of bowel cancer diagnosed each year and around 4½ thousand deaths from it.

Couple these statistics with our ageing population and the life expectancy gap of Indigenous Australians and you soon understand that more must be done. As such, we have seen the establishment of the Preventative Health Taskforce and a men’s health policy that is the first of its kind in Australia. The Rudd Labor government is focused on deliverable outcomes. The government is about providing preventative health programs and strategies and focusing on the trifecta of chronic disease caused by obesity, tobacco and the excessive consumption of alcohol. Sadly, an impending outcome of chronic disease is that the life expectancy of children in Australia today will be lower by two years if current levels of lifestyle abuse continue.

With facts like this underlying the importance of taking preventative action, government and community must work together to promote a healthy future for all Australians. The National Preventative Health Taskforce has been providing the government with evidence based advice on the framework for the preventative health partnerships between the Commonwealth and the states and territories and to develop a national preventative health strategy. We have also seen the release of the task force paper entitled Australia: the healthiest country by 2020, which was created to kick-start debate on a number of targets which it says can be achieved by 2020. These are: halting and reversing the rise in the number of people who are obese or overweight; reducing the prevalence of daily smoking to nine per cent or less; reducing the prevalence of harmful drinking for all Australians by 30 per cent; and contributing to closing the gap in life expectancy between Indigenous and non-Indigenous Australians. The paper outlines options for reform, rather than making final recommendations.

Finally, I want to specifically mention Inala Primary Care, the local primary care provider in my electorate of Oxley, of which I am a community board member and which is working very hard to deliver health and medical services within our community and to relieve the pressure on our hospital system. CEO Cathy Brown and her dedicated team of doctors, nurses and administrative staff are doing a great job, and the service they provide in primary health care is absolutely first class. The service began in 2007 and will not only continue to provide bulk-billing services but has opened up new opportunities for the University of Queensland to expand community teaching, promote healthier lifestyles and place greater emphasis on preventative health care to the wider community. This is a great initiative that forms part of an integrated Inala health hub, a one-stop shop for all our local health needs. It is also great to recognise the private sector as a place that can contribute to further developments in both primary and community health care, and I look forward to working with them to deliver results both now and into the future.

Preventative health care works, and for the past 25 years the introduction of policies to discourage smoking has resulted in the use of tobacco products in Australia being at a historic low. I think everyone would agree that good health policy is also good economic policy. But let us not rest there, because much more needs to be done. The changes in lifestyle, policy and strategic policies needed in the future will require a concerted effort across the community, involving individuals, governments, industry, media and non-government organisations alike. Organisations such as Inala Primary Care are at the forefront of that primary healthcare delivery and are an essential part of the battle that we all face in dealing with one of the greatest challenges of the 21st century. I commend the motion to the House.

Danna Vale (Hughes, Liberal Party) Share this | Link to this | Hansard source

I welcome the opportunity to speak on this important motion raised by the member for Oxley. According to the World Health Organisation, chronic diseases are diseases of long duration and generally slow progression. Chronic diseases such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes are by far the leading cause of mortality in the world, representing 60 per cent of all deaths. In Australia chronic conditions such as asthma, diabetes, depression, arthritis and cardiovascular disease are among the main causes of death and disability.

According to the National Health Priority Action Council, the burden of chronic conditions is expected to reach 80 per cent of healthcare expenditure by 2020. This is despite the fact that chronic conditions are also amongst the most preventable health conditions in the world. In November 2005, the Australian Health Ministers Conference endorsed a national strategic policy approach to manage and improve chronic disease prevention and care in the Australian population. The proposed national approach to chronic disease prevention and management comprises three complementary components: (1) national chronic disease strategy, which provides the overarching framework of national direction for improving chronic disease prevention and care across Australia; (2) national service improvement frameworks that cover the national health priority areas of asthma, cancer, diabetes, heart disease, arthritis and osteoporosis; and (3) the blueprint for nationwide surveillance of chronic diseases and associated determinants.

I would also like to take this opportunity to recognise the work of the Friendship Foundation, a not-for-profit organisation based in my electorate and dedicated to working with the community to improve quality of life for carers and people disadvantaged by chronic illness or injury and/or long-term social displacement. The foundation has a large focus on carers in the Australian community. We can clearly understand that people suffering from chronic health conditions rely heavily upon the selfless and untiring work of their carers. In support of carers, the Friendship Foundation brought to my attention a report from Deakin University, Carers Australia and Australian Unity entitled The wellbeing of Australians: carer health and wellbeing.

This report tells us that (1) carers face high levels of depression, anxiety and stress; (2) carers develop illness and injuries brought about by caring for others; (3) carers often neglect their own health, fitness and nutrition because they do not have the time or money to take care of themselves as well; and (4) many working carers live in uncertainty and fear that they will lose their jobs if their loved one needs more intensive care.

Earlier this year, I was pleased to support an application by the Friendship Foundation for funding under the Department of Health and Ageing’s Chronic Disease Self-management/Lifestyle and Risk Modification Grants Program. The foundation sought to build a more interactive self-management care model than is currently in place to support, prevent and self-manage chronic conditions in conjunction with healthcare professionals in my electorate. Unfortunately, the Friendship Foundation was notified today that they were unsuccessful in their application for funding under this program. As I believe there is a real need within our community for the support envisaged by the Friendship Foundation, I will continue to support them in their initiatives to meet this unmet need.

I would also like to pay special attention to part 2(c) of this motion, which mentions the role of the private sector in delivering health and medical services. Unfortunately, 1.7 million Australians will be immediately affected by changes to rebates for private health insurance and will facer either higher premium payments or higher tax payments through the Medicare levy. Those with insurance face higher premiums as others drop out, or they will have to lower their cover. And those relying on the public health system will face longer hospital waiting times and queues. There is an alternative. I ask that the Prime Minister recognise the importance of the private sector and accept the coalition’s suggestion to increase taxes on cigarettes instead of changing the health insurance rebates.

In conclusion, Australia’s healthcare system must be able to respond in an appropriate way to the challenge of chronic disease. Failure to prevent, detect and treat chronic disease at an optimal stage in its course impacts on affected individuals and their families and cares in terms of pain and suffering, and involves the whole Australian community in higher healthcare costs. I thank the member for Oxley for bringing this matter to the attention of the chamber.

Damian Hale (Solomon, Australian Labor Party) Share this | Link to this | Hansard source

I thank the member for Oxley for putting this motion before the chamber. I am delighted to speak in support of the points he has made. Chronic disease is one of our country’s most critical health challenges. Statistics tell us that more than half our population suffers from some form of chronic or long-term condition. With that sort of number, I would suggest that everyone in this place has been personally impacted by chronic disease. I know I have. I have had very good mates in Darwin die as a result of having a chronic disease—heart disease, diabetes and cancer. A good mate of mine is currently battling with chronic kidney disease. I played footy with this bloke. He is a great guy. He has a wife and young family and my thoughts are with him whilst he goes through his personal battle.

The impact of chronic and long-term conditions on the sufferers, their families, their friends and their colleagues is devastating. It is life changing. It turns your world upside down and it turns everyone’s world upside down. Major chronic diseases like heart disease, stroke, diabetes, kidney disease, depression and cancer all have devastating impacts. The life expectancy of children in Australia today could be cut by two years if current levels of obesity and people being overweight continue. The Australian Chronic Disease Prevention Alliance suggest that chronic illness accounts for nearly half of the burden of disease and injury in Australia and costs the healthcare system well over $12 billion dollars each year.

A recent report released by the Australian Institute of Health and Welfare shows that chronic diseases are associated with more days off work and/or with being out of the workforce altogether. While Australia is a healthy country by international standards, around 32 per cent of the nation’s illness is caused by tobacco, obesity, harmful and high use of alcohol, physical inactivity, poor diet and associated risk factors of high blood pressure and cholesterol. Facts like this underline the urgency and importance of taking preventative action to ensure a healthy future for all Australians.

It is widely accepted that the basics of our health system are strong, including the high-quality training of our hardworking and dedicated health professionals. But there are significant inequalities in our health system that leave fellow Australians in lower socioeconomic circumstances more susceptible to chronic disease, in particular Indigenous Australia.

Statistics prove that Indigenous Australians make up a population of individuals who are young and growing and who face different demographic challenges to other Australians. It is also a population facing unacceptable levels of disadvantage in living standards, education, health and employment. The difference in life expectancy is a shocking statistic. That is why I am proud that our government has committed $805 million over four years to the national partnership agreements on closing the gap in Indigenous health outcomes. Figures released today show that life expectancy differs by 11.5 years in men and 9.7 years in women.

The major investment aims to prevent and better manage chronic disease by tackling risk factors, improve management in our primary care, improve follow-up care and increase the capacity to deliver effective health care to Indigenous Australians. Part of this funding will be used to improve access to renal dialysis services for remote communities in the Northern Territory. This government is working closely with our NT colleagues to implement this initiative in a phased approach and it is vitally important that we do, because in the Northern Territory Aboriginal people have an incidence of end stage renal disease 28 times higher than that of non-Indigenous Australians. That is why am proud to be part of a government that is prepared to take action on chronic disease.

Our government, particularly the Minister for Health and Ageing, is very serious about tackling childhood obesity. The fight against the obesity epidemic starts with our children, and the Stephanie Alexander Kitchen Garden project is an innovative and practical way of getting children involved. This project tackles childhood obesity by giving children hands-on experience in healthy eating. It was both a pleasure and an honour to open a demonstration site at Alawa Primary School last year with the very hardworking Minister for Health and Ageing

It was fantastic the other week when our minister announced that the Rudd government will invest a massive $85 million into health projects for the people of Darwin and the Northern Territory, health projects that will build on the Rudd government’s investment of $19 million for an oncology facility and $10 million for a GP superclinic at Palmerston, and I am happy to report both are progressing well. Because of the failures of the previous Liberal government to plan for the future of the health system and despite the major challenges of the budget caused by the global recession, health and ageing remains a top priority for our government. The Rudd government is investing in the whole health system across the whole country to deliver better health outcomes for Australians, no matter where they live. I commend this motion to the House.

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

In speaking to what is a commendable motion, I think it would be incomplete if we did not mention some of the very important budgetary and fiscal measures upon which a functional health system relies. This debate would be incomplete if we were not to note the events of the last few months, in particular the global financial crisis. What I want to cover today in the brief time available is the current government’s policies on smoking and alcohol, some of the Indigenous health issues—end stage renal failure to name one—and their most recent announcement to cut support for cataracts, the most cost-effective surgical intervention known to mankind.

Before I do that, I want to recognise some very good work done by my intern, Matt Haney, on closing the gap. He has done an extraordinary piece of work on the role of Indigenous community stores, which the member for Solomon will have a great interest in reading when it becomes available and tabled. That report looks very closely at the availability of fresh fruit, vegetables and foodstuffs, the supply chain issues and profitability of community stores. I congratulate Matt for his diligence enthusiasm.

Now to the bad news. We have seen a global financial correction of hitherto unknown dimensions, and you have to go back generations to see something quite as large. But what we have seen in this country is what I would argue to be a completely disproportionate response that makes it virtually impossible to fund some of the noble measures that are mentioned in this motion. For us to be able to afford the future price of alcohol related disease, smoking, obesity and closing the gap we need some fiscal breathing space. That has been completely taken away in the budget of this year by this government and their reckless fiscal spending. To go $188 billion in debt, to talk about having to return our budget hopefully by the year 2020 back again to within 3.7 per cent of GDP debt or less, is to basically iron out and wipe out for a decade chances of fixing some of these desperate health issues and the noble notions that are contained within that.

The problem is when you are presented, as a government, with a 15 per cent cigarette tax increase and you refuse it, when you have an option to reform alcohol tax and you merely come up with an alcopops tax, or when you have an option to fix Indigenous health and you merely bargain with the Tangentyere Council about $50 million, saying: ‘They will not accept $50 million? Let’s make it $100 million.’ I mean, in that bargaining process around Alice Springs, you are effectively wiping out all of the savings that you are achieving from cataract surgery reform in one single measure. So what are you going to do? You are going to make cataract surgery more expensive as a government. We are going to see people who save up and pay for private cataract surgery because surgery in a public hospital, with a three-year waiting list, is utterly impossible. People will be denied cataract surgery. People will turn away from the most cost-effective intervention in medicine because they cannot pay the gap.

I concede that gaps may possibly come down as a result of a falling Medicare rebate, but not to the extent of $350. We know that there are 20,000 people who pay, who reach into their pocket every year and pay for that cataract operation they cannot get from a dysfunctional state government hospital system. Those people will pay more. People with private health cover will pay higher premiums as a result. They will pay greater gaps as the reduced rebate is simply forced onto people who are good enough, hardworking enough and committed enough to their own health to find some way to pay their premiums.

It is a very sorry notion that the most effective intervention is effectively having its support halved by this government’s reduction of those rebates to such an extent and with no real foresight as to the impact it could have on remote and rural cataract surgery delivery. Remote and rural cataract surgery delivery is not a profitable enterprise—this is not about bashing wealthy doctors. This is about making it harder to deliver these services in remote and rural areas, where they are quite expensive to deliver.

Worst of all, what we will see with that move is that people who, at the moment, are paying for this intervention may choose to delay the operation. What is the alternative to not having your cataracts done? Blindness—not a great alternative. The alternative to not having the operation done is falling over and fracturing your hip, resulting in charges to the health system and the public purse that we do not want to contemplate. But that has been done in a small measure, for short-termism and to try and find some easy costs with which to bag greedy medical specialists. It fits into that ideological attack on private health cover which we are starting to see more and more from this government.

I commend this motion, but I ask the House to note that the actions of this government are working completely contrary to the good recommendations that are contained here.

Dick Adams (Lyons, Australian Labor Party) Share this | Link to this | Hansard source

The time allocated for this debate has expired. The resumption of the debate will be made an order of the day for the next sitting.