House debates

Monday, 15 October 2018

Private Members' Business

World Osteoporosis Day

4:47 pm

Photo of Julie CollinsJulie Collins (Franklin, Australian Labor Party, Shadow Minister for Ageing and Mental Health) Share this | | Hansard source

I move:

That this House:

(1) notes that:

(a) 20 October is World Osteoporosis Day and aims to increase awareness of the prevention, diagnosis and treatment of osteoporosis;

(b) osteoporosis is a fragile bone disease that causes painful and debilitating fractures, particularly of the hip and spine;

(c) every year in Australia around 165,000 fractures occur, many of which could have been prevented with earlier diagnosis and treatment; and

(d) 4.7 million Australians over 50 have poor bone health;

(2) acknowledges that the cost of fractures associated with osteoporosis nationally amounted to $2.1 billion in 2017; and

(3) recognises that:

(a) early action can be taken through regular exercise, a bone-healthy diet and consultation with a doctor about osteoporosis risk factors;

(b) diagnosis and treatment of osteoporosis can halve the risk of fracture; and

(c) effective preventative treatments include regular exercise, a bone healthy diet and consultation with doctors about risk factors.

Today I'd like to recognise that this Saturday, 20 October is World Osteoporosis Day. It is a disease that makes bones become brittle, leading to higher risk of fractures. For the individual, it of course can cause pain, decreased mobility and loss of independence, particularly in those over the age of 65. Every year around 165,000 fractures occur, often from just a minor bump or a fall. That is around one bone broken every three minutes. The cost of fractures to the health system is over $2 billion. As many as 4.7 million Australians, or 66 per cent of Australians, over the age of 50 have poor bone health.

But there does remain hope. Many people don't know that effective treatments are available and can halve the risk of fracture. The fracture risk, particularly for hip fractures for older Australians, is quite alarming. Indeed, when it comes to mortality and morbidity from hip fractures, five per cent of those over 65 who get a hip fracture never leave the hospital; 10 per cent go straight to a residential aged-care facility; 50 per cent have a mobility disability within a year; and, sadly, 15 to 20 per cent die within a year because of the complications post-hip-fracture.

This is a really serious issue when it comes to older Australians, and we must do everything we can to make sure that older Australians, in particular, understand that you need to take good care of your bone health early. Indeed, early detection is vital to ensure that bone health is managed to prevent these fractures. You can take action to maintain and improve your bone health at every stage of your life. The earlier you start, the better. A calcium-rich diet, adequate vitamin D levels and regular exercise are all very important for that bone health. When diagnosed with osteoporosis, there are also medications that can help you manage it and improve your bone health or stop the decline in bone health. Labor had a proud history when last in government of dealing with those diagnosed with osteoporosis and of trying to prevent the diagnosis of osteoporosis in people by advocating healthy physical activity.

There is always more that needs to be done. We know that as many as 80 per cent of patients fail to receive appropriate treatment post-fracture. There are some places in Australia, particularly in some large hospitals, where there is a fracture liaison service run by the state government. These are remarkable facilities. They do a quick quiz of people who have had a fracture to see whether they are at risk of osteoporosis. If they are, they send them off for a bone density scan so that osteoporosis can be detected much earlier and they can receive appropriate treatment if they do have the early signs of osteoporosis.

It is critical as we go into World Osteoporosis Day that we advocate on behalf of older Australians, in particular, to look at their bone health and self-assess. There is a web site, knowyourbones.org.au, which has a five- to 10-minute quiz that people can do to see whether they are at risk of osteoporosis. If they are at risk, they can go to their GP and get appropriate referrals to get treatment and/or further diagnostics to see whether they are at risk of osteoporosis. It is really, really important that this is highlighted in the lead up to World Osteoporosis Day because, as I said, it costs the health system billions of dollars, but also for older Australians who are getting spine and hip fractures it is a huge cost to their physical health and to their families and loved ones in trying to provide the additional support.

I have my own story of my grandma, who fractured her hip in her 90s. I had to go and fight the hospital for her to have a hip replacement. I think she was 91 or 92 at the time. I remember them saying to me, 'She's unlikely to survive this,' and all the difficulties around that. I'm proud to say that my nan was one of the best rehabilitation patients in their 90s that that hospital had ever seen. She went on to live to 98, but it did put her into a residential aged-care facility some months post that hip fracture. So I know from my own family's experience just how difficult this can be, and then having to access all of the systems and supports of aged-care services, such as the ACAT teams. It would be much better if we dealt with the incidence of osteoporosis much earlier in our lives. I've done the Know Your Bones quiz, and I need to go and get a bone density scan. I'll absolutely be doing that, and I recommend that many people do it also.

Photo of Sharon ClaydonSharon Claydon (Newcastle, Australian Labor Party) Share this | | Hansard source

Do we have a seconder for the motion?

4:52 pm

Photo of Cathy O'TooleCathy O'Toole (Herbert, Australian Labor Party) Share this | | Hansard source

I second the motion. Osteoporosis is a growing issue for many Australians. Osteoporosis causes bones to become weak and fragile, so that they break easily. This can happen as a result of a minor fall, bump, sneeze or sudden movement. Fractures caused by osteoporosis can be life threatening and they are a major cause of pain and long-term disability. Fractures due to osteoporosis have a devastating impact on millions of people worldwide and result in enormous socioeconomic costs to society and healthcare systems. Worldwide, one in three women and one in five men aged 50 years and over will suffer an osteoporotic fracture. Every year in Australia around 165,000 fractures occur, many of which could have been prevented with earlier diagnosis and treatment.

But the problem is far greater for the population than those who have experienced a fracture. More than 4.7 million Australians over 50 years of age have poor bone health. In 2012, Osteoporosis Australia released individual state reports identifying the burden that osteoporosis and fractures will have and are projected to have from 2012 to 2022. The statistics for Queensland are incredibly concerning. The facts for poor bone health in Queensland between 2012 and 2022 are that by 2022 it is estimated there will be 1.27 million older Queenslanders with low bone mass, an increase of 39 per cent from 2012. Millions of adults in Queensland aged 50 years and older—66 per cent, in fact—had osteoporosis or osteopenia, poor bone health, in 2017. In Queensland, 910,000 adults aged 50 years and older, or 66 per cent, had osteoporosis or osteopenia in 2012. Among Queenslanders aged 50 years and older, 14 per cent had osteoporosis and 52 per cent had osteopenia. Among Queenslanders aged 70 years and older, 43 per cent of women and 13 per cent of men had osteoporosis—that is, 92,000 women and 23,000 men.

The fracture impact in Queensland from 2012 to 2022 results in the total number of fractures over the 10-year period—2013 to 2022—to be projected at 329,071. In 2022, it is expected that there will be a 46 per cent increase in the annual number of fractures over 10 years, resulting in 38,800 fractures per annum. In 2022, there will be 106 fractures every day amongst older Australians in Queensland. Approximately one in six of these fractures will be a hip fracture. In 2017, there were 88 fractures each day among older adults in Queensland. This is a serious cost that needs to be a concern for governments because between 2012 and 2022 the total direct cost of fractures over the 10 years—2013 to 2022—will be $4.3 billion. These costs include ambulance services, hospitalisations, emergency and outpatient departments, rehabilitation, limited aged care and community services.

In 2017, the total direct cost of osteoporosis and osteopenia in Queensland adults aged over 50 years was more than $611 million, of which $414 million—68 per cent—relates to the treatment of fractures. In 2012, the total direct cost of osteoporosis and osteopenia in Queensland adults aged 50 years and over was $495 million, of which $335 million—68 per cent—relates to the treatment of fractures. Nationally last year, the cost of fractures associated with osteoporosis amounted to $2.1 billion. This clearly identifies the fact that the projections for 2022 are well and truly on track.

But early action can be taken through regular exercise, a bone-healthy diet and consultation with a doctor about osteoporosis risk factors, with diagnosis and treatment of osteoporosis halving the fracture risk. On 20 October, it will be World Osteoporosis Day. I urge people in the Herbert electorate to take at least one preventative measure—that is, exercise, see your doctor, drink a glass of milk—and together let's work to prevent osteoporosis.

4:57 pm

Photo of Keith PittKeith Pitt (Hinkler, National Party) Share this | | Hansard source

I thank those opposite for the opportunity to provide a brief contribution to this motion. Certainly World Osteoporosis Day is an important recognition of those challenges inside this part of the health sector. The reason that I've jumped to my feet is, quite simply, my wife is a radiographer; this is an area in which she works regularly—in fact, every single week. I do want to recognise the work of those people, both the radiographers and the radiologists, who are working in the radiology practices. As I'm sure some of my colleagues know, it can be a challenging environment to work in.

But I do want to relate one very brief story, and that's about the toughness of our people. Bone-D scans are things that do happen regularly, every single day, on a full list. But I've got to say that typically they tend to be hardy older women. The story I want to relate—clearly I can't break any confidences—is about a lady who came in for a bone-D scan and who was then promptly sent off for an X-ray, because she'd been in a fair bit of pain and was feeling uncomfortable. When my wife completed the X-ray, she found this lady had a broken hip; it was completely snapped off. She said to the patient, 'Are you in any pain?' The answer to that was, 'It's a bit uncomfortable, love.' So I just want to reflect on the resilience of the Australian people. It is important to keep your diet right, to do what you need to, to take the advice of your doctor. Particularly given that I have probably the highest number of people on the age pension of any electorate in Australia—I have some 45,000 people on a concession card for the age pension—my electorate is a place where this is something that happens regularly.

So I just want to say thanks to those opposite for giving me an opportunity to make a brief contribution. It is an important matter that we are discussing, and I would urge all of those in my electorate to do what you need to do, take the advice of your medical practitioner. I also want to give a shout-out to all who are in there, doing this work—I can't use their full names obviously, for reasons that everyone here knows—including Alison, Nat and Tracey, who do a lot of the bone-D work in those local facilities.

4:59 pm

Photo of Mike FreelanderMike Freelander (Macarthur, Australian Labor Party) Share this | | Hansard source

I'm delighted to speak on the motion moved by the member for Franklin, who, as the shadow spokesperson on aged care, is very well aware of the major issues we have with osteoporosis as our population ages. I'm delighted to speak on this before 20 October, World Osteoporosis Day.

Osteoporosis, as anyone who's worked in any of our busy hospital emergency departments would know, is a very important medical problem that is faced day in, day out by our hardworking nursing and medical practitioners. I've certainly worked in a number of emergency departments and seen many people—the lady who presents with the Colles' fracture of the wrist; usually a lady but sometimes an older man, presenting with a shortened, externally rotated leg due to a fractured neck of femur, requiring hip replacement. We know that, as our population ages, this is likely to become an increasing problem. Unfortunately, it's a cost of billions of dollars every year to our medical system. It is also a cause of significant morbidity and, unfortunately, significant mortality.

We know there are risk factors. We know that post-menopausal women are at a higher risk of osteoporosis than the general population. We know those who are sick, those who have a poor diet and those who are sedentary—and especially those who are immobile—are at particular risk of osteoporosis and the fractures that can occur. In the paediatric age group, children who are extremely premature and children who suffer from conditions leading to poor mobility are also at risk of osteoporosis. However, we know that most of us, from about the age of 35, lose bone density. Unfortunately, sometimes the first time that we become aware of pathological osteoporosis is when a fracture occurs. This fracture can often occur following very minimal trauma and is a cause of significant pain and significant debility. Unfortunately, in some older people, it can be a leading factor in their ultimate demise.

We know that our medical, nursing and allied health practitioners can provide world's best practice in the treatment of osteoporosis and in the fractures that are due to it—particularly hip fractures, which in years gone by would ultimately lead to a person becoming bedridden and dying from their fracture. We now know, with best practice—an operation within 24 hours of fracture and early mobilisation—that survival rates and, indeed, mobility are really excellent.

Unfortunately, however, as I've said, for many people who present with hip fractures it's the first idea they have that they may have osteoporosis. However, it is important to note that treatment is available. Treatment depends on awareness, early diagnosis and attention to bone health. That's why recognition of World Osteoporosis Day on 20 October is so very important. We know that things like improving our diet, improving sun exposure, improving exercise, early diagnosis and the use of some of the newer treatments, including drugs called bisphosphonates, lead to remarkable improvements in bone health and reduction in fractures. We know that with attention to all of these, fracture rates can be halved and morbidity and mortality can be markedly reduced. I encourage every one of us, particularly in this place, to be aware of our bone health and make sure our practice ensures we do have good bone health. That means diet; sun exposure, which is very hard to get in this place; and good, healthy exercise.

I really am very pleased to speak on this motion. All my colleagues are very well aware of the difficulties when osteoporosis occurs, and we are also increasingly aware of how treatment, early diagnosis and recognition can make remarkable differences to people's lives. I thank you for the opportunity to speak to this motion. I recommend bone health for everyone.

Photo of John McVeighJohn McVeigh (Groom, Liberal Party) Share this | | Hansard source

I thank the honourable member. There being no further speakers, the debate is adjourned and the resumption of the debate will be made in order of the day for the next sitting.